Different forms of TCM formulas and herbs: decoctions, pills, powders, plasters, ointments, syrups, and granules

By Me & Qi
May 09, 2023

Decoction, pill, powder, plaster, ointment, syrup, granule are the most common TCM formula forms. This article discuss these forms and their features.

Decoction 汤

A decoction, also known as ‘tang’, is a liquid form of Chinese medicine made by soaking, boiling, and filtering herbs in water or alcohol. It is the most commonly used TCM formula form in clinical practice and can be taken internally or used externally, such as in baths, fumigation, or gargling.

Advantages of decoctions:

  • Fast acting: Medicinal effects are produced quickly after taking a decoction. Some highly effective drugs taking only a few hours to work.
  • Convenient for modifying the formula combination: As a person's physical condition changes, the combination and dosage of herbs needs to be adjusted accordingly. Decoctions can be modified easily because they are often prepared and taken once a day.

Disadvantages of decoctions:

  • Large volume and poor taste: Many Chinese herbal decoctions have a bitter taste, even if sweetening ingredients like licorice are added. This makes it difficult to swallow some decoction, especially if it is in large quantity. 
  • Not suitable for large-scale production: Decoctions are often prepared on a daily basis according to each person's prescription. This makes it difficult to store in large quantities.
  • Inconvenient to carry: Decoctions are liquid and heavy, making them inconvenient to carry when traveling or on business trips. Raw herbs can be carried, but they are relatively large in volume as well. 

 

Pill 丸

Pills, also known as "wan," are solid forms of TCM formulas made by grinding herbs into a fine powder or using extracts and mixing them with a binding agent to create a ball-shaped pill. Based on the type of binding agent used, TCM pills are also called honey pills, water pills, or paste pills.

There is also a modern form of Chinese herbal medicine called concentrated pills. They are made by taking herbal extracts and compressing them into pill form. They are also known as "concentrated herbal pills" or "granule pills".

Pills are mostly taken orally and are particularly useful for chronic diseases that require long-term treatment.

Advantages of pills include:

  • Easy to take and carry: Pills are a convenient TCM formula form that is easy to take and carry around. Unlike decoctions, pills do not require preparation time.
  • Long-lasting medicinal effects: Although pills take longer to take effect than decoctions, they have a longer-lasting medicinal effect.
  • Some herbs have toxic properties that make them unsuitable for decoctions. Pills can also reduce the toxic effects of certain herbs with strong or stimulating properties. Expensive and aromatic herbs such as musk, cow bezoar, white and black cloud, are best used as pills to preserve their medicinal effectiveness.

Disadvantages of pills include:

  • Slow to take effect: Pills take longer to produce medicinal effects than decoctions. It may take several days, weeks or even months for pills to take effect.
  • Inconvenient for modifying the medicine: Pills are generally made in large quantities, and even with technological advances, small batches for individual prescriptions may only last a few months.

 

Dan 丹 

丹 (Dān) - is an ancient term that refers to the end product of alchemy. In the early days, they were made by heating and refining minerals into a new compound in the shape of a large round pill. In contrast, 'wan' is typically shaped by hand rubbing.

Nowadays, despite some formula are called "Dan," there are no longer any actual "Dan" medicines. Some are in the form of "Wan" (pill) and some are in the form of "San" (powder).

'Dan' can also refer to formulas made from natural plant herbs other than mineral ingredients, such as Tian Wang Bu Xin Dan.

 

Powder 散

Powder, also known as "San," refers to a type of TCM preparation made by grinding herbs into a fine powder and uniformly mixing them.

Powdered TCM formula is divided into two types: internal use and external use. Internal-use powdered medicine is further divided into fine powder and coarse powder. Fine powder can be taken directly or dissolved in hot water, such as Qi Li San, while coarse powder needs to be boiled in water before use, such as Yin Qiao San.

In terms of internal use, powdered medicine has the advantages of being easy to take, quickly absorbed, effective, and cost-efficient, especially for expensive and aromatic herbs like musk and borneol that are not suitable for decoctions.

Characteristics of powdered medicine:

  • Easy to prepare: powdered medicine is easier to prepare than pill and ointment forms and can even be prepared in a small pharmacy or at home.
  • Convenient to carry.
  • Difficult to control dosage: due to the nature of its dosage form, controlling the dosage of powdered medicine can be challenging, and it is recommended to use a weighing tool for accuracy if long-term use is needed.

 

Plaster / Ointment/ Syrup 膏

Plaster/Ointment/Syrup, also known as 'Gao' or ‘Koa’, is a type of TCM formula prepared by boiling herbs in water or plant oil until the residue is removed.

It can be used for internal or external purposes. Internal-use syrup is categorized into three types: flow-soaked, soaked, or boiled. They are easy to store and take and are generally made from tonifying herbs, making them suitable for patients with weakened constitution or chronic diseases that require long-term treatment.

External-use ointments/plasters can be divided into two types: soft and hard. Soft ointments are made by adding an appropriate amount of fat or vaseline to the herbs after boiling and removing the residue and are used for treating ulcers, swelling, and itching of the skin.

Hard ointments are made by boiling herbs in plant oil, filtering out the residue, adding vinegar or lead oxide to make a viscous gel, and then spreading it on paper or cloth. They are used for treating rheumatism, bruises, and sprains.

Characteristics of ointments/ plasters/ syrup:

  • Complex preparation process: ointments/plaster/syrup usually require boiling, removing residue, and concentration, which is time-consuming and generally takes several days. The production process requires professional pharmacists and is difficult for ordinary people to complete.
  • Long-lasting medicinal effects: ointments contain gelatinous components that help to retain the medicinal effects and spread them evenly.
  • Convenient to carry.

 

Granule 颗粒剂

TCM granules represent a modern innovation in the field of Traditional Chinese Medicine. They are a pure and refined form of TCM products derived from traditional preparations such as decoctions, pills, and powders. These traditional forms undergo a series of modern pharmaceutical processes, including extraction, concentration, separation, drying, granulation, and meticulous packaging. This combination of traditional wisdom and advanced techniques ensures the quality, efficacy, and convenience of TCM granules, making them a preferred choice for contemporary healthcare practices.

 

Advantages of TCM Granules:

  • Mechanized large-scale production, surpassing traditional decoction methods:

Traditional decoction methods involve soaking, boiling, and multiple decoctions, taking around 90 minutes to prepare a single dose of Chinese herbal medicine. This process requires careful attention to details such as the sequence of adding specific herbs, alternating between gentle and vigorous heat, and constant stirring to prevent burning or overflow. It can be a cumbersome process, leading to loss of volatile components and inefficient utilization of medicinal resources.

In contrast, TCM granules are produced using modern pharmaceutical techniques, following standardized preparation guidelines. They offer the convenience of mass production, ensuring consistent quality and preserving the complete characteristics of the original herbal medicine.

  • Sealed packaging for convenient storage and administration:

TCM granules are individually packaged in aluminum foil or plastic bottles, providing a sealed and moisture-free environment. This not only enhances the convenience of carrying and storing the granules but also prevents issues such as oil leakage, mold, or insect infestation that can occur with improper storage of traditional decoction pieces.

  • Demonstrated significant clinical efficacy:

Extensive clinical observations by many TCM practitioners have shown that TCM granules exhibit remarkable therapeutic effects. They are comparable to, or even superior to, traditional decoctions in terms of efficacy. The granules retain the fundamental principles of traditional Chinese medicine, including the herb's properties, channels it enters, and therapeutic effects. Additionally, TCM granules eliminate concerns regarding pesticide residues in decoction pieces and strictly control heavy metal content. They offer accurate dosage, high efficiency, and safety in clinical applications.


Disadvantages of TCM Granules:

  • Higher cost compared to traditional decoction pieces:

The production process of TCM granules involves extraction, concentration, drying, and sealing, which increases production costs. Consequently, the price of TCM granules is higher than that of ordinary decoction pieces. This may pose a challenge for some chronic disease patients who require long-term medication.

  • Lack of reactions occurring during the decoction process:

Traditional decoction methods involve a series of physical and chemical reactions, which can alter the pH value of the decoction, enhance solubility, increase efficacy, and reduce toxicity. Precipitates or newly formed components generated during the decoction process may contribute to certain therapeutic effects.

TCM granules, being a mixture of individually extracted herbs, ensure maximum dissolution of individual herbs but overlook the interactive processes that occur during decoction. This oversight may impact the therapeutic actions of the herbs.

Article tags: Chinese herbal medicine