I started making deep decoctions out of necessity. Recently graduated and too broke to set up my own dispensary, I had to find a way to give my patients the medicines they needed. Fortunately, I have access to a remarkable little shop which is at the heart of the local community. Alongside all the usual fare found in any independent wholefood retailer (the brown rice and dairy-free ice lollies, the kamut flour and organic sauerkraut) they stock nearly 300 herbs, from agrimony to wild yam, from Achillea to Zanthoxylum. This wonderful local asset allowed me to supply my patients with the dried herbs and instructions for how to make teas and decoctions. While this works well for some folks, others need the convenience of the nasty tasting medicine in a brown bottle. Further than this, the official Brown Bottle seems engender in some patients a trust in the process of becoming well that a bag of dried herbs cannot give.

During training, we were taught how to make decoctions, and told that a well-made decoction will last for a good while if it’s concentrated. It occurred to me that I might try to make some for my patients. I had a few patients who would not – or could not – take alcohol, and this was more incentive to attempt a decoction process.

I can’t recall all the steps between the idea and the process that I now employ. Once I’d decided to use herbs in this way, it was almost as if the process was teaching me, or as if I was remembering it as I went along. With each new batch, a realisation or understanding came to me that felt like a recollection.

It now seems perfectly obvious to me that these deep decoctions are very nourishing and sustaining for the body; that they are closer to food than to medicine and therefore they are assimilated and used by the body very readily. There being no alcohol, there is no physiological tax, no price to pay by the liver.

While a decoction is brewing or reducing, my whole house is filled with the smell of it. A friend who encountered this rich incense remarked that the medicine was like a spell for my home. And of course the inverse is also true: while imbuing my home with all the magic in the brew, it is also absorbing energy and mood from my home. So long as all is well in my home, all is well with the brew. For this reason, I try to avoid making decoctions when I am unwell or out-of-sorts.

It has been said that whenever a patient takes a medicine provided by a herbalist, they are remembering and once again receiving the supportive attention they experienced in the consultation. I try always to imbue my medicines with my hopes for the enhancement of the healing journey for my patients.

This is a time consuming process. It is no good at all for acute medicine. But in most cases, I can ask my patients to be patient with me, and they seem to like the idea that I am cooking up a special brew for them, made for them alone, something made in my kitchen, to which I have paid close attention for several days.

I treat acute problems with teas, tinctures, and with the promise that I will make a deep decoction to treat the underlying problems.

Results are often remarkable. My star patient was told by his doctor after a set of results: “This simply doesn’t happen”.

Of course the process of learning and developing the technique is far from over – I am eager to pick up new ideas, learn new tricks and add to my knowledge

How to make a deep decoction

Choose your herbs

I like to round off the number of herbs in an appropriate way. If someone needs to be more stable, I’ll choose four, or 8, or 12 herbs. If the problem seems to be more energetic, I may give them 9, 15, or 13 herbs.


While this may seem like an arbitrary approach to prescribing, it does compel me to think about the prescription in terms of the whole, and also to consider the energetic impact of the mix I am making.

I used to avoid polypharmacy, but I find that I tend to use between 9 and 15 herbs in most cases. Of course if a simple is more appropriate, I will use one herb alone.

Quantities

In the beginning, I used to calculate how much of each herb would be equivalent to so many cups of tea each day for a whole month. As a consequence, I was using enormous amounts of herbs. So I stopped. I now use one ounce of each herb, with exceptions made as appropriate. For instance, I may double the amount of a trophorestorative herb such as Avena or Tilia if I think the need is great. And I only use half an ounce of a herb if I’m adding it for purely energetic reasons, for instance mugwort for pathfinding, or horsetail for structure.

The first cooking

I used to decoct the herbs on the stove top, as I’d been taught. Now I like to cook them very slowly in the oven. The heat surrounds the herbs rather than rising from beneath the pot. I use an enormous stainless steel pan with a tight fitting lid, with no vent hole in the lid. I put all the herbs into the pot, and add enough water to allow them to swim about freely. Into the oven it goes for a minimum of four hours on the lowest possible heat. Often the herbs are left to cook overnight.

When the herbs have had a good long wallow at low heat, I turn off the heat and allow the brew to cool down a bit. The whole lot is then strained through a large colander into a steel bucket. I prefer to use steel, since I cannot be sure that a plastic bucket will be food safe. The marc is then returned to the pot for a second cooking.

The second cooking

Why cook it twice? I have no clear rationale for this part of the process. The second cooking seems to go into the herb at a deeper level and fetch out something extra. I’ve made decoctions with a single cooking and they seem thinner somehow, less deep. It is this second cooking that has led me to name the finished product a Deep Decoction.

Sometimes I will only cook the herbs once, for instance when treating a condition that has not settled into a deep pattern, or when treating something at the surface, such as gingivitis. The second cooking is done in the same way as the first, for a minimum of four hours on a very low heat. It is then allowed to cool, and then strained to join the menstruum from the first cooking.

A word about cooling

While the brew is cooling, it is of course also drawing. I see the cooling time as a part of the process.

Pressing out the marc

I used to press the menstruum through a cloth in a colander, squeezing the cloth so that the menstruum ran through my fingers, wrenching the last drops out by hand. I like the way the last drops passed through my hands, I made sure I was properly focused when I was doing this, muttering over my working hands like an old herb mother. But of course this was a lot of hard work and I was missing the last of the menstruum, so I invested in a wine press. Once the marc is pressed out, all the menstruum is passed through a cotton cloth. I choose white cotton, with a high thread count. It’s important that it is strained very well, since any floaters or bits of herb can enable colonies of bacteria to set up home.

When laundering the filter cloths, I only use mild non-detergent washing liquid, and never use a fabric softener or other harsh cleaning agent. My cloths are now stained with turmeric and elderberries and so forth.

I have considered whether to filter the menstruum through a fine filter, such as charcoal, but on reflection it seems to me that such measures may take the decoction one step further away from the plant. I would rather retain as much as possible of the original plant in the medicine.

Reducing the decoction

So now I have several litres of decoction, sometimes as much as eight litres. This goes into a tall, wide stainless steel pot over a low heat and is then allowed to reduce. I never boil it. The surface may tremble, smoke, and even simmer occasionally, but it is not allowed to boil. The menstruum now reduces for many hours, as many as eight or ten. It takes as long as it takes. Every so often, I’ll check it and scrape down the residue from the insides of the pot with a wooden spoon, mix it back into the menstruum, break the skin that might have formed and mix that in. When it gets down to a certain level, I have to watch it quite carefully: it can go from plenty to scorched residue in a remarkably short time. The intention is to reduce it down to less than 500 mls. By the time it gets down to less than a litre, there is so little water in there that it evaporates pretty fast. I keep meaning to scratch a mark into the inner side of the pot so that I know when I’ve reached 500 mls, but without such a mark I measure it by eye. I’ve thought of using a steel ruler, but that is just another implement to keep clean and so forth.

Every decoction is different, and its properties will reflect the herbs. So any mix with Althea in it will be thick and smooth, while one with diuretic herbs is more likely to be more watery. Now that I’ve done plenty of these, and many repeat prescriptions, I am able to say that J’s mix is always quite loose and watery even at the end, while M’s mix is always pretty viscous and thick even at the beginning.

A word about equipment

I have a wooden spoon that is only used for decoctions, so that onions and garlic and cake mix flavour will not taint the medicine. I use only stainless steel pans and strainers. After washing up, I always rinse soap off all equipment before allowing it to dry.

Why reduce it down to less than the required 500 mls?

The finished decoction is poured from the pot into a glass measuring jug. I will always reduce the decoction down to less than the finished 500 mls to give myself room for manoeuvre. At the very least, it allows me to use a little fresh water to rinse out the residue from the cooking pot and add that in – after all, this is hard-earned medicine and I don’t want to waste any of it! Reducing down to less than 500 mls also allows me to make additions to the medicine.

Additions

Of course most of the volatiles will be lost in this process, so I now add back some of those in the form of essential oils, but I’ll only do this if the volatiles are important to the mix. If I want to add aromatic water such as rose water, I’ll reduce the decoction down further than 400 mls and make up the difference with the rose water. If I want to use cleavers or chickweed in the mix, I make a cold decoction with those herbs and then reduce the deep decoction down as far as possible, then make up the difference with the strained cold fresh-plant decoction. Sometimes I’ll reduce the decoction down to less than 400 and add in alcohol as a preservative. I’ll do this if the mix is for infrequent use, for instance a patient who suffers with intermittent insomnia and night cramps. I’ll add tincture to the mix sometimes too. Tinctures seem to go in at a higher level than the decoctions, and this may be a useful addition to the mix.

Decanting the mix

The decoction, if allowed to sit, will separate out into two or maybe three bands. It’s important to mix it up again if it is to be decanted into more than one bottle. I will often give patients two or three smaller bottles so that the mix can be taken to work. It also allows for the patient to store the unused mix in the fridge while using one bottle. As we all know, patients may take a few days (or weeks…) off from a medicine, and I want to be certain that the unused mix is in good shape when they resume the regime.

With tinctures, we can rely upon the alcohol in the medicine to sterilise the bottle. Of course there is no alcohol in deep decoctions, so the bottles and lids must be sterilised, either with alcohol, or Milton sterilising fluid.

Another way to ensure preservation of the decoction is to float some oil on the surface. This is a good idea for those patients who prefer to eschew alcohol. Once the decoction is bottled, add enough good quality oil to seal the decoction from the air. The decoction is shaken well before use, and the oil will then settle back to the surface between doses. If the oil is depleted before the bottle is empty, it is easy for the patient to add a little more oil. I like to use oil that is appropriate to the need, for instance hemp oil if there is a need for Omega 6 & 3, olive oil if Olea europea is indicated. And of course essential oils can be easily carried in such a medium.

Fermentation

Sometimes the deep decoction undergoes fermentation. This can happen very swiftly, for instance when I’ve left the brew straining through the colander for a while. It sometimes happens far more slowly, in the bottle. Whether or not this happens seems to be dependent on ambient temperature, humidity, and pressure at the time of medicine making; in other words, the weather. The first time this happened I was worried and advised the patient to throw away the mix. I then did some research into fermentation and now consider it a beneficial gift. Fermented foods have formed a healthy part of the human diet over millennia, and so long as I know the medicine has been made hygienically and the bottles properly cleaned and sterilised, I have no concerns about fermented medicine. Indeed, some medicines seem to be enhanced by the fermentation process: I’m thinking of starting a Mother that I can then use as a deliberate addition to some of my decoctions. Patients are always warned of the possibility of fermentation and told what to look out for: a fizzy sound when the bottle is opened, a fizzy sensation in the mouth, a sour taste, a reduction in viscosity of the mix. I tell them that it’s not a problem, but if they feel uncomfortable with it, I’m happy to replace the mix. I find that so long as they know in advance of the possibility, they are far less likely to be put off by fermentation. I don’t mean to give the impression that this is a common occurrence. It only happens occasionally, but it is something that should be considered.

Dosage

I advise patients to take one teaspoonful, three times daily, with food (theoretically 5 mls tds). I don’t give out measuring cups, instead I tell my patients to use a normal teaspoon. In effect, I’m asking my patients to find the dose that best suits them. I find (as I’m sure do may other herbalists) that they tend to do this anyway. Some patients take as much as a pudding spoonful three times daily, while others seem to have very tiny teaspoons in their kitchen drawer. Generally, I tend to trust my patients to do what is right for themselves. If they have gone to the trouble of finding and consulting with a herbalist, waiting for their medicine to be made, collecting it, and then they take the bitter nasty-tasting stuff, then it’s fairly safe to assume that they are committed to the process of healing. I believe that their own body is the authority in that journey, and will soon tell them whether they are taking too much or not enough of the mix. For those patients who are weakened and unable to absorb nourishment, or who are terribly sensitive, I advise them to take a few drops of the mix frequently, as often as once each hour, and then – with my input and guidance – graduate upwards to 5mls tds over time. This seems to work well too.

If the taste is an issue, I suggest taking the mix in a little apple juice. Most people, however, accept that medicine is “supposed” to have a challenging taste. Indeed, they often seem reassured that if it tastes bad, it must be good medicine.

At a glance

Choose the herbs: Think about how the herbs will work together. The finished product is more like soup or stock than it is like medicine.

First cooking: In a large pot with plenty of water, cook the herbs in the oven on a low heat for a minimum of four hours. When cool, strain and save the menstruum, and return the marc to the oven with fresh water.

Second cooking: Repeat the cooking process, again for a minimum of four hours at a low heat. Allow to cool and strain, adding the second menstruum to the first

Pressing out: Press out as much of the menstruum as possible and discard the marc, which is an excellent mulch for the garden.

Reduction: In a wide pan, over a very low heat, allow the marc to reduce down to around 400 mls. This will take a good long while. Be careful not to let it scorch!

Additions: The medicine can now be made up to 500 mls buy the addition of water used to rinse out the reducing pot, or any appropriate additions such as essential oils, flower waters or tinctures.

Bottling: Since there is no alcohol in the deep decoction, it is important to sterilise the bottles and lids before decanting.

Fermentation: Sometimes a deep decoction will ferment. So long as the decoction was made and bottled hygienically, this is not a problem. Advise your patients of the possibility of fermentation.

Cristina Cromer

January 2009

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