Always Thirsty, Constantly Urinating, Getting Thinner No Matter How Much You Eat? Doctor Zhang Xichun Treated Xiaoke (Diabetes) with Yu Ye Tang (Jade Liquid Decoction) — Chinese Yam as the Core Herb

What people search for: always thirsty / constantly wanting water / urinating a lot / frequent urination / hungry all the time / getting thinner and thinner / diabetes / high blood sugar Corresponding medical terms: xiaoke (wasting-thirst) · diabetes mellitus · spleen failing to transform and transport · dual deficiency of qi and yin

Opening: after more than thirty days of yam stories, today we say goodbye

Over the past weeks we have been talking about how Doctor Zhang Xichun used Chinese yam (shan yao) — and today is the final episode of the yam series. We could never finish everything there is to say about how Doctor Zhang Xichun used yam, because his case records are full of brilliant yam cases. What was his most common way of using it? In the treatment of external contraction illnesses (wai gan) — using yam to support and fortify the body’s upright qi while the pathogen was being driven out.

💬 Note from Doctor Luo: So in Doctor Zhang Xichun’s case records, a large proportion are cases where yam was used in treating external contraction illnesses. Today we look at one special use — regulating diabetes. And diabetes is no small matter: these days it has become the next great disease after cardiovascular and cerebrovascular conditions.

Who was the patient? A hometown fellow of Doctor Zhang Xichun, in his twenties, doing business in Tianjin

Today’s patient was a fellow villager of Doctor Zhang Xichun — from the same district, in his twenties, very young. He was doing business and trade in Tianjin when he came down with xiaoke (wasting-thirst).

💬 Note from Doctor Luo: What is xiaoke? In Chinese medicine, xiaoke is not exactly the same as diabetes, but it is very closely related to it — quite a large proportion of xiaoke patients are in fact today’s diabetics. Doctor Zhang Xichun himself called this condition diabetes: he said that what Western medicine called diabetes was precisely this disease.

How bad was it? The “three excesses and one loss,” three-plus months of treatment in Tianjin, more than ten doctors

What are the symptoms of xiaoke? First, thirst — the person drinks a remarkable amount of water, unbearably thirsty, far more than usual. Second, an enormous appetite — big meals, always eating, always hungry. Third, excessive urination — the urine pours out in a steady stream, trips to the bathroom one after another. And finally, the person wastes away, growing thinner and thinner.

This man began treatment in Tianjin, and the result was: he was treated for over three months and saw more than ten doctors, all with no effect — still in that state of being desperately thirsty.

💬 Note from Doctor Luo: Look at that — three months, a dozen doctors. That’s hardly unusual even today, because diabetes is genuinely hard to treat. But he was young, and the disease had just started — exactly the best window for treatment. At his wit’s end, he thought: no choice, I have to go back home and let Doctor Zhang Xichun take a look.

Back home for the consultation: an extremely thin and faint pulse, and water turning straight into urine

Back in his hometown, Doctor Zhang Xichun felt his pulse — what was it like? Extremely fine and faint (wei xi). Then he looked at the symptoms: he drank water, and the water became urine almost as he drank it — a sip, then off to the bathroom, several trips in no time at all.

💬 Note from Doctor Luo: What does a fine, faint pulse tell you? A dual deficiency of qi and yin — the foundation is already weakened. The water he drank was never actually used by the body; it went straight out as urine. Fluids are depleted, the spleen cannot transform and transport — that is the situation. Doctor Zhang Xichun said: I’ll write you a prescription to tonify and regulate.

The prescription: Yu Ye Tang (Jade Liquid Decoction), raw yam leading the charge

The formula is called Yu Ye Tang (Jade Liquid Decoction). At the top of the list — yam: one liang (about 30 g) of raw yam (when Doctor Zhang Xichun said “raw yam,” he meant dried yam slices). Then: raw astragalus (huang qi) five qian (about 15 g), anemarrhena (zhi mu) six qian (about 18 g), raw chicken gizzard lining (ji nei jin), pounded fine, two qian (about 6 g), kudzu root (ge gen) one and a half qian (about 4.5 g), schisandra fruit (wu wei zi) a few qian, and finally a little trichosanthes root (tian hua fen), plus some wild taixi ginseng (ye tai shen) — a variety of Shanxi codonopsis used to tonify qi.

💬 Note from Doctor Luo: Trichosanthes root is a herb we rarely use today, though some people still do. My advice: leave out the trichosanthes root. The logic of this formula is very clear: yam tonifies the spleen and nourishes fluids; astragalus tonifies qi; anemarrhena nourishes yin and clears heat; chicken gizzard lining helps the spleen transform and transport; kudzu root raises and generates fluids; schisandra secures the kidney and astringes yin — tonifying the spleen as the core, nourishing both qi and yin at the same time.

The turning point: results after just a few doses; one added herb — cornel — and ten doses to full recovery

How did it go? After just a few doses, the symptoms began to settle — clearly effective. But the urination was still frequent and copious, so Doctor Zhang Xichun added cornel (shan zhu yu), five qian (about 15 g) to the formula. After ten consecutive doses, the patient recovered.

💬 Note from Doctor Luo: See, now that we have gone through the materia medica herb by herb, you can all hear exactly why Doctor Zhang Xichun used cornel — to astringe and secure (shou lian gu se): it holds the kidney qi in place, and the urination becomes less frequent. As for “ten doses curing diabetes” — don’t misunderstand: what Doctor Zhang Xichun treated was xiaoke, presumably one pattern of diabetes. This patient came for treatment at the very start of the problem, so it resolved. In the two formulas Doctor Zhang Xichun left for treating xiaoke, the main herb in both is yam — and he explicitly required raw huai yam.

Why was it so effective? Diabetes — the root is in the spleen

Why does yam work? Chinese medicine holds that diabetes is mainly a problem of the spleen — the spleen fails, and can no longer transform and transport the essential nutrients of food and drink.

💬 Note from Doctor Luo: And if we look at real life, it certainly matches: how do many diabetics get the disease? By eating too well. They gradually grow heavy, exercise little, put enormous strain on the pancreas, and blood sugar gradually goes wrong. If such a person would exercise, watch their diet, and tonify the spleen at the same time, the situation would improve a great deal. Huai yam tonifies the spleen, and so it can markedly improve the symptoms of diabetes — the xiaoke of Chinese medicine can even be cured, and diabetes can certainly be brought under control.

The controversy: can diabetics actually eat yam?

People often ask: everyone says yam is good — pharmacological analysis does show it has a blood-sugar-lowering effect. Yet others say diabetics cannot eat yam, because like other tubers it contains starch, and eat too much starch and blood sugar shoots right up. So — can they eat it or not?

💬 Note from Doctor Luo: I’ll tell you: yes, they can. On balance, yam’s tonic benefit to diabetics is very strong, and that bit of starch really is nothing. And let me share a wonderfully practical method — the key is in how you eat it.

The trick: simmer dried yam slices into a drink — take in the medicinal goodness, leave the starch behind

Usually we eat yam as food, and the starch all goes in with it. If instead you dry it into dried yam slices (gan shan yao pian) — either store-bought slices or your own sun-dried — take a little every day and simmer it into water, and just drink the water. For example, simmer ten or fifteen grams and drink the water; the leftover slices can be given to others, so nothing is wasted.

💬 Note from Doctor Luo: You drink the water and take in the medicinal quality of the yam, but you don’t take in much of the starch — you keep the part that benefits you and drop the part that is not ideal for diabetics. Truthfully that bit of starch is not a big deal, but when you have the chance, drink the yam water — the effect is better.

Aftercare: yam as a long-term food therapy for diabetics

Yam can absolutely serve as a regular part of a diabetic’s diet for regulation — used over the long term as a food therapy, it is very beneficial for recovery. When the thirst is severe, you can take Doctor Zhang Xichun’s Yu Ye Tang; in daily life, tonify with yam slices, which is very good for the body’s recovery.

💬 Note from Doctor Luo: That is the inspiration this case gives us. One reminder: once diabetes has taken hold it is very hard to treat, because the causes inside are complex — including emotional distress and other factors. If people can keep their emotions settled, exercise every day, and control their diet, a very substantial proportion of diabetics can manage the condition extremely well — and huai yam can help your body repair and recover along the way. It tonifies the spleen and at the same time generates fluids, so you no longer feel parched and dry.

What to take away

• Xiaoke in Chinese medicine corresponds closely to diabetes. The classic picture — always thirsty, huge appetite, constant urination, steady weight loss — is the “three excesses and one loss” Doctor Zhang Xichun described.
• Doctor Zhang Xichun treated xiaoke with yam as the core herb, in his formula Yu Ye Tang (Jade Liquid Decoction): raw huai yam, raw astragalus, anemarrhena, chicken gizzard lining, kudzu root, schisandra, and codonopsis — tonifying the spleen while nourishing both qi and yin.
• The root of diabetes, in Chinese medicine, lies in the spleen failing to transform and transport. The typical modern path into the disease — rich food, weight gain, little exercise — matches that view.
• Yes, diabetics can eat yam. For the best result, simmer dried yam slices into water and drink the water — you get the medicinal benefit without much of the starch.
• Cornel (shan zhu yu) was the finishing touch — added to astringe the kidney and cut down the frequent urination; ten doses completed the cure.

That’s all for today, friends. Tomorrow we begin a new herb, and we’ll see what other wisdom Doctor Zhang Xichun drew from the ordinary herbs of daily life.

Compiled from Doctor Luo Dalun’s commentary on Doctor Zhang Xichun’s case records; the original case is from Yixue Zhongzhong Canxi Lu (Records of Chinese Medicine with Reference to Western Medicine).