External Medicine, Traumatology, and Specialties
External Medicine, Traumatology, and Specialties
This domain tests external sores, skin conditions, trauma, and specialty patterns in gynecology, pediatrics, ENT, and ophthalmology.
Core rules
- External medicine differentiates yin/yang, stage, and site. Red, hot, swollen, painful lesions are often yang/heat; pale, cold, chronic, painless lesions are often yin/cold. Treatment combines internal pattern differentiation with external applications.
- Traumatology principles: reduce, fix, and rehabilitate. Before manipulation, assess neurovascular status, deformity, and open wounds. Suspected fracture or dislocation requires immobilization and imaging; do not massage an acute injury.
- Sprains: early care limits swelling and protects tissue; later care restores movement. TCM principles may include moving blood and reducing swelling, but acute heat application can worsen swelling.
- Gynecology: menstrual disorders are differentiated by cycle, amount, color, clots, and pain. Pediatrics: dosing and needle retention differ; ENT: distinguish wind-heat from wind-cold and refer for airway compromise.
Worked example
A patient twists an ankle two hours ago; it is swollen and tender but they can bear weight. Reasoning: likely sprain, but fracture cannot be excluded. Protect, rest, compress, elevate, and arrange assessment if bony tenderness or inability to bear weight. Avoid vigorous massage and hot herbal soaks in the acute phase because they may increase swelling. Later, gentle movement and rehabilitation are appropriate.
Traps
Do not massage or manipulate before excluding fracture/dislocation. Do not miss compartment syndrome-severe pain, pallor, paresthesia, pulselessness, paralysis. Do not use toxic external herbs on broken skin. Do not treat gynecologic bleeding without considering pregnancy or emergency.