granules

[Guest guest]

Well, we've all covered this granule v. decoction issue several times if I

recall. Still here are a few reiterated thoughts:

 

1. When you cook the tea and smell the herbs cooking this is not

necessarily a good thing since in many cases that smell is the medicinal

being cooked off. The granules are decocted in closed vats and the

essential oils are purportedly returned to the finished product prior to

spray drying.

 

2. I find granules a lot more reliable than decoctions (and have used both)

too. There are many reasons for this. Compliance and cooking method are

preeminent. Very, very rarely have I found clients willing to decoct for

more than a few weeks, if even that long. For a cold, flu, something acute

they are willing to sacrifice time and the smell of their house. For HIV,

diabetes, etc, they are not willing to decoct indefinitely. Even after a

week, clients would apologize for forgetting to do it/not having time/just

plain refusing to go through the odor.

 

My groovier clients were, of course, slightly more willing to do decoctions.

Although they were also quite non-compliant, often missing days of herb.

However, most of my patients are busy urban yuppies for whom TCM is nothing

but a last resort. Chinese culture, yin/yang, and purism in herb decocting

are utterly meaningless to them. They see me because everything else has

failed. They have nice houses and almost universally bitched about how they

couldn't get rid of the herbs smell for hours after cooking the decoction.

Silly, I know. But this must be a pragmatic consideration since the best

medicine in the world won't work if the patient won't take it.

 

Patients can take the granules to work, on vacation, late at night when

they're too tired to do anything but brush their teeth, while suffering from

an exacerbation of Chronic Fatigue Syndrome (try to get a CFS patient at the

peak of her fatigue to decoct herbs!), or in any other pinch.

 

3. Cooking. Several examinations of patients' herb cooking have been done

over the last 20 years of TCM journaling that I have access to. I'm not

going to dig into my piles again, but I know that Subhuti Dharmananda at the

Institute of Traditional Medicine did one of them and I'm sure he'd be happy

to furnish anyone interested with these results. I do remember that in an

attempt to determine how well patients complied with instructions many ITM

patients were given a decoction containing Ma Huang as one of the

ingredients, as well as precise instructions on how to cook them (i.e amount

of water, time of cooking, size of pot, etc). They were asked to bring back

a sample of the product which was then assayed for ephedrine, one consituent

of Ma Huang. My brain is foggy, but I believe that the variation in

ephedrine content among the different patients was in the 60% range

indicating a wide variation in cooking methods.They can't make a mistake in

anything other than dosage with granules, and a teaspoon is fairly easy to

maneuver for all but the most dense.

 

4. Jason: What is meant by much 'much' more reliability in potency?

There is no way I can agree that granules are more potent than raw herbs

until there is some substantial studies with some proof.

 

Mark: Well, you are absolutely right that nothing conclusive can be made of

any one pracitioner saying that they are reliably getting higher potency in

their herbs in one form over another without a large scale study to back it

up. Of course the compliance issue bears heavily on this. The only real

life comparison I can bring to bear, and it is only anecdotal being just one

case, is with a Hep C patient who I started on decoction. We watched her LV

enzymes almost normalize after a month after which she went on a sabbatical

for 6 months, left town and couldn't do decoction. She came back with

elevated enzymes again (just as before), whereupon I put her on granules (I

had begun to switch my pharmacy at this point) and watched her enzymes

normalize completely. Are the herb more potent? Is she just more compliant

with them? Who knows. But it was the clearest example of results between

the two methods.

 

 

5. Jason: This guaranteed potency and therefore a much different processing

that originally intended, for a given formula, would make sense that it is

changing the overall properties of the formula. I can not imagine that

herb's constituents are extracted in the same ratio as making a decoction,

so therefore this supposed higher potency would not be higher in the same

ratios in a normally decocted formula, again changing the properties.

 

Mark: This is, of course a distinct possibilty --- something else that

Subhuti Dharmananda has dealt with via ITM. Only time and studies can tell.

Certainly with formulas that have immediate distinct effects: anti-asthma

(acute), anti diarrheal, and purgative, the effect is quite immediately

notable with granules. Still, it is a possiblity that long term

administration of complex formulas with more subtle effects may differ in

one form vs. another. I have yet to note that personally, but my sample

size is not statistically meaningful.

 

 

Well, there's my biannual decoction v. granule spiel. I personally would

love it if I could use decoctions only. They're fun, look awfully cool, and

give one a sense of cultural lineage. I stopped only because I wasn't

serving my patient population adequately.

 

 

Mark Reese