HEMAFECIA, HEMATOCHEZIA, BLOOD IN THE STOOLS, RECTAL BLEEDING

Clinical Manifestations
  • Bleeding of fresh Blood from the bowel which often precedes the bowel movement
  • The bleeding may follow the passage of stool
  • The bleeding may be alarmingly copious
  • Abdominal pain or
  • Absence of pain, itching, swelling or distention or
  • A burning sensation in the rectum and anus
  • Dry mouth
  • Tendency toward constipation
  • Dry or difficult stools
  • T: Red
  • C: Yellow
  • P: Slippery and rapid or Thready and rapid
Treatment Principle
  • Clear Heat from the Intestines
  • Cool the Blood
  • Stop bleeding
Herb Formulas
  • Huai Jiao Wan modified
  • Huai Hua San modified
  • Topical: Mix 3g Alumen Ming Fan in a little water, dissolve 30g petroleum jelly and mix in the Ming Fan. Place on sterile gauze and insert into the anal canal.
  • Chinese Patent Medicines:
    Yi Zi Tang
    Zheng Gan Zhi Gen Duan

    To stop bleeding:
    Yun Nan Bai Yao

    Shen Tian Qi Pian
    For Intestinal bleeding with Heat: Zhong Gan Zhi Gen Dan
    For Damp-Heat: Huang Lian Jie Du Wan
    With Spleen and Stomach Deficiency: Xiang Sha Yang Wei Wan
Points
  • Ahshi points, DU-1, Erbai, SP-1, ST-25, ST-37, UB-30, UB-32, UB-57
    With pain in the rectum or lower Intestine: + UB-2, UB-52
    With severe bleeding: + PC-4, SP-10
  • Ear:
    1. Large Intestine, Small Intestine, Distal Segment Rectum, Subcortex, Shenmen
    2. Hemorrhoids, Large Intestine, Distal Segment Rectum, Shenmen
Clinical Manifestations
  • High fever
  • Confusion of mind
  • Delirium
  • Mania
  • Dark yellow urine
  • Excessive skin rashes all over body
  • Hemorrhage:
    Hematemesis
    Hemoptysis
    Epistaxis
    Hemafecia
    Hematuria
  • T: Deep red, dry or Purple red
    C: None
    P: Rapid or Thready and rapid or Thready and feeble
Treatment Principle
  • Cool the Blood
  • Dispel Heat and Toxins from the Xue Stage
  • Promote Blood Circulation
Herb Formulas
Points
Clinical Manifestations
  • Difficulty passing stools
  • Diarrhea with tenesmus which intensifies after defecation
  • Frequent stools which are small in quantity
  • Stools are yellow or brown, thin, watery, with foul smell or sticky and pasty like jam or sticky fluid or containing pus and Blood
  • The stools may be loose or firm depending on the ratio of Dampness to Heat
  • Burning hot sensation in anus
  • Abdominal pain, fullness and distention
  • Urine short and red
  • Sustained fever despite profuse perspiration or
  • Raging fever in the afternoon
  • Severe cases: High fever and coma
  • Mouth dry but no desire to drink
  • A sticky sensation in the mouth
  • A bitter taste in the mouth
  • Body heavy
  • Limbs tired
  • Fullness in chest
  • Lump in epigastrium
  • Anorexia
  • Vomiting
  • T: Red
  • C: Yellow and greasy
  • P: Slippery and rapid or Soft and rapid
Treatment Principle
  • Clear Heat
  • Transform Dampness
  • Cool the Blood
  • Stop bleeding
Herb Formulas
  • Di Yu San Er Hao
  • Shao Yao Tang
  • For lingering Damp-Heat with mild Yin and Blood Deficiency: Zhu Ju Wan  modified
  • For lingering Damp-Heat with marked Yin Deficiency: Zhu Ju Wan+ Liu Wei Di Huan Wan  modified
  • Chinese Patent Medicines:
    For Damp-Heat: Huang Lian Jie Du Pian
    For Damp or Toxic Heat: Chuan Xin Lian
    For Damp-Heat with a tendency toward constipation or sluggish stools: Niu Huang Qing Huo Wan
    For bleeding from Internal Heat: Zhong Guo Zhi Gen Duan
    For bleeding :
    Yun Nan Bai Yao
    Sheng Tian Qi Pian
Points
Clinical Manifestations
  • Mild bleeding of dark, purplish Blood or, less commonly, red Blood preceding or following defecation or
  • Black, tarry, sticky stools or occult Blood discovered in testing
  • Intermittent dull abdominal pain, alleviated by pressure
  • Easily satiated
  • Nausea
  • Waxy, sallow or pale complexion
  • Anorexia
  • Fatigue
  • Weakness
  • Four limbs feel tired and heavy
  • Physical and mental exhaustion
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose or unformed stools or
  • Diarrhea
  • Shortness of breath
  • Spontaneous sweating
  • Dizziness
  • Light-headedness
  • Palpitations
  • Functional Uterine Bleeding
  • Purpura
  • Epistaxis
  • Hemafecia
  • Hematuria
  • Menorrhagia
  • Metrorrhagia
  • T: Pale and flabby - may have toothmarks
    With Blood Deficiency: Pale and thin
  • C: White
  • P: Thready and weak or Moderate
Treatment Principle
  • Strengthen the Spleen
  • Benefit Qi
  • Nourish the Blood
  • Stop bleeding
Herb Formulas
Points
Clinical Manifestations
  • Chronic loose stools or diarrhea which may contain undigested food
  • The stools may be urgent
  • Early morning diarrhea
  • Dark, purplish or pale Blood preceding, following or
  • Black, tarry or Blood-streaked loose stools (the bleeding may also be occult)
  • Dull, persistent abdominal or epigastric cold-pain which improves with warmth and pressure
  • Sallow complexion
  • Anorexia (maybe with vomiting)
  • Four limbs feel tired and heavy
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Intolerance to Cold
  • Shortness of breath
  • Cold abdomen
  • Cold limbs
  • Feeling chilled
  • Frequent, clear urination
  • Mental fatigue
  • Weakness
  • Exhaustion
  • Maybe scanty urine with edema
  • Maybe clear, watery vaginal discharge
  • T: Pale, wet and swollen with toothmarks
  • C: Thin and white
  • P: Deep and weak or Deep, weak and slow
Treatment Principle
  • Warm the Center
  • Dispel Cold
  • Nourish the Blood
  • Stop bleeding
Herb Formulas
  • With relatively severe bleeding: Huang Tu Tang modified
  • With relatively mild bleeding: Fu Zi Li Zhong Wan modified
  • With Dampness in the Lower Jiao and Dryness in the Upper Jiao: Lian Li Tang
  • When the bleeding has stopped:
    Bu Zhong Yi Qi Tang

    Si Jun Zi Tang
  • Chinese Patent Medicines:
    For Spleen Yang Deficiency with severe Cold: Fu Zi Li Zhong Wan
    For Spleen Yang Deficiency: Li Zhong Wan
    For bleeding:
    Yun Nan Bai Yao
    Sheng Tian Qi Pian
Points
Clinical Manifestations
  • Dark, purple Blood in the stools or
  • Black, tarry, sticky stools
  • Epigastric or abdominal distention
  • Burning Heat and pain in the epigastrium
  • Epigastric or abdominal distention
  • Dry mouth
  • Irritating thirst: drinks copious fluids and prefers cold drinks
  • Excessive appetite: hungry again quickly after eating (as if food vanishes)
  • Swelling, pain, ulceration and bleeding of gums
  • Foul breath
  • Bitter taste in the mouth
  • Acid reflux
  • Heartburn
  • Belching
  • Toothache
  • Irritability
  • Restlessness
  • Maybe vomiting right after eating
  • Vomiting acid or undigested food
  • Constipation
  • Maybe scanty, red urine
  • T: Red
  • C: Thick, yellow and dry
  • P: Slippery, big, Excess and rapid or Wiry and rapid or Slippery and rapid
Treatment Principle
  • Clear and Purge Stomach Fire
Herb Formulas
Points
Clinical Manifestations
  • General signs and symptoms:
    Epigastrium Cold with pain
  • Mild cases:
    Constant pain
  • Severe cases:
    Sudden bouts of sharp pain
    Pain is aggravated by Cold and relieved by warmth and hot drinks
    Cold hands and feet
  • Cold Penetrates the Stomach and Intestines:
    Pain is sudden and sharp
    Pain is relieved by warmth
    Nausea
    Diarrhea
    Loose stools
    T: Pink
    C: White
    P: Deep and tight
  • Retention of Fluid in the Stomach due to Cold:
    Pain is dull
    Pain is relieved by warmth
    Succussion sound in the epigastrium on palpation
    Vomiting of clear, watery fluid
    T: Pink
    C: White and sticky
    P: Thready or Thready and slow
  • Stomach Deficiency with Stagnation of Cold:
    Pain is dull
    Pain is relieved by warmth and pressure
    Vomiting clear, watery fluid
    T: Pale
    C: Thin and white
    P: Deep and slow or Deep and thready
Treatment Principle
  • Warm the Stomach
  • Warm Cold
Herb Formulas
Points
Clinical Manifestations
  • Bleeding of dark, purple Blood from the bowel or
  • Sticky, tarry stools or
  • Mixed dark and fresh Blood
  • Epigastric or abdominal pain
  • The pain may be intermittent or detected on palpation
  • The pain is fixed, stabbing and /or severe
  • Pan is worse with pressure
  • The pain may also be found in the left and right lower abdomen
  • Dark complexion
  • Fixed, palpable masses
  • Bleeding with clots
  • Purple lips
  • Purple nails
  • Dry skin
  • Blue, dark or purplish discoloration of skin in small or large areas,
  • Varicose and spider veins
  • Cold hands and feet
  • Tendency to hemorrhage dark blood or clots
  • T: Purple, possible purple or red spots
    Red purple if there is Heat
    Blue purple if there is Cold
  • C: White
  • P: Choppy or Wiry and choppy
Treatment Principle
  • Activate the Blood
  • Break up Stagnation
  • Move Qi
  • Stop bleeding
Herb Formulas
Points
Clinical Manifestations
  • Black, sticky, tarry or dark, dry stools
  • No appetite or
  • Famished but with no desire to eat or
  • Indeterminate gnawing hunger
  • Persistent, dull, nagging epigastric pain
  • Heartburn
  • Morning nausea
  • Abdominal distention after meals
  • Irritability with low grade fever
  • Maybe dry retching or
  • Hiccups
  • Thirst
  • Dry skin, hair and mucous membranes
  • Tendency toward constipation or
  • Pellet-like stools
  • Facial flushing
  • Malar flush
  • Nightsweats
  • Five-sole-Heat
  • With Kidney Yin Deficiency:
    Dizziness
    Tinnitus
    Low back and knee weakness and pain
  • T: Red or Slightly red with a peeled center or Red and dry
  • C: Little and dry or Peeled in the center or Shiny
  • P: Thready and rapid
Treatment Principle
  • Nourish Yin
  • Clear Heat
  • Nourish the Stomach
  • Cool the Blood
  • Stop bleeding
Herb Formulas
  • Yu Nu Jian modified
  • Chinese Patent Medicines:
    With Stomach Qi and Yin Deficiency: Gu Ben Wan
    With marked Deficient Heat: Zhi Bai Ba Wei Wan
    With Stomach Qi and Yin Deficiency: Sheng Mai San Wan
    With Kidney Yin Deficiency: Liu Wei Di Huang Wan
    With bleeding:
    + Yun Nan Bai Yao
    + Sheng Tian Qi Pian
      
Points
Clinical Manifestations
  • Palpitations
  • Insomnia
  • Much dreaming
  • Easily startled
  • Poor memory
  • Four limbs tired and lethargic
  • Loss of appetite
  • Distention and fullness of the epigastrium and abdomen
  • Loose stools
  • Sallow complexion
  • Copious, pale menses
  • Uterine bleeding or
  • Light menstrual flow or
  • Amenorrhea
  • T: Pale
  • P: Thready and weak
Treatment Principle
  • Reinforce and Benefit the Heart and Spleen
Herb Formulas
  • Gui Pi Tang modified
  • Chinese Patent Medicines:
    Gui Pi Wan
    With Cold or Spleen Yang Deficiency: Li Zhong Wan
Points
Clinical Manifestations
  • Epigastric bleeding of dark, purplish or occasionally fresh, red Blood from the rectum
  • Epigastric pain
  • The bleeding and pain may be worse when emotionally upset or may appear premenstrually
  • Belching with acid regurgitation
  • Heartburn
  • Nausea
  • Vomiting
  • Anorexia
  • Epigastric, abdominal or hypochondriac, distention and/or pain
  • Distention and pain in the sides or flanks
  • Suffocating sensation in the chest
  • A bitter taste in the mouth
  • Tendency to sigh
  • Melancholy
  • Depression
  • Irritability
  • Inappropriate anger
  • Temporal and frontal headaches
  • Red, sore eyes
  • Facial flushing
  • A dry mouth
  • Thirst
  • Irregular menses
  • Dysmenorrhea
  • Breast distention and pain before and during menses
  • A tendency toward constipation or
  • Alternating constipation and diarrhea
  • T: Red or Red edges or Red spots on the edges
  • C: Thin and yellow
  • P: Wiry and rapid
Treatment Principle
  • Soothe the Liver
  • Harmonize the Stomach
  • Clear Heat from the Liver and Stomach
  • cool the Blood
  • Stop bleeding
Herb Formulas
  • Jia Wei Xiao Yao San modified
  • Without Heat: Chai Hu Shu Gan Tang modified
  • Chinese Patent Medicines:
    Jia Wei Xiao Yao Wan
    For Liver Fire: Long Dan Xie Gan Wan
    Without Heat
    : Chai Hu Shu Gan Wan
    For bleeding
    + Yun Nan Bai Yao
    + Sheng Tian Qi Pian
      
Points
Clinical Manifestations
  • Yang jaundice (sclera and skin bright yellow)
  • Pain and fullness in ribs on both sides
  • Maybe pain in the right hypochondrium
  • Bitter taste in mouth
  • Nausea
  • Vomiting sour and bitter fluids
  • Anorexia
  • Maybe alternating chills and fever
  • Concentrated, dark urine
  • Abdominal distention
  • Hematochezia
  • Women:
    Yellow vaginal discharge with foul smell
    Pruritis vulvae
  • Men:
    Pain, swelling and burning sensations of testicles
  • T: Pink
  • C: Yellow and greasy or sticky
  • P: Wiry and rapid or Slippery and rapid
Treatment Principle
  • Clear Dampness
  • Purge Heat from Liver and Gall Bladder
Herb Formulas
Points
Clinical Manifestations
  • Facial complexion pale and sallow
  • Both cheeks slightly red
  • Dizziness
  • Dry eyes
  • Blurred vision
  • Spots before the eyes
  • Numbness of limbs
  • Flaccid paralysis (Wei syndrome), weakness
  • Tinnitus
  • Deafness
  • Forgetfulness
  • Low back and knees sore and painful
  • Throat dry and painful
  • Five sole Heat
  • Low-grade fever
  • Night sweats
  • Irritability
  • Insomnia
  • Stools difficult to pass
  • Constipation
  • Men:
    Spermatorrhea
  • Women:
    Irregular menses or
    Scanty menses or
    Amenorrhea
    Vaginal discharge
  • T: Red
  • C: None
  • P: Thready and rapid
Treatment Principle
  • Nourish and Reinforce the Liver and Kidneys
Herb Formulas
Points
Clinical Manifestations
  • High fever
  • Fidgeting
  • Thirst with desire for drinks
  • Skin eruptions
  • Hot feeling of the skin
  • Irritability
  • Insomnia
  • Mania
  • Unconsciousness
  • Hematemesis
  • Epistaxis
  • Hemafecia
  • T: Deep purplish
  • C: White, greasy and thick, obvious in the middle part or Thin and white, with scanty fluids
  • P: Wiry and rapid or Thready and rapid
Treatment Principle
  • Clear Heat
  • Relieve toxicity
Herb Formulas
Points

Clinical Manifestations
  • Continuous uterine bleeding (either spotting or gushing)
  • Leukorrhea
  • Pale, thin Blood
  • Palpitations
  • Shortness of breath
  • Hemafecia
  • T: Pale
  • C: Thin and white
  • P: Thready and weak or Gigantic and forceless or Weak and soft or Feeble and hollow
Treatment Principle
  • Tonify the Spleen
  • Benefit Qi
  • Astringe and consolidate the Chong and Ren channels
  • Stop bleeding
Herb Formulas
Points