Decoctions (tang) are one of the primary methods of administering Chinese herbal medicine. Making a decoction involves boiling herbal ingredients together until a strong medicinal liquid is created. In modern times, another method of making a decoction is to use herbs that have been previously decocted (boiled) and formed into dried, concentrated extract granules. These granules are mixed together and dissolved in hot water to reconstitute the decoction.
Technically, we do not refer to this decocted liquid as a “tea,” as this term (cha in Chinese) is reserved for the common tea plant Camellia sinensis. Colloquially however, most patients refer to their medicine as “tea.”
The single most commonly asked question by patients about their decoction is “can I add honey?” There are variations of course – “can I add lemon”, “can I add sweetener”, “can I put it in juice,” etc. In anticipation of or in response to the decoction tasting badly, people want to moderate the taste. Here is my answer – The medicinal action of the herbal formula is based upon its flavor (wei 味) and nature (xing 性). Anything that alters the flavor of the medicine alters its properties as well. Do not add honey to your Chinese herbal decoction.
In modern science and in Western common understanding of mechanism, herbs are thought to have effect according to the biochemical action of their components. In Chinese medicine, it is not what is “in” the herbs that matters. The herbs and the formulas that are created from them have action upon the body based on their flavor and nature. For individual herbs, flavor refers to the five primary flavors of sour, bitter, sweet, pungent, and salty, which correlate respectively with the Liver, Heart, Spleen, Lungs, and Kidneys. Sour astringes and absorbs, bitter dries and purges, sweet moistens and tonifies, pungent disperses and moves, salty softens and descends. Nature refers to the Qi or in this case quality of the herb, including but not limited to its temperature. This means hot, warm, cool or cold, and describes how the herb effects physiology.
This is a bit of a simplified presentation and there are other factors that describe the actions of individual herbs (in particular, the direction of action and the channels they enter). Formulas are a mixture of herbs and reflect more complexity beyond simple flavor and nature. However, all of the stated functions of individual herbs and complex formulas are based upon understanding of the dynamics of flavor and nature. Chinese herbology is a complex system of treatment, but the foundations are relatively simple and in fact can be directly observed and experienced. Chili pepper isn’t hot to the touch, but it feels hot and creates internal heat when ingested. Pickles are sour and make the mouth pucker from astringency.
Related to the topic of adding honey to the herbal decoction is the issue of holding the nose, eating something sweet right after drinking the decoction, drinking it quickly, immediately brushing the teeth or scraping the tongue to reduce the intensity of taste. As above, all of these actions should be avoided. The aroma of the herbs and the taste that is left in the mouth are part of how flavor and nature are transmitted. Chinese herbal decoctions are medicine, not beverage teas. They don’t always taste good, and the action of the formula should be the primary concern.
There are, however, many formulas that can be or are intended to be ingested in other forms, such as pills or powders. Certain situations also dictate administering herbs in forms other than decoctions. Particularly for people who either cannot or prefer not to work past the taste issue, these methods offer an alternative when needed. For example, pills may be a better choice for a neurodivergent child who has taste aversions, or an adult with IBS or reflux. More information on this is available in the articles Bulk Herbs, Pills, Powders, “Teas” (On Traditional Chinese Herbal Formulas) and I Don’t Like Tea. Is there another way to Take Chinese Herbs?