Diarrhoea

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Textbook Prescriptions Digestive

Essentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.

Points

ST25 Tianshu bilateral

Front-Mu of the Large Intestine; regulates its transporting function to stop diarrhoea
BL25 Dachangshu bilateral

Back-Shu of the Large Intestine; paired with ST25 front and back
ST36 Zusanli bilateral

He-Sea of the Stomach; strengthens transportation by the spleen and stomach

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

Treatment Principle

Regulate the large intestine and stop diarrhoea, warming in cold and deficient types and clearing in the damp-heat type.

Indications

Acute cold-damp: watery stools with abdominal pain and borborygmi, chilliness eased by warmth, no thirst; pale tongue, white coating, deep slow pulseAcute damp-heat: yellow, hot, foul loose stools with abdominal pain, anal burning, scanty dark urine, possibly fever and thirst; yellow sticky coating, rolling rapid pulseChronic spleen yang deficiency: loose stools with undigested food, epigastric and abdominal distension, no appetite, tiredness; thin white coating, thready forceless pulseChronic kidney yang deficiency: diarrhoea at dawn with slight pain and borborygmi, cold abdomen and legs; white coating, deep forceless pulse

Method

Cold-damp: even method with moxibustion, or moxibustion on ginger. Damp-heat: reducing method. Chronic cases: reinforcing method with moxibustion; for kidney yang deficiency moxibustion can be the main treatment.

⚠ Cautions

Watch for dehydration, especially in children and the elderly; blood in the stool, high fever, or chronic diarrhoea with weight loss need medical investigation. BL25 and ST25 are safe at ordinary depth; avoid deep needling of ST25 in thin patients.

About

The colleges' base prescription for diarrhoea, built on the Front-Mu and Back-Shu points of the large intestine, with pattern-specific additions for acute and chronic types.

Rationale

ST25 and BL25 are the front and back collecting points of the large intestine and act together on its function to stop the diarrhoea. ST36 supports the spleen and stomach in transporting food and fluid, so the bowel is treated together with the organs that feed it.

Clinical Notes

Additions by pattern: cold-damp, CV12 and CV6 with needling and moxibustion to warm the middle; damp-heat, ST44, SP9 and LI4 with reducing method to clear damp-heat; spleen yang deficiency, BL20, LV13 and SP3 (the Back-Shu, Front-Mu and Yuan-Source of the spleen) with CV12, needled and moxaed; kidney yang deficiency, BL23, GV4 and KI3 to warm kidney yang, plus CV4, and GV20 with moxibustion to lift sinking qi. The book places acute and chronic enteritis, dyspepsia, intestinal parasites, pancreatic, liver and biliary disease, endocrine disorders and nervous diarrhoea under this heading.

Sources

Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Diarrhea, p. 357–359.

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