Fecal incontinence

Involuntary loss of stool. Fecal incontinence is attributable to spleen-kidney yáng vacuity, qì vacuity fall, or exuberant heat toxin.

Patterns

Spleen-kidney yáng vacuity (脾肾阳虚 pí shèn yáng xū) causes prolonged diarrhea with frequent defecation the makes the anus incapable of containment so that there is periodic discharge of slimy stool. Other signs include physical cold and fear of cold lack of warmth in the limbs, reduced eating, abdominal distension, aching lumbus, tinnitus, and long voidings of clear urine. The tongue is pale and enlarged with white, possibly glossy, fur. The pulse is sunken and fine.

Medicinal therapy: Treat by warming and supplementing the spleen and kidney, assisted by promoting astriction and stemming desertion. Use Six Pillars Beverage (六柱饮 liù zhù yǐn) with cinnamon bark (Cinnamomi Cortex, 肉桂 ròu guì), dried ginger (Zingiberis Rhizoma, 干姜 gān jiāng), and halloysite (Halloysitum Rubrum, 赤石脂 chì shí zhī).

Acumoxatherapy: Base treatment mainly on CV, GV, and back transport points. Select BL-25 (Large Intestine Transport, 大肠俞 dà cháng shù), BL-20 (Spleen Transport, 脾俞 pí shù), BL-23 (Kidney Transport, 肾俞 shèn shù), GV-4 (Life Gate, 命门 mìng mén),^mx CV-4 (Pass Head, 关元 guān yuán),^mx CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), LR-13 (Camphorwood Gate, 章门 zhāng mén), ST-25 (Celestial Pivot, 天枢 tiān shū), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ); needle with supplementation and moxa. Cross moxa can be applied.

Qi vacuity fall (气虚下陷 qì xū xià xiàn) causes involuntary passing of stool of which the patient is unaware at the time. In severe cases, there is prolapse of the rectum. Other signs include emaciation, dullness of essence-spirit, poor appetite, oppression in the stomach duct after eating, heart palpitation and shortness of breath, scantness of breath and laziness to speak, faint low voice, and a bright-white facial complexion. The tongue is pale and enlarged with dental impressions on the margins. The pulse is sunken, fine, and forceless.

Medicinal therapy: Supplement the center and boost qì; raise the fall and stem desertion. Use Pure Yáng True Man Viscus-Nourishing Decoction (纯阳真人养脏汤 chún yáng zhēn rén yǎng zàng tāng) plus astragalus (Astragali Radix, 黄芪 huáng qí), and dried ginger (Zingiberis Rhizoma, 干姜 gān jiāng).

Acumoxatherapy: Base treatment mainly on GV and BL. Select GV-20 (Hundred Convergences, 百会 bǎi huì), BL-25 (Large Intestine Transport, 大肠俞 dà cháng shù), GV-1 (Long Strong, 长强 cháng qiáng), BL-57 (Mountain Support, 承山 chéng shān), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), and CV-6 (Sea of Qì, 气海 qì hǎi); needle with supplementation and moxa.

Intense heat toxin (热毒炽盛 rè dú chì shèng) causing fecal incontinence is observed in epidemic toxin dysentery. This disease begins rapidly and is characterized by diarrhea that contains pus and bright purple blood or that is like blood water. Other signs include high fever, vexation and agitation, and thirst. In severe cases, there is tetanic reversal and clouded spirit with involuntary discharge of stool. The tongue is red with yellow fur. The pulse is surging and rapid or slippery and rapid.

Medicinal therapy: Clear heat and resolve toxin; cool provisioning and open the orifices. Use Coptis Toxin-Resolving Decoction (黄连解毒汤 huáng lián jiě dú tāng) combined with Pulsatilla Decoction (白头翁汤 bái tóu wēng tāng). For orifice block with clouded spirit, use Peaceful Palace Bovine Bezoar Pill (安宫牛黄丸 ān gōng niú huáng wán) or Supreme Jewel Elixir (至宝丹 zhì bǎo dān).

Acumoxatherapy: Base treatment mainly on LI and ST. Select LI-4 (Union Valley, 合谷 hé gǔ), ST-25 (Celestial Pivot, 天枢 tiān shū), ST-37 (Upper Great Hollow, 上巨虚 shàng jù xū), ST-44 (Inner Court, 内庭 nèi tíng), LI-11 (Pool at the Bend, 曲池 qū chí), and GV-14 (Great Hammer, 大椎 dà zhuī), needling with drainage; prick the Ten Diffusing Points (十宣 shí xuān) to bleed.

See efflux diarrhea.