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Pattern Differentiation, Treatment, and

Complications of Diabetes

 

by Jen-Yuan Chang

Cun De Tang Traditional Chinese Medicine Clinic

 

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The causes of diabetes include dietary irregularities, overeating sweets, greasy or heavy foods, emotional stress, or excessive sexual activity. Over time, excessive thinking and worrying damage the lung, stomach, and kidney meridians. The condition becomes one of dryness heat caused by Yin deficiency and further develops into a pattern of wasting and thirsting that includes the three wasting symptoms of lung heat, stomach heat, and kidney deficiency. The “wasting” aspect of the wasting and thirsting pattern describes rapid digestion and elimination, consumption, and emaciation. The “thirsting” aspect describes perpetual thirst and increasing fluid intake. Thirst with increased fluid intake indicates upper wasting; swift digestion and becoming hungry very fast indicates middle wasting; polyuria with turbid urine indicates lower wasting. Another important clinical characteristic of diabetes is a sudden loss of weight.

 

 

TCM Disease Causes and Mechanisms

1.           Dietary irregularities, overeating greasy, sweets or heavy foods, and accumulated heat damaging the fluids:

People who are fond of fine foods and have indulged in sweet, greasy, heavy, spicy, and/or stimulating foods and alcohol for long periods of time will damage their spleen and stomach. This results in the malfunction of the transportation and transformation function of the middle jiao, causing the accumulation of interior heat over time. The internal blazing of the constrained heat accelerates digestion and consumes fluids. The lack of body fluids causes the zang-fu organs to lose their nourishment and leads to “wasting and thirsting”. The Su Wen．Treatise on Strange Diseases explains, “This condition occurs in those who are fat. This person must eat many sweet, fine foods, and too much fat. All fats cause heat within humans, and all sweets cause center fullness. Therefore, the Qi spills upward and transforms into wasting and thirsting.” This explains the cause and effect relationship between wasting and thirsting and dietary irregularities.

 

2.           Emotional imbalances, overreaction of the five emotions, and stagnant fire damages Yin:

For example, anger damages the liver. The prolonged constraint of the liver Qi transforms into fire. This intense fire damages and consumes the fluids in the stomach and kidney. When the fire is burning upwards and the fluids are leaking downwards, the symptoms of polyphagia, polydipsia, and polyuria arise. Liu He-Jian’s Treatise on the Three Wastings says “Lower wasting is caused by the stagnant dry heat following consumption caused by chaos of the emotions and spirits.” This statement explains the close relationship between wasting and thirsting and the emotional imbalances and overreactions stemming from imbalances of the five emotions.

 

3.           Insufficiency of pre-heaven Qi, weakness of the five viscera, and exhaustion of the essence and fluids:

The five viscera store the essential Qi, which is the root of human life. Kidney receives and stores the essential Qi of the five viscera and six bowels. If there is insufficient pre-heaven Qi or if any of the five viscera are fragile or weak, the essential Qi, Qi, and blood will be deficient and weak and there will be no essential Qi for the kidney to store. If this condition is compounding because there is lack of health management, the essence and fluids will be exhausted and the wasting and thirsting symptoms will develop. Ling Shu．Five Changes states, “If the five viscera are soft and weak, there will be susceptibility to pure heat wasting disease.” This explains the clear relationship between wasting and thirsting and insufficient pre-heaven Qi, lack of health management, nourishment, weakness of the five viscera, and especially deficiency of the kidney.

 

4.           Excessive sexual activity and overexertion cause kidney essence consumption and deficiency:

Excessive sexual activity consumes and damages the kidney essence and Qi. When kidney essence is insufficient, Yin fails to control Yang, and generates interior deficient fire. “The fire becomes more fierce due to water vacuity, water becomes drier due to fierce fire” and finally kidney deficiency leads to wasting and thirsting symptoms. The Wai Tai Mi Yao．Wasting and Thirsting - Middle Wasting says, “Excessive bedroom affairs must consume kidney Qi resulting in kidney Qi deficiency and the engenderment of heat in the lower burner. This heat leads to kidney dryness, and kidney dryness leads to thirst.” It explains the clear relationship between wasting and thirsting and excessive sexual activity.

 

Recommended Formulas for Diabetes

Code	Chinese Name	Pin Yin Name	English Name
0408	六味地黃丸	Liu Wei Di Huang Wan	Rehmannia Six Formula
0510	白虎加人參湯	Bai Hu Jia Ren Shen Tang	Ginseng & Gypsum Combination
0512	甘露飲	Gan Lu Yin	Sweet Combination
0525	生脈散	Sheng Mai San	Ginseng, Schizandra & Ophiopogon Formula

 

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