The methods of medication in traditional Chinese medicine generally refer to the ways of applying Chinese herbal medicine. The methods of applying Chinese herbal medicine are diverse and generally include four aspects: route of administration, decoction methods, and methods of taking the medicine.
1. Route of Administration
The route of administration is one of the factors that affect the efficacy of medications. Our ancestors have accumulated a lot of experience in the use of medications through different routes of administration. The traditional routes of administration for Chinese herbal medicine mainly include oral administration and external use (oral administration and topical application). In addition, there are also various other routes such as inhalation, sublingual administration, mucosal surface administration, and rectal administration. Since the 1930s, the routes of administration for Chinese herbal medicine have also included subcutaneous injection, intramuscular injection, acupoint injection, and intravenous injection.
Different routes of administration have their own characteristics. Different tissues in the body have different absorption properties and sensitivity to drugs, and the distribution and elimination of drugs in different tissues are also different. Therefore, the route of administration can affect the speed, quantity, and intensity of drug absorption. Some drugs may even need to be administered through a specific route to exert their effects. For example, gypsum is mainly taken orally for clearing heat and reducing fire, while it must be applied externally after calcination for dampness and wound healing. When choosing the route of administration in clinical practice, the characteristics of the drug and the specific condition of the patient should be considered. The selection of the route of administration based on the patient's condition and the drug also needs to be reflected in the choice of dosage form.
2. Decoction Methods
The efficacy of Chinese herbal medicine is closely related to the selection of dosage form and the operation of preparation techniques. Since decoctions are the most commonly used dosage form in clinical practice and are mostly prepared by patients themselves, mastering the correct decoction methods is also an important condition for ensuring the efficacy of medications. The control of water and heat is particularly crucial in the decoction process. Li Shizhen said, "Even if the quality of the medicine is excellent and the formulation and treatment are done according to the rules, if the decoction is done recklessly and the water and heat are not properly controlled, the medicine will be ineffective."
(1) Decoction Vessels
It is best to use ceramic vessels such as clay pots or sand jars for decoction. They have stable chemical properties and are not easily reactive with the chemical components of the herbs. They also have even heat conduction and good heat preservation. White enamelware or stainless steel pots can also be used. It is important to avoid using iron, copper, aluminum, and other metal utensils for decoction. These metal elements can easily react with the chemical components in the decoction, reducing the efficacy and even causing toxic side effects.
(2) Decoction Water
It is best to use clean and uncontaminated well water or running water for decoction. In urban areas, tap water is mostly used. In general, any water that is safe for drinking can be used for decoction. However, the water should be odorless, clean, clear, and low in mineral and impurity content. The amount of water added is also an important factor in preparing a good decoction. The amount of water should be determined based on the density and water-absorbing properties of the herbs and the duration of decoction. Generally, the amount of water should be enough to cover the herbs by about 2 centimeters when the herbs are slightly pressed. If the herbs are hard or sticky, or if they need to be decocted for a long time, slightly more water can be added. If the herbs are loose in texture or if the active ingredients are easily volatile and the decoction time is short, slightly less water can be added. In order to facilitate the full dissolution of active ingredients and to shorten the decoction time, it is recommended to soak most herbs in cold water before decoction. Generally, the soaking time for most herbs is 20 to 30 minutes, while seeds and fruits may require soaking for 1 hour. In hot weather, the soaking time should not be too long to avoid spoilage.
(3) Heat Control
The heat control and duration of decoction are also important considerations. In general, herbs should be decocted with high heat first and then simmered with low heat. After reaching boiling point, the heat should be lowered to maintain a gentle boil to prevent the decoction from boiling over or drying out too quickly. For diaphoretic herbs and other aromatic herbs, it is generally recommended to quickly bring them to a boil with high heat and then simmer for about 10 to 15 minutes. For minerals, bones, shells, shells, and tonic herbs that are not easily extracted, they should be simmered for a longer time with low heat to fully dissolve the active ingredients.
(4) Number of Decoction Rounds
In general, one prescription can be decocted three times, with a minimum of two rounds. During the decoction process, the active ingredients of the herbs will first dissolve in the water within the herbs, and then diffuse into the surrounding liquid. When the concentration of the solution inside and outside the herbs reaches equilibrium, the effective ingredients will no longer dissolve. At this point, the liquid needs to be filtered out, and the herbs need to be decocted again with fresh water to continue extracting the active ingredients. In order to fully utilize the herbs and avoid waste, it is recommended to decoct the herbs two or three times. After decoction, the residue should be squeezed to extract the remaining liquid. This is because some medicine residue can adsorb certain liquid after boiling. Additionally, the active ingredients in the main liquid need to be fully utilized.
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