In addition to being a licensed acupuncturist, I am also an herbalist. Often patients leave my office with a Chinese herbal formula meant to treat their pain or illness. Some patients receive only acupuncture; some receive only herbs. In many cases, the combination of both can offer quicker and more effective results, as herbs and acupuncture work in different ways.
There are some therapeutic interventions you can accomplish with one, but not the other. While it is common in both the West and in modern day China for practitioners to specialize in either herbal medicine or acupuncture, most of the great Chinese doctors of the past had expertise in both. I’ll write more soon on this subject and on why I decided to study herbal medicine in addition to acupuncture.
In my practice, I maintain both a bulk (raw, loose) herbal pharmacy and a granulated herb pharmacy. Each contains about 250 different herbs. The pharmacies contain mostly the same herbs, but there are some herbs that are available in one form but not the other. Availability of herbs, as well as preference for consumption makes it better to stock multiple kinds of herbs. I’m happy to discuss this in detail during our visit if you’re interested in learning more, but here is a little background on the preparation of and method for dosing Chinese herbs.
A typical Chinese herbal formula I prescribe and prepare for a patient might consist of ten herbs, each dosed at ten grams, for a total of 100 grams per container or bag. These herbs are decocted, strained, and the remaining liquid is consumed in two to three doses during the day. (For reference, the average black or green tea bag you would buy at a supermarket contains five grams of tea.)
What does it mean, “decocted?”
Well, the primary delivery method for Chinese herbal medicine is called a decoction. In Chinese, the word is “tang,” and it is commonly translated as “tea.” A decoction in a medical context implies boiling multiple ingredients together for the purpose of combining and extracting the active ingredients.
Decocting produces a stronger final product than a simple tea. Teas use leaves and flowers rather than roots and barks, are typically steeped, and produce an overall less concentrated liquid than decoctions. (In addition, the term ‘tea’ in Chinese specifically refers to the leaves of the common tea plant, Camellia Sinensis. Herbal preparations, whether as beverage or medicine, are not referred to as tea in Chinese.)
It’s important to remember that the resulting liquid is a medicine, not a beverage, and the taste is linked to the medicinal action of the formula. (More on that in a future post.) As anyone who has ever consumed a Chinese herbal decoction knows, the taste is not typically mild. Their taste and the amount of effort required for preparation sometimes prohibit some people from using them.
If taste is preventing you from trying or taking your Chinese herbal formula, let’s talk about it. Chinese herbal formulas are very effective for treating many conditions. Fortunately, there are alternative ways to consume Chinese herbs.
Chinese medicine utilizes all forms of herbal preparations, including pills, powders, capsules and tinctures (alcohol extracts). The primary alternative to decoctions using loose herbs are concentrated granules, which can also be decocted in water or used in pill form. (The granulated formulas are called “san” in Chinese.)
For granulated herbs, an individual herb is decocted in water in the traditional way. The water is then evaporated, and the remaining medicinal residue is mixed with a carrier, typically a small amount of the dried herb itself, or some sort of simple starch. This process takes place in large vats. There are numerous companies that manufacture Chinese herbal granules. In my own practice, I primarily use Tianjiang Pharmaceutical and Classical Pearls because of their high standards in herb selection, processing, testing and packaging.
Granules are typically 5:1 extracts, meaning that five pounds of raw herb is used to produce one pound of granule. This results in a full-spectrum extract that provides both high concentrations of active ingredients, as well as the full array of plant constituents.
This is in contrast to typical herbal preparations used in the West, which often focus on one supposed primary ingredient that is concentrated in high-dosage. The resultant “nutraceutical” does not contain the many other constituents of the original herb that also contribute to its medicinal action. Full-spectrum extracts have broader action than standardized extracts. Individual granulated herbs are combined in a formula in the same way as the loose herbs that are used for decoction.
Chinese herbal medicine uses complex formulas rather than single herbs, and the practice of Chinese herbal medicine requires the study of both individual herbs and formulas. This is an entire branch of study that is not part of acupuncture training, even though many of the fundamental principles are the same).
A daily dosing equivalent of 100 grams of decoction is twenty grams of granules since they are concentrated by a factor of five. The granules are dissolved in hot water and then the liquid is consumed.
Granules retain the flavor of the unprocessed herbs, but generally the taste is milder and more palatable for most people. The effectiveness is similar and the preparation is easier. For these reasons, granulated herbs are a good alternative to traditional decoctions.
I’ll just add here again that I welcome your questions, and encourage you to let me know if there is anything in the way of you taking your herbs regularly and at full dosages, as there are ways we can make adjustments, as long as I am aware. To learn more about additional ways to consume Chinese herbs, see I Don’t Like Tea – Is There Another Way to Take Chinese Herbs?