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Hematochezia (Blood in the Stool)

How Chinese medicine differentiates blood in the stool, the six patterns you'll actually meet in practice, and the points for each. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment. Blood in the stool always needs medical evaluation to find the cause — it can range from hemorrhoids to something more serious, and this page is educational reference only, never a substitute for that workup.
General Acupuncture Points

Acupuncture points traditionally used for hematochezia — 9 key points, used across the patterns below rather than tied to just one.

PointKey action
DU-1Local point, directly calms the anus and clears Heat.
BL-57Clears Heat and cools Blood, classic point for hematochezia.
SP-6Resolves Dampness and regulates the Spleen.
L.I.-11Clears Heat from the Large Intestine.
DU-20Moxibustion lifts sinking Qi and reduces prolapse.
ST-36Tonifies Spleen Qi to strengthen Blood containment.
LR-3Moves Liver Qi to relieve stagnation and pain.
L.I.-4Promotes Qi circulation and helps move Blood.
SP-10Cools the Blood, invigorates Blood and eliminates stasis.
The Six Patterns

↑ reinforcing   ↓ reducing   ⊥ even method.

1. Damp-Heat in the Large Intestine View full pattern →

Clinical manifestations: Bright red blood mixed with mucus, burning sensation at the anus, urgent straining with incomplete evacuation, foul-smelling yellow-brown stools, abdominal pain and cramping.
Tongue: Red body with thick, yellow, greasy coating, thickest at centre and root. Pulse: Slippery and rapid.
Treatment principle: Cool Blood, clear Heat, and dry Dampness to stop rectal bleeding.
Note: no moxa. Direct match with this site's own Damp-Heat-in-the-Large-Intestine slide.

2. Heat in the Large Intestine View full pattern →

Clinical manifestations: Bright red blood in stool, constipation with dry hard stools, burning sensation at anus, thirst for cold drinks, abdominal pain worsened by pressure.
Tongue: Red body with prickly papillae and thick dry yellow coating. Pulse: Deep, full, and rapid.
Treatment principle: Clear Heat that dries fluids and irritates the intestinal lining.
Note: no moxa. Direct match with this site's own Heat-in-the-Large-Intestine slide.

3. Heat in the Blood

Clinical manifestations: Bright red or spurting blood in stool, internal heat sensation worse at night, restlessness and irritability, thirst for cold drinks.
Tongue: Red body with red spots or prickles, thin yellow dry coating. Pulse: Rapid, wiry, slippery, and forceful.
Treatment principle: Heat penetrates the Blood level, agitating it and forcing blood out of the vessels.
Note: no moxa. No standalone Heat-in-the-Blood slide exists on this site, so no pattern link is given here.

4. Spleen Qi Sinking View full pattern →

Clinical manifestations: Pale or dull blood in stool, anal heaviness with bearing-down sensation or prolapse, chronic/recurrent bleeding worse after exertion, extreme fatigue, poor appetite and loose stools.
Tongue: Pale, puffy, tender body with teeth marks, thin white coating. Pulse: Weak and forceless, especially at right Guan.
Treatment principle: The Spleen loses its lifting and containing power, letting blood leak from the vessels.
Note: moxa strongly indicated, especially DU-20. Direct name match with this site's own Spleen-Qi-sinking slide.

5. Qi and Blood Stagnation View full pattern →

Clinical manifestations: Dark or clotted blood in stool, fixed stabbing abdominal pain worsened by pressure, abdominal distension and bloating, irritability or mood swings.
Tongue: Purple or dark body with stasis spots and distended sublingual veins. Pulse: Wiry and choppy.
Treatment principle: Stuck Qi prevents smooth Blood movement, damaging tiny vessels and producing dark, clotted bleeding.
Note: no moxa. Matches this site's Liver-Blood stasis slide — a purple/dark tongue with stasis spots is the same discoloration marker named there.

6. Toxic-Heat

Clinical manifestations: Massive spurting bright red blood, high fever with chills or burning sensation, intense local anal pain or swelling, extreme thirst for cold drinks, restlessness and flushed face.
Tongue: Red body with prickly raised papillae and dry yellow coating. Pulse: Rapid, forceful, and overflowing.
Treatment principle: Deep-seated fire poisons the Blood and damages vessels — this is a medical emergency.
Note: no moxa — seek urgent medical care. No standalone Toxic-Heat slide exists on this site, so no pattern link is given here.
Related conditions

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