Preparation for ingestion and METHODS OF DELIVERY Materia Medica I

Methods of Delivery Decoctions (tang) Powders (san) Pills (wan) Special pills or vermillion pills (dan) Syrups (gao) Plasters (gao) Medicinal wines (jiu) Processing vs. preparation

Decoctions (tang) Most common method. Pros Easily absorbed, good for acute conditions Easily modified to fit clinical need Easily ingested, no special equipment Cons Time-consuming to prepare Taste and odor Relatively expensive Literally, “soup”

How to Prepare a Decoction Use covered non-aluminum cookware (non- metal is best) Place herbs in pot, cover with sufficient water, and allow herbs to soak Heat to a boil, then simmer Cooking time depends on type of formula, 20-30 minutes being average When liquid is reduced to approx 2 cups, pour off the “tea” Dregs may be cooked again or discarded Military fire, then civilian fire – Li Shi Zhen 10-15 minutes for exterior releasing and heat clearing (especially cool acrid for wind-heat like Sang Ju Yin) 45-60 minutes for tonic formulas

Cooking Herbs Video - How to Prepare a Decoction

Herbs Requiring Special Decoction Decocted first (pre-decocted) Added near end (post-decocted) Decocted in cheesecloth/gauze Decocted separately Dissolved in strained decoction Taken at the same time with strained decoction

Decocted First (Pre-Decocted) Type of Herb Pre-decoction Time Example Herb Toxic herbs. Longer cooking time reduces toxicity. 30-45 mins Fu Zi Minerals and shells. Longer cooking time to extract ingredients. 10-20 mins Shi Gao Lightweight substance with large dosage. Not enough room in the cooking pot. 20 minutes, then use the liquid to decoct the other ingredients Bai Hua She She Cao Lists of herbs with special decoct reqs in Bensky introduction. Fu Zi: acrid, hot, toxic, HT, SP, KD. Shi gao: acrid sweet very cold, LU & ST. Bai Hua She She Cao (White flower snake tongue herb) 15-30 grams, clears heat and detoxifies, anti-cancer herb for GI tract esp

Added Near the End (Post-Decocted) Type of Herb Post-decoct Time Example Herb Aromatic herbs (Exterior Releasing, Qi Regulating). Adding near the end prevents volatile oils from evaporating. 5-10 mins Bo He Mu Xiang Certain herbs requiring a stronger effect. 10 mins Da Huang Bo he: acrid, cool. LU and LIV. Wind-heat, regulate Liver qi. Mu Xiang: acrid bitter warm, SP-ST-GB-LgInt. Move qi, alleviate pain in ST and intestines Da Huang: bitter, cold, SP, ST, LgInt, LIV, HT. purge heat, cool blood, activate blood.

Decocted in Cheesecloth Wrap herbs with fine hairs, small seeds, and some minerals in order to avoid irritation to the throat or digestive tract Che qian zi (plantain seed), Xin Yi Hua (pussy willow magnolia bud) Che Qian Zi Xin Yi Hua

Decocted separately Rare and expensive substances are sliced thin and simmered in a covered double- boiler for 2 hours to facilitate extraction of ingredients. Ren Shen Ren shen, lu rong (young deer velvet antler - $155/lb) Lu Rong

Dissolved in strained decoction Viscous, sticky substances that will stick to the pot and other herbal ingredients should be dissolved in a separate bowl or pot and then added to the strained decoction. Yi Tang E Jiao Shan Dong (Dong-E) E Jiao is best, Yi Tang

Taken with Strained Decoction Expensive aromatic herbs are not cooked. They are shaved or filed into a powder, mixed with a little water or decoction, and swallowed. Follow with rest of decoction San Qi Niu Huang

Taking a Decoction Most decoctions are taken warm Take approx one cup, 2-3 times per day In cases of vomiting or for children and the seriously ill, small amounts may be taken more frequently Usually taken before meals to facilitate absorption, especially tonic formulas Formulas with ingredients that irritate the stomach are taken after meals Formulas that calm the spirit are taken before going to bed Take most decoctions warm, unless warm medicine causes nausea (in which case take cool) Before meals for maximum absorption

Powders (san) Herb is ground into powder or boiled, freeze-dried, then ground. Pros Relatively easy to absorb (less than decoction, greater than pills) Flexibility in clinical use Easy to store, convenient to use Cons May irritate stomach Bacteria and other organisms may contaminate ground raw herbs (use cGMP products)

Pills (wan) Herb is ground into fine powder and formed into a pill or bolus using a viscous medium. Pros Different mediums may be used (water, honey, wax) Easy to store, convenient to use Good for maintenance therapy Cons Mild and slow in action Cannot modify ingredients and dosages within the formula Honey for tonifying, wax to prevent dissolving until intestines and prevent stomach irritation Bao He Wan

Special Pills (dan) Finely processed and expensive substances Sometimes called “vermilion pills” because Zhu Sha (Cinnabaris) was used as a protective coating Zhu Sha, composed mostly of mercury sulfide, is toxic and no longer used Example formula: Tian Wang Bu Xin Dan Tiny pills Daoist search for immortality. Were considered very refined and powerful. Today dan is used like wan.

Syrups (gao) Prepared by simmering in water until reduced to a thick concentrate, then adding granulated sugar or honey Used for treating cough and sore throat or chronic, debilitating diseases Easily absorbed, palatable, convenient Chuan Bei Pi Pa Gao – loquat cough syrup Pi Pa Ye Chuan Bei Mu Nan Sha Shen Wu Wei Zi Chen Pi Jie Geng Ban Xia Bo He Kuan Dong Hua Xing Ren Feng Mi

Plasters (gao) Applied externally Used for dermatological disorders, painful musculoskeletal conditions, fractures and sprains Herbs may be simmered in oil, mixed with beeswax, and spread on a cloth; or herbal powder can be added to heated oil and beeswax Yun Nan Bai Yao Plasters Pain Terminator used in clinic

Medicinal Wines (jiu) Medicinal substances are steeped in wine Wine is dispersing and increases circulation Used to treat wind-damp painful obstruction (rheumatic conditions), traumatic injuries, and some deficiency disorders Snake wine. Bai hua she: sweet, salty, warm, toxic, LIV. Wind-damp category for W-D Bi and post-stroke hemiplegia. Wu shao she, sweet, salty, neutral and non-toxic. Qi she: sweet, salty, warm, toxic, LIV. Die da tian qi yao jiu