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Any deviation from established bowel rhythm characterized by increased frequency of the stool; the semi-liquid or liquid stool characteristic of this condition. Diarrhea occurs in vacuity, repletion, cold, and heat patterns.

• Fulminant (sudden and violent) diarrhea usually indicates repletion.
• Enduring diarrhea generally indicates vacuity, or a vacuity-repletion complex.
• Diarrhea characterized by ungratifying defecation and foul-smelling stool, and associated with abdominal pain indicates damp-heat in the large intestine.
• Diarrhea characterized by frequent defecation with blood and pus in the stool, abdominal pain, tenesmus, and a burning sensation in the rectum constitutes dysentery, which is another form of large intestine damp-heat.
• Abdominal pain followed and relieved by diarrhea is most often attributable to food accumulation.
• Bouts of diarrhea with abdominal pain that is unrelieved by defecation are brought on by emotional stimuli in patients suffering from liver-spleen disharmony.
• Diarrhea occurring shortly after eating indicates spleen-stomach qì vacuity.
• Diarrhea each day before dawn is known as early morning diarrhea (fifth-watch diarrhea) and is attributable to spleen-kidney yáng vacuity.
• Diarrhea with loss of voluntary control over bowel movements, sometimes accompanied by prolapse of the rectum, is known as intestinal vacuity efflux desertion and is attributed to vacuity cold or to center qì fall.
• Fulminant diarrhea and vomiting is a sign of cholera, which includes what Western medicine calls cholera and some forms of gastroenteritis.

Specific types of diarrhea are named in three ways: according to pathomechanism, according to the associated morbid bowel or viscus, and according to signs.

Diarrhea

Classification According to Causes

• Cold diarrhea
• Heat diarrhea
• Summerheat diarrhea
• Food damage diarrhea
• Vacuity diarrhea

Classification by Morbid Bowel or Viscus

• Spleen diarrhea
• Kidney diarrhea

Classification According to Features

• Sloppy diarrhea
• Enduring diarrhea
• Early morning diarrhea
• Efflux diarrhea
• Outpour diarrhea
• Food diarrhea
• Clear-grain diarrhea

These categories are not mutually exclusive. Food damage diarrhea, for example, is the result of damage to the digestive system by ingested food, as opposed to preexisting dysfunction. It may therefore include certain forms of stomach, large intestine, and small intestine diarrhea, but excludes large intestine diarrhea due to lung qì vacuity.

Association between causes and form of diarrhea is variable. For example, kidney diarrhea is always a form of fifth-watch diarrhea, whereas sloppy diarrhea may be part of either heat or cold patterns.

Etymology

Chin 泄 xiè pour, flow, discharge; explained in this context to mean remittent sloppy stool; 泻 xiè, flow, drain; explained in this as meaning defecation like the pouring down of water. The two characters therefore cover the various forms of diarrhea.

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