With the development of social economy and the improvement of living standard, people pay more and more attention to health and health care. From daily diet to health care drugs and Chinese herbal medicines, as long as the word “tonic” is associated with them, they are all very popular. However, in the process of “tonic” being commonly implemented in life and clinical practice, some people not only do not get the proper tonic effect, but also suffer from many discomforts, which are often attributed to “deficiency without tonic”. It is one of the basic rules of Chinese medicine, which was first mentioned in “Nei Jing”, and medical practitioners of all generations have attached great importance to deficiency supplementation. At the end of Ming Dynasty, Qishi, a medical doctor, wrote a special treatise on deficiency and deficiency labor, and wrote “The Book of the Deficiency”, which discusses in detail the evidence, treatment, prevention, protection and identification of doubts of various deficiency diseases. The term “deficiency without tonic” was first mentioned in Chen Shiduo’s “New Compilation of Materia Medica” in the Qing Dynasty, and his “Ten Dosage Theory” said: “It may be suspected that tonic is needed because deficiency disease is suitable for tonic. However, there are often more and more deficient tonic, is not the tonic can not be fully relied on. Appeal! Deficiency without tonic how to take weakness. The more you make up, the more deficient, it is not deficient, not deficient can not make up. Therefore, the method of supplementation should also be changed. Tonic in the increase in the product to eliminate the guide, tonic inside and use the method of restraint, do not have to make up all and tonic, better.” After that, the term “deficiency without tonic” was found in various medical texts, but no medical doctor has discussed it systematically so far. At present, the understanding of “deficiency without tonic” is not uniform, so I try to summarize the relevant contents in the ancient and modern literature, in order to draw the attention of fellow doctors. 1, “inappropriate” said (1) the spleen and stomach weakness spleen and stomach for the latter day of the essence, “Su Wen, meridians and veins,” cloud: “drink into the stomach, overflow essence, up to the spleen, spleen qi dispersed essence, up to the lungs …… water essence four cloth, five parallel meridians .” If you do not take into account the deficiency of the spleen and stomach, you will be able to digest and transport the nourishing blood and yin tonic and the slightly larger doses of qi and yang tonic, and it will be impossible to talk about dispersing essence. In its place is righteousness, but not in its place is evil. Yin tonics can lead to discomfort such as poor nourishment, bloating and diarrhea. Qi tonic and yang tonic medicines will cause the lung qi to be stagnant in the upper jiao, and qi surplus is fire, so there will be heat in the upper jiao, which is also one of the reasons why qi tonic medicines tend to cause fire. This is also one of the reasons why qi tonics can easily lead to fire. The above situation is often considered to be the main reason for “deficiency without tonic”. (2) The tonic is not the right one According to Chinese medicine, “one medicine has one nature, and a hundred diseases have a hundred prescriptions”. Each kind of tonic can only be suitable for a certain body type and corresponding disease evidence. A person’s age and physical condition are different, the disease evidence is different, the seasons are different, the physique is different, so the tonic must be the right evidence, according to the person, the time, the place and the disease, there is no tonic for all diseases. There is no such thing as a universal tonic for all diseases. Only accurate identification and corresponding medicine can play the role of a tonic. Without distinguishing yin and yang qi and blood, without distinguishing the five organs, just blindly and indiscriminately tonic, not only will not benefit the disease, but also will appear uncomfortable symptoms, or even aggravate the disease or new diseases. This situation is also considered by some doctors as “deficiency without tonic”. (3) Mixed deficiency and reality, only tonic is not clear Clinically, there are few patients with pure deficiency, and relatively more patients with mixed deficiency and reality. In cases where deficiency is the main evidence, of course, the main focus should be to supplement the deficiency, but if we do not pay attention to solving the standard real evidence, sometimes it will affect the effect of supplementing the deficiency. There are two common clinical causes for the symptoms of the actual symptoms: one is the presence of deficiency and the feeling of external evil or internal injury to diet; the other is the weakness of positive qi and the irregularity of distribution, resulting in the production of phlegm, blood stasis, food accumulation and other actual evil, which should be treated both at the symptoms and at the root. The many discomforts caused by the lack of tonic will also be considered by some doctors as one of the reasons for “deficiency without tonic”. 2, “inappropriate supplement” said Taking supplements, must be targeted. As a famous doctor in the Qing Dynasty, Yu heard Hong say: “See the disease should not be indiscriminately tonic, one day of misuse, ten days not to recover.” The following four situations belong to the “inappropriate tonic” situation. Nei Jing cloud: “Great reality has wonky symptoms”. Some real evidence may appear as a false appearance of deficiency. If the evidence is not well understood, the actual evidence is mistaken for the deficiency evidence and the tonic is mistakenly used, it will only misuse the tonic to benefit the disease and even threaten the life. Certain patients with depression, intestinal dampness and heat, phlegm and stagnant internal obstruction, because Yang Qi is depressed by the evil Qi and closed inside and does not reach the extremities, resulting in the illusion of deficiency such as tiredness and weakness of the extremities, which is mistaken for deficiency and given as a tonic, is like the opposite. The fire is burning inside and cannot be dispersed outside, and the strong fire eats the qi and hurts the yin and fluids, so the internal consumption and external exhaustion become false signs of deficiency. At this time, mistaken as a false evidence, the administration of supplements, as if holding the salary to put out the fire. The body is not deficient, but addicted to tonic, and blindly take tonic, and the tonic is stagnant, or plugged in the yin part, or blocked in the yang part, will produce the feeling of suffocation. This “improper tonic”, and the discomfort caused by the wrong tonic, is categorized by some doctors as “deficiency without tonic”. 3. “The spleen and the stomach are in a state of failure and do not receive medicine”. The Nei Jing says: “If you have gas, you will live, if you don’t have gas, you will die.” The spleen and stomach are the source of biochemistry and the sea of water and grain. Many patients in the late stage of deficiency labor, their yin and yang Qi and blood deficiency, stomach gas has been extinct, even if the miracle medicine, the spleen and stomach do not accept, it will not help. Some doctors also attribute this to “deficiency without tonic”. 4. “Special constitution”. Clinically, we may encounter some patients with deficiency, even if the identification is accurate and the corresponding tonic method is applied, the expected effect is still not achieved, and even some adverse reactions may occur. For example, some patients, regardless of the severity of the disease, lifelong intolerance to ginseng and astragalus. At present, some doctors believe that this should be classified as an allergic reaction to the drug, while others believe that it is a special constitution – “deficiency without tonic” constitution. At present, the definition commonly quoted in the literature and press is that some middle-aged and elderly people who are physically weak or suffering from chronic diseases, due to weakness of the spleen and stomach or spleen deficiency and dampness, poor transportation and transformation functions, etc., after applying tonic products, not only can they not get the proper benefit, but also will have symptoms such as dullness and anorexia, indigestion, distention and fullness of the abdomen, nausea and vomiting. This definition is not rich enough and only covers the weakness of the spleen and stomach in “improper tonic”. In the author’s opinion, the first three of the above four articles are not really “deficient in tonicity”, but can only be regarded as “inappropriate treatment”, “mis-treatment”, and “dirty extinction”. It can only be regarded as “inappropriate treatment”, “mistreatment”, and “dirty extinction”. The real meaning of “deficiency without tonic” is the last one, which is a special kind of physique. This group of people can only eat light food when they are not sick, a little bit more meat and eggs, even chicken soup, a few dates will appear hot and dry mouth and other discomfort. When the disease develops, the use of ginseng and astragalus products will lead to various kinds of heat evidence, and the slightest consumption of nourishing and greasy products will immediately lead to poor appetite, chest tightness, abdominal distention and fullness. Even when the disease is more serious, ginseng and astragalus can not be used as normal people. Such patients are mostly poor constitution, congenital endowment deficiency, any link is extremely fragile, the body is usually in an unstable balance, once the onset of the disease, can only be adjusted to its potential, to “and method” as the main, do not Meng Long, should be flat, slow tonic, otherwise it is very easy to break its fragile balance, resulting in a series of evidence of change. In conclusion, the term “deficiency without tonic” appears quite frequently, but its concept is mixed, the boundary is ambiguous, and there is no clear definition and connotation in the Chinese medical community.