ABSTRACT
Objective In critically ill elderly patients with "heat fecaloma with watery discharge", deficiency syndrome occupies its eighty to ninety percent, while "heat accumulation" occupies its ten to twenty percent; in fact, it is "dry feces accumulation stagnation and manure water side stream". Factors of Qi deficiency, blood deficiency, Yin deficiency, Yang deficiency, etc. are the main causes of dry stool accumulating in the intestine and manure water flows to side stream. The therapeutic principles of this disease should be removing stasis by purgation, in the mean time supplementing Qi and moistening intestine, or moisturizing dryness by nourishing blood, or supplementing Yin and increasing fluids, or warming yang for relaxing bowels in order to solve the root causes of the disease. The mechanism of heat fecaloma with watery discharge in critically ill elderly patients is different from that of general patients; clinically it is necessary to interrogate the disease history in detail, synthesize the four diagnostic methods, and differentiate manifestations from root cause, deficiency from sthenia, mildness from severity and amelioration from urgency. Casually using attack should be avoided, and aiming to treat its root cause is the proper therapeutic method.