Confused
Any manifestation of being unconscious and not responding to any external stimulus is called coma. Also known as "dream", "dirty", and "dirty".
The causes of coma are relatively complicated, and can be caused by external and internal injuries. Generally speaking, external infections are mostly transmitted from the external evil to the internal heat; internal injuries are mostly caused by the loss of qi and blood and the failure of yin and yang. In short, if the evil qi is strong, it will be solid, and phlegm, turbidity, heat, wind and yang, and blood stasis will block the clear orifices, resulting in the qi reversal, and the spirit will be confusing as the main pathological mechanism. If the positive energy is taken away, it will cause deficiency. Due to long-term illness, qi and blood are severely damaged, sweating, vomiting, and lower treatments are not suitable, yin and essence are not maintained, and the spirit is weak and has no support. The main pathological mechanism is the transformation. Regardless of external injuries and internal injuries, deficiency and excess, the focus is on damaging the heart, brain, liver and kidneys.
Coma can exist independently as a disease syndrome, and it is often manifested in many disease syndrome processes with very important symptoms. In any case, it indicates that the condition is serious and must be closely observed, a correct diagnosis is made quickly, and emergency rescue measures must be taken.
Key points for identification
Since coma is an independent disease, any other diseases that can have coma symptoms should be identified. However, coma is a complex clinical manifestation of many diseases, so you should pay attention to internal analysis.
l. Symptoms that can cause coma: In addition to the original symptoms of coma, diseases that can also cause coma in clinical practice can be divided into two categories: exogenous diseases and internal trauma diseases:
(1) Exogenous diseases: mainly refer to external fever diseases, such as typhoid fever, evil heat in typhoid fever, internal yangming gastrointestinal tract, warm disease, evil enters the blood of the blood or reverse transmission of pericardial stroke, urgency convulsion , dysentery , malaria, etc. Viper bites are traumatic coma.
(2) Internal injury diseases: stroke , swelling syndrome, sneezing syndrome, phlegm syndrome, diabetes, swelling and swelling, etc.
2. Coma closure and syndrome-relieving type identification: Coma is a very complex pathological process. According to the specific clinical manifestations, it can be divided into two types:
(1) syndrome-relieving type; when coma is in a coma, the teeth are urgent, the hands are firm, the face is red and the air is thick, and the phlegm sounds are pulled by the saw.
(2) Abnormal symptoms: When you are in a coma, your limbs are cold, your eyes are closed, your mouth is opened, your hands are sprinkled, your nose is enuresis, and your face is red like makeup, your sweat is oily, and your pulse is slightly disintegrating.
3. Inquiry into the medical history in detail: The typical medical history of various diseases that cause coma is very helpful in the diagnosis of the nature of coma. If there is obvious high fever course, it is more common in external warm fever. An unclean diet may cause dysentery. There is a history of recurrent coma, which is mostly a symptom of dysfunction. If the phlegm and dampness are excessive, dizziness and numbness of limbs are common, it is mostly caused by stroke or phlegm syndrome. The body is strong and there is obvious mental stimulation before the onset. It is usually , qi , or blood syncope symptoms coma. If you are weak all day long, you will experience excessive fatigue before you fall into a coma, lack of sleep, hunger and cold, etc., it is a deficiency syndrome of coma. If you eat a vegetarian diet and eat fatty and sweet body fat, you should consider coma in phlegm and symptoms. After overeating, it is a coma of the feces. Under the long and fierce sun, or in a high temperature environment, coma is heatstroke. The child suddenly fell into a coma with high fever, which was a sudden shock. If you have a history of swelling, stagnation, and diabetes, you should be alert to coma in the later stages of the disease. Those with obvious blood loss are coma. In the smoky and malaria areas of Lingnan, my country, we should pay attention to the occurrence of malaria coma.
4. Master the main characteristics of some diseases that are prone to coma: When a patient becomes unconscious, in addition to understanding the medical history and knowing which diseases can occur, pay special attention to the characteristics of coma of various diseases.
(1) Stroke coma: fainting after being quenched, unconscious, and a long time. My companion saw crooked mouth and eyes, hemiplegia, snoring, etc. This syndrome is very urgent, changes rapidly, and the symptoms are critical.
(2) Coma: Although there are sudden fainting and unconsciousness, they often wake up gradually in a short period of time, and there are no sequelae such as hand and foot aside, crooked mouth and eyes, aphasia, etc. Reverse cold limbs are often accompanied by the main symptoms, and it is not difficult to distinguish them from stroke and coma. As for those who die without recurrence, it is rare to have serious evidence. Clinical clinical practice should be divided into food, phlegm, qi, blood, and coma caused by heat circumcision.
① Coma of Qi and Slowness: You may have a mouth clenched and clenched fists, breathing thickly, thin and white moss, and a dull or stringy pulse, which is true. If the face is pale, breathing is weak, the limbs are cold and sweating, and the tongue is pale; the pulse is deep and weak, it is a syndrome of qi deficiency.
② Blood-cold coma: the symptoms are red and purple in the face, the tongue is red, and the pulse is deep and stringy.In addition, the symptoms of deficiency symptoms are pale face, unpretentious lips, trembling limbs, eyes sinking and opening mouth, spontaneous sweating and cold limbs, weak breathing, pale tongue, weak pulse or thin and weak pulse.
③ Coma of phlegm: phlegm sounds in the throat, or vomiting phlegm, white and greasy tongue coating, and deep and slippery pulse.
④ Coma in the feces: breath is suffocated, abdominal distension, thick and greasy tongue coating, smooth and solid pulse.
⑤Summer coma: dizziness and headache before attack, chest tightness, hot and red body, or delirium after coma, red tongue, dry pulse, heavy and rapid pulse, or weak and stringy.
(3) Coma: During the attack, it is often accompanied by abnormal sounds such as pigs, sheep and animals, limb twitching, saliva spitting, teeth urgent, mouth and eyes are attracted, eyes are hung, and after waking up, there are often dizziness, headaches, mental fatigue, and others are just like ordinary people.
(4) The child has a sudden convulsion and coma: first there is strong fever, then there is twitching and twitching, crying without tears, then it turns into a coma, the neck is straight, the horn arch is stretched, the teeth are closed, the eyes are directly looking at, and the fingerprints are blue and purple. It can cause diseases due to slaughter, wind, phlegm, heat, etc.
(5) Coma in phlegm syndrome: Any coma in phlegm syndrome may be caused by phlegm and qi, or phlegm is depressed and heat is transformed by phlegm. Those with phlegm and qi are also suffering from vomiting, phlegm and saliva, or choking when eating, or infarction of throat, red tongue, thick and greasy coating, and stringy and slippery pulse. If the patient becomes stagnant and heat, there will be phlegm in the throat, thick and greasy moss, and stringy and slippery pulse.
(6) Coma with closure syndrome: It usually occurs at the end of this syndrome, with difficulty in urination, swelling, nausea and vomiting, blurred vision, or abnormal changes in consciousness.
(7) Diagnosis syndrome of coma is always caused by the "three multiples", namely, drinking more, eating more, and shit. When the yin is exhausted in the later stage, the yang is destroyed, and often falls into a coma.
(8) Swelling coma, abdominal distension, pale and yellow skin, and exposed veins. Late stage of coma. Second, constipation disorders, vomiting of blood, or mouth and nose bleeding, are difficult to cure dangerous symptoms.
(9) Coma of the syndrome of dysentery: accompanied by high fever, thirst, headache and irritability, severe abdominal pain, acute internal and severe back, fresh purple pus and blood under diarrhea, red tongue, yellow and dry tongue coating, slippery and rapid pulse. Children are in a coma without obvious abdominal pain and diarrhea, and the condition is critical, so pay attention.
(10) Coma symptoms: it may be more heat, less cold, or more cold, more heat. Daily attacks or daily attacks, heavy body, drowsiness, or crazy and delirium.
(11) External symptoms of coma: it usually occurs during the course of warm diseases or typhoid fever. If the heat invades Yangming, the hot weather will be hot every day, and the irritability will be uneasy and sometimes delirious. If the evil attacks the pericardium, the tip of the tongue will be red, and you will pinch the empty lines and touch the bed along the clothes. When heat enters the blood, it is often accompanied by skin spots, its color is purple and dark, its tongue is red or purple and has no coating, and its pulse is deep and thin. If blood heat is and lower abdomen , it is a blood-storing syndrome in the lower abdomen, and it will be a sudden knot in the lower abdomen, and it will be crazy and will be self-confident.
(12) Coma with dampness and warm symptoms: coma is often found during the white period of translucent hair, but it often seems bright and twitchy, or sometimes clear and sometimes twitchy, sometimes delirium, yellow and greasy tongue coating, and moist and slippery or rapid pulse.
(13) Suddenly dizzy, unconscious, pale, and spontaneously sweating, which is called "disiased". It is mostly caused by deficiency of both liver and kidneys and disturbance of wind and yang. In mild cases, you can wake up naturally within a few minutes, in severe cases, sweat continuously, and the limbs and pulses are cold and swelling
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