Intestinal heat bowel pattern

Also:

• Large intestine heat bind (大肠热结 dà cháng rè jié)
• Large intestine repletion heat (大肠实热 dà cháng shí rè)
• yáng brightness (yáng míng) bowel pattern (阳明腑证 yáng míng fǔ zhèng)

A disease pattern chiefly characterized by heat effusion; constipation; abdominal fullness, hardness, and pain.

NB: Intestinal heat bowel repletion is a modern bowel and visceral pattern identification name for the traditional yáng brightness (yáng míng) bowel pattern.

Description: High fever (vigorous heat effusion) or late afternoon tidal heat effusion; copious sweat (streaming sweat); thirst; distension, fullness, hardness and pain in the umbilical region that refuses pressure; constipation; in some cases, heat bind with circumfluence with foul-smelling stool; short voidings of yellow urine; in severe cases, clouded spirit, delirious speech, and manic derangement; red tongue with thick dry yellow fur or black fur with prickles; a pulse that is sunken and rapid (or slow) and forceful.

Diseases: Constipation; abdominal pain; cold damage greater yáng (tài yáng) (yáng míng) disease; warm disease.

Pathogenesis: Externally contracted heat evil damaging intestinal humor and creating dryness-heat that causes the stool to bind. This may occur

• in cold damage, when evils in the exterior transform into heat and pass into the interior or
• in warm disease, when warm-heat evil enters the intestines.

In either case, excessive sweating (including inappropriately induced sweating) may be a contributory factor.

Note that in cold damage (six-channel pattern identification), this pattern is called a yáng brightness (yáng míng) bowel pattern. In warm disease, it is a qì-aspect pattern in the four-aspect pattern identification system and a center burner pattern in triple burner pattern identification. See yáng brightness (yáng míng) disease patterns, qì-aspect patterns, center burner patterns.

Analysis of signs

• Heat in the large intestine: Late afternoon tidal heat effusion. The large intestine is associated with yáng brightness (yáng míng), whose channel qì is strongest in the late afternoon watch (3–5 pm).
• Intestinal heat deprived of moisture and evil heat binding with dry stool: Constipation and abdominal fullness, hardness, and pain that refuses pressure.
• Evil heat forcing liquid down past impacted stool: Passing of green-blackish foul-smelling water in the stool. This is called heat bind with circumfluence.
• Evil heat and foul turbidity rising to harass the heart spirit: Clouded spirit with delirious speech and manic spirit derangement.
• Interior heat steaming and forcing liquid outward: High fever (vigorous heat effusion), copious sweating, thirst, and short voidings of yellow urine.
• Tongue: Red with thick dry yellow fur, or alternatively burnt-black fur with prickles. This reflects the evil heat binding with dry stool and fuming upward.
• Pulse: Sunken, forceful, and rapid, or alternatively slow when the dry stool causes congestion in the vessels and obstructs the flow of qì.

Treatment

Medicinal therapy: Offensive precipitation using Major Qì-Coordinating Decoction (大承气汤 dà chéng qì tāng).

Acumoxatherapy: TB-2 (yè mén), BL-57 (chéng shān), TB-6 (zhī gōu), LI-11 (qū chí), and ST-44 (nèi tíng).