Small Acupuncture Graphic DIABETES MELLITUS FROM WESTERN AND TCM PERSPECTIVES
by CLINTON CHOATE L.Ac.

WESTERN CLINICAL OBSERVATIONS

  1. SYMPTOMATOLOGY
  2. PRESENTING SYMPTOMS
  3. LAB DIAGNOSIS
  4. COMPLICATIONS OR SEQUELLE OF DIABETES
  5. DRUG THERAPY
  6. NUTRITIONAL THERAPY
  7. HERBAL RX

DIABETES MELLITUS ACCORDING TO TRADITIONAL CHINESE MEDICINE

  1. NEEDLING PRESCRIPTION
  2. NEEDLING PRESCRIPTION, DIFFERENTIATION AND TREATMENT ACCORDING TO THREE BURNERS
  3. CHINESE SYSTEM OF FOOD CURES
  4. HERBAL REMEDIES FOR DIABETES MELLITUS
  5. BIBLIOGRAPHY


WESTERN CLINICAL OBSERVATIONS

BACKGROUND

Diabetes, because of its frequency is probably the most important metabolic disease. It affects every cell in the body, and the essential biochemical processes that go on there. There is nothing new about diabetes; it has been a medical problem since antiquity, and one which in the U.S. ranks eighth as a cause of death. The name which was originated by Aretaeus (30-90 AD) came from the Greek words meaning "siphon" and "to run through" and in medicine signifies the chronic excretion of an excessive volume of urine.

The cause of spontaneous diabetes mellitus, hereafter referred to as DM, is not known. The fundamental difficulty, however, is a relative or complete lack of insulin, the hormone produced by Beta cells in the islets of Langerhans of the pancreas which is necessary for the metabolism of carbohydrates. Since we know that the way the body derives energy from food sources- carbohydrates, proteins, fats- are intermingled, any problem in carbohydrate metabolism will necessarily affect the metabolism of protein and fat as well.

Carbohydrate is the active fuel of the body and is ordinarily the main source of energy of the tissue cell. It is utilized chiefly by the body in the form of glucose and is circulated to the tissues by the blood which keeps it in constant supply. The quantity of glucose in the blood seldom exceeds 160 mg/100cc of blood shortly after food sugar has been absorbed nor seldom falls below 60 mg/100cc during fasting.

In the blood, glucose apparently freely enters certain cells such as those of the CNS but requires the help of insulin to enter most cells at a normal rate. An insufficiency of insulin production by the pancreas for the metabolizing of food sugars and starches produce the diabetic condition. In the normal digestive process, these food sugars and starches (carbohydrates) are changed into sugar glucose. This is stored in the form of glycogen (animal starch) in the liver and muscles for later use as a body fuel, at which time it is reconverted into glucose. For both the storage and conversion of glucose, insulin is the essential hormone. The metabolic failure characteristic of DM may occur because the body produces too little insulin, or because of a faulty chemical reaction, or a combination of both. The result of the disturbed metabolism of glucose causes an abnormal accumulation of sugar in the blood stream and the diabetic condition.

SYMPTOMATOLOGY

DM is characterized by three well-known syndromes, polydypsia (excessive thirst), polyphagia (excessive hunger), and polyuria (excessive urination). Laboratory findings reveal high blood sugar and glucose in the urine and as the metabolic derangement worsens, excessive ketone bodies in the blood and urine. The accumulation of these produces acidosis which, if not counteracted, can result in coma and death.

A great deal has been written about the possibly etiology of diabetes, most of it speculative, and none of it conclusive. Furthermore, knowledge of the etiology is not particularly helpful in the clinical management of the disease and will not be considered in detail here. Most of the ideas can be classified under one of the following categories: heredity, endocrine imbalance (hyperpituitarism, etc. ), dietary indiscretion, sequelle of infection and severe and continued psychic stress. The case for hereditary tendency to the disease is good which would indicate a desirability in keeping a close check on the relatives of known diabetics.

The other hypothesized etiologies all stem from factors known to aggravate the disease such as infections, obesity, and psychic stress. From a practical point of view, therefore, it is wise for diabetics or potential diabetics to control their weight, to avoid as much psychic stress as possible and to treat any infections promptly....but who shouldn't?

PRESENTING SYMPTOMS

The clinical manifestations of diabetes in the order in which they usually appear are:
  1. frequent.copious urination
  2. excessive thirst
  3. rapid weight loss
  4. excessive hunger
  5. drowsiness, fatigue
  6. itching of genitals and skin
  7. visual disturbances
  8. skin infections
In juvenile cases 50-75% of the earliest symptoms noted are increases urination, thirst and hunger. Physical findings in the adult are mostly attributable to complications, and the first sign of the disease may be some dermatological, circulatory, neurological or visual complications.

LAB DIAGNOSIS

The laboratory diagnosis of diabetes depends on finding glucose in the urine concurrently with an elevated blood sugar. The appearance of glucose in the urine depends not alone of the level of the arterial blood sugar but also on the rate of glomerular filtration and the efficiency of tubular resorption in the kidney, so that there is considerable variation in renal thresholds for glucose both in normal persons and in diabetics. Glycosuria may also occur incidental to emotional stress, systemic infection, or be the result of hyperthyroidism.

According to the Second Edition of the Diabetics Guide for the Physician published by the American Diabetes Association, the upper limit of *normal for venous blood sugar concentrations is 130 mg/100cc in the fasting state and 200 after a meal. Values in excess of this in the abscence of complicating illness, drugs, or stress, usually indicate diabetes. After meals, values of 250 to 350 mg/100cc are not unusual in moderately sever DM. Some mild diabetics will have normal fasting blood sugar values and values in the diabetic range only after meals. Occasionally very mild cases will have values within normal at both times and the diabetic tendency will be evident only when these persons are required to handle more than an ordinary amount of carbohydrate. The Glucose Tolerance Test (GTT) was conceived to test such patients by giving a large amount of glucose or food at one time to measure the adequacy of their islet tissue.

* Normal fasting glucose in venous plasma is between 60-110 mg/ml, increasing about 2 mg/100/ml/ decacade after age 30 1 In Type II or maturity-onset diabetes (NIDDM) there is usually plenty of insulin being secreted, a situation unlike Type I or juvenile diabetes, were there is not enough insulin. In many Type II diabetics there is actually too much insulin, the message carrier that orders the sugar to go down, but no one is receiving it and the blood sugar rises. In juvenile diabetes, there isn't any message, so again the blood sugar rises.

COMPLICATIONS OR SEQUELLE OF DIABETES

Sometimes a complication of diabetes may give a clue to the recognition of the disease. The principle complications or sequelle associated with diabetes are retinopathy, neuropathy, nephropathy, and arteriosclerosis. Whether these are the unavoidable consequences of the existence of the diabetic state over a period of time or whether they may be influenced by the degree of control of the diabetes is still a question. Complications do, however, create trouble for the diabetic and may when they are vascular disorders, reduce life expectancy.

Since the discovery of insulin nearly 70 years ago, the patterns of morbidity from diabetes have changed. The major cause of death were diabetes ketoacidosis and infection, whereas they are now the microvascular and cardiovascular complications of diabetes - renal failure and myocardial infarction. These complications are responsible for a reduction in the life expectancy of a newly diagnosed insulin dependent diabetic by about one-third. The basis of managing diabetes in the 80's is an improvement in the life-style of the diabetic and prevention of complications responsible for morbidity and mortality in diabetes.

RETINOPATHY

The changes occurring in the eye which are distinctive of diabetes involve the veins and capillaries of the retina. Cataracts, early associated with diabetes, seem more frequent in young diabetics, senile cataracts are as frequent in non-diabetics. It usually takes between 10-13 years for diabetic retinopathy to develop and it is present in some degree in most diabetics who have had the disease for 20 years. In only about half of the diabetics who develop it, however, is vision markedly impaired and blindness occurs in only about 6%.

NEUROPATHY

Diabetic neuropathy, which includes pain, parasthesias and myalgias, is largely peripheral neuritis. The femoral nerve is commonly involved giving rise to symptoms in the legs and feet, although nerves in the arms, abdomen and back may also be affected. Pain is the chief symptom which tends to worsen at night when the patient is at rest and is relieved by activity. It is aggravated by cold. Parasthesias are a common accompaniment of the pain. Attendant cramping, tenderness and weakness of the muscle may occur but atrophy is rare.

Autonomic nerve involvement may give rise to such signs as reduced or absent perspiration, reduced vasomoter and pilomotor function, dependent edema, sever edema, severe constipation or nocturnal diarrhea, sexual impotence, urinary and fecal incontinence, bladder atony and paralysis.

DM is probably the single most common disease associated with erectile failure. As an erection involves all levels of the nervous system, from the brain to the periferal nerves, lesions anywhere along the path may be responsible for erectile failure. It has been estimated that close to 50% of diabetic males have some degree of erectile dysfunction since diabetes is a metabolic disease with vascular and nervous system complications. The diabetic condition may affect the blood and nerve supply to the penis with the consequent nuerogenic impotence.

Neuropathies usually improve with the control of the diabetes. Severe of chronic changes may require several weeks or months to show maximal improvement. Paradoxically, there may be a transient aggravation of symptoms with regulation of the disease and the reasons for this are still unknown. A high protein intake and supplements of the B-complex vitamins, including 1000 mg of vitamin B-12 daily may be helpful.

ARTERIOSCLEROSIS

The diabetic state is associated with earlier and more severe vascular changes than occur normally at a given age. Cardiovascular-renal disease is the leading cause of death among diabetics. The diabetic appears generally subject to arteriosclerotic changes, but the heart, brain and leg arteries are most often affected by occlusive lesions. The incidence of coronary occlusion in patients with clinical diabetes has been estimated at from 7.9-17.5%

Arteriosclerosis obliterans in the lower extremities may produce such sensations as disturbances in sensation, decrease in muscular endurance, intermittent claudication on effort (cramping of calf muscle) and finally gangrene. Diabetic gangrene usually involves the toes, heels or other prominent parts of the feet and is precipitated by trauma, infection or extreme in temperature.

The aetiology of large vessel disease is multifactorial in the diabetic as well as the non-diabetic population with lipoprotein metabolism, hypertension, physical activity, obesity, cigarette smoking, stress, personality, genetic and racial factors all playing a part. In addition to these general factors operative in diabetes, attention has been paid to a number of specific metabolic disorders in diabetes which could theoretically increase the severity or rate of formation of atheroma. Epidemiologic data do not show any increased risk from diabetes independent of hypertension, cigarette smoking and hyperlipaemia, however, it is possible that hyperfibrinoginaemia, decreased fibrinolysis, abnormalities in platelet adhesiveness and platelet dysfunction, changes in prostaglandin metabolism and the vessel wall, may all play a part. Insulin deficiency itself may influence the progression of atheroma through synergistic mechanisms involving hyperlipaemia, altered platelet behavior and abnormalities in the arterial wall.

NEPHROPATHY

Nephropathy is a common and important accompaniment of diabetes and one in which young diabetics take precedence over heart disease as a cause of illness and death. As with eyes changes, there is a wide variation in the type and degree of renal damage. Nephropathy is less frequent than retinopathy and where it occurs is also a development of long standing diabetes.

One study reported that among 200 juvenile diabetics who survived 20 years after onset, 1/2 had evidence of renal disease. The typical nodular lesions of the glomeruli may or may not give rise to clinical symptoms, depending on the number of glomeruli involved. Another study found that the majority of these patients have hypertension and 2/3 show significant albuminuria, but the fully developed nephrotic syndrome of hypertension, proteinura and edema occurs in less that 10% and renal function is impaired in only 1/2-3/4 of those patients.

KETOACIDOSIS

One of the by-products of fat metabolism is the formation of chemical compounds called ketones. When ketone bodies are excessive, the condition known as diabetic acidosis results, leading to possibly fatal diabetic coma.

The possibility of ketacidosis is suggested by:

Before the discover of proper treatment by insulin and other intravenous injections, acidosis was the chief cause of death among diabetics.

HYPOGLYCEMIA

If there is too much insulin in the body compared to the amount of blood sugar and the blood sugar level falls below normal levels, a condition known as hypoglycemia occurs. In this condition, commonly referred to as insulin shock, the brain is deprived of an essential energy source. The first sign of insulin shock is mild hunger, quickly followed be dizziness, sweating, palpitation, mental confusion and eventual loss of consciousness. Before the condition reaches emergency proportions, most diabetics learn to counteract the symptoms by eating a piece of candy or by drinking a glass of orange juice. In some cases, the only effective measure is an intravenous injection of glucose.

DRUG THERAPY

Insulin was the first, and remains the best, means of treatment for diabetes. It is administered by subcutaneous injection. This method is necessary since insulin is destroyed by gastric stomach secretions when it is taken by mouth. Many diabetics inject insulin only once a day, thus duplicating the normal insulin action of a nondiabetic. Others require two or more injections. The usual time for a dose of insulin is before breakfast. The dosage is initially established according to the severity of the condition, but it often has to be reassessed as one or another of the variables in the person's condition changes.

Oral hypoglycemic agents were developed in the 1950's for controlling milder cases of diabetes that develop in people over 45. They are used to stimulate the release of insulin from the pancrease and foster insulin activity in other ways. None of the oral agents should be used as a substitute, however, for insulin in the ketoacidosis-prone patient since they are not oral forms of insulin. The biologic half-lives following administration cannot be measure accurately, making the selection of dose and timing of administration somewhat haphazard. Furthermore, the administration of oral hypoglycemic drugs has been reported to be associated with increased cardiovascular mortality.

The current use of any of the oral drugs represents to some extent laziness and lack of understanding of the problem at hand with most of the non-insulin dependent diabetics. If used correctly in patients who are on the appropriate diet and exercise program and are approaching optimal weight, some of the new generation drugs have a specific and beneficial place.

NUTRITIONAL THERAPY

A nondiabetic produces the constantly varying amounts of insulin necessary for obtaining energy from glucose. A diabetic cannot achieve this balance. Beyond the basic requirements to provide adequate calories and necessary nutrients, there are marked differences in diet strategy for the two major groups of diabetic patients: 1Type II, obese patients who do not require insulin (NIDDM), and Type I, insulin-dependent non-obese patients (IDDM). In overweight patients, special attention must be given to total caloric consumption; patients who are on insulin therapy must schedule their meals to provide regular caloric intake.

There is no need to disproportionately restrict the intake of carbohydrates in the diet of most diabetic patients. Flexibility in diet design, therefor, helps many patients to adhere to an effective program. Lowering of fat consumption, however, may reduce risk factors of coronary heart disease, the most important cause of death and debility in the diabetic. One third of diabetic patients in clinical surveys have hyperlipidemia, clearly indicating the need for dietary management. This is reflected in the standard diet and food exchange lists revised in 1976 by the American Diabetes Association which restricts the intake of fat to 35% of calories .

In the system of food exchanges the calculation of the proper diet and the selection of foods by the patient are divided into six food lists. In each is listed the kind and amount of food having about the same nutritional value in carbohydrate, protein, and fat. The diet exchange method is based on "Exchange Lists for Meal Planning" prepared by and available from the American Diabetes Association and the American Diabetic Association.

One of the first dietary rules for all diabetics is to avoid all sugar and food containing sugar, such as pastry, candy, and soft drinks. While these refined sugars and other simple carbohydrates like white flour must be carefully watched, most diabetics are actually encouraged to eat more complex carbohydrates - the same bulky, fiber-rich unprocessed foods that are now recommended for everyone. Vegetables are ideal. For example, a diabetic can eat a large plate of spinach, which contains as much carbohydrate as a tablespoonful of sugar, without suffering any ill effects.

Spinach, asparagus, broccoli, cabbage, string beans, and celery are among the so-called "Food Exchange Group A" vegetables which the American Diabetes Association says can be generously included in the diabetic diet. What makes these complex carbohydrates special is their ability to slow down the body's absorption of carbohydrates by helping to delay the emptying of the stomach and thereby smoothing out the absorption of sugars into the blood. Whole grain cereals also have this ability.

Since diabetics are also particularly prone to atherosclerosis with the complicating problems of heart attacks, strokes, and poor circulation to the feet, they must also limit the amount of fat in their diet and to substitute polyunsaturated fats for the saturated type when possible. Fish and poultry are especially recommended instead of fatty cuts of meat. Greasy, fried foods are strongly discouraged.

It has also been found that in diabetics, platelets, the blood elements which are part of the blood clotting mechanism, tend to clump together too quickly. This condition is thought to contribute to vascular complications such as retinal hematoma, coronary thrombosis, and microangiopathy. At present there are at least eight natural substances which have been shown to inhibit abnormal platelet adhesiveness. These include, Vitamins C, E, B6, Linoleic acid, onions, garlic, bromelain, and mackerel- the active ingredient in mackerel being eicosapentaenoic acid. Important tests to measure for platelet aggregation and other conditions which may indicate the progression of atheroma include test for cholesterol, HDL-cholesterol, triglycerides, and a treadmill EKG.

Overweight diabetics, by carefully calculating the proper daily calorie intake for their body weight and activity level, and never exceeding it, can usually bring their weight down to an optimal level - a level which is actually 10% less than the standard height and weight charts recommend.

"The overweight diabetic who successfully brings their weight back to normal usually experiences a dramatic improvement in their condition. Indeed, the symptoms often virtually disappear," says Charles Weller, M.D., in his book, The New Way To Live With Diabetes (Doubleday, N.Y. rev. 1976). "Weight reduction and control can bring this incurable disease closer to complete remission than any medication."

Many diabetics eat smaller, more frequent meals, rather that the two or three big meals most people consume daily. Researchers have found that multiple frequent feedings tend to keep blood cholesterol levels lower, for the diabetic and nondiabetic alike. Since diabetics eat less than most of us, they are advised to make every calorie count.

Generally, a well-balanced diet rich in vitamins and minerals is one of the most important factors in the control of diabetes. Some authorities find that the diabetic is unable to convert carotene into vitamin A, while others deny such findings. It is advisable, therefore, for the diabetic to ingest at least the Recommended Dietary Allowance of vitamin A from a non-carotene source, such as fish-liver oil. Diabetics and others on low-fat diets often need supplemental amounts of this fat-soluble nutrient.

Also recommended is a vitamin E supplement, ranging from 400-1200 I.U. per day and a vitamin C supplement ranging from 1000-4000 mg per day to help prevent small-vessel disease of the extremities. Diabetics, like everyone else, need all the known nutrients, including 12 vitamins and 17 minerals. To be sure of getting the full range of trace elements and other nutrients, diabetics are encouraged to eat the widest possible variety of permitted foods, in addition to taking supplements. It is interesting to note that certain nutrients- vitamins B1, B2, B12, pantothenic acid, C. protein, and potassium- along with small frequent meals containing some carbohydrate, can stimulate production of insulin within the body. The minerals zinc, chromium, and manganese have also been associated with the treatment of diabetes.

Brewer's yeast is another food supplement that is recommended for the diabetic patient. The yeast is a rich source of chromium-containing GTF (glucose tolerance factor), which is able to potentiate the insulin in our bodies. Both brewer's yeast (9 gm/day) and trivalent chromium (150-1000 mcg/day) have been shown to significantly improve blood sugar metabolism when taken for several weeks to months. As a side benefit it has also been found that brewer's yeast and chromium supplementation lower elevated total cholesterol and total lipids, and significantly raise the levels of HDL-cholesterol- the beneficial or protective fraction of cholesterol. Diabetics who wish to minimize the ill effects of their condition should also eliminate cigarette smoking and alcohol and follow a program of moderate but regular exercise. It is also important to wear shoes which do not cause abrasions of the feet since a small sore that may be a nuisance to most people can lead to gangrene in a diabetic.

NUTRIENTS THAT MAY BE BENEFICIAL IN TREATMENT OF DIABETES

Vitamin Amount (when available)
Vitamin B complex
Vitamin B1 10 mg
Vitamin B2 10 mg
Vitamin B6 500-1000 mg
Vitamin B12 25 mcg minimum
Inositol 2-6 gm
Niacin Up to 100 mg
Panothenic acid
Pangamic acid
Vitamin C 1000-4000 mg
Vitamin D 400 IU
Vitamin E 400-1200 IU
Unsaturated FAT 2 Tbsp
Calcium
Chromium 150-200 mg
Iron
Magnesium 500 mg
Manganese Up to 50 mg
Potassium 300 mg
Zinc 100-150 mg
Vanadyl Sulfate 100-150 mg
Protein
Lecithin 3 Tbsp
Note: Quantities shown are not prescriptive; some are very high and represent therapeutic test dosages. Individual needs and tolerances will vary according to body size, metabolism, age, diet, and ailment.

HERBAL RX

Traditional herbalism places great value on blueberry leaves as a natural method of controlling or lowering blood sugar levels when they are slightly elevated. Results have shown that the leaves of the common blueberry plant has an active principle with a remarkable ability to reduce excess sugar in the blood. For those who have moderately elevated blood sugar, steep some leaves in hot water for half and hour and drink a cup of the tea 3x/day. Make the infusion fresh each time.


DIABETES IN THE YEAR 2001

Though there are no preventative measures that can be taken against diabetes at this time except for appropriate dietary and exercise guidelines, research into the causes and control of this disease continues to provide the possibility of new cures. With the discovery of insulin in the 1920's and the development of oral hypoglycemic drugs in the 1950's, a person who has diabetes can live an active and product life. The importance of early detection and proper management of this chronic disease cannot, however, be emphasized too strongly.

The therapy of insulin-dependent diabetes will surely be altered dramatically over the next few decades. One can project that there will be improved strategies for glucose control in established IDDM. This will include the widespread use of mechanical devices, which will involve both implantable glucose sensors and implantable insulin infusion systems; and successful pancreas, islet or beta cell transplantation, in the absence of the need of immunosuppressive therapy to prevent rejection. The advances will change the face of diabetes as we know it.

Moreover, we will see the application of immune intervention strategies at the time of onset of IDDM, with the reversal of the disease process. Ultimately, these strategies will be applied earlier in the sequence during a stage which we do not yet recognize as clinical diabetes. In these individuals otherwise destined to develop IDDM, the disease will be prevented.


DIABETES MELLITUS

ACCORDING TO TRADITIONAL CHINESE MEDICINE

There are two words in the Chinese language for diabetes: the traditional medical name, xiao-ke, which means "wasting and thirsting", and the modern term tang-niao-bing, which means "sugar urine illness". Discussion of diabetes by its traditional name appears in all the earliest texts, including the Nei Jing. Traditionally, it is divided into three types: upper, middle, and lower. Each type corresponds to a disproportionate emphasis on the three main symptoms - thirst, hunger, and excessive urination. Deficient Yin is usually associated with all three types. Also, a traditional diagnosis of "wasting and thirsting" may include illnesses besides the modern entity of diabetes. And the opposite is true - someone with tang-niao-bing would not necessarily have xiao-ke.

For this discussion Diabetes Mellitis will be viewed as it is in TCM, namely xiao-ke, or "wasting and thirsting disease" It is believed to be related to eating fatty or sweet foods in excess, and to emotional factors. In chapter 47 of Simple Questions it is explained that "...fat causes Interior Heat while sweetness causes fullness in the Middle Burner. The Qi therefore rises and overflows and the condition changes into that of thirsting and wasting". A passage from chapter 46 of the Spiritual Axis elaborates: "The five inner [Yin} Organs are soft and weak and prone to symptoms of wasting Heat...When there is something soft and weak there must be something hard and strong. Frequent anger is hard and strong and the soft and weak are thereby easily injured".

This condition arises when Heat exhausts the body fluids, injuring the Yin. According to TCM, irregular food intake in the form of over-consumption of fatty, greasy, pungent and sweet food, hot drinks and alcohol generates internal heat. Long-term internal heat may turn into pathogenic dryness, consuming body fluids. When body fluids are consumed, they fail to nourish the Lungs and Kidney The pathological changes seen in diabetes therefor always include Yin Xu and dry heat. These factors mutually influence each other- Yin Xu leads to dry heat, dry heat to Yin-Xu.

Xiao-Ke syndrome may also occur when there is Deficiency of the Kidney Yang whose Essence is unable to transform the Qi. Depending on the pattern, the disease is classified as upper, middle and lower wasting. These conditions are intimately related to the Lungs, Spleen and Kidneys respectively.

When dry heat consumes Lung fluid there is thirst. "Lung Fire" is characterized by great thirst, drinking large quantities of water and a dry mouth. The tongue is red with yellow moss; the pulse floating and rapid.

When heat is retained in Stomach and Spleen there is excessive appetite and constant hunger. "Stomach Fire" is characterized by large appetite and excessive eating, thinness and constipation. The tongue is red with yellow moss; the pulse rapid. If the Kidney is injured by Fire there can be profuse, frequent urination. "Kidney Fire" is characterized by frequent, copious urination, cloudy urine (as if greasy), progressive weight loss, dizziness, blurred vision, sore back, skin itching or ulceration, and vaginal itching. The tongue is red with scanty or no coat; the pulse is fine and rapid.

All three pathomechanisms involve the mutual exacerbation of yin vacuity and dryness heat scorching Kidney Yin essence and the fluids of the Lung and Stomach. Yin vacuity is primarily associated with Kidney and according to the principle that detriment to Yin affects Yang, Kidney Yang vacuity is also invariably observed in enduring cases.

Treatment is directed toward draining the Heat which has collected in the Triple Burner.

NEEDLING

Principle pointsFunctions
M-BW-12 (Yishu) Controls function of pancreas
UB-13 (Feishu) LU shu point to drain heat from Upper Jiao
UB-20 (Pishu) SP shu point to drain heat from Middle Jiao
UB-23 (Shenshu) KID shu point to drain heat from Lower Jiao
ST-36 (Zusanli) Uniting point of ST
KI-3 (Taixi) Source point of KID

Supplemental points

PointsFunctions
LI-11 (shaoshang)Drains Fire from LU
LI-10 (Yuji) Drains Fire from LU
UB-17 (Geshu)Meeting pt of Blood. Helps to gen. fluids
N-BW-10 (Pirexue)
UB-21 (Weishu)
CV-12 (Zhongwan)
When Heat in SP/ST results in hunger and
emaciation, these pts along with other Alarm
and Associated pt are use to drain excess
CV-4 (Guanyuan)Str. source Qi for freq. urination and def. KID Yang.
KID-7 (Fuliu)Used together to stabilize the KID Qi.
KID-5 (Shuiquan) Used together to stabilize the KID Qi

Method

The principal points on the back should be needled with only mild stimulation and without retaining the needles. The remaining points can be needled with moderate stimulation, retaining the needles from 10-15 minutes. Treat on alternating days, the treatments constituting one course.

For excessive thirst, add LI-11(Shaoshang), LI-10 (Yuji) and UB-17 (Geshu). For increased appetite accompanied by emaciation of the muscles, add M-BW-10 (Pireshu), UB-21 (Weishu) and CV-12 (Zhongwan). For frequent urination, add CV-4 (Guanyuan), KID-7 (Fuliu) and KID-5 (Shuiquan).

Ear Acupuncture

Points:
Method:
Insert and retain needles for about 15 minutes. Ten treatments constitute one course. Cutaneous Acupuncture
Tap along both sides of the spine, emphasizing the region between T-7 thru T-10. Each treatment should last about 5-10 min. daily, or on alternating days. Fifteen to thirty treatments constitute one course.

Moxibustion


For dryness in the mouth, burn 100 cones at UB-27 (Xiaochangshu). For frequent urination, moxa can be burned at the tips of the little finger and toe, as well as at points along the cervical vertebrae [e.g., GV-14 (Dazhui)].

Other Prescriptions


Remarks


Note: The foregoing discussion of point formulas was taken from Acupuncture-Comprehensive Text, (Shanghai). The following discussion is taken from a lecture presented by Professor Qui Mao-liang, Vice President of the China National Acupuncture Association.

Differentiation and Treatment According to Three Burners

I. Upper Burner

For Upper Wasting; injury of body fluids by LU-Heat, the treatment principal is to strengthen function of LU and tonify Yin.

Points: Functions:
UB-13 (Feishu) To strengthen LU, clear LU-Heat
LU-5 (Chize) To clear LU-Heat
CV-23 (Lianquan) To stimulate prod. of body fluids
ST-36 (Zusanli) To assist Feishu in strengthening LU.
Treatment should be given daily or every other day. Needles are retained for 30 min. Apply reinforcing method. In cases of severe thirst with very red tongue, apply reducing method.

II. Middle Burner

For Middle Wasting; injury of Yin by ST-Dryness, treatment principle is to clear ST-Dryness and tonify Yin.

Points: Functions:
UB-20 (Pishu)
UB-21 (Weishu)
ST-36 (Zusanli)
To clear ST-Dryness
ST-44 (Neiting) To clear ST-Dryness and Heat
KID-3 (Taixi) To tonify Yin
M-BW-12 (Yishu) Pancreas pt. [Loc 1.5 cun lat. T-8] Indicated for hyperfunction of SP
Apply reinforcing method. If the heat is severe apply reducing method. Treat daily or every other day. Retain needles 30 min.

III. Lower Burner

For Lower Wasting; exhaustion of KID-Jing and KID-Yin treatment principle is to strengthen function of KID and tonify Jing.

Points: Functions:
UB-23 (Shenshu) Tonify KID
CV-4 (Guanyuan) Nourish and stabilize KID
SP-6 (Sanyinjiao) Benefits KID, SP, LIV
KID-3 (Taixi) Tonify KID, pacify empty fire
Apply reinforcing method. Treat every other day. Retain needles 30 min.

Discussion

Patients commonly present with mixed syndromes. Treatment should be given according to the predominant clinical manifestations. Where there are clear signs of two of the excesses, e.g., thirst and excessive appetite, treat both. Flexibility in treatment is therefor necessary, for example:

  1. If there is thirst, yellow dry tongue coating, overflowing pulse, select points from Yang Ming channels.
  2. If there is Yin-Xu and uprising of Yang, with symptoms such as low-grade fever, night sweats, malor flush, deep-red tongue body, Fine and Rapid pulse, select P-5 (Jianshi) and GV-13 (Taodao) to clear Fire of the Xu type.
  3. If night-sweating is severe, add SI-3 (Houxi).
  4. KID-Yin Xu can lead to Qi-Xu. Alternatively Heat can consume ST-Yin leading to Qi-Xu. In the case of Qi-Xu symptoms such as shortness of breath after exertion, spontaneous sweating, Deep Thready pulse, apply moxibustion to CV-6 (Qihai) and CV-4 (Guanyuan).
  5. In the case of KID-Yang Xu with cold limbs, lower limb oedema, copious urination, pale tongue with white coating, Thready Deep, Weak pulse, apply moxibustion to GV-4 (Mingmen), and CV-4 (Guanyuan).

CHINESE SYSTEM OF FOOD CURES

Chinese nutrition uniquely differs from modern Western nutrition in that it determines the energies and therapeutic properties of foods instead of analyzing the chemical constituents of them, for example:

Spinach: cooling; strengthens all organs, lubricates intestines, quenches thirst, promotes urination. Boil tea from spinach and chicken gizzard. Drink 1 cup 3x/day. Or cook spinach with seaweed to cleans the blood and relieve hot skin eruptions and itchy skin.

Furthermore, Chinese nutrition takes into consideration such factors as method of preparation, body type, season, and one's geographical location in determining the appropriate diet. It is used both as a healing system and a disease prevention system. The advantage of Chinese nutrition lies in its flexibility in adapting to every individual's needs in the prevention of disease, and treatment of the whole person.

Diabetes Food Remedies

Sugar in the urine as one of the most important symptoms of diabetes was included in the Chinese medical classic, A Collection of Diseases, by Wang Shou, published in 752. For the first time in Chinese medical history, diabetes was listed among the eleven hundred diseases in the book. The author recommended pork pancreas as treatment for the disease, and had also used a special method of testing sugar in the urine: The patient passed urine on a wide, flat brick to see if ants gathered to collect the sugar.

This method of testing urine was more than ten centuries ahead of Richard Thomas Williamson (1862-1937), who invented a test for the same purpose. The Chinese author's treatment using pork pancreas was similar to modern treatment by insulin. In Chinese medicine, however, thirst, weight loss, fatigue, and sugar in the urine are considered the key symptoms of diabetes. When a patient recovers from any of these symptoms, the diabetes treatment is considered successful.

Case reports

1. Twenty-five diabetes patients were treated at the Canton College of Traditional Chinese Medicine by dried bitter melon slices; each dosage per day consisted of 250 g dried bitter melon slices boiled in water. The levels of their blood sugar taken 2.5 hours after meals, and of their urine sugar taken 24 hours after meals, were both statistically very significant; the same method has subsequently been applied on diabetic rats, which also resulted in a significant decrease in the level of blood sugar. The same report concludes that the effects of dried bitter melon are comparable to those of insulin. It is also suggested that when 100 g fresh clams are boiled in water with the dried bitter melon slices, the results should be better.

2. At the International Symposium on the Effects of Ginseng held in the Soviet Union in 1954, a report indicates that ginseng is capable of lowering the level of blood sugar; and a Chinese physician also points out that according to his experiments, ginseng is capable of reducing the level of blood sugar by as much as 40 to 50 mg/100 ml blood; such effects can continue for more than 2 weeks after the patient stops taking ginseng. Moreover, in some cases, insulin intake can be reduced while the patient is taking ginseng.

3. According to Chinese herb remedies, pork pancreas has a neutral energy and a sweet flavor. It was used as an ingredient in a dietary formula to treat diabetes in China that was originally published in 1846 in a Chinese diet classic, New Collected Works of Proven Dietary Recipes ; following is the recipe:

Boil a pork, beef, or lamb pancreas in water with 200 g yam; season with some salt. Divide into 4 parts. Eat each part once a day for 4 days. Or cut up a pork pancreas and bake until dry over low heat; grind into powder. Take 3-5 g in warm water each time, 3x/day. Or wash the pork pancreas, remove and discard all the white fat, and cut into thin pieces; boil over low heat in water with 20 g corn silk; season with some salt. Eat daily.

Vegetable and Grain Remedies for Diabetes

Bamboo Shoots: Cooling. Strengthen stomach, resolves mucous, promotes diuresis.
Blend bamboo shoots and celery juice, warm up and drink 1 cup 2x/day. Eat plenty of bamboo.

Bok Choy: Cooling. Clears Heat, lubricates intestines, quenches thirst.
Drink boy choy and cucumber juice.

Celery: Cooling. Tonifies kidneys, strengthens spleen and stomach, clears heat, promotes diuresis, lowers blood pressure.
Drink 3 cups lightly boiled celery juice daily. Or combine celery, yam and pumpkin to make vegetable pie.

Corn Silk: Neutral; sweet. Promotes urination; affects the liver and gall bladder; lowers blood sugar.
Boil corn silk with watermelon peel and small red beans in water. Drink as soup for relief of chronic nephritis with edema and ascites.

Kohlrabi: Neutral; bitter; sweet; pungent. Detoxicates.
Crush 10 g kohlarbi seeds into pwdr. Mix with a glass of boiling water. Strain through cheesecloth over a bowl and squeeze out all liquid.. Drink the liquid as tea first thing in the morning to induce bowel movements and urination.

Mung Bean: Cold; sweet. Cleans heat; quenches thirst; aids edema in lower limbs.
Make soup from mung beans, barley and rice. Or soak 100 mg mung beans overnight; boil in 3 cups water over low heat; drink 2x/day. Or grind mung beans into powder and take 15 g pwdr. dissolved in warm water 2x/day.

Mushroom (Chinese Black or Shitake): Neutral; sweet. Strengthens stomach; promotes healing; lowers blood pressure counteracts cholesterol; lowers blood fat levels.
Soak, blend with soak water; heat like soup and take on an empty stomach to clean toxins in the intestines. Or bake until it appears burned on the surface; eat 10 g 2x/day; or eat fresh.

Pearl Barley: Cooling. Promotes diuresis; str. spleen; clears heat.
Blend barley and water, boil and drink the liquid. Or cook soupy barley and eat like porridge. Pumpkin: Cooling. Dispels dampness; reduces fever; particularly beneficial for diabetes.
Eat a slice of pumpkin with every meal or bake pie with pumpkin, yam and potato.

Snow Peas: Cold. Strengthens middle warmer, detoxifies, promotes diuresis, quenches thirst.
Cook snow peas, blend juice; take 1/2 cup 2x/day.

Soybeans: Cooling. Clears Heat; detoxifies; eases urination; lubricates lungs and intestines.
Drink plain soy milk or eat tofu to relieve heat conditions.

Soybean Sprouts: Cooling. Promotes diuresis; cleans heat, esp. in the stomach.
Boil 4 hrs; drink tea lukewarm. Continue over a period of one month to relieve hypertension.

Spinach: Cooling. Strengthens all organs; lubricates intestines, quenches thirst; promotes urination.
Boil tea from spinach (incl. roots) and chicken gizzard; drink 1 cup 3x/day. Or cook with seaweed to cleanse the blood and relieve hot skin eruptions and itchy skin.

String Bean (Green Bean): Neutral; sweet, Kidney and Spleen tonic.
Boil 50 g dried string beans (with the shells) in water. Drink as soup once a day to relieve diabetes, thirst, and frequent urination.

Sweet Potato (Yam): Neutral; sweet. Strengthens spleen and stomach functions; tonifies qi; cleans heat; detoxifies.
Cook soup with winter melon. Or mix 50 g yam pwdr with 10 g pwdr American Ginseng. Dissolve 15 g in warm water; drink 3x/day .

Sweet Rice (Glutinous): Warm; sweet. Used as an energy tonic. Affects the spleen, stomach, and lungs. Relieves excessive urination, perspiration, and diarrhea.
Cook 50 g sweet rice with 60 g Job's tears and 8 red dates. Eat at meals to relieve various kinds of chronic diseases.

Tomato: Slightly cooling. Promotes body fluids; quenches thirst; strengthens stomach; cools blood; clears heat; calms liver.
Eat at least 1 raw tomato/day on an empty stomach.

Turnip: Cooling. Clears heat; removes dampness.
Boil with tops as a side dish.

Water Chestnut: Cold; sweet. Relieves fever and indigestion; promotes urination; affects the lungs and stomach.
Boil 5 water chestnuts in water with 1 fresh mandarin orange peel. Drink as tea 3x/day to relieve hypertension. Or Peel 100 g water chestnuts and chew them slowly in the morning and evening; or drink water chestnut juice to cure sore throat, hemorrhoids, and mouth canker.

Winter Melon: Cooling. Clears heat; detoxifies; quenches thirst; relieves irritability; dispels dampness.
Drink the fresh juice or make soup; drink 3x/day.

Wheat Bran: Cool; sweet. Affects the stomach.

Clinical report:

A treatment of diabetes: steam 60% wheat bran and 40% all-purpose flour ; add an adequate amount of vegetable oil, eggs and vegetables. Eat at meals to relieve diabetes. The proportion of wheat bran decreases as conditions improve. No drugs or nutritional supplements are given in this treatment. Among the 13 diabetes cases treated, blood sugar dropped to below 140 mg % in 3 cases and to 180 mg % in 7 cases; after treatment (which lasts from 4 days to 89 days), sugar in the urine changed from ++++ or +++ to neg. in 10 cases; but in general, sugar in the urine changed to negative within 1 month along with the disappearance of neuritis associated with diabetes.

Animal Product Remedies for Diabetes

Abalone: Neutral; sweet; salty. Detoxicates; sharpens vision. CI for persons with weak digestion.
Boil 20-25 g abalone with 250-300 g fresh radish in water. Drink as soup once every other day. Repeat 6-7X as a treatment program. (This is a time-honored recipe in Chinese folk medicine for diabetes).

Beef: Neutral; sweet. Used as a spleen, stomach, energy, and blood tonic; affects the stomach and spleen.
Boil lean beef with yam to make soup.

Clam (freshwater): Cold; sweet; salty. Detoxicates; sharpens vision; acts on liver and kidneys. Freshwater clam saliva is especially benificial for diabetes.
Cook clam with chive. Boil 150 g chives with 200 g clam and suitable seasoning. Drink in a day.

Milk: Cow's milk is Neutral; sweet. Pushes downward; used as a lung and stomach tonic; produces fluids and lubricate intestines; affects heart, lungs, and stomach. C.I. with diarrhea or mucous discharge.
Mix equal amounts cow's milk and goat's milk. Drink the milk as a substitute for tea or juice to improve the physical condition of diabetes patients and frequent urination.

Pork: Neutral; sweet; salty. Used to lubricate dryness; affects spleen, stomach and kidneys.
Cut up 100 g lean pork (red meats) to boil in water with 100 g Job's tears over low heat for 2 hrs. Eat at meals.

Fruit Remedies for Diabetes

Crab Apple: Neutral; sweet and sour. Quenches thirst; obstructive, affects the heart, liver, and lungs.
Boil 10 partially ripe fresh crab apples in an adequate amount of water until the water is reduced by half. Drink the soup and eat the fruit to quench thirst and relieve diarrhea.

Guava: Warm; sweet. Obstructive and constrictive; stops diarrhea.
Crush 90 g fresh guavas; squeeze out the juice to drink before meals; 3X/day to alleviate SX of diabetes.

Peach: Very cooling. Clears Heat; aids diabetes.
Eat fresh peaches.

Plum: Neutral; sweet; sour. Produces fluids; promotes urination and digestion; affects liver and kidneys.

Strawberry: Cooling. Lubricates lungs; promotes body fluids; strengthens spleen.
Drink 1 glass fresh juice 2X/day

Mulberry: Slightly cold. Quenches thirst; detoxifies; ton. kidneys; lubricates lungs. relieves constipation; calms spirit; promotes diuresis.
Boil mulberries as tea and drink 1/2 cup 2X/day.

Recipes

Winter Melon Soup

Cook until tender (about 25 min.) Then season with 1 tsp chives, 1 Tbls. tamari, 1 tsp peanut oil. Serves 4.

Stuffed Pumpkin

Cut the top off a small pumpkin; clean out the seeds and strings; save the lid. Fill with the following mixture:

Cover with pumpkin lid and bake at 350 degrees for 1.25-1.5 hrs. (Fork will easily go into pumpkin when done). Serves 4-6.

Azuki Bean and Squash Casserole

Cover beans and kombu with water and simmer about 1 hr, adding water as needed. Then add the cubed and peeled squash. Cook until tender (about 1/2 hr) Stir in a pinch of sea salt or 1-2 tsp tamari. Serves 4

HERBAL REMEDIES FOR DIABETES MELLITUS

While acupuncture is a distinctive feature of traditional Chinese medicine, China's herbal medicine has many parallels to, and is a part of the general quest for effective medicines to treat illness. Our ancestors recognized their dependence upon nature in both health and sickness. Led by instinct, taste and experience, they used plants, animal parts and minerals that did not belong to their usual diet. Until well into the 20th century, much of the pharmacopeia of scientific medicine was derived from the just this type of herbal lore. Today in the United States, about one quarter of the prescriptions dispensed by pharmacies contain at least one active ingredient derived from plant material.

The 20th century has also seen a revival of the more natural medicine as an outcome of the increasing discontentment with conventional medicine. By utilizing natural substances together in their whole form in accurate formulations, effectiveness will be maximized and side effects minimized. This is contrary to conventional medicine that extracts or synthesizes active chemicals which often, over time, produce drastic side effects due to their partiality.

Following is a list of herbs and herbal formulas that, through time-tested usage and modern pharmacological research have demonstrated their effectiveness in treating Xiao-Ke ; a disease specifically characterized by Increases intake of both fluids and solids, emaciation, polyuria, and glycosuria and broadly corresponding to diabetes mellitus.

Individual Herbs

Radix Anemarrhenae Asphodeloidis (Shi Mu)
Bitter; Cold. Enters LU, KID, ST. Cleans heat; quells fire; generates fluids. Comb w/ Rx Trichosanthis.

Radix Astragali (Huang Qi) Sweet; slightly warm. Enters SP, LU Tonifies SP and benefits Qi. Comb w/ Rx Dioscorea Oppositae (Shan Yao) and Rx Rehmanniae Glutinosae (Sheng Di Huang)

Tuber Asparagi Cochinchinensis (Tian Men Dong)
Sweet; bitter; cold. Enters LU, KID. Moistens the LU and nourishes the KID; used for LU and KID Yin Xu patterns.

Radix Codonopsis Pilosulae (Dang Shen)
Sweet; neutral. Enters SP, LU. Strengthens Qi; nourishes fluids; tonifies Middle Burner. In general the functions of this herb are analogous to Radix Ginseng (Ren Shen), although not as strong. Clinically used to tonify Qi of SP & LU. Dang Shen has a vasodilitory effect on terminal blood vessels.

Herba Dendrobii (Shi Hu)
Sweet; slightly salty; bland; cold. Enters ST, LU, KID. Nourishes deficient ST Yin. Comb/w Tuber Ophiopogonis Japonici (Mai Men Dong) and Rx Trichosanthis (Tian Hua Fen) for abdominal discomfort associated with ST Yin XU.

Radix Dioscoreae Oppositae (Shan Yao)
Sweet; neutral. Enters SP, LU, KID. Benefits the LU and nourishes the KID (yin &yang). Comb/w Rx Trichosanthis (Tian Hua Fen) for irritability and thirst associated with injured Fluids .

Radix Ginseng (Ren Shen)

Sweet; slightly bitter; slightly warm. Benefits Yin and generates Fluids. Tonifies Lu; benefits Qi; strengthens the SP and ST; benefits HT and calms the Spirit. Some patients can lower their insulin by taking this herb.

Radix Glycyrrhizae (Gan Zao)
Sweet, neutral (raw); sweet, warm (honey-baked). Enters all 12 Primary Channel (principally ST, SP) Tonifies SP and benefits Qi: commonly used for SP XU patterns.

Fructus Lycii Chinensis (Gou Qi Zi)
Sweet; neutral. Enters LIV, KID. Nourishes and tonifies LIV & KID: used for Yin and Xue Xu.

Fructus Mori Albae (Sang Shen)
Sweet; cool. Enters LIV. KID. Nourishes Yin and Xue. Comb w/Rx et Caulis Jixueteng (Ji Xue Tang) for Yin Xu

Tuber Ophiopogonis Japonici (Mai Men Dong)
Sweet; sl bitter; sl cold. Enters LU, ST, HT. Nourishes Yin and clears Heat. Experimentally has lowered serum glucose, speeded recovery of islets of Langerhans, and increased glycogen storage levels in rabbits with artificially induced diabetes mellitus.

Poria Cocos (Fu Ling)
Sweet; bland, neutral. Enters HT, SP, LU. Strengthens SP and harmonizes the Middle Burner; transforms phlegm and eliminates dampness.

Rhizoma Polygonati (Huang Jing)
Sweet; neutral. Enters SP, LU. Tonifies SP: used for Deficient SP or ST and debility after prolonged illness. Also tonifies Essence after a chronic wasting disease. Comb w/ Rx Dioscoreae Oppositae (Shao Yao) and Rx Astragali (Huang Qi).

Rhizoma Polygonati Odorati (Yu Shu)
Sweet; sl cold. Enters LU, ST. Nourishes Yin and moistens dryness: used for LU and ST Dry Heat or Deficient Yin patterns with cough, dry throat, irritability, thirst and intense hunger, and constipation.

Fructus Pruni Mume (Wu Mei)
Sour; warm. Enters LIV, SP, LU, LI. Generates fluids; alleviates thirst: used for thirst from Deficient Heat or Deficient Qi and Yin. Comb w/ Rx Trichosanthis (Tian Hua Fen) for thirst and irritability from injured fluids.

Radix Puerariae (Ge Gen)
Sweet; acrid; cool. Enters SP,St. Nourishes fluids; alleviates thirst, esp from ST Heat. Comb w/ Rx Trichosanthis (Tian Hua Fen) and Tuber Ophiopogonis (Mai Men Dong) for thirst.

Radix Rehmanniae Glutinosae (Shu Di Huang)
Sweet; sl warm. Enters LIV, KID, HT. Nourishes the Yin: used for Deficient Kidney Yin. Lowers blood pressure and serum cholesterol.

Fructus Schisandrae Chinensis (Wu Wei Zi)
Sour; warm. Enters LU, KID. Restrains Essence. Used for deficient LU/KID patterns. Calms spirit. Recent reports state this herb increases usuage of both liver glycogen stores and serum glucose. Comb w/ Radix Codonopsis (Dang Shen) and Ophiopogonis Japonici (Mai Men Dong) for symptoms associated with exhaustion from Qi and Yin.

Scrophulariae Ningpoensis (Xuan Shen)
Salty; sl bitter; cold. Enters LU, ST, KID. Nourishes yin; cleans true heat or internal heat. Lowers blood sugar, dialates blood vessels.

Radix Trichosanthis (Tian Hua Fen)
Bitter; sl sweet; sour; cool. Enters LU, ST. Quells heat; promotes fluids. Comb w/ Rx Glehniae Littoralis (Sha Shen), Tuber ` Ophiopogonis Japonici (Mai Men Dong), and Rx Rehmannieae Glutinosae (Sheng Di Huang) for ST Heat induced injured Yin.

Stylus Zeae Mays (Yu Mi Xu)
Sweet; neutral. Enters UB, SI, LIV. Promotes urination.

Herb Formulas

For Heat & Drought in the LU & ST
Bai Hu Jia Ren Shen Tang [White Tiger & Ginseng]
Eliminates Heat in the Qi-Stage and Yang-Ming Channel. To tonify vital energy and increase body fluids.

For Depletion of KID Yin
Liu Wei Di Huang Wan [Rehmanniae Six Formula]
Zuo Gui Wan [Replenishing the Yin (left) Pills]
These formulas reinforce the Yin of the LIV and KID.

Tian Wang Bu Xin Dan [King's Mind-Easing Tonic Pills]
Nourishes the Yin (vital essence) of HT & KID; sedative

For Depletion of both Yin & Yang
Jin Gui Shen Qi Wan [Pills to Restore Vital Energy and Ba Wei Di Huang Wan Function of KID]
Replenishes the Yang (vital function) of the KID; to warm the lower part of the body.

Yin and Yang depletion in the Upper Burner
Bai Hu Jia Ren Shen Tang [see above]

Yin and Yang depletion in the Middle Burner
Yu Nu Jian [The Fair Maiden Decoction]
Eliminates the intense Heat or Fire from the ST; to replenish the Yin (vital essence).

Yin and Yang depletion in the Lower Burner
Liu Wei Di Huang Wan [see above] Yin Gui Shen Qi Wan [see above]
You Gui Wan [Replenishing the Yang (right) Pills]
Replenishes the Yang (vital function) of KID; treat spermatorrhea

Patent Formulas

Yuechung Pills also known as Yu Quan Wan [Jade Spring Pills]
Nourishes Yin, strengthens KID, LU, & SP; dispels phlegm-heat; relieves thirst; circulates fluid; regulates appetite; calms shen. A classical RX for "sugar urine disease", used for both juvenile and insipid diabetes in mainland China.
The United Pharmaceutical Manufactory, Szechuan, PRC

Specific Juk Tsyn Wan
Produces saliva, quenching thirst; relieving fever, alleviating mental uneasiness; vitalizing blood activity, nourishing KID; invigorating nervous system and improving appetite.
Kwangchow United Manufactory of Chinese Medicine, PRC

BIBLIOGRAPHY

Western Medical Sources

  1. Merck Manual, Fourteenth Edition, Merck & Co. Inc. 1982
  2. Bricklin, Mark, The Practical Encyclopedia of Natural Healing, Rodale Press, 1983.
  3. Fishbein's Illustrated Medical & Health Encyclopedia, H.S. Stuttman Co. Ind, 1978.
  4. Biermann, June and Barabara Toohey, The Diabetics Total Health Book, J.P. Tarcher Inc. 1980
  5. Whitaker, Julian M., Reversing Diabetes, Warner Books, 1987.
  6. Turtle, John R., Diabetes Mellitus-Recent Knowlege on Aetiolgy, Complications and Treatment, Academic Press, 1984.
  7. A Monograph on the Nature, Diagnosis and Treatment of Diabetes Mellitus, The Upjohn Co. 1960.
  8. Guyton, Arthur C., Textbook of Medical Terminology, W.B, Saunders Co. 1976.

Traditional Chinese Medical Sources

  1. Kaptchuk, Ted, J., The Web That Has No Weaver, Conydon & Weed, 1983
  2. Jianfei, Chen, A Hemorrheological Study on the Effect of Acupuncture in Treating Diabetes Mellitus, Journal of TCM 7(2): 95-100, 1987
  3. 3. Li Cheng-Yu, Fundamentals of Chinese Medicine, East Asian Medical Society, Paradigm Pub. 1985
  4. O'Connor, John, Acupuncture-A Comprhensive Text, Eastland Press 1981
  5. Yeung, Him-Che, Handbook of Chinese Herbs and Formulas Vol II, Institute of Chinese Medicine, 1985
  6. Ni, Maoshing, The Tao of Nutrition, Union of Tao & Man, 1987
  7. Lu, Henry C., Chinese System of Food Cures-Prevention and Remedies, Sterling Publishing Co. 1986
  8. Fratkin, Jake, Chinese Herbal Patent Formulas-A Practical Guide, Institute for Traditional Medicine, 1986
  9. Bensky, Dan, Chinese Herbal Medicine-Materia Medica, Eastland Press, 1986.
  10. Qui Mao-liang, The Treatment of Diabetes by Acupuncture, Journal of Chinese Medicine, 15: 3-5, 1984

CLINTON CHOATE L.Ac.
E-MAIL: CHAOTE1@aol.com
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