Mechanism Blood velocity1 Blood vascosity Valve: narrowed or incompetent; organic or relative Abnormal connection Vibration of loose structure Diameter of vessel ^or

Woman complained of tightness in abdomen associated with belching wind which did not relieve feeling. Symptoms usually began between 5 and 6 p.m. lasing several hours. Relieved by White mixture. (D=Doctor, P=Patient)

Definition: Palpitation may be defined as an awareness of the beating of the heart, an awareness most commonly brought about by change in the heart's rhythm or rate or by an augmentation of its contractility

IMPORTANTCE! Despite recent advances in neuroscience and the continuing development of sensitive diagnostic procedures, the essential skill required for the diagnosis remains the clinical neurologic examination Most neurologic diagnosis can be made on the basis of the history alone

I. Auscultatory Valve Area 1. MV: apex, fifth left intercostal space, medial to the midclavicular line 2. PV: second left intercostal space 3. AV: second right intercostal space 4. AV,: left third intercostal space 5. TV: lower part of sternal ·6. Other part

Jaundice Definition Accumulation of yellow pigment in the skin and other tissues bilirubin)

Diarrhea Definition increase in the frequency of bowel movements increase in stool liquidity in some cases increase in daily stool weight

Fever .Normal body temperature 37°C, Circadian variation oral T00.5> axillary(腋温)

Definition Clinically apparent increase in the interstitial (间质) fluid volume Weight gain precedes overt edema Weight loss in edematous patients before “dry weight Massive edema is called Anasarca

INTRODUCTION Palpation of the pulse Measurment of arterial blood pressure Auscultation of blood vessels