(1) Look at the complexion: When the qi and blood of human internal organs are abnormal, the corresponding color will often be reflected on the face. If the face is pale and the body is fat and vain, it is mostly qi deficiency and phlegm dampness. Clinically, there are menorrhagia, premenstrual period, metrorrhagia, menstrual diarrhea and so on. Visible; Pale complexion and emaciation are mostly caused by blood deficiency and spleen deficiency. Clinically, there are late menstruation, less menstrual flow and amenorrhea. Those with red complexion and cheekbones are mostly due to yin deficiency and fire. Clinically, amenorrhea, metrorrhagia, menstrual vomiting, menstrual fever and so on can be seen. The complexion is purple and dark, mostly blood stasis, dysmenorrhea and amenorrhea; People with dark complexion, dark spots on cheeks and forehead, or black eyes are mostly kidney-qi deficiency, such as late menstruation, amenorrhea, metrorrhagia, Sheehan's disease, etc.
Although China people belong to the yellow race, their skin color can't be consistent because of their different working environment, nutritional status, age and climate. People who work indoors for a long time have slightly whiter skin color, while those who have been exposed to the sun have relatively darker skin color; Young women's skin color is white and tender, and older women's skin color will become slightly black accordingly. Moreover, because some women make good use of cosmetics, their original skin color will be affected. The above situation should be paid attention to in clinic.
(2) Looking at the tongue: Looking at the tongue is of great significance in judging the rise and fall of viscera and qi, distinguishing the location and nature of the disease, judging the severity of the disease and predicting the prognosis of the disease. Seeing the tongue includes tongue quality and tongue coating.
① Tongue quality: Tongue quality is the tongue itself. The inspection of tongue quality should also pay attention to the changes of spirit, color, shape and state. God's performance is mainly in the decay and glory of the tongue. Most patients with wet red tongue coating have mild illness and good prognosis; If the tongue is dry, dull, hard or thin, it means that the course of disease is long, the condition is serious, the treatment is difficult and the prognosis is poor.
Tongue colors are red, yellow, crimson, purple, gray and black. Tongue color is hotter than normal, and redness on the tip of the tongue is heart fire or lung heat, while redness on the edge of the tongue is hepatobiliary fire, which is more common in premenstrual, menorrhagia, metrorrhagia, menstrual vomiting and so on. Those with pale tongue color are mostly blood deficiency, while those with pale tongue color are mostly caused by qi and blood loss or internal cold, which are more common in late menstruation, less menstrual flow, amenorrhea, dysmenorrhea and so on. Tongue color is darker than normal, mostly caused by qi stagnation and blood stasis, and it is not smooth, with irregular menstruation, breast distension during menstruation, stomach pain during menstruation, hypochondriac pain during menstruation, etc. The tongue is dull, even with petechiae or ecchymosis, mostly due to internal resistance of blood stasis, common dysmenorrhea, amenorrhea, and embryo residue after abortion.
Tongue shape and tongue state include old and tender tongue, pricking, swelling and contraction, and softness, hardness, flaccidity, deviation, looseness, contraction and vomiting of tongue. The main factors closely related to menstrual diseases are the expansion and contraction of tongue shape and the softness and hardness of tongue body. Tongue swelling, fat and moist, or with tooth marks on the edge, mostly due to spleen deficiency or spleen deficiency with phlegm, which is common in menstrual edema, menstrual diarrhea, and syndrome before and after menstruation. Thin and thin tongue is mostly caused by lack of body fluid and blood, while thin and thin tongue is mostly caused by lack of qi and blood, which is common in late menstruation, less menstrual flow, metrorrhagia and amenorrhea. Thin, red, dry and cracked, mostly due to yin deficiency and excessive fire, yin and body fluid failure, common in menorrhagia, premenstrual, metrorrhagia, menstrual fever, menstrual low back pain and so on. Patients with soft and elastic tongue have mild illness and short course of disease, which is mainly used in the clinic of menstrual disease. Hard and strong tongue is rarely seen in clinic, but it often indicates serious illness, which is mostly caused by excessive heat evil or meridian block, which can be seen in menstrual convulsions and coma.
② Tongue coating: Tongue coating is the coating on the surface of the tongue. The thickness of tongue coating can detect the rise and fall of pathogenic factors; The color of tongue coating can diagnose the cold and heat of the disease; The moistening of tongue coating can wait for the survival of body fluid. White tongue coating is mostly cold; Yellow is mostly hot; Black people have cold or heat, mostly for a long time; White and greasy fur governs cold and dampness; Those with white and dry fur mainly control cold evil and convert heat into body fluid; Those with yellow and greasy fur control damp heat; Those with yellow and rough fur mostly belong to stomach heat injury; Thick yellow fur is mostly gastrointestinal damp heat; Most people with black and thin fur belong to deficiency cold; The fur is black and thick, mostly because of excessive heat.
Although tongue coating and tongue quality are two different aspects, they cannot be completely separated in clinical application, and a comprehensive analysis is needed to make a correct diagnosis.
(3) Look at the lips and teeth: the spleen opens in the mouth and its flowers are in the lips; The kidney dominates the bone and the tooth is the bone.
Observing lips and teeth is helpful to the diagnosis of spleen and kidney diseases.
① Look at the lips: pale lips are mostly blood deficiency, which is common in hemorrhagic menstrual diseases such as menorrhagia and metrorrhagia; Deficiency of spleen deficiency often leads to pale lips. Red lips are mostly heat syndrome, while dark red and dry scorch are signs of excessive heat damaging body fluids, which are common in premenstrual, menorrhagia, menstrual fever, menstrual thirst, menstrual vomiting and so on. Those whose lips are thicker than usual are mostly due to spleen deficiency and dampness, which can be seen in menstrual diarrhea, menstrual edema, menstrual thinning and various syndromes before and after menstruation.
Those with blue lips control cold, pain and blood stasis, which are common in dysmenorrhea, chest pain during menstruation, epilepsy during menstruation, convulsion during menstruation and asthma during menstruation. Lips are chapped, even bleeding from cracks, which are mostly caused by dryness-heat and body fluid injury, yin deficiency and fire flourishing. More common in menstrual flow, menarche, menstrual fever, menstrual bloody stool and so on.
2 Look at the teeth: The condition of the teeth can also reflect the health status of the human body, and the rise and fall of kidney qi can be inferred. Generally speaking, people with dry teeth are more vulnerable to body fluid damage caused by heat, which is common in menorrhagia, menstrual irritability, menstrual thirst, menstrual fever, menstrual insomnia, menstrual mania and so on. Tooth dryness, such as bone dryness, is mostly due to deficiency of kidney yin and essence, which can be seen in low back pain during menstruation, premenstrual syndrome, amenorrhea, scanty menstruation and late menstruation. People who lose their teeth before they are old often indicate premature failure of kidney qi and congenital deficiency, which is common before July 7th (that is, around 49 years old).
In, symptoms such as amenorrhea, less menstrual flow, fatigue in menstruation, drowning in menstruation and syndrome before and after menstruation appeared. Girls are born too late, mostly due to congenital deficiency and kidney essence deficiency. In the year of "February 27" (that is, around 14 years old), menstruation will not be timely, and there will be phenomena such as late menstruation, sparse menstruation and menstrual disorder in adolescence.
(4) Look at the shape: the shape includes the shape and posture. Observing the patient's physical strength, fat and posture is also an important content. When a woman reaches the age of 14, her body gradually matures. Her chest, shoulders and buttocks are plump, her breasts are bulging, and her armpit hair and pubic hair grow, which shows her posture and menstrual cramps, which is a sign that she has entered puberty. If you 18 years old, your body is still short, your muscles are thin, your breasts are flat, you look like a girl, and you don't have menstrual cramps, that's a sign of your kidney insufficiency. Prosperity is an excessive expression; Emaciation is a symbol of incompetence. Fat people are thick, often with more blood and less gas, and qi deficiency, which is easy to stop dampness and produce phlegm; Thin people have yin deficiency, more qi and less blood, and fire is easy to get excited. As "Danxi Heart Method" said: "Fat people are wet, thin people are hot." Empathy is common in clinic, while yang deficiency mostly comes from cold and yin deficiency mostly comes from heat, which shows that although the etiology is the same and the physical endowment is different, the nature of the disease and its transformation are often inconsistent. Therefore, observing the patient's physique is helpful to comprehensively analyze the clinical symptoms.
(5) Look at menstruation: the depth of menstruation, the thickness of menstruation, the amount of menstruation, and the presence or absence of blood clots. Most of them were obtained through clinical consultation. Sometimes people's complaints are not necessarily accurate, and they can be obtained by seeing an outpatient clinic when necessary. Those with deep menstrual color are mostly true and belong to heat, while those with light color belong to deficiency and cold; Most of it is actually hot; The small amount is mostly deficiency cold; Thin people are mostly deficiency syndrome, thick people are mostly empirical, and those with masses are mostly qi stagnation or blood stasis. In fact, clinical testimony is needed to identify it.
The contents of the visit are rich and varied, so I won't go into details here. In clinic, no matter how small the plot is, we should pay attention to differentiation and combine with other diagnostic methods to make a more correct diagnosis.