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The chapter "On the Origin of Tonification" should not have been written, as contemporary discussions on tonification contradict the *Neijing* (Classic of Internal Medicine). I was compelled to write it. For health preservation, one should discuss dietary tonification; for treating disease, one should discuss pharmacological attack/expulsion. However, listeners find these words disagreeable and consider my statements strange. Generally, critics know the benefits of tonification but ignore its harms. There are six methods of discussing tonification: mild tonification (Ping Bu), severe/strong tonification (Jun Bu), warm tonification (Wen Bu), cold tonification (Han Bu), tonification for sinews and strength (Jin Li Zhi Bu), and tonification for sexual intercourse (Fang Shi Zhi Bu). Ginseng (Renshen) and Astragalus (Huangqi) are used for mild tonification; Aconite (Fuzi) and Sulfur (Liuhuang) for severe tonification; Cardamom (Doukou) and Cinnamon Bark (Guigui) for warm tonification; Asparagus Root (Tianmendong) and Dogwood Bark (Wujiapi) for cold tonification; Morinda Root (Bajitian) and Cistanche (Roucongrong) for tonification of sinews and strength; Stone Swallow (Shiyan), Seahorse (Haima), Arsenic Trioxide (Qishi), and Cinnabar (Dansha) for tonification of sexual function. These six constitute what modern times call tonification. If applied to treating disease, not only are their effects sparse and broad, but their harms are countless.

The *Nan Jing* (Classic of Difficult Issues) states: "East is excess, West is deficiency; drain the South, tonify the North." This refers to Liver Wood excess and Lung Metal deficiency; draining Heart Fire and tonifying Kidney Water. By this logic, the aforementioned six types of tonification are irrelevant. Let us cite examples of how tonification causes harm: Malaria (Nué) originates from summer heat injury. Critics attribute it to Spleen Cold and apply tonification; warm tonification leads to danger, strong tonification to death. After purgation in Cold Damage (Shanghan) or febrile diseases, if warm-acrid herbs are used for tonification, heat will recur, potentially leading to fatal hemorrhage (Xie Xue); after bleeding stops, warm tonification may cause blood heat, dysuria, or transform into edema (Shuizhong), Huoluan (cholera-like vomiting and diarrhea). If originally caused by Wind-Dampness, warm tonification is dangerous, strong tonification fatal. After pediatric sores, warm tonification can trigger carbuncles and swelling. Postpartum women often have un-descended Heart Fire and un-ascended Kidney Water; using Heishen San (Black Divine Powder) for tonification can lead to danger or death. Elderly people with dim vision and deafness suffer from declining Kidney Water and flourishing Heart Fire; strong tonification dries Kidney Water further and exacerbates Heart Fire. Elderly people with Kidney deficiency causing lumbar pain: the Kidney dislikes dryness, and the waist is the mansion of the Kidney; strong tonification worsens Kidney deficiency. Elderly people with Kidney deficiency, weakness, and nocturia: the Kidney governs the feet; deficient Kidney Water fails to descend fire, causing foot flaccidity; Heart Fire attacks the Lungs instead of entering the Bladder, causing nocturia; strong tonification drives fire upward and chills the Bladder! Elderly people with wheezing and coughing due to Fire attacking the Lungs: warm tonification aggravates the condition, strong tonification endangers life. Patients with retained fluid cannot be tonified, as it increases stagnation and fullness. Patients with heavy legs cannot be tonified, as it weighs down the calves and knees.

Men around twenty with insufficient essence, and women around twenty with stagnant blood, both suffer from Yangming disease. Laypeople fail to recognize this, treating it as accumulated cold and extreme exhaustion with mild-warm tonification. Accumulated warmth generates heat; how much more so when burning needles are applied below the navel or moxibustion is used on the wrist and ankle bones? The *Neijing* originally had no concept of "Consumption Disease" (Lao Zheng). From this misinterpretation arises Consumption, characterized by irritability, thirst, coughing with phlegm, emaciation, alternating chills and fever, night sweats, and facial redness at noon. These are mistaken for "Transmitting Corpse Consumption" (Chuanshi Lao), a disease that does not exist naturally but is created by medical error. "Two Yang" refers to Yangming, the Stomach meridian. If the Heart is affected, blood does not flow; if the Spleen is affected, flavors are not transformed. Thus, scanty semen in men and amenorrhea in women result from excessive sexual activity ("making use of the interior"). Consequently, intimate acts become impossible. Only those who deeply understand the methods of inducing vomiting (Yong) and purging (Xie) can treat this. Similarly, in the spring months, wind injures the Ying (Nutrient) level; Ying belongs to Blood, so Yin is affected. Warmth injures the Wei (Defensive) level; Wei belongs to Qi, so Yang is affected. Initially, symptoms resemble Cold Damage: headache, fever, dry mouth, tidal fever, constipation for several days. This matches Zhang Zhongjing's description of "both Yin and Yang pulses floating, spontaneous sweating, body heaviness, excessive sleepiness, and unwillingness to open the eyes." If treated with cold purgatives, Zang organs are damaged; if treated with warm tonics, fire aids wind-warmth, leading to jaundice, macules, and intensified warm-toxic heat. Severe external wind-warmth causes staring eyes, tidal fever, delirium, picking at empty air, fright, and death—this is the fault of warm tonification. Although the *Neijing* states that for form/Qi deficiency, one warms with Qi; for essence deficiency, one tonifies with flavor, and that Qi is Yang (nourished by Heaven's five qi) while Blood is Yin (nourished by Earth's five flavors), this warns against imbalance, not that "warm" equals "hot." Furthermore, "Deficiency is tonified, Labor is warmed"—here "warm" means gentle care, not heat. "Tonify the Mother when deficient, Drain the Child when excess" aims for balance. Why must one use burning needles, intense fire, refined stones, arsenic, sulfur, ginger, aconite, etc., to call it tonification? "Tonifying the upper requires slowness, tonifying the lower requires speed"—where is this speed in such harsh substances? One relies on sour, bitter, sweet, acrid, salty, and bland flavors, and cold, cool, warm, hot, and neutral properties, acting as Sovereign, Minister, Assistant, and Courier. "Mild tonification" means balancing Yin and Yang equally. Yet people hate cold and love warmth, willingly accepting toxic harshness even unto death. Alas!

My use of tonification is different. I address the excess aspect of Qi, allowing the deficient aspect to normalize naturally. The medical way is to reduce excess, thereby supplementing deficiency. I once said: Vomiting contains sweating; purging contains tonification. Is this not true? When I use tonification, I first observe where the patient can be tonified. Formerly, Zhao Xianzhi, Prefect Judge of Weiyang, suffered from emaciation and brown diarrhea, a case of Dongxie (profuse watery diarrhea) due to Cold-Stagnation. He reacted violently to the smell of Rhubarb (Dahuang). His pulses were deep and soft. I ordered over 100 moxa cones on Shuifen (CV9), followed by Guiling Ganlu San, Weifeng Tang, and Baizhu Wan. He recovered in months. Zhao Jindao, Wine Supervisor of Xicheng, suffered from low back pain for over a year. His pulses were deep, solid, and forceful. I purged him 5-7 times with Tongjing San. Then, I prepared Du Zhong (Eucommia Bark) finely chopped and stir-fried until silk threads break, powdered. Each dose: 3 qian. One pig kidney, sliced thinly, soaked in pepper salt to remove fishiness, stuffed with the powder, wrapped in lotus leaf, sealed with wet paper, and cooked slowly. Chewed well before bed, taken with warm wine. Additionally, Wubi Shanyao Wan was taken every morning. He recovered in days. Yue Chengzhi, Wine Inspector of Xiangtai, suffered from weak slippery diarrhea day and night, with intestinal borborygmus and mouth ulcers (folk name: Heart-Labor Mouth Ulcer), lasting three years. I decocted Wuling San (Five-Ingredient Powder with Poria) with ginger and jujube in long-flowing water, taken on an empty stomach to treat the lower burner. I mixed Huanglian (Coptis Rhizome) and Fuling (Poria) in equal parts, made pills with wheat paste, taken after meals with warm water to treat the upper burner. He recovered in 100 days. Wanyan Junbao, Vice Commander of Runan, suffered from Zangdu (visceral toxin), bloody stools, thirst, alternating chills and fever, lasting six years, becoming progressively emaciated and yellow-faced. His pulses were deep, and his body was cool. The *Neijing* says cold indicates Ying Qi remains, thus survival is possible; it is treatable. I purged him 5-7 times with Qixuan Wan. Then, I administered Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) with Dang Gui (Angelica Sinensis) and Chishao (Red Peony Root), decocted with Diyü (Sanguisorba Root). He recovered in one month.

In these cases, although I used tonification, I always preceded it with attack/purgative drugs. Why? Because if pathogenic factors remain, one cannot speak of tonification; tonifying then only aids the enemy. Once pathogens are eliminated, one should nourish with grains, assist with fruits, benefit with meats, and fill with vegetables, adapting to the needs of the Five Zang organs without causing imbalance. All medicines are toxic. Not just major or minor toxins are called toxic; even Licorice (Gancao) and Sophora (Kushen) are toxic. Long-term use inevitably causes imbalance. Prolonged increase of one Qi leads to premature death. Therefore, gentlemen value flow over stagnation, and balance over strength. Lu Shi said: "Strength breeds all diseases." How insightful! Relying on strength invites diseases from sexual fatigue; why value tonification? Even Emperor Taizong and Xianzong, with their high intelligence, fell victim to vulgar prejudices and were misled by alchemists' drying drugs. Han Yu and Yuan Zhen died of urinary retention and edema. Some died of sudden collapse after taking Dan (elixirs); some died of beard sores after taking Caowutou (Aconitum carmichaelii) or Rusheng Wan; some suffered urinary retention from Milkstone (Rushi) and Sulfur; some died of depleted essence/blood seeking heirs; some died of madness and hallucinations from alcoholism; some developed tea addiction. Thus, we know medicines should not be taken long-term; they are only for expelling pathogens. Once pathogens are gone, stop. Recently, Transport Commissioner Zhang Boying took Sulfur, Ginger, and Aconite for months for chronic injury and lost his sight in a day. Censor Chen Weiqing took Zhuru (Stalactite) powder for years for cough and died of hematemesis. Alas! Those who discuss tonification in later generations should take this as a warning!