At present, many people are talking about “not being able to take supplements”, and it is true that we have encountered many people who are not able to take supplements in clinical practice. I feel that women are more common, and some patients cannot meet a little bit of “various kinds of ginseng”. I have seen a patient who was very uncomfortable after taking a proprietary Chinese medicine and said that the medicine contained ginseng, but when I checked, it really did, although there was only a little bit of ginseng in the Chinese medicine. Fang Yutao, Cardiovascular Department, Guang’anmen Hospital, Chinese Academy of Traditional Chinese Medicine
I feel that there are several views on the understanding of “deficiency without tonic”.
1. Real and false deficiency.
2, Yang depression does not reach the extremities, resulting in tiredness and weakness of the extremities.
3.Dampness and heat in the intestines, showing the illusion of spleen deficiency, which cannot be treated with qi tonics alone.
4.Stomach qi has been extinguished and is not subject to tonics.
5.Tonic is not suitable, such as yin deficiency mistaken for qi deficiency, wild tonic, indiscriminate tonic, dull tonic.
6, a very small number of people have similar allergic drug reactions to ginseng and astragalus.
This basically reflects the current understanding of “deficiency without tonic” in Chinese medicine. If we discuss within the scope of these, it is true that they can all be explained. But it is not really understood.
I have checked that the term “deficiency is not supplemented” only appeared in the Ming and Qing dynasties, and there is no clear definition or meaning at present. It is only now that people’s awareness of health care has greatly increased and indiscriminate supplementation has become a trend in society that this term has gradually become more frequent. Since we all think so, there is nothing wrong with agreeing to make it happen.
But I would like to say my point of view, there is another situation is also considered deficient in tonic, this is the real deficiency is not tonic, it is a kind of body, is a theory, seems to be able to explain the above problems —– clinically, even if you identify the right evidence, the routine use of drugs, maybe appear “deficient in tonic” clinical manifestations, do not think it is definitely Don’t think that it is definitely caused by your poor medical skills, the patient’s pretentiousness or mental problems. If you consider one more way, you may be able to rise to a higher level.
Before I talk about my point of view, I would like to talk about some of the phenomena that I have seen in my life and in the clinic.
1, you have seen the “body of a lady maid life” of people?
When I was a child, in my hometown, I often saw the so-called lazy mother-in-law, grunting all day, not moving, not feeling well, not being able to do the work, as if they were interested in eating. Now when I think about it, my ears will still ring with the sighs of gray-haired old people: this person is good at eating and lazy, how her man’s life is miserable to have such a wife! The meaner mouth will sneer and say: Miss body maid life. At that time, I also think they are lazy, so also follow the disdain.
Now I seem to understand them somewhat, so that may be unfair to some of them: they are not short, perhaps even fatter than others, but born with a “miss body”, congenital deficiencies, the essence of the muscles and bones are weak, according to the standards of rural people require them, they can only make ” Effort” to do normal people very easy work. Long time, not grumbling is strange? Who to blame, really cast the wrong birth.
2, you have seen the people who drink chicken soup are on fire?
Some people, doomed to a lifetime of Bodhisattva intestines, can only eat vegetarian (whether they willingly so), clear soup and water, the intestines are comfortable, the body only Kangtai, a little more meat, on fire, exaggerated, even more bowls of chicken soup, the next day will feel hot. Some TCM practitioners may think that they have deficiency cold or damp heat in their intestines, which is the reason for this situation. In fact, this is not quite true. I feel that it has to do with the body type. Everything in heaven and earth is very different, and as humans of the same race, the function of each organ is also very different, although they all have about the same height, weight, appearance, intelligence, and emotional intelligence.
From the point of view of animal evolution, human evolution is the fastest, in terms of diet alone, from a pure vegetarian diet (fruit of the woods to cereal starch) to omnivorous (I do not know whether to say so, really can not think of a more professional word), and even to the modern part of the people have been all day basically do not eat starch cereals, especially the second half of the evolutionary speed is very fast, so it causes inconsistency and imbalance of the digestive and metabolic organs. I have seen some people prefer to eat meat, three days not to eat leg weakness, dizziness, weakness, can not eat all the time to be good, (really envy these people’s good stomach ah, of course, these people to old age, there will be some problems), and some people, even eat two meals of meat, on fire, dizzy, feeling uncomfortable, folk will think that eating too much meat, the production of turbidity. So people’s organ function, very different, some people are unable to digest too much meat, but also metabolism; some people are digested, metabolism; some people digested, but also metabolism. The mind is not balanced, right.
So in life, there is destined to be such a small number of people, their gastrointestinal function, metabolic function is relatively weak, relatively primitive, can only digest starchy things, and a little fat protein. If they have to eat more meat, they will become uncomfortable and sick.
For example, the children, think that their parents have worked hard all their lives is not easy, want to do their filial piety, non-let the parents in their later years to eat some delicious, nutritious, and then some tonic, satiated, in fact, some elderly people are unable to eat or can not stand too much nutrient-rich things, eat more than the accident, just wait for the disease, children do not know what causes. Because their biggest problem is —- take the “average” people’s habits to treat the “average” people, guilty of one-size-fits-all. So children have to be filial to the point of filial piety, otherwise, in addition to their own peace of mind, other good role at all.
3, you must have seen the “young is low blood pressure, old is high blood pressure” patients?
The diagnosis of hypertension is greater than or equal to 140/90mmhg, in fact, the development of this standard is based on statistical principles to determine, that is, 95% of people greater than this standard will meet the diagnosis of hypertension. For the other 5% of people, is this criterion too low or too high for them? I often see women who have dizziness and swelling when their blood pressure is 120-130/. Upon closer questioning, I find that many of them are young with low blood pressure, and their blood pressure gradually increases after menopause, but this is not enough to make a diagnosis. I have seen some women with dizziness when their blood pressure is 140-150/ and some lacunar infarcts on CT, and some patients ask: How can atherosclerosis be so severe and so many lacunar infarcts when blood pressure is slightly high? There are certainly many causes of lacunar infarction, but for them who were hypotensive when they were young, perhaps the high blood pressure alone is an obvious risk factor.
In the diagnosis of shock, there is such a criterion, the blood pressure is less than 90/60mmhg or less than one-third of the original blood pressure, then why in the diagnosis of hypertension, there is no consideration to add such a clause, if the blood pressure increase is greater than one-third when young, can not be diagnosed with hypertension, in this case, they can take antihypertensive drugs at least 3-5 years earlier. I am not a Western doctor and have no right to say such things. I would be grateful if any expert in this field could give an explanation.
With the above three examples, I just want to show that there are a small number of people who are not in the 95% normal range, and it is a bit too harsh if you use the conventional standards to require them.
When a patient sits in front of you, she looks like an ordinary individual in terms of appearance – her face, her size, her speech, her behavior, and her intelligence are not abnormal, so you must know them, analyze them, and treat them in the same way you treat ordinary people. Because they may be someone other than 95 percent.
The deficient people are such a small group of people with relatively weak digestive function, relatively weak metabolic function, relatively weak essence, relatively weak muscles and bones, only no one comes to tell this, so they keep treating themselves as ordinary people (because they look no different from other people), the same study, the same work and fight, the same diet, the same health care and health (because it is easier to be weak) But what they get is different discomfort, different diseases, and different results from common treatment, and what they get is probably the explanation or consolation of “deficiency without tonic”.
I will use pure Chinese medicine theory to explain “deficiency is a kind of constitution”, otherwise I dare not say I am a Chinese medicine doctor.
Try to use the theory of yin and yang to explain
From a two-dimensional point of view, all things in heaven and earth are yin and yang, and so is man. Under normal circumstances, it is the appropriate firewood to maintain the appropriate amount of water and water temperature in the pot, thus achieving a dynamic balance. More firewood, the pot of water will boil, this is the real fire, how to deal with, remove the fire; firewood did not increase, the pot of water less, the water will also boil quickly this is a false fire, what to do, add water, if the water for a while half will not add it, then temporarily remove the fire.
What is it like for people who are deficient in tonic? They are a special physique, as if they are actually a small pot, the pot of water relative to the large pot will naturally be much less, to maintain the appropriate amount of water and water temperature, you need a relatively small fire. It’s like growing an adult’s body shape, but an 8-12 year old’s physique. This is also the reason why these people why they always feel that they are deficient, not enough energy stamina, for this type of people, tonic is also moderate, because to reach the normal human standard, for them is already overkill.
So, why is there a deficiency of tonic?
Firstly, from the appearance, people who are deficient in tonic are no different from normal people in terms of appearance, remember that this is the premise that we may take a detour from the beginning.
Second, they can also get sick, from the clinical manifestations, can also be presumed to have qi deficiency, yin deficiency, damp heat, deficiency of cold
Third, the biggest problem lies in this stage, since there is deficiency, then adjust the tonic, there are deficiencies and real it, fill the deficiency diarrhea real. Because at the beginning you see them as a cauldron, ready to add water and firewood tools are naturally a cauldron, so a little add water, water will be diffused out, a little add firewood, water immediately boiled, even if you feel that only a little added. At this point you may still be wondering, eh, how can this look like, is it not yin deficiency is yang deficiency, not real fire is false fire?
In short, people who are deficient are very adult-like in appearance, and they have a congenital deficiency in one or more of their organs and have a little balance of their own that you just accidentally disrupted.
Such examples, perhaps a bit extreme, are too typical. You don’t see many in a lifetime. But if you close your eyes, consider the graph of normal distribution, and use your imagination, there should be many such cases between such cases and normal people, just how much the proportion of deficiency of a certain organ or multiple organs is not compensated. Thinking this way, there should be many, many more.
The most important thing is that you should use a third or a fifth of the normal amount, such as 3g each of Radix et Rhizoma Ginseng and Radix Astragali, and there are also some drugs that are relatively calm and will not cause fire, such as Ganoderma Lucidum and Rhizoma Polygonatum.