There are many dosage forms of traditional Chinese medicine, such as tablets, pills, granules, and oral liquids. For example, Huo Xiang Zheng Qi (Huo Xiang Zheng Qi Decoction) is available in various forms including Huo Xiang Zheng Qi Shui (Huo Xiang Zheng Qi Water), Huo Xiang Zheng Qi Pian (Huo Xiang Zheng Qi Tablets), Huo Xiang Zheng Qi Di Wan (Huo Xiang Zheng Qi Pills), Huo Xiang Zheng Qi Jiao Nang (Huo Xiang Zheng Qi Capsules), and Huo Xiang Zheng Qi Kou Fu Ye (Huo Xiang Zheng Qi Oral Liquid).
Have you ever wondered why the same medicine comes in so many forms?What are the differences between the same ingredients in decoction and in patent medicine?Which dosage form has the fastest absorption rate?Generally, the order from slowest to fastest absorption is: pills < tablets < granules < suppositories < oral liquids < tinctures < subcutaneous injections < intramuscular injections < aerosols < intravenous injections. (This includes both Chinese and Western medicines)Pills are generally the slowest. As the ancient saying goes: “Decoctions are for expelling major illnesses; pills are for gradual treatment.”Advantages of Decoctions vs. Disadvantages of Pills1. Decoctions are flexibleDecoctions are versatile and can be adjusted according to the doctor’s diagnosis and treatment, allowing for individualized and timely treatment;while pills are not as flexible, as patent medicine pills are fixed; if you ask someone to make pills for you, it is usually in large quantities, making pills less adaptable and timely compared to decoctions.2. Decoctions are absorbed quicklyDecoctions are liquid preparations that are absorbed quickly after oral administration, leading to rapid effects;pills have a slower release process, resulting in slower absorption compared to decoctions.3. Decoctions can be used externallyBecause decoctions are liquid, they can be used not only for oral consumption but also for external applications, such as fumigation and gargling;pills are not commonly used externally.Advantages of Pills vs. Disadvantages of Decoctions1. Pills are suitable for chronic diseases and tonicsTraditional pills release the medicine slowly, providing a mild and lasting effect, and are suitable for tonics or treating chronic diseases for long-term use;decoctions are absorbed too quickly, have an unpleasant taste, and are cumbersome to prepare, making long-term use inconvenient.2. Pills can be made into controlled-release formulationsPills can also utilize new technologies and processes, some of which can achieve sustained or controlled release effects, allowing the medicine to exert its effects better, effectively reducing the frequency of use, enhancing safety, and minimizing gastrointestinal side effects;decoctions have a relatively singular effect and cannot undergo new process modifications (after modification, they become liquid preparations, which are mass-produced without individual needs).3. Pills are convenient to carryPills are easier to transport, carry, and store, with a longer shelf life; however, honey pills, due to the addition of honey, are not easy to preserve;decoctions, being liquid, are inconvenient to carry and store, and can easily spoil over time.4. Pills can extract fat-soluble substancesPills, due to their manufacturing process, can extract some fat-soluble and poorly water-soluble components;whereas decoctions, if not combined with alcohol, have difficulty extracting fat-soluble and poorly water-soluble components, which may reduce the content of these effective components.5. Other advantages of pillsAlthough chronic diseases are suitable for pills, they can also be prepared in advance for acute illnesses, serving as a backup when needed.Highly toxic drugs and those with strong gastrointestinal irritation can also be made into pills to delay absorption, reducing toxicity or adverse reactions.Pills can also be used for some unpleasant-tasting medicines, which are difficult to ingest; auxiliary materials can be added to make pills, helping to mask the taste.Pills also come in several types, each with different absorption rates, arranged from fastest to slowest as follows: water pills → honey pills → paste pills → wax pills. Ancients pointed out: “Water pills are easy to dissolve, honey pills are slow to dissolve, paste pills are delayed in dissolution, and wax pills are difficult to dissolve.”
Summary from Huang YaoshiIn summary, if you want flexibility in adjusting prescriptions, high individual matching, quick onset, or need for external use, choose liquid preparations (decoctions);If you want long-term use, good taste, convenience in storage, or when the medicinal components are mostly fat-soluble, you can choose pills.Of course, there are many other dosage forms available for you to choose from, such as granules, pastes, pills, oral liquids, etc., each with its own advantages and disadvantages, as well as various new dosage forms that do not adhere strictly to traditional forms.
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