Hypothyroidism
This is due to insufficient secretion of thyroxine. It is more common in women. The main
symptoms and signs are mental and physical debility, slow speech, somnolence, headache,
feeling of cold, dyspnoea on exertion, obesity, sallow complexion, puffy eyes, coarse and dry
skin, dry hair, scanty periods or amenorrhoea, oedema of legs, hypothermia and in severe cases,
mental confusion.
Diabetes Mellitus
This is due to insufficient secretion of insulin. At its onset, the main symptoms and signs are
polyuria, thirst, hunger and loss of weight. The urine and blood contain glucose. During the
chronic stage other manifestations include: obesity, pruritus vulvae, boils, peripheral neuritis,
retinitis and a dry tongue.
The Western medical causes of tiredness are summarized in Table 12.2Table 12.2.
The condition which goes under the name of "Chest Painful Obstruction" (Chest Bi) is
characterized by a feeling of oppression and pain in the chest, extending to the shoulders. In
severe cases the pain is greater than the sensation of oppression and in very severe cases there is
a stabbing pain in the heart region on the left side of the chest extending to the left shoulder and
down the left arm.
This type of condition is mentioned in the "Yellow Emperor's Classic of Internal Medicine". The
"Simple Questions" in chapter 22 says: "When the Heart is diseased there is pain in the centre of
the chest, hypochondrial fullness and pain, pain between the scapulae and in both arms."1(351)
The "Spiritual Axis" in chapter 24 says: "In true Heart pain the arms and legs are cyanotic and
cold up to the elbows and knees and there is severe pain in the heart region ...".2(352) This
corresponds to a severe type of Chest Painful Obstruction.
During the Han dynasty, Zhang Zhong Jing in the "Essential Prescriptions from the Golden