Identification of Chochukei (Zhang Zhongjing) as the revolutionist of decoctions

ABSTRACT Aim This study verifies Chochukei (Zhang Zhongjing) as the revolutionist of decoctions. Methods We compared the frequency of decoctions in both the Shokanzatsubyoron (Shanghanzabinglun) and recovered literature from before the Shokanzatsubyoron, furthermore we examined the administrations of pills, powders and decoctions. Results Concerning the preparation forms in three recently recovered Chinese pharmaceutical texts dating back to before the later Han, the Gojunibyoho (Wushierbingfang), the Rokujubyoho (Liushibingfang) and the Buikandaiikan (Wuweihandaiyijian), the rate of decoctions was less than 10% in each one. The most frequently used formulas were powders, followed by pills, whereas the basic preparation form in the Shokanzatsubyoron by Chochukei from the end of the later Han was decoctions. Also, decoctions were given at a higher rate in this text, compared to the pharmaceutical literature of later ages. Focusing on the contents of the Shokanzatsubyoron, Chochukei refuted pills and powders, and specified to take decoctions. In addition, a transitional process was taking place from pills and powders to decoctions; the form of decoctions was considered superior, as decoctions realize a maximal therapeutic effect by reducing the burden on patients, allowing many medicines to be taken, and enhancing the strength of the medicinals by taking them warm. Conclusion From an examination of the existing pharmaceutical literature, we could establish that Chochukei developed decoctions that abstract the essence from crude drugs by adding water. He recognized that decoctions were more effective than pills and powders, the main medication in earlier times. We deduce that he was the ‘revolutionist of decoctions’ who developed and established the form of decoctions.