Chinese society was, until the last 50 years, by and large, a sedentary, agrarian society. Patients of Chinese doctors lived nearby. They cooked their meals three times per day.
Therefore, they came to depend upon decoctions or tang (lit-erally soups) as their major method of medicinal administra-tion. This is in contradistinction to nomadic Tibetans and Mongols who primarily came to rely on pills and powders.
There are a number of different methods of making a Chinese decoction. In fact, every teacher with whom I have studied Chinese medicine has had their own, slightly different
method. The method I use with my patients is to simmer the herbs in six cups of water till they are reduced to approxi-mately three cups. If there are shells or minerals in the decoc-tion, these should be decocted for 30-45 minutes in advance before the other ingredients are added. If there are various aromatic substances in the formula, these may have to be added at the end of the cooking for the last 5-7 minutes.
These include Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis), Gou Teng (Ramulus Uncariae Cum Uncis), C h u a n Xiong (Radix Ligustici Wallichii), Mu Xiang (Radix Aukandiae Lappae), Yan Hu Suo (Rhizoma Corydalis Yanhusuo), and S h a Ren (Fructus Amomi) to name a few of the most common such ingredients. Some flowers, such as Hong Hua (Flos Carthami Tinctorii) and Ju Hua (Flos Chrysanthemi Morifolii) should only be steeped at the end. The various gelatins, such as E Jiao
(Gelatinum Corii Asini) and Lu Jiao Jiao (Gelatinum Cornu C e rvi), should be broken up first and then dissolved in the hot
liquid after the liquid has been strained and the dregs removed.
Certain resinous powders, on the other hand, such as Hu Po (Succinum), should be chased down when drinking the decoc-tion. In addition, some very small ingredients need to be placed in cotton muslin bags during decoction so that they do not get caught in or irritate the throat when drinking the decoction.
This includes Pu Huang (Pollen Ty p h a e), for instance.
Using the method above, one makes up six half-cup doses every two days and stores these for use in a clean, lidded, glass jar. If the weather is not too hot, this can be stored with-out refrigeration for the 36-48 hours necessary till it is used up. If the decoction is meant to clear heat, it may be drunk at room temperature. If the decoction is meant to supplement yang or warm the interior, it is best if each dose is reheated.
Some American practitioners allow their patients to make up even 4-5 days’ decoction at a time. However, my experience is that the flavor of stored decoctions changes after 36-48 hours.
This change in flavor suggests to me that the decoction itself has undergone a chemical change and is no longer the same physical substance. Therefore, I have no assurance that it will have the same, intended effect. Because of this, I recommend my patients to only make up two days’ supply of decocted herbs per time.
If I want my patients to get a higher, more potent dosage of decocted herbs, another method I sometimes use is to cook one bao or packet as above but with only three cups of water.
This results in 11/2C of decoction, or a one day’s dose at 1/2
C, three times per day. However, instead of discarding the dregs, I tell the patient to reserve them in the refrigerator. The second day, the patient makes up a new bag of herbs just like the day before. Again they reserve the dregs. On the third day, they take the dregs, combine them, and recook them the same way to get a third day’s dose from the ingredients of the two combined packets.
A somewhat similar method of stretching a single bao or packet of medicinals is to decoct it twice and then pour together the resulting two decoctions. However, in the People’s Republic of China, most patients use only one bao per day. The method I was taught in Shanghai was to place the medicinals in a teapot and cover the medicinals with cold water one inch or so above the top of the medicinals. These medicinals are then allowed to soak for one hour. Then they are decocted for 45 minutes. After decoction, they are
decant-INGREDIENT COOKINGMETHOD SAMPLEINGREDIENTS
SHELLS& MINERALS
GINSENGS
Simmer in 6 cups down to 3 cups for 30-45 minutes
Add during the last 5-7 minutes of cooking
Sheng Jiang, Gou Teng,Chuan Xiong, Mu Xiang, Yan Hu Suo, Sha Ren
Steep after the heat is turned off for 5 minutes
Hong Hua and Ju Hua
GELATINS Dissolve in the hot liquid
Put in mouth and chase down with decoction
Place in a muslin bag when cooking so that powders are not difficult to drink
E Jiao and Lu Jiao Jiao
Hu Po
Pu Huang
ed and the liquid reserved to be drunk in three measured doses within a single day. When I asked about reserving the dregs and recooking them, I was told that the peasants would rather throw the dregs on the road, thus symbolically casting the disease out of the house, there to be crushed by the wheels of passing buses and trucks.
It is important to remember and to explain to patients that making their Chinese herbal decoctions is no more time-consuming or difficult than cooking a pot of rice. In fact, I recommend that patients cook their decoctions when they are cooking dinner. If the patient says that they never cook their dinner from scratch but either always eat out or eat ready-to-serve, microwavable food, that in itself is a major problem with which the practitioner is going to have to deal. In my opinion, it is hard to be really healthy if we do not eat prima-rily a diet of freshly purchased, freshly cooked food. If a patient takes the time, as they or at least someone in their family should, to prepare at least one meal per day from scratch, then it is little extra trouble to cook their Chinese medicinals at the same time.