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■ Source | Shanxi New Medicine
This article elaborates on the rise of decoction powders and their clinical significance.It references classical texts and provides detailed information, particularly regarding experimental research on decoction powders and the author’s own practice, further demonstrating the immense value of using decoction powders.Decoction powder refers to the process of grinding Chinese medicinal materials into coarse powder and boiling them in water for consumption. Currently, discussing its origins and principles is still of considerable significance.
The practice of decoction powders has a long history, as seen in the “Ma Xing Yi Gan Tang” (Ephedra, Apricot Kernel, Coix Decoction) from the “Shang Han Za Bing Lun” (Treatise on Cold Damage and Miscellaneous Diseases), which is an early example of a decoction powder. However, in ancient formulations, it was relatively rare.
The term “decoction powder” seems to have become a specialized term during the Tang Dynasty. According to statistics, there are over twenty formulas explicitly labeled as decoction powders in the “Wai Tai Mi Yao” (Essential Prescriptions from the Imperial Pharmacy), although those that actually used the decoction powder method were still referred to as “tang” (decoctions) and were not included in this count.
During the Song Dynasty, the officially promulgated standard formula manual, “Tai Ping Hui Min He Ji Ju Fang” (Formulas for Benefiting the People), included a significantly larger number of decoction powder formulas. It is reported that this book contains 788 prescriptions, of which 237 are decoction powders (including various types), indicating that by that time, decoction powders had become one of the mainstream dosage forms.
In the Northern Song Dynasty, Shen Cunzhong (Note 1) mentioned in his work “Mengxi Bitan” (Dream Stream Conversations) that decoction powders were listed as the fifth category of “Yao Yi” (Pharmaceutical Discussions), and he also included this in his work “Liang Fang” (Good Formulas), stating: “Tang, wan, san each have their appropriateness; ancient formulas used tang the most, while wan and san were rarely used.”
He further discussed the differences in the use of tang, wan, and san, contrasting the method of using decoction powders with that of swallowing powders. He then stated: “In recent times, the use of tang has decreased; those who require tang should use decoction powders entirely. The amount of decoction powder is generally only three to five qian (a traditional Chinese weight unit).”
What Shen said reflects the actual situation of that time and is consistent with the facts.
The promotion of decoction powders has historical significance and practical relevance. The main point is that it conserves medicinal materials without reducing efficacy. In other words, it makes full use of medicinal materials, preventing unnecessary waste.
Furthermore, institutions like the Hui Min He Ji Ju were primarily focused on selling standardized medicinal products and sometimes distributed medicines in war zones and disaster areas (Note 2). Therefore, in addition to fixed formulations of coarse powders, decoction powders were used to replace liquid decoctions. The advantages of decoction powders in this regard are:
They occupy less volume (much smaller than raw medicinal materials), are easy to carry (unlike pills and pastes that cannot withstand pressure), are easy to store (unlike honey pills and pastes that are prone to mold), require fewer steps in the preparation process (just coarsely grinding is sufficient), and are quick and convenient to brew (in conditions where boiling is not possible, they can even be steeped in hot water). They also conserve medicinal materials (about one-third to one-fourth the amount of a decoction).
Based on these characteristics, the proportion of decoction powder formulas in the “He Ji Ju Fang” significantly increased, and they almost became mainstream. It is no wonder that Shen Cunzhong stated that “in recent times, the use of tang has decreased; those who require tang should use decoction powders entirely.”
At that time, the emphasis on conserving medicinal materials can be seen in the work of Pang Anshi, who wrote the “Shang Han Zong Bing Lun” (Comprehensive Treatise on Cold Damage). In Volume Six of this work, there is a section on “Distinctions” and a letter discussing “Distinctions in Cold Damage,” both mentioning decoction powders. Moreover, in the appendix “Revising Medicinal Methods,” there is a statement from Pang’s disciple, Wei Bing, primarily discussing decoction powders. Pang clearly explained the reasons for changing decoctions to decoction powders.
In the distinctions, it is stated: “Since the Tang Dynasty, due to the An-Shi Rebellion, local warlords have been rampant, and by the Five Dynasties, the country was in turmoil, making transportation difficult. Therefore, physicians conserved by using decoctions as decoction powders.” In the letter, the reasons are generally similar, but the latter two sentences are clearer: “Therefore, physicians used decoctions less and practiced decoction powders more.” Pang only mentioned the Tang Dynasty, avoiding the Song Dynasty, but in reality, during the Northern Song Dynasty, the northern regions of China experienced frequent changes in power, and transportation in the north and northwest was often obstructed. Some medicinal materials even had to be exchanged for goods, so the supply was insufficient, necessitating conservation efforts.
Decoction powders not only conserve medicinal materials but also address some practical difficulties. Under the research and advocacy of medical scholars during the Song, Jin, and Yuan Dynasties, they experienced significant development and almost became the primary dosage form.
For instance, in the “He Ji Ju Fang,” some important formulas adopted the decoction powder method, such as “Ren Shen Bai Du San” (Ginseng Powder to Overcome Pathogenic Factors), “Liang Ge San” (Cool the Diaphragm Powder), “Ba Zheng San” (Eight Rectification Powder), and “Dao Chi San” (Guide Out Red Powder). These involve grinding medicinal materials into coarse powder, boiling them, and consuming the strained liquid, with a typical dosage of two to three qian.
There are also those ground into fine powder, boiled, and consumed with the dregs, such as “Huo Xiang Zheng Qi San” (Agastache Powder for Correcting Qi) and “Ping Wei San” (Stomach Comforting Powder), with each dose also being two qian.
Some formulas, although named “tang” or “yin” (drinks), still follow the decoction powder method in practice, such as “Sheng Ma Ge Gen Tang” (Cimicifuga and Kudzu Decoction), “Liu He Tang” (Six Harmony Decoction), “Su Zi Jiang Qi Tang” (Perilla Seed Decoction for Regulating Qi), “Er Chen Tang” (Two Aged Decoction), “Si Qi Tang” (Four Seven Decoction), “Gan Lu Yin” (Sweet Dew Drink), and “Qing Liang Yin Zi” (Cool Drink), with a single dose being two qian, and the maximum amount not exceeding four qian.
By the Ming and Qing Dynasties, the use of decoction powders gradually decreased. If we apply Pang Anshi’s argument in reverse, it may be that the domestic situation had stabilized for a long time, and the supply of medicinal materials was relatively sufficient, leading to the predominance of decoction pieces.
Decoction pieces are visually appealing and less prone to errors, which is an advantage, while decoction powders were no longer strongly advocated by physicians.
However, during the cutting process, soaking can lead to a loss of medicinal content. Therefore, in works like “Lan Tai Gui Fan” and “Wen Bing Tiao Bian,” many formulas still employ the decoction powder method, such as the first famous formula in “Wen Bing Tiao Bian”—”Yin Qiao San” (Silver Flower Powder), which is indeed a decoction powder.
Up until the founding of New China, in my hometown of Yangzhou, pharmacies mostly stocked “Yin Qiao San,” “Jia Jian Pu Ji Xiao Du San” (Modified Universal Detoxifying Powder) (Note 3), and “Su Bi San” (Nasal Powder) (Note 4), which had almost become household names. They could effectively prevent and treat upper respiratory infections, pharyngitis, tonsillitis, parotitis, rhinitis, and sinusitis.
Patients with mild conditions often purchased them themselves, solving many problems.
Additionally, I personally noticed that using a typical decoction (weighing about two taels) reduced to one-third of its weight, ground into coarse powder for decoction, resulted in a much thicker consistency than a whole decoction.
I have observed that when boiling soup over coal fire, if the heat is too intense, it often results in a clear broth. Upon examining the medicinal materials, the center of the coix seeds and job’s tears remains dry, the lotus flesh has not softened, and the majority of the cassia seeds and black beans are only slightly moistened, with most still intact (whole cassia seeds, when soaked for a certain time, exude a gelatinous substance that wraps around the exterior). Some Poria, cut into cubes like dice, after boiling, only the outer skin is moistened, while the center remains dry. I have also tasted the boiled astragalus and jujube, which still taste sweet.
Decoction powders, due to their smaller unit area, increase the contact area with water during boiling, making it easier for the effective components of the medicine to dissolve. Although the dosage is smaller, it can enhance the utilization rate of the medicine, achieving effects comparable to decoction pieces.
Some research institutions and clinical units have conducted substantial practical research, which is quite persuasive. For example:
1. The Institute of Traditional Chinese Medicine Research selected different prescriptions to compare the effective content of decoction pieces and coarse powder decoctions. They measured two prescriptions.
One was “Da Huang Huang Lian Xie Xin Tang” (Rhubarb and Coptis Decoction), primarily measuring the anthraquinone content extracted from rhubarb; the other was “Si Ni Tang” (Frigid Extremities Decoction), measuring the content of aconitine from fuzi. They used the original prescription dosage for decoction pieces and reduced the coarse powder prescription by two-thirds.
The soaking time, boiling time, heating, and containers were all identical (Note 5). The results showed that the coarse powder reduced the dosage while the quality of the decoction did not significantly decrease. Using coarse powder decoctions (decoction powders) not only reduces waste and conserves medicinal materials but also shows little difference from ordinary decoctions.
2. The same unit conducted in-depth experimental research using several formulas, including “Xie Xin Tang,” “Si Ni Tang,” “Si Wu Tang” (Four Substance Decoction), “Qin Shao Tang” (Scutellaria and Paeonia Decoction), and “Gui Pi Tang” (Restore the Spleen Decoction). The conclusions indicated that the extraction amounts of the contained components were all increased,
“showing that the coarse powder at 1/3 dosage had a higher extraction rate than the full amount. This may be due to the reduced dosage, which relatively increases the concentration, but whether using the full amount of coarse powder or 1/3 amount, it indicates that medicinal materials can be conserved. Initially, it seems that the dosage should be 1/3 to 1/2 of the decoction piece prescription amount.”
3. Some research units have studied the decoction of coarse powder and the administration of fine powder, believing that it can enhance efficacy and utilization (Note 7).
4. Some places compared the decoction of single herb licorice in both decoction pieces and coarse powder, finding that the decoction from coarse powder had greater physical constants and glycyrrhizin extraction than the decoction pieces (Note 8).
5. Some places conducted a comparison of the extraction rates based on the size of the medicinal material volume, which can be referenced (Note 9).
There are many related materials, but the above five examples are sufficient to illustrate the issue. They demonstrate that the decoction powder method used by Shen Cunzhong, Pang Anshi, and in the “He Ji Ju Fang” does not reduce efficacy and can conserve some medicinal materials.
Today, our social system, production conditions, living conditions, and health levels are entirely different from those of their time.
In the past, the vast majority of people could not receive timely treatment for illnesses. Medicinal materials were used not only for treating diseases but also for preventing them, leading to a demand that is many times greater than before. Moreover, some medicines naturally have low yields, thus, conservation and rational use remain necessary.
Chairman Mao taught us to “practice frugality” and emphasized that “everywhere must cherish human and material resources, and never waste them for immediate gain.”
Decoction powders can conserve some medicinal materials while ensuring quality and quantity, making them worthy of review and research.
In 1965, I participated in a medical team in a certain commune in the suburbs of Beijing, where I did some work in this area. Coincidentally, we were stationed at a commune health center, which had a simple Chinese medicine pharmacy. Although the supply of medicines was not abundant, the variety was acceptable, and there was a set of traditional pharmaceutical tools.
Initially, I prescribed according to the principles of syndrome differentiation and treatment. However, I only used one-third of the dosage, personally selecting the herbs and dividing them into several groups: one group for grinding, which I ground into appropriate coarse powder; another group that was difficult to grind, such as Asparagus and Rehmannia, which I cut; a group that could not be cut, such as bamboo leaves, loofah fibers, and large abdomen skins, which I scissored; and a group that, when ground, became fine powder, which was not suitable, such as flower stone, purple quartz, and oyster, which I crushed with a copper pestle (these are just examples and not all from one prescription).
After processing, I combined them into one prescription, divided it into several portions, and instructed patients to use one portion each time, boiling it twice and straining it for consumption. The price was low, and the effect was good, which was well-received by patients.
Later, after a general survey, combining the local incidence and living habits, I derived some commonalities from the specifics. To avoid confusion during urgent situations, I collaborated with team members and local physicians to study and determine several formulas based on ancient prescriptions, collective experience, and current needs, known as agreed prescriptions. These were prepared and packaged, and if necessary, I would add one or two herbs based on syndrome differentiation for patients with relatively stable and uncomplicated conditions.
This way, obtaining medicine was quick, and using it was convenient, with satisfactory effects.Although the dosage form was modified and the content correspondingly reduced, the theoretical foundation remained unchanged, and the efficacy was not affected, standing firm while clearly explaining the principles. In a short time, the local trend of “preferring large formulas and expensive medicines” was shifted.
Patients became increasingly interested, with some even specifically requesting the coarse powders made by the doctor.
Of course, the implementation of a practice cannot be entirely smooth. Although this was a partial reform, I still heard some rumors from nearby individuals claiming to be knowledgeable about medicine (Note 10).
At that time, our approach was flexible and adaptable; using decoction powders did not mean abandoning all other methods, nor did using agreed prescriptions mean discarding everything else. The principle was to use what was appropriate. If a single prescription required decoction pieces or coarse powders, it was still followed. Thus, there were three forms:
One was specially prepared decoctions from decoction pieces, the second was custom coarse powder decoctions, and the third was agreed prescription decoctions, primarily based on the condition, without compromising the principles.
Whether decoction powders or agreed prescriptions, they were still used under the premise of syndrome differentiation and treatment, without deviating from the principles of theory, formulas, and medicines, remaining within traditional practices, and should not be viewed in opposition.
Promoting decoction powders does not mean completely replacing decoction pieces; they each have their advantages and should be adapted to the location, disease, and individual. The “Shang Han Zong Bing Lun” also clearly states that certain prescriptions are not suitable for decoction powders.
Did not Shen Cunzhong also say, “The application depends entirely on the skill of the practitioner; it cannot be rigidly defined”?
In some places, promoting decoction powders involves pre-preparing each medicinal herb into coarse powder for temporary use, which is also a convenient method. However, it must be labeled clearly to avoid confusion; if it is ambiguous, it could lead to mistakes. Therefore, careful verification must be emphasized, treating “verification” as an important part of the decoction powder process, which I want to elaborate on here.
Decoction powders also have the advantage of possessing disinfecting properties, as pills and swallowed powders are often unheated and may contain insect eggs, etc.
Now, I will quote two passages from the paper to conclude.
“The dosage of decoction powders is less than that of decoctions, yet the application methods and properties of the dosage form are the same as those of decoctions, so in clinical application, it can achieve effects basically consistent with decoctions, still fully utilizing the characteristics of decoction prescriptions, syndrome differentiation, and treatment adjustments according to symptoms.”
“Using coarse powder decoctions aligns with traditional Chinese medicine theory and habits while also having a certain scientific basis.”
This article has been reviewed by Liu Shoushan, and I express my gratitude.
(Note 1) Shen Cunzhong (1031–1095), also known as Kua, was a prominent figure in the Northern Song Dynasty, known for both governance and medicine. He authored the “Mengxi Bitan” in twenty-six volumes, with the last volume being “Yao Yi” (Pharmaceutical Discussions), which includes several related entries in the “Bu Bi” (Supplement). He also wrote “Liang Fang” and “Ling Yuan Fang,” the latter of which has been lost, while the former still exists in mixed editions.(Note 2) For detailed information, see the “Song Hui Yao Ji Gao,” which contains extensive data, including events from the Xining, Yuanfeng, Shaosheng, Chongning, Xuande, Shaoxing, Longxing, Qiandao, and Chunxi periods, covering events such as distributing summer medicines, pestilential medicines, and responses to floods, wars, and diseases. The articles are not fully cited.(Note 3) Referring to the “Wen Bing Tiao Bian” treatment of warm toxins with the modified universal detoxifying powder, which does not use Chai Hu and instead includes Jin Yin Hua (Honeysuckle). (Note 4) Based on Yu Tuan’s “Medical Transmission,” using the root of loofah vine, roasted and ground into powder, is very effective for nasal diseases.(Note 5) The original text can be found in the “Chinese Medicine Journal” 1961, Issue 4, titled “Preliminary Introduction to Decoction of Powdered Chinese Medicine,” with detailed methods not fully cited.(Note 6) The original text can be found in the “Chinese Medicine Journal” 1962, Issue 5, titled “Experimental Research on Decoction of Coarse Powdered Chinese Medicine,” authored by Meng Guangrong, Chen Mei, and Lin Yuhua, with content not fully cited.(Note 7) The original text can be found in “Guangdong Traditional Chinese Medicine” November 1960, Issue 11, titled “Inheriting the Experience of Traditional Chinese Medicine Dosage Forms, Experimental Introduction to Improving Efficacy and Utilization Rates of Coarse Powder Decoctions and Fine Powder Ingestions.” Unit: Guangdong Provincial Institute of Traditional Chinese Medicine.(Note 8) The original text can be found in “Jiangxi Medicine” 1965, Volume 5, Issue 2, titled “Comparison of Licorice Decoction Pieces and Coarse Powder in Extracting Effective Components,” authored by Liu Zhongyu.(Note 9) The original text can be found in “Harbin Traditional Chinese Medicine” 1964, Volume 7, Issue 5, authored by Shi Jiuliang, Shen Yinghuan, and Tong Wanjun.(Note 10) For example, saying decoction pieces are better, coarse powders are unreliable, claiming that one cannot cure diseases without spending three to five yuan, or that physicians who do not use ginseng, deer antler, antelope horn, or rhinoceros horn are not skilled, or that one cannot create good formulas without using twenty or thirty herbs. Overall, these are all promoting large formulas and expensive medicines. I have also heard the saying, “Medicines must fill the stomach,” insisting that patients must drink several large bowls of decoction until their stomachs swell, which is considered authentic, etc.I Copyright StatementThis article is sourced from “Shanxi New Medicine,”author/Geng Jianting,copyright belongs to the rights holder.· END · 
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