Daxiang shi re

　　Mostly due to irregular and unclean diet, damaging the intestines and stomach, and the pathogenic factors of damp-heat taking advantage of the weakness to invade internally.

　　Damp-heat invades the large intestine, blocks the Qi mechanism, causing abdominal pain and urgent defecation; damp-heat scorches the intestines, damages the collaterals, and blood becomes pus, causing diarrhea with red and white pus and blood; damp-heat descends, and the transmission of food and water is lost, causing copious diarrhea with a yellow and smelly color; dampness blocks the large intestine, heat stagnates Qi, and the Qi mechanism of the large intestine is not smooth, causing loose stools; heat scorches the intestines, causing anal heat and ice-like fluid to leak from the stool, causing short and red urine; heat consumes body fluid, causing thirst, fever, and sticky and smelly stool. Red tongue with yellow greasy coating is the sign of damp-heat; when dampness is heavier than heat, the pulse is mostly thready; when heat is heavier than dampness, the pulse is mostly slippery and rapid.

　　In addition to general symptoms, it can also cause other diseases. This disease may appear with dysentery, diarrhea, abdominal pain, hemorrhoids, and other diseases. Therefore, once found, it needs to be treated actively, and preventive measures should also be taken in daily life.

　　Clinical manifestations:Excessive diarrhea with red and white sticky mucus, urgent defecation, or sudden copious diarrhea with a yellow and smelly color, increased frequency of defecation, anal heat, short and red urine, thirst, or aversion to cold with fever, or only fever without cold, red tongue with yellow greasy coating, slippery and rapid or soft and rapid pulse. Accompanied by abdominal pain, fever with sweating, chest and epigastric fullness, heavy limbs, poor appetite, and vomiting; seen in acute and chronic enteritis, acute bacterial dysentery, acute and chronic amebic enteritis, bacterial acute food poisoning, and other diseases.

　　1. Acupuncture:Take the acupoints of Tianju, Zusanli, Yinlingquan, Quchi, Weizhong; add Hegu and Quchi for those with fever, aversion to cold, and body pain; add Jinjin and Yuyin for summer heat, vomiting, and diarrhea; add Zhongwan and Neiguan for epigastric distension and pain; add Juque for food accumulation; add Shangjuxu and Xiaguan for sticky, smelly stool, urgent defecation, and strong stimulation. Quchi, Weizhong, Jinjin, and Yuyin can be punctured and bled, and cupping can be applied after needling Tianju. Add Pishu, Guanyuan, and Shenshu for rest痢. Treat once a day.

　　2. Cupping:Once a day, draw and suck at the acupoints of Dachangshu, Sanjiao, Qihai, Tianju, Guanyuan, and Zusanli.

　　Further diagnosis depends on laboratory tests. Bacterial enteritis can be diagnosed by vomiting and stool culture to obtain the pathogenic bacteria. Some pathogenic bacteria, such as Salmonella infection, can be detected through blood culture. Viral gastroenteritis can be checked by electron microscopy, immunoelectron microscopy, immunofluorescence, and serological tests such as complement fixation test, enzyme-linked immunosorbent assay, and radioimmunoassay to detect viral antigens and antibodies. Viral isolation can also be achieved by tissue culture. Parasitic enteritis can be directly examined under a microscope to find the pathogen and its eggs. Fungal enteritis can be detected by directly smearing stool under a microscope or by stool fungal culture.

　　In the hot summer of the Lingnan region, people often suffer from triple-energizer damp-heat. In traditional Chinese medicine, 'triple-energizer' refers to the heart, lungs, spleen and stomach, large and small intestines, and kidney and bladder. Baihuashecao winter melon stewed with lean pork is good for treating various symptoms caused by damp-heat accumulation in the lower jiao. The Chinese herbal medicine Baihuashecao can clear heat and detoxify, clear heat and dampness; Yimai can invigorate the spleen, tonify the lung, clear heat, and drain dampness; winter melon can dissipate summer dampness, nourish the stomach fluid, purify the body, relieve pain, promote diuresis, and reduce swelling. Lean pork can tonify the middle and invigorate the qi, nourish yin and increase the marrow. After being added to the soup, it can reduce the cold nature of Shejiecao and make the soup delicious and nutritious.

　　Ingredients: 120 grams of fresh Baihuashecao (35 grams for dried), 80 grams of Yimai, 500 grams of winter melon, 400 grams of lean pork, and 5 slices of ginger.

　　Cooking: wash all ingredients separately, slightly soak Shejiecao and Yimai; cut the lean pork into pieces. Boil them together with ginger in a clay pot, add 2500 milliliters of water (about 10 bowls), bring to a boil with high heat and then simmer over low heat for 2 hours, add salt before serving. Serves 3 to 4 people.

　　Treatment method

　　First, internal medicine formula

　　1. Basic formula:(1) Modified Shaoyao Decoction: 10 grams of Shaoyao, 10 grams of Huangqin, 6 grams of Huanglian, 6 grams of Dahuang, 15 grams of Yinhua, 10 grams of Biejiao, 10 grams of Danggui, 6 grams of Gancao, and 6 grams of Muxiang. This formula is suitable for patients with dysentery mainly characterized by abdominal pain, urgent need for defecation, and dysentery with red and white pus and blood. (2) Modified Ge Gen Qin Lian Decoction: 15 grams of Ge Gen, 10 grams of Huangqin, 6 grams of Huanglian, 6 grams of Gancao, 15 grams of Yinhua, 15 grams of茯苓, 6 grams of Mutong, and 10 grams of Cheqianzi. This formula is suitable for patients with diarrhea characterized by abdominal pain and urgent defecation. The above herbs are decocted in water, and 300 milliliters of juice are taken 2 to 3 times a day, one dose per day.

　　2. Modification and variation:If dysentery starts with an initial stage accompanied by exterior symptoms, add 10 grams of Jingjie, 6 grams of Fangfeng, and 10 grams of Qianghuo to the basic formula (1); if there is an excessive heat-toxin, with more red stools and fewer white stools, or pure red stools, add 15 grams of Baihetong, 10 grams of Qinpi, 10 grams of Diyu, and 10 grams of Danpi; if there is food retention, with greasy tongue coating and slippery pulse, add 10 grams of Shengtang, 10 grams of Qingpi, 10 grams of Chenpi, and 10 grams of Mangxiao (to be added to the decoction); if damp-heat lingers and does not go away, with intermittent dysentery, difficult to heal over time, add 6 grams of Renshen (or 15 grams of Dangshen), 10 grams of Baizhu, and 6 grams of Ganjiang; if dysentery starts suddenly and the exterior symptoms have been relieved but the dysentery has not stopped, Shaliangwan can be used, 6 to 9 grams per dose, taken three times a day; if the stools are a sauce-like color, appearing and stopping intermittently,鸦胆子仁 can be added for treatment, three times a day for adults, 15 grains each time, in capsules, taken after meals, for 7 to 10 days. If damp-heat diarrhea is characterized by an excess of dampness, with a slightly yellow and thick greasy tongue coating and a soft and slow pulse, add 10 grams of Houpu, 30 grams of Yiyen to the basic formula (2); for those with food retention, add 10 grams of Shengtang, 10 grams of Shanzha, and 10 grams of Maiya; if there are symptoms of wind-heat exterior syndrome such as fever, headache, and floating pulse, add 10 grams of Lianqiao and 10 grams of Bohe; if it is the peak of summer, consider adding 10 grams of Huoxiang, 10 grams of Xiangru, 6 grams of Biandouhua, and 6 grams of Heye.

　　Two, External Medication

　　1, Appropriate amount of Sophora flavescens powder, mixed with warm water into paste, apply to the navel.

　　2, Safflower powder, mixed with egg white into paste, apply to both feet Yongquan points.

　　3, 15 grams of alumen, 15 grams of schisandra, 15 grams of myrobalan, grind into fine powder, mixed with hot water into paste, apply to the Shenque point.

　　4, Lockjaw Dysentery Paste: 6 grams of tooth soap, 27 grams of asarum, 6 scallions (cleaned of soil, do not wash), 2 snails, 12 grams of wheat mold. Mix all the herbs, crush and mix into paste, apply to the Shenque point, cover with gauze and bandage, change when the medicine dries.

　　5, Heat Diarrhea Powder: 12 grams of coptis, 30 grams of talc, 15 grams of costus, 10 grams of evodia, mix all the herbs into powder, sift, take 10-15 grams of powder, apply on a 2-8 square centimeter adhesive plaster, respectively stick to the Shenque and Dachangshu points, change once a day.

　　6, 9 grams of rhubarb, or 4.5 grams of evodia or euphorbia, ground into fine powder, applied with vinegar to the navel and fixed. Suitable for patients with epidemic toxin dysentery and abdominal distension.

　　Three, Enema Therapy

　　In clinical practice, for patients with long-term recurrent symptoms, enema therapy is often used.

　　1, 30 grams of Dandelion, 30 grams of Patrinia scabiosaefolia, 30 grams of Spatholobus suberectus, 30 grams of Houttuynia cordata, 15 grams of Phellodendron amurense, decocted to 150 milliliters, retained enema when the temperature is between 30-40°C. If it can be retained for more than 8 hours, the efficacy is better.

　　2, 1 gram of Xilie powder, 1 gram of Yunnan Baiyao, 1 gram of Shengji powder, 5 milliliters of 5% procaine, mixed with 100 milliliters of normal saline, heated and retained enema.

　　3, 100 grams of Sophora flavescens, decocted to a concentrated solution, take 50 milliliters each time, add 5 milliliters of 1% novocaine, as a retention enema.

　　4, 60 grams of Pulsatilla chinensis, decocted into 100 milliliters of medicine, retain enema once a day, treat amebic dysentery.

　　5, 30 grams of garlic, crush and squeeze juice, add 160 milliliters of warm tap water, as a retention enema. Treat amebic dysentery.

　　6, 100-150 milliliters of 10-15% Chrysanthemum flower decoction, retain enema, once a day, 10-15 days as a course of treatment, rest for a few days before starting the second course.

　　Four, Diet Therapy

　　1, Portulaca oleracea and Mung Bean Soup:120 grams of fresh Portulaca oleracea (or 60 grams of dried product), 60 grams of mung beans, decoct and take. Take 1-2 times a day, for 3 consecutive days. The combination of the two is very effective for damp-heat diarrhea or heat-toxin blood dysentery.

　　2, Plantago ovata Drink:30 grams of Plantago ovata, wrapped in gauze, add 500 milliliters of water, boil to 300 milliliters, remove dregs, cook with glutinous rice to make porridge, divide and take 300 milliliters in two doses, take warm. Treat diarrhea.

　　3, Ginger and Coptis Powder:120 grams of ginger, squeeze juice; 30 grams of coptis, grind into powder, stir-fried over low heat with ginger juice, mix well until dry. Take 6 grams each time, washed down with green tea, three times a day. It is very suitable for patients with damp-heat diarrhea and vomiting.

　　4, Persimmon Peel Honey Paste:1000 grams of fresh persimmon peel (500 grams of dried product), chopped, boiled in a sand pot twice to extract the juice, then simmered over low heat until thick and sticky. Add 300 milliliters of honey, stir until boiling and stop heating, cool and bottle. Take 10 milliliters each time, dissolved in hot water, three times a day.

　　5. White honey Portulaca oleracea juice:Take 1000 grams of fresh Portulaca oleracea, wash clean with warm water, squeeze the juice, add 30 milliliters of white honey, or an appropriate amount of sugar, take it all at once, 2 times a day.

　　6. Green tea decoction:Boil 100 grams of green tea to make a concentrated juice of 300 milliliters, take 100 milliliters each time, add 10 milliliters of vinegar, and drink hot, 3 times a day. Or take 12 grams of green tea powder, for white dysentery, take with ginger soup, for red dysentery, take with licorice water, 3 times a day. Continue to take for 3 days after the symptoms disappear to consolidate the efficacy.

　　7. Amaranthus porridge:Take 100 grams of fresh Amaranthus tricolor, remove the roots, wash clean, chop, and cook with 100 grams of glutinous rice to make porridge, take twice a day, in the morning and evening. This porridge is particularly suitable for elderly patients with acute bacillary dysentery and enteritis.

　　8. Os manis wrapped Brucea javanica powder:Take 10 seeds of Brucea javanica, grind into powder, wrap with Os manis, and take 3 times a day to treat amebic dysentery. This formula is suitable for taking after meals and should not be taken for a long time.

　　Key Points of Treatment

　　1. Clinically, dysentery and diarrhea are mostly due to this condition, and treatment should focus on eliminating the evil. New cases of this condition are particularly common, and treatment should emphasize the principle of treating the cause of the symptoms, and avoid using astringent and astringent remedies. Dysentery patients should pay attention to the application of regulating Qi and promoting blood circulation, and if there is a lot of bleeding, it is necessary to use more blood-activating herbs; for diarrhea patients, it is necessary to use herbal formulas that differentiate damp-heat, and the diarrhea can be stopped. However, damp-heat diarrhea is prone to consume Qi and Yin, and elderly patients with physical weakness may lead to critical conditions of Yin and Yang injury or both Yin and Yang injury. In addition to treating according to the symptoms, great attention should also be paid to the changes in the condition of such patients.

　　2. When treating dysentery, it is necessary to always protect the stomach Qi. The herbal formulas for treating damp-heat dysentery are mostly bitter and cold, and should not be used in large quantities for a long time to prevent injury to the stomach Qi.

　　3. If this condition persists for a long time without healing, recurs frequently, showing that the body is weak and the evil lingers, it is advisable to use both reinforcing the body and eliminating the evil. The enema medicine is often an effective and feasible treatment method in clinical practice. Medicines include the White Hair Herb, Chinese toon bark, Phellodendron amurense, Prunella vulgaris, Indigo, Lithospermum erythrorhizon, Alum, Oyster, Prunus mume, Poppy shell, and Myrica rubra. Each dose is added with 1000 milliliters of water and boiled to 200 milliliters, humidity 37-38°C, initially using 50-100 milliliters for retention enema once in the morning and evening, and after adaptation, using 200 milliliters each time, enema once a day. The patient takes a lateral position, with the buttocks higher than the head, slow enema, and after enema, assume the chest-knee position for 15 minutes, then lie on the back for more than 1 hour.