The Efficacy and Functions of Medicinal Pastes in Traditional Chinese Medicine

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Medicinal pastes, also known as gāo zī jì (膏滋剂), are one of the eight forms of traditional Chinese medicine (TCM) preparations, which include pills, powders, pastes, elixirs, wines, tinctures, soups, and tablets. They can be used externally or taken internally. Internal medicinal pastes are made by concentrating large compound decoctions and adding certain auxiliary materials to create a thick semi-liquid or gel-like preparation, which serves as a highly nutritious tonic with comprehensive therapeutic and preventive effects.

Medicinal pastes have a long history. The Huangdi Neijing (黄帝内经) mentions external pastes, such as mǎ gāo (马膏). The earliest recorded medicinal paste in medical history is the Da Wutou Gao (大乌头膏) documented in the Jinkui Yaolue (金匮要略) by Zhang Zhongjing during the Eastern Han dynasty. By the Song dynasty, medicinal pastes were widely used, and many formulas are still in use today. The methods of preparation became well-established during the Ming and Qing dynasties. In modern times, the use of medicinal pastes has become prevalent in Shanghai, Jiangsu, Zhejiang, and Guangdong, particularly in Shanghai.

Medicinal pastes can regulate the body’s immune function, eliminate free radicals, combat aging, enhance endocrine regulation, strengthen the body, improve cognitive function, beautify the skin, adjust the body’s stress response, improve cardiovascular function, regulate digestive system function, exhibit anti-tumor effects, and lower the “three highs” (hypertension, hyperglycemia, and hyperlipidemia).

Each medicinal paste formula is tailored to the patient’s unique constitution, health status, symptoms, and results from various physical examinations. TCM practitioners with a solid foundation in TCM diagnose and treat based on the principles of dialectical reasoning, combining differentiation of syndromes and diseases, and adapting treatment to the individual, time, and place. This personalized treatment principle involves careful consideration and selection of herbs based on the roles of monarch, minister, assistant, and envoy, ensuring a comprehensive approach to restoring the dynamic balance of yin, yang, qi, and blood. As the ancients said, “It is better to prescribe ten doses of medicine than to prescribe one medicinal paste.” Therefore, medicinal pastes have the dual functions of tonifying and attacking, with treatment and tonification intertwined, and the expulsion of pathogens integrated with nourishment. The selection of medicinal materials for pastes emphasizes the use of authentic and high-quality herbs to ensure efficacy. The preparation process of medicinal pastes is complex, involving soaking, decocting, concentrating, storing, and other steps, with specific procedures and strict operational processes. The meticulous preparation process determines the high quality of the medicinal paste.

Individuals in recovery after acute illnesses, surgeries, childbirth, or bleeding; those with hypertension, stroke precursors, and various chronic diseases in the elderly; sub-healthy individuals with prolonged mental labor and high work stress; children with recurrent respiratory infections, anorexia, and weak constitutions; individuals with endocrine disorders such as chloasma, acne, hair loss, and sallow complexion; patients with gynecological conditions such as irregular menstruation, chronic pelvic inflammatory disease, and endometriosis; and postpartum women with qi and blood deficiency, prolonged lochia, abdominal pain, and insufficient lactation are suitable candidates for medicinal pastes. However, for patients with acute diseases and infections, as well as those in the active phase of chronic diseases, it is advisable to wait until their condition stabilizes before considering the use of medicinal pastes.

Medicinal pastes can generally be taken throughout the year, with winter being the primary season, especially from one week before the winter solstice to before the beginning of spring. TCM emphasizes the principle of “spring growth, summer flourishing, autumn harvest, and winter storage; this is the great principle of heaven and earth, and if not followed, there can be no order.” There is also a saying in folk culture: “Taking supplements in winter allows one to fight tigers in spring,” which holds much truth.

Medicinal pastes are typically taken twice daily, in the morning and evening, preferably on an empty stomach. For consumption: take an appropriate amount of the paste, place it in a cup, add boiling water, stir to dissolve, and consume. For adjustment: if the paste is thick and difficult to dissolve, it can be heated in a water bath with yellow wine or other liquids until well mixed and then consumed. For sublingual absorption: also known as “holding and dissolving,” the paste is held in the mouth to dissolve slowly, allowing the medicine to take effect, such as in the case of pastes used for chronic pharyngitis. During the consumption of medicinal pastes, it is advisable to avoid tea, coffee, cola, and to refrain from eating seafood, raw, cold, greasy, spicy, and other hard-to-digest or irritating foods. The spoon used to take the paste should be cleaned, dried, and sterilized. If any discomfort occurs during the use of medicinal pastes, consumption should be stopped immediately, and the cause should be investigated. After addressing the symptoms, consumption can be resumed.

Medicinal pastes should be stored in a cool place, and refrigeration is preferable. If mold appears on the surface of the paste, it is advisable to scrape off the moldy layer with a clean fruit knife and then steam it at high temperature. However, if there are many mold spots or if they are deep within the paste, it should not be consumed.

“One medicine, one nature; a hundred diseases, a hundred formulas.” Each type of medicinal paste has its own specific functions, but regardless of the type, it can only treat certain conditions and cannot be used universally for all diseases. Tonic pastes should not be used indiscriminately; using the wrong one can be harmful rather than beneficial. In cases of simultaneous deficiency of both yin and yang, insufficient qi and blood, and multiple diseases, careful observation and analysis are essential when selecting formulas and using herbs to achieve optimal results, avoiding reckless prescribing.

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