Herb 301: Lecture 2 (Part 1): Previous Lecture Review, Structure of Formula, Decoctions

Housekeeping and Announcements

  • Attendance: Roll call was taken.
  • Lecture Notes:
    • Will be available by the end of the week.
    • The administrator will send an email when they are ready.
    • Use the notes sent in the chat for now.
  • Assignment (20% of mark):
    • Creating study notes of the course content.
    • The goal is to have notes useful for studying (course, grad exams, licensing exams, etc.).
    • Should serve as a foundation for future learning.
    • Format is flexible (table, written notes, flashcards, etc.) as long as it's useful.

Assignment Requirements

  • When covering herbs, include:
    • Herb name (required).
    • Nature (required).
    • Meridian tropism (required).
    • Action indication (required).
    • Applications (optional).
    • Dose (mandatory).
    • Cautions/contraindications (mandatory).
    • Additional information from class is allowed.

Questions and Answers

  • Memorizing Chinese Names:
    • Only need to know the herb name in Chinese Pinyin.
    • Everything else will be in English.
  • Barefoot Doctor Book: Unfamiliar with the book but acknowledges that barefoot doctors had unique skills due to limited resources.
  • Download Lecture 2: Available in chat.
  • Examination:
    • Will test herbs, names, action indication, and everything included in the assignment.
  • Number of Herbs:
    • Learning hundreds, not thousands, of herbs.
    • Involves memorization, repetition, application, and association.
  • Herb TA (Amanda):
    • Trying to arrange for TA support, like last term.
    • Would hold review sessions half an hour before class.
    • Offer student perspective, study tips, and memory tricks.
    • Presentations on covered herbs.
  • Tutorials: Not mandatory.
  • Scientific Names: Not provided as licensing exams use Pinyin names only.
  • Meaning of Names: Some meanings will be explained if relevant.
  • Grad Exam:
    • Contact school administration (Karina, Mary, Robert) for the number of attempts.
    • Must pass the grad exam before applying for the Pan-Canadian exam.
  • Pan-Canadian Exam: Contact the college for the number of attempts.

Review of Previous Lecture

  • Properties of single herbs:
    • Direction.
    • Thermal nature.
    • Flavors and their actions.

Structure of a Formula

  • Emperor Herb (Primary/Chief/Monarch/Sovereign/King):
    • Main herb providing the primary function.
    • Addresses the syndrome or treatment principle.
  • Minister Herb (Deputy/Associate/Secondary):
    • Assists the main herb.
    • Addresses secondary syndromes or treatment goals.
  • Adjuvant Herb (Assistant):
    • Supports the main and secondary herbs.
  • Envoy Herb:
    • Harmonizes the formula (consolidates actions).
    • Acts as a guide, directing the formula to a specific body part.
    • High affinity for a particular body part.
  • Upper, Middle, and Lower Medicines:
    • Upper: Very useful, non-toxic, non-drastic.
    • Middle: Somewhat useful, may be toxic or drastic.
    • Lower: Only used when necessary, toxic or drastic.
  • Lower Medicine as Emperor Herb: Possible if it provides the main function.
  • Emperor Herb Always with a Minister: generally yes, but not necessarily
  • Single Emperor herb Formulas: Possible but rare (e.g., Dú Shēn Tāng, 獨參湯獨參湯)

Dosage

  • Measured in grams in modern TCM (not units).

  • Standard dosage: 6-9 grams daily.

  • Dosage is dictated by:

    • Properties of the herb (stronger herbs = less).
    • Toxicity of the herb (more toxic = less).
    • Application (decoction, topical, etc.).
    • Patient's condition (child, severe illness, etc.).
    • Geographical considerations (climate).

  • Example prescription:

    • Herb A (9g).
    • Herb B (12g).
    • Herb C (3g).
    • Herb D (1g).

  • Weekly supply, multiply the daily dosage by 7.

Factors Affecting Dosage

  • Nature of the Herb:

    • Safe herbs with mild action have a wider dose range.
    • Drastic herbs with strong action or toxicity have a small dose range (e.g., 0.25g-2g).
    • Dense herbs (minerals, shells) are used in higher dosages.

  • Quality of the Herb:

    • High-quality herbs require less.
    • Low-quality herbs require more.
    • Quality relates to the concentration of active ingredients.

  • Fresh Herbs: Use a larger dose (double or triple) due to water content.

  • Herb Quality Detection:

    • Experience lets you pick up markers.
    • Based on smell, taste, and look.

  • Mushrooms:

    • Not a lot of mushrooms are used in TCM
    • Some mushrooms are used

  • Origin of Herbs:

    • Most are native to China/Asia.
    • Some have been added from other regions through trade and globalization.

  • Example:

    • Xiangshan is a North American ginseng growing in North America.

Dosage and Formula Structure

  • Compatibility, Form, and Purpose:
    • Primary herb: higher dose.
    • Envoy herb: lower dose.
    • Single herb: higher dose.
    • Herb in formula: lower dose.
    • Decoction (boiling): higher dosage.
    • Powdered form: lower dose.
  • Purpose of the Herb:
    • Small dose: raise blood pressure.
    • Higher dose: lower blood pressure.

Patient Condition

  • Condition, Constitution, and Age:

    • Severe/persistent/acute: higher dose.
    • Mild/chronic: smaller dose over a longer period.
    • Strong constitution/young patients: can take a higher dose.
    • Children/elderly/weak constitution: smaller dose.

  • Children's Dosage:

    • 6-12 years old: half of the adult dosage.
    • Under 6 years old: a quarter of the adult dose.
    • Infants: a very small dose (1-2 grams).

  • Example Formula and adjustments for children

    • Herb A (9g for addults , 4.5g for 6-12 year old).
    • Herb B (6g for adults, 3g for 6-12 year old).
    • Herb C (12g for adults, 6g for 6-12 year old).

Geographical Considerations

  • Hot Climate:
    • Use smaller amounts of diaphoretics (sweating herbs).
  • Damp/Humid Climate:
    • Use larger doses of aromatic and drying herbs.
    • Avoid sticky, cloying herbs.
  • Colder Climates:
    • Use larger amounts of warming herbs.
    • Only use cooling herbs when necessary.
  • Dry/Arid Climate:
    • Use larger amounts of moistening herbs.
    • Only use drying/dispersing herbs when necessary.

Methods of Administration

  • Oral (most common).
  • Cutaneous (topical wash, powder).
  • Rectal (suppositories).
  • Nasal/Inhalation.
  • Vaginal.
  • Sublingual (under the tongue).
  • Intravenous/Intramuscular/Subcutaneous injection.
  • Acupoint injection.
  • In Canada, only cutaneous is within the scope of practice for now.

Decoctions

  • Most conventional method:
    • Boiling processed and dried herbs in water and taking orally.

Decoction Vessels and Utensils

  • Chemically inert materials:
    • Glass or ceramic (ideal).
    • Stainless steel (okay).
    • Avoid: cast iron, copper, aluminum, zinc pots/utensils.

Water

  • Clean and free of contaminants and excessive minerals.
    • Tap water is generally fine.
    • Traditionally, water itself was considered part of the ingredients (28 types).
      In modern day its not required as long as it's clean and free of contaminants and it's not too hard

Amount of Water

  • Depends on the amount and type of herbs.

Soaking

  • Prior to decocting, soak herbs in cold water for ~30 minutes.

Process

  • 1. Put herbs in pot (glass, ceramic, or stainless steel).
  • 2. Add cold water to cover the herbs.
  • 3. Soak for 20-30 minutes.
  • 4. Put pot on stove, high heat -> rolling boil.
  • 5. Reduce heat -> simmer (low or medium-low).
  • 6. Cover and simmer for 20-40 minutes (depends).
  • 7. Strain the herb juice out.
  • 8. Boil a second time with more water (no need to soak).
  • 9. Repeat process (rolling boil -> simmer 20-40 min).
    1. Strain the herb juice from the second boiling and mix with the first boiling.
    1. Maybe boil again a third time.
    1. Squeeze out the herb dregs to get as much active ingredients as possible.
    1. Discard the herb dregs and drink the herb juice.
  • Herb Juice Potency
    • Second boiling will be less concentrated compare to the first boiling.
    • As such mix the second boil with the first. (and the same for the third if present).
  • Boil first packages are boiled before the main pack is added into the boiling.
  • How often should the herbs be made:
    • Generally you add enough herbs into a bag for 3-4 days.
    • Consuming too much past 3-4 days affect the herbs taste
    • Solution would be to place it in the freezer

Specific Recipes

  • Not hard ratios of grams of herbs to how many cups of water.
  • Make sure that the herbs are submerged under at least an inch of water on top.

Boiling Time and Temperature

  • Light, aromatic, pungent herbs:
    • Boil at a higher temperature for a shorter time.
    • Minimizes loss of aromatic, pungent, volatile compounds.
  • Heavy, bland herbs:
    • Boil at a lower temperature for a longer time.
    • Extracts active ingredients more fully.

First Boil - Shells

  • Herbs with active ingredients that are difficult to extract and not sensitive to overheating:

    • Animal horns, shells, mineral herbs.
    • Boil for 30 minutes - 1 hour before other herbs.

  • Boil First Example Process

    • Boil the herbs in the boil first pack for 30 mintues
    • After 30 Mins start soaking the main pack (since main also takes 30 mins)
    • SO soak the boil pack and boil the main herbs together.

Toxic herbs

  • Ma huang, chuan wu, cao wu, fuzi:

    • Boil to reduce toxicity.
    • MAHUANG, the first one that we'll talk about.

  • Boil First Procedure - MH

    • boil for about one hour, Take a spoon and skim away that froth as you boil it
    • take like a chopstick or something, dip it in the liquid, and then just put it gently on your lips, k, and see if it's still numbing (still toxic)

Later add Herbs

  • Herbs with volatile oils that are heat sensitive

    • add to the decoction later. Do not burn it fully in the start.

  • Example of herbs to add later

    • BO HE -- Mint leaf

  • Boil Later process
    *Add during the final 5-10 minutes of the main herb's cooking time

    Do Not Boil Herbs- Cinnabar (Mercury Herb) - Fights for Life (LAST Of Us Connection)

  • What you would do then is instead you would pulverize it into a powder

  • add it after the boil with the juice (since toxic and applying heat will break the compound and release the toxicity)

Wrap the Herb, the poop and hairs

  • Wrap it prior for easier boiling so it doesn't go everywhere.
  • (Gong -- Flying Squirriel poop).
  • (Xin Yi Hau -- Plant hair that can irritiate during boil).

Small amount Herbs

  • Herbs in small amounts should be decocted or administered separately.
  • Example: ginseng is like ($200-$300 a pound)

Sticky or Glue Type

*should be melted separately
*Example AH JUJ (Donkey Hide Paste)
*Yi Tang (Concentrate herbs) Paste
Stir this in a seperate bowl Melt it during boil.

Easly Dissolving Herbs

  • dissolved into the herb juice after the decoction is is done boiling

Final Notes on Medication

  • Herbatl Decoctions, should be taken warm otherwise it hurts the digestivey System.
    Taken twice a day.
    Generally, speakin, if my patient has never taken herbs before, I will ask them to take it on a full stomach, right, just to protect the digestive system.
    Soaking For the herbs for the patient:
    *It dependes on the types of herb, the rule of thumb is if its a wood or the bark/plant (they take a long time and would need it)
    Overnight soak can change colour due to oxidation so generally its not reccommended. Its better to soak for 30 mins.