Middle consumption

　　1. Inheritance: As early as the Spring and Autumn and Warring States periods, it was realized that insufficient congenital endowment is an important internal factor causing diabetes. 'Ling Shu. Five Changes' says: 'Those with weak five internal organs are prone to diabetes, among whom those with yin deficiency are most susceptible to it.

　　2. Diet: Long-term excessive consumption of sweet and greasy foods, strong wine, rich flavors, spicy and dry foods, damages the spleen and stomach, leading to malfunctions in their transportation and transformation, internal accumulation of heat, drying of body fluids, consumption of grain and fluid, and resulting in diabetes. 'Su Wen. Strange Diseases' says: 'This is caused by the richness of food, and this person must have eaten a lot of sweet and delicious food and been overweight. The overweight person causes internal heat, and the sweet food causes the middle to be full, so the Qi rises and turns into diabetes.'

　　3. Emotional imbalance: Long-term excessive mental stimulation, such as depression and anger damaging the liver, leading to liver qi stagnation, or over-exertion of the heart and mind, excessive thinking, etc., causing long-term depression to transform into fire, internal combustion of fire, consuming the yin and juice of the lung and stomach, and resulting in diabetes. As mentioned in 'Medical Record Guide. San Xiao': 'Depressed and melancholic, the internal fire spontaneously ignites, which is a major disease of diabetes.'

　　It is said that patients with disease of middle consumption do not feel thirsty but have frequent urination, also known as internal consumption. It is caused by the evil heat smoldering the five internal organs. Then it extends to the muscles and physical form. It usually occurs in young people who consume stones excessively and have excessive sexual activity, leading to exhaustion of true qi and isolation of stone qi. If it accumulates in the kidneys, it becomes solid, causing the kidneys to consume water and fluid. Therefore, they do not feel thirsty but have frequent urination. They cannot nourish the five internal organs, and all the food they eat is excreted as urine. Treatment should be to nourish kidney water and moisten body fluids, and then it will recover.

　　Middle consumption is a type of diabetes mellitus. 'The Supplement to Treatments and Cures of Diabetes Mellitus': 'The upper consumption is related to the heart, with excessive drinking and little eating, normal stool, frequent urination. The middle consumption is related to the spleen, with a strong thirst and hunger, being able to eat but losing weight, red urine and constipation. The lower consumption is related to the kidneys, with depletion of essence and marrow, drawing water to save itself, and then urinating it out, thick and greasy like grease.'

　　The cause of internal consumption disease is that the patient does not feel thirsty but has a lot of urine. It is caused by taking a small amount of five stones, with heat stagnating in the kidneys. It is the action of internal heat. Therefore, those who take stones and have frequent urination, the stones go to the kidneys, and the kidneys become solid. Being solid, they consume water and fluid, so they urinate a lot. The more they urinate, the less they can nourish the five zang organs. When the zang organs are weak, various diseases occur. When the kidneys are strong, one does not cherish the true qi and indulges in pleasure, excessively consuming the body. The heat of the stone becomes isolated and excessive, causing internal consumption, so there is no thirst but a lot of urine.

　　The 'Qianjin Yao Fang' says: 'The disease of internal consumption is caused by heat. The urine is more than the amount of water drunk, causing extreme exhaustion and shortness of breath. Those with internal consumption can digest all food, produce urine, but not feel thirsty. The case of Li Wenbo, the Governor of Zizhou for ten years, first took Baiquanshi for a long time. Suddenly, his sexual performance became strong. After a month, he gradually felt thirsty. After several days, he had a large amount of urine. He went to the toilet many times a day. After trying many remedies, the condition gradually worsened. His body became emaciated, and he could not get up or lie down.

　　The patient is confused and delirious. The mouth and tongue are dry and eventually die. Although this disease is rare, it is very可怕的. The pulse is deep, thin, and weak when in diarrhea. Taking the Gouqizi Decoction will have an immediate effect. If one is afraid that the disease cannot be cured for a long time, taking the Qianfan San will have an immediate effect. During this period, the patient will take the Churu Xuanbu Pill. The formula of the Gouqizi Decoction.

　　1. Urine sugar

　　Normal people almost completely absorb glucose filtered out from the renal tubules, and only a trace amount of glucose (32～90mg) is excreted in urine daily, which cannot be detected by general glucose qualitative tests. Diabetes mellitus usually refers to the excretion of glucose in urine exceeding 150mg per day. Urine sugar can be detected when the blood glucose level is 8.9～10mmol/L (160～180mg/dl), and this blood glucose level is called the renal glucose threshold. Elderly people and those with kidney diseases have an elevated renal glucose threshold, and diabetes mellitus may not occur even when blood glucose exceeds 10mmol/L, or even 13.9～16.7mmol/L. On the contrary, during pregnancy and in some cases of renal tubular or interstitial lesions, the renal glucose threshold is reduced, and diabetes mellitus may occur even when blood glucose is normal. The common methods for checking diabetes mellitus include the Bence-Jones method (aided by the reduction reaction of copper sulfate) and glucose oxidase, etc. The Bence-Jones method is often affected by drugs such as lactose, fructose, pentose, ascorbic acid,先锋霉素, isoniazid, and salicylates in urine, resulting in false positives, and it is not very convenient to operate, so it has been gradually phased out. The glucose oxidase method is specific because the enzyme only reacts positively with glucose, but when large doses of ascorbic acid, salicylic acid, methyldopa, and levodopa are taken, false positives may also occur. Urine sugar is not used as a diagnostic indicator for diabetes, but is generally used only for monitoring the control of diabetes and as an indicator that further examination may be needed for the possibility of diabetes. The factors affecting urine sugar, in addition to considering the renal glucose threshold and interference from certain reducing substances, are also often affected by the amount of urine and the emptying condition of the bladder.

　　2. Urinary ketones

　　Ketone body determination provides an indicator of insulin deficiency, warning diabetic patients of impending or existing diabetic ketoacidosis, suggesting the need for further blood ketone body determination and blood gas analysis. The determination of urinary ketones uses sodium nitrate to react with acetic acid, forming a purple substance, indicating a positive urinary ketone body. However, the reaction based on sodium nitroprusside cannot measure the β-hydroxybutyrate, which accounts for the majority of the amount in ketones (acetone, acetic acid, and β-hydroxybutyrate). Reports have shown that the use of drugs containing thiol groups, such as captopril, can produce false positives; while if the urine sample is exposed to the air for a long time, false negatives can occur.

　　Diabetic patients, especially type 1 diabetic patients, should undergo urine ketone body examination when combined with other acute diseases or severe stress states, during pregnancy, or when there are unknown digestive symptoms such as abdominal pain, nausea, and vomiting.

　　3. Urinary albumin

　　The determination of proteinuria albumin can sensitively reflect the damage and extent of diabetic kidney disease.

　　4. Urinary C-peptide

　　C-peptide and insulin are both secreted by pancreatic B cells and are isomeric peptide substances formed by the cleavage of proinsulin. The determination of C-peptide concentration can also reflect the reserve function of pancreatic B cells.

　　5. Cast urine

　　It is often found simultaneously with a large amount of proteinuria, more common in diffuse glomerulosclerosis, mostly belonging to transparent and granular casts.

　　6. Microscopic hematuria and others

　　Occasionally found in cases with hypertension, glomerulosclerosis, renal arteriosclerosis, pyelonephritis, renal papillitis with necrosis or heart failure, etc. A large number of white blood cells often indicate urinary tract infection or pyelonephritis, which is more common than in non-diabetic individuals. In some cases with renal papillary necrosis, renal papillary necrotic tissue can be excreted, which is a strong supporting evidence for the diagnosis of the disease.

　　1. Pay attention to eating more fresh vegetables and appropriate intake of high-quality protein, such as egg, milk, meat, and soybean foods.

　　2. Avoid excessive intake of staple foods, especially bread, and avoid eating fruits, snacks, potatoes, noodles, and vegetables like vermicelli and tofu skin to prevent the condition from worsening.

　　3. Pay attention to adequate rest, avoid staying up late, maintain an optimistic attitude, have moderate exercise, and maintain physical fitness to prevent the occurrence of complications.

　　1. Stomach Heat and Exuberance Syndrome
　　(1) Syndrome Excessive eating and easy hunger, emaciated body, dry and hard stools. Yellow and dry fur, slippery and rapid pulse.
　　(2) Treatment Principle Clear the stomach and relieve fire, nourish yin and generate saliva.
　　(3) Medicines ①Prescription 1 Ophiopogon japonicus, Rehmannia glutinosa, Scrophularia ningpoensis, Gypsum fibrosum, Semen Panici, Coptis chinensis, Gardenia jasminoides, Anemarrhena asphodeloides, Achyranthes bidentata. Decocted and taken. ②Prescription 2 Rheum, Cinnamomum cassia, Persica, Natrii sulfas, Glycyrrhiza uralensis, Scrophularia ningpoensis, Rehmannia glutinosa, Ophiopogon japonicus, Astragalus membranaceus. Decocted and taken. ③Prescription 3 Codonopsis pilosula, Anemarrhena asphodeloides, Gypsum fibrosum, Coptis chinensis, Asini corii, Paeonia lactiflora, Semen Panici, Dioscorea opposita, Polygonatum multiflorum, Morus alba, Ophiopogon japonicus, Lycium barbarum, Coix seed, Oyster shell. Decocted twice and taken twice, one dose per day. ④Prescription 4 Codonopsis pilosula, Atractylodes macrocephala, Dioscorea opposita, Adenophora trachycarpa, Ophiopogon japonicus, Liliaceae, Polygonatum odorum, Fructus Crataegi, Gasteroptychus, Citrus peel, Nardostachys chinensis, Pueraria lobata. Decocted twice and taken twice, one dose per day.
　　2. Lung Fire and Dryness Syndrome
　　(1) Syndrome Excessive thirst and polydipsia, dry mouth and tongue, frequent urination with large volume. Tongue with red and little moisture, thin yellow fur, surging and rapid pulse.
　　(2) Treatment Principle Clear heat and moisten the lung, generate saliva and relieve thirst.
　　(3) Medicines ①Prescription 1 Semen Panici, Pueraria Lobata, Rehmannia glutinosa, Ophiopogon japonicus, Scutellaria baicalensis, Schisandra chinensis, Dioscorea opposita, Dendrobium. Decocted and taken. ②Prescription 2 Astragalus, Rehmannia glutinosa, Dioscorea opposita, Scrophularia ningpoensis, Scutellaria baicalensis, Coptis chinensis, Ligusticum chuanxiong, Phellodendron amurense, Paeonia lactiflora, Atractylodes macrocephala, Gardenia jasminoides, Poria cocos, Angelica sinensis, Oyster shell. Decocted twice and taken twice, one dose per day. ③Prescription 3 Gypsum fibrosum, Anemarrhena asphodeloides, Panax ginseng, Oryza sativa, Glycyrrhiza uralensis. Decocted twice and taken twice, one dose per day.