Symptomatic Diagnosis: Metabolic Disorders

Metabolic disorders are functional and systemic health issues for which Chinese medicine has many well-developed differentiations, treatment principles, and herbal formulas.
Obesity
Emaciation
Fatigue

Obesity

• Accumulation of phlegm and damp (excess condition)

  Clinical manifestations:
  
  • Obesity, XS appetite
  • Likes sweet and fatty, greasy food
  • heavy sensations in body, foggy thinking
  • Aversion to heat
  • T: Flabby; thick, greasy coat
  • P: Wiry/slippery.
  • Slippery can suggest any earth element disharmony such as abundant phlegm, heat, or food stagnation, while wiry suggests any stagnation.
  • Left untreated, the phlegm can lead to heat, leading to yin deficiency, leading to wind, leading to stroke.
  Treatment principle
  
  • Remove damp and phlegm
  Formula
  
  • Wen Dan Tang + Ping Wei San (Calm the Stomach Powder)

• Qi deficiency (deficiency condition)

  Clinical manifestations:
  
  • Fatigue, weak voice, shortness of breath
  • phlegm damp accumulation
  • Aversion to cold, edema, puffy face, poor digestion, sleepy, hypofunctions.
  • Not necessarily an over eating problem, but an “under-metabolism” issue.
  • T: Pale with white coating
  • P: Thready and weak.
  Treatment principle
  
  • Tonify yang, raise metabolism

Emaciation

• Spleen/Stomach deficiency (more focused on digestion)

  Clinical manifestations:
  
  • Anemia, malnutrition, indigestion, thin constitution with indigestion. Poor appetite, chronic loose stool, fatigue, shortness of breath, weak voice
  • Sallow or pale complexion
  • T: Pale
  • P: Weak
  Treatment principle
  
  • Tonify Spleen
  Formula
  
  • Si Jun Zi Tang (Four Gentlemen Decoction)
  • Ba Zhen Tang (Eight Treasure Decoction)

• Qi and blood deficiency (less focused on digestion)

  Clinical manifestations:
  
  • Anemia, malnutrition.
  • Pale face, nails, tongue, lips
  • fatigue, dizziness, vertigo
  • yang qi and blood unable to rise to nourish head
  • T: Pale
  • P: Thready/Weak
  Formula
  
  • Ba Zhen Tang (Eight Treasure Decoction)
  • Stress tonic herbs such as He Shou Wu (Rx. Polygoni), E Jiao (Colla Corii Asini), Ji Xue Teng (Caulis Spatholobi)

• Lung yin deficiency (any yin deficiency leads to a certain amount of emaciation)

  Clinical manifestations:
  
  • Thin, emaciated body
  • Chronic dry cough, i.e. allergies
  • Lung TB, AIDS, both lead to this sort of emaciation
  • Cough with blood streaked sputum
  • Hematemesis
  • Dry mouth, tidal fever, night sweats, five center heat
  • T: Red with scanty coat
  • P: Thready, rapid
  Treatment principle
  
  • Tonify yin
  Formula
  
  • Bai He Gu Jin Tang (Lily Combination)
  • Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) for any yin deficiency

• Stomach Heat (genetic, or acquired, usually chronic)

  Clinical manifestations:
  
  • excessive appetite, hypermetabolism, bad breath, thin constitution
  • Craves cold drinks
  • Irritability
  • Scanty urine, tends to be constipated
  • T: Red with dry coat
  • P: Thready, rapid, forceful
  Formula
  
  • Qing Wei San (Clear the Stomach Powder)
  • Yu Nu Jian (Jade Woman Decoction) for Stomach yin deficiency due to Stomach heat

• Liver Fire (XS heat)

  Clinical manifestations:
  
  • Easily angered
  • Chest and hypochondriac pain or burning
  • Bitter taste, dry mouth
  • Insomnia, restlessness
  • Dark yellow urine, constipation
  • T: Red with yellow coat
  • P: Wiry, rapid, forceful
  Formula
  
  • Long Dan Xie Gan Tang (Gentianna Drain the Liver Decoction)

Fatigue

• Summerheat

  Often associated with damp, because the heat weakens the Spleen, leading to production of damp.
  Clinical manifestations:
  
  • Symptoms follow excessive sweating, sun stroke, and always include an exposure to heat or hot weather.
  • fatigue and weakness in extremities
  • Dehydration, shortness of breath
  • fever
  • Weak voice, thirst
  • Dusky face color if damp is involved
  • Possible loose stool
  • T: Possible greasy coat
  • P: Weak and rapid, may be soft
  Formula
  
  • Qing Shu Yi Qi Tang (Clear Summer-heat and Augment the Qi Decoction)

• Accumulation of damp

  Could be associated with a Spleen deficiency if the symptoms stress it.
  Clinical manifestations:
  
  • Sluggish and heavy sensations.
  • Cloudy, foggy head
  • Spleen qi Def.
  • indigestion, loose stool, bloating, low appetite
  • T: Greasy coat
  • P: Soft and slippery
  Treatment principle
  
  • Dry damp, stimulate digestion
  Formula
  
  • Ping Wei San (Calm the Stomach Powder)
  • Then later, tonify spleen

• Qi and blood deficiency

  Clinical manifestations:
  
  • Fatigue and Pale color
  • Pale skin, face, lips, nails… etc.
  • Dizziness, palpitations
  • T: Pale
  • P: Deep thready, weak
  Formula
  
  • Ba Zhen Tang (Eight Treasure Decoction)