Main Signs and Symptoms
Over the past 2 weeks: severe fatigue, profuse sweating, low energy, significant weight loss; elevated blood sugar, polydipsia, polyuria, and polyphagia. He is a solicitor, working long hours and often has insufficient sleep. His GP measured his fasting blood sugar and found a reading of 8.7mmol/L (which indicates well established diabetes type 2); urine sugar ++++. He looks physically and mentally exhausted.
Tongue: pale with very little coat
Diagnosis and Treatment
Xiao Ke (literally: wasting-thirst disorder) due to Spleen-Kidney Yang deficiency (mainly Kidney Yang deficiency)
Treatment Principle: Warm-tonify the Kidney Yang
Treatment: Zhuang Yang Yi Jing Wan (Epimedium & Ginseng Formula) for 4 weeks.
In addition he was advised to modify his diet and to begin exercising.
After 4 weeks taking Zhuang Yang Yi Jing Wan (Epimedium & Ginseng Formula) all of his symptoms were relieved and his energy levels had returned to normal. His fasting blood glucose had also returned to normal (5.5 mmol/L). Although a successful clinical outcome had been achieved, it was still necessary to continue treatment in order to consolidate the results and prevent relapse. The patient was advised to take Zhuang Yang Yi Jing Wan (Epimedium & Ginseng Formula) for a further two weeks.
The disorder traditionally described as xiao ke (wasting-thirst disorder, equivalent to diabetes in Western medicine) is commonly due to Yin deficiency with deficiency Heat and is thus generally treated by nourishing the Yin. However, this patient was unusual in that he had Yang deficiency. Therefore the appropriate treatment principle in this case was to warm-tonify the Yang. Treating with a large dose of Zhuang Yang Yi Jing Wan (Epimedium & Ginseng Formula) was the best way to do this, as the clinical results confirm.
In the ‘Yi Guang’ by renowned Ming dynasty physician, Zhao Xian-ke, there is a famous quote: ‘In treating xiao ke, there is no need to follow (the traditional differential diagnosis of) upper, middle and lower (type disorder); treat by primarily tonifying the Kidney’. In my clinical experience I have found this to be true. This is a very important insight as diabetes is a common disorder in modern times, which requires a clearly targeted approach for effective treatment