| "Xiaoke disease" is a common disease inTraditional Chinese Medicine (TCM), clinically characterized by typical symptoms of polydipsia, polyphagia, polyuria and unexplained weight loss. Diabetes, a western medicine disease, is belonging to the TCM’s "Xiaoke disease" category. Currently, diabetes has become the third-largest killer second to malignant cancer and cardiovascular diseases. Due to the fact that "Xiaoke disease" comprises diabetes, this article is to discuss the awareness of TCM as the base of history of the "Xiaoke disease" development. TCM is a holistic medicine for whole human body and is continuously rolling forward with whole of life as the driving force. For the awareness of the " Xiaoke disease" the first effort is to understand the disease name, etiology, pathogenesis and treatment in TCM. In the "Nei Jing", "Xiao" and "Ke" are different symptom names, "Xiaoke" is therefore a combined name of these two symptoms characterized by polydipsia, polyphagia, polyuria, weight loss and fatigue.Accumulated experience of clinical diagnosis found a key feature of sweet urine in "Xiaoke disease" patients, and this finding was recorded in the book of "Yixue-Zhong-Zhong-Can-Xi-Lu" authored by Zhang Xi-Chun (1860-1993) for the points concerning "Xiaoke disease", a statement about sweet urine copied from "Sheng-Ji-Zong-Lu" deals "always feel thirsty and drink much water, frequent micturition, urine looks like oil and with oatmeal-like sweet, all are features of "Xiaoke disease". In addition, "urine is unusually sweet when disease comes up"Zhang Xi-Chun, a modern physician, definitely proposed that "Xiaoke disease ", so-called diabetes mellitus in western medicine. The time that Zhang giving this proposal is close to that Dr. Charles Herbert Best (1899-1978), a Canadian who won the 1923 Nobel Prize for medicine, finding that pancreatic hormone insulin could be used for diabetes treatment. Zhang Xi-Chun is the first Chinese physician who suggested spleen (including pancreas) pathology to be involved in "Xiaoke disease". Boldly to conjecture, Zhang’s profound researches about sweet urine of "Xiaoke disease" patients is quite probably earlier than 1923.Awareness of disease etiology is divided into five categories. Mostly are improper diet, accumulated heat injuring yin essence, and congenital deficiency. Others are deficiency of five zang-organs, emotional depression which impairs the human body, improper labor and idleness which cause internal injuries, excessive sexual activity which hurts kidney, dampness qi and dryness qi, which are the" conciseness of six unhealthy qi". About the awareness of the pathogenesis, traditional mainstream believes dry-heat engendered by yin deficiency to be the major cause, and the modern Chinese medicine summarizes it as yin deficiency to be the root and dry-heat to be the tip.For awareness of the pathogenesis, there are different perspectives with respective basis, and treatment is also based on different understanding for syndrome differentiation. Yin deficiency-engendered dry-heat is as the main pathogenesis for "Xiaoke disease" in TCM. While modern medicine considers yin deficiency and dry-heat to be processes in early pathogenesis stage of "Xiaoke disease". Following the deterioration of patient’s condition, the disease will enter the process of dual deficiency of qi and yin and dual deficiency of yin and yang. Internal phlegm and stasis are the pathological product of "Xiaoke disease", which would raise the induction of "Xiaoke disease" and make complications more serious, and is therefore mutually related to the development of "Xiaoke disease" as reciprocal causation.Pathogenesis analysis should note " similarities", which are divided by the inner arts of structure system、physiological functions、basic substance states、and movement of exercises as the bases. Take note of connecting the structure system and physiological function of the system as a whole, along with the relationship between the five viscera, the relationship between five viscera and basic substances, the relationship of conversion between basic substances, the relationship of functions between viscera and the lifting state and discrepancy of basic substances, and smooth condition analysis of physiological and pathological characters. Avoiding long phase development of disease, so that the overall analysis of pathogenesis reduced to stages and classifications of syndromes; and then to see the wood of trees; but ignore the similarities of the pathogenesis of diseases, which are the deepness, mechanism, and spirituality of I-ching.Yin deficiency-engendered heat dry and internal growth of phlegm and stasis, the former is a pathogenesis name of "Xiaoke disease" disease process, and the latter is a pathological product name. Phlegm and stasis plus damp turbidity could further aggravate the "Xiaoke disease" and accompanied complications; however, neither is the core pathogenesis for "Xiaoke disease". The real core pathogenesis is the so-called "spleen and stomach of nutrient essences not properly transformed", that is, the spleen and stomach as the central burner decrease their function to digest and transform the quintessence to whole body organs. The disease is originated in the center burner and spleen is first influenced, and then to the stomach. If both the spleen and stomach are affected, according to Huang Yuan Yu’s" central qi and four zang-organs preservation theory", the liver, lung, heart and kidney will also be affected. Therefore, all the five zang-organs in the body will finally be sick, with just little difference in severity.As the awareness of the pathogenesis, there are various perspectives based on respective knowledge and experience, clinical treatment also based on different understanding for syndrome differentiation. All the past Chinese medicine left valuable experience for later generations. In 19th century, after collisions between Chinese and western medicine, medical persons still have diverse viewpoints on pathogenesis of "Xiaoke disease" Modern Traditional Chinese Medicine physicians recognize that the pathogenesis is the happenning,development, and change of mechanism of desease ending. Pathogenesis theory is the study of interation of body mechanism and causes of diseases factors. Research the principle and regulation of developments and changes after diseases happenmings. Explain the relationship between process and the causes of science of disease. However, the definition of pathogenesis of Traditional Chinese Medicine approaches to syndromes.Finally, on the basis of contributions collected from the various, and great numbers of medical persons,, and passing smooth of basic substance between viscera forming the energy of functions of viscera prolonged chronic disease "Xiaoke disease", divided into different stages. And, a novel core pathogenesis theory is herein proposed for the "Xiaoke disease" based on the complex pathogenesis concepts. This core theory will incorporate the transformation invalidation of spleen and stomach as the central parts to validate subtleties errors. The major damage is at the central parts to spleen and stomach for the first phase. Secondly internal organs are implicated also of different damage by degree. This pathogenesis is matched with the TCM philosophy. Prospecting in the new era, the Traditional Chinese Medicine(TCM)will play a greater advantage and role in the treatment of "Xiaoke disease"... |
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