Diabetes and Insulin Resistance Syndrome

[Guest guest]

Been doing some research into the pathogenesis of insulin resistance and

diabetes according to the TCM paradigm. There's a lot of research going on

about this at the moment, a lot of comparisons between TCM and western

models. Insulin resistance sometimes leads to diabetes - not always.

 

Diabetes (3 worsening levels):

1 Yin deficiency

2 Qi and Yin deficienct

3 Yin and Yang deficiency

--over heat, wet and turbid and blood stasis are symptoms

 

Insulin resistance/syndrome x/hypertension (four types):

abundant phlegm-dampness type

exuberant Liver-Fire type

Yin-Yang deficiency type

Yin deficiency and Yang-Excess type

CONCLUSIONS:

The Excess Syndrome was severe and deficiency Syndrome was mild in

hyperinsulinemia. The pattern of change was in accordance with etiology and

pathogenesis of TCM.

 

Is phlegm an excess syndrome?

Can phlegm and liver fire lead to yin deficiency?

 

 

Then I found an article by Bob Flaw about Insulin Resistance syndrome:

 

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HREF= " http://www.chinesemedicaldiabetes.com/articles/articles/article_syndrome_x\

..h " >http://www.chinesemedicaldiabetes.com/articles/articles/article_syndrome_x.h\

</A>

tml

 

" My one criticism of this article is that it does not take into

consideration

spleen qi vacuity, and, in my experience with Western patients with this

condition, spleen vacuity often plays a significant part. This is because,

when the liver becomes exuberant and replete, the spleen commonly becomes

vacuous and weak. This tendency is so great that there are sayings in

Chinese medicine that, " If the liver is disease, first treat the spleen, "

and, " Liver disease is spleen disease. " Dr. Yang's protocol appears to be a

good one for those whose only vacuity is a yin fluid vacuity and

insufficiency. However, if there is a concomitant spleen qi vacuity, the

above protocol would need to be modified for that as well as the other

modifications Dr. Yang does suggest. "

 

I can't discern who is saying what condition is actually at the root of the

process, if anyone is indeed expressing an opinion as to 'which comes

first'??

 

Could spleen deficiency/liver excess lead to phlegm-damp and/or yin

deficiency too?

 

Victoria - help!?

 

Jackie

 

 

 

 

[Guest guest]

--- jackiejataylor wrote:

 

> Is phlegm an excess syndrome?

 

I wouldn't say so, although phlegm is an acumulation,

just in and of itself.

The source of phlegm can be from either excess or

deficiency. In the latter case, hypofuntion of spleen

will cause the spleen to generate phlegm. In the

former case we could have a heated liver congealing

the bile stored in the gallbladder leading to phlegm

accumulation in the gallbladder (stones). These are

jut examples, of course, there are many different kind

sof excess and deficiency which will produce phlegm.

 

> Can phlegm and liver fire lead to yin deficiency?

 

Liver fire will directly lead to deficiency of k yin

since it is directly burning off of the liver blood

and yin. Sorr about the clumsy wording - I said " off

of the liver blood " because it is very useful to keep

in mind that a fire cannot occur without fuel, and

that liver fire _always_ occurs concurrently with

damage to the liver blood/yin / kidney yin/jing. It's

just a matter of how much damage is incurred and how

quickly we recover from it.

 

There are some sayings in Chinese about how the

" kidney is the liver " , and the " liver is the kidney "

(sorry, I am paraphrasing). This is because of the

very close relationship between kidney essence and

liver blood/yin. In fact many herbs which treat liver

blood and yin also exactly treat kidney yin, eg

BaiShao and GouQiZi.

 

> Could spleen deficiency/liver excess lead to

> phlegm-damp and/or yin deficiency too?

 

Of course. Anytime there is fire it will burn down

the yin, and anytime there is a weakness of the 2

acquiring sources (lungs and spleen) the yin will not

be replenished.

 

It is very very important to be able to replenish our

Yin via our digestion and respiration, it's somethign

I can't stress enough to my patients, friends, family

and myself!

 

Hope that helps,

Hugo

 

 

 

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[Guest guest]

In a message dated 10/02/2003 05:13:29 GMT Standard Time, subincor

writes:

 

 

> > Is phlegm an excess syndrome?

>

> I wouldn't say so, although phlegm is an acumulation,

> just in and of itself.

> The source of phlegm can be from either excess or

> deficiency. In the latter case, hypofuntion of spleen

> will cause the spleen to generate phlegm. In the

> former case we could have a heated liver congealing

> the bile stored in the gallbladder leading to phlegm

> accumulation in the gallbladder (stones).

 

 

Right, got it.

 

>

> Liver fire will directly lead to deficiency of k yin

> since it is directly burning off of the liver blood

> and yin. Sorr about the clumsy wording - I said " off

> of the liver blood " because it is very useful to keep

> in mind that a fire cannot occur without fuel, and

> that liver fire _always_ occurs concurrently with

> damage to the liver blood/yin / kidney yin/jing. It's

> just a matter of how much damage is incurred and how

> quickly we recover from it.

 

 

So, I assume liver fire would be very obvious, but would liver heat, over a

long period, also damage blood/yin/jing, just to a lesser extent? Or is it a

progressive thing so that it can only damage eg the kidneys once it actually

reaches 'fire'?

 

>

> There are some sayings in Chinese about how the

> " kidney is the liver " , and the " liver is the kidney "

> (sorry, I am paraphrasing). This is because of the

> very close relationship between kidney essence and

> liver blood/yin. In fact many herbs which treat liver

> blood and yin also exactly treat kidney yin, eg

> BaiShao and GouQiZi.

 

 

Interesting - the same is said about liver/spleen isn't it.

 

>

> > Could spleen deficiency/liver excess lead to

> > phlegm-damp and/or yin deficiency too?

>

> Of course. Anytime there is fire it will burn down

> the yin, and anytime there is a weakness of the 2

> acquiring sources (lungs and spleen) the yin will not

> be replenished.

 

 

Ah yes - 'acquiring sources' helps.

>

> Hope that helps,

>

 

It does indeed, thank you! I really think I am nearly grasping that pattern

that is affection thousands of horses in some way that is becoming more and

more of a problem!!

 

There definately seem to be two main types affected - the more 'plegmatic',

easy-keeper ones who tend to fat, maybe hypothyroid (maybe spleen deficient

naturally) and the more constitutionally yin deficient types - the more

neurotic ones who are high energy and have trouble keeping weight on

naturally.

 

Insulin resistance starts out as a 'weight gain' condition, but both diabetes

and Cushings disease are 'wasting'. I was trying to see how the one type

could turn into the other, and if there might be general principles that

could be applied.

 

It seems it could be broadly spleen/liver -----> heat, phlegm, fire ------>

yin/kidney damage.

 

The more naturally yin deficient ones would more easily move towards the

wasting state anyway, I assume it would take less to 'tip them over'.

 

Jackie

 

 

 

 

 

[Guest guest]

> Is phlegm an excess syndrome?

 

Yes. Any Phlegm is too much. Just as any Qi Stagnation or Blood

Stasis is too much.

 

> Can phlegm and liver fire lead to yin deficiency?

 

Yin is damaged by Heat/ Fire. (Yang is damaged by Cold.)

 

> " My one criticism of this article is that it does not take into

> consideration

> spleen qi vacuity, and, in my experience with Western patients with

this

> condition, spleen vacuity often plays a significant part. This is

because,

> when the liver becomes exuberant and replete, the spleen commonly

becomes

> vacuous and weak. This tendency is so great that there are sayings

in

> Chinese medicine that, " If the liver is disease, first treat the

spleen, "

> and, " Liver disease is spleen disease. " Dr. Yang's protocol appears

to be a

> good one for those whose only vacuity is a yin fluid vacuity and

> insufficiency. However, if there is a concomitant spleen qi

vacuity, the

> above protocol would need to be modified for that as well as the

other

> modifications Dr. Yang does suggest. "

>

> I can't discern who is saying what condition is actually at the

root of the

> process, if anyone is indeed expressing an opinion as to 'which

comes

> first'??

>

> Could spleen deficiency/liver excess lead to phlegm-damp and/or yin

> deficiency too?

 

Spleen Qi Deficiency will lead to Damp which leads to Phelgm. One of

the functions of Spleen Qi is to transport and transform Fluids. If

the Spleen is weak, this doesn't get done, and Dampness accumulates.

If Dampness hangs around too long, Phlegm develops.

 

In actuality, the Liver can invade the Spleen because 1. the Liver is

in Excess or 2. the Spleen is weak.

 

But what he's talking about goes beyond Liver Invading Spleen.

Remember that in 5 Element Theory, Wood (Liver) and Earth (Spleen)

are in a Victor-Vanquished relationship to each other. If Wood

(Liver) is in Excess, Earth (Spleen) will be suppressed and

Deficient. If Wood (Liver) is Deficient (as in Liver Yin

Deficiency), Earth (Spleen) will be in Excess. Excess in this case

refers to Damp, and the Dampness further impedes Qi circulation.

(This can be one of those situation in which both Dryness and

Dampness are problems.)

 

Maciocia gives a clue for determining which came first. What color

is the face? " When the clinical manifestations pertain to one

Element and the face colour pertains to the Element which over-acts

on it, the face colour usually shows the origin of the disharmony.

In this case, loose stools and poor appetite are symptoms of

deficiency of Earth (Spleen) but the face is greenish: this indicates

that the root of the problem is in Wood, i.e. Wood over-acting on

Earth. " (Giovanni Maciocia, The Foundations of ,

p.304.)

 

There is a relationship not only between Wood and Earth, but between

the Liver and the Spleen. (I'm fine-tuning here.) This will not

only show up in many cases of diabetes, but in some other things as

well. For example, mononucleosis (glandular fever). I suffered from

recurring and chronic mono for a good part of my life. I would

experience pain in the liver area. Evenually, I would start to

experience pain in the left side (spleen area). The pain in the

right side in the liver area was annoying and uncomfortable (at times

cramping and severe), but I came to dread when I felt pain in the

left side as it always signaled that my health was going to get worse

overall. At the time I didn't know I had chronic mono. I knew I had

had mono several times when I was younger, but I thought I

had " outgrown " that. When I mentioned dreading pain in the left

side, that was when my doctor ordered a monospot test. It was

positive. A few years after that I discovered TCM, and a lot of

things began falling into place.

 

I have learned to pay attention to those pains in the liver area and

other symptoms of Liver imbalance because I don't want my Spleen

further weakened and hurt. I don't want to come down with another

active case of mono again. Experience has taught me that recurring

and chronic mono is a lot easier to prevent than it is to treat once

it has taken hold.

 

Victoria

[Guest guest]

In a message dated 10/02/2003 16:57:13 GMT Standard Time, subincor

writes:

 

 

> SPLEEN Qi Deficiency WITH phlegm accumulation in the

> middle warmer and Lungs.

 

 

Yes, I can see what you are both saying.

 

>

> The problem si not the phlegm, the problem is the

> Spleen Qi Def.

 

 

Funnily enough that is me - though I don't know where the phlegm is. It was

'harrassing my heart' to start with, but that was very quickly dealt with.

But, there was a real limit to the amount of tonification I could take - Ren

Shen sent me sky high with palpitations, so my herbalist went to (bai zhu?

one of the angelica's, the 'open the orifices one!) which really helped.

 

Then I read that Dang Shen (codonopsis) had a very different chemistry from

Ren Shen and asked if I could try that - and I'm fine on that.

 

>

> It is progresive, it is a spectrum, and there is no

> on off switch, so the kidneys are always affected.

> It's a constant supply line from the kidneys to the

> liver - so any changes in the liver's economy are

> immediately reflected in the kidneys as they either

> reduce supplied or need to provide more. It's mainly a

> question of amount.

>

 

Makes sense. Thank you very much, it really helps.

 

Jackie

 

 

 

[Guest guest]

> > > Is phlegm an excess syndrome?

> >

> > I wouldn't say so, although phlegm is an

> acumulation, just in and of itself.

 

> Right, got it.

 

Victoria stated clearly that phlegm is excess, I do

agree with her, however my point, I suppose, is that I

don't consider phlegm an excess syndrome in and of

itself. For me, phlegm is always an end result of a

fairly developed pattern (we could say a mature

pattern). The phlegm has many effects, of course, and

contributes to a pattern, but only in a dead and

stupid way. Phlegm is not an organ and has no function

on its own; it's an unintelligent, non-living

obstruction.

So, for example, if we have a phlegm accumulation in

the middle warmer and lungs, we need to make our

diagnosis something like this:

SPLEEN Qi Deficiency WITH phlegm accumulation in the

middle warmer and Lungs.

We can clearly see that the phlegm is a result and

that treating " phlegm " is not correct. It would also

be incorrect to use herbs which resolve phlegm in the

lungs to treat this since the Lungs are suffering

seconfarily. The root must be treated. The priority is

clearly to treat the Spleen Qi Def, then to resolve

phlegm in the mid warmer, then to treat the lungs with

their phlegm.

The problem si not the phlegm, the problem is the

Spleen Qi Def.

 

> So, I assume liver fire would be very obvious, but

> would liver heat, over a

> long period, also damage blood/yin/jing, just to a

> lesser extent?

 

Yes, it does.

 

> Or is it a

> progressive thing so that it can only damage eg the

> kidneys once it actually

> reaches 'fire'?

 

It is progresive, it is a spectrum, and there is no

on off switch, so the kidneys are always affected.

It's a constant supply line from the kidneys to the

liver - so any changes in the liver's economy are

immediately reflected in the kidneys as they either

reduce supplied or need to provide more. It's mainly a

question of amount.

 

Ok, bye for now,

Hugo

 

 

 

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