Traditional Chinese Medicine is vast and profound. There are many considerations when it comes to decocting medicine, such as the choice of utensils, the amount of water used, and the order of decoction. There are also many things to be aware of when it comes to taking medicine and dietary restrictions.
In the book "Treatise on Cold Damage Disorders," there are many considerations mentioned regarding decoction and dietary restrictions. Here, I will introduce them as follows:
【Considerations for Decoction】
1. Decoction Method
The choice of utensils: It is best to use a sand pot or an enamel pot. Avoid using metal utensils such as copper, iron, or aluminum to prevent chemical reactions.
The amount of water used: Tap water is fine, but spring water is better if available. The amount of water should be enough to soak the herbs. Before decoction, soak the herbal ingredients in cold water for half an hour to facilitate the extraction of active ingredients.
Decoction time: The decoction time depends on the type and nature of the herbs. Generally, herbs are brought to a boil over high heat, and then simmered over low heat for 20-25 minutes. Tonic herbs, such as Rehmannia, Polygonum Multiflorum, and Eucommia Bark, require a longer decoction time of 30-35 minutes. However, for herbs that are used to relieve exterior conditions, clear heat, or have aromatic properties, such as Cinnamon Twig, Schizonepeta, Saposhnikovia, Peppermint, and Agastache, a decoction time of 10-15 minutes is sufficient to prevent the loss of active ingredients. It is also important not to frequently open the lid during decoction to prevent excessive evaporation of active ingredients.
2. Special Herbs Decoction
Pre-decoction: For hard herbs such as seashells and minerals, such as Dragon Bone, Oyster Shell, Mother of Pearl, Turtle Shell, Soft-Shelled Turtle Shell, Haliotis, and Magnetite, their hard texture makes it difficult to extract the active ingredients, so pre-decoction for 20-30 minutes is recommended.
Late addition: For herbs with aromatic smells and volatile properties, such as Peppermint and Fructus Amomi, they should be added towards the end of the decoction, about 5 minutes before other herbs are done, to prevent the loss of active ingredients.
Package decoction: Some herbs may cause the decoction to become turbid or irritate the digestive tract and throat. In these cases, the herbs should be wrapped in cloth before decoction, such as Cinnabar, Plantago Seed, and Inula Flower.
Separate decoction: Some precious herbs require separate decoction to maximize the preservation of their active ingredients, such as Ginseng and Cordyceps.
Melting: Some herbs with high gel content and high viscosity, such as Donkey-Hide Gelatin, Deer Antler Gelatin, Licorice, and Honey, should not be decocted together with other herbs. They should be melted separately by warming or dissolved with hot herbal decoction to prevent them from sticking to the pot and burning.
Oral administration: For powdered medicine, pill medicine, small pill medicine, natural juice, or aromatic and precious herbs, oral administration is suitable, such as Calculus Bovis, Musk, Notoginseng Powder, Agarwood Powder, Zixuedan, and Liushen Pill.
【Methods of Taking Medicine】
Frequency of medication: Generally, after decoction, the medicine is taken warm. Usually, one dose of medicine is decocted in the morning and evening, or one dose of medicine is decocted once, and the decoction is poured into a bowl. Then, water is added for a second decoction. The two decoctions are combined and taken in two doses. Depending on the specific condition of the patient, some medicines can be decocted every two days, or they can be decocted and taken as tea, such as various cooling herbal teas and Liu Yi San, etc.
Timing of medication: For tonifying medicines or medicines that treat lower body disorders (below the diaphragm), it is recommended to take them before meals. For medicines that may irritate the stomach, they should be taken after meals. For medicines that treat insomnia, they are best taken before bedtime. Anthelmintic medicines are best taken on an empty stomach. For patients with vomiting, small and frequent doses are recommended. Medicines for treating cold conditions are best taken warm, while medicines for treating heat conditions are best taken cold.
【Considerations for Dietary Restrictions】
Some people ask, when taking Chinese medicine, traditional Chinese medicine often requires dietary restrictions, such as avoiding spicy, stimulating, raw, cold, or greasy foods. Is this restriction only during the period of taking medicine, or for a few days before and after taking medicine, or is it necessary to restrict the diet indefinitely?
In fact, the reason why traditional Chinese medicine emphasizes dietary restrictions mainly has two reasons:
First, traditional Chinese medicine focuses on differentiation of symptoms and signs (Bian Zheng). Second, both Chinese herbs and foods have four properties and five tastes.
Diseases can be classified as cold or hot, deficient or excessive, even for the same disease, there can be differences in cold or hot and deficient or excessive patterns due to differences in individual constitutions. Therefore, in addition to using herbs to tonify or reduce pathogenic factors in the treatment, dietary restrictions or "selective diet" should also be considered based on the individual's condition to enhance the therapeutic effects of herbs or reduce their side effects. In this sense, "dietary restrictions" is actually part of traditional Chinese medicine treatment. In clinical practice, we have found that some foods have similar properties and tastes as herbs. To avoid adverse effects of food on herbs, the concept of "dietary restrictions" in traditional Chinese medicine has emerged.
Dietary restrictions include two aspects: dietary restrictions based on the nature of the disease, which belong to pathogenic dietary restrictions. For example, for various heat conditions, people with excessive internal heat, and external pathogenic diseases, they should avoid spicy, greasy, fried, and deep-fried foods. For those with cold conditions, they should avoid raw or cold foods. During an asthma attack, foods high in protein such as eggs, milk, fish, and shrimp should be avoided. For patients with hemorrhoids or skin diseases, seafood, mutton, dog meat, and other irritating foods should be avoided. For patients with edema, salt should be avoided. For patients with hepatitis, spicy, greasy foods should be avoided.
Regarding dietary restrictions based on the characteristics and contraindications of the herbs being taken, which belong to medicinal dietary restrictions:
When taking Ginseng, radish should be avoided. When taking Turtle Shell, Amaranth and Peppermint should be avoided. When taking Poria, vinegar should be avoided, etc.
In addition, when taking any Chinese medicine, it is not recommended to drink strong tea because it contains a lot of tannic acid, which can reduce the efficacy of the medicine. It is best to drink plain water instead.
A case study regarding dietary restrictions in the treatment of fever with Chinese medicine: A student with a fever that did not subside was hospitalized for treatment. The author, who was engaged in academic activities at the hospital, was invited to use traditional Chinese medicine to lower the fever. The prescription was used, and the fever subsided after taking only two doses. The student had no appetite when having a fever but had a good appetite after the fever subsided. He requested to eat meat, so his mother cooked pig's trotters for him. The fever returned that evening. Another prescription was given, and it was advised to have a light diet. The fever subsided two days later. The student's mother strictly followed the doctor's advice and did not allow him to eat meat. On the day of discharge, a classmate came to visit. During lunch, the main course was noodles. One classmate, thinking that he had just recovered from an illness and was physically weak, served him two bowls of thick noodles with an egg in the soup. Unexpectedly, the fever returned that evening. The student sought treatment again and was advised to avoid meat and eat only soupy noodles. After a week of adjustment, the fever did not recur.
This case study illustrates the importance of dietary restrictions in the treatment of fever with traditional Chinese medicine. "The Yellow Emperor's Inner Canon" has long pointed out the dietary care after the onset of an external pathogenic fever: "Avoid raw, sticky, meaty, spicy, alcoholic, and foul-smelling foods" because these foods may affect the timely dispersion of external pathogens, leading to a prolonged fever. Therefore, they should be avoided.
As for how many days dietary restrictions should be followed, it should be based on the specific condition of the disease. For external pathogenic diseases, dietary restrictions should be adhered to during the medication period and for one week after the cold symptoms have completely recovered. For internal organ disorders, mixed diseases, and chronic diseases, dietary restrictions should be followed during the medication period and for one month after the disease has completely recovered. Some diseases require dietary restrictions for life, such as diabetes, which requires a lifelong restriction of sweet foods, and liver disease, which requires a lifelong restriction of alcohol, etc.
However, it is not necessary to excessively expand dietary restrictions. Restricting everything can weaken the body and delay recovery. Excessive dietary restrictions can also make it difficult to take medicine. With a weak body and low digestion ability, no matter what medicine is given, it may not be effective. Therefore, my opinion is that during the illness, as long as it does not violate the nature of the disease and the nature of the medicine, and does not affect the digestive function of the spleen and stomach, you can eat whatever you like.
In addition, it should be noted that during the illness, not only should dietary restrictions be observed, but also "opening the mouth" should be emphasized, especially for some chronic diseases. "Opening the mouth" is more important than "dietary restrictions." This is because life is a process of material metabolism, and it requires continuous "opening the mouth" to intake nutrients in order to rejuvenate. As the saying goes, "Disease is three parts treatment, seven parts nourishment." The "Yellow Emperor's Inner Canon" explains this point very well, "For treating severe poison, eliminate 60% of it; for treating mild poison, eliminate 70% of it; for treating common poison, eliminate 80% of it; for treating no poison, eliminate 90% of it; and for cereals, meat, fruits, and vegetables, eat until full."
Above, I have introduced the methods of decocting Chinese medicine and the considerations for dietary restrictions. If you are not familiar with decocting Chinese medicine, you can have the hospital do it for you. When taking medicine, be sure to pay attention to dietary restrictions.
