There is an eye-catching scene in Bernardo Bertolucci’s magnum opus and Oscar-winning film, The Last Emperor. The movie details the life arc of the last Chinese emperor, Puyi, told through a series of flashbacks. Puyi took the throne as a two-year-old in 1908. He was raised by eunuchs, handmaidens, Chinese physicians, monks and attendants in the Forbidden City. In one scene from the film, the infant Puyi is sitting on a potty, defecating as dozens of attendants wait expectantly. When Puyi finishes, one assistant grabs the poop pot and rushes off through the halls of the expansive palace to the quarters of the Chief Physician. The saffron-robed doc takes the pan, swirls the turds, sniffs, pokes at them and looks solemnly at the awaiting attendant. “No bean curd,” he declares and the sycophant of shit hastily returns to the royal chamber with the doctor’s orders.

No butts about it. There’s an encyclopedia of knowledge in the wise observation of the body and its functions, pooping included. But modern medicine has done away with the natural interface of physician and patient in favor of lab metrics, computer modeling and test results. I remember a doctor entering the examination room to see my mom during an appointment years ago. He held a clipboard with lab work data and for the entire length of time that he “examined” my mom, he never looked at her; just the papers, the back of his stethoscope and his watch.

No one is expecting to take a stool sample when you go in for a doctor appointment but when things go wrong the poop does hit the fan and goes straight to the lab. What Puyi’s doctor was doing is simple: adjust life before radical illness. It was called preventive medicine.

Some of the subtlety has been lost in modern medicine. Small changes in lifestyle can help us avoid calamities later on. Knowing what our body tells us before major symptoms make it obvious can help us adjust beforehand. Poop is just one of those telltales.

Size matters. Traditional Chinese medicine (TCM) and ayurvedic (traditional Indian medicine) sources agree on many of the arcane indications fecal examination might reveal. Authentic descriptions by either discipline are beyond Western ken, utilizing terms that make sense in TCM and ayurveda but confound the Occidental mind. But even in Western words, gross characteristics usually describe an optimum stool as resembling a ripe, soft banana in size and texture. TCM and ayurvedic sources say stools should float and be a medium brown color, with little or no sheen. Bowel movements should occur at least once daily. Deviations from that simple standard are notable and could have a variety of metabolic or pathological causes.

While small, hard, dry stools may prompt ayurveda to use descriptors like “hardening shows an imbalance of the vata dosha.” Too soft shows “a pitta abnormality.” In TCM, loose stools indicate “deficiency cold in the spleen or stomach.” Descriptions and causes are specific and remedies precise but they are vested in TCM or ayurvedic sensibilities.

The West on waste. Modern Western medicine is aware of the import of the appearance in the potty but ignores it for the most part, relying more on blood tests, scans and urine samples. Fecal studies are way down the list. But as in many things, the West is learning from the East and its long history in medicine. TCM and ayurvedic medical theory are often at odds with some conventional medicine but surprisingly indicate identical problems.

Traditional medicine emphasizes that a daily evacuation is normal. Some Western medicine sources say that going three days without a stool is okay. In Western terms, when stools are hard and dry, we are counseled that we need to drink more water. Any discoloration from the normal medium brown can indicate a number of different pathologies. Sometimes stools are tinted by the food we eat. Beets are a good example.

Nobody expects poop to smell good and even healthy poop doesn’t. But if it shows up exceptionally stinky, especially with discoloration, it should be clear that something is out of balance. Chalky, pale stools could mean a gall bladder or liver problem. If the stools smell somewhat of ammonia, then overgrowth of intestinal bacteria or even liver dysfunction is possibly the cause.  Yellow stools could mean a bile problem or again a dietary cause. Western sources say poop should sink and if it floats it could mean flatulence problems. Most people have other, more boisterous indications when they’re gassy. Many of the imbalances that can be indicated by the subtleties of stools can be addressed before they become serious diseases.

The Poop Chart. While it’s not really a diagnostic tool but rather a descriptive device, the Bristol Stool Chart was published by Dr. Ken Heaton in 1997. It helps describe stool type. Types 3 and 4 are considered ideal. Types 1 and 2 indicate constipation and 5, 6 and 7 tend toward diarrhea. But the causes? You’ll need Puyi’s doc to tell you that.

Be well.

Heartland Healing is a metaphysically based polemic describing alternatives to conventional methods of healing the body, mind and planet. It is provided as information and entertainment, certainly not medical advice. It is not an endorsement of any particular therapy, either by the writer or The Reader. Visit for more information.

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