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Flashcards in week 3 - annie Deck (60):

what standards must herbs meet in the official Chinese Pharmacopoeia?

- ash content
- loss on drying
- content of extract
- content of volatile oil
- content of a particular constituent


what natural + man-made contaminants can make herbs unfit for consumption?

free of:
- mold
- microbes
- pesticides
- heavy metals


what is Pao Zhi?

general term for any type of herb processing


how to increase an herb's surface area?
why do this?

- slice or pulverize it, to increase surface area and facilitate extraction + digestion
- slicing shapes an herb into a standard size + weight
- pulverizing is often used for minerals + shells


why are herbs prepared?

- increase potency
- direct its actions to a certain place
- minimize side effects
- increase or alter properties of an herb


why? used for what substances?

- removes oils
- reduces side effects + toxicity
- often used for grains + seeds


aqueous trituration:
what is it? used for what?

- grinds minerals with water until they are reduced to an extremely fine powder
- often used for ophthalmalogical preparations


6 methods utilizing heat to prepare an herb

1. dry frying (chao)
2. frying with liquids (zhi)
3. calcining (duan)
4. quick-frying (pao)
5. dry curing or baking (hong or bei)
6. roasting in ashes (wei)


dry frying + browning herbs:

- used to dry herbs for storage
- increases Spleen-awakening + Stomach-strengthening actions


dry frying with salt:

directs action downward to the Kidneys


dry frying until charred:

increases hemostatic ability (helps stop bleeding)


frying with honey:

increases tonifying + moistening actions


frying with vinegar:

enhances astringent, analgesic, blood-invigorating + detoxifying actions


frying with wine:

enhances ability to clear blockages from the channels, expel wind + alleviate pain


frying with ginger juice:

- reduces the tendency of bitter + cold herbs to upset the Stomach
- may enhance an herb's ability to warm the Stomach + stop vomiting


what is it? why? used for what substances?

- places a substance directly or indirectly in the flames until it is thoroughly heated + turns red
- makes the substance brittle + easy to pulverize
- commonly used for minerals + shells


what is it? why?

- fries a substance at an extremely high temperature until it is dark brown or cracked
- reduces toxicity or moderates harsh characteristics


dry curing or baking:
what is it? used for what substances?

- uses slow, mild heat to avoid charring
- often done with flowers or insects, which are more delicate


roasting in ashes:
what is it?

wrap an herb in moistened paper, paste, or mud before heating it in hot cinders until the coating is charred or cracked, and its insides have reached a high temperature


4 methods utilizing both heat + water to prepare an herb

1. steaming (zheng)
2. boiling (zhu)
3. quenching (cui)
4. simmering (ao)


what is it? why?

- steam + then dry the herbs in the sun
- increases moisture + heat


how many times do we steam Sheng Di Huang to transform it into Shu Di Huang?

9 times
(Sheng Di Huang is in the clear heat, cool blood category; Shu Di Huang is in the tonify yin + blood category)


what is it? why?

- mostly boiled in water but could also be boiled in another medium, such as vinegar
- alters an herb's characteristics or toxicity


what is it? why?

- heat + then immediately immerse a substance in cold water or vinegar
- often used with minerals to facilitate pulverization + moderate their properties


what is it? what is the end product?

- reduces herb to a thickened liquid, syrup, or gel
- use low heat over a long period of time: boil in several changes of water, collect the supernatants, then condense + solidify into a gel


7 methods of delivery for herbs

1. decoctions
2. drafts
3. pills
4. powders
5. syrups
6. plasters
7. wines


strongest method of delivery?

decoctions are the strongest way to administer herbs (aside from injections)


what is it?

- literally means "soup" (tang)
- decoctions are solutions + suspensions that are readily absorbed, thus expediting their effect
- commonly used for acute conditions


general guidelines for preparing a decoction

- do not use aluminum pots or cooking utensils (bc they can have a chemical effect on herbs)
- better to use corning ware, porcelain pots, or ceramic pots
- use a tight fitting lid


3 solvents used for decoction + what functions they enhance

1. water - most common
2. wine - invigorates the Blood
3. vinegar - astringent


2 types of heat used for decoction + how to use them

1. high flame or "Military Fire" (wu huo)
2. low flame or "Civilian Fire" (wen huo)

according to Li Shi-Zhen, "bring to boil with a Military Flame and then lower to Civilian Fire for cooking"


how to cook a decoction?

1. cover herbs with water + allow to soak for awhile (this helps with extraction of ingredients)
2. bring to a boil + then reduce heat
3. keep the herbs covered (so the "flavors" do not escape)
4. most common method is to decoct the herbs twice (using less water the 2nd time)
5. both times, the herbs are boiled down to 1 cup of liquid
6. after both decoctions, discard the herbs + combine the 2 cups of liquid (the first decocion will be more potent, so you want to combine it with the second to even out the potency)


how long to cook herbs generally?

generally cook a formula 20-30 minutes (but this may vary depending on ingredients)


when to use less time?

- formulas that Release the Exterior, Clear Heat, or contain herbs with volatile oils (aromatic) should be cooked over a high flame for a shorter period of time (10-15 minutes)
- flowers + leaves should cook for less time


when to use more time?

- tonics + other formulas with rich, cloying substances should be cooked over a relatively low flame for a longer period of time (45-60 minutes) to extract as much as possible
- toxic substances should be cooked for at least 45 minutes to reduce their toxicity
- bones, shells + sedating substances should cook for longer


most common dosage for decoctions?

- take 1 cup 2x daily
- or take 2/3 cup 3x daily


dosage when taking a formula with toxic herbs?

start with a small dose and slowly increase the dosage until the desired effect is obtained


when to take a formula?

- decoctions are generally taken before meals (more effective on an empty stomach)
- if ingredients irritate digestive tract, then take after meals


what temperature to take a decoction?

- decoction is usually taken warm, even when the disorder is due to excess heat
- EXCEPTION: when the decoction causes nausea + vomiting


when to take a tonic?

- tonics should be taken on an empty stomach
- (they are more expensive, so you want to get the most bang for your buck)


when to take Calm the Spirit formulas?

- Calm the Spirit formulas should be taken before bed
- e.g. formula to tonify the heart should be taken between 11pm and 1am (since this is the best time for the heart organ)


when to take formulas for Malarial disorder?

formulas for Malarial disorder should be taken 2 hours before an attack, if the timing is regular


what type of herbs are "decocted first"?

- toxic herbs (bc they get less potent the longer you cook them)
- minerals + shells (bc they're hard, take longer to decoct, and need to be softened for digestion)
- lightweight substances in a large dosage (bc they take up space in the pot)


what type of herbs are added near the end?

- aromatic herbs (bc you want to retain potency of volatile oils)
- Da Huang (to have a strong purgative effect)
- or other specific herbs, for their particular effect


what substances need to be bagged in gauze before decoction?

- herbs with cilia (so they don't float at top of pot)
- small seeds
- some minerals
- powdered substances (so they don't mix directly with water and turn it muddy)


what substances are decocted separately?
how is this done?

- rare + expensive substances (e.g. ginseng, or Ren Shen)
- often cooked in a double broiler for 2-3 hours to extract all the active incredients (double broiler prevents burning)


what substances are dissolved in a strained decoction?

highly viscous substances (bc they would stick to the pot or the other herbs, and thereby reduce the effect of decocting)


what substances are taken with a strained decoction?

- some expensive, aromatic substances are ground into a powder and then taken first, followed by the strained decoction
- e.g. precious horns, which are shaved or filed into a powder + ingested, followed by the decoction


boiled powders / drafts:
what are they? how different from a decoction?

- these are powders decocted for 10 minutes
- dosage is much smaller than decoctions, therefore less potent


why use them? how strong are they?

- convenience for seller: easy to store, long shelf life
- convenience for patient: easily absorbed, takes little time to prepare
- medicinal action is bw decoction + pill


how are they prepared? how strong are they?

- made by combining fine powder of pulverized herbs with a viscous medium
- usually milder and slower in action than a decoction or powder
- common solvents include: water (most common); honey (dissolves slowly, good for tonic pils); wax (dissolves slowly, will bypass stomach and make it all the way to intestines)


'Dan' (vermillion pills):
what are they?

- the name "vermillion" refers to cinnabar (zhu sha), which was used as a protective coating and had a calming, sedating effect but is no longer used due to its toxicity
- pills were made of finely processed, expensive substances or minerals


what are they good to treat?

- good for sore throat + cough (e.g. loquat syrup)
- syrups are prepared by decocting water, reducing the strained decoction to a thick concentrate, and adding sugar or honey


how are they used? what do they treat?

- external application (think of it as a paste)
- for dermatological issues, painful joints + muscles, fractures + sprains, fixed masses


medicinal wines:
how are they made? what do they treat?

- made by steeping medicinal substances in wine
- wine is used to nourish, invigorate blood, and unblock channels
- also used to treat wind-damp painful obstruction, traumatic injury (gets rid of old blood), and deficiency-induced disorders (tonifies)


2 types of herb-drug interactions to be cautious about?

1. pharmacokinetic interaction
2. pharmacodynamic reaction


pharmacokinetic interaction:
what is this?

- a change in the absorption, distribution, metabolism, or elimination of herbs or drugs in a way we don't want
- several mechanisms may interfere with the ABSORPTION of drugs through the intestines
- DISTRIBUTION refers to the process in which herbs or drugs are carried and released to different parts of the body
- METABOLISM refers to the rate at which the liver metabolizes herbs and drugs, and determines the length of time they stay active in the body
- the kidney is responsible for ELIMINATING herbs and drugs from the body


pharmacodynamic reaction:
what is this?

- can alter the way in which a drug or herb effects a tissue or organ system
- hard to predict
- can be synergistic (amplifies the effect) or antagonistic (removes or decreases the effect)


general guidelines to reduce the possibilty of herb-drug interaction

- keep a record of all drugs patients are taking (review this list with the patient regularly)
- take drugs + herbs at different times or via different methods of administration
- reduce dosage of herbs that may have the same therapeutic effects as a drug (e.g. diuretics)
- adjust when Intestinal Motility drugs are used (i.e. laxatives will move through the digestive system faster, decreasing absorption, so in this case you would increase herb dosage)


when to use extreme caution prescribing herbs?

- with patients scheduled for surgery
- with patients who have Liver or Kidney disease
- with multiple-drug users, especially elderly
- if patient is taking medication for the Heart or Kidney, or blood thinners