Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)Buy vitamins and supplements.Buy vitamins and supplements
01 The Process of the Creation of Feces 大便原委 대변이 만들어지는 과정
① In the Classic of Difficult Issues (難經), it is said, “The place where the large intestine and the small intestine meet is called the ileocecal conjunction.” When water and food are fermented in the stomach, they are delivered from the lower exit of the stomach to the upper entrance of the small intestine. As clear and turbid divide at the lower exit of the small intestine, fluid goes into the bladder and becomes urine and leftovers go into the large intestine and become feces. As they divide at the ileocecal conjunction, it is called the ileocecal conjunction because it is blocked with a door latch.
② In the Inner Classic (內經), it is said, “The large intestine is the delivering organ where transformed material comes out from.” In the Annotation, it is said, “What transformed material means is feces.”
02 The Causes of Feces Disease 大便病因 대변병의 원인
① Pathogenic wind and deficient pathogen are received from yang, and the loss of moderation in food and life is received from yin. It goes into the six bowels when received from yang and it goes into the five viscera when received from yin. When it goes into the six bowels, the body becomes feverish and the patient feels sleepy with dyspnea. When it goes into the five viscera, the stomach is blocked from bloating and undigested food comes out in feces and develops into jangbyeok (腸澼) [jangbyeok means dysentery] If it is not cured for a long time.
② If the patient get damaged by wind in spring, swill diarrhea occurs in summer.
③ When the patient gets damaged by wind in spring, the pathogen stays so it becomes flux diarrhea.
④ When wind that has stayed long invades, it becomes intestinal wind or swill diarrhea.
⑤ When clear-qi exists at the bottom, swill diarrhea occurs.
⑥ When dampness is excess, soggy diarrhea occurs. In the Annotation, it is said, “When dampness is excess it attacks the spleen-stomach to the inside. If the spleen-stomach gets attacked from dampness, water, and food are undivided, so the large intestine pushes them down as they are and the patient has diarrhea.”
⑦ That the spleen and stomach cannot save essential qi of water and food is because the door is not closed well. In the Annotation, it is said, “This is because the door of the large intestine is not closed.”
⑧ When cold is in the large intestine, most feces are watery like duck droppings; when heat exists, feces containing dysentery with mucus comes out.
⑨ What Changhou (腸垢) means is that juice builds up inside the intestines so dysentery with mucus appears. This is also called Cheha (滯下). It is called so because dampness and Fire are blocked in the intestines.
⑩ Causes of dysentery are two. First, is because the patient ate raw and cold things too much as thirst occurred in summer. Second is because wind-dampness invaded as the patient did not cover oneself with bedclothes. As the two kinds all make water and food undigested, it is when stagnantation and heat occur. When heat and dampness combine and there is the damage in the qi aspect, white dysentery occurs. When there is damage in the blood aspect, red dysentery occurs, and when it damages both qi and blood, red-white dysentery occurs.
⑪ Men of old times said, “Dysentery does not occur if there’s no accumulation.” It is all that people eat too many raw and cold things in summer and they cannot digest well, so foods accumulate and become blocked so dysentery occurs.
03 Color of the Feces 辨便色 대변의 색
① When the intestines are cold, a rumbling sound is heard in the abdomen and undigested food comes out by feces. When heat exists in the intestines, yellowish feces which looks like watery porridge comes out.
② If the color of diarrhea is white, it is a cold symptom, and if the color is blue, yellow, violet, red, or black, it is a heat symptom. Some people see blue dysentery as a cold symptom which is wrong. Bluish water coming out by dysentery due to a Cold Damage lesser yin disease is because heat exists inside. It is sure that most diarrhea being blue is due to a kid’s acute infantile convulsions belonging to heat. Yellowish dysentery is spleen-heat. Reddish dysentery is a heat symptom; it is the color of heart-Fire. A red color means that heat is severe. A black color means that the Fire-heat intensified too much and changed into Water.
③ If blood is cold, it binds, and becomes dysentery. Feces surely form the purple-black mass or blood-pus comes out mixed. Usually, pus results from a long period of accumulation, and blood is because of new accumulation.
④ When dampness is excess, the five diarrhea occur so it comes out as pouring water.
⑤ Heat dysentery is black-reddish and cold dysentery is white just like duck droppings. Dampness dysentery looks like black bean juice, and wind dysentery is diarrhea of bluish water. Qi dysentery looks like froth and red dysentery looks yellowish or a color similar to a fish’s brain. Deficient dysentery is as white as frozen mucus, and parasitic dysentery is as black as the liver of a chicken.
04 Diagnosis by Pulse Taking 脈法 맥법
① With diarrhea, the patient will live if the pulse is moderate or sometimes small and bound, and will die if it is floating, large and rapid.
② If the pulse is surging and large in diarrhea, it is unfavorable.
③ When a patient’s diarrhea consists of a bloody stool and the pulse is replete, it is hard to cure.
④ With diarrhea, the pulse is usually sunken. It is floating when damaged by wind, sunken and fine when damaged by cold, sunken and faint when damaged by summer-heat, and sunken and moderate when damaged by dampness.
⑤ With diarrhea, the pulse is normally sunken. If the pulse is sunken and short, it is damaged by cold; if it is sunken and rapid, it means the existence of Fire-heat. When it is sunken and vacuous, the anus opens so feces just flows out; when it is moderate and weak, it means damage by summerheat-dampness. This pulse mostly appears in the summer.
⑥ When blood-pus comes out by jangbyeok (腸澼), the patient will live if a sunken and small pulse continues, but will die when the pulse is rapid, racing, and large with heat.
⑦ If the pulse is faint, weak, and rapid in dysentery, it is that diarrhea is going to stop by itself, so even if fever exists, the patient does not die.
⑧ If the pulse is large in dysentery, it will not stop.
⑨ If the pulse is replete even though feces come out ten times a day due to dysentery, the patient will die.
⑩ With dysentery, the pulse has to be faint and small not surging or large.
⑪ With dysentery, the patient will live if the pulse is faint and small, and the disease will not be cured if the pulse is large, floating, and surging.
⑫ Dysentery does not occur if there is no accumulation. In the case of dysentery, the pulse has to be slippery and large. The patient will die suddenly if it is floating and string-like; it is okay if the pulse is sunken and fine.
⑬ With dysentery, the patient will live if the body is cold and the pulse is fine, but will die if the body has fever and the pulse is large.
⑭ With dysentery, it is good to have a faint and small pulse, and it is hard to cure if it is floating and surging.
⑮ When feces is blocked and the spleen-pulse is sunken and rapid so it connects down to cubit pulse, it is yang-type constipation. If the right and left cubit pulses are deficient or sunken, fine and slow, it is yin-type constipation. A floating right cubit pulse is constipation due to wind.
⑯ When the feces is dry and united, it is natural for the pulse to be sunken and hidden. The pulse is sunken and rapid with yang-type constipation and the pulse is sunken and slow with constipation due to weakness. With wind-dryness, the right cubit pulse is floating and obese.
⑰ If the pecking sparrow pulse appears to the old or deficient, the person is unable to relieve oneself, and it cannot be cured.
05 Five Kinds of Diarrhea 泄證有五 5가지의 설사
① There are stomach diarrhea, spleen diarrhea, large intestine diarrhea, small intestine diarrhea, and huge mass diarrhea.
② Stomach diarrhea results from undigested food and the feces is yellowish. A stomach Wind Decoction should be prescribed.
③ With spleen diarrhea, the stomach becomes bloated, diarrhea comes out, and the patient vomits right after eating. A Poria Calm Stomach Decoction should be prescribed.
④ With large intestine diarrhea, releasing feces becomes urgent after having food and the feces is white in color, and rumbling sounds are heard from the abdomen with excruciating pain. Five Ingredients Powder with Poria (五苓散) should be prescribed.
⑤ With small intestine diarrhea, urine does not come out well, blood-pus is shown in the feces, and the lower abdomen hurts. A Peony Decoction should be prescribed.
⑥ With huge mass diarrhea, there is a pulling pain in the abdomen, costive, and the patient frequents the restroom for relieving feces but in vain. The inside of the penis will hurt as well. A Rhubarb Decoction should be prescribed.
Stomach Wind Decoction 胃風湯 위풍탕
It treats abdominal pain and diarrhea that looks like black bean juice or static blood from dampness-toxin in the intestine-stomach. Ginseng Radix (人參), Atractylodis Rhizoma (蒼朮), Poria Sclerotium (茯苓), Angelica Gigantis Radix (當歸), Cnidii Rhizoma (芎藭), Paeoniae Radix (芍藥), Cinnamomi Cortex (桂皮), and Glycyrrhizae Radix (甘草) 1 don each. Slice these medicines, put one handful millet and decoct it in water as 1 pack and take.
Poria Calm Stomach Decoction 胃苓湯 위령탕
It treats diarrhea, abdominal pain, and undigested water-food from the excess of dampness in the spleen-stomach. Atractylodis Rhizoma (蒼朮), Magnoliae Cortex (厚朴), Citrus Unshius Pericarpium (陳皮), Polyporus (猪苓), Alismatis Rhizoma (澤瀉), Atractylodis Rhizoma (蒼朮), Poria Sclerotium (茯苓), Paeoniae Radix (芍藥) 1 don each, Cinnamomi Cortex (桂皮), and Glycyrrhizae Radix (甘草) 5 pun each. Slice these medicines as 1 pack, put 3 pieces of Zingiberis Rhizoma (乾薑), 2 Zizyphi Fructus (大棗), decoct it in water, and take.
06 Many Kinds of Diarrhea 泄瀉諸證 여러 가지 설사
① There are many kinds of diarrhea: Dampness diarrhea, Soggy diarrhea (濡泄), Wind diarrhea, Cold diarrhea, Summerheat diarrhea, Fire diarrhea, Heat diarrhea, Deficient diarrhea, Efflux diarrhea (滑泄), Swill diarrhea (飱泄), Alcohol diarrhea (酒泄), Phlegm diarrhea (痰泄), Food accumulation diarrhea (食積泄), spleen diarrhea (脾泄), kidney diarrhea (腎泄), spleen-kidney diarrhea (脾腎泄), Dawn diarrhea (瀼泄), Fulminant diarrhea (暴泄), Throughflux diarrhea (洞泄), and Chronic diarrhea (久泄).
② As diarrhea always accompanies dampness, first of all, make the division well and go through in the middle energizer, and you have to make urine go out in the lower energizer. It should be pulled up if it is prolonged and one should top it with astringent medicine only after it is sure that the feces does not stop.
③ When tonifying for diarrhea, medicines with sweet, warm, or too sweet properties should not be used. It is because a sweet taste creates dampness. Bitter medicines should also be avoided when lowering heat because the bitter taste damages the spleen. It is good to make urine come out well only with a plain tasting activator.
④ To make water and food divide well and go through, Five Ingredients Powder with Poria (五苓散) should be taken with water decocted with Plantaginis Semen. Then the middle energizer should be treated with an Order the Center Decoction or Treat the Center Decoction. If it is still uneffective even after treating the middle energizer, the medicines that stops diarrhea should be prescribed. Prescribe a Stabilize Yang Pill.
⑤ To manage the middle energizer first in treating diarrhea, prescribe an Order the Center Decoction and Order the Center Pill. Because water and food have to be divided well and go through, next use Five Ingredients Powder with Poria (五苓散). As diarrhea should be blocked, if it is ineffective to cure the middle energizer, Halloysite, and Limonite Decoction (赤石脂禹餘粮湯) should be prescribed.
⑥ Most medicines that cure diarrhea are made and taken in a pill form.
⑦ With diarrhea, clear, white, and unblocked urine is a cold symptom, while red difficult urination is a heat symptom.
⑧ Cold hands and feet are a cold symptom, and warm hands and feet are a heat symptom.
⑨ Feces of undigested food, no change in color, vomiting, and having diarrhea of fishy or dirty things, clear, white and unblocked urine, a cold body with no thirst, and a faint, fine, and slow pulse are all cold symptoms. If food is digested, it can be judged as a heat symptom no matter what color or what other symptoms appear. There is no way that food can be digested in the cold symptom.
⑩ Sometimes, there is a case of Swill diarrhea with the Fire property that is urgent, so undigested food comes out undigested. Zhang Zhongjing (仲景) said, “Pathogenic heat cannot digest food. Therefore, if heat combines with dampness, swill diarrhea occurs.
⑪ Sudden diarrhea is not a yang symptom and chronic diarrhea is not a yin symptom.
⑫ When curing diarrhea throughout, a Three Whites Decoction (三白湯), Decoction to Dry Dampness (燥濕湯), Augment Base Powder (益元散) should be prescribed.
Stabilize Yang Pill 固腸丸 고장환
It treats chronic diarrhea or dysentery. When feces comes out often and flows out so the body becomes thin and weak, it should be stopped with this prescription. Fossilia Ossis Mastodii (龍骨), Aconiti Lateralis Radix Preparata (附子) (baked after wrapping with watery paper), Alumen (礬石) (baked), Terminaliae Fructus (訶子皮) 1 nyang each, Syzygii Flos (丁香), Alpiniae Officinari Rhizoma (良薑), Halloysitum Rubrum (赤石脂), Amomi Fructus (縮砂), Rotundus (白豆蔲), Amomi Fructus (砂仁) 5 don each, and Aucklandiae Radix (木香) 3 don. Powder these medicines, make a paste by combining with vinegar, and make into pills the size of a royal foxglove tree seed. Take 30 pills with porridge made of millet.
Three Whites Decoction 三白湯 삼백탕
① It treats all kinds of diarrhea. Atractylodis Rhizoma (蒼朮), Poria Sclerotium (白茯苓), Paeoniae Radix (芍藥) 1.5 don each, and Glycyrrhizae Radix (甘草) (baked) 5 pun. Slice these medicines, decoct in water as 1 pack, and take it.
② These three white medicines are important medicines in treating diarrhea.
Decoction to Dry Dampness 燥濕湯 조습탕
① It treats all kinds of diarrhea. Atractylodis Rhizoma (蒼朮) 2 don, Poria Sclerotium (白茯苓), Paeoniae Radix (芍藥) (baked) 1.5 don each, Citrus Unshius Pericarpium (陳皮) 1 don, Glycyrrhizae Radix (甘草) (baked) 5 pun. Slice these medicines, decoct it in water as 1 pack and take.
② This is Citrus Unshius Pericarpium (陳皮) added to a Three Whites Decoction.
③ This is also called an Atractylodes, Poria, and Peony Decoction.
