CHAM CUU LUAN TRI HOI & CLB Y HOC DAN T! Y TE TP. HO CHI MINH TAI BAN LAN THU’ NHAT 1984Lai gigi thitu Ly thuyét Cham cira hoc, Bong y hoc ndi chung, rat sdu stic, thdm cht rét kh6 hide néu cluing ta khong géin lién voi the té céng tic chin dodn va dite tri. Kinh nghiém da cho théy, néu chi nghién citu y hoc tropg pham vi lj thayét thi cé Rhi trank lugn véi nhaw mai ma khéng tim ya dau ta chan ly. Do 46, ching t6i nght réng ‘cia tao diéa kién cho nhitng ngieai nuvi hoe tap tree tién di odo thie lé chin tri, d2 thay rd két qua xdy ra, t® yeu thich cham ctrn, tir dé sé thank khan mudn di siu vdo ly thuyét sau nay. Trong tai li¢u ndy, 06 cde phan sau: 1, Gidé thidu qua vdi nét ly thayét co bin ctia nganh cham edu. Dé la kim chi nam; 14 phuong phdp ludn chi dao moi céng tac chin dodn va tri 2, Phong pidp chin dodn va tei Wéu. ni mue dich lam cho bon doe dp dang mit phony phap chan dodn dyn gian 3nhurng khé chink xée va mét phiceng phap chém ettu ding qui cach d? dat két qua (dt 3. Phung phap sit duny Bin cham eeu luda tri: day ta dia ban va bin a6 dt di vae rivng y.Trong phitn nay, ban doc sé hiku cd trtic vd cach sit dung Ban chdm citw luau tri mot edch Linh hoat, chit dong. Trege mot bénk nhan, ching ta lim xem cé bao nhitu triéu ching, x8p thank cdc hoi chieng cia cde dirong kink ‘hée nhau, tit dd suy ra béuh gi va nhanh chéng tlm ra céng ture diéu tri teeng trng. 4. Cham citu tri cdc trigu.chitng va cée hoi ching : qua ¢6 gitip ban doc biét cdch chin dodn va ditu tri nkitu ching bénk tir don gidn dén phice tap. Ném duge noi dung phony Ban cham citu ludn tri. ban doc sé lam chit diege céng tae chin dodn od tri lida, tie 46, trinee bat ci bénh nhdr ndo ching ta ciing tinh hoat gidti quyét, khong rang budge vio cde phdc 43 diéu tri, trai lai, phong khodng, chit dong va phir hyp voi tieng Aodn cdnh, sip chin doan tri liga od Tai lige Thee hank Cham citu indn tri da dage studt bin itn thit nhét ndni 1981, nay tai ban cé sita chita vd bd the dé fam cho dé hidu, dé thre hank hen nita. Day la mgt tai liga sdng, xudt phat tic kink nghi¢m ‘thee tién do kha nhié ndm lin tin trong nganh cham cteu, Tai lieu nay chée con nhiéu thiéu sot clin duoc gitip dit bd Khuyét. Tay nhién, bing th? aghigm cia ban than va eta cde cong tic vién, chitng toi tin trong tai tigu ndy khéng lam phy Ung ban doc. Xin moi ching ta hay cing nhaw kham pha sie ky Ia cha Cham cita hoe 4 ri sau név sé trao @bi sau hon trong tai ligut Phat tritn Ly ludn Bong y — Cham cttu hoe.HUONG I NHONG LY THUYET Co’ BAN cta CHAM COU HOC Cham citu hoc hay Bong y hoc noi chung dirge xay dung trén nhimg hoc thuyét Khi hoa, Am dirong, Ngii hanb, Tang turgng, Kinh mach... Mudm van dung chdm ctu ludn tr} mot céch ding dan, ching ta clin nfm vitng céc hoc thuyét trén. 1— HOC THUYET Kui HOA RHI: 2 * 5 Moi bien trgng va sir vat du cé co sé vat chit cla chung, Bong y hoc da khai quat cic vat chit dé thanh khai nigm KHE. Vay, khi noi dén Khf la uéi d@n mot co'sé vat chat nao diy. HOA Moi bign twong va sur vat ludn luén bitn chuytn van dng khong ngirng, Dong y hoc di khai quat moi vah dong trén bing khai nigm HOA. Vay, khindi dén Hoa 1a néi dén sy bin hos, van dong nhw thé nao 46. KH AOA 1a hoi kbai niem trigt hoe ding d& chi che chat nao dé, van dong nhir thé nao dé d8 sink ra hién twang Va sig vat nao dé. Can cy thé chat gi, chuy&n bién rs sao lei tly theo kha ning phat hién cia khoa hoc ty nhién.Vidu: — HOA RHI ; B6 1a khai nigm d2 chi nhitng chit nao day, chuyén hoa nhir thé nao diy dé sinh ra Nniét. — MOC KH: Bo la-k gm 42 chi nhitng chat nao day, chuytn héa nh thé nio day dé sinh ra Bong... Cham ctu hoc dc bigt cha y dén cée dang nang leng tic co th? phat ra hay tir bén ngoai dua vio. Bo 1a nhitng thude tinh, nhiing biéu hin cia Khf héa. Phin sau, chting ta sé thy, bing ly luan va thee tién tree quan, Bong y hoe di tin doan c6 120 nhém chit trong tng voi 120 van dong ma dén nay y hoe hién dai di xac minh dirge mot phan nao. Vi vat chit 1A vé cing tin, nén Khf hoa efing vo eding tan, Khang chi djnh mot vat th chuy2n hoa cu thé uio ea. Trai tai moi vat thé vin dong durge phat hign déu thuge v8 Khi hoa va tam sdfhg-té them khdi niém cia nd, KHi hoa, nhé c6 noi dung nti trén, dB tn tai voi thei gian, virot én sur trong di cia moi hoc thuyét khoa hoc ty nhién vé ciu tgo vat chit, bao trim len tét cd moi vat thé va van dong, nén la déi tirgng chung cha moi nganh y hoe ke c& cham cira hoe. H— HOC THUYET AM DUONG _ Phan trén ching ta di néi co sé cia moi hign tiryng va sir vat la Khi hoa, la Vat chat van dong, whwng khi Kht hoa, Vat chat d& hinh thanh cae vit thé thi indi hign turyng xdy ra ludn fugn & mot trong haé trang thai 46i nghich, vira phii dinh vira xdc dinh Lin nhau (nhu dong — tinb, sing — t0i,ém — lanh, néng ~- mit,..). Bo 1a do trong ban than sir vét vi hin tugngluon luén cé hai chat va Edi chét, c6 hai vdn dong va phda dong. mau thadn thong nhat qui dinh ting cap trang thai d6i nghich 6ma Bong y boc khai quit thaah AM DUONG, «dm Duong tuong phn tong thanh ». Khi dm thang Duong thi sinh ra bi¢n tugng Am, khi Duong thing Am thi sinh ra hién tueng Duong. Nhe hoe thuyét Am Dirong, nh nhikng hidu biét su bén trong ban chét cia ign tryng va six vitt ma ching ta biét dirge hai nguyén nhan cia cing mot hign tirgng, do d6 co nhitng cach gidi quyét khic nhau. ‘Noi dung hoc thuyét Am Duong ciing chinh 14 noi dung ctia qui ludt thong nhit vé ddu trank ciia cde met di ldp trong Duy vat bién ching. Su théng nbét va déu tranh ciia cic mat d3i lap hay Am Duong twong phan twong thanh 1a hat nhén cia phép bign chirng cia Y hoc cd truy&n dan téc. Vay, khi néi d&n indt co ning, mot trigu ching nao da, ching ta ein phii nhin sau vao hai thé lye Am Duong qui dinh né; khi diih mot benh, chung ta clin phat hign lt ea nhimng cp mau thudn Am Duong ; khi phan logi cae huyét vj cham etru, ching ta cling diva trén tac dyng Am hay Duong cia ching... Am Duong bang bac kbip not trong ¥ hoc cb truyEn Bong phuong. I— HOC THUYET N6O WANE Trén co sé hoc thuyét Am Duong va .pham tra nguyen nhan va hau qua, khi xét todn bd nban qua cia moi hign tieyng cha su vat, ching ta thay : Mdt hién tueng xdy.re ludn luén c6 2 nguyén nhan, mot nguyén nbdn we ché va mot nguyén nan hung phiin nd. Khi mt hién tung xdy ra, lyon ludn cé 2 hau qua : No bung phiin mot hién tugng va irc ché mot hi¢n tung khac. N6i theo cd ngit : « Trong van vat hé co Ta thi phai 6 cai Sinb.ta va cé cai Khdc ta; kbi cé Ta thi phii c6 cai Ta sinh va cai Ta khic ». Nhw vgy, toan’ bd nbn qué cia sy vat lu6n ludn bao gim 5 van dgng phd bién. Bo 1a ngi banb wa ngwoi xwa tam aut 7tén la Mgc, Hoa, Thd, Kim, Thay (cho khéng phai Ja 5 chat co bin cia van vat theo hoc thuyét duy vat thé so). Cée nguyén nbn va hat qué quan h¢ hing phan va te ché Hin nhau mét cach bién cheng to thanh mot hg théng tr ign chinb, théng nhat hai hoa. Neu van dung qui.luat mau thudn Bong va Phan dong trong vat ly hoc hay tac dong va hoi tac trong digu khién hoc, hay néi theo cd ngit: « Cai khée ta thi ta phaf sinh ra cdi khdc Iai né va cdi sinh ta thi ta cling sinh ra cdi khée lui nd», ching ta co th? ching minh méi quan hé bién chitng gidtw 5 van dong phd bign trén nhwr ngwéi xia d& dién té « Ngi hanh twong sinh trong khéc» theo dd hinh sau: H6s MOE THO Tuty xy tung phin lin nhau +. Be ché tn phan Noi dung Ngii hanh trén méi chi 48 c4p dén mdi quan he nhan qué gida céc higm trong. Néu phén tich stu hon, ta sé thay trong mdi hanh cé mau thufn ngi.tai; nghfa la mdi hinh 6 hai khi Am va Duong qui dinh n6. Nhu vay, toan bd nhan qua cia sx vat c6 10 khi héa két hop voi nau: Am Méc, Dwong Moc, Am Héa, Dong Héa, 4m Thd, Dong thd, Am Kim, Duong Kim, Am Thiy, Duong Thiy. Nam van dng phd bign trong ede si vat tae dong qua lai 14n nhau mét cach bign ching, ching phdc hoa toan bd nhan qua cia nhimg van dong co ban trong ban than sy vat, Néu tach biét hign tng ra khdi aguyén nhan va hu qua thi ching ta chi thy cé hai m§t mau thudn thdng uhft trong cuc bo hign 8tirgng do ma théi cho khong thay toan ho chudi mée xich nhan qua tao thanh mot thé théng nhdt céa sir mau thudn nhién mét trong ban than sir val. Khi xét ting hign turgng, ching ta van dung Am Duong, tie sy thong nhat va dia tranh gida hai mat i lap ;‘nhwng khi xét dén toan hé nhigu hign teong trong su vat thi ching ta cn van dung Ngit hanh tire st thong nhat va d&u tranh gitra 5 cp d0i lap. ‘Qua méi quan hé bién ching trén, chung ta hién dirge sr MAU THUAN BEN TRONG noi than si vat-— ft nhat la trén tam chién liryc — Qua mau thudn bén trong. nay chting ta biét duge khau chinh cia méi quan he bign chitng gia BEN TRONG va BEN NGOAT sy vat. Ap dung hoe thuy#t Ngf han vao ¥ hoc, vé phirong dién Sink 1y hoe, Bong y phat hign dirge 5 co nang phd hign va quan trong la: 4 CO NANG PHAT NHIEY (thuge HOA KHA : Bo 1a hign turng phat ra uhigt ning do sw chuy&n héa cia tit ed moi tébao. 2. CO NANG PHAT BONG (thuge MOC KHI) : Bo la bign- “tweng phat ra co dng do cée bap co, s¢i co & kh&p co thé. 3. CQ NANG TIET XUAT (thuge THO KHi) : Bo la hién tugng dia cic khi chét ra khdi co quan bé phan cia minh. 4. CO NANG HAP THU (thuge KIM RH} : Bo la hign trong thu hit khi chit vao“trong co quai bd phan ciia minh. 5. CO NANG TANG ‘TRO (thuge THUY Ki); Bo fa bien tong dy trit kht chit cia moi co quan ho phin a2 dem sir dung khi can. MOi co ning lai co hai van dong mau thudn’thdng nhat qui dinh nd, mot van dong bung phiin va mot van dong tre ché, mot Dirong va mét Am tuong phin tuong thanh (go ra tinh trang gia cu ning trén. Nhw vay ching ta cé {ited 19 vam dong twang ttng voi nim co ning phd bigr oh sau:Van dong hung phin phat nbigt hay DUONG HO Van dong ate ché phat nbiet hay AM HOA Van déng hung phiin phat dong hay DUONG MOC Van dong tre ché phat dong hay AM MOG . Van dong hung phin tié xudt hay DUONG THO Van dong tte ché tidt xudt hay AM THO Van dong hung phan hép thu hay DUONG KIM » Van dong ire ché bap thu hay AM KIM Van dong hung phén tang tr hay DUONG THUY 10. Van dong te ché tang tra bay AM. Nhu vay, trén co sé dm Ditong Ngai han, Y hee ed truyén tién doan trong toan bo nhan qua cia su vat co. 10 van dong, 10 nhém chit. Ngoai mau thudn noi tai cia tirng co nang, nm co nang phd bién trén quan bé hung phin te ché ln nhau mot cdch bien chirng theo qui luat Ngii hanh tong sinh twong khée uhit sai: Phat nbiét HOA fe Pema ee Phat Jong MOC THO Tidt xudt Tang trie THCY KIM Hap thu Nam co ning phd bién dong mot vai tro quan trong déi voi hau hét moi hign tong’ sinh by va benh ly eit co thé. Ching. qui dinh moi hin tueng, moi tri¢u ching lam sang. Ching két hop voi nhau tay theo s5 lrgng va khi thé nay, khi thé kia ma sinh ra v6 s6 hign trong, trigu chitug khic nhau. N6i cach khae, moi hi¢n tweng, moi trigu chitng déu co chung ngudn géc la nim co ning phd bin. Nhw vay —trén chién luge -- khi chan doan bit ct binh gi, bat er cv quan bo phan nao, ebing ta cin pdm chac nim miu ehdt tren, 10IV-— HQC THUYET TANG TUQNG Vat chit va van dong, co quan va co nding khong thé tach roi nhau, Ching ta c6 mgt cach nhin sy vat bling bén ciugu ba chidu khong gian va mt chigu ca thii gian, Tren co sir Khong thdi lun bén chidu Zy, Y hoc cd truy8n Bong phuong 4% phan logi sy vat trong con ngwai thanh nhéng hé thong co thé sinh ly. That vay, mot co quan doc lap khong th? hoan thinh chitc nfng cila chinh minh dirge ma cin két hep vei nhitu. co quan bo phan khac ohau tao thinh mot hé thing. Nguoi xwa di tgo ra nhiing md hinh co thé ainb Iy hoc dua trén co sé 5 co nding phd, bién: Néu ching ta dién ta 5 eo ning dé bang 5 dinh cia hinh ngi gidc déu va.cdc co quan bo phan thyc hign 5 co nang trén bang b’ mat cia no thi céi khéi duy nhét két hop nbitng hich ngii giae déu tren chi c6 thé 18 mot kh6i gdm 12 mat. D6 1a 12 mé hinh co thé sinh ly hoc tire 12 tang tuyng. Céc tang tugng trong toan bj con ngusi cling quan he mau thudn théng nhft, do dé 12 tang twgng hgp thinh 6 cip Tang Phi voi nhing chite nang riéng. Pane (-) PHU (+) CHUC NANG CHINE Ty vi Van da, tity boa Pné Bal truéng Vn khi, bd hip ‘Thao Bing quang —-—iRu hda nGf méi, tit niga, sink dye Can Bom Van dgng co, hanh: dgng Tam ‘Tidy truong Sdn ahidt, tun hoan, tam thin kink Tam bao ‘Tam tidu Phy sin nbiét, tun hoin, tam thin kish Biba cinchii ¥ la tén cba cdc tang phii chi 1a nhimng daub tir ma Bong y ding dé goi c&c hé thong co th? sinh I¢ hoc cho kh6ng phdi chi cae co quan theo nghia den cia ching. M6i hé théng tang pho bao gdm ohitng co quan bo phan cing thie hign mot s6 chire ning nbét dinh. Nhung con ngudi 1a mgt bé thdng thong nhatt, do d6 cac tang tugng khong tach WOi nhau ma quan hé voi nhau mot céch chat ch8. NOi dn mot tang tweng that ra la ndi déu toan thé co the ditng tte goc &o tang tirgng dé ma xét. Noi cach khic, tuy phan tach ra nhung khong dgc lap, tang tigng nay quan hé voi nhidu co quan bé phan cia cic tang teng khée, caj durge néu lén chi cé y¥ nghia lem sang di bet ma thoi. “v— HOC THUYET KINE HUYET ‘Trong mdi hé théng tang treng cé nbigu co quan hd phan ma nguoi ta da bigt hay chufa biét, nhing chiic chin ching lién hé mat thiét voi ohau. Ngoai thin kinh, huyét mgch, con ed mot hé thdng lién lac nifa la cdc ditong Kinh vgn hanh khi héa. D6 Ja soi chi xuyeén su6t cAc co quan by phan va lién hé dén 5 co ning phd bién cia mot hé théng tang tgng. Nhw vay, 12 diong kinh 2a 12 dai bidu cia 12 mé hinh co’ thé sinh Ig hge néu trén. ‘Mat khde, trong thie tifnctia nganh cham citu, 06 12 dong kinh ma hién nay ta chia hiéu biét day di cdu tric cha ching. Chung chang phdi la thin kinh, ching phdi la mach man, ching phai Ja mot tbng thé gdm thin kinh, mach mau ma la mot bi¢n thie nao do bao trim lén tat cé-edc co quan’ bd phén-ke 3 nhitng méi quan he giita chiing tue than'kinh, buyét mach. Trén during kinh cing ohi ngoai durdng kinh, cd nhiing huyét lien he dén tirng co n&ing phd bign cia cic tang tiryng. Khi cham cira véo huyét trén, ta cé thd thay. abi tinh trang co nang twong ing voi né tai tang tirgng abt dinb. Nhir vay, kinh mach co noi dung quan trong vira dai bigu cho tang titgng, vita bing cde huyé¢t-vi cia ching, ta thay ddi dirgc tinh trang cia cae co ning phd bitn. Tom lai, nhfng hoc thuyét Kbi hoa, Am dirong, NgO hanh Tang tong, Kink mgch... 1a kim chi nam hiéng din to&an bo Bong y hoc néi chung va nganh cham ctu noi rigng. Céc hoc thayét tren xuyén suét chi dao moi cong tac chin doan va iri lieu 48 dat durge nhiing k&t qua tét dep. 12CHLONG PHUO'NG PHAP CHAN BOAN VA CHAM CCU Triréc mat ching’ ta, vi du cé nhi8u d khoa khac nhau, mdi 3 khoa phi cd mot chia khoa riéng moi mé ra duge. Ay vay ma ngwéi thy khea di mé duge tat cd cic khoa tren chi bing mot vai que sft rat doti gidn ! Trong y hoe cing vay, co thé con ngwdi co rit nhitu co quan bd phan voi nhitng cfu tac hinh thé, chire nang khéc nhao va vO cing phic tgp. Vide nay déi héi sy nghien cau nfm tinh hinh riéng cfa ting co quan bo phan, tirng chire ning bout dong va cach gidi quyét rigng khi ete’ co quan bo phan ad bi bgnh. Lim nbu vay thi ching khée gi doi hdi ngwai the khoa phai cd tét cd mgi chin khda riéng cho mii Jogi b khoa..Cé thé, ndo cé dirge mot vai chia khéa chung, don gidn, phd bigén 6% mé ra sy bidu biét ve moi co quan trong co th? va d® gidi quyét bénb tal bAng not phuung phip chung khong? Y hoe cb truyén phirong Dong di céng hién cho chung ta bachia khéa dé. 1, Nhiing cai chung abt cia moi hoat dng trong co the con ngwéi 1a 5 co ning phd bién: Phat dong, Phat nhiet, Tiét xugt, Hip thu va Tang tri. Nam co ning phd bign pay Jién hé hung phdn va we ché lén nhau mot cach bién chirng, ebiing qui dinh moi hign trgng sinh ly va bénh ly cla con ngidi. Bo la mot chia khoa chung thir nba cha viée chin benh. 2. Nhitng cai chung nhat che nhibu co quan bd phan trong con ngwai la cic dong kinh, moi dwong kinh la mot cai gée, 1Bmot «s¢i chi dd » xayén suét mot tap thé nhituco quan bé phan (Tang turgng). Nim duge cai g6c nay la nim duge cai chung abit cia nhidu co quan bd phan ma nbio khi ching te khong biét toi. Bé la chia khéa thé: hai cia vige chin bénh. 3. Cai chung cia moi co quan va co nang qui dinh bénh tat la hog vurgng lén bode suy xudng. Nguyén thc diy tri co ban nbat 1a tang cdi say len, gidm cdi virgng xudng. BS Ja chia khoa thir ba cia vite tri bénh. Tém lai, mye dich che vige chin doan trong cham ctu hoc 1a xdc djnh bénh ching do r8i logn co ning cha dong kinh nao, ti dé dua téi muc dich cha vige digu tri 14 chim cttu cde huyét vj nhim dity chinh ching. I— PHUONG PHP CHAN DOAN Chin doin trong Cham cita hoc ¢6 ba ngi dung chi yéu 1. Chan dodn 5 co nang phd bién: qua m6i lién hé bing phiin wre ché eda ching ma tim ra co ning nguyén han gay rea moi sy bat throng cia tét 4 cic co-nang. 2. Chan doin Hu, Thue dé xdc dinh nguyén ahaa 1 dm hay Duong cia co nang Wren. 3. Chin doan Kinh ingch, phat hign dugng kinh nao, teng tiryng nde bi benh, ‘Tir ba nOi dung trén, ta di toi két ludn benh xay ra’ o dwéng kinh nao, co nang nao 1a nguyén nhan cia moi réi Joan va bénh thuge Hu hay Thue. 1. CHAN BOAN CO NANG Chin doan co ning la thyc hi¢n nhitng vite sau: — Phat hi¢n va sip xép moi tritu chtrng theo 5 co ning pb) bigs MWCo nang phat dong virgng hay suy Co ning phat nhiet vitgng hay suy Co nang tiét xudt virgng hay suy Co ning hip thu virong hay suy Co nding tang trit viryng hay suy. — Qua méi quan hé bien ching gid 5 co ning phd bién tim ra co’ n&ing nguyén nhan cia moi tri¢u ching. Phat ahiét HOA Phat dong MOC THO Tist xutt Tang tre THCY KIM Bap tha. —-—— Hung phiin nhau (tong sinh) Te ché nhau (1wong khac) co nang phd bién xay ra khdp noi, khdp moi co quan 8 chite trong con ngudi, lién hé dén moi /hién tirgng sinh ly va bénh ly. Do 46, khi chan doan bat ci bénh gi, chung ta cing xét ¢€n tinh hinh cia 5 co ning phd bign trén. Nhe méi quan’ hé bin chirng gida 5 co ning phd bién, ching ta biét dige mau thudn bén trong eda ngwai bénh va xac dinh co_ning géc gay ra réi loan.ctia cac co ning khac. Vidut: : Phat nhi@t HOA fe J Phat gag MOC P and Tit xost Tang ra THCY ¥o RIM Hap thoNgurén nhan gay ra r8i loan cila cfc co nang trén 1a do co ning tang tri suy (Thiy suy khong hing phin doc Moc vii Kim, khéng te cb€ duge Hoa va Thd). Vi du 2: Phat nbiét HOA Lp Phit déng W007 iP THO Tift xutt Tang tet THEY y’ ~ KIM Hap thu Nguyén nhan gay ra rdi loan eba cae co ning trén 1a do co nang phat nbiét wong (Hoa virgng hung phi Moe va Thd, ite ehé Thy va Kim). Vidu 3: Phat nhiét HOA ZL phat dona soc 7 2 THO THE xukt Tang tre THCY vi Mf OX IM Hp tha Nguyén nhan gay ra rSi loan elie ede ¢o ning trén la eo nang hip thu sur ( Kim suy khong hing phén Thity va Th8, khong te ché Mée va Hoa). Mudn tim thay nguyén nha mot edch nhanh’ chéng, ta chu ¥ dén 3 mOi ten lien tiép cing chidu, mii tén gitta chink la nguyén nhan. Ching ta ean tap thdi quen tinh ton sit hung phan va irc ché gita 5 co nang dé tim ra co nang géc lam thay dBi cac cor nang khac. Biéa chinh co nang gée ite dite chinh toan ho Ai eo ning. 4A2. CHAN BOAN HU THUG M8i co nding phd bign Iai c6 hai van dong, mt. Drong hung phén va mot Am ire ch€ cing nhau qui dinh né, do dé 6 10 van dng Am Mge, Dirong Moc, Ar Hée, Duong Hae, Am thd, Duong Thd, Am Kim, Duong Kim, Am Thy, Duong ‘Thay. or (~) Am te ob Co NING of” N (+) Duong Hung pha — Co khi Am suy gay ra trigu cheng Duong vegng, ngayén aban 1 Am suy thi phai bb Am 48 te ché Dirong \gi cho khong nén ta Duong vi sé lam cho cd Am Duong déu suy. —Cé khi Duong suy gay ra triu ching Am virgng, nguyén nhén 18 Dirong suy thi phai b3 Duong 42 tre ch€ Am ché khong ‘nén td Am cfing vi ly do nhur trén. — C6 kbi Am vugng gay ra tri¢u ching Duong suy, nguyen nhan la Am vugng thi phai ta Am 42 bot tre ché Drong cho khong nén bd Duong vi sé lam cho cd Am Duong déu vuong thai qué. — C6 khi Duong vwong gay fa trigu ching Am suy, nguyén nhan la Diong virgng thi phai t& Duong 42 bet wre ch€ Ata eh khong nén b3 Am cling vi lf do nhw trén. Mudn phan hiet dirge nguyen nhén la Am hay Duong thi phaj nam tinh chat Hie Thue efi bénh. BENH HU. thong 1a man tink (suy nhirge tr tip, mdi thireng (do noi tang yéu) va mach yéu, vd lye (dn manh tay xudng thiy rat yén), BENH THU'C thong cfip tinh (dang khde bi bénh ngay), ngoai cam (do ngoai ta) va mach hiru lye (din mach xndng sdu thiy con manh),Méi co ning phd bién cla mdi kink du cd cep huyet tuong tng, ben trai la hayet Dirong, bén phdi la huyet Am. Mu6n bd ta Dirong khi thi ding huygt bén trai. Muén bd ta Am khi thi ding huyét cing tén bén phi. Ching ta tré Ii vi dy 1» Nguyén nhan bénh la’eo ning ‘tang tri suy ; néw bénh nhan vite bj.cdm Jgnh bat theong, mach hifu lye, 46 14 do Khf lanh (Am) xAm nhgp cong thémn voi Am khi trong ngwoi lam cho Am virgag Duong suy. Vay 14 phai ta Am buyét cita co nang tang trit bén phai. ‘Név bénh nhan bj bénh tr lau, say nbwge din din, mach yéu v6 lye, dé la do Dirong kbi suy.nén phai bb Dirong huyet cia. co nding tang trik hén trai, 3. CHAN BOAN KINH MACH Sau khi chin doan co ning, hur thyre, chung ta chan doan sit r6i loan ede co quan d6 xay ra 6 cdc co quan nao (ttre tang turgng nao). Mdi hé théng co quan d&u lidn he dén duréng kinh. De 6, chin doin trong chim citu la xde dinh duéng kinh nao benb. Co 4 yéu t6 gitip la xe djnh kinh benh : 1, Xét cdc trigu chitng xdy raé ede co quan thuge kinh nao. ‘Vi du: Trigu ching tiéu héa khign ta nghi dén cdc kink T$ V trigu ching bo, hip khign nghi dén cée kinh Phé Bai trivdng. 2. Ket trign ching xay. ra theo 1g trinh ede kinh nao. Vi du: Trigu ching & mit sau diti va cing chan khign ta nghi déa Bang quang kinh c6 19 trinh qua vang trén, 3. dn vao cde huyét cbin dodn cia cée durong kinh, kinh nao hénh thi huyét chan doin cia né ¢6 cam gidc bit thing (dan, tite, cing, nang...) nbit [4 cdm gide dan mdi khi ta tin- ng6n tay vao né. Vi du: An dau huyét Trung phi tire kink Phe Dénh vi day la huyet chin dodn cia nd. 4, Bat mach tai 12 bo vj & hai cd tay twoag ung voi 12 duang kinh 42 xem mach trang nao bat thing. 48— O cd tay trai: BO thén pha [a mach Tidu trrong, D> thn tram 14 mach Tam ; bd quan phii la mgch Bom, bd quan trim la nigch Can; bd xich phi [a mach Bang quang, bd xich tram la mach ‘Than. — Geb tay phai: BO thdn pha la mach Bai trirdng, bo thon tram 1a mgch Phé; bo quan pha 1a mach Vi, bs quan trim 1a mgch Ty i bd xich phi 1d mach Tam tidy, bg xich trim la mach Tah bao. Wide: Mach vo bie =: bu Mgeb sic (nhanb) : co ning ‘Mech hitw hye |: thie phat nbiét virgng (Hoa 7) Mgch phi 2 ngoaicim Mach tri (cham) : co nang Mach trim : nt thong tang trit sdy (Thoy 7) XY \ / a TT-Tam = Bom-Can BQ-Than Tom lai, phwong phap chin doan trong Cham cus noc la: 1, Xdedinh tinh trang virgng hay suy chia 5 co nang phd digu va tim co ning gée dia {oi sie Dt thireng céa ton bo 3 eo nang. 2. Xae dinn Am kbi hay Dirong khi la nguyen chin thay dBi co nang 46 (Hie Thre). 8. Xae dinh diong kinh litn hé voi cdc cor ning trén. Chit ys 1, Trong bénh ¢6 cic trigu chitng cia co ning nguyen nban va ce bign ching cia ie co ming khic, vide chika gde 191A can thiét, tay nhiéa, nbi8u khi cdc bign chirng tram trong c&n phai gidi quyét nhanh cho bénh nhén bét khé chju, ching ta cé thé didu tri ngon bling cich digu chinh co ning cia no. 2. Trén thie 18 khong phai kbi nao cdc tri¢u chikng cila 5 co’ ning fu hién ré, 6 bhi chi thy trigu ching cia mot hai co nang, tire méi théy ching, chwra thy dure bénh, Thre t€ cing cho thdy nhigu khi khong cé nhirng tri¢u chirng cia co niing gée ma chi thy ohidu tri¢a ching cia céc co ning khéc, do 14 tinh trang hign tergng che lip ban cbét, cin phdi tink toan xc dinh ban chat va trj tai d6 1A chi yéu. U— PAVONG Pip cHim clu 1, NGUYEN TAc BIBt TRI Khi ching tacd mot chin dodn, biét dirge co ning, dwong kinh nao bat thiang thi cham citu cde huyét lien be voi co nang va dwong kinh do nhdm digu chinh Iai, Ching ta co th vi ding kinh nhw mot cham day, mdi day co huyét riéng va lién hé voi mot co ning. Cham ecu huyet ritng d6 sé lam cho co ning cia no thay ddi. ~ Vi da: Kinh Phé va cae huyét lién he yoi 5 co ning: ‘Thiéu thong | Ngwt€ Thai uvén Kinh co Xich trach (Phat dong) (Phat nbiéty (Tit xuSf) (Ap thu) (Tang tro) L UL M6i kinh c6 hai nhanh, nixinh bési phai thuge Am ¢6 nhiing Am huyét (huyét tte chéy va nbinh bén trai thage Dirong 6 nhdng Dong hugat (huyél bug phéni, Tinh ch&t cia hai huyet cang tén & bén tréi va bd phd ade thuin nhau, do dé tiy tring hop ma chien huy(t niy hay cham buygt kia, 0Vi dy: — Co ning ting trét cia Ph€ kinh suy do bj cdm Ienh thi phai ta huy¢t Xich trach bén phai (Bénh thyc). — Co nang tang trit cia Phé kinh suy dé ndi than suy nbuge thi phai bd huyét Xich trach ben tréi. (Bénb bir) Chi 9: 1. N€u mt co nding bi r6i loan tai nhigu duwéng kinh khéc nhau thi ngoai nhirng huyét cia Neng dung kinh tng voi co nang d6, ching ta con cé thé dang nhirng huyét tdng quat cho moi dirdng kin. 2. Trong nbigu trang hyp, digu chink quan binh gita Sco nang phd hign vdn chia 44 vi cé khi do chi 1a sg quan binh diéi mite sink Iy -bink thuung, do 46, sau “shi digu chink 3 co nang, ta con cin phai nang toan hd né len bing cach cham cttu cde huyét chung cits Sco ming d2 tao mot th® quan Dinh sinb Ix. Mat khée, c6 abitu truéng hop bénh man, nang, 5 co nang 44 hao mit nid ning lutgng nén céc ber ching kheng cén virgng suy tuan theo qui ludt sinh khdc trén nia. Do dé ta cin nang toan bd ching !én bing cac huyet chung cia 5 co ning rdi moi digu chinh ching sau. 2. PHUONG PHAP BO TA Khi ching ta biét huyét lien hé voi co nang bénh rai thi tay tinh trang vugng hay suy cia co nang ma cham ciru cing mét huyét dé, nhung vei thi thudt khac nhau. Hu thi Bd, ‘Thy thi Ta. 1. Cham TA — Hwong kim cham ngitge chitu véi'duing kinh. — Vé nhe kim ngiryc chidu ddng hd 461 voi cdc kinh ly tam, tire day ngén tay tré vé phia trie, keo agén edi lid dang sau. a