(Note: Today, I’m taking another break from the TCM weight-loss series. It’ll be back soon–maybe Sunday.)
Herbal medicine should look like roots and grass and flowers and fruits, right? Traditionally yes. In fact, many TCM pharmacies in China offer this form: dried, baked, or fried to preserve it, then chopped, parsed into dosages, mixed with other herbs, and provided to the patient, each dose in a separate bag. See featured picture. Thus you take it home in a still recognizable plant form. And depending on the prescription, you boil it into a decoction (herbal liquid/tea) or a jam-like spread.
The far more convenient, and probably most common form of prescriptions in China–also the one I’m most accustomed to taking–is where it’s sold already boiled into the herbal liquid. These come in individual vacuum-sealed bags, which you heat and drink, chasing with a glass of warm water. The jam-like spread, usually translated as “paste” is also sold directly, but this can be even harder taste-wise to consume than the herbal liquid. It is sometimes mixed with hot water into a tea, or else chased with warm water.
Most Westerners, particularly Americans, being a bit squeamish and averse to strange or bitter tasting foods are usually not too comfortable with these forms of prescription. Besides that, the very traditional kind that you boil yourself takes a lot of work, sometimes even 12 hours for a dosage. The resulting brown liquid can see scary, stink up your house, and the dosage–usually a lot larger than the standard tablespoon of cough syrup in the West–can be hard to get down. Presumably this is one of the main reasons the more natural and traditional forms have low penetration outside of China. Interestingly though, most Western expatriates who do go to TCM doctors in China, end up taking and even preferring the pre-made herbal liquids and pastes, as opposed to the below forms.
Increasingly common especially in China, much faster to dispense, and most widely used in the US, are common formulas pressed into pills and capsules. Obviously, there are limitations to these: one formula for all constitutions–you can’t manipulate the formula to suit the person. This limits the targeted function, but for recurring complaints, such as the common cold (cold syndrome), a universal formula can still be useful. These have their own advantages: prepackaged so you can buy them immediately at any pharmacy in China (no waiting), doctors have standard go-to formulas they can stock and distribute to patients, easy-to-swallow (usually a lot smaller than vitamin tablets), no taste, no refrigeration, boiling, or other considerations, and an entire course fits in your pocket. Convenient for the patient at every level. These are gaining headway both in clinics and hospitals in China, and with TCM doctors overseas.
But as I mentioned, they have their limitations: no customization for the patient’s unique constitution and syndrome, and limited ability to change dosage. Well today, I discovered a new form, more flexible from the doctor’s perspective, super fast to dispense, and uber convenient for patients–pocket-sized, no boiling or refrigerating, no waiting, just add to water. See picture. Each packet is a different herb made into granules and these packets come in different sizes: ranging from (in this case) .5 grams to 10grams. Since each herb is individually packaged, the doctor can pick and choose which herb to prescribe and also the amount. Then the patient only has to mix all the packets into water and drink. How simple and cool is that? Everyone is happy.
But my question is, does this extra step in processing reduce efficacy? Increase side effects? Taste better or worse? Slow delivery and uptake time? Maybe these are all questions I’ll investigate with my Chinese herbs’ teacher over the course of the semester.