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Chapter Five Administration of the Formlllae

It includes the methods of decocting herbs and the methods of taking herbs which consist of oral administration and external application. Correct methods of decocting and taking herbs play very important role in the therapeutic effect, sa it is necessary to pay more attention to them.
Section 1 The Method of Decocting Herbs
It refers to the appropriate way to make a decoctiou. The decoction is used most commonly in clinical practice. Medical doctors over the past ages have devoted their great attention and efforts to it. Just as Miao Xi-yung described: that “Whether the tea tastes wonderful or nut and whether the food is delicious or not arc directly, related to culinary art with water and fire. From this, you can understand the art of decoction of the herbs. “ Xu Liugtai alsu described: “The methods of decucting the herbs must be deli with seriously, which is closely related to thc therapeutic effect uf a prescription.
Utensils for decocting herbs: Predecessors held that “silverware for the dccoetion belongs to the best way, the chinaware to the second”. Tin or iron vessels are forbiddeu for the decoction. The reason is that components of some herbs may appear sediment, lower solubility, even side-effect caused by the chemical reaction. At present, ceramic clay pot with lip is universally used to avoid the chemical re action of the herbs with utensil in the course of decoctiug.
Water for decocting herbs: predecessors sometimes took running water, spring, rice-washed water, and wine, etc. to decent the herbs. Nowadays, the watci to he used should be pore and clean except some special needs. Tap water, we1 water or distilled water can be used. Usually 30 gram herbs need 200’—’300ml wa tar, that is, the herbs are about one cun(3Omm) underwater.
Fire for decocting herbs: The fire fur decocting herbs is divided into tw types: soft fire and strong lire. The former refers to slow fire which make temper ature of decoctiou go op slowly, while the latter points to vigorous fire whicl makes the temperature of decoctiug solution rise quickly. The strong fire is usual ly used first, and the soft fire is applied after boiling decoction.
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Methods for decocting herbs: First, put The herbs into a pot, then add water until the herbs are slightly suhnierged under the water and decoct it after the herbs are soaked for 30 minutes, in this way the effective components of herbs can be separated out. First, strung fire should be used until the water is boiling, and then soft fire is applied to prevent the medicinal solution from overflowing or drying up quickly, Meanwhile it must not take the put lid off very frequently so as to minimize the loss of the volatic components and the therapeutic effects. Herbs for relieving exterior syndrome, herbs for clearing away heat, and aromatic herbs are preferably decocted on strong fire to avoid the volatilization of the effective components. It is advisable to decoct the tonic herbs with strong flavor on soft fire so that their effective components may be completely released. Some poisonous herbs such as aconite root, prepared aconite root, and langdu root should also be decocted on soft fire for a longer time so as to reduce their toxicity. Herbs burnt at the bottom of the pot should not be osed. ‘I’he special methods for decocting some herbs should be noted in a prescription. They are introduced in details as follows:
(1) To be decocted first: Sonic minerals or shell herbs are so hard that their effective components can not be extracted easily, so they should be smashed first and he boiled for 10—20 minutes before other herbs are put in, such herbs as tor toise plastron, turtle shell, red uchre, shell of abalone, oyster shell, dragon’s bone, magnetite, and gypsum, etc. Some crude herbs with sand and mud, such as bess lining of a hay-burning stove, glutinous rice rout and some herbs with slight weight but bulk amount, such as reed rhizome, cogongrass rhizome, prunella spike and bamboo shavings, etc. should be decocted and removed the precipitate first to obtain the clear liguid, and then other herbs are decocted in this liquid instead of water.
(2) To be decocted later:The exertion of some aromatic herbs relies on vola tile oil of herbs. When the decoction is ready done, they should be added to decoction for 4--5 minutes in order to prevent the volatilization of their active compositions hese herbs include pepermint, vilbous amnoum fruit, round eardamon seed, costus root, and elscholtzia, etc.
(3) To be decocted with wrappings:Some herbs such as red holloysite, talc, inula flower and bess lining of a hay-burning stove, etc should be wrapped with a piece of thin cloth for decoction to avoid turhid solution and to reduce irritations to the throat and the digestive tract.
(4) To be simmered or decocted separately: Some rare and expensive herbs
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should be simmered or decocted separately so as to avoid the destructioo of their effective components and being absorbed by othar herbs when decocted together. For cxample, ginseng or American ginseng should be sliced into thin slice and theo boiled in a separate vessel which is pot in a covered clay pot with watar which is boiled on fire for 2—3 hours.
(5) To he melted: Some of the gluey, viscous easy dissolved herbs such as donkey hide gelatin, antler gelatin, honey and malt sugar, etc should he melted separately, end then being put into the decocted solution of other herhs(ofter re- moved of the residue) , dissolved by gently boiling and stirred in order to prevent from adhesion to the bottom of put to he charred or to the other herbs in this way the therapeutic effects may be inhibited.
(6) Instant tee: Powder, pillets, pills, natural medicinal juice and fragrentor rare herbs should be taken after being infused with boiling water, hot decoction or wine, such as bovine gall stone, musk, eagle wood powder, cinnamon bark powder, not oginseng powder, Purple Snow Powder, Six Miraculous Herhs Pills and juice of lotus root, etc.
Section 2 Methods of Oral Administration
That whether method of herb administration is right or not is directly. related to the therapeutic effect. It includes the time and the method of administration.
Time for administration: Usually herbs are recommended to be taken one boor before meals; however there are also exceptions of it. Herbs irritating to the gastro intestinal tract should be taken after meals; Tonic herbs should be taken with an empty stomach; Anti-malaria decnetion should be taken twn hours prior to the attack; Sedatives and tranquilizers should be taken before bed-time; The herbs for acute diseases should be taken at any tim While those for chronic cases such as pills, powder, extract, and medicated wine, etc. should he taken at regular time. In addition, herbs can be taken many times o day to meet the need of illness, and some herbs can also be decocted and taken frequently like tea. Special formulas may be taken by special method. For example, Cock Crowing Puwder shnold be taken with cool solution on an empty stomach before dawn, which will give better effects.
Method of administration:The decoction is usoally divided into two or three equal portions and also can be taken at one draught in an emergency ease. Meantime,according to the need of illness,the patient should take the medicine in small
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portions at frequent intervals so that the therapeotic effect can he maintained. At present, Chinese herb is usually one dose a day, with each dose heing decoctad two times as first deacoction and second decoction and taken two times with each. In the special condition, in order to strengthen potency of herbs, two doses can be token a day, Generally speaking decoction should be taken warm. In addition, the patient should be kept warm to avoid wind and to induce slight sweat if the decoction is used fur relieving exterior syndrome. Cold natured decoction fur heat syndrome should be taken cool,while hot natured decuction fur cold syndrome should be taken hot. But for treatment of simultaneous occurrence of cold and heat syndromne, there may appear vomiting due to inter repelling of yin ang yang after taking dccoction. In case of cold syndrome with pseudo-heat symptoms, it is better to take cold decoetion, and contrarily, in the case of heat syndrome with pseudo-cold symptoms, hot decoction should ha taken. These belong to the methods of contra ry adjuvant. For vomiting patient, little ginger juice can be put into the decoction, or patient takes some ginger to rub the tongue or chews some tangerine peel, or the dccoction can be given cold or given frequently in small amount. For uncon scinus patient or patient who has difficulty in swallowing, the decuctiun can be given by nasal feeding.
As patent medicine such as pill, bulus, powder, extract, pillets, etc is usually taken twice a day, but some can also be taken one or three times a day. The drastic poisonous herbs must be given according to pernutted duse or following doctor’s instruction. The dose for child and aged people should be decreased propertionally. Patent medicine is taken mostly with warm boiled water or coul boiled water, and sume patent medicines demand to he taken with millet wine, wine, soup of rice porridge, saline, juice of lotus root, radish juice, and decocted solution of herbs, etc. For child ur patient who has difficulty in swallowing, powder or bolus can be mixed into paste with water or milk and f ad. Usually patent medicine fur treatment of throat disorder is held in the mouth to dissolve and then swallow slowly, such as Six Miraculous Herbs Pills. Gluey medicine such as donkey hide gelatin, antler gelatin, etc. should be taken alone, and they can he melted in yellow wine (Crystal sugar can be also added to it. ) for oral administration.
Section 3 Methods of Externafi Application
Different Preparation of external application demands different methods for applical inn. It should fallow the instructiun to ensure the therapeutic effect.
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The ointment and liquid medicine such as badger oil, tinea-treating liquid, and Three Yellow Ointment, etc arc usually used by smearing, that is, they are even spread nn affected area where clearing has been dune. The pnwdcrs with effects ni promuting granulation, stopping bleeding, astringency and relieving pain are usually applied by dusting, that is, powder is dusted on the affected area, Pearl Pow der and Granulation-Promoting Powdcr being examples. Powders fer external application can also be used after being pasted, that is, powder and wine, or vinegar or tea water, etc. are mixed into the paste to be applied on the affected area, such as Ruyi Jinhuang Powder, Qili Powder, and Natural Indigo and Gecko Powder, etc. Some pnwder can also be applied by blowing method, by which a hard paper is rolled into a thick tube with oblique opening in one end and is used to fetch small amount of powder, and then the powder is blown on the affected area. This method is used most commonly in blowing into ear, throat and on gum. Hongmian Powder, Xilei Powder and Boroel Borax Powder arc examples. Powder for treat ment of eye disorders should be pot into the corner of the eye by a small glass stick moistened with cold boiled water, such as Guazi medicament for the eyes, etc. Disorders of the ear, nose, vagina and anus can be treated with inserting method, by which the herbs wrapped in a piece of gauze, or drug made into troche and then is inserted into the orifice, such as Xiafan Troche, Cnidium Fruit Tablet for External Application, etc. (Drug used in vagina and anus is known as soppoaitori om. ). Black plaster is usually used to stick on the skin for the treatment. The method goes like this that the black plaster is heated to turn soft and then stock on the clean affected area. Dogskin Plaster and Wind Dispelling Plaster are examples.

 



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