The standard proportions for both infusions and decoctions are 25 grams of dried herbs to 500 ml of water. This converts to 5 doses, a single dose being equivalent to 5 grams of dried herbs in 100 ml (1 cupful) of water.

For single herb remedies this can be adjusted according to the strength required. Thus a weak dose would be 2 grams of dried herbs to 100 ml of water (or 10 grams to 500 ml for 5 doses), and a strong dose would be 5 grams to 100 ml (or 25 grams to 500 ml for 5 doses).

For compound formulas using several herbs, the herbs should be combined by weight in the ratios indicated, their total weight being equal to the standard proportions of 25 grams of dried herbs to 500 ml of water.

2 parts     Elder flowers

2 parts     Peppermint herb

1 part          Yarrow herb

Infusion:     3 cups per day

Thus in the above example 1 dose would be: 2 grams each of Elder flowers and Peppermint and 1 gram of Yarrow mixed together in 100 ml of water. Prepared as a larger amount, enough for 5 doses, there would be: 10 grams each of Elder flowers and Peppermint and 5 grams of Yarrow mixed together in 500 ml of water.

Herbal infusions and decoctions can be sweetened to taste with honey or sugar. Individual doses can be made up one at a time, or a larger amount may be prepared if desired. After the first dose is taken the remainder should be covered and stored in the refrigerator or a cool place. Subsequent doses should be gently reheated — but without boiling. Infusions and decoctions are not normally kept longer than a day or two, as they tend to go off.

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Infusion

This method is used to extract water-soluble substances from the finer, more delicate plant materials such as leaves, stems and flowers. It is also sometimes used for barks, seeds, roots and rhizomes when these are finely cut or powdered.

The method, much like making a pot of tea, consists of pouring 500 ml of boiling water onto 25 grams of finely cut dried herbs and allowing it to steep in a covered vessel with a properly sealed lid. The lid keeps in volatile oils which otherwise would be lost through evaporation during the ten to fifteen minutes normally required for infusion.

After straining, the liquid may be taken straightaway (a warm or hot infusion), or allowed to cool completely before use (a cold infusion). A hot infusion is normally preferred, and it is always used with diaphoretic or stimulant herbs, as it tends to enhance their action.

The standard adult dose is 100 ml (1 cupful). Normally 3 doses are taken per day, usually before meals.

Decoction

Among hard or woody plant materials such as roots, rhizomes, barks and seeds there are some which require prolonged hot water treatment to release their water-soluble constituents. Decoction is essentially a form of simmering, and the materials, rather than used whole, should first be cut, crushed, broken open or otherwise rendered into small pieces suitable for simmering.

The method consists of adding 25 grams of dried herbs to 500 ml f cold water and allowing to soak for ten minutes. The mixture is heated to boiling point and simmered for ten to fifteen minutes. It is then left to steep for a further ten minutes or so. During the entire process the vessel is kept covered. The mixture is strained and the plant residue discarded. The liquid is then ready for use.

The standard adult dose is 100 ml (1 cupful). Normally 3 doses are taken per day, the same as for an infusion.

Combining Decoctions and Infusions

Sometimes a herb formula will combine roots or barks that require decoction with leaves or flowers that require infusion. In such cases a decoction is first made with the coarser materials, then strained and poured over the finer materials. This is then steeped in a covered vessel, as for a normal infusion, for ten to fifteen minutes.

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This is all part of being your own advocate. It doesn’t mean that you have to be militant, or obnoxious, or that you should call your doctor in the middle of the night just to chat (please don’t!).

What it does mean, however, is that you have certain rights. If you have a question or problem during office hours, by all means, go ahead and call; you may not always get the doctor, but you’ll get somebody who can help.

And if you have a problem that you don’t think can wait until morning, call at night. Most doctors have 24-hour answering services; many doctors have partners who share “on-call” time—they split it up, each taking a certain number of nights, weekends and holidays a year. They do this because they expect to get some calls at night, because they know from years of training and experience that medical emergencies don’t always happen during office hours.

This won’t be the first phone call your doctor gets in the middle of the night, and it certainly won’t be the last. What would you rather do—wind up in the hospital as a result of a serious complication that should have been treated hours ago, or “bother your doctor?”

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Because patients are in and out of the hospital so fast these days, it’s likely that any post-surgical trouble you experience will occur when you’re at home. That’s why it’s essential that you and your family be aware of the warning signs of a clot in the leg or a clot that has gone to the lung. You may have a clot if you have swelling or tenderness in the leg, especially in the calf. Signs of a clot in the lungs include sudden chest pain—especially pain that gets worse when you take a deep breath—and coughing up blood. If you have any of these signs, call your doctor immediately’. Don’t wait for your doctor’s office hours if this happens in the middle of the night. If you can’t get to your doctor, go to an emergency room and tell the doctor there that you need to be evaluated for deep venous thrombosis or pulmonary embolism. Early treatment with anticoagulant medications generally takes care of the problem with excellent results. But if diagnosis—and therefore, treatment—is delayed, it’s possible that a large clot to the lungs could be fatal.

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Important: If you have ever before had a blood clot, make sure your doctor knows about it. This could influence the way your anesthesia is administered. Also, men considered at higher risk of developing a blood clot may have a stronger blood-thinning medication administered by IV throughout their stay in the hospital. These preventive treatments are highly successful in preventing a blood clot from forming in the lungs.

Exercise is another crucial factor in helping to avert blood clots. Walking is good; it pumps blood back to the heart. Walk as soon as you’re allowed to after surgery. Your doctor probably will encourage you to do dorsiflexion exercises —pumping your feet up and down to exercise the calf muscles. Do them often, about 100 times an hour in between naps. Also, it’s a good idea not to sit upright in a firm chair (with your legs hanging down) for more than an hour at a time during the first four weeks. Try to sit with your legs elevated on a sofa, reclining chair, or comfortable chair with a footstool, as much as possible. This accomplishes two goals: One, because it raises your feet, it improves the blood flow from the veins in your legs. Two, it protects the area of surgery from bearing your full weight.

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