08 Mar Chinese Herbal Medicine for Diabetes Mellitus
Modern Medicine and Traditional Chinese Medicine: Diabetes Mellitus (Part Three)
by Clinton J. Choate
Published in the Journal of Chinese Medicine, No. 60, May 1999
According to TCM, diabetes mellitus is classified as upper, middle or lower xiao-ke (wasting and thirsting syndrome) and is generally characterised by thirst, hunger, frequent urination and wasting (see footnote). Cloudy urine and sugar in the urine may also accompany these symptoms, each of which is said to have a predominant symptom: excessive thirst in the upper jiao (Lung), excessive appetite in the middle jiao (Stomach) and excessive urination in the lower jiao (Kidney). In reality there is usually a mixture of all the symptoms, although one often predominates slightly. By analysis of the symptoms, one should be able to determine which organ, whether the Lung, Stomach or Kidney is most yin deficient and therefore have a focus for treatment.
* Upper xiao-ke syndrome is characterised by Lung heat drying up body fluids leading to great thirst, restlessness, dry cough, dry skin, hoarseness, dry red tongue with or without cracks, a thin yellow tongue coating, and a forceful rapid pulse especially at the cun (distal) position.
* Middle xiao-ke syndrome is characterised by Stomach fire leading to excessive appetite and constant hunger, desire to drink cold liquids, burning sensation in the epigastrium, constipation, a red tongue with a thick yellow coating, and a slippery-forceful-rapid pulse.
* Lower xiao-ke syndrome is characterised by Kidney yin deficiency where there is excessive urination (clear or turbid), dry mouth at night, night sweating, sore back and aching bones, red-peeled tongue, and a deep-thready-rapid pulse. Lower xiao-ke syndrome with deficiency of both Kidney yin and yang (with the latter more pronounced) is characterised by frequent urination of turbid urine especially at night, soreness and weakness of the lower back and knees, aversion to cold, lassitude, impotence, a pale red tongue with teethmarks and a white tongue coating, and a deep thready-weak pulse.
Xiao-ke is attributed to three main factors: improper diet, emotional disturbance, and a constitution that is yin deficient:
1. Improper diet refers to irregular eating and drinking habits which damage the transporting and transforming functions of the Spleen and Stomach. The accumulated food in turn generates internal heat that consumes the fluids, thus bringing on wasting and thirsting.
2. Prolonged emotional disturbance contributes to wasting and thirsting by hindering the flow of qi. Over-thinking damages the Spleen. Anger, resentment and frustration lead to constrained Liver qi which transforms into heat and fire and consumes the yin of the Lung and Stomach. Excessive worry damages the Kidneys and weakens the qi.
3. When an individual is constitutionally yin deficient, factors such as prolonged stress or illness, overwork or excessive sexual activity can consume the essence. The result is Kidney yin deficiency that can be mixed with Lung and Stomach yin deficiency symptoms as well as with Kidney yang deficiency.
…The following section lists the herbs and herbal formulations that, through time-tested usage and modern pharmacological research have demonstrated their effectiveness in treating xiao-ke. Two of the more frequent formulas used for this purpose in China and Japan today were first described in the book Jin Gui Yao Lue, written around 200 CE.
One is Ba Wei Di Huang Tang (Eight-Ingredient Pill with Rehmannia) which was originally prescribed for persons showing weakness, fatigue and copious urination soon after drinking water. In some cases, this may have been diabetes as we know it today. The other is Bai Hu Jia Ren Shen Tang (White Tiger Plus Ginseng Decoction), which was prescribed for severe thirst and fatigue. This formula, considered ideal for diabetes of recent onset, is used more frequently for this today in Japan than in China.
The full article can be found at: Clinton J. Choate (1999). Modern Medicine and Traditional Chinese Medicine: Diabetes Mellitus (Part Three).