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Diarrhea & Dysentery
Flux (Diarrhea)
Bloody Flux (Dysentery, or Diarrhea with Blood)
Bloody Flux (Dysentery, or Diarrhea with Blood)
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.
Ayurvedic Differentiation of Dysentery:
1. Vata (Wind) Dysentery: acute pain, rumbling, bloating, with lassitude
2. Pitta (Bile) Dysentery: foul smelling stool with blood, urning sensation, fever
3. Kapha (Phlegm) Dysentery: Mucus in the stool which is loose, cold feeling
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:
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.
Ayurvedic Differentiation of Dysentery:
1. Vata (Wind) Dysentery: acute pain, rumbling, bloating, with lassitude
2. Pitta (Bile) Dysentery: foul smelling stool with blood, urning sensation, fever
3. Kapha (Phlegm) Dysentery: Mucus in the stool which is loose, cold feeling
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:
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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 |
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Western Tradition
Simples
1. Scorched or Parched Rhubarb has been highly praised for Diarrhea and Dysentery when used as a single medicine.
2. Likewise, Scorched Chebulic or Yellow Myrobalan has been used as a stand-alone medicine. |
TCM Classification
Simples
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Diarrhea
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General for Diarrhea and Dysentery
Syrup of Chebulic Myrobalan 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) Bilwadi Churna (Ayurveda) Diarrhea, Chronic Electuary of Scoria Ferri Athanasia Magna Syrup of Chebulic Myrobalan Syrup of Myrtle Simple Syrup of Myrtle Compound Coptis 5 Pill (Tibetan Medicine) Diarrhea, Bilious (from Bile Humor) Syrup of Chebulic Myrobalan 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) Bilwadi Churna (Ayurveda) |
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 Huang Qin Huang 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 Stomach and Intestine Cold / Damp diarrhea and loose stool, abdominal pain relieved by warmth, pale tongue with white coat, slow pulse. Gan Cao Gan Jiang Fu Ling Bai Zhu Tang Li Zhong Wan Tao Hua Tang 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 Shen Ling Bai Zhu San 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 Wen Pi Tang 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 Jian Pi Wan |
Special Formula
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1. "To eat in his Bloody Flux every morning fasting half a dram of Rhubarb parched [scorched], is a thing well tried, and very acceptable".
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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 FLOWER 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
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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) Bilwadi Churna (Ayurveda) 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 Huang Qin Huang 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
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An Ayurvedic Compound
Barberry Chebula Boerhaavia Tinospora Ginger Powder or Decoction (Ayurveda) A PROVEN FORMULA FOR DYSENTERY Yellow Myrobalans, parched Plantain seed, parched Sorrel seed, parched Endive seed, parched 3 drams ea. Cordial flowers (except Violet) 1 handful ea. Boil gently in water in which Steel has been quenched a number of times. Strain and add Rhubarb, parched, 2 ½ drams and Philonium Persicum, 4 scruples. "This drink is found very good by experience" (Secrets of Alexis) ANOTHER FOR DYSENTERY: Frankincense Mastic Red Earth Red Coral Burnt Deer Horn ½ dram ea. Hematite burned 2 scruples Powder, steep in dry red wine. Give 1 ½ drams before bed. (Secrets of Alexis) |
1. Decoct Green tea (2 grams) in 100 mls of water down to half.
2. Agrimony and aged Black tea, equal parts, decocted. 3. Prunus mume (Wu Mei) 1 piece, Black Tea, decoct 4. Prunus mume (Wu Mei), fresh Ginger, decoct 5. Chinese Red Dates (Da Zao), Green tea, decoct and add Honey 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. |