Diarrhea: Differential Diagnosis

Diarrhea
In children under two years

of age diarrhea is a
common symptom in
summer and autumn, and is
usually caused by
indigestion, acute
gastroenteritis or enteritis.

Differential diagnosis:
Babies with indigestion
may suffer from abdominal
distension and pain,
diarrhea after onset of abdominal pain, relief of abdominal pain after diarrhea with
foul stool, vomiting and indigested food, dirty and greasy tongue coating, and rolling
and forceful pulse. Babies with damp-heat pathogens may suffer from diarrhea with
yellow, thin and foul stool, abdominal pain, hotness in body, thirst, hotness in anus,
discharge of short streams of dark urine, yellow and greasy tongue coating, and
rolling and rapid pulse. And babies with Yang deficiency may suffer from repeated
diarrhea, often after meals, with undigested food in thin stool, or chronic diarrhea over
a long time, poor appetite, mental and physical fatigue, sallow complexion, very cold
limbs, incomplete closure of eyes during sleep, pale tongue with white coating, and
thready and moderate pulse.

Treatment:

Foot massage: The massage is applied to coeliac plexus (20), small intestine (25),
stomach (15), colon (28-30), duodenum (16), liver (18), gallbladder (19) and spleen
(34) reflecting areas. The foot is held in one hand by the physician and the knuckle of
the first interphalangeal joint of the other index finger is used to apply pressure from
toes to heel and from heel to toes, and also to apply massage to above areas 3-4 times
(Fig. 94).

Foot acupuncture:

1) Meridianal acupoints: At Taibai (SP 3) and Gongsun (SP 4) acupoints, a reinforcing
acupuncture technique is applied for deficient type patients and a reducing technique
is applied for excessive type patients. The needles are retained for 20 minutes, or
moxibustion is applied for 15 minutes to patients with Yang deficiency or with cold
and damp pathogens.
2) Extra acupoints: At Yinyang (EX-F 5) and Nuxi (EX-F 6) acupoints, a reducing
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technique is applied to excessive type patients and a reinforcing technique is applied
to deficient type patients. The needles are retained for 20 minutes, or moxibustion is
applied for 15 minutes to patients with cold and damp pathogens or Yang deficiency.
3) Foot acupoints: At Spleen (FA-P 10), Small intestine (FA-P 11) and Colon (FA-P 13)
acupoints, a reducing technique is applied to excessive type patients, and a reinforcing
technique is applied to deficient type patients. The needles are retained for 20 minutes,
or moxibustion is applied for 15 minutes to patients with cold and damp pathogens or
Yang deficiency.

External application of drugs:

1) Diarrhea due to damp-heat pathogens: The powder of Zhusha (cinnabar) 3 gm,
Pengsha (borax, fried) 1.8 gin, Shexiang (musk) 0.1 gm, Huoxiao (potassium nitrate)
3 gm, Mengshi (chloride-schist, calcined) 1.2 gm, gold sheet 5 pieces, Xionghuang
(realgar) 1.8 gm and Bingpian (borneol) 0.9 gm is mixed with boiled water to prepare
a paste for application to coeliac plexus (20), stomach (15), small intestine (25) and
spleen (34) reflecting areas, twice a day.
2) Diarrhea due to cold pathogens: Baijiezi (white mustard seed) 9 gm, fresh ginger
120 grn and 3 bulbs of garlic with red skin are fried in sesame oil 180 gm and
Tongyou (Tung oil) 60 gm with Zhangdan 120 gm gradually added into pot over a
low fire to prepare a paste for application to above areas, twice a day.
3) Diarrhea due to cold and damp pathogens: Fresh Cang'ercao (cocklebur fruit) 2
portions and fresh ginger 1 portion are boiled to prepare a thin glue. After the dregs
are removed Huangdan (yellow lead) is added in a proportion of thin glue 500 gm
with Huangdan 120 gm to prepare a paste for application to above reflecting areas.
4) Diarrhea due to deficiency of spleen and stomach: Powder of Kufan (calcined alum)
50 gm and wheat flour 20 gm is mixed with a proper amount of vinegar to prepare a
thin paste for application to above areas after spreading over the gauze and affixing
with adhesive plaster, 3-5 times a day.

Foot bath:

1) A warm decoction of Gegen (kudzuvine root) 50 grn, Baibiandou (white lablab
seed) 100 gm and Cheqiancao (plantain) 150 gm at 30 degrees centigrade is used to
soak both feet below ankle joint for 30 to 60 minutes, 2-3 times a day to treat diarrhea
due to damp-heat pathogens. Laifuzi (radish seed) 20 gm is added for diarrhea due to
indigestion, and Fengxianhua (garden balsam) 30 gm or Guizhi (cinnamon twig) 50
gm is added for diarrhea due to spleen deficiency.
2) A hot concentrated decoction of Guizhencao (hairy begger- ticks) 5 pieces prepared
in a barrel is used to steam both feet of children repeatedly, 3-4 times at 5 minute
intervals after a rest of 2 minutes between treatments for simple diarrhea. For babies
between 1-5 years old only the sole is steamed; for children between 5-15, the entire
feet may be steamed; and for severe cases the legs above the feet may also be steamed.

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Diarrhea

In children under two years

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