Chinese Patent Medicine or a Brewed Decoction — Which One Should You Choose? Doctor Luo Dalun’s Simple Rule: When the Decisive Round Comes, Drink a Decoction; for Everyday Constitutional Care, Use Patent Medicines

What patients search for: patent medicine vs decoction / which to choose / tonify the body with patent medicines / Bu Zhong Yi Qi Wan / Liu Wei Di Huang Wan / Jia Wei Xiao Yao Wan / breast nodules / yin deficiency constitution Corresponding medical terms: tang zhe dang ye (the decoction sweeps like an army) · chronic deficiency and constitutional care · low-level repetition · zheng qi (upright qi) · phlegm damp · stagnant blood · the people’s three treasures of health

Opening: a question every household asks

Dear friends, good morning to you all. What are we talking about today? A question everyone runs into — a brewed decoction or a Chinese patent medicine: which should you choose?

💬 Note from Doctor Luo: When people talk about regulating the body and taking medicine, what do they usually think of? Almost always the decoction — the doctor writes a prescription, you brew it at home, or the hospital brews it for you, and you drink two or three bowls a day. How effective is a decoction? Compared with a patent medicine, its results really are excellent. The ancients said tang zhe dang ye — the decoction sweeps like an army on the attack. Because the dose is large, it all goes in at once, the medicinal potency is fuller, and the regulating effect is comparatively strong.

So when should a decoction be used? Doctor Luo Dalun offers a metaphor — play the decisive round with a decoction.

Tang zhe dang ye: for the decisive round, drink a decoction

What counts as a “decisive round”? The moment when the body must turn the situation around immediately.

💬 Note from Doctor Luo: Under ordinary circumstances, when we play the decisive round — the body must turn around right away, the situation is urgent and must be reversed at once — the usual advice is to drink a decoction. Once it goes down it takes effect immediately and turns the situation around. And after control is gained, what about the aftercare? Then you take a patent medicine to consolidate the result. That is generally how it is handled.

First the decoction wins back the ground, then the patent medicine consolidates the victory — in Doctor Luo’s eyes that is the classic battle plan.

But! A decoction hits hard — if the direction is wrong, the patient truly suffers

A decoction is so good — does that mean everyone should drink one? Doctor Luo changes tone and throws cold water on the idea.

💬 Note from Doctor Luo: A decoction is fierce in potency and excellent in effect. If the direction is right, it can instantly turn the cosmos around, overturn the body’s whole pattern, and secure the victory. But can you guarantee you will meet a good enough Chinese doctor? Sometimes, if the prescription is written backwards, if the direction goes wrong — a decoction hits hard, and some patients really cannot bear it. So the decoction is powerful, its medicinal force is thick and deep — you absolutely must fight only a battle you are sure of winning.

So how do you make sure of winning? The answer is four words — diagnosis comes first.

💬 Note from Doctor Luo: When studying decoctions, when you prescribe a decoction, you must invest real effort in diagnosis and keep learning to diagnose. Take what Doctor Zhang Xichun taught about da qi xia xian (sinking of the great qi) — when the symptoms match well enough, you can brew the decoction and drink it: very few herbs, very small doses, and after drinking it the effect is immediate. Many friends have cured themselves this way. When the illness is relatively single-patterned, when you see it very clearly and the diagnosis is very clear, a decoction acts with excellent, immediate results. Especially when you meet a truly fine doctor, with clear diagnostic analysis, the prescription brings very fast recovery.

The clearer the diagnosis, the sharper the decoction; when the diagnosis is muddled, the decoction becomes a sword that wounds.

What about chronic deficiency? Patent medicines are the other road

What if the illness is not that urgent? Many people’s illnesses are accumulated over time.

💬 Note from Doctor Luo: Some patients have quite complex illnesses — all kinds of problems tangled together, lingering and unresolved, built up over a long time. Most patients with deficiency and impairment are exactly this type: the illness accumulates little by little until it reaches its present state. At this point one approach is to use a decoction to solve it in one blow — comparatively fast. But there is another approach, the one I especially advocate — regulating slowly with a Chinese patent medicine is also entirely workable.

What are patent medicines like? Small pills, small doses, mild and gentle.

💬 Note from Doctor Luo: Patent medicines are all small pills — large honey pills or small water pills. The dose you take is small; you are not made to swallow a whole bottle of water pills at once. In fact, if you dissolved that whole bottle, it would amount to about one bowl of decoction — but you are not told to take it that way: eight pills at a time, a few pills at a time, the amount is limited and small. But everyone must know: the formulas inside patent medicines are all classic formulas — Bu Zhong Yi Qi Wan is the Bu Zhong Yi Qi Tang turned into pills; Liu Wei Di Huang Wan, Jin Gui Shen Qi Wan, Jia Wei Xiao Yao Wan, Bao He Wan… every one of these that became a pill is a supremely classic formula.

Unravel it thread by thread: dig out the “landmines” one by one

When deficiency and complex problems have formed in the body over years, regulating them also demands patience. Doctor Luo tells a vivid metaphor — digging out landmines.

💬 Note from Doctor Luo: The body’s deficiency and complex problems take shape gradually, so when you regulate them you must also unravel the thread bit by bit and adjust piece by piece. Say there is phlegm damp inside, stagnant blood, qi-and-blood problems — then just fix them one at a time: first fill the qi, nourish the blood a little, then dissolve a bit of stagnant blood. I often say: in front of us there are many landmines, buried over the years. What to do? Just take them out one by one — each one you pull out is one less, and eventually every landmine is gone. So we regulate little by little, and the effect is quite good too.

Yin deficiency constitution: a state to “maintain” for life

Speaking of constitutional care, Doctor Luo offers the most common example — yin deficiency.

💬 Note from Doctor Luo: A yin-deficient constitution causes all kinds of problems: deficient fire, acne on the face, dry stool, assorted skin conditions, internal deficient heat. Strictly speaking, yin deficiency mostly has to do with constitution — either inherited from the parents or formed over a long time; in fact most cases are related to heredity. Yin deficiency is a state, and to flip it over in one stroke is, strictly speaking, very hard. What to do then? Start with habits of life: eat less spicy food, stay up less, take fewer hot-natured medicines; in food therapy eat more moistening, yin-nourishing ingredients; and with patent medicines — for example Mai Wei Di Huang Wan or Liu Wei Di Huang Wan — regularly take a little yin-nourishing medicine, slowly. No need to take much — just a little at a time.

And Doctor Luo says it plainly: a yin-deficient constitution may be a state of lifelong maintenance.

💬 Note from Doctor Luo: Adjust this state slowly and you will find your body changing. But whether yin deficiency is completely cured — not necessarily. The tongue may still be a little red, yet compared with before it will be much improved, and many symptoms will disappear. So a yin-deficient constitution is a state of lifelong maintenance that must be adjusted slowly, and patent medicines are especially suited to this situation. What, drink a yin-nourishing decoction every single day? I tell you, after two weeks the stomach cannot take it anymore and starts to feel awful — why? The dose is too large. So you see, patent medicines have their advantage: solving the problem a little at a time, gradually turning the pattern around — the effect is also very good.

A real case: breast nodules, eaten away in under half a year

Principles alone are not enough — Doctor Luo tells a real story — breast nodules.

💬 Note from Doctor Luo: My friend’s wife had breast nodules. Western medicine generally says to just observe — some fraction will turn into breast cancer, some say cut them out when it comes to that. She read my articles and asked: can I take Jia Wei Xiao Yao Wan together with a little Ru Pi Xiao? I said yes — her emotions were pent up; her mood really was not good, so take it. She kept taking it, and one day told me: I went back to the hospital for a check, and they were completely gone. How long? Under half a year. Adjusting slowly, a little at a time — Jia Wei Xiao Yao Wan soothes the liver, regulates qi, nourishes blood and strengthens the spleen; what harm is there in that? Ru Pi Xiao opens the meridians and gradually dissolves the nodules, so recovery slowly began.

The thinking behind this is not “attack with a fierce drug” but changing the constitution.

💬 Note from Doctor Luo: A patent medicine adjusts the body state little by little. If you say you want to smash it all down at once and dissolve it in a few days — I think that is very hard. Dissolving it bit by bit is changing the constitution. I do not advocate violent frontal assaults — a violent assault wounds zheng qi. On one side Xiao Yao Wan tonifies the spleen, nourishes the blood, soothes the liver and regulates qi; on the other, Ru Pi Xiao opens the meridians. Watch: slowly the body begins to recover. This recovery is an accumulation of days and months, a tiny bit at a time — and before you know it, the body has improved.

Doctor Luo’s “simple trick”: three doses a day, one cycle to adjust the constitution

What if the body is a tangle of deficiency and excess, cold and heat mixed, and you have gone from doctor to doctor without improvement? Doctor Luo offers a “particularly simple trick” — the morning-noon-night three-dose cycle.

💬 Note from Doctor Luo: When you are truly out of options, let me tell you a very simple trick. It may not strike the precise point every time, but it can still support zheng qi effectively. In the morning, after breakfast — half an hour to an hour after the meal — take Bu Zhong Yi Qi Wan (Tonify the Middle and Replenish Qi Pill): in the morning it generates yang qi and lifts the yang upward. At noon, drain the liver fire with a little Jia Wei Xiao Yao Wan (Augmented Free and Easy Powder Pill). In the evening after dinner, if you are a yin-deficient person, take a little Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) to nourish yin at night — the morning generates yang, the evening nourishes yin. If your yang qi is genuinely insufficient, you can take Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) or Gui Fu Di Huang Wan (Cinnamon and Aconite Rehmannia Pill) instead, to tonify the kidneys and warm yang. Noon corresponds to the liver and gallbladder — when the sun’s yang is at its height, soothe the liver and drain fire. Follow this cycle, take the dose stated on the label — very little.

Many friends who persisted for a while reported back: the constitution improved visibly.

💬 Note from Doctor Luo: Some friends said that before, walking had no strength in it and all day they were dazed and listless — then, as they kept taking it, they seemed to gain a little strength. One day it suddenly struck them: why do I seem to have more energy? — the person was gradually improving. This is low-level repetition: repeat one action, accumulate a little at a time, gradually change the body state, and you can actually absorb something in, absorb some energy. When the body’s zheng qi begins to be sufficient and qi and blood begin to move, a little stagnant blood dissolves easily, a little phlegm damp dissolves easily — when zheng qi is sufficient, the pathogens can gradually be cleared. You see, this kind of slow tonification can sometimes do more than gulping down a few days of decoction. But some people take it for one day and say they feel nothing — you must persist; persist for one or two months and you will see clear improvement.

Patent medicines + external therapies + food therapy: the people’s three treasures of health

So how should ordinary people use patent medicines well? Doctor Luo gives a complete “health trio”.

💬 Note from Doctor Luo: For ordinary people protecting their health: first, master the external therapies — gua sha scraping and moxibustion; everyone should learn at least one technique so they can use it themselves. Second, learn food therapy — how to eat according to your constitution without landing in big trouble. And what else? Use patent medicines too — on the basis of pattern differentiation, a little patent medicine is very helpful for the body’s recovery. The core of patent medicines is that the formulas are all supremely classic, hammered out over a thousand years — like Bu Zhong Yi Qi: formulas that have been forged by a millennium of use. Made into patent medicines for people to take, the prescription is dependable.

What if you cannot modify the prescription? You do not have to.

💬 Note from Doctor Luo: Keep it simple — no modification is fine. Occasionally you do need a tweak: for example, if the dampness is a bit heavy, use a little huo xiang (patchouli) and pei lan (Eupatorium) — steep 6 g of each in water and use that water to wash down whatever medicine you take — clearing dampness on one side while tonifying zheng qi and adjusting the body. All kinds of methods work. Basically, ordinary patent medicines have extremely sensible prescriptions and their effects are quite good.

Granulated herbs: one direction of the future

Now another dosage form is growing ever more popular — granulated herbs (scientific Chinese medicine), concentrated granules in little sachets. How are they?

💬 Note from Doctor Luo: Granulated herbs have some effect — they are all right, but probably a bit less than a decoction. The biggest problem is that they too involve a prescription: what is the level of the doctor who prescribes your granules? Get the direction wrong and drinking them naturally has no effect; get the direction right and, persisted with, they can work even better than patent medicines — a bit less than a decoction, a bit more than a patent medicine. This is one direction of future development. Because it is so convenient — nobody wants to brew a decoction anymore; it is too much trouble, you have to throw away the dregs, and if you are not careful the pot boils dry. Granulated herbs: tear open a sachet, stir it into hot water, and drink — sachet after sachet. Many practitioners now advocate them, and I think they are worth adopting.

The biggest problem with patent medicines: far too few varieties

After all this praise for patent medicines, Doctor Luo candidly points out their biggest problem — too few varieties.

💬 Note from Doctor Luo: The biggest problem with patent medicines today is that the variety is too narrow, too small. In fact, ancient China produced an enormous number of famous formulas. Our country’s regulation is a bit too rigid — it should be relaxed. So many time-tested famous formulas could be approved for production as patent medicines. Take the formula I often use to regulate people’s emotions, Doctor Zhang Zhongjing’s Chai Hu Jia Long Gu Mu Li Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction) — formulas like this are exceptionally effective and excellent. Chinese people are under so much pressure today, and countless people need it — 70 to 80 percent of people need it. A formula like this should be produced! Japan does it well: any of Doctor Zhang Zhongjing’s formulas needs no review, no experiments — they just take it and produce it, so in Japan you can buy Chai Hu Jia Long Gu Mu Li Tang off the shelf. On our side, trying to get this medicine approved is very hard; pharmaceutical companies complain to me that approving a new variety is harder than climbing to heaven.

If it cannot be approved, what should ordinary people do? Doctor Luo offers a workaround.

💬 Note from Doctor Luo: If we want to take a little Chai Hu Jia Long Gu Mu Li Tang but there is nowhere to buy it, let me give you a method — foot bathing. To drink it directly — that I may not be able to judge for you; foot bathing is simpler and safer. But how much better it would be to take the medicine — only we do not have it. This is an area that should be opened up. My prediction: there will soon be a worldwide wave of studying Chinese medicine. After the pandemic, just watch — with such effects, no one will fail to notice. Those foreign pharmaceutical companies are extremely well informed.

Going global: patent medicines are the key to internationalizing TCM

Why is loosening approval a “strategic question”? Doctor Luo does the math on the international stage.

💬 Note from Doctor Luo: A decoction going international is somewhat difficult — it is a big pot of bone soup; will foreigners brew it? Brew it, throw away the dregs, drink it every day — foreigners would probably never accept that. Patent medicines are actually very easy: made as granule infusions, pills, oral capsules — all acceptable to foreigners. Chinese medicine is a blessing for humanity; the whole world should need it. My judgment: after this pandemic, the whole world will recognize the power of Chinese medicine. Foreigners do not yet understand some things, but once they truly understand, they will discover — my goodness, Chinese medicine is this powerful! After the pandemic a wave of the whole world rushing to seize the wealth of Chinese medicine will certainly break out.

This judgment is no fantasy — Doctor Luo tells a true story about a high-school classmate.

💬 Note from Doctor Luo: Before the pandemic, a high-school classmate of mine was chief scientist at Procter & Gamble in the United States. What does P&G mean? A Fortune 500 company, the leader of the daily-chemicals industry, Number One — many of the daily products in our lives are made by them. My classmate told me: we at P&G are not a pharmaceutical company, but we still list researching Chinese medicine as one of our important future directions. Do you see? Even companies that are not pharmaceutical companies are studying Chinese medicine; pharmaceutical companies study it even more eagerly. Foreigners are studying it. If we restrict ourselves — do not produce, do not approve — then there will be no patent medicines; foreigners take Japan’s Chai Hu Jia Long Gu Mu Li Tang, produce it freely, sell it on the street, use it widely; while we Chinese, the ones who want to eat it, have nowhere to buy it. What a pity.

Closing: Li Dongyuan’s cases are done — next comes the patent-medicine series

So in Doctor Luo’s eyes, this matter long ago stopped being the small question of “which medicine to take”.

💬 Note from Doctor Luo: The relevant regulators should loosen approval for Chinese herbal medicines, patent medicines, and health foods considerably. This is a strategic question — we should have more pharmaceutical companies and more varieties available to the people, accumulating more experience. And in the future, as for intellectual property: when foreigners want to use it, we have it here — export it to them. Patent medicines are a very important weapon protecting the people: cheap, convenient to take, genuinely effective when used correctly, and all classic formulas. Put patent medicines to use; friends with body problems will change their constitutions bit by bit and will certainly recover their health. If you have the conditions to drink a decoction every day, the improvement is faster; if business travel makes it inconvenient, or the spleen and stomach are too weak to handle decoctions, then use patent medicines to adjust little by little — the effect is also very good.

Finally Doctor Luo previews what comes next — an important “program switch”.

💬 Note from Doctor Luo: Doctor Li Dongyuan’s spleen-tonifying theory and earth-school case records — that is just about as much as I will tell; a few more sessions and that section ends. Next I may talk with you about patent medicines — for a whole stretch, walking into the pharmacy and introducing as many patent medicines as I come across, hoping you will get to know them well. Thank you, dear friends, for listening. See you next time!

What to take away

A decoction wins the decisive round; a patent medicine consolidates the victory. When the body must turn around immediately, drink a decoction — tang zhe dang ye, it sweeps like an army. Once the situation is controlled, switch to a patent medicine for aftercare.
A decoction hits hard, so diagnosis comes first. Get the direction right and it turns the pattern around; get it wrong and the patient truly suffers. When the pattern is single and clearly seen, a small decoction acts like a needle.
Chronic deficiency and complex tangles are “dug out” like landmines — one at a time. Fill the qi, nourish the blood, dissolve stagnant blood, transform phlegm damp: pull out one landmine at a time, and eventually they are all gone.
A yin-deficient constitution is a lifelong-maintenance state. Nourish yin a little at a time with Mai Wei Di Huang Wan / Liu Wei Di Huang Wan; a daily yin-nourishing decoction will make the stomach rebel within two weeks.
The morning-noon-night cycle for a tangle of deficiency and excess: after breakfast Bu Zhong Yi Qi Wan to raise yang; at noon Jia Wei Xiao Yao Wan to soothe the liver and drain fire; in the evening Liu Wei Di Huang Wan to nourish yin (for yang deficiency, Jin Gui Shen Qi Wan / Gui Fu Di Huang Wan). Low-level repetition, persisted in for one or two months — the constitution visibly improves, and when zheng qi is sufficient the pathogens are cleared on their own.
The people’s three treasures of health: external therapies (gua sha scraping, moxibustion) + food therapy + patent medicines (with 6 g each of huo xiang and pei lan steeped in water to wash down medicine when dampness is heavy).
The big strategic question: patent medicines and granulated herbs — not the hard-to-internationalize decoction — are the key to carrying Chinese medicine to the world. Loosening approval for classic formulas is not a small regulatory matter; it is a strategic one.

Compiled from Doctor Luo Dalun’s special topic on Chinese medicine — opening episode of the patent-medicine series: the art of choosing between decoction and patent medicine.