Chapter Four Preparations of Formulas
The formola of traditional Clanese medicine consists of two parts: prescrip tion of ingredient and preparation.
Preparations refer to the forms of herbs prepared according to the prescription, such as decoetion, pills and boloses, powder, semi-floid dope plaster, pillets, etc. Only in this way can the effective ingredients be obsorbed by the homan body, and herbs be effective in treatment. This is why these two parts are inseparable. As early as in book Prescriptions for Fifty-two Kinds of Disease there were records of decoction, pills and powder, etc. Internal Classic records thirteen formo lao, incloding semi-fluid dope, medicated wine, pillet, etc. Later on, physicians of generations created some new preporating forms in clinical practice, such as dis tilled medicinal water, troehe, medicated tea, slender roll of medieoted paper, medicated thread, moxo-preparation, enema, fomigant, soppositories, etc. All forms above mentioned conform to the scientific idea. With development of science and technology, modern techniques of pharmaceoties are being applied widely, and new preparation forms have been developed in recent years, such as tablet, injection, ointment, infusion, plaster, etc. Here are several common forms of prepared herbs:
Decoetion implies the medicinal solution obtained by boiling for certain time. The selected herbs, which have been soaked in an appropriate amoont of water, are strainned off the dregs. Generally it is osed for oral administration, soch forms as Cassia Twig Decoction, Major Purgative Decoet ion, Four Gentlemen Decoction, etc. Sonic decoctions can be used externally as fumigant or lotion. It is particulorlly easy to he absorbed, quick effective and easy to be modified to meet the needs of diseases. It reflects the principles of treatment based on syndrome differentiation. It is the common form in clinical practice.
It refers to a preparation of herbs groond into dry powder and well mixed, and it has two types, the powder for oral administration and for external applica22
tion. The former, which is in fine powder and small dosage, cen be taken orally with water, such as Six to-One Powder, Violet Snow Powder, etc. , or which in coarse granules and large dosage, should be boiled in water and then strained with the medicinal solution to be taken orally, such as Cyperus and Perilla Powder etc. The latter is usually sprinkle or applied rypieally to the affected part, such as, Granulation-promuting Powder, Qili Powder, etc. [t eon be also used for eye drop pings ,throat insufflation, etc. such as, Borneol Borax Powder, etc. The powder has such advantages as being easy to he prepared, economical convenient in orally administration, ensy to be carried about, good absorption and easy to be preserved, etc.
3. Pill and Boins
Pill or halos refers to round medicinal masses of various sizes prepared by mixing herbal powder with excipients such as honey, rice paste, flour poste, also with water, wine, vinegar, and herb juices, etc. It is characterized by moderate action, lasting potency, small size, being easy to be taken, easy to be carried about and to be stored up, so it is also one of common forms. They are usually for chronic diseases or diseases of deficient type. Sonic examples are Rehmaonia Bolos with Six Herbs, Ten Powerful Tonic Herbs Pills, etc. Some boluses are also used for a cute diseases. Peaceful Palace Bovine Gall Stone Pills, and Storax Pills, are good examples. Clinically, the following forms are eoronionly used.
(I) Honeyed bolos or honeyed pills:It refers to pills or boloses prepared by mixing fine herbal powder with the excipient, refined honey. It is often prepared into holoses. They are soft and moist in property and moderate in action, and have functions in regulating flavor, replenishing and tonifying effects, and fit for the treatment of many chronic diseases. Examples are Spleen-Invigorating Bolos, Eight Treasures Bolos, etc. Some honeyed pills are prepared by half honey to half water. Middle-Reinforcing and Qi Benefiting pill is an example.
(2) Water-paste pills: It refers to rne.dicinal pills prepared manually or mechanically by grinding herbs into fine powder, mixing it with exeipients such as cold boiled water, wine, vinegar, or some herbs juices. Comparing to honeyed bolus or honeyed pill, water-paste pills are small in size, easy to be swallowed and quick to be absorbed. It is also a common form of patent medicine, which is applicable for many kinds of disease. Merry Life Power, and Gentian Liver-Purging Pills are examples.
(3) Paste-pill :1 L refers to a medicinal mass prepared by nuxing herb powder
with excipients such as rice paste ur flour pasta. Paste—pill is very sticky. It is ah sorbed more slowly than honeyed bolos, honeyed pills and water paste pill. Be cause of its slower it can be absorption, the therapeutic effects are prolonged and irritation to the gastru-intestinal tract is reduced. Bovine Gall-Stone Pills etc are examples.
(4) Concentrated Pill: It refers to medicinal pills prepared by decoetiun some herbs of the prescription until the decoetion is condensed, then mixing the eon densed fluid with the powder of the rest of herbs, drying the mixed material and finning, and then mixing Ce pnwder with same exeipients, such as water, wine, or decoetion of some herbs in the prescription. The commonly used Bovine Gall Stone Detoxieating Pill is an example. It has such advantages as containing more effective components, small in size and dosage, convenient for orally administration and applicable widaly.
4. Extract,Ointment and Plaster
They refer to the form made hy decncting herbs in water ur plant oil and then concentrating them. They are divided into two kinds: oral administration and cx ternal application. Extract for oral administration includes liquid extract, senu snl id or dry extract and soft extract, while those for external application includes ointment and plaster.
(1) Liquid extract: It refers to a liquid-soaking form of preparation made by using appropriate solvent to soak out the effective components of the herbs, then distilling out same solvent of the extract at low temperature, and adjusting its concentration and the alcohol content to formulated standard. A milligram effective component of liquid extract is usually equal to a gram uf herbs except in specific cases. Both liquid extract and tincture contain alcohol, but the effective com punent of the former is higher than that of the latter. So it has less side effect. Lic once Liquid Extract and Motherwort Liquid Extract are cummunly used.
(2) Semi-solid or dry extracts: It refers to semi-solid or solid form of prepa ration made by using appropriate solvent to soak out the effective components of the herbs, thcu rcrnoviitg all thc solvents by macens of distillation at luw temperature. According to the formulated standard, potency of one gram extract equals that of two to five grams of herbs. Semi solid or dry extract has no solvent, so they don’t have any side-effect of the sulvent and have such advantages as higher concentration, smaller volume and dosage. They can also be turned into tahlets or pills and boluses, or they are poured into the capsules fur oral administration.
Semi solid extract tends to be used tu make tablets or pills such as Hairy Holly Root Extract,while dry extract is a kind of dry fine powder which can be taken o rally after being infused with boiling water or put into capsules for oral adminis tration such as Callicarpa Pedunculata Extract and Gentian Root Extract, etc.
(3) Soft extract: It is a thick, semi-solid form of preparation made by decoc ting the herbs in water to a certain concentration, discarding the residue, then coucentrating it again, adding appropriate honey, crystal sugar or granulated sugar in the decuction. Since the most of impurities of herbs such as cellulose etc are elimi nated, soft extract is small in size, convenient to be token end contains a great desl of honey and sugar and of better nourishing effect. It is suitable for deficiency due to chronic illness. Extract Ginseng, Astragalus and Pear crc good examples of it.
(4) Ointment: It refers to a senu solid form of preparation made by mixing appropriate matrix and herbs, which is easy to be applied to the skin and mocoos membrane. The matrix of ointment is semi solid at room temperature. It gradoally becomes softer or melted after being applied to the skin and mucoos membrane. Its effective components can he absorbed slowly, producing lasting therapeutic effects. The Ointment can exert action on the local area, and is suiteble for treatment of sores. Of them the kinds of Ointment called Three Yellow Herbs and Green Chiretta Ointment are commonly used.
(5) Plaster: It refers to a form of preparation made by decocting herbs in plant oil to a certain degree, removing the dregs, adding Yellow Fillet and white wax, appearing dull black color, and then spreading over a piece of cloth of some other material to be stock on the skin for external application. It is also named black plaster or in ancient China known as “Bode”. It remains in a solid state at room temperature, while at 36° to 37°C turns softer and acts its effects both on the affected local region and the whole body. At the same time, it provides action of mechanical protection. The plaster has such advantages as simple application, being convenient in cstrying and storage. It is used most commonly io traomatic injury, arthralgia due to wind-dampness and abscess, etc. Plaster for Yang-Activating and Mass-Resolving and Removing Toxic Plaster ars examples of this kind.
Pillet in TCM usually refers to a chemical preparation made hy heating and subliming the medicinal minerals containing mercury and sulphur. It is characterized by small dosage hot very effective in treatment, being taken either by oral ad ministration and external application, hot it may be used most commonly in exter25
nal application, soch as Hongsheng Fillet; Baijiang Pillet, etc. In addition, some preperations of herbs that contain rare herbs or produce specific cffcct are also known as pillet. It does not have a fixed form. For example, Real Treasure Pillets, Purple Snow Pillets are in form of pills;Jade Pivot Fillets is in form of troehe; I- ron Resolving Pillets is in form of liquid.
6. Medicated Wine
It is a transparent merlicated liquid made by using wine or millet wine as a solvent to soak out the effective components of the herbs, or to boil together and then removing thedregs. The medicated Wine is used in oral administration or external application, roost commonly in deficiency, rheumatic pain and traumatic in jury. Medicated Wine for Rheumatism and Ten Powerful Tunic herbs Wine are examples. As wine is warm and dispersing in nature, it is euntraindicaterl in cases with flaring of fire due to yin deficiency.
7. Medicated Tea
It is a solid preparation made from coarse powdered herbs and adhesive eseipients, and drunk as tea alter heing infused with boiling water in a vessel with a lid, so it is called Medicated Tea. It has nut fixed patterns. They may be small square mass, small rectangle mass, cake or powder in forms, which is put into paper bag with certain amount for oral administration. It is characterized by being convenient in preparation of use. So some patients like to drink medicated tea, such as Wushi Tea.
8. Distilled Medicinal Water
It refers to distilled water obtained by distilling fresh herbs containing components with volatility in water by heating. it is bland in flavor, delicately aromatic and colorless, and is convenient to be taken orally. Distilled medicinal water is u sually used as beverage, particularly in summer, such as Distillate of Honeysuckle Flower and Distillate of Sweet Wormwood, etc.
9. Troche and Medicated Cake
They refer tu solid forms of prescriptions with different shapes made of the fine herbs powder and appropriate excipients such as pasted powder, honey, etc. or only made of powder of herbs without excipients. Troehe and medicated cake are used fur oral administration and external application. They can he taken urslly by
mixing or grind with watcr and can be stuck on the diseased region by grinding with water such us Purple Gold Troche, etc.
10. Slender Roll of Medicated Paper
It refers to a form made by twisting medicated paper into a slender roll or by twisting medicated paper into a slender roll and then dipping in medicated powder, so it is named “slender roll of medicated paper”. It is used most commonly in surgery to help draw out pus by inserting it into the wound of a sore, and taken out after drainage of pus, such as Slender Roll of Medicated Paper for Expelling Poison and Draining Pus, etc.
11. Medicated Thread
It is made by decocting silk or cotton thread in medicated liqoid and then dr ying it, which is usually used to ligate fistolo or vegetation and makes them withered and separated.
It is a form of prescription for external application made by pulverizing Chinese mogwort leaves into mogwort floss and making into different shapes. in practice a lighted moxa is applied over the selected points or the affected part of the body from a certain distance to cause a mild warmth or borning sensation. It is osed either for preventive or therapeutic purpose.
It is a saturated solution of sogar with or without herbs. The one that doesn’t contain herbs is called simple syrup, is often applied as cxeipients or condiment. The other one that contains herbs is made by concentrating the decoction of herbs and finally potting some cane sogar into it. Syrup tastes sweet and is soitable for children, such as Syrup of Apricot Kernel and PenIle Fruit for Stopping Cough, Expelling Parasites Syrup, etc.
- it is a form of prescription made by pressing the mixture of refined herbs and some excipients. Tablet is small in size and accurate in content. Bitter herbs and herbs with an offensive odor can be pot into sugar coated tablets which is easy to be swallowed. If it is aimed at acting only on the diseases of the intestinal tract or
if the herb’s component is apt to lose the curative effects when affected by the gastric acid, enterie coasting can he taken so as to enable it to break dawn in the intestine. At present tablet is widely used in clinical practice. Three Yellow Tablet, Agastaehe Genuine Qi Tablet and Lanicera and Forsythia Detoxieating Tablet are good examples of it.
It is a farm of prescription made by taking an extract of the herbs into mcdi cated granule, mixing the granule with an appropriate amount of excipients materials(sueh as starch, dextrin, powdered sugar, etc.) it is a new preparation for oral administration derived from decoetion and syrup in recent years. The infusion is apt to get damp. It should he stored in confining vessel, and is usually put into the plastic bag according to formulated standard. It is quick-acting in treatment than pills or bolus. Comparing with deenctian, syrup, it has the characteristics of being small in volume, light in weight, cunvenient to be used, easy to be carried about and is suitable fur the treatment of many different diseases. Isatie Root Infusion and Infusion for Reducing Fever due to the Common Cold are examples.
It is a kind of germ free solution made by refining the herbs, extracting the effective components and preparing intu injection according to pharmaceutical standard, which is used for subcutaneous, muscular or intravenous injections, it has such advantages as being accurate in dosage, quick in action, convenient tu he used and of not being affected by food and digestive juice, directly entering tissues of the body. Buplenrum Rout Injection and Composite Red Sage Injection are examples of it.
In addition to above-mentioned preparation furms, there are still some new preparations, such forms as ‘sponge, oil, nebulized spray, suppository, frostlike powder, capsule, and few specific forms used in diseases of the sense organs. All of these are well worth to pay more attention and further study.