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Bear / Cow Bile

Xiong Dan 熊胆 (Bear Bile, TCM)
Niu Dan 牛胆 (Cow Bile, TCM)
Dom mkhris  དོམ་མཁྲིས  (Bear Bile, Tibetan Medicine)
Dried Cow Gall Bladder as used in Tibetan Medicine in place of Bear Bile. (Adam, 2016)

Zoological name:
Traditionally, Bear Bile has been used in both East and West:
  1. Ursus arctos (European Brown Bear)
  2. Ursus thibetanus (Asian Black Bear)
  3. Others such as the American Black Bear (Ursus americanus)
However, modern substitutes use other animals including:
  1. Cow, Bull
  2. Sheep, Pig, Goat
  3. Rabbit bile has been demonstrated to have similar efficacy.

Parts used:
Often the Gall Bladder is listed, rather than the Bile. However, if Gall Bladders are used, they are dried with their Bile, the Bile still being the most active component.
Bear Gall Bladder / Bile (Traditional)
Cow (or other) Gall Bladder / Bile (Modern)

Temperature & Taste:
Cold, dry. Bitter (TCM)
"All types of gall bladders are hot and dry in the fourth degree"  (Avicenna)

Uses:
1. Clears Liver Heat, Stops Spasms: (TCM, West)
-Childhood Convulsions, Epilepsy (TCM, West);
-Paralysis (West)
-Eclampsia
-Delirium
-Hepatitis, Jaundice
-"Twenty Drops of Bull's Gall [Bile], taken at a time in some Antepileptic Vehicle, also snuft up the Nostrils, saith Rhasis, help to cure the Falling Sickness [Epilepsy]". (Medicinalis Hibernica, K'eogh, 1739)

2. Clears Heat, Resists Poison: (TCM, West)
-all types of Fever and Poison (Salmon)
-Venomoud Bites, especially Snake bite.
-Spotted Fevers including Measles (Siddha)
-Hot-toxin Sores, Carbuncles, Furuncles, Lesions
-acute severe Sore Throat
-topically to alleviate pain including Hemorrhoids
-"It was well known to the ancient Hindus that bile mitigates the action of snake venom" (Nadkarni, Indian Materia Medica)

3. Clears Heat, Benefits the Eyes: (TCM, West)
-severe red, painful, swollen eyes; conjunctivitis, nebula (topically and internally)
-'Films, Clouds, Pin and Web, Pearls, or other diseases which hurt the Sight' (Salmon)
-"cures most Disorders of the Eyes if curable". (Medicinalis Hibernica, K'eogh, 1739)

4. Childhood Nutritional Impairment: (TCM, West)
-used for various types of nutritional impairment in Children
-Salmon said taken with Stomach Tincture it 'warms and restores the Body'. (Seplasium)

5. Constricts the Vessels, Heals Nerves:
-special effect of constricting the mouth of the vessels (Tibetan Medicine)
-promotes growth of damaged nerves (Tibetan Medicine)

6. Externally:
-applied to red, sore, swollen eyes
-Wounds, Ulcers, Fistulas, Cancers (West)
-applied to clear Freckles, Spots, Pigmentations, Scurf, Sunburn and similar skin deformities
-"The Tincture extracted from the Gall [Bile] of a Bull, is a most excellent Cosmetic, for it wonderfully beautifies the Skin , making it veгу white". (Medicinalis Hibernica, K'eogh, 1739)
-dropped in the ears for Deafness and Tinnitus
-"The Gall [Bile] mixt with Women's Milk, or Hydromel, cures the Pain, and Noise of the Ears, and Ulcers of the same, being applied to them with Cotton". (Medicinalis Hibernica, K'eogh, 1739)
-topically to Toothache
-stops necrosis, promotes growth of new flesh (Tibetan Medicine)


Dose:
Used in Pills and Powders; also used externally.
Bear Bile (Traditional): 1–2 grams; the dose in the West for Bear Bile was 1 scruple (1.3 grams)
Cow (or other) Bile: 1.5–3 grams

Comment:
1. Bear Bile, although still available on the Chinese market, should be totally avoided due to the endangered nature of some species, particularly in Tibet and China, but mostly due to the cruelty associated with farmed Bear Bile. The efficacy of other animal Bile, although requiring a larger dose, means that there is no reason to continue using Bear bile.
2. It should be noted that Bear Bile was also previously highly regarded as a medicine in northern European countries. Salmon (Seplasium, 1693) says 'the Norwegians esteem it as a panacea in all diseases'

Substitutes:
1. As stated above, Cow Bile or Gall Bladder is typically used as a substitute for Bear Bile. Other animals including Sheep, Goat etc.
2. Recent research has shown Rabbit Bile to be useful and effective as a substitute for Bear Bile, having very similar therapeutic effects
3. Saussurea likiangensis and S. pachyneura (Kon pa gab skyes) is typically used as a vegetable substitute for Bear Bile in modern Tibetan Medicine.
4. A mix of Yellow Chre, Veronica ciliata and Sugar has been used. (Tibet)
5. Ursodeoxycholic acid can be used.
6. Suggested Plant substitutes include Gardenia Zhi Zi, Scutellaria Huang Qin, Coptis Huang Lian, Phellodendron Huang Bai, Andrographis Chuan Xin Lian and Rhubarb (Da Huang). These were suggested to be used either singly or in combination. (see research below)

Preparation:
"Dioscorides advised that the gall bladder should be bound on both sides when it is boiled in water for a period of time in which three meals are taken by a man. It should then be taken out and left to dry in a shadowy place. When it becomes moistureless, it should be preserved for future use". (Avicenna)

Main Combinations:
1. All types of Fever and Poison:
i. Bear (Cow) Bile, Bezoar, Cochineal, Camphor (Salmon)
ii. Bear (Cow) Bile, Bezoar, Tabasheer, Pearl, Red Coral, Camphor
2. Febrile Convulsions in Children:
i. Bear (Cow) Bile with Curcuma Yu Jin, Alum (TCM0
ii. Bear (Cow) Bile, Pearl, Tabasheer
3. Measles, Ox Bile (0mg) taken with water. (Siddha)
4. Epilepsy:
i. Bear (Cow) Bile, Peony, Mistletoe, Amber
ii. Bear (Cow) Bile was taken with the salt extracted from a Man's Skull (West)
5. Hepatitis, Jaundice:
-Bear (Cow) Bile with Artemisia Yin Chen Hao
6. Severe red, painful, swollen eyes:
i. Bear (Cow) Bile with Borneo Camphor, applied topically (TCM)
ii. Bear (Cow) Bile, Pearl, Coptis Huang Lian as eye drops. (TCM)
7. Fire Toxin causing Carbuncles, severe painful and swollen throat, mouth, tongue or gums:
i. Bear (Cow) Bile with Picrorhiza (Hu Huang Lian), Coptis Huang Lian, Catechu, Borneo Camphor (Bing Pian), Bezoar (Niu Huang), Musk (She Xiang) (as in Wan Ying Ding)
ii. Bear (Cow) Bile with Bezoar (Niu Haung), Pearl (Zhen Zhu), Toad Venom (Chan Su), Realgar (Xiong Huang), Cinnabar (Zhu Sha), Borax (Peng Sha), Frankincense (Ru Xiang), Myrrh (Mo Yao), Dragons Blood (Xue Jie), Borneol (Bing Pian) (as in Dian She Wan)
8. Films and obstructions of the eyes, Bear (Cow) Bile (1 oz.), with Honey, Tincture of Aloes (½ dram each), and Verdigris (10 grains); form a collyrium (Salmon, Seplasium)
9. Wounds, Fistulas, Bear (Cow) Bile, made into an ointment with oil, wax and turpentine (Salmon)
10. Freckles and Spots, mixed with equal amount of Brandy and applied topically (West)
11. Scars, mix Rocket juice with Ox Bile and apply often. (The Secrets of Alexis, 1615)
12. Toothache, Bear (Cow) Bile mixed with Tincture of Opium and applied topically (West)

Major Formulas:
Antelope Horn 14 (Rgya ru bcu bzhi) (Tibetan) 
Auscpicious Conqueror (Bkra shis rnam rgyal) (Tibetan)
Barberry 8 Powder (Skyer sun brgyad pa) (Tibetan)
Bezoar 13 (Gi Wan 13) (Tibetan)
Black Camphor 10 (Gar Nag 10)
Calcite 35 (Cong Zhi 35)
Calm the Shocked Mind 20 Pills (Mogolian)
Cantharide 37 (Tibetan)
Chebula 18 for Urinary Incontinence (Gcin snyi a ru 18) (Tibetan)
Cliff Garuda Pill (Brag Khung Ril Bu)
Conqueror of Brown Phlegm (Smug po gyul rgyal) (Tibetan)
Crystal Moon 37 (Zla shel so bdun) (Tibetan)
Goethite 25 (Mdung rtse nyer lnga) (Tibetan)
Great Precious Iron Pill (Rin chen lchags ril cheng mo) (Tibetan) 
Great Precious Purified Moon Crystal Pill (Rin chen tso bkru zla shel) (Tibetan)
Possessor of Ruby Color (Pad rag mdog ldan) (Tibetan)
Precious and Great Multi-Jewel Compound Pill (Rin chen mang sbyor chen mo) (Tibetan)
Safflower 8 (Gur Gum 8)
Safflower 9 (Gur Gum 9)
Shilajit 9 (Brag zun dgu pa) (Tibetan)
Universal Conquering Vajra (Tibetan)

Dian She Wan (TCM)
Wan Ying Ding (TCM)

Cautions:
Only used for Heat diseases; contraindicated in deficiency

Main Preparations used: