Traditional Chinese Medicine Decoction Methods
The decoction method of traditional Chinese medicine is one of the key factors determining clinical efficacy. Throughout the ages, medical practitioners have placed great importance on the decoction and administration of herbal formulations. When studying classics and ancient medical texts, we often focus on the composition and therapeutic functions of the medicines, while neglecting the decoction and administration methods.
In the Qing Dynasty, Xu Lingtai wrote in his book "Yixue Yuanliu Lun" (The Origins of Medicine): "The method of decocting medicines deserves the utmost attention, as the effectiveness of the medicine depends entirely on it. Even the improper cooking of poultry, fish, sheep, and pigs can cause harm to people, let alone medicines used specifically for treating diseases. Shouldn't we emphasize this?" "Most dispersing medicines and aromatic medicines should not be decocted for too long, as they should be taken while still fresh and dispersive. Nourishing and greasy medicines, on the other hand, should be decocted for longer to reach maturity and accumulation. This is the general principle." Only by mastering the correct decoction method can we ensure clinical efficacy. Otherwise, "even if the herbal formulation is suitable for the disease, if the decoction method is improper, the medicine will surely be ineffective. While patients who are used to taking medicine regularly may still be able to follow the instructions, how can we expect crude and impoverished households to adhere to proper procedures? Nowadays, even many doctors are unaware of this, let alone the patients." "Whether the disease improves or not depends not only on the suitability of the herbal formulation, but also on the correct administration method. If the administration method is not followed, not only will the medicine be ineffective, but it may also be harmful. This is something we must be aware of."
Currently, there is a standardized method for decocting and administering herbal formulations: place the herbal pieces in a decoction vessel such as a clay pot, add water to cover the herbs by 3-5 centimeters, soak for half an hour, then bring to a boil over high heat and switch to low heat, simmering for about 30-40 minutes. Pour out the decoction, then add water to the herbs again, decoct for a second time, and mix the two decoctions. Take the mixed decoctions in two separate doses, morning and evening. Alternatively, the Chinese herbs can be decocted three times, and the three decoctions can be combined, then taken in three separate doses.
According to the textbook "Pharmaceutical Formulas", the decoction method is as follows: "Before decoction, put the medicinal materials into a container, add cold water to cover the herbs, let them soak until fully absorbed, and then decoct. This will facilitate the extraction of active ingredients. Once it reaches a boil, switch to low heat to prevent the decoction from spilling over or drying out too quickly. It is not advisable to frequently open the lid during decoction to prevent the loss of aroma and the evaporation of volatile components."
The modern practice of decocting the herbal formulation a second time and combining the two decoctions for separate administration is commonly referred to as "fu jian" or "zai zhu" in Chinese. However, this method of decoction and administration was unheard of in ancient times. In fact, the decoction and administration methods of ancient practitioners were not based on a one-day, one-dose regimen with two decoctions, but rather on flexible methods tailored to specific conditions, constitutions, and properties of the medicines.
Number of Decoctions
Single Decoction Method
According to the records in "Shang Han Lun" (Treatise on Febrile Diseases) and "Jin Kui Yao Lue" (Synopsis of Prescriptions of the Golden Chamber), the single decoction method was commonly used, where a single dose of medicine was decocted once and divided into three separate administrations. For example, in the case of Guizhi Tang (Cinnamon Twig Decoction): "Take the five ingredients, chew them thoroughly, add seven liters of water, decoct over low heat until it reduces to three liters, remove the dregs, adjust the temperature to hot or warm, and take one liter. After taking the medicine, wait a moment and then drink a hot thin rice gruel to enhance the efficacy of the medicine. Take the warm drink and let it circulate throughout the body."
