男性，46岁。主诉：会餐后右上腹疼痛伴恶心、呕吐2天。请针对该案例，说明问诊内容与技巧。
参考答案：
问诊内容
现病史：
1.根据主诉及相关鉴别询问
（1）发病诱因：暴饮暴食、高脂饮食、疲劳。
（2）腹痛情况：是持续性还是阵发性，是否伴有右肩不适和疼痛。
（3）腹痛与呼吸、体位的关系。
（4）恶心、呕吐发作的时间和特点，性状，是否含胆汁。
（5）是否伴有下腹痛、寒战、发热、黄疸？是否伴有心前区不适。
（6）饮食、小便变化情况。
2.诊疗经过
（1）是否曾到医院就诊，做过何种检查（如B超，CT）。
（2）治疗情况：用药、效果。
相关病史：
1.有无药物过敏史、手术及外伤史。
2.与该病有关的其他病史：过去有无类似发作史，有无胆囊结石、胃病、肝病、心脏病等。
问诊技巧
1.条理性强，能抓住重点。
2.能围绕病情询问。参考诊断急性胆囊炎
| Freudian theory indeed took western 20th-century civilization by storm. How so The answer lies in four factors. Of Freud’s powers as a writer and advocate of ideas, and as a possessor of an extraordinary ability to weave together medical knowledge, some genuine insights into the human condition and a powerful imagination, there can be no question. He has the narrative skills of a first-rate novelist, and a knack for devising striking ways to describe the psychological phenomena he studies. His marvelous powers of imagination fed on analogy and metaphor, and annexed the austere terminologies of scientific medicine and psychology to them. This gave them authority. His case studies are highly organized narratives constructed from true-life gossip based on voyeurism—irresistible to human curiosity. The second attraction—that Freud offers each individual a revelation of secrets about himself that he does not himself know—is equally irresistible. The same compound of insecurity and curiosity, anxiety and desire that makes so many resort against their better judgment to fortune-tellers, is at work here; except that here the imprimatur of science makes the proceeding respectable, which is why people will spend far more on their analysts than on their astrologers. The third attraction is the promised theory of human nature. Religious accounts of fallen man, of humanity as midway between beast and angel, of imperishable souls trapped in disgusting matter and therefore sinful from birth, had lost their grip with many, while at the same time Darwinian views offered no account of why evolution had made man as he is. In identifying sexual and aggressive impulses as the fundamental human drives, and in specifying their causes, Freud offered an inclusive philosophical psychology. Humans struggle with conceptual bewilderments about themselves and their complex natures; one can see why the appearance of Freud’s magisterial new insights seemed as welcome as rain in drought. And finally there is the fact that sex lies at. the core of the stow. Freud performed a great service by liberating debate on the matter, but it is questionable whether the importance he assigns it is correct. The hungry always think of food; the fed put eating in its proper place. The accidents of social history are easily mistaken for the essentials of human nature. The surprise is that people do not see how, at most, sex can only be part of a far more complicated story. From Animism to Zoroastrianism, every view known to man retains at least a few devotees. There might always be Freudians, and there will always be admirers of Freud’s great imaginative and literary powers; these two, as the foregoing remarks suggest, are intimately linked. But as to Freud’s claims upon troth, the judgment of time seems to be running against him. |
It seems that the author of this passage ______ .
A．is one of Freud’s devotees
B．believes in both Animism and Zoroastrianism
C．thinks that Freudian theory is sound
D．thinks that the truth is not in the hand of Freud