On December 1, 2017, the Norms for English Translation and Writing in the Public **** Service Area was formally implemented, stipulating that the standard English name for internal medicine is Internal Medicine Department.[1]
Chinese Name
Internal Medicine Department
Foreign Name
Internal Medicine Department
Subdivision
Clinical medicine
Status
Mother of medicine
Contains
Disease definition, etiology, symptoms, signs, etc.
Introduction
Internal medicine is a specialty of clinical medicine, and the foundation of almost all other clinical medicine. It is the foundation of almost all other clinical medicine and is also known as the mother of medicine. The content of internal medicine includes the definition of disease, etiology, pathogenesis, epidemiology, natural history, symptoms, signs and symptoms, laboratory diagnosis, imaging, differential diagnosis, diagnosis, treatment, and prognosis. The method of internal medicine is to conduct physical examination after history or interview, and to conduct laboratory diagnosis and imaging examination based on the history and examination findings in order to exclude the less probable among the many differential diagnoses and obtain the most probable diagnosis; after obtaining the diagnosis, the treatment of internal medicine consists of tracking and observation, lifestyle, medication, and interventional therapies (e.g., cardiac catheterization, endoscopy), and to adjust the use of medication according to the patient's condition, to prevent and manage side effects, and to provide a prognosis. After the diagnosis is made, the internal medicine treatment includes follow-up observation, lifestyle, medication, interventional therapy (e.g., cardiac catheterization, endoscopy), etc., adjusting the medication according to the patient's condition, and preventing and treating side effects and complications.
Red Cross
Internal medicine occupies an extremely important position in clinical medicine, which is not only the foundation of clinical medicine, but also closely related to them. The knowledge of internal medicine comes from medical practice. In the process of treating the sick and saving people's lives, the former medical doctors gradually formed a systematic method of diagnosing and treating diseases by accumulating experience, removing falsehoods and saving the truth, removing the roughness and extracting the essence, and improving the level of understanding from practice through many years of long-term accumulation. Through generations of medical doctors, the knowledge gained from these practices has been organized and summarized. And systematic research (including evidence-based medical research), before the development of internal medicine. An excellent clinician should not only have the desire to serve the people, but also the ability to serve the people. To acquire the ability to cure diseases, one must be good at reading, but also diligent in practice, and constantly summarize the experience and lessons learned in practice, so many years of deep research and hard drilling, in order to become a talented person.
The significance of the examination of internal medicine: used to understand the chest, cardiopulmonary auscultation, bowel sounds, heart rate, murmur, heart rhythm, liver, spleen abdominal wall varicose veins.
Internal medicine is generally divided into: cardiology, neurology (headache facial paralysis, paralysis coma, convulsions, vertigo, muscular dystrophy involuntary movement), respiratory medicine (fever, coughing and hemoptysis, dyspnea ergotism), gastroenterology, nephrology, endocrinology (edema, growth and development abnormalities, abnormal urine output, urinary glucose, goiter), rheumatology, hematology, hepatology, infectious disease, otorhinolaryngology and pediatric internal medicine.
Branches of medicine
Internal medicine includes subspecialties classified according to different organ systems: cardiology, respiratory medicine, hepatobiliary and gastroenterology, nephrology (urology), hematology, oncology, endocrinology, infectious diseases, immunology, rheumatology, neurology, pediatrics, neurology, geriatrics, and so on, but the classification of the subspecialties may be different from region to region and even from hospital to hospital. Most of the subspecialties have established their own medical societies, which review the qualifications of subspecialists and organize academic activities. In the broader sense, internal medicine includes non-surgical specialties such as dermatology, ophthalmology, psychiatry, rehabilitation, radiology, palliative care, environmental and occupational medicine, and so on.
Gastroenterology
Characteristics of the examination
The main contents of the internal medicine physical examination are as follows:
-Cardiac examination: apical pulsation, size of the heart border, rapidity of the heart rate, whether the rhythm is neat or not, whether there is a heart and blood vessel murmur, and pericardial friction sound.
-Respiratory system: chest sound, lung and liver boundaries, respiratory rate fast and slow, the presence of dry and wet rhonchi and pleural friction sound.
Respiratory examination
-Nervous system: whether the state of consciousness is clear, whether the language is fluent, cerebral nervous system examination, muscle strength, muscle tone, physiological reflexes are normal, and whether there is any pathological signs.
- General: whether the sclera is yellowish, whether the conjunctiva is red, whether there is edema in the eyelids and both ankles.
Classification
Internal medicine can be divided into the following categories: respiratory medicine, gastroenterology, cardiovascular medicine, neurology, endocrinology, hematology, infectious diseases, pediatrics and so on and so forth. Respiratory medicine: including diseases such as colds, pneumonia, emphysema, tuberculosis, bronchodilatation, asthma, lung cancer, pulmonary heart disease, respiratory failure, chronic bronchitis, pneumothorax, lung abscess, pleural effusion, interstitial lung disease.
Internal Medicine Consultation
Endocrinology: a place in the hospital specializing in the treatment of endocrine diseases, the following symptoms should go to the endocrinology department: weight change: weight loss or gain, such as emaciation, obesity; physical development disorders: growth disorders, such as excessive shortness or gigantic; psychiatric symptoms: mental excitability, irritability and anger, depression, and less speech; skeletal system changes: unexplained bone pain. system changes: unexplained bone pain, low back and leg pain, osteoporosis, susceptibility to fracture; gastrointestinal symptoms: loss of appetite, hyperactivity, abdominal distension, increased frequency of bowel movements; changes in urinary output: thirst, polydipsia, polyuria, increased nocturia; puffiness: especially if accompanied by dry skin, thick lips, and a large tongue; symptomatic hypertension: especially if accompanied by polycythemic appearance, acne, cyclic lower extremity muscle weakness, or paroxysmal hypertension
Hematology: a very specialized department. The main treatment of anemia (some complex causes of anemia), leukemia, hemophilia, lymphoma, myeloproliferative disorders, as well as the management of some of the complications belonging to the hematology category. For example, sometimes DIC requires intrahematologic treatment. Infectious Diseases: This is the department that treats infectious diseases. Common infectious diseases include bacillary dysentery, typhoid fever, cholera, viral hepatitis A, meningitis, scarlet fever, whooping cough, influenza, measles, filariasis, encephalitis B, and schistosomiasis.
Examination
Meaning of internal examination: used to understand the chest, cardiopulmonary auscultation, intestinal sounds, heart rate, murmur, heart rhythm, liver, spleen abdominal wall varicose veins.
The main contents of internal medicine physical examination are as follows:
-Cardiac examination: apical beat, size of the heart boundary, heart rate fast and slow, rhythm is neat or not, there is no heart and blood vessel murmur, pericardial friction sound.
-Respiratory system: chest acoustics, lung and liver boundaries, rapidity of respiratory rate, the presence of dry and wet rhonchi and pleural friction sounds.
- Digestive system: abdominal pressure pain, liver and spleen enlargement, the presence of masses and mobile turbidity, intestinal sounds are normal.
- Nervous system: whether the state of consciousness is clear, whether the language is fluent, cerebral nervous system examination, muscle strength, muscle tone, physiological reflexes are normal, and whether there are signs of pathology.
- General: whether the sclera is yellowish, whether the conjunctiva is red, whether there is edema in the eyelids and both ankles.
Interview
Interview in internal medicine has the following contents:
1. History of illness: whether there has been regular hospital diagnosis of disease, if so, medication and treatment and how effective.
2. Family history: there is no hereditary diseases, infectious diseases, hypertension, diabetes, coronary heart disease, stroke, tumor and other family history.
3. Personal history: nature of work, dietary habits, smoking and drinking habits.
4. Focus on symptoms: paroxysmal palpitations, chest tightness, chest pain, paroxysmal dizziness, fainting, obvious emaciation, fecal abnormalities, black bloody stools, diarrhea, dry cough, coughing up blood, irritability, urinary frequency, urinary urgency, urinary pain, low-grade fever, and so on.
Internal medicine physical examination of the following diseases have a suggestive role:
The body's main organs heart, liver, spleen, lungs, kidneys are within the scope of the internal medicine physical examination of many diseases and signs, such as bronchitis, pneumonia, pleurisy, cardiac arrhythmia, pericarditis, cardiopulmonary insufficiency, hepatosplenomegaly, anemia, jaundice and so on, there is a role of preliminary screening and diagnosis. Some people think: "Physical examination anyway to check the electrocardiogram and abdominal ultrasound, internal medicine physical examination can be exempted". This is not the case, any instrumentation has limitations, such as electrocardiogram examination of myocardial ischemia, arrhythmia has diagnostic qualitative value, but the diagnosis of congenital heart disease, rheumatic heart valve disease diagnosis and no specificity; and general physical examination does not do cardiac B ultrasound, if not through the internal medicine vision, touch, percussion and listening to the examination may miss the misdiagnosis. Doctors with stethoscopes in the chest can directly hear the murmur, make a diagnosis, and propose further auxiliary examination programs, conducive to the early detection of disease and timely treatment.
Dietary therapy
1, Salvia Miltiorrhiza chicken (ribs)
Regulation of qi and blood, improve the circulation of the medicinal herbs: Salvia Miltiorrhiza 12 grams, 12 grams of red peony, Angelica Sinensis 12 grams, Ligusticum Chuanxiong 6 grams, 12 grams of the raw land, 3 grams of licorice, Poria 10 grams, Atractylodes Macrocephala 10 grams, 3 grams of Yu Jin, orange red 3 grams, Hovenia citrus shells 3 grams, Cinnamon stick 9 grams, red jujubes 5, wolfberry 12 grams of the medicinal herbs are soaked and then boiled. Five minutes later, pour the soup into another pot, continue to heat and boil, add chicken, smothered until the chicken is cooked, add appropriate amount of rice wine, salt, boiling can be.
2, wolfberry and chrysanthemum tea
10 grams of wolfberry, chrysanthemum 3 grams, 15 grams of raw hawthorn slices, 15 grams of cassia, suitable for patients with high blood fat, can prevent atherosclerosis.
3, cinnamon jujube kernel tea
Poria 10 grams, 15 grams of cinnamon meat, 30 grams of sour jujube kernel, *** boiled into a soup, remove the dregs, add 30 grams of silver fungus, the right amount of rock sugar, suitable for restlessness of the heart and mind, poor sleep, arrhythmia, limbs slightly swollen patients.
Distinction from Surgery
In essence, although both internal medicine and surgery belong to the category of medicine, even though the two have so many ***Same place***common, but the nature of the work of the two, as well as the way of thinking of doctors and surgeons are very different. Internal medicine, as a systematic discipline, has a complete set of theoretical systems, although it has its practical aspects. It treats the human body as an independent system for research. Surgery, on the other hand, due to the intervention of human factors, more often than not has to think of the human body as an open system. If the physician is called a "family", then the surgeon is a "craftsman".
But if an internist only closes his door to do academic research, and does not go to clinical practice, he will never become a "medical doctor" in the true sense of the word; similarly, if a surgeon only goes to study how to do the operation beautifully and perfectly, and ignores the theoretical learning and summarization, he will never become a "skillful craftsman". The same is true for a surgeon who only studies how to do surgery beautifully and perfectly, but neglects to learn and summarize theories, he will never become a "skillful craftsman". Perhaps the nature of the work is different, inside and outside the doctor's external temperament is also a certain difference, surgical work on the requirements of the doctor is thunder and lightning, bold and careful, decisive and dry, calm and organized. Internal medicine requires doctors to be thoughtful, knowledgeable and meticulous. Female graduates of medical school generally aspire to work in internal medicine because it requires more patience and meticulousness. Male students aspire to work in surgery because it is more challenging, more fulfilling and more attractive.
Subject classification
Medical internal medicine is the core of clinical medicine, clinical medicine **** diagnostic and therapeutic thinking, focused on the expression of internal medicine; and in clinical practice, internal medicine diseases are also the most common, so learning internal medicine is not only beneficial to the study of learning, mastery of other disciplines, but also is the majority of the needs of patients.
The study of internal medicine should be based on basic medicine and diagnostics, review, consolidate anatomy, physiology, pathology and diagnostics courses at the same time, learning this new course. In the study, attention should be paid to the principle of linking theory to practice, step by step, through thinking, discovering problems, analyzing problems, and constantly improving the ability to solve problems.
Internal medicine is a secondary discipline, including respiratory disease, circulatory disease, digestive disease, urinary system diseases, hematology, endocrine metabolic disease, rheumatology and immunology nervous system part. In order to reflect the comprehensive quality education, the curriculum conforms to the transformation of the medical model, according to the teaching plan, the total teaching hours are 126 hours, 98 hours of classroom lectures, 28 hours of classroom internship, in addition to nearly one semester of graduation internship. Teaching content is rich, scientific structure, clinical practical content and basic theory combined with the organic combination of peripheral science, adapted to the role of the course in the training of talents.