bubble_chart Concept

This condition refers to the symptoms in children of increased frequency of bowel movements, with stools that are thin or even watery, or completely undigested. It generally does not involve pus or blood, nor is there significant tenesmus.

In classical medical texts, this condition has many names. For example, Neijing refers to it as "soggy diarrhea," "lienteric diarrhea," and "profuse diarrhea." Zhubing Yuanhou Lun．miscellaneous disease in pediatrics 諸候》 calls it "diarrhea," "profuse diarrhea," "注下," "久利," "冷利," etc., and it is now collectively referred to as diarrhea. Zhengzhi Zhunsheng．幼科 divides "diarrhea" into nine types, with more detailed descriptions of symptoms and signs, reflecting significant progress in understanding.

bubble_chart Pattern Analysis

1. External Contractionwind-cold︰The diarrhea is clear, watery, and frothy with little foul odor, accompanied by borborygmus and abdominal pain, or aversion to cold with fever, nasal congestion, clear nasal discharge, mild cough, absence of thirst, thin white tongue coating, floating pulse, and red finger venules. $Wind-cold diarrhea and dampness-heat diarrhea! One is cold diarrhea, the other is heat diarrhea, with different disease causes and mechanisms of disease, manifesting distinct symptoms. Wind-cold diarrhea is caused by exposure to wind-cold pathogens. Suwen.Jutong Lun states: "Cold Xieke in the small intestine prevents the small intestine from retaining contents, hence resulting in diarrhea and intestinal pain." Its characteristics include: clear, watery diarrhea with little foul odor, borborygmus and abdominal pain, and may also present with nasal congestion, clear nasal discharge, absence of thirst, thin white tongue coating, floating pulse, and other symptoms of the pattern of common cold due to wind-cold. Treatment involves dispersing wind and dissipating cold, resolving dampness to expel pathogens, using Patchouli Qi-Righting Powder with modifications. Dampness-heat diarrhea is caused by exposure to summerheat-dampness pathogens, injuring the spleen and stomach, which then press downward on the large intestine, leading to diarrhea. Its characteristics include: loose or sticky diarrhea with a strong foul odor, or even sudden gushing diarrhea, and may also present with thirst but little desire to drink, scanty dark urine, yellow greasy tongue coating, slippery rapid pulse, and other symptoms of predominant dampness-heat. Treatment involves clearing heat and draining dampness, using Pueraria, Skullcap and Coptis Decoction with modifications.
2. Dampness-heat︰Fever or no fever, diarrhea that is thin or sticky, yellow or green in color, occurring more than ten times a day, accompanied by thirst, restlessness, scanty dark urine, a yellow and greasy tongue coating, a slippery and rapid pulse, and deep red or purple stagnant finger venules. Both conditions exhibit foul-smelling stools, a yellow or greasy tongue coating, a slippery or rapid pulse, and other manifestations of an excess heat pattern, but their disease causes and mechanisms differ, and their clinical symptoms vary. The disease cause of food injury (dyspepsia) diarrhea is improper feeding, which damages the spleen and stomach. Suwen· "On Bi Syndrome" states: "Overeating harms the intestines and stomach." When the spleen and stomach are injured, they cannot digest food properly, leading to water transforming into dampness and food into stagnation. When water and food are not separated, they pass together into the large intestine, resulting in food accumulation diarrhea. This condition is often caused by irregular eating habits and lacks obvious seasonality. Dampness-heat diarrhea is mostly caused by summerheat-dampness or dampness-heat pathogens and is more common in summer and autumn. Food injury (dyspepsia) diarrhea occurs due to the stagnation and indigestion of milk or food, leading to putrid accumulation in the intestines. Its characteristics include abdominal distension and pain, with pain prompting the urge to defecate and relief after diarrhea, foul-smelling stools resembling rotten eggs, and symptoms of food retention in the stomach and intestines such as fetid mouth odor, anorexia, and a yellow, greasy, and dirty tongue coating. Dampness-heat diarrhea, on the other hand, results from the accumulation of dampness-heat, causing loose and sticky stools or sudden, forceful diarrhea, sometimes up to ten or twenty times a day. Although the stools are foul-smelling, they do not have the distinct odor of rotten eggs. Additionally, symptoms such as scanty dark urine and a yellow, greasy tongue coating are present. Food injury (dyspepsia) diarrhea is treated by promoting digestion and removing food stagnation to harmonize the stomach, using modified Harmony-Preserving Pill.
3. Food Stagnation︰Abdominal pain with distension, sticky stools, foul-smelling diarrhea resembling rotten eggs, pain relieved after defecation, fetid mouth odor, anorexia, often accompanied by vomiting, yellow and thick or greasy tongue coating, slippery pulse, and dark red and hidden finger veins. $Food injury (dyspepsia) diarrhea and dampness-heat diarrhea! Both present with foul-smelling stools, yellow or greasy tongue coating, slippery or rapid pulse, and other signs of excess heat pattern, but their disease causes and mechanisms differ, and clinical symptoms vary. The cause of food injury (dyspepsia) diarrhea is improper diet, damaging the spleen and stomach. Suwen· "On Impediment" states: "Overeating injures the intestines and stomach." When the spleen and stomach are impaired, they fail to digest food properly, leading to water transforming into dampness and food into stagnation. As a result, water and food are not separated and flow together into the large intestine, causing food accumulation diarrhea. This condition is often linked to dietary indiscretion and lacks clear seasonality. Dampness-heat diarrhea is typically caused by summerheat-dampness or dampness-heat pathogens and is more common in summer and autumn. In food injury (dyspepsia) diarrhea, undigested food stagnates in the intestines, resulting in symptoms such as abdominal pain and distension, pain relieved after defecation, foul-smelling diarrhea resembling rotten eggs, fetid mouth odor, anorexia, and yellow, greasy, and dirty tongue coating—all signs of food retention in the stomach and intestines. In contrast, dampness-heat diarrhea arises from dampness-heat accumulation, leading to loose, sticky stools or sudden, forceful diarrhea, sometimes occurring 10 to 20 times a day. Although the stool is foul-smelling, it does not have the distinct odor of rotten eggs. Additionally, symptoms like scanty dark urine and yellow, greasy tongue coating are present. Food injury (dyspepsia) diarrhea is treated by promoting digestion, removing food stagnation, and harmonizing the stomach, using modified Harmony-Preserving Pill.
4. Spleen Deficiency︰Chronic diarrhea persists or occurs intermittently, with loose stools and undigested food, often occurring after meals. The complexion is sallow, accompanied by poor appetite, mental fatigue, drowsiness with eyes half-open, a pale tongue with thin white and moist coating, a deep and weak pulse, and faint or pale red finger veins. Typically, the condition has a prolonged course, often due to congenital weakness, spleen qi deficiency, improper post-illness care, or excessive use of cold and purgative medications, leading to spleen-stomach weakness, impaired transportation and transformation, and failure to separate the clear from the turbid, resulting in diarrhea. The characteristics include loose stools or undigested food, relatively infrequent diarrhea, along with symptoms such as emaciation, poor appetite, pale or sallow complexion, mental fatigue and weakness, a pale tongue, and a deep, weak pulse—all signs of spleen deficiency and qi weakness. Treatment focuses on strengthening the spleen to stop diarrhea, using modified Ginseng, Poria, and White Atractylodes Powder.

Diarrhea must be differentiated into cold, heat, deficiency, and excess. Cold diarrhea presents with clear and cold stools, clear urine, a pale tongue with thin white coating; heat diarrhea is characterized by sudden, forceful diarrhea with yellow, foul-smelling stools that burn the anus, scanty dark urine, a rapid and strong pulse, and a yellow greasy tongue coating; deficiency diarrhea often has a prolonged course, with undigested food in the stools, fewer bowel movements, emaciation, and a weak pulse; excess diarrhea has a shorter course, with frequent bowel movements, a robust physique, abdominal distension and fullness, abdominal pain that resists pressure, and a strong pulse. Children are prone to both deficiency and excess, often presenting with a mix of deficiency and excess, and intertwined cold and heat patterns. Therefore, a comprehensive analysis of pulse and complexion is essential, and careful differentiation is required.

bubble_chart Documentation

1. 《Youke Quanshu》: "All diarrhea is attributed to dampness."
2. Youke Fahui ．diarrhea》: "There are three types of diarrhea: cold, heat, and accumulation. Cold diarrhea is not thirsty... Heat diarrhea is thirsty... Accumulation diarrhea has a yellow face, and the discharge is sour and foul-smelling food. The general method for treating diarrhea, regardless of cold or heat, is to first take Middle-Regulating Pill , which regulates the middle qi. Treating diarrhea without benefiting the small intestine is not the correct treatment, Five Ingredients with Poria Powder is the main remedy. If it still does not stop, it is due to the sinking of stomach qi, Middle-Tonifying Qi-Replenishing Decoction , clearing the qi aspect to rise will stop the diarrhea. If it still does not stop, this is slippery diarrhea, and it should be astringed, whitefruit amomim fruit pills are the main remedy, this is a secret method passed down from ancestors."