Chinese Herbal Tonics for Health and Vitality*

Hong Hai The Renhai Clinic 仁海堂

www.renhaitang.com.sg 1 June 2013

The Brahm Centre

*Main information slides

TCM Classification of Constitutions

1. Balanced and Peaceful 平和体质

2. Qi deficiency 气虚体质

3. Yang deficiency 阳虚体质

4. Blood deficiency 血虚体质

5. Yin deficiency 阴虚体质 6. Phlegm-Dampness 痰湿体质

7. Damp-Heat 湿热体质

8. Qi stagnation 气郁体质

9. Blood stasis 血瘀体质

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Qi Deficiency and Blood Deficiency

Some symptoms of Qi deficiency

(hypofunction of zang-fu organs)

Fatigue Less desire to speak Spontaneous sweating Tender and swollen

tongue with teeth imprints

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Some symptoms of Blood deficiency

(Caused by poor nourishment or endowment, bleeding, excessive

anxiety)

Thin body & slack muscles Dizziness Numbness in limbs Pale complexion Insomnia

Some symptoms of Yang deficiency and Yin deficiency

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Yang deficiency (Often comes with ageing)

Cold body and limbs Soft (and fat) body Aversion to cold,

preference for hot food Pale lips Copious urine Impotence

Yin deficiency (can be induced by overwork, loss

of blood, excessive sex. )

Body thinness Feverish sensation in

palm and soles Dry mouth, preference

for cold drinks Red tongue with scanty

fir

Chinese herbal supplements

The pi 脾 and shen 肾 are the organs most directly related to cultivating longevity. Hence tonics for qi, shen and pi are the most commonly used in TCM

Pi vulnerable to si 思 (contemplation, or anxiety) and irregular/oily diet. Decline in pi leads to deterioration of qi and shen

Shen is weakened by excessive fear, overstrain, and weakening pi Decline in shen leads to weakness in yang, yin and

pi

Some common Qi tonic herbs Ginseng 人参 Huaishan 山药

American ginseng 西洋参 Liquorice 甘草

Taizishen 太子参 Baizhu 白术

Dangshen党参 Red dates 红枣

Astragalus 黄芪 White hyacinth bean 白扁豆

三七（田七）Sanqi/tianqi – also known as pseudoginseng. It is strictly not a qi tonic but more of a herb for promoting blood circulation without damaging the zhengqi 正气 (化瘀不伤正）. Sanqi is an ingredient in the prescription yunnan baiyao

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Xiyangshen 西洋参

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Renshen 人参

• Slightly warm

• Action of invigorating qi is the strongest (大补元气). Can even use alone to treat severe cases.

• Can also boost yang

• “American ginseng”

• Clears heat

• Can also use to nourish the yin of spleen and lung

• Often used to treat the syndrome of spleen and lung qi, yin deficiency

肺脾气阴两虚

• Similar to American ginseng, it has the action of nourishing yin. However, the action is weaker. Hence, it is only used in mild cases of spleen and lung qi, yin deficiency

• Cheapest among all , hence is often used to treat long term chronic illnesses

• Action of invigorating qi is weaker.

• More often used to tonify and strengthen the spleen qi because it can also dry dampness

Taizishen 太子参

Dangshen 党参

Natural Man-made

Yerenshen 野人参

(Wild Ginseng)

Shengshaishen 生晒参

Hongshen 红参

Shenxu 参须

Gaolishen 高丽参

• It has the strongest actions among all types of ginseng. Used in severe cases of qi and fluid deficiency

• Most expensive

• Dried ginseng • Used in the

syndrome of qi and yin deficiency

• Steam-dry ginseng

• The nature is warmer than 生晒参

• Used in the syndrome of qi and yang deficiency

• Sweet, bitter and neutral

• Action of strengthening qi is generally weaker

• Can also be used to treat nausea resulting from spleen deficiency

• Also known as 朝鲜参or别直参

• Similar function as hongshen 红参

Different types of ginseng

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Huangqi 黄芪

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Renshen 人参

• Is a stronger qi tonic than huangqi, and is used to treat severe deficiency in qi and yang.

• Also calms the nerves

• Is not as warm as ginseng hence it is suitable for most body constitutions

• Used to treat prolapse of organs caused by over descending of spleen qi.

• Protects the exterior of the body from invading pathogens (eg Jade-Screen Powder 玉屏风散)

• Promotes diuresis and the healing of sores

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Baibiandou 白扁豆

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Shanyao 山药

• Neutral flavour, hence it is suitable for most body constitutions

• A mild tonic for spleen, lung and kidney

• Can also use as food

• The action of strengthening the spleen is weaker but it can resolve dampness.

• Hence, it is used to treat mild cases of diarrhoea and vomiting due to dampness, especially during the summer season when the humidity level is higher.

• Stir-fried biandou can better promote its action of relieving diarrhoea

• Pharmacological studies suggest that it can treat food poisoning as it has detoxification action

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Gancao 甘草

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Dazao 大枣

Both tonify the spleen and act as regulator in a prescription. They are mild on the spleen.

• Also known as hongzao红枣. It is warmer than gancao. Remove the seeds of the dates can help to reduce its warm nature.

• Additional action of nourishing the blood to treat sallowness or hysteria due to blood deficiency.

• Can be used as food

• The actions of stir-baked gancao are more diverse as it not only acts on the spleen but also can be used to treat cough and relieve pain, especially those that are caused by spasm of muscles.

• Raw gancao is mostly used for

eliminating toxins and heat to treat sores/carbuncles etc due to its cooler nature.

Some qi tonic prescriptions Prescriptions Actions

四君子汤 The Decoction of the Four

Noble Herbs

Tonify qi and strengthens the spleen

六君子汤 The Decoction of the Six Noble

Herbs

For deficiency of spleen/stomach syndrome with dampness and phlegm (loose stool, nausea, poor appetite)

香砂六君子汤 Xiangsha Liujunzi tang

For spleen-stomach deficiency with more pronounced dampness and phlegm leading to qi stagnation (nausea, bloatedness, poor appetite, lassitude)

补中益气汤 Buzhong Yiqitang

For shortness of breath, low and weak voice or prolapse of organs (eg uterus),

参苓白术散 Shenling Baizhu san

For qi deficiency syndrome of the spleen and stomach with dampness (diarrhoea)

Blood tonic herbs

Angelica 当归 Heshouwu 何首乌

Angelica 当归 Ejiao 阿胶

Baishao 白芍 Heshouwu 何首乌

Shudihuang 熟地黄 Dried longan 龙眼肉

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Heshouwu 何首乌

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Danggui 当归

• Among all three, only danggui has the action of promoting blood circulation

• The danggui head is more for tonifying blood whereas the danggui tail has a stronger action in promoting blood circulation

• Often used to regulate menstruation

• Invigorate the kidney, hence, promotes the growth of blacker hair and “anti-ageing”

• More often used in the treatment of insomnia and palpitation due to mild cases of deficiency in heart and spleen

• It is generally a mild tonic which is suitable for most constitutions

Longan meat 龙眼肉

tail

head

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Shudihuang 熟地黄

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Ejiao 阿胶

All three tonify blood and nourish kidney yin.

Should be taken with caution in patients who have qi stagnation as they are hard to digest which may result in abdominal distension and poor appetite.

• Have to melt it separately before brewing with other herbs

• Good for beauty enhancement (yang guifei used ejiao to enhance her complexion)

• Can also treat cough caused by lung yin deficiency as in 清燥救肺汤

• Can be used in all types of blood deficiency syndrome

• A common herb used in clinical to tonify kidney yin eg, the principal herb used in 六味地黄丸which is used to treat kidney yin deficiency syndrome

• It has a sour taste which gives it the action to arrest sweating

Baishao 白芍

Some blood tonic prescriptions Prescriptions Actions

四物汤 The Decoction of the Four

Ingredients

Nourishes and regulates blood

当归补血汤 Chinese Angelica Decoction

for Tonifying the Blood

Particularly blood deficiency with fever and headache following childbirth or menstrual disorder with severe loss of blood; anemia

归脾汤 Guipitang

For blood deficiency in spleen and heart that leads to insomnia, heart palpitations etc

桃红四物汤 Taohong Siwutang

For nourishing blood and promoting blood circulation. Usually used to regulate menstruation with stasis

八珍汤 （四君子汤 + 四物汤） The Decoction of the Eight Ingredients

Nourishes both qi and blood

Yin tonic herbs

The renowned physician Zhudanxi 朱丹溪 (Yuan dynasty 1281-1358) believed that yin deficiency and asthenic heat 虚火 are present in most people and the cause of most illnesses.

Wolfberry 枸杞子 Yuzhu 玉竹

Maidong 麦冬 Shihu 石斛

Lily bulb 百合 Beishahen 北沙参

Black sesame seed 黑芝麻 Nvzhenzi 女贞子

Biejia (Turtle shell) 鳖甲 Huangjing 黄精

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Beishashen 北沙参

Nourish lung and stomach yin. Treat dry coughs due to lung yin deficiency.

• Stronger yin nourishing action, hence it is a better choice for treating chronic dry cough

• Not for coughs from initial exposure to cold and wind

• Besides clearing heat from the stomach, it can also clear heat from the heart to remove vexatiousness.

• People with weak stomach should take it with caution due to its cold nature

• Not for coughs from initial exposure to cold and wind

Maidong 麦冬

Baihe 百合 (Lily bulb)

Flavour Sweet

Nature Slightly cold

Actions • Nourish yin and moisten the lung • Clear heat from the heart to calm the

mind

• For chronic dry cough with little phlegm, or blood in severe case

• For insomnia and palpitation caused by asthenic heat (heart-yin deficiency)

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Yuzhu 玉竹

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Shihu 石斛

• Clear asthenic heat without damaging the fluids

• For kidney yin deficiency

conditions accompanied with symptoms such as thirst and hot flushes

• Also nourishes stomach

yin in which the deficiency will manifested as dull or burning stomach pain, poor appetite, dry mouth, constipation

• A yin tonic for the lung and stomach

• Promote the production of fluids to quench thirst

• Often used with shashen and maidong to treat dry cough caused by lung yin deficiency

• Common form of yin tonic for the liver and kidney

• To treat poor vision due

to liver-kidney yin deficiency

• Can also boost the

immune system – used in post-chemotherapy restoration of body balance

Gouqizi 枸杞子

Heizhima 黑芝麻 (Black Sesame Seed)

Flavour Sweet

Nature Neutral

Actions

• Tonify the kidney and liver • Moisten the large intestine • Tonify essence and blood

• For premature greying of hair • Anti-ageing • Promote bowel movement especially in elderly

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Nvzhenzi 女贞子

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Turtle Shell 鳖甲

• Often used for nourishing kidney yin and clearing asthenic heat

• Usually need to boil longer than most herbs to extract its active ingredients and remove its smell

• Often used as an ingredient in soups.

• Nourish both liver and kidney yin to improve vision and prevent premature greying of hair

• It can also help to strengthen one’s immune system

• Besides nourishing kidney yin, it also tonifies qi and strengthens the spleen and lung

• However , it has a stronger action in tonifying the kidney

Huangjing 黄精

Some yin tonic prescriptions

Prescriptions Actions

六味地黄丸 Pill of Six Ingredients

with Rehmanniae

Treat the deficiency syndrome in liver and kidney yin. Has a cooling action for asthenic heat

左归丸 Zuogui wan

Treat kidney yin deficiency without significant asthenic heat. It also supplements the essence to tonify the marrow.

Yang tonic herbs

Antler 鹿茸 Cordycep 冬虫夏草

Antler 鹿茸 Cordycep 冬虫夏草

Horny-goat weed 淫羊藿 Walnut 核桃仁

Duzhong 杜仲 Seahorse 海马

Tusizi 菟丝子 Yizhiren 益智仁

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Honey-goat weed 淫羊藿

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Cordyceps 冬虫夏草

Antler 鹿茸

• It is generally a good tonic for strengthening the immune system especially during the recovery phase of an illness

• Used to treat chronic cough which results in weak lung

• Strong yang tonic

• Used to treat menstruation disorder and poor development resulting from kidney yang deficiency

• Besides strengthening bones and tendons, it is also used to treat arthralgia and numbness in limbs caused by the invasion of wind-dampness pathogens

Some yang tonic prescriptions Prescriptions Actions

肾气丸/金匮肾气丸 Pill for Nourishing Kidney Yang

Deficiency of kidney yang syndrome, often accompanied by weakness of back and knees, coldness in lower trunk, frequent night urination, sexual dysfunction

济生肾气丸 Jisheng shenqi wan

To warm the kidney yang and promote diuresis to relieve edema. It is often used to treat water retention due to kidney-yang deficiency

右归丸 Yougui wan

Used for feeble elderly patients or those with long debilitating illness Much warmer than shenqi wan

Some Tonic foods Qi: Chinese yam (huaishan 淮山), peanuts,

biantou 扁豆(hyacinth bean), millet, carrot, chicken, pork tripe

Blood: pork liver, lamb, sea cucumber, raisins, red

dates, blackstrap molasses, spinach, carrot

Yin : white fungus, bird’s nest, pear, turtle, black sesame 黑芝麻, black beans 黑豆, duck, sea cucumber

Yang: lamb, shrimp, walnut, Chinese chives 韭菜