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笔者临证,能一矢中的者虽不少,然误诊害人者亦有之。清夜自省,弥觉内疚。究误治之因,或读书甚少,学识谫陋;或经验匮乏,拘泥常法,不通达变;或辨证粗疏,徒逞己能;或囿于西医诊断,不能辨证辨病结合。然一旦审谛覃思,审证求因,改弦易辙,卒可获效。今举误诊治案二则,以志教训,亦可供后学镜鉴。(一)未遵表里施治程序郑某,男,21岁。农民。1969年11月14日诊。主诉:发热咳嗽4天。今见巩膜皮肤发黄,病前途中淋雨,当晚恶寒发热,咳嗽痰白,继而胃脘胀满,不欲饮食,小便黄短,大便三日未行。体检:体温39.1℃;白细胞23000/立方毫米,中性81%;肝功能:黄疸指数27单位,谷丙
The author’s clinical evidence shows that although there are a lot of people who can be found in one, they are misdiagnosed. Late night self-examination, feel guilty. Reasons for misunderstandings, or reading less, lack of knowledge; or lack of experience, rigidly adherence to the common law, no access to change; or syndrome differentiation, practice has been able to; or in Western medicine diagnosis, can not distinguish between disease differentiation. However, once the trial is reviewed and the reason is verified, the decision can be made and the stroke can be effective. There are two cases of misdiagnosis and treatment in this move. (A) Zheng Zheng, male, 21 years old, did not follow the application process. Farmers. November 14, 1969 consultation. Chief complaint: fever cough for 4 days. See today the sclera skin yellow, the disease in the shower, the night fever, cough, sputum white, then stomach fullness, do not want to eat, short yellow urine, bowel movement on the 3rd. Physical examination: body temperature 39.1°C; leukocyte 23000/mm 3 , neutral 81%; liver function: jaundice index 27 units, G