What are the differences between the various types of herbal delivery systems?
Chinese herbal medicine can be dispensed in a number of methods. For example, there are bulk herbs (from which the patient makes a tea), powdered herbs, granular herbs, tinctures, capsules, honey pills and tea pills. Bulk herbs are the choice method for prescribing medicinals. They are the most effective, fast acting, quality assured, and reliable method. However all methods have their merits and drawbacks, and consequently their time and place.
Bulk herbs are the most effective, time-tested, fast acting, quality assured, and reliable method for dispensing Chinese medicinals.
There are a few key issues to consider when prescribing Chinese medicinals.
- Does the delivery system allow for individual tailoring of the prescription? Quite simply, does the practitioner actually write a customized formula or just use a stock pre-made product? This question is essential, since all master herbalists customize their prescriptions.
- Is the dosage adequate and does it match what has been used traditionally?
- Does the delivery method drastically change the constituent profile? For example, when a formula is meant traditionally to be given as a decoction (tea) and for some reason it is made into a tincture one must realize that the actual herb’s extracted constituents will differ, leading to a formula with different therapeutic properties. This is because alcohol will extract different components than water. Even when starting with the same herbs, all of the below methods will result in differing constituent profiles. The question becomes, is the method supported with history and literature within Chinese medicine? For example, if a given formula was meant to be taken as a decoction and is now a given as a pill how does this change things?
Here is a summary of the major methods of prescribing Chinese herbs with the advantages and disadvantages. Please feel free to contact us with any questions or comments.
Bulk herbs (or Raw herbs)
– These are cooked into a decoction/ tea and consumed over a 1 to 6 day period. This is the most traditional delivery method which has been used for over 2000 years. It is the choice method of prescribing herbs in China as well as in our practice.
Advantages: This method is time tested and hence we know very precisely how the herbs work in the body. It offers the most effective and quickest results. This method allows for individual tailoring of the formula for the specific patient/ complaint.
Disadvantages: Cooking the herbs can be slightly time consuming and taste can be an issue for some.
– These are ground up raw herbs that one mixes with hot water, which is then steeped 5-10 minutes, creating what is called a draught. This method was used traditionally for a number of formulas.
Advantages: Convenience (requiring much less preparation time), and like bulk herbs, has the flexibility which allows for individual tailoring of the formula for the specific patient/complaint.
Disadvantages: For some, the “sludge issue” is a concern, but this can be addressed with teabags or a strainer. Since the herbs are only cooked for a small amount of time, some harder-natured herbs may not be broken down adequately for one’s stomach. As with bulk herbs, taste may be a concern.
– These are herbs that undergo an extraction process whereby the end result is a concentrated powder that is also consumed in hot water. The end product has an extraction ratio of anywhere from 1:1 to 10:1 depending on the herb or formula (a 5:1 ratio starts with 5 lbs of herbs and yields 1 lb. of granular). The goal of granulars is to mimic bulk herbal decoctions as best as possible. This method was not traditionally used and is about 60-70 years old.
Advantages: As with powdered herbs, granulars are convenient. The granulars may also be encapsulated and swallowed. Since they have undergone a cooking process, the stomach does not have to digest the herbs. Many times, depending on the pharmacy / practitioner, granulars can allow for individual tailoring of the formula for the specific patient/complaint.
Disadvantages: The end product is similar to, but not equal to, a bulk herb decoction, producing differing constituent profiles. Furthermore, many herbs that undergo this process lose their full potency. Consequently, they bring varying clinical results as compared to bulk herbs. Generally speaking, granulars also obtain slower results. Therefore if a condition is serious or quick results needed, granulars may not be best. Furthermore, because the extraction process is different for each company, constituents differ from source to source, as well as extraction ratios. This renders products that are drastically different in the marketplace. Finally, many granular companies use fillers that sensitive people may react to.
– These are made by soaking bulk herbs in alcohol. The alcohol is then consumed over a varying amount of time. This method was used traditionally for a small percentage of supplementing formulas.
Advantages: Convenient, and may be suitable for low-level maintenance where no immediate symptoms are present. May be useful for children.
Disadvantages: Extremely weak in potency. For example, a tincture contains about 5-10 g of actual herbs per ounce, whereas a two-day supply bulk herb formula might contain anywhere from 50 to 150 g of actual herbs. One ounce is usually consumed over a week or more. Traditionally in Chinese medicine one would consume about 1 ounce a day. This becomes extremely cost ineffective in the Western marketplace. Furthermore, many people try to make tinctures out of formulas that traditionally were not meant for this method. Tinctures, because of the alcohol, extract different constituents than the water based decoctions. Hence the effect on the body is different. These pre-made tinctures are also unable to be customized for the individual.
– These are small, usually black or brown, pills that are widely available from practitioners and health food stores. Usually one takes about 2-8 pills three times a day. Each bottle usually lasts about one week, and if used symptomatically may last longer.
Advantages: Convenient and inexpensive. They can treat general symptoms many times without requiring a practitioner’s sophisticated diagnosis, such as indigestion, allergies, or other minor complaints.
Disadvantages: Relatively weak in potency and not suitable for serious problems. These pre-made pills are unable to be customized for the individual. They generally work for symtomatic relief only, and rarely can resolve long-term significant problems.