Diabetes Due to Overstrain

There are five kind of impairment due to overstrain (22) defined in "Huangdi's Internal Classic" and they are related to the five Zang organs. The five overstrains are important pathogenic factors in TCM. In this section we only concentrate on overstrain relates to the kidney that initiates the Xiao Ke syndrome. It does not mean the other overstrains and Zang-fu organs are unrelated and not important when dealing with the disease, But it is the kidney impairment due to overstrain that considered to be the fundamental cause.

In TCM the kidney system is not only a urogenital system with the functions of waste and toxic disposing and water adjustment, but also an important system of metabolism of the body fluid together with lung and spleen. Moreover, the kidney has the functions of storing essence and original Yin and Yang. It dominates water and bones, produces marrow, and connects to the brain. It has its opening in ears, anus and urethra, and it blooms in hair. And through the activities of kidney essence (23), it also regulates the growth and development of an individual. So kidney system covers many important processes and aspects that are vital constituents of the whole life activities. It has been regarded as the foundation of congenital essence and the root of life.

In the "Huangdi’s Internal Classic", it is said that "Kidney dominates water, receives and stores up the essence from the five Zang systems and six Fu systems". The essence that is stored up in the kidney can be subdivided into two kinds, the congenital essence and acquired essence. In "Huangdi's Internal Classic", it is said that "when the two Shen pulsate together, combined and formed, and a substance is born before the body, it is the essence." So the congenital essence is the reproduction essence inherited from parents before the forming of embryo.
Acquired essence, on the other hand, constitutes of the essence fluid transformed by Zang-fu organs and the essence transformed and produced from foodstuff and water by the spleen and the stomach. The congenital essence and acquired essence combined together as essence of life and stored in the kidney. It is the essential substance that maintains human life activities.

Kidney impairment due to overstrain (24) is most likely to occur with excessive sexual life. In addition, long term excessive physical labor that beyond the limitation a person can bear also lead to pathological change in the kidney. The long term over stretch of physical strength impairs the Qi of bone and marrow, which in turn consumes kidney-Qi (25). Excessive consumption of Qi causes obstruction of blood circulation and deficiency of body fluid thus deficiency of Yin. The deficiency of Yin generates heat that burns the Yin fluid of the kidney. The mal-nourishment of the liver system due to lack of kidney-fluid contributes to deficiency of Yin and hyperactivity of Yang, thus internal stagnation of dryness and heat. The pathogenic fire transformed from the internal stagnation of dryness and heat burns the Yin-fluid and aggravates Yin deficiency. Since there is an imbalance between the Yin and Yang in the liver system, the smooth circulation of Qi and blood is obstructed, thus affects the process of nutrient absorption and causes pathological changes in other parts of the Zang-fu system.

Excessive sexual life causes pathological change in the kidney system in a more direct and severe way. Excessive sexual life consumes the essence stored in the kidney and results in deficiency of Yin fluid which is vital for the nourishment of the whole Zang-Fu system. As the kidney essence is consumed by overstrain, the process of consolidating essence transformed from food and water by the stomach and the spleen to the kidney is obstructed. Like discussed above, the impairment of kidney-essence causes pathological changes in the liver system and the spleen system. The consumption of essence and deficiency of Yin-fluid result in deficiency of Yin and deficiency-heat (26), thus occurred Xiao Ke syndrome. In TCM, Xiao Ke syndrome caused by these factors is often referred to the syndrome of "Lower Xiao" (27), diabetes of the kidney type.

The kidney is the source of essence and interacts with other Zang-fu systems, pathological change in the kidney will have a severe negative impact on the whole body thus leading to various pathological changes in other parts of the body. E.g., deficiency of Kidney-Yin (28) results in hyperactivity of Yang that will cause excessive liver-Yang (29) and cause pathological change in the spleen. Deficiency in Kidney-essence results in malnutrition of marrow and brain. Deficiency of kidney fluid causes deficiency-fire burns the lung and can lead to asthma. Collectively, weak kidney is the source of deficient diseases of the whole body system including diabetes. Thus strengthening kidney-Qi and balancing the Yin and Yang of the kidney is an essential way to treat diabetes and its complications.