Tonification, in the context of medicine and Traditional Chinese Medicine (TCM), primarily refers to therapeutic methods that nourish the body and correct states of deficiency through the use of herbs or other therapies.
The Theoretical Status of the Tonification Method: The tonification method is one of the Eight Therapeutic Methods in TCM (sweating, emesis, purgation, harmonization, warming, clearing, elimination, and tonification); it is also known as “tonifying and nourishing” or “replenishing deficiency.” It is rooted in the theoretical principle from the *Su Wen*: “Treat deficiency by tonifying it.”
Four Major Categories and Clinical Applications:
Tonifying Qi: Indicated for symptoms caused by qi deficiency, such as shortness of breath, reluctance to speak, fatigue in the limbs, and spontaneous sweating. Commonly used herbs include ginseng, astragalus, and white atractylodes.
Tonifying Blood: Indicated for symptoms caused by blood deficiency, such as dizziness, blurred vision, a sallow complexion, and scanty menstruation. Commonly used herbs include angelica root, prepared rehmannia root, and donkey-hide gelatin.
Toning Yin: Suitable for fluid deficiency resulting from the late stages of febrile diseases or chronic illnesses, manifested as dry mouth, hot flashes, and night sweats. Commonly used herbs include raw Rehmannia, Ophiopogon, and Scrophularia.
Toning Yang: Suitable for symptoms of Yang deficiency, such as aversion to cold, cold limbs, soreness and weakness in the lower back and knees, and erectile dysfunction or premature ejaculation. Commonly used herbs include deer antler, Aconite, and Cinnamon.
The Story of the Reservoir
When farming rice in rural areas, farmers always dig a reservoir above a paddy field. When it rains, the reservoir collects the rainwater until it is full. When the weather turns hot and there is a prolonged drought, farmers open the sluice gates to release the water and irrigate the fields below.
It was the same in my hometown of Daoyunling. A large reservoir was built against the mountainside, just above the rice paddies. Every time we went to the rice fields to check on the crops’ growth, my father would always stop by the reservoir. Whenever he saw it full to the brim, he would feel very satisfied, because with that full reservoir, this year’s harvest was assured.
One year, I accompanied my father to the fields to check on the crops. When we reached the edge of the reservoir, he stopped, looking puzzled. I asked him, “Is something wrong?”
Father said, “It’s rained a lot recently; the reservoir should have been full by now. Why is it still only half full? There must be a leak somewhere!”
So my father and I jumped into the pond and used our feet to feel for any leaks. Sure enough, just as my father had suspected, we found two holes the size of eggs. My father stuffed appropriately sized pebbles into the holes and then sealed them with mud. Only after repeatedly checking to make sure there were no leaks did we head home. On the way back, my father said over and over, “Thank goodness we checked the pond today—otherwise, we’d have been in big trouble!” I knew all too well what it would mean if the pond drained completely!
I. When You’re Calcium-Deficient, Do You Really Need to Take Calcium Supplements?
1. Plugging the Leaks Is Better Than Taking Calcium Supplements
Many years later, whenever I encounter patients with calcium deficiency—who, despite long-term calcium supplementation, experience leg cramps as soon as they stop taking the medication—I’m reminded of that day when my father and I plugged the leaks in the pond. If there are holes in the bottom of the pond, no amount of rain will ever fill it up.
In fact, the same applies to patients with calcium deficiency. All the calcium in the human body is like the water in that pond. When we take calcium supplements every day but still have a calcium deficiency, we should ask ourselves: Is this “calcium pond” in our bodies leaking as well? If so, no matter how much calcium we consume, it won’t be enough to keep up with the leakage!
The key to treating calcium deficiency isn’t primarily taking calcium supplements, but rather reducing “calcium leakage.” Since our daily diet already contains calcium, as long as the “calcium pond” doesn’t leak—or leaks only minimally—it will naturally fill up, and calcium deficiency will naturally be resolved!
2. Who Is Responsible for Calcium Loss in the Human Body?
“The kidneys govern the bones and are responsible for storage!” When the kidneys are deficient and their storage capacity is insufficient, calcium is lost from the patient’s bones. Nourishing the kidneys means strengthening this storage capacity—it means plugging the leaks. Only in this way can the “calcium reservoir” remain free of calcium deficiency!
Patient Zhang, a 80-year-old woman, has suffered from cramps in both calves for over three years. For the past three years, she has experienced intermittent muscle spasms in both calves—up to four or five times a day at their worst—accompanied by weakness while walking and frequent nighttime urination. A bone density test at the hospital confirmed osteoporosis, and she was prescribed calcium supplements. While her symptoms were manageable with the medication, they would recur as soon as she stopped taking it for just one week.
I shared the “water reservoir” story with the elderly patient, and she laughed: “But where is the leak in my case?” ” I smiled and replied, “It’s not water leaking! It’s calcium leaking!”
I then wrote a prescription: Epimedium and Small Zhongjin Grass, one dose daily for seven consecutive days.
The seven doses cost only about ten yuan in total, but after the patient finished them, she experienced no leg cramps for half a year, and her frequent nighttime urination also improved (provided, of course, that she did not take calcium supplements during that time). Half a year later, the patient’s leg cramps recurred. I had her fill another seven doses according to the same prescription, and since taking them, the cramps have not returned.
There are many truths in life; once we grasp them, we gain a profound understanding of certain illnesses.
Once you’ve grasped the “story of the reservoir,” and then look at the traditional Chinese patent medicine for treating osteoporosis—Xianlinggubao Capsules (formulated with Epimedium, Dipsacus, Psoralea, Rehmannia, Salvia, and Anemarrhena)—it becomes very clear why these kidney-tonifying herbs are used to treat and prevent osteoporosis.
Some might ask, “If there’s a calcium deficiency, why do leg cramps occur?”
In fact, this question can be reframed as: Why do leg cramps occur when there is kidney deficiency?
Among the Nineteen Principles of Pathogenesis in the *Huangdi Neijing* (The Yellow Emperor’s Classic of Internal Medicine), one states: “All cases of spasm and stiff neck are attributable to dampness!” In other words, leg cramps and muscle spasms in the legs are all caused by pathogenic dampness. When pathogenic dampness accumulates in the calves, calf muscle spasms occur. But how does this pathogenic dampness form?
It is caused by an obstruction in fluid metabolism following kidney deficiency, leading to the retention of dampness! Understanding this clarifies the true significance of tonifying the kidneys to treat leg cramps. In the prescription mentioned earlier, Epimedium (Yinyanghuo) warms and tonifies kidney yang; once kidney yang is sufficient, dampness naturally dissipates; Xiaozhongjincao (Cynanchum atratum) relaxes the tendons, activates the meridians, dispels wind, and eliminates dampness. Once the tendons and bones are relaxed and the dampness within the tendons is expelled, how could leg cramps not subside?
3. Black Beans Nourish the Kidneys and Seal the Body’s Leaks
Medical principles stem from daily life; only by continuously distilling life’s wisdom from our experiences can we gain a profound understanding of disease. Once you grasp these principles, treating illnesses becomes much easier. People often ask me, “Doctor, while Chinese herbal medicine is effective, it’s not practical to take it every day. Is there a simpler dietary remedy?” Below, I’ll recommend another convenient dietary remedy.
Many households now own soy milk makers, making it very convenient to drink soy milk. Some brands can even process dry soybeans—no soaking required; simply add water and blend directly into soy milk, which is extremely convenient. For patients suffering from leg cramps, I often recommend blending black beans with walnut kernels to make soy milk. This helps tonify the kidneys and dispel dampness, with good results, and the method is very simple.
Take one liang of black beans and four walnut kernels. Place them in the soy milk maker and process directly into soy milk. The resulting soy milk is enough for two or three people to drink. Drink one cup every morning for a period of time, and the dampness in your body will be significantly reduced; symptoms such as lower back pain, weak legs, and leg cramps will naturally subside.
Some may ask: Earlier, when discussing morning lower back pain, we mentioned that it is caused by dampness sinking downward. Since drinking soy milk made from black beans and walnut kernels can eliminate dampness, can this method also be used for the lower back pain mentioned earlier?
Of course it can be used—the underlying principle is the same, so it will naturally be effective!
II. Why Does the Body Keep Getting Thinner Despite Long-Term Use of Tonics?
Everyone understands the “story of the reservoir,” and there’s another principle—increasing income and reducing expenses—that everyone is familiar with as well. For a family to accumulate wealth, in addition to “increasing income” by earning more money, it’s crucial to “reduce expenses” and save what you earn. If you only know how to make money but don’t know how to save it, and spend lavishly every day, it will be very difficult to accumulate wealth. Isn’t supplementing calcium to treat leg cramps in the human body based on the same principle as increasing income and reducing expenses?
We easily grasp the principles of everyday life, but the principles of medicine often elude us. If we can understand some of these principles before consulting a medical professional, we’ll gain a deeper understanding of our illnesses, and treatment will become much easier.
Once we understand the science behind calcium supplementation and reflect on it deeply, a series of questions will become clear—such as: Why does the body fail to gain weight and instead grow increasingly thin despite long-term use of supplements? Why, after taking blood-nourishing medications for a long time, does the body still suffer from blood deficiency? Why, after taking kidney-tonifying medications for a long time, do we still experience lower back pain and weak legs?
This series of questions shares the same underlying principle as the question, “Why do we still lack calcium even after regularly supplementing it?” We can all draw inspiration from the story of the reservoir. Let’s look at the first scenario: Why, after taking supplements for a long time, does the body not gain weight but instead become increasingly thin?
In daily life, overweight people want to lose weight, while thin people want to gain weight—especially slender men. When they see burly men, they feel a pang of envy, and their desire to gain weight is just as urgent. To gain weight, they eat high-nutrient foods and take supplements every day, but no matter how much they eat, their bodies just won’t put on weight.
Why is this? Think about the “Story of the Reservoir”—we can surmise that the body must not be fully absorbing all the nutrients; there must be a gap in the absorption process. So, which organ is responsible for nutrient absorption in the human body?
The stomach’s function is to “digest and transform food”; the small intestine’s function is to “receive and transform substances”; and the spleen’s function is to “govern transportation and transformation”!
Once we understand the functions of the digestive organs—the stomach, small intestine, and spleen—we can resolve the gaps in absorption!
“Digesting and breaking down food” refers to the process by which food is digested in the stomach. The stomach uses its digestive function to process the food we eat into a semi-liquid mass, which it then transports to the small intestine—at which point the stomach’s task is complete.
“Receiving and transforming substances” refers to the fact that the small intestine’s function comprises two aspects: one is “receiving,” and the other is “transforming.”
“Receiving and containing” means to receive and hold; that is, the small intestine receives and holds the chyme transported from the stomach. In this context, the small intestine functions as a container—a vessel for holding chyme.
“Transforming substances” refers to the process of extracting the essence from food matter; it describes the small intestine’s absorptive function, through which it gradually absorbs nutrients from the chyme to produce the essence of substances.
“The spleen governs transportation and transformation” refers to the process by which the spleen transports and transforms the refined substances derived from food.
The *Huangdi Neijing: Suwen: Treatise on the Meridians and Collaterals* states: “When food and drink enter the stomach, the essence and qi that overflow are transported upward to the spleen; the spleen’s qi disperses the essence, which then ascends to the lungs.”
By understanding the functions of these three organs, we can see that the stomach is the organ responsible for digesting food, the small intestine is the organ that holds the chyme and absorbs the “essence” from it, and the spleen is the organ responsible for transporting this “essence.” People fail to gain weight because of poor nutrient absorption, and this poor absorption stems from a problem with the small intestine—not the stomach or the spleen.
This explains why, when thin people seek treatment from TCM practitioners, many doctors say: “ ‘You have spleen deficiency, which is causing poor absorption.’ As a result, they end up taking a whole host of spleen-tonifying medications—yet still fail to gain weight! What we need to treat is not the spleen, but the small intestine!
Why does the small intestine have poor absorption?
Let’s examine the physiological characteristics of the small intestine. It is the longest part of the human digestive tract, measuring 4 to 6 meters in length. The small intestine’s length plays a significant role in enabling the digestion and absorption of food in the gut.
There is a certain type of patient who experiences diarrhea as soon as they eat even a small amount of “cooling” food. Why is that? It’s because there is cold in the intestines. After consuming cooling foods, the cold pathogen intensifies, causing the small intestine to spasm and its peristalsis to accelerate. It rushes to expel the cold pathogen, but in the process, the essential nutrients from the food are also expelled. Just think about it—can such a person fully absorb the nutrients from their food?
For such patients, simply dispelling the cold pathogenic factor from the intestines is enough to restore the small intestine’s function. Once intestinal absorption improves, their constitution will naturally improve as well! What is the best medicine for dispelling cold pathogenic factors from the intestines? Fuzi Lizhong Pills will do the trick!
Some children frequently eat junk food, which is predominantly sweet and spicy. Long-term consumption leads to severe internal heat and toxins in the small intestine, resulting in dry, hard stools and skin that feels hot (though body temperature remains normal). Such children are also prone to emaciation. Because the essential nutrients from food are not absorbed in the small intestine but are instead converted into energy, these children appear energetic yet remain thin and gaunt, with hot palms and soles. If the intestines are properly regulated and the “accumulation” in the intestines is eliminated, the body will naturally gain weight. For such children, treatment must be tailored to address this accumulation.
III. Why Does Anemia Persist Despite Long-Term Blood-Nourishing Treatment?
Some patients take blood-nourishing medications for a long time yet still exhibit symptoms of anemia; their condition improves slightly while on the medication but worsens immediately after stopping it. In fact, this follows the same principle as a reservoir; we should reflect on where the “leak” in the patient’s system lies.
I once treated a patient with this condition: a pale complexion, pale lips, low blood pressure, and a complete blood count showing reduced red blood cells and platelets. After taking blood-nourishing medication for half a month, the symptoms improved, but shortly after stopping the medication, the condition returned. Only after repeated questioning did I learn that the patient had a habit of drinking strong tea. Tea contains acids that bind with iron ions in food to form precipitates, which interfere with the body’s absorption of iron and ultimately lead to iron-deficiency anemia.
Understanding this is equivalent to identifying the root cause of the anemia. I advised the patient to minimize consumption of strong tea in daily life so that iron from food could be absorbed, the body could gradually recover, and the long-term problem of anemia could be resolved.
There is another category of patients who suffer from chronic eye strain—as the saying goes, “prolonged visual strain depletes blood.” While they are taking blood-nourishing medications, they are simultaneously secretly depleting their yin blood. How can such blood-nourishing treatments possibly be effective under these circumstances?
IV. Why Do Lower Back Aches and Leg Pain Persist Even After Kidney Tonification?
Let’s now examine the following issue: Why do patients still experience lower back aches and weak legs even after regularly taking Liuwei Dihuang Pills, a kidney-tonifying formula? Could there be a flaw in the treatment?
When it comes to kidney deficiency, most people tend to attribute it to excessive sexual activity, but this is not actually the case. Our bodies are constantly consuming kidney yin and kidney yang. For example, when we stay up late, kidney yang is the first to be depleted. Since kidney yang is derived from kidney essence, excessive consumption of kidney yang inevitably leads to a deficiency of kidney essence and a depletion of kidney yin.
In the principle of Tai Chi, movement generates yang, and stillness generates yin. During the day, the body’s yang energy emanates from the surface—movement generates yang—but the generation of yang energy is based on yin energy. At night, when we enter a state of stillness and rest, yang energy retreats inward, promoting the generation of yin energy. People who stay up late and suffer from chronic sleep deprivation will damage both their yang and yin energies.
Staying up late damages the kidneys, but there are many other activities that can also harm them, such as standing for long periods.
The *Huangdi Neijing* collectively refers to the five types of diseases caused by excessive exertion as the “Five Labors.” They are: “prolonged staring damages the blood; prolonged lying damages the qi; prolonged sitting damages the flesh; prolonged standing damages the bones; and prolonged walking damages the tendons.”
The phrase “prolonged standing damages the bones” specifically refers to damage to the kidneys, as the kidneys govern the bones. Maintaining an upright posture requires the consumption of kidney essence; over time, this naturally damages the kidneys. If you don’t believe this, just look at teachers in the education field—very few do not suffer from kidney deficiency. Once kidney deficiency sets in, one is prone to soreness and weakness in the lower back and knees, which can eventually lead to herniated lumbar discs.
Once we understand these principles, we can approach kidney deficiency with a rational perspective, rather than immediately associating it with excessive indulgence. While taking Liuwei Dihuang Pills is effective for kidney yin deficiency, it’s futile to consume large amounts of kidney-tonifying herbs if one’s work and lifestyle habits remain uncorrected—because poor lifestyle habits are the very source of kidney deficiency!
Some might ask: “I don’t stay up late, I’m not a teacher, and I certainly haven’t overindulged in sexual activity—so why do I still experience lower back pain and weak legs? Why haven’t the kidney-tonifying medicines I’ve taken cured my kidney deficiency?”
This raises another issue: the principle of mutual generation. Do the foods we eat and the kidney-tonifying medicines we take actually reach the kidneys—in other words, do they truly serve to tonify the kidneys? Let’s illustrate this with another story: the story of irrigating a field.
