DEFINITION AND SYMPTOMS Diabetes Mellitus, is a disease in which the pancreas produces insufficient amount of insulin, or in which the cells fail to respond appropriately to insulin. Insulin is a hormone that helps the cells to absorb glucose (sugar), so that it can be used as a source of energy. In people with diabetes, glucose levels build up in the blood and urine, causing excessive urination, thirst, hunger, and problems with fat and protein metabolism. Diabetes mellitus differs from the less common diabetes insipidus, which is caused by lack of the hormone vasopressin (ADH), which controls the amount of urine secreted.
TYPES Type 1: Diabetes is classified into two types. In Type 1 diabetes, formerly called insulin-dependent diabetes mellitus (IDDM) and juvenile-onset diabetes, the body does not produce insulin or produces it only in very small quantities. Symptoms usually appear suddenly, typically in individuals under 20 years of age. Most cases occur around puberty and around age 10 to 12 in girls and age 12 to 14 in boys. In the United States Type 1 diabetes accounts for 5 to 10 percent of all diabetes cases. In Canada, Type 1 diabetes accounts for about 10 percent of all diabetes cases. Type 2: In Type 2 diabetes, formerly known as non-insulin-dependent diabetes mellitus (NIDDM) and adult-onset diabetes, the body's delicate balance between insulin production and the ability of cells to use insulin goes wrong. The symptoms or characteristics of Type 2 diabetes include those found in Type 1 diabetes, as well as repeated infections or skin sores that heal slowly or not at all, generalized tiredness, and tingling or numbness in hands or feet.
SIGNS AND SYMPTOMS: Increased thirst, a frequent urge for urination, hunger, a flu-like feeling, including weakness and fatigue, unexplained weight loss, blurred vision, irritability, slow healing of cuts and bruises, tingling or numbness in hands or feet, red, swollen and tender gums, recurring infections of the gums, skin, vagina or bladder
DIFFERENTIAL DIAGNOSIS AND FORMULAS In Oriental Medicine, Diabetes is categorized under "Xiao Ke".
1. LU Heat with Fluid Deficiency S/S: thirst with desire to drink even after drinking, dry and heat sensation in the throat, polyuria, red tongue, lack of saliva, thin yellow coating, rapid pulse Modified Xiao Ke Fang (Dan Xi Xin Fa, 1481) Huang Lian Tian Hua Fen Ou Jie Sheng Di Sheng Jiang + Mai Men Dong Xuan Shen Ge Gen
2. ST Heat S/S: thirst with drinking lots of water, hungry easily even after big meal, thin body, dry stool, frequent urination, red tongue, yellow coating, slippery and rapid pulse
Modified Yu Nu Jian (Jing Yue Quan Shu, 1624) Shi Gao 9-15g Shu Di Huang 9-30g Mai Men Dong 6g Zhi Mu 4.5g Niu Xi 4.5g + Xuan Shen Jue Ming Zi
3. Qi and Yin Both Deficiency S/S: mental fatigue, tiredness, shortness of breath worse with exertion, weakness of lower limbs, dryness of mouth and throat, five palms heat, drinking lots of water, polyuria, slight pale tongue with teeth mark, thin white coating, lack of saliva, thready pulse Modified Ren Shen Bai Hu Tang (Za Bing Yuan Liu Xi Zhu, 1773) Ren Shen 6g Zhi Mu 10g Shi Gao 15g Tian Hua Fen 10g Ge Gen 10g Mai Men Dong 8g Dan Zhu Ye 8g Geng Mi 20g + Huang Qi Sheng Di Huang Xuan Shen
4. Yin and Yang Both Deficiency S/S: Pain on the lower bak and knee, aversion to cold, cold limbs, spermatorrhea, impotence, frequent urination during night time, dizziness, tinnitus, dark face, slight pale and swollen tongue, white coating, deep and week pulse. Modified Jin Gui Shen Qi Wan (Jin Gui Yao Lao, 3rd century) Sheng Di Huang 24g Shan Yao 12g Shan Zhu Yu 12g Fu Ling 9g Ze Xie 9g Mu Dan Pi 9g Gui Zhi 3g Fu Zi 3g + Gou Qi Zi Tu Si Zi Huang Qi Ba Ji Tian
1. The general treatment strategy in using acupuncture for weight loss: is to strengthen the Spleen, harmonize the Stomach, transform phlegm and drain dampness, warm and unblock the channels and collaterals, as well as raise the clear and descend the turbid
2. Select points: along the Foot Taiyin Spleen channel, Foot Yangming Stomach channel, the Ren channel and Foot Taiyang Bladder channel. Use tonifying or draining methods according to pattern diagnosis
3.Locations ● On the abdomen: choose ST25, RN6, and RN9. Insert the needles perpendicularly to a depth of approximately 1 cun ● On the upper limbs: use LI4 and SJ6. Insert the needles perpendicularly to a depth of approximately 1.5 cun ● On the lower limbs: select ST36, ST37 and ST39, use perpendicular insertion to a depth of approximately 2 cun. For all these points, needling should result in the area feeling achy and distended
4. Technique ● Select 4-6 points at a 1 or 2 cun from RN8. Needle all points obliquely towards the navel. Insert to about 1 cun, or until the area is achy and distended
5.Differentiation ● Spleen deficiency: add UB20, RN12, and RN4, using a tonification technique ● Stomach Heat: add UB21 and UB17. Use a draining technique, and strong stimulation. ● Liver and Gallbaldder damp-heat: add UB18, UB17, and LV3; use a draining technique ● Liver and Kidney Yin deficiency: add UB18, UB23, KD3, and SP6. Apply a tonifying technique ● Qi stagnation and Blood stasis: add UB18, UB17, LV3, and SP10. Use a draining technique on LV3 and tonifying on all other points.
6.Electro Acupuncture After the arrival of Qi, an electrical acupuncture stimulation device may be applied to the needle handles. Use continuous waveform, with a frequency of 3-4 cycles/second, and an intensity as strong as the patient can tolerate. Treat for 30 minutes. Treatment should be given every other day; a treatment course consists of one month of treatment.
7.Key aspect The key aspect of acupuncture treatment for weight-loss is to select points on the basis of pattern differentiation; and to use tonifying or draining manipulations suitable to the body's Yin and Yang, Zang Fu, Qi and Blood, and Channels. In this way, it can achieve similar treatment results for different patients.
8.Auricular Acupuncture ● Primary Point: Appetite Control, Mouth, Stomach, Small Intestine, Shen Men ● Supplementary Point: Point Zero, Thalamus Point, Master Sensorial, Master Cerebral, Endocrine Point, Anti-Depressant Point, Occiput
1. FANG FENG TONG SHENG SAN ● EXCESS + HEAT ● CENTRAL OBESITY ● DETOX: CIRCULATION, INTEGMENTARY, DIGESTIVE SYSTEM Dang Gui 4.8g Bai Shao 4.8g Chuan Xiong 4.8g Zhi Zi 4.8g Lian Qiao 4.8g Bo He 4.8g Sheng Jiang 4.8g Jing Jie 4.8g Fang Feng 4.8g Ma Huang 4.8g Da Huang 3g Mang Xiao 3g Jie Geng 4g Bai Zhu 4g Gan Cao 4g Huang Qin 4g Shi Gao 4g Hua Shi 6g
2. FANG JI HUANG QI TANG ● EDEMA + DEFICIENCY ● KNEE PAIN ● EDEMA/SWOLLEW ON FEET AFTER PROLONG STANDING Fang Ji 8g Gan Cao 4g Bai Zhu 6g Huang Qi 9g Sheng Jiang 6g Da Zao 6g
3. DA CHAI HU TANG ● UPPER BODY OBESITY ● CONSTIPATION, STRESS ● YELLOW COATING Chai Hu 12g Ban Xia 12g Huang Qin 6g Bai Shao 6g Zhi Shi 6g Da Zao 6g Sheng Jiang 8g Da Huang 4g
4. TONG DAO SAN ● LOWER ABDOMEN OBESITY ● BLOOD STASIS ● ESP. FOR WOMEN Dang Gui 6g Da Huang 6g Mang Xiao 6g Hong Hua 6g Zhi Shi 4g Su Mu 4g Mu Tong 4g Hou Po 4g Chen Pi 4g Gan Cao 4g
5. YUE BI JIA ZHU TANG ● EDEMA + EXCESS ● ACUTE JOINT PAIN INCLUDING KNEES ● DIAPHORESIS AND THIRST Ma Huang 12g Shi Gao 16g Sheng Jiang 6g Da Zao 8g Gan Cao 4g Bai Zhu 8g
K.F. (1) Obesity Basic Formula Yi Yi Ren 10g Shu Di Huang 10g Tian Hua Fen 4g Fang Ji 4g Gan Cao 3g Ze Xie 3g Zhu Ling 2g Dang Gui 2g Hong Hua 1g Su Mu 1g
K.F. (2) Obesity + Drinker, Thick fat deposit under skin, Heat Yi Yi Ren 20g Tian Hua Fen 10g Ge Gen 8g Mu Tong 6g Ze Xie 6g Zhu Ling 6g Huang Qi 6g Shan Yao 6g Shu Di Huang 6g Hong Hua 4g Su Mu 4g Gou Qi Zi 4g Shan Zhu Yu 4g Fang Ji 4g Yin Chen 4g Dang Gui 4g Ma Huang 4g Su Ye 4g Qiang Huo 4g
K.F. (3) Hypertension, Atherosclerosis, Stroke, Constipation, Heat Yi Yi Ren 20g Shu Di Huang 20g Gan Cao 6g Huang Lian 6g Shi Gao 6g Huang Qin 6g Jie Geng 6g Dang Gui 6g Mu Tong 6g Ze Xie 6g Chuan Xiong 4g Chi Shao 4g Hong Hua 4g Su Mu 4g Da Huang 2g Ma Huang 2g Bo He 2g Jing Jie 2g Bai Zhu 2g Zhi Zi 2g
K.F. (4) Obesity + Healthy in general, Good appetite, Desire to sleep, Don't want to exercise Yi Yi Ren 20g Shu Di Huang 40-60g Fang Ji 8g Gan Cao 6g Mu Tong 6g Ze Xie 6g Zhu Ling 6g Hou Po 6g Lai Fu Zi 6g Sang Bai Pi 6g Dang Gui 4g Gou Qi Zi 4g Shan Zhu Yu 4g Chuan Xiong 3g Hong Hua 3g Su Mu 3g Deng Xin Cao 2g
K.F. (5) Obesity + Gain weight easily even with drinking water Yi Yi Ren 20g Cang Zhu 10g Hou Po 10g Lai Fu Zi 10g Shu Di Huang 10g Mu Tong 10g Ze Xie 10g Zhu Ling 10g Fang Ji 6g Dang Gui 6g Gan Cao 6g Sang Bai Pi 6g Hong Hua 3g Su Mu 3g Ban Xia 3g Zhi Shi 3g
K.F. (6) Obesity + Weakness, Neurosis, Stress, Eating late at night Shu Di Huang 20g Yi Yi Ren 20g Shan Yao 10g Bai Fu Ling 10g Long Yan Rou 10g Dang Gui 8g Bai Zhu 8g Mai Men Dong 8g Bai Zi Ren 8g Suan Zao Ren 8g Ze Xie 6g Zhu Ling 6g Huang Qin 6g Hong Hua 4g Su Mu 4g Mu Tong 4g Yuan Zhi 2g Wu Wei Zi 2g
(1) Obesity + Food retention: Relieve food stagnation, Transform Damp Shan Zha 7g Ze Xie 7g Lai Fu Zi 7g Mai Ya 7g Shen Qu 7g Xia Ku Cao 7g Chen Pi 7g Bai Qian Niu Zi (fried) 7g (Semen Pharbitidis - white) Hei Qian Niu Zi (fried) 7g (Semen Pharbitidis - black) Jue Ming Zi 7g Fu Ling 7g Chi Shao Dou 7g Huo Xiang 7g Cha Ye 7g
(2) Obesity + Hypertension: Extinguish Liver Wind, Move Qi, Transform Damp He Shou Wu 10g Xia Ku Cao 10g Shan Zha 10g Ze Xie 10g Shi Jue Ming 10g Lai Fu Zi 10g Cha Ye 10g
(3) Obesity + Edema: Strengthen SP, Dry Damp, Drain Damp Cang Zhu 10g Bai Zhu 10g Ze Xie 10g Fu Ling 10g Che Qian Zi 10g Zhu Ling 10g Fang Ji 10g Cha Ye 10g
(4) Obesity + Excess Heat in Yangming: Relieve stagnation, Move Stool Da Huang 20g Zhi Shi 20g Bai Zhu 20g Gan Cao 20g Cha Ye 50g
(5) Obesity + Spleen deficiency with Damp: Strengthen SP, Expel Damp Ban Xia 5g Fu Ling 5g Chen Pi 5g Chuan Xiong 5g Zhi Ke 5g Da Fu Pi 5g Dong Gua Pi 5g Xiang Fu Zi (fried) 5g Ze Xie 5g Che Qian Zi 5g Cang Zhu (fried) 5g Bai Zhu (fried) 5g Yin Chen 5g Cha Ye 5g
(6) Obesity + Food retention and Blood stasis: Relieve food retention, Move Blood stasis Shan Zha 40g Ze Xie 7g Lai Fu Zi 7g Mai Ya 7g Shen Qu 7g Xia Ku Cao 7g Chen Pi 7g Bai Qian Niu Zi (fried) 7g (Semen Pharbitidis - white) Hei Qian Niu Zi (fried) 7g (Semen Pharbitidis - black) Jue Ming Zi 7g Fu Ling 7g Chi Shao Dou 7g Huo Xiang 7g Cha Ye 7g
FORMULA 1: Clear Stomach heat, Drain Damp, Strengthen SP Fan Xie Ye 1.5g (Folium Sennae) Ze Xie 12g Shan Zha 12g Jue Ming Zi 12g
FORMULA 2: Benefit Qi, Nourish Yin, Clear Damp-Heat Jue Ming Zi 6g Ze Xie 6g He Ye 6g Fang Ji 6g Lu Hui 6g Sheng Di 12g He Dou 12g Shui Niu Jiao 12g Yi Yi Ren 12g Ren Shen 12g
FORMULA 3: Strengthen SP, Expel Phlegm and Damp Ban Xia 9-12g Fu Ling 9-12g Cang Zhu 9-12g Yi Yi Ren 9-12g Da Fu Pi 9-12g Chen Pi 5-9g
FORMULA 4: Strengthen SP, Dry Damp and Phlegm Ban Xia 10g Chen Pi 10g Fu Ling 10g Yi Yi Ren 10g Da Fu Pi 10g Che Qian Zi 10g Ze Xie 10g Xiang Fu 10g Dong Gua Pi 10g Cang Zhu 15g Bai Zhu 15g Bai Zi Ren 15g
Indications are listed according to the following aspects of L.I. channel Organ: Large Intestine Channel: LI channel Five Element: Metal Six Energy: Yangming (Dry Metal)
Points Tonify ST36, LI11 Sedate SI5, LI5
Indications 1.Headache: headache on rainy day or damp weather 2.Ear: Middle ear infection, Parotitis (below the ear) 3.Eye: red eyes, sty 4.Nose: nasal blockage, nasal discharge, rhinitis, sinusitis 5.Tooth: toothache 6.DU14: if DU14 area is much more protrude than other person 7.Back: lordosis, lower back pain due to LI deficiency (can't stand long time) 8.Abdomen: abdominal distention, pain around the umbilicus 9.L.I. organ: Irregular bowel movement, constipation or diarrhea, rectal prolapse, chronic dysentery, bloody stool 10.Dampness: Excess Dampness pattern (b/c LI belongs to Yangming Dry Metal) 11.Skin: itchy, weepy, oozing skin 12.Channel: shoulder pain due to dislocation of shoulder joint, joint squishing sound, hernia, knee pain
HB's Tip: Korean four needle technique should be understood by comprehensive aspects; organ, channel, five element, and six energies.
DEFINITION AND SYMPTOMS Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually due to the change in the normal balance of vaginal bacteria or an infection. Vaginitis can also result from reduced estrogen levels after menopause.
Signs and symptoms: irritation and/or itching of the genital area, inflammation, vaginal discharge, foul vaginal odor, discomfort or burning when urinating, pain/irritation with sexual intercourse
Most common types: Bacterial vaginosis: Vaginitis caused by Gardnerella(a bacterium). This type of vaginitis results from overgrowth of one of several organisms normally present in your vagina, upsetting the natural balance of vaginal bacteria. More than one in six pregnant women in the United States has bacterial vaginosis, though many aren't aware of it. (Key: fish odor, pH>4.5) Yeast infections: Vaginitis caused by Candida albicans(a yeast). An estimated three out of four women will have a yeast infection in their lifetime. (Key: no smell, pH<4.5) Trichomoniasis: Vaginitis caused by Trichomonas vaginalis (a protozoan). This type is caused by a parasite and is commonly transmitted by sexual intercourse. (Key: possible smell, pH>5.0) Atrophic vaginitis: This type is resulted from reduced estrogen levels after menopause. The vaginal tissues become thinner and drier, which may lead to itching, burning or pain. (Key: Yin deficiency symptoms)
DIFFERENTIAL DIAGNOSIS In Oriental Medicine, Vaginitis is categorized under "Leukorrhea" or "Vaginal itching". There are two main differential diagnoses. 1. Damp-Heat pouring downward: itching, a thick, white or yellow, cottage cheese-like vaginal discharge, bitter taste, yellow coating, wiry-rapid pulse 2. Yin Deficiency with Heat: dry vagina, burning sensation, itching, yellow leukorrhea, five-palm heat, dry mouth, dry throat, red tongue, no coating, thready-rapid pulse
HERBAL FORMULAS 1. Damp-Heat pouring downward:Long Dan Xie Gan Tang Long Dan Cao 6g Huang Qin 9g Zhi Zi 9g Chai Hu 6g Mu Tong 4.5g Che Qian Zi 12g Ze Xie 9g Sheng Di 12g Dang Gui 9g Gan Cao 4.5g
2. Yin Deficiency with Heat:Zhi Bai Di Huang Wan Zhi Mu 6g Huang Bai 6g Shu Di 24g Shan Zhu Yu 12g Mu Dan Pi 9g Shan Yao 12g Fu Ling 7g Ze Xie 7g
EMPIRICAL FORMULAS Formula 1: Yeast infection or Trichomoniasis (External) Actions: Clear Heat, Expel Wind, Stop itching, Stop leurkorrhea Huang Bai 100g Gan Cao 50g Hua Jiao 50g Bai Zhi 50g
Formula 2: Atrophic vaginitis or Elderly vaginitis (Internal) Actions: Nourish Yin, Clear Heat, Relive stagnation, Transform Damp Ban Xia 10g Di Gu Pi 10g Zhi Ke (fried) 10g Gua Lou Pi 15g Bei Mu 15g Tu Fu Ling 25g Niu Xi 15g Zhi Gan Cao 15g Bai Shao 30g Chen Xiang 9g
Formula 3: Various Kinds (External) Actions: Dry Damp, Clear Heat, Kill parasties, Stop itching She Chuang Zi 30g Bai Bu 15g He Shi 12g Ku Shen 12g Xiong Huang 12g
Q: Hello! I'm looking for help in putting together a raw herbal formula for a patient who recently was involved in a motorcycle accident. He suffered six fractures total-collarbone, 3 ribs and 3 hairlines in the pelvis (ASIS, acetabulum and sacral area). Any suggestions? He is 29 y.o., tongue is enlarged (particularly at the sides and tip) with normal color and thin white fur, pulses are bowstring, slippery and long. Previous history of alcohol abuse, depression, migraines and bouts of anger. Had been working with him based on a diagnosis of damp heat in the Liver and had good success with a modified version of Xiao Chai Hu Tang. Any suggestions would be greatly appreciated!
A:FORMULA For collarbone fracture, try the following formula.
6.0g Pu Huang 6.0g Mu Dan Pi 6.0g Wu Ling Zhi 8.0g Tao Ren 8.0g Chi Shao 8.0g Dang Gui Wei 8.0g Niu Xi 8.0g Xu Duan 8.0g Bai Shao 6.0g Jing Jie 3.2g Gan Cao