Further, the expectorant action, as measured in laboratory mice, was better with the powder than the liquid. In ancient times it was said that "The qi of raw materials is most poignant and works first. In the standard textbook Zhongyao Xue , 80 medicinal materials are suggested to be prescribed in powder or pill form, either because they should never be boiled, are best if not boiled, or are more efficiently used if they are not extracted first. Among items commonly used in the West and not already mentioned above that are recommended in powder form are: the antiparasitic herbs torreya, quisqualis, and brucea a tea of this herb is too bitter to consume ; the purgatives mirabilitum and aloe; the animal substances gecko, wasp nest, arca shell, eupolyphaga, pangolin, leech, earthworm, tabanus, and clam shell; the minerals actinolite, magnetite, and lapis; the blood-vitalizing herbs cnidium, corydalis, and san-chi; the saps styrax, calamus gum, and bamboo sap; and miscellaneous items such as zizyphus, bletilla, indigo, cardamon, schizandra, and gleditsia.
Convenience of ingestion is a major reason why powders are recommended by Chinese doctors. For example, if one has an acute symptom e. It is much more appropriate to have a prepared powder at home or at a public pharmacy which can be consumed by boiling in water for just a few minutes, or swallowing it down directly even more convenient in pill, capsule, or tablet.
These forms are also more convenient for those who are debilitated and don't have easy access to assistance in preparing decoctions, and for materials used repeatedly, for which the preparation and drinking of a decoction becomes tiresome.
Prepared medicinal wines have similar advantages. As the population of China has soared, and the adoption of Chinese medicine by other cultures has grown, the demands on natural resources have dramatically increased while the land available for their cultivation has declined. One of the methods for dealing with this situation is to rely more heavily on powders, which are used at lower dosages, to replace the higher dosage decoctions.
For "boiling powders," the dosage of crude herbs is usually reduced by about two-thirds. When ingesting powders directly, one-fifth to one-tenth the weight of herb materials utilized for decoction can sometimes be used in order to obtain similar effects. A gram herb decoction might be replaced by two 9-gram boluses or by two dozen tablets.
However, there are some limitations when the amount of crude materials is reduced in this way, such as getting reasonable amounts of trace minerals from the herbs. This must be taken into account when deciding which formulas to use in a lower dosage powder form and what disorders are to be treated by them. When herbs are powdered, their shelf-life is quite limited. The powdering process leaves much more surface area exposed to air, moisture, and light.
Therefore, powdered herbs must be stored in tightly sealed, opaque containers, preferably in temperature-controlled environments if they are to be retained for an extended period. Making a tablet or pill alleviates this problem by again removing the exposed surface; encapsulation partly resolves the problem, depending on how tightly the powder has been packed into the capsules. Modern packaging e. Directly swallowing loose powders has met with some resistance among Western patients true also of the dried decoctions in powder or granule form.
Making a tea from powdered herbs may be more acceptable for some, as long as the taste of the prescription is not too strong. Tableted powders have solved the majority of compliance problems encountered, but the number of tablets to be consumed still surprises many patients and there are some individuals with throat problems that have considerable difficulty swallowing tablets. Large tablets intended for treatment of adults may prove unacceptable to children who might otherwise benefit from the same formula. There are also some potential clinical disadvantages to prepared formulas presented as powders, capsules, pills, or tablets.
One does not have control over the formulation as would be the case with combining crude herbs for a decoction or combining dried decoctions of individual herbs , so one who relies solely on these forms is stuck trying to find a formulation that is compatible with the patient needs. Sometimes, it is necessary to combine two different formulas, with the result that a few herbs from each formula are included in the treatment even though they are unnecessary for the patient. Also, many Westerners are used to taking capsules or tablets made with Western drugs, at a dosage of one or two units at a time.
With Chinese herbs, to get similar therapeutic activity, one may need to take units at a time; this may deter patients and make them particularly concerned about any bodily changes that could be deemed an adverse effect of the herbs since they would certainly expect an adverse effect of that much of a drug product. The term "alcohol" comes from the Arabic, meaning "finely divided spirit" and this makes reference to the idea that all substances have a spirit; the spirit of wine is so finely divided that it becomes invisible as it is driven from the liquid by heat, reappearing only upon condensation.
The Chinese term for medicine, " yi ", includes the pictogram for wine. It is meant to distinguish the "true" medical practitioners from the shamans, who were of questionable repute and relied on rituals, amulets, and things other than medicines.
Preparations and Uses of Chinese Medicated Spirits and Wine
The best way to understand the uses of wine in medicine is to realize that, unlike water used to make tea or to swallow a pill, the wine or other alcohol preparation also serves a role as an herb. Alcohol contributes its own properties which are deemed rather potent and therefore must be taken into consideration. In the historical encyclopedia of the Han Dynasty, wine is classified as being hot, and is said to reach every part of the body, harmonize the blood and qi, open the meridians, foster yang, and expel cold.
These properties are important to consider today because, in the West, a growing number of practitioners of Chinese medicine are using a wide variety of herb formulas in the form of tinctures alcohol extracts. These same practitioners are often very cautious about using "hot" herbs, such as aconite, cinnamon bark, deer antler, and curculigo, or highly dispersive herbs, such as bupleurum, but may not give the same level of consideration to the role of the alcohol because it has not been discussed by most authors.
If one were to visit China, Taiwan, or Japan, the use of herbal tinctures as substitutes for teas, powders, or pills would not be seen as common practice. There are medicinal wines, but these are to be consumed in substantial quantity and for specific ailments, not just any ailment. The utilization of all sorts of Chinese herbal formulas and single herbs in tincture form is a Western development, based on a practice of making tinctures of Western herbs, a practice that had rapidly expanded at about the same time that Chinese herbs were introduced to the West.
The dosing of Chinese herbal formula tinctures was set at the same level as that for Western single-herb tinctures, resulting in consistent underdosing of the complex formulas. Henry C.
Lu, a well-known Chinese doctor and teacher has said "Herbs may be taken with Chinese or Japanese wine or whisky or brandy in case of arthritis, rheumatism, and other symptoms of weakness, such as sexual impotence and recuperating from prolonged illness Wine remedies mentioned in the Neijing are for treatment of meridian blockage, sudden fainting, and ear problems.
Shang Han Lun formulas that are made with alcohol are exclusively for warming and blood-vitalizing effects; among them are two that are still widely used today: Carthamus Wine, for gynecological disorders, and Trichosanthes Fruit Wine, for cardiac disorders.
Sun Simiao 6th century described 80 formulas made with alcohol, also for warming and blood-vitalizing therapy. It is indicated in the Shengji Zonglu A. The author also mentions the use of alcohol-based formulas for a syndrome of blood deficiency combined with qi stagnation, for cold syndrome, paralysis, cramping, and sudden fainting. Wine has been known in China for about 4, years. Originally, low-alcohol wines were produced from rice; specific herbs, such as curcuma yujin , were included during the fermenting process to produce the finished product.
Since about A. During the Qing Dynasty period, the practice of boiling herbs in wine instead of water was introduced as an alternative technique.
Modern Chinese researchers have investigated the use of the "wine formulas. The uses of the alcohol-based formulas are mainly in the following categories:. In Japan, a study of a medicinal wine, Youmeishu , first described in China during the Ming Dynasty, showed it to be an effective agent for post-surgical recovery for gynecological patients; consistent with use of wines in treating blood stasis. Because blood stasis and meridian obstruction are characteristic problems of aging, there is growing use of medicinal wines for that purpose. However, these materials can be problematic for some, since alcohol interacts with a wide range of modern drugs, and because of direct problems with alcohol ingestion for those with liver disease or alcohol hypersensitivity.
The influence of alcohol on herb formulas is illustrated by the instructions for use of one of China's most famous remedies, Yunnan Pai Yao. When the product is to be used for stopping bleeding, it is to be taken with water. When, on the other hand, it is to be used to vitalize blood circulation, it is to be taken with wine for best effects.
The amount of alcohol to be consumed with herbs was addressed by Sun Simiao. He indicated that to obtain the desired action, it was essential to consume a quantity which was sufficient to feel the effect of the alcohol more than momentarily as a response to tasting it. He cautioned about the adverse effects of consuming too much. Recent Western findings that regular ingestion of wines made with red grapes may have health benefits, such as preventing heart disease, and that wines in general seem to promote longevity perhaps by relaxation response when consumed in the amount of about two to four glasses daily, tend to support the Chinese experience with wine ingredients that are even more medicinally potent than grapes.
In many instances, Western manufacturers of Chinese herb tinctures do not select the tincturing process for any specific medicinal purpose, but rather to serve as a medium for extraction and preservation and to enhance compliance especially among children. The dosage of herbs used in making the preparation is usually quite small, about grams of dried crude herbs per one ounce of fluid extract.
In some cases, such as the immune-enhancing polysaccharides of astragalus, lonicera, medicinal mushrooms, and other herbs, alcohol is actually a poor medium because it causes the components to condense out of the liquid thus they stick to the herb dregs that are tossed out or to the surfaces of the processing equipment. The dosages usually recommended for tinctures, a few drops, may provide the extract of less than a gram of crude herbs and usually does not provide the "alcohol action" that Sun Simiao deemed important if the alcohol is indeed to count as part of the treatment which may be of benefit in cases where alcohol provides a non-desired action, such as warming.
The thousands of years experience gained by Chinese herbalists and doctors in the use of alcohol in relation to herbal treatments should not be set aside lightly. Pretreatment of herbs with wine e. In the West, tincturing was originally developed as a means of dealing with fresh plant materials; by soaking them in alcohol and straining out the plant mass, one could preserve herbs for future use.
A large proportion of Western herbs are flowers and leaves, which have a very poor shelf-life if simply dried, as opposed to the Chinese tendency to rely on roots, rhizomes, and barks that have a longer shelf-life.
The Methods of Preparation of Herb Formulas
The vast majority of early American patent medicines in liquid form relied on alcohol as the principal effective ingredient, containing very little of herb extracts. Most recently, tinctures have become common in part because of ready availability of alcohol for commercial use and the willingness of consumers and practitioners to accept the idea that minuscule amounts of such preparations have a substantial therapeutic potential.
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