Tonifying herbs

Yim TK, Ko KM, Ko R (2002) Antioxidant and immunomodulatory activities of Chinese tonifying herbs. Pharm Biol 40 329-335... 

Gentle tonifying herbs can be used for months or even years at low doses to keep the patient s condi-... 

Gentle tonifying herbs can be used at low dosages for a long period of time to strengthen the body s resistance or to maintain good health. 

Tonifying herbs should initially be prescribed at low dosages because their cloying nature may cause indigestion. If all is well, the dosages may be gradually increased. 

Pour another 200 ml of cold water onto the herbs in the pot and cook for a further 20 minutes. Strain the resulting liquid into the receptacle holding the first decoction, thus mixing the two decoctions together. The total liquid obtained should be about 200-250 ml. (Herbs that expel wind-cold or wind-heat should be cooked for 10 minutes less and tonifying herbs should be cooked for 10 minutes longer each time.)... 

Tonifying herbs are best taken 1 hour before meals. 

Since the actions of the strong purgative formula are harsh, they are only used for excess syndromes and for people with a strong constitution. For patients who suffer from deficiency syndromes but who also need these herbs in the treatment of acute or severe accumulation, such as in weak, elderly people and people with a chronic disease, tonifying herbs must be used as well. 

When Qi and blood are too weak to activate Qi movement in the intestines in order to move the stool, it is better to use some tonifying herbs to assist the purgative herbs. Otherwise, not only may the accumulation of heat and stool increase rapidly in the intestines, but these pathogenic products may also further injure the Qi and blood. 

Ban Xia soothes the Stomach-Qi, improves appetite and stops vomiting. As it has a pungent taste and a moving ability, it can reduce the heaviness of the tonifying herbs. Zhi Gan Cao and Jing Mi are able to tonify the Spleen and accelerate the recovery process. These three herbs all serve as assistants. 

Compared with formulas in the other chapters, formulas that tonify contain many tonifying herbs. These herbs have a sweet and cloying nature and are not easily digested, especially in patients with deficiency of the Spleen and Stomach, in elderly people and in children. The herbs that stimulate Qi and the herbs that promote digestion are almost always recommended in composing these formulas. 

Second, herbs that regulate the Qi movement and water metabolism in the Middle-Jiao, and therefore strengthen the function and reduce the cloying nature of the tonifying herbs, are selected. 

These two herbs are often used as assistants in formulas to regulate the Qi in the upper abdomen and reduce fullness and distending sensations that are caused by Spleen-Qi deficiency or by the heavy and cloying nature of tonifying herbs. They can therefore accelerate food and water transportation and transformation in the Middle-Jiao. 

Wu Wei Zi is sour and warm, and enters the Lung, Heart and Kidney meridians. It has no function to tonify the Qi, but it can stabilize the Heart-Qi, especially when it is used with tonifying herbs. This herb is especially effective to treat palpitations, shortness of breath after exertion and sweating due to weakness of the Heart-Qi. 

Middle-Jiao to prevent tonifying herbs obstructing the Qi movement the latter can remove the invisible phlegm and connect the Heart with the Kidney, thereby calming the mind. 

Moreover, Zhi Gan Cao and Wu Wei Zi stabilize the Qi and blood, and can reduce the speed of the tonifying herbs and warm herbs. They insure the stable effect of calming the mind of the formula. 

Zhi Gan Cao is often used as an assistant in the formula. It moderates and harmonizes the tonifying herbs in the formula, moderates the Liver-Qi movement and reduces its speed. At the same time, it can... 

Sha Ren is pungent and warm, and enters the Spleen and Kidney meridians. It specifically removes the turbid dampness in the Lower- and Middle-Jiao. At the same time, it can promote the Qi movement, reduce distension and improve appetite. It is often used for reducing the cloying nature of tonifying herbs, such as Shu Di Huang (Rehmanniae radix praeparata). 

Fu Ling is bland and neutral. It cannot promote Qi movement but is able to leach out dampness from the Lower-Jiao. As its action has a downward tendency, this herb can be used for reducing the side effects of the cloying nature of tonifying herbs. Moreover, it can slightly tonify the Spleen-Qi and is suitable to treat distension in the abdomen. 

This formula nourishes the Yin of the body in a gentle and balanced way. Since the tonifying herbs bring strong and effective actions without side effects, this formula can be used for a long period of time. 

Herbs that enter the Kidney, strengthen the bones, expel wind, cold and dampness and benefit the back and legs are also often used. Herbs that regulate Qi and promote water metabolism are used to reduce the cloying nature of the tonifying herbs, to aid digestion and to make the whole formula more active and effective. 

In this formula, as in the formula Zuo Gui Wan, there is no herb to regulate the Qi and reduce the cloying nature of the tonifying herbs. This is a specific feature of formulas composed by Zhang Jing Yue - to focus on the main syndrome and treat it intensively. In clinical practice, it is better to include some of the herbs that regulate the Qi, particularly in conditions of Spleen deficiency. 

In the second group, on the base of the Yin-tonifying herbs, a small amount of Fu Zi and Gui Zhi are used to gently stimulate the Yang and promote the Yang and Qi growing in the body. 

Zhi Gan Cao and Yi Tang are able to tonify the Spleen-Qi. Compared with tonifying herbs such as Huang Qi and Ren Shen, their tonifying strength is mild. However, they have special usage in tonifying the Spleen. 

The formulas that stabilize abnormal discharge of the essential substances focus on treating the manifestations. As they do not have sufficient function to treat the cause of the disorder, they are only used for a short period of time. When the abnormal discharge stops, formulas that tonify should be used in the first instance, or tonifying herbs should be added to the original formulas. 

In clinical practice, to treat a chronic condition, tonifying herbs should be added to this formula. 

Formulas that remove food accumulation are suitable for excess and acute conditions. In a condition of chronic food accumulation, among people who have deficiency of the Spleen and Stomach, a formula with tonifying herbs should be used for a long period of time, together with gentle herbs that promote digestion. 

The action of intense reducing herbs is balanced by using tonifying herbs. 

Mu Xiang, Chen Pi and Sha Ren are able to reduce food accumulation through activating the Qi movement in the Stomach and Large Intestine. They can also reduce the cloying and heavy nature of the tonifying herbs. 

Lu Gen can transform pus Bai Mao Gen is able to cool the blood and stop bleeding Tian Hua Fen is able to nourish the fluid of the Stomach. All are used at the late stage or during the recovery period of febrile diseases, such as acute bronchitis or influenza. Moreover, as these herbs do not have a cloying nature, they do not have the same side effects as the Yin tonifying herbs. 

In this formula, the moving herbs and the tonifying herbs are used together the drying herbs and the moistening herbs are used together both Upper- and Lower-Jiao are involved and both the manifestations and the cause of the disorder are treated. 

These two substances can tonify the blood and are often used in chronic bleeding conditions. Unlike many tonifying herbs that can move the blood, Bai Shao Yao and E Jiao tonify and stabilize the blood because Bai Shao Yao is sour and E Jiao is sweet. They can either tonify the blood or stop the bleeding. 

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