Bob Flaws, Lynn Kuchinski and Robert Casanas MD
Blue Poppy Press, 2002
Hardback, 401 pages, £73

(Reviewed by Richard Farrer, EJOM Vol. 4 No. 5)

The book starts with a history of the observation of the disease, its incidence in the US and the definition of type 1, type 2 and gestational diabetes. Aetiology and diagnosis from a western medical perspective and a discussion of drug therapy and its risks follows. The section on complications of diabetes is a grim reminder of the wisdom of tight control of blood sugar levels and reference is made to recent studies on large groups of patients which illustrates that the occurrence of previously considered inevitable long term complications of diabetes can be dramatically reduced.

The chapter on the history of diabetes in Chinese medicine wets the appetite to acquire a more profound historical appreciation of our roots as practitioners. There follows a discussion of the disease causes and mechanisms from a TCM view including dietary irregularities, ‘psychoemotional stress’ (or just stress perhaps), the usual unregulated sexual activity, iatrogenesis and ‘gu’ or invisible worms. Gu worm theory from the Qing dynasty perhaps paralleling the pathology of chronic candidiasis. The authors quote ‘diabetes is one of the fastest growing health problems today’; clearly our potential to assist is enormous. A diabetic materia medica and a chapter on commonly used medical formulae follows. These I feel could easily be found in other texts and the way the formulas are listed across the page makes them less user friendly. The chapter on acupuncture is brief and does not do justice to the discipline listing formulas from Chinese texts. Discussion of the treatment of diabetes based on pattern discrimination with herbs, again listed across the page, and acupuncture, goes some way to improve this. Recommended diet is comprehensively covered, including some unusual dishes such as schisandra hard-boiled eggs and the appealing pig pancreas soup.

A review of appropriate exercise is useful and gestational diabetes is well covered. The authors then launch into some specialised area of diabetes such as hepatogenic diabetes, diabetic ketoacidosis, nonketotic hyperosmolarity, diabetic hypertension, hyperlipoproteinemia, retinopathy, neuropathy, diabetic arteriosclerosis obliterans and acromelic gangrene, dermatological complications, diabetic heart disease, diabetes being the most common cause of MI in people under 30 years old in the US, nephropathy, common opportunistic infections in diabetes, other associated endoctrine disorders such as Cushing’s syndrome and acromegaly. All of these are accompanied by representative case histories. Syndrome X is discussed and a chapter on integrating Chinese and western medicine which encouragingly states ‘we have failed to find a single published article that describes an adverse reaction from such a combination’.

An extensive bibliography is listed at the end of the book, both English language and Chinese and the website www/chinesemedicaldiabetes.com is a source of an immense amount of relevant information.

This is a specialist book, invaluable for those of us who need more knowledge about diabetes and TCM. The text is comprehensive but not particularly clinic friendly. However, this book is an example of another pioneering work in our discipline.

Richard Farrer
Richard Farrer attended the College of Traditional Chinese Acupuncture at Leamington Spa and went on to study TCM and Chinese herbs with Giovanni Maciocia. He then gained a degree in physiotherapy at Coventry University. He works in private practice in Oadby, Leicester in the UK.

Acknowledgement
This review is published with kind permission of the Register of Chinese Herbal Medicine.