DIARRHEA

Lee Chong Leng

1

CONTENTS

1)

Introduction 4

2)

Clinical Manifestations 10 - 15

3)

Essentials for Diagnosis 16 - 17

4)

Treatment with Tuina Therapy

18 - 42

5)

Cautions 433

DIARRHEA

May occur at any time, especially in summer and autumn

Frequent and sloppy stool, sometimes even appearing like water

Similar to intestinal inflammation, chronic enteritis, gastrointestinal neurosis and non-specific ulcerated colitis in Western medicine

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DIARRHEA

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CLINICAL MANIFESTATIONS

• 1. Acute diarrhea• (1) Attack of dampness• (2) Improper diet• 2. Chronic diarrhea• (1) Deficiency of spleen & stomach• (2) Yang deficiency of kidney &

spleen• (3) Liver Qi over-straining the

spleen10

ACUTE DIARRHEA

(1) Attack of dampness

Sudden onset with thin and loose stool or mixed with mucus, ten times a day

Accompanied by abdominal pain, borboygmus, aching pain of the extremities, yellowish or whitish greasy tongue coating, soft or rapid and slippery pulse11

ACUTE DIARRHEA(2) Improper diet

Sudden onset with a history of improper diet, diarrhea with rotten egg smell

Accompanied by abdominal distension, foul belching, alleviation of pain after diarrhea, acid regurgitation, thick greasy tongue coating, soft or rapid slippery pulse 12

CHRONIC DIARRHEA(1) Deficiency of spleen and

stomach

Usually occur after taking greasy, oily food, marked by loose or watery stool

Poor appetite, pale tongue with whitish tongue coating, slow and weak pulse

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CHRONIC DIARRHEA(2)Yang deficiency of kidney and

spleen(3)Diarrhea accompanied by pain

around the umbilicus occurring at dawn and right after borboygmus

(4)Pain is relieved after diarrhea (5)Other symptoms include cold

feeling in abdomen, aching and coldness in the waist and limbs, pale tongue with whitish coating, deep and thin pulse

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CHRONIC DIARRHEA

(3) Liver Qi over-restraining the spleen

Often induced by excessive emotional changes

Accompanied by abdominal pain, borborygums, full sensation in the chest and hypochondriac regions, belching, thin tongue coating, taut and thin pulse

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ESSENTIALS FOR DIAGNOSIS

1. Loose or watery feces, increased frequency, often abdominal distension

2. Sudden onset of acute fulminate diarrhea with short duration, aversion of cold and fever

3. Slow onset of chronic diarrhea with longer duration and frequent relapse and fluctuation 16

ESSENTIALS FOR DIAGNOSIS

4. Improper diet, cold attack or emotional changes that can lead to diarrhea

5. Red and white blood cells can be seen in stool test, the bacteria culture of stool is either positive or negative

6. Barium meal X-ray examination or intestinal endoscope should be done if necessary

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TREATMENT WITH TUINA THERAPY

Principle:

Invigorating the spleen and harmonizing the stomach, warming the kidney to strengthen yang, soothing the liver to regulate Qi

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TREATMENT WITH TUINA THERAPY

Acupoint and location:

Zhongwan (CV 12), Tianshu (ST 25), Qihai (CV 6), Guanyuan (CV 4)

Pishu (BL 20), Weishu (BL 21), Shenshu (BL 23), Dachangshu (BL 25) and Changqiang (GV 1)

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TREATMENT WITH TUINA THERAPY

Operation 1:

(1)Patient - lateral recumbent position

(2)Push first gently and then strongly from Zhongwan (CV 12) down to Qihai (CV 6) and Guanyuan (CV 4) for 5-6 times

(3)Rub the abdomen counter-clockwise for about 8 minutes.

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Zhongwan (中脘 ) ， Tianshu (天枢 ) ， Qihai (气海 )

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Guanyuan (关元 )

TREATMENT WITH TUINA THERAPY

Operation 2:(1)Patient - prone position

(2)Roll from Pishu (BL 20) to Dachangshu (BL 25), 1 minute each

(3)Press Pishu (BL 20), Weishu (BL 21), Dachangshu (BL 25) and Changqiang (GV 1) repeatedly for about 3-4 times

(4)Rub the left side of the back until it is warm for about 10 minutes

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Geshu (膈俞 ) ， Ganshu (肝俞 ) ， Pishu (脾俞 ) ， Shenshu (肾俞 )

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Shenshu (肾俞 ) ， Dachangshu (大肠俞 )

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Weishu (胃俞 )

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Changqiang (长强 )

MANIPULATIONSACCORDING TO

SYNDROME DIFFERENTIATION

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(1) COLD AND DAMPNESS

Rub Shenque (CV 8), Qihai (CV 6) until the abdomen becomes warm

Press and rub Zusanli (ST 36) and Neiguan (PC 6) for 1 minute each

Rub the left side of the back and lumbosacral region till it turns warm

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Shenque (神阙 )

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Zusanli (足三里 )

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Neiguan (内关 )

(2) IMPROPER DIET

Rub the abdomen clockwise

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(3) GASTRICSPLENIC DEFICIENCY

Rub Guanyuan (CV 4) and Zusanli (ST 36) gently for 2 minutes each

Rub Qihai (CV 6) for a longer period of time

Rub the whole abdomen anticlockwise, mainly focusing on the epigastric region

Rub the lower abdomen clockwise

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(4) YANG DEFICIENCY IN BOTH SPLEEN AND

KIDNEYS

Rub gently Qihai (CV 6) and Guanyuan (CV 4) for 3 minutes each

Rub vertically the govern vessel on the back

Rub transversely Shenshu (BL 23), Mingmen (GV 4) and Baliao

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36

Mingmen (命门 )

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Baliao (八髎 )

(5) LIVER QI OVER RESTRAINING THE

SPLEEN Press and knead gently

Zhangmen (LR 13) and Qimen (LR 14) for about 5-10 minutes

Rub obliquely backward and forward hypochodrium region until it is slightly warm

Rub Ganshu (BL 18), Danshu (BL 19), Geshu (BL 17), Taichong (LR 3) and Xingjian (LR 2)

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Qimen (期门 ) ， Zhangmen (章门 )

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Geshu (膈俞 ) ， Ganshu (肝俞 ) ， Pishu (脾俞 ) ， Shenshu (肾俞 )

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Danshu (胆俞 )

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Dadun (大敦 ) ， Xingjian (行间 ) ， Taichong (太冲 )

CAUTIONS

1. Abstain from starch and fat food, avoid food difficult to digest

2. Keep warm, avoid overstrain and pay attention to mental state and diet

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THANK YOU