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Diarrhea & Dysentery

Bloody Flux (when with Blood)


Picture
Neue Artznei und Practicierbuchlin, Bock, 1551

Diarrhea is a large problem is the developing world. It is the second leading cause of death in children with over 500,000 children under the age of 5 dying annually according to WHO figures. It is also the leading cause of malnutrition in children. It is both preventable and treatable.

Acute Diarrhea is most commonly caused by an intestinal infection, either bacterial, viral or parasitical.

In Traditional Medicine, Diarrhea is generally divided into Hot and Cold types.

Heat–type Diarrhea
Typically associated with Infection and/or inflammation such as Gastroenteritis. It may be the result of Food or Water poisoning and often comes with Fever, abdominal pain, and burning, foul-smelling, loose, watery stool. Because it is associated with Fever, Inflammation and Infection, it is classed as a Heat disease. Because the Fluids are also involved, it is classed as Damp-Heat in TCM. Treatment uses bitter and dry medicines to clear Damp-Heat and stop Diarrhea.

Cold–type Diarrhea
Associated with internal Coldness and Damp. In Western Tradition it might be referred to Coldness in the Stomach and Intestines. In TCM, it may be associated with Cold and Damp attacking the Stomach and Intestines, or in severe cases, Spleen and Kidney Yang deficiency. The stool is loose and watery, but without burning or foul smell. There may be undigested food in the stool (due to lack of Heat). Treatment uses Warm and dry Stomachic medicines to increase digestion, stimulate digestive fire (Agni or Spleen Yang), as well as drying astringent medicines to restrain excess fluid.

Chronic Diarrhea
Chronic cases are usually associated with deficiency. Even if the initial disease was excess Heat, it will eventually drain the body and cause deficiency. Chronic cases can be from Cold and deficiency of the Spleen and/or Kidneys. Cases with excess Phlegm/Damp require drying medicines along with medicines to strengthen the Spleen. In chronic cases with Heat, cold medicines may be prescribed with suitable tonics.

Diarrhea with Blood
Diarrhea with Blood may occur in prolonged Damp-Heat type infective Diarrhea, or in serious infections such as Amoebic Dysentery. In these cases, medicines to clear Heat and combined with demulcents to sooth the membranes and with drying medicines that stop Bleeding, for example Red Earth.

Dysentery
Dysentery is treated similarly to Diarrhea, along certain medicine have shown particular efficacy against Dysentery. Acute Dysentery is usually Damp-Heat. In chronic cases, the patient becomes weak and requires astringent and strengthening medicines. Dysentery is often divided into "Red" and "White", that is, Dysentery with Blood or Pus respectively. If there is Blood present in the stool, medicines to stop bleeding are combined with astringents. If there is pus, medicines that clear heat and toxin are combined.

Dysentery is a particularly dangerous disease, especially in developing countries where it is still responsible for many fatalities.

Important Notes
1. As always, treat the underlying condition. Hot medicines will be beneficial to Diarrhea from Cold and Damp, whereas the same medicines may aggravate Hot-type Diarrhea.
2. In the treatment of Diarrhea and Dysentery, it is important to separate acute and chronic cases. Acute heat or damp-heat cases are generally associated with an acute bacterial or viral infection and require bitter, draining medicines to attack the pathogen. Chronic cases require astringent and strengthening medicines. If cold, draining medicines are used in chronic cases with weakness, it will drain them further. If astringent tonic medicines are used in acute cases with Heat, the pathogen may be strengthened or penetrate deeper.


Some Herbs with Proven Anti-amoebic Activity:

Pomegranate rind
Garlic
Long Pepper
Nutmeg
Bael (Agele) fruit
Cotton seed
Plantain seed
Galls
Wormwood
Cyperus rontundus
Holarrhena
Barberry

Coptis Huang Lian
Scutellaria Huang Qin
Pulsatilla Bai Tou
Chebula



Western Tradition

Simples
Tormentil
Agrimony
Pomegranate flower
Galls
Rosehip
Chebula (scorched)
Red Earth

Alum

Bistort
Camomile
Pomegranate rind
Sumac
Nutmeg
Rhubarb (scorched)
Kaolin

Burnt Deer horn
TCM Classification

Simples
Pulsatilla Bai Tou Weng
Agrimony (Xian He Cao)
Galls (Wu Bei Zi)
Coptis Huang Lian
Rosehip (Jin Ying Zi)
Nutmeg (Rou Dou Kou)
Schisandra Wu Wei Zi
Limonite (Yu Yu Liang)
Red Earth (Chi Shi Zhi)

Phellodendron Huang Bai
Plantain seed (Che Qian Zi)
Chebula (He Zi)
Scutellaria Huang Qin
Lotus seed (Lian Zi)
Pomegranate rind
Prunus mume (Wu Mei)
Alum (Bai Fan)
Oven Earth (Zao Xin Tu)



Diarrhea
General for Diarrhea and Dysentery

Syrup of Quince with Spices (Nicholas)
Syrup of Dry Rose
Conserve of Pomegranate flower
Quince Conserve
Micleta (Nicholas)

Athanasia Greater (Nicholas)
Triphera Minor (Triphera Phoenonis) (Mesue)
Powder for Dysentery (Nicholas)
Powder for Dysentery (Riverius)
Powder for Dysentery of Galen
Troches of Sealed Earth

Troches of Ramich (Mesue)
Pills Against Fluxes (Nicolas)



Diarrhea, Chronic

Electuary of Scoria Ferri
Athanasia Magna
Syrup of Myrtle Simple
Syrup of Myrtle Compound


Coptis 5 Pill (Tibetan Medicine)


Diarrhea, Bilious (from Bile Humor)

Syrup de Agresta
Rob of Currant
Rob of Barberry
Troches of Ramich (Mesue)

Troches of Spodium (Avicenna)

Coptis 5 Pill (Tibetan Medicine)
Crystal Moon 37 (Zla shel so bdun) (Tibetan Medicine)



Diarrhea, Pituitous (from Phlegm Humor)

Syrup of Mint

Triphera Minor (Triphera Phoenonis) (Mesue)





Acute Cold Damp
acute diarrhea, cramping abdominal, epigastric and abdominal distension, loss of appetite, nausea, lethargy.

Huo Xiang Zheng Qi Shui



Acute Damp Heat
acute or recurrent diarrhea, burning and smells badly, maybe violent diarrhea, fever, restless, cramping abdominal pain, high colored urine, thirst.

Ge Gen Qin Lian Tang



Liver Qi Invading the Spleen
recurrent diarrhea, stomach pain after diarrhea, abdominal distension, poor appetite, nausea, indigestion, flatulence, irritability.

Bai Zhu Shao Yao San
Tong Xie Yao Fang



Spleen and Stomach Deficiency
frequent loose stools or diarrhea, abdominal distension, poor appetite, fatigue, sallow complexion, puffiness around the eyes, weight loss.

Bu Zhong Yi Qi Tang
Xiang Sha Liu Jun Zi Tang
Li Zhong Wan
Ling Gui Zhu Gan Tang



Yang Deficiency
diarrhea, especially early in the morning, cold and pain of the abdomen, fear of cold, cold feet, lower back pain, weak knees, poor digestion, poor appetite, fatigue, always tired.

Ling Gui Zhu Gan Tang
Fu Zi Li Zhong Wan
Si Shen Wan



Food Stagnation
acute diarrhea or chronic intermittent diarrhea, foul smelling stools, abdominal distension and pain, bad breath, acid reflux, nausea, foul smelling flatulence.


Bao He Wan

Special Formula

1.  Plantain seed (Che Qian Zi) 10 grams
    Black Tea                                 3 grams
Boil briefly, then steep. Used for Spleen deficient Diarrhea or Diarrhea from Heat or Heat and Damp.

2. Hawthorn fruit, stir-fried.        25 grams
    Costus                                         6 grams
    Black Tea                                   15 grams
Decoct and add Sugar (White Sugar for Heat and Blood; Brown Sugar for Spleen deficiency)

STOP DIARRHEA TEA (Zhi Xie Cha)
    Honeysuckle (Jin Yin Hua)    9 grams
    Green tea                                 9 grams
    Rose                                          6 grams
    Tangerine peel (Chen Pi)       6 grams
    Jasmine flower                        3 grams
    Licorice                                     3 grams

This is prepared as an infusion.

TWO FLOWERS TEA (Er Hua Cha)
    Black tea                                   9 grams
    Honeysuckle (Jin Yin Hua)     9 grams
    Rose                                           6 grams
    Licorice                                      6 grams
    Coptis Huang Lian
                    6 grams

Dysentery

Dysentery

Syrup of Marshmallow (Fernel)
Powder of Chebula and Rhubarb (Philon)
Powder of Tormentil Compound (Grieves)
Powder for Dysentery (Nicholas)
Powder for Dysentery (Riverius)
Powder for Dysentery of Galen

Philonium Persicum
Electuary of Micleta (Nicholas)
Troches of Coral (Diacorallium) (Nicholas)



Diarrhea or Dysentery with Blood
1. Rhubarb (1 oz.), burnt Deer Horn (2 drams). Powder and form 3 boluses with Conserve of Roses.
2. Comfrey, burnt Rhubarb, Chebula
3. Comfrey, Knotgrass, Shepherd's Purse, Cinquefoil, Plantain, Ribwort Plantain, Strawberry leaves (1 handful each), decoct.
4. Woman's Milk taken for 9 days together was said to cure any Bloody Flux

Athanasia Greater (Nicholas)
Troches of Coral (Galen)


Damp Heat
frequent foul-smelling diarrhea with blood and mucus, burning feeling when defecating, abdominal pain, scanty urine, red eyes, fever, restless, dry mouth.

Bai Tou Weng Tang
Ge Gen Qin Lian Tang
Huang Qin Tang
Shao Yao Tang
Lian Po Yin



Epidemic Heat and Toxin
explosive diarrhea with blood, high fever, severe abdominal pain, thirst, dehydration, headache, nausea, vomiting, irritable; in severe cases delirium, convulsion, severe cramping, cold limbs.

Huang Qin Tang
Huang Lian Jie Du Tang
Bai Tou Weng Tang
Zhi Bao Dan



Liver Qi Invading the Spleen
chronic or recurrent diarrhea with blood or mucus, abdominal distension, irritable, depression, headache, red eyes, red face, night sweats, hot feeling, bitter taste, dry mouth.

Dan Zhi Xiao Yao San


Spleen Qi Deficiency

chronic diarrhea with blood and mucus, fatigue, poor appetite, indigestion, weak pulse

Bu Zhong Yi Qi Tang
Jian Pi Wan



Yang Deficiency

chronic dysentery, diarrhea is worse in the cold or after cold food, mild tenesmus, abdominal pain, feels cold, poor appetite, fatigue, pale complexion, cold extremities, lower back and legs pain and weak, deep, slow and weak pulse

Fu Zi Li Zhong Wan
Zhen Ren Yang Zang Tang
Si Ni Tang
Si Ni Jia Ren Shen Tang
Si Shen Wan



Yin Deficiency
chronic diarrhea with little mucus and blood, mild lower abdominal pain, tenesmus, nausea, poor appetite, dry mouth, tidal fever, night sweats, emaciation.

Huang Lian E Jiao Tang



Food Stagnation
diarrhea, foul smelling stools, abdominal distension and pain, bad breath, acid reflux, nausea, foul smelling flatulence.

Mu Xiang Bing Lang Wan


Special Formulas for Dysentery

1. Decoct Green tea (2 grams) in 100 mls of water down to half.
2. Barberry, Chebula, Boerhaavia, Tinospora, Ginger
3. Agrimony and aged Black tea, equal parts, decocted.
4. Prunus mume (Wu Mei) 1 piece, Black Tea, decoct

5. Prunus mume (Wu Mei), fresh Ginger, decoct
6. Chinese Red Dates (Da Zao), Green tea, decoct and add Honey

7. ANCESTRAL POPPY AND MUME DECOCTION (Zu Chuan Ying Mei Tang)
    Poppy capsules (Ying Su Ke)     15 grams
    Licorice                                           9 grams
    Prunus mume (Wu Mei)               7 pieces
    Black Pepper                                 7 pieces
    Black tea                                         9 grams
Decoct all the ingredients twice, combine the strained liquids, add Brown Sugar. This is only used for chronic and persistent cases of dysentery. It is not for acute Heat-type dysentery.


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