Diarrhea & Dysentery

Diarrhea & Dysentery

Flux (Diarrhea)
Bloody Flux (Dysentery, or Diarrhea 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.
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:

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


Tormentil Bistort
Agrimony Camomile
Pomegranate flower Pomegranate rind
Galls Sumac
Rosehip Nutmeg
Chebula (scorched) Rhubarb (scorched)
Red Earth Kaolin
Alum Burnt Deer horn

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

Pulsatilla Bai Tou Weng Phellodendron Huang Bai
Agrimony (Xian He Cao) Plantain seed (Che Qian Zi)
Galls (Wu Bei Zi) Chebula (He Zi)
Coptis Huang Lian Scutellaria Huang Qin
Rosehip (Jin Ying Zi) Lotus seed (Lian Zi)
Nutmeg (Rou Dou Kou) Pomegranate rind
Schisandra Wu Wei Zi Prunus mume (Wu Mei)
Limonite (Yu Yu Liang) Alum (Bai Fan)
Red Earth (Chi Shi Zhi) Oven Earth (Zao Xin Tu)

Diarrhea

General for Diarrhea and Dysentery Acute Cold Damp
Syrup of Chebulic Myrobalan acute diarrhea, cramping abdominal, epigastric and abdominal distension, loss of appetite, nausea, lethargy.
Syrup of Quince with Spices (Nicholas) Huo Xiang Zheng Qi Shui
Syrup of Dry Rose Acute Damp Heat
Conserve of Pomegranate flower acute or recurrent diarrhea, burning and smells badly, maybe violent diarrhea, fever, restless, cramping abdominal pain, high colored urine, thirst.
Quince Conserve Ge Gen Huang Qin Huang Lian Tang
Micleta (Nicholas) Liver Qi Invading the Spleen
Athanasia Greater (Nicholas) recurrent diarrhea, stomach pain after diarrhea, abdominal distension, poor appetite, nausea, indigestion, flatulence, irritability.
Triphera Minor (Triphera Phoenonis) (Mesue) Bai Zhu Shao Yao San
Powder for Dysentery (Nicholas) Tong Xie Yao Fang
Powder for Dysentery (Riverius) Stomach and Intestine Cold / Damp
Powder for Dysentery of Galen diarrhea and loose stool, abdominal pain relieved by warmth, pale tongue with white coat, slow pulse.
Troches of Sealed Earth Gan Cao Gan Jiang Fu Ling Bai Zhu Tang
Troches of Ramich (Mesue) Li Zhong Wan
Pills Against Fluxes (Nicolas) Tao Hua Tang
Bilwadi Churna (Ayurveda) Spleen and Stomach Deficiency
Diarrhea, Chronic frequent loose stools or diarrhea, abdominal distension, poor appetite, fatigue, sallow complexion, puffiness around the eyes, weight loss.
Electuary of Scoria Ferri Bu Zhong Yi Qi Tang
Athanasia Magna Xiang Sha Liu Jun Zi Tang
Syrup of Chebulic Myrobalan Li Zhong Wan
Syrup of Myrtle Simple Ling Gui Zhu Gan Tang
Syrup of Myrtle Compound Shen Ling Bai Zhu San
Coptis 5 Pill (Tibetan Medicine) Yang Deficiency
Diarrhea, Bilious (from Bile Humor) 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.
Syrup of Chebulic Myrobalan Ling Gui Zhu Gan Tang
Syrup de Agresta Fu Zi Li Zhong Wan
Rob of Currant Si Shen Wan
Rob of Barberry Wen Pi Tang
Troches of Ramich (Mesue) Food Stagnation
Troches of Spodium (Avicenna) acute diarrhea or chronic intermittent diarrhea, foul smelling stools, abdominal distension and pain, bad breath, acid reflux, nausea, foul smelling flatulence.
Coptis 5 Pill (Tibetan Medicine) Bao He Wan
Crystal Moon 37 (Zla shel so bdun) (Tibetan Medicine) Jian Pi Wan
Diarrhea, Pituitous (from Phlegm Humor)
Syrup of Mint
Triphera Minor (Triphera Phoenonis) (Mesue)
Bilwadi Churna (Ayurveda)

Special Formula

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”. 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

Dysentery Damp Heat
Syrup of Marshmallow (Fernel) frequent foul-smelling diarrhea with blood and mucus, burning feeling when defecating, abdominal pain, scanty urine, red eyes, fever, restless, dry mouth.
Powder of Chebula and Rhubarb (Philon) Bai Tou Weng Tang
Powder of Tormentil Compound (Grieves) Ge Gen Huang Qin Huang Lian Tang
Powder for Dysentery (Nicholas) Huang Qin Tang
Powder for Dysentery (Riverius) Shao Yao Tang
Powder for Dysentery of Galen Lian Po Yin
Philonium Persicum Epidemic Heat and Toxin
Electuary of Micleta (Nicholas) explosive diarrhea with blood, high fever, severe abdominal pain, thirst, dehydration, headache, nausea, vomiting, irritable; in severe cases delirium, convulsion, severe cramping, cold limbs.
Troches of Coral (Diacorallium) (Nicholas) Huang Qin Tang
Bilwadi Churna (Ayurveda) Huang Lian Jie Du Tang
Diarrhea or Dysentery with Blood Bai Tou Weng Tang
1. Rhubarb (1 oz.), burnt Deer Horn (2 drams). Powder and form 3 boluses with Conserve of Roses. Zhi Bao Dan
2. Comfrey, burnt Rhubarb, Chebula Liver Qi Invading the Spleen
3. Comfrey, Knotgrass, Shepherd’s Purse, Cinquefoil, Plantain, Ribwort Plantain, Strawberry leaves (1 handful each), decoct. 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.
4. Woman’s Milk taken for 9 days together was said to cure any Bloody Flux Dan Zhi Xiao Yao San
Athanasia Greater (Nicholas) Spleen Qi Deficiency
Troches of Coral (Galen) 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

An Ayurvedic Compound 1. Decoct Green tea (2 grams) in 100 mls of water down to half.
  Barberry 2. Agrimony and aged Black tea, equal parts, decocted.
  Chebula 3. Prunus mume (Wu Mei) 1 piece, Black Tea, decoct
  Boerhaavia 4. Prunus mume (Wu Mei), fresh Ginger, decoct
  Tinospora 5. Chinese Red Dates (Da Zao), Green tea, decoct and add Honey
  Ginger ANCESTRAL POPPY AND MUME DECOCTION
Powder or Decoction (Ayurveda) (Zu Chuan Ying Mei Tang)
A PROVEN FORMULA FOR DYSENTERY   Poppy capsules (Ying Su Ke)   15 grams
  Yellow Myrobalans, parched   Licorice   9 grams
  Plantain seed, parched   Prunus mume (Wu Mei)   7 pieces
  Sorrel seed, parched   Black Pepper   7 pieces
  Endive seed, parched  3 drams ea.   Black tea   9 grams
  Cordial flowers (except 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.
  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)