This paper will examine the cognitive processes involved in palpation in order to develop an appropriate remote palpation system. In a conventional remote palpation system, the tactile condition of the patient is conveyed to the doctors using a force feedback system. A clarification of the cognitive process during palpation suggests that the purpose of palpation is to formulate a clear idea about the patient's medical problems using the tactile sensation as a trigger to combine the results of other assessments, past experience and memory, and patient reactions to the doctor's touch. This is in contrast to the objective of acquiring the detailed tactile condition of the affected body part. In order to demonstrate this purpose, we will describe the two significant signal pathways for the perception of tactile sensation, both in doctors and patients. The perception of doctors progresses as the result of active touch to the affected part, thereby implying that the simultaneous stimulation of kinaesthetic and tactile sensation is necessary. Conversely, the tactile sensation experienced by patients is the result of passive touch, which evokes a more subjective and emotional response. Patients both explicitly and implicitly perceive the stimulation, and doctors use these perceptions as reactions of the pain to the doctors' touch. This paper proposes the fundamental concept of a remote palpation system, ``Palpation Reality beyond Real'', to achieve the purpose of palpation. Palpation reality implies a system in which the whole cognitive process progresses at the same level or better than palpation in the standard examination, rather than presenting the real tactile sensation.

翻译：本文旨在通过探究触诊过程中的认知机制，以构建适宜的远程触诊系统。传统远程触诊系统通常通过力反馈系统向医生传递患者的触觉状态。对触诊认知过程的解析表明，触诊的核心目标并非获取患部精确的触觉信息，而是以触觉为触发，整合其他评估结果、既往经验与记忆、以及患者对医生触压的反应，从而形成对患者医疗问题的清晰认知。为阐明此目标，本文将分别描述医患双方感知触觉的两条关键信号通路。医生的感知源于对患部的主动触压，这意味着需要同时激发动觉与触觉感知；而患者的触觉体验则源于被动接触，会引发更为主观和情绪化的反应。患者通过显性与隐性方式感知刺激，医生则将这些感知解读为疼痛对触压的反应。基于此，本文提出“超越真实的触诊现实”作为远程触诊系统的基础理念，其目标不在于呈现真实的触觉，而在于构建能使完整认知过程达到或超越标准触诊水平的系统。