Diabetes Mellitus - Xiao Ke

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Contents

Definition

A condition characterised by excessive intake of water, polyphagia, polyuria and emaciation or turbid urine with sweet smell.

Xiao

Ke

  • Thirst

Causes

  • Food and drink: spicy, fatty and sweet food. Alcoholic drinks. Heat accumulation and over-consumption of fluid
  • Extreme emotions: the five emotions. Stagnated heat consumes and impairs fluid.
  • Intemperance of sexual activity: kidney essence consumption. Kidney deficiency leads to fire.
  • Febrile diseases consume yin fluid.

Pathological Mechanisms

Upper Xiao – Lung

Middle Xiao – Spleen and Stomach

  • Excess Fire (Stomach)

a. digest food and drink too rapidly b. Stomach Fire burns the Lung, aggravates upper xiao c. transfers downwards to the Kidney: becomes lower xiao

a. Stomach Fire impairs Yin b. overwork impairs Spleen Qi

Lower Xiao – Kidney

a. root of Yin and Yang, the Zang of Water and Fire b. yin-yang and water-fire imbalance and disharmony c. upper xiao and middle xiao can impair the Kidney, leading to “combined disease” of upper, middle and lower xiao d. Kidney water fails to support the Lung and Stomach, leading to “combined disease” of upper, middle and lower xiao e. Vital Gate Fire (Kidney Yang) extinguishing: leads to Lung Cold and Stomach Cold

Patterns

Upper Xiao

  • Symptoms: Thirst, hunger and urination: excessive intake of water but not food, frequent and large amount of urination and a dry mouth.
  • Tongue: Dry tongue, red edge and tip, thin and yellow coating
  • Pulse: Surging and Rapid
  • Treatment strategy: Clear heat and moisturise the lung to generate fluid and relieve thirst
  • Formula: Xiao Ke Fang or Sheng Mai Yin
  • Acupoints:

Middle Xiao - Stomach Fire

  • Symptoms: Thirst, hunger and urination: excessive intake of water and food, feeling hungry all the time, dark urine, constipation and weight loss.
  • Tongue: Yellow coating
  • Pulse: Slippery and Solid
  • Treatment strategy: Clear and purge stomach fire, nourish yin and replenish fluid
  • Formula: Yu Nu Jian
  • Acupoints:

Middle Xiao - Spleen Qi Deficiency and Stomach Qi Deficiency

  • Symptoms: Thirst, hunger and urination: thirsty but drinks not much and hungry but appetite is poor. If drinking a little more there will be edema. Feeling very weak when slightly hungry, clear and sweet urine, lassitude and tiredness and loose feces.
  • Tongue: Pale tongue
  • Pulse: Weak
  • Treatment strategy: Tonify qi to control the essence
  • Formula: Bai Zhu San
  • Acupoints:

Lower Xiao - Kidney Yin Deficiency

  • Symptoms: Thirst, hunger and urination: thirsty but not too hungry, frequent and large amount of urination, sweet urine, cloudy and turbid urine, dry mouth, achy and weak lower back and knees, vexation, seminal emission and insomnia.
  • Tongue: Red and dry tongue
  • Pulse: Thready and Rapid
  • Treatment strategy: Nourish yin and consolidate the kidney
  • Formula: Zuo Gui Yin and Liu Wei Di Huang Wan
  • Acupoints:

Lower Xiao - Yin and Yang Deficiency

  • Symptoms: Thirst, hunger and urination: long history of three Xiaos, thirst but drinks not much, not very hungry, frequent and large amount of urination (even “drink one and urinate two”). Clear, sweet or turbid urine, dull black complexion as if smoked, dry ear as if baked, achy and weak lower back and knees, cold body and limbs and impotence.
  • Tongue: Pale tongue with white coating
  • Pulse: Deep, Thready and Weak
  • Treatment strategy: Warm yang, nourish and consolidate the kidney
  • Formula: You Gui Wan and Jin Gui Shen Qi Wan
  • Acupoints:

References

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