Chinese herbal medicine can be dispensed in a number of methods. For example, there are bulk herbs (from which the patient makes a tea), powdered herbs, granular herbs, tinctures, capsules, honey pills and tea pills. Bulk herbs are the choice method for prescribing medicine. They are the most effective, fast acting, quality assured, and reliable method. However all methods have their merits and drawbacks, and consequently their time and place. Bulk herbs are the most effective, time-tested, fast acting, quality assured, and reliable method for dispensing Chinese medicine. Otherwise, powdered herbs can be a better alternative.
There are a few key issues to consider when prescribing Chinese medicine.
Here is a summary of the major methods of prescribing Chinese herbs with the advantages and disadvantages.
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Raw herbs – These are cooked into a decoction/ tea and consumed over a 1 to 6 day period. This is the most traditional delivery method which has been used for over 2000 years. It is the choice method of prescribing herbs in China as well as in our practice.
Advantages: This method is time tested and hence we know very precisely how the herbs work in the body. It offers the most effective and quickest results. This method allows for individual tailoring of the formula for the specific patient/ complaint.
Disadvantages: Cooking the herbs can be slightly time consuming and taste can be an issue for some.
Raw Herbs Powder– These are ground up raw herbs that one mixes with hot water, which is then steeped 3-5 minutes, creating what is called a draught. This method was used traditionally for hundreds of years for many formulas.
Advantages: Convenience (requiring much less preparation time), and like bulk herbs, has the flexibility which allows for individual tailoring of the formula for the specific patient/complaint. It would use small dosage while compare to Raw Herbs, the potency quickly release after few minutes boiling or a few hours mixed with boiling water in the flask.
Disadvantages: For some, the “sludge issue” is a concern, but this can be addressed with teabags or a strainer. As with bulk herbs, taste may be a concern. Some practitioners using Luo Han Guo to take away the bitter taste of herbs without adding the suggar, and also soothers the throat.
Benefit of using Raw Herb Powder:
1. Powders are cheaper than decoctions because they use smaller dosages.
2. Increased compliance – Quicker and Easier Preparation.
3. No corn starch added, no allergy, safe use for diabetes patients.
4. More potent than concentrated granules, then more effective
5. Easy to manage in the clinic as it require less space.
6. Proven formulas over hundreds of years.
Granulated herbs – These are herbs that undergo an extraction process whereby the end result is a concentrated powder that is also consumed in warm water. The goal of granule is to mimic bulk herbal decoctions as best as possible. This method was not traditionally used and is about 60-70 years old.Advantages: As with powdered herbs, granule is convenient. The granule may also be encapsulated and swallowed. Since they have undergone a cooking process, the stomach does not have to digest the herbs. Many times, depending on the pharmacy / practitioner, granule can allow for individual tailoring of the formula for the specific patient/complaint.
Disadvantages: The end product is similar to, but not equal to, a bulk herb decoction, producing differing constituent profiles. Furthermore, many herbs that undergo this process lose their full potency. Consequently, they bring varying clinical results as compared to bulk herbs. Generally speaking, granule also obtains slower results. Therefore if a condition is serious or quick results needed, granule may not be best. Granule requires using starches that sensitive people may react to, also an issue with diabetic patients.
Patent pills – These are small, usually black or brown, pills that are widely available from practitioners and health food stores. Usually one takes about 2-8 pills three times a day. Each bottle usually lasts about one week, and if used symptomatically may last longer.
Advantages: Convenient and inexpensive. They can treat general symptoms many times without requiring a practitioner’s sophisticated diagnosis, such as indigestion, allergies, or other minor complaints.
Disadvantages: Relatively weak in potency and not suitable for serious problems. These pre-made pills are unable to be customized for the individual. They generally work for symptomatic relief only, and rarely can resolve long-term significant problems