Dysentery

WESTERN MEDICINE: Dysentery usually includes the bacillary dysentery, and amebic dysentery. Bacillary dysentery Is an acute infection of the bowel, caused by organisms of the Shigella group and characterized by frequent passage of stools containing blood, pus, and mucus, accompanied by abdominal cramps, tenesmus, malaise, and fever. Amebic dysentery is an infectious disease caused by Entamoeba histolytica, producing a colitis characterized by the painful passage of bloody mucoid stools but often causing only mild symptoms.

SYMPTOMS AND SIGNS: The typical symptoms of dysentery are: abdominal pain and fullness, rectal tenesmus, frequent passage of stools containing blood, pus, and mucus. Mostly occurs during the summer and fall seasons. White or yellow greasy tongue coating, slippery or rapid pulse in the damp heat type; pale tongue, white, thin and greasy tongue coating, thready, slow or weak pulse in the cold damp or spleen deficient type.

Bacillary dysentery, amebic dysentery of western medicine are included in this disease; hypersensitive colitis, chronic ulerative colitis can also consider the treatment in this category according to Chinese medicine. 

ETIOLOGY AND PATHOLOGY: Dysentery is caused by the damage of spleen, stomach and intestine due to exogenous damp-heat, the seasonal infectious Qi, or irregular food intake. The location of dysentery is the intestine. All those damp-heat, cold-damp, seasonal infections combined with Qi and blood obstruct the intestines, damage the collaterals (vessels), causing the frequent passage of stool with blood, pus, and mucus. The basic factor for the cause of dysentery is the deficiency of spleen and stomach. During the chronic stage, kidneys will usually be involved and show their deficiency at certain degrees.

DIFFERENTIATIONS:

1. Dysentery due to Damp-Heat:

Indications: Abdominal pain and fullness, especially at lower abdomen, frequent urgent passage of stools with blood, pus and mucus, equal amount of blood and mucus and pus. Burning sensation around anus area, rectal tenesmus, scanty urine, red tongue, yellow and greasy tongue coating, slippery and rapid pulse.

Treatment & Formulas: Eliminate the damp-heat, assisted with the herbs to regulate the Qi and blood.

Products:

    • Shuo Yao Tang (Paeonia Combination): This is a typical formula to treat dysentery of damp-heat type. Its ingredients are the following:
    • Bai Shao Yao (Paeonla Radix, Item No. 1056): 26%
    • Dang Gui (Angelica Sinenusu Radix, Item No.1214): 12%
    • Huang Lian (Coptis Rhizoma, Item No. 1073): 12%
    • Bing Lang (Areca Semen, Item No. 1250): 7%
    • Mu Xiang (Saussurea Radix, Item No. 1032): 7%
    • Da Huang (Rheum Rhizoma, Item No. 1013): 12%
    • Huang Qin (Scutellaria Radix, Item No. 1192): 12%
    • Rou Gui (Cinnamomum Cortex, ltem No. 1079): 7%
    • Gan Cao (Licorice, Item No. 1072): 7%
    • Ge Gen Huang Lian Huang Qin Tang (Pueraria, Coptis, and Scute Combination, Item No. 2224): This is a very good formula to treat dysentery due to the damp-heat. It Is often applied for acute gastroenteritis, colitis, diarrhea, vomiting and hypertension, which are all caused by damp-heat. 
    • Huang Lian Tang (Cortis Combination, Item No. 2209): This eliminates the damp-heat, at same time it harmonizes the relationship spleen and stomach (or intestines). 
    • Shan Huang Xie Xin Tang (Coptis and Rhubarb Combination, Item No. 2026): This is a purgative formula to treat damp heat symptoms. 
    • Huang Lian Jie Du Tang (Coptis and Scute Formula, Item No. 2212): This eliminates the damp-heat San Jia (Triple Burner): lung, stomach and lower burner of intestines or bladder.
    • Jing Fang Bai Du San (Schizonepeta and Siler Formula, Item No. 2166): This treats dysentery with external wind symptoms such as aversion to cold, fever, headache sore and tight body.

2. Dysentery due to Seasonal Infectious Qi:

Indications: Sudden onset of fever, thirsty, headache, restlessness, or even coma, spasmodic abdominal pain, urgent and burning sensation around
rectal tenesmus, frequent passage of stools with blood, mucus and pus, more blood than mucus and pus, the color of blood is bright. Red or dark red tongue, yellow and dry coating, slippery and rapid pulse.

Treatment & Formulas: Eliminate the damp heat, cool blood and detoxify the seasonal infectious Qi.

Products:

    • Bai Tou Weng Tang (Anemone Combination, Item No. 2073): This is the most effective and popular formula used for dysentery due to damp-heat or with seasonal infectious Qi. It eliminates the damp-heat, and cools blood at same time. It can apply for both bacillary dysentery and amebic dysentery. 
    • Ren Shen (Ginseng Radix, Item No. 1321) and Fu Zi (Baked Aconitum Radix, Item No. 1294): This should be used for serious cases: coma, loss of consciousness, or profuse perspiration are present. 

3. Dysentery due to Cold - Damp:

Indications: Frequent passage of stool with blood, pus and mucus, there are more pus and mucus than blood: or totally pus and mucus, abdominal pain, rectal tenesmus, poor appetite, full and suffocating sensation of epigastric region, heaviness of head or body, fatigue. The tongue is pale with white and greasy coating, thready and slow pulse. 

Treatment & Formula: Eliminate the cold - dampness by warming method, assisted with Qi regulation, or blood regulation. 

Products:

    • Wei Ling Tang (Magnolia and Hoelen Combination, Item No. 2135): This is a typical formula for dysentery due to cold damp type. 

4. Dysentery due to Deficient Cold:

Indications: Chronic dysentery, loose stool with white pus and mucus, slight pain at abdominal region, no taste in mouth, poor appetite, fatigue, cold limbs and body, pale tongue, white and thin tongue coating, thready and weak pulse. 

Treatment & Formulas: Tonic for spleen and warms the stomach and intestines, eliminates the cold dampness. 

Products:

    • Li Zhong Tang (Ginseng and Ginger Combination, Item No. 2191): This is a good formula to treat dysentery and diarrhea of deficient cold type. It is also used for gastritis, gastroptosis, peptic ulcer, hemoptysis due to the spleen Yang deficiency. 
    • Shen Ling Bai Zhu San (Ginseng and Atractylodes Formula, Item No. 2173): It treats the chronic digestive diseases or due to spleen deficiency.
    • Bu Zhong Yi Qi Tang (Ginseng and Astragalus Combination, Item No. 2225): This is used in the chronic stages of dysentery when the Qi of spleen and stomach are weak.

5. Dysentery in Recurrent Form: 

Indications: Dysentery in resting situation, or recurrent for a long period of time, when it does occur, it shows the typical symptoms of dysentery; when it stops, symptoms show poor appetite, fatigue, cold limbs and body. Pale tongue, greasy coating, thready pulse.

Treatment & Formulas: Tonify the spleen and stomach, clear damp heat, promote the circulation of Qi and blood. 

Products:

    • Li Zhong Tang (Ginseng and Ginger Combination, Item No. 2191) plus the single herb Huang Lian (Coptis Rhizoma, Item No. 1073): This combined formula can tonify the spleen and stomach at the same time, it can eliminate the damp-heat. This is good for the chronic stage of dysentery when there is deficiency of spleen and stomach, but the internal damp heat still stays in the intestine causing the recurrence of dysentery. 
    • Xiang Sha Liu Jun Zi Tang (Saussurea Cardamon Combination, Item No. 2125): This formula can be used to strengthen the function of spleen and stomach before the dysentery recurs. 
    • Wen Qing Yin (Tang-kuei and Gardenia Combination, Item No. 2226): It tonifies the blood and clears the interior damp-heat at the same time. It can be used at the intermit period of dysentery. 
    • Ba Wei Di Huang Wan (Rehmannia Eight Formula, Item No. 2011): This can be used in intermit period of dysentery when kidney deficiency symptoms show, such as soreness and weakness of lumbar region, cold sensation at lower part of body, etc. 

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