According to different dosage forms, the corresponding methods of administration are established, which are called dosage form administration methods. Here, we will mainly discuss commonly used dosage forms including decoctions, pills, powders, ointments, tinctures, and tablets.
1. Decoctions
Decoctions are prepared by boiling and filtering crushed or powdered herbs in water or other liquids. Examples include Huangma decoction and Dachengqi decoction. Sun Simiao once said, "For sudden illness caused by evil pathogen, decoction should be used to cleanse and eliminate." The Shengji Jing also states, "Decoctions are the main treatment for cleansing the channels and removing pathogenic factors. In the treatment of febrile diseases, decoctions are often used." Li Dongyuan in the "Yongyao Faxiang" said, "Decoctions are used to cleanse, and they are used for severe diseases." Due to the fast absorption and easy exertion of therapeutic effects, decoctions are commonly used for acute diseases. In terms of administration, decoctions can be taken at once, two to three times a day, or even four to five times a day. In terms of timing, they can be taken before or after meals, depending on the condition and the pharmacological effects of the medicine.
2. Pills
Pills are solid dosage forms made by grinding herbs into fine powders and then mixing them with honey, water, rice paste, vinegar, or herbal juice. Li Dongyuan said in the "Yongyao Faxiang," "Pills have the meaning of relaxation and cannot be easily dispersed. They are used to relax and treat diseases." Pills have the characteristics of slow absorption and long-lasting effects, so they should not be used for treating acute diseases (although there are exceptions). However, for certain weak diseases that require long-term medication, pills are the preferred form as they are convenient for storage, transportation, and administration. Depending on the location of the disease, pills have corresponding administration methods. For diseases of the upper respiratory tract, heart, and lung, pills are often taken after meals or dissolved in the mouth. For example, the Shenghui Fang uses Bei Mu pills for treating lung injury caused by wind-cold, instructing to "wrap one pill in cotton and dissolve it in saliva," and Mai Men Dong pills for treating cough and asthma due to lung deficiency, instructing to "dissolve one pill in the mouth with saliva." For diseases of the middle burner, spleen, and stomach, pills are often chewed. For example, the Dajianpi pills for treating spleen deficiency and stagnation are instructed to be "chewed finely and taken with warm rice drink." For diseases of the lower burner, kidneys, and bladder, pills are preferably taken on an empty stomach, and larger and smoother pills are chosen to facilitate direct delivery to the lower burner. Due to the different types of pills, such as honey pills, water pills, paste pills, and concentrated pills, which have different dissolution rates, the time intervals for administration should also be adjusted accordingly. Generally speaking, water pills are easier to disintegrate and absorb faster, while paste pills and honey pills are absorbed more slowly, so the time intervals for the former should be slightly shorter and the latter relatively longer. Since pills have a slower action, it is important not to abruptly increase the dosage due to impatience. Instead, a small amount should be taken consistently. However, pills with aromatic properties that open the orifices and have a strong calming effect should not be used for a long time.
3. Powders
Powders are uniform mixtures of dried and powdered herbs, which can be taken internally or applied externally. For fine and small amounts of powder, it can be directly mixed with cold water, hot water, or warm wine for oral administration. For coarse powder, it can be boiled and then taken. Powders have the characteristics of rapid absorption and quick effects, so they are suitable for treating acute diseases. When treating acute diseases, the powder can be mixed with clear wine to enhance its efficacy, or it can be dissolved in boiling soup and taken orally. Of course, this should be considered in conjunction with other factors.
4. Ointments
Ointments are concentrated preparations made by boiling and condensing herbs with water or plant oils. They can be used for internal or external application. Here, we will only introduce internal ointments. Internal ointments mainly include liquid-infused ointments, infused ointments, and decoction ointments. Since the methods of preparing various ointments are different, the time for taking them also varies. Liquid-infused ointments are prepared by extracting the active ingredients from herbs with a suitable solvent. A part of the solvent is evaporated at a low temperature, and the concentration and alcohol content are adjusted to meet the specified standards, resulting in a liquid infusion. Due to the presence of alcohol in the infusion, large doses and long-term use should be avoided. Infused ointments are semi-solid or solid extracts containing soluble active ingredients from herbs. They do not contain solvent-related substances and do not have the side effects of solvents. Infused ointments can be divided into two types: semi-solid infused ointments, which are mainly used for making pills or pills, and dry powdered infused ointments, such as Zizhucao infused ointment and Longdancao infused ointment, which can be directly taken or filled into capsules. Decoction ointments are thick semi-solid extracts obtained by concentrating the water extract of herbs and adding sugar. It is prepared by heating and boiling the herbs, removing the residue, concentrating the extract, and adding honey or rock sugar. Due to the large amount of honey and sugar, decoction ointments have a nourishing effect, so they can be taken for a long time by patients with chronic weakness. However, due to the detoxifying effects of honey, the dosage can be slightly larger, but it is not suitable for those with phlegm-heat internal accumulation or water-dampness obstruction.
5. Tinctures
Tinctures are clear liquid extracts made by using alcohol as a solvent. They are suitable for tonifying deficiency, relieving rheumatic pain, and treating traumatic injuries (such as Shiquan Dabu wine and Fengshi Yaojiu). Due to the high alcohol content, they should not be taken by those with damp-heat internal accumulation. If taken, the dosage should be reduced, as alcohol can aggravate dampness and generate heat. Regarding the administration of tinctures, Sun Simiao once made a profound statement: "When taking medicinal wine, one should ensure that the wine qi is continuously connected without interruption. Interruption will result in the loss of medicinal effects. The dosage should be determined based on the principle of moderation and should not cause drunkenness or vomiting, as it would cause great harm to the body."
6. Tablets
Tablets are solid dosage forms made by processing or refining one or more herbs and mixing them with excipients. For tablets that need to act in the intestines or are easily destroyed by gastric acid, they should not be chewed or taken with water to prevent affecting their efficacy. Tablets are absorbed more slowly than decoctions, and their effects last longer. Therefore, the dosage is usually given 2-3 times to prevent the accumulation of drugs in the body. The timing of administration should also be determined based on other factors.
