姓名Name:性别Sex:(xìngbié)年龄Age:职业Occupation:民族Race:婚姻状况Maritalstatus:住址Address:病史陈诉者Complainer:可靠性Reliability:入院日期Dateofadmission:记录日期Dateofrecord:第一页，共九十三页。症状描述：a.好转(hǎozhuǎn)、减轻:alleviate,palliate,reduceb.消失、消退:disappear,c.加重、恶化:becomeworse(aggravated)d.无变化:remainthesamee.时好时坏:waneandwax,hanginthe(zhǔsù)balance第二页，共九十三页。时间(shíjiān)描述：coughwithyellowsputumforfivedaysblacktarrystoolofthreedays’durationlowfever2weeksindurationtwo-dayhistoryofchestpain(zhǔsù)第三页，共九十三页。全身症状(General)feverpain发热malaise疼痛lassitude；fatigue不适weakness；debilitating疲倦wasting；thin；虚弱(xūruò)sweating；perspiration瘦hidrosisemaciationfeelchilly出汗chillysensations多汗shivering；shakingchillpruritus发冷itching畏寒寒战瘙痒痒第四页，共九十三页。A）呼吸系统：气喘(qìchuǎn)asthma咳嗽cough呼吸困难dyspnea咯血hemoptysis喘鸣wheezing痰sputum；phlegmB）循环系统：胸痛chestpain心前区痛precordialpain；胸骨后痛retrosternalpain；胸部压榨感（压迫感；窒息感；紧缩感）squeezing(pressing；choking；tightness)sensationofthechest泡沫样痰frothysputum活动后气促breathlessnessofexertion阵发性夜间呼吸困难paroxysmalnocturnaldyspnea第五页，共九十三页。C）消化系统(xiāohuàxìtǒng)胃灼热pyrosis腹痛abdominalpainstomachache胃痛anorexiapoorappetite厌食nausea纳差vomitinghematemesis恶心stercoraceousvomiting呕吐biliousvomiting呕血belchingsourregurgitation呕粪postprandialdistension呕胆汁constipation嗳气diarrheatenesmus返酸饭后腹胀便秘腹泻里急后重第六页，共九十三页。D）泌尿系统：无尿anuria尿浑浊cloudyurine绞痛colic浮肿edema腰痛lumbodynia；lumbago夜尿nocturia少尿oliguria多尿polyuria排尿中断interruptionE）造血系统：出血bleeding皮肤出血点bleedingspotsintheskin鼻出血epistaxis牙龈出血gumbleeding术后伤口(shāngkǒu)出血postoperativewoundhemorrhage血尿hematuria第七页，共九十三页。F）内分泌系统：贪食hyperorexia矮小dwarfism过高excessiveheight多汗excessivesweating手抖handstremble肥胖obesity消瘦wasting烦渴polydipsia；excessivethirstG）生殖系统：月经不调menoxenia月经过多过频epimenorrhagia月经过频epimenorrhea；polymenorrhea月经过少hypomenorrhea（指量）；oligomenorrhea(间隔(jiàngé)长)月经过多menorrhagia；闭经amenorrhea；绝经menostasis；menopause第八页，共九十三页。H）神经系统：agitation焦虑不安anxiety忧虑aphasia失语amnesia；健忘dizzinessdrowsiness头晕倦睡formication蚁走感hemianesthesia偏身麻木hemiplegia半身不遂insomnia失眠numbness麻木vertigosyncope眩晕(xuànyùn)tingling昏倒wanderingpain麻刺感第九页，共九十三页。游走痛i)运动系统(xìtǒng)：arthrodynia；arthralgia关节痛backpainlumbago；lurnbodynia背痛footpain腰痛paininlimbs；acrodynia足痛bloodoozedoutafterscratch肢痛anitchj)皮肤科症状exudation抓痒后渗血scurfswollen渗出头皮屑肿第十页，共九十三页。耳疾病deafness；anacousiaotalgia；otodynia聋tinnitus耳痛vertigo耳鸣drynessofthenose头晕anosmia鼻疾病hyposmia鼻干燥嗅觉(xiùjué)丧失frontalheadache嗅觉减退nasalobstruction额部头痛purulentrhinorrhea鼻塞rhinorrhagia脓鼻涕rhinorrheasneezing鼻出血snoring流鼻涕wateryrhinorrhea打喷涕第十一页，共九十三页。打鼾水样鼻涕咽部疾病dysphagia咽下困难hoarseness声嘶painonswallowing咽食时疼痛sorethroat咽喉痛throatyvoice声音沙哑(shāyǎ)stridor喘鸣blurredvision；hazyvisionL)眼科diplopia视物模糊flashinglights复视foreignbodysensation闪光losethesightnictitation异物感失明eye-ache；ocularpainvertigo眨眼第十二页，...
