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Anamnesis Form View full size

Anamnesis Form

Full color prints A4 paper Only available in Dutch

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€ 5,95

 This publication is only available in Dutch

Anamnesis form as basis for intake and diagnosis.
Overview of the main components on 4 A4 pages

  • Patient data
  • Complaints
  • Pulse
  • Tongue
  • Characteristics
  • 10 + 2 questions
  • Pattern differentiation (Ba Gang, Basic substances, Zang Fu, Jing Luo, Wu Xing, Causes of disease, 6 divisions, 4 radicals
  • Treatment principle and treatment plan
  • Height 21
  • Width 29.7
  • Depth 0.05
  • Weight 0.02

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tcm acupuncture pattern symptoms differentiation syndromes pattern differentiation kidney spleen zang pattern identification liver pathology heart yang small intestine colon yin bladder stomach lung sanjiao pulse pericardium tongue fire fu water gallbladder triple warmer cycle qi wood 5 metal heat jing earth wu cold five xue meridians chinese elements internal basic substances vacuity zodiacal diagnosis shi clock external shu nourishing shen repletion xing body clock re organ bi-hour ying hand post heaven double hours divisions gall bladder postheaven zangfu color organ clock mental tissues meridian characteristics front sheng phlegm feng 24 hour clock relationship 3 hour na zi fa li yuan wind traditional luo urine earthly branches points health rebellion hands wuxing pre heaven zi wu liu zhu controlling blood preheaven time basic meridian clock cheng wall clock wei xiang between xu jinye 24 hour relationships daily medicine cosmological chrono biao bioritm entiteiten treatment root renmai upper dominant gu month vormen deviation thorax antique fluids causes food weefsels sacrum warmth generation 6 xin seasons oogst palpitation fissure he causes of disease earthy pure their smaken long back lumbar vertebrae five elements huisdieren chi flaccid stream flegma zao foot xia metaal cervical spine warmer fever flavors full trigrams planeten cun swollen source shang planets slow dry thoracic divergent pallor child cosmology ontwikkelingh blue etiology dan entities deep gray Latin jin pain mother coeli 10000 tijdstip red ming ziwuliuzu dachang tastes form vacuous white spinal cycles feces bagua klimaat history veins tai pinyin pi sense organs fengshui peeled chest sprin stagnation summer dominating wei qi dao emotie principle moisture re- middle radicals kong day gebouwen thick vertebrae collapse emotional drink mentale shape level excess gan climate symbolen trembling sea illness 24 lung impure zintuigen tongue diagnosis coccyx 4 control direction landbouw pulse diagnosis short river huo 12 branches substances smaak questions mu thoracic vertebrae thirst senses body connections dieren guan stiff well rheum damp organs zhong kleur patient moist lumbar stool flavor things getallen thin han jiao numbers fast black cervical pibu sweating son 64 dag purple jue xiaochang emotions superficial yellow rear ba general sweat sixiang richting pale shao fei taste shui intake replete map spine mai drought generating pang guang taiji seizoenen medical bottom bl- lower soil zhen development objecten absent skeleton stasis other ke air