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Bezoar, Niu Huang 牛黄

Niu Huang (TCM)
Gi Wam གི་ཝང༌  (Tibetan)

Bezoar is a stone from the stomach of a quadraped. Classically, it was from the 'Bezoar-Goat’, Capra aegagrus and related species. In the West, it was differentiated into Oriental (Eastern) and Occidental (Western) varieties, the former being regarded as strongest, the latter coming from Europe, South America etc. Today, the Cow and Ox are the common sources and it commands prices of around US$20,000 per kilo, being still regularly used in Unani, Ayurveda, Tibetan Medicine and TCM. The word 'Bezoar' is derived from Arab origins and means a medicines against poison.

Illustration showing a poisoned victim being administered Bezoar
Ortus Sanitatis, Beck, 1517

'Bezoar Goat', the Traditional source of Bezoar
A Complete History of Drugs, Pomet, London, 1748

Aldrovandi, Musaeum metallicum, 1648
Metallotheca Vaticani, Mercati, 1719
'Oriental Bezoar' (TCM)
'Occidental Bezoar' (from Peru)
Calculus Bovis Artificialis (Synthetic Bezoar) available on the Chinese Market
Parts used:
The Bezoar of various animals have been used.
Traditionally, 2 main kinds of 'true' Bezoar were recognised:
  i. Occidental Bezoar: from Peruvian Lamas
  ii. Oriental Bezoar: from Antelopes or 'Deer-Goats'
Various other animal stones supplied the market including Coromandel Bezoar from 'Sea Cow' or Manatee (Trichecus).
In Tibetan Medicine, Bezoar stones from Cow, Elephants, Pigs and Yak are accepted, while those of Sheep and Goat are inferior. Today, Cattle supply the majority of the Natural Bezoar market.

Temperature & Taste:
Cold, dry. Bitter

Classifications:
2B ATTENUATERS
3A. SUDORIFICS & DIAPHORETICS
3B. FEBRIFUGE & ANTIPYRETIC
3C. ALEXIPHARMICS
4c. CARDIAC
TCM:
B. Clear Heat

Uses:
1. Clears Heat, Resists Poison (West, TCM, Ayurveda, Tibetan Medicine):
-strong heat and poison causing sore throat, diphtheria, sores, boils, carbuncles and toxic swellings;
-Measles, Plague, Small Pox, Fevers.
-all sorts of poisons and venomous Bites
-scrofula and similar nodules, as well as pulmonary abscesses;
-cancers of the breast, lungs etc.

2. Clears Heat and Phlegm, Induces Resuscitation:
-used where extreme heat, or heat with phlegm causes coma, delirium, acute infantile convulsions, apoplectic coma etc. (TCM)

3. Clears Wind, Stops Spasms and Convulsions (West, TCM, Ayurveda, Tibetan Medicine):
-spasms and convulsions from high fever, or phlegm and heat (TCM)
-Vertigo, Epilepsy, Migraine and fainting

4. Moves the Blood, Promotes Menstruation and Birth:
-promote menstruation and give easy birth to women in labor. (West)

5. Clears Stones. (West)
-sometimes recommended for Stones ('like cures like')


DOSE:
Genuine Bezoar in Powder: 150–350mg, up to 500mg (up to 3 grams has been used traditionally).
West ('Occidental') Bezoar is used in doses 30–50% greater than East Bezoar: 200–500mg
Synthetic Bezoar is used in doses of 600mg–1 ½ grams (3–5 times that of genuine Bezoar). However, the version of Artificial 'Cultured' Bezoar listed in the Chinese Pharmacopoeia is used in the same doses as true Bezoar (150–350mg).

PREPARATION OF ARTIFICIAL BEZOAR:
1. Artificial Bezoar is commonly used due to the high cost. It is prepared from Cow Bile, cholic acid, hyodeoxycholic acid, taurine, bilirubin, cholesterol, trace elements etc. Some versions add herbs like Rhubarb and Coptis or Gentian. (Chinese Pharmacopoeia).
2. 'Cultured' Bezoar are now listed in the Chinese Pharmacopoeia. Fresh Cow Bile with deoxycholic acid, cholic acid, compound calcium bilirubin and other ingredients added and mixed to form a stone half–3cm in diameter. The dose is the same as a the standard product.

Main Combinations:
1. Infantile Fever, Bezoar with Saffron and Tabasheer (as in Powder for Childrens Fever)
2. Childhood Convulsions, Febrile Convulsions:
i. Bezoar, Indigo Qing Dai, with Gastrodia Tian Ma
ii. Bezoar with Peony, Mistletoe, Pearl, Amber, Red Coral (as in Powder for Childhood Convulsions)
iii. Bezoar, Tabsheer, Pearl, Sandalwood
3. Liver Heat:
i. Bezoar with Sandalwood, Tabasheer, Safflower, Swertia, Picrorrhiza (Tibetan Medicine)
ii. Bezoar with Shilajit, Safflower, Swertia and Costus (Tibetan Medicine)
4. Resists Poison and Infection, Bezoar with Pearl, Red Coral and Crab Claws (as in Bezoardic Powder)
5. For Heat and Toxin Fever, Inflammation, acute Sore Throat, Toothache, Headache oral Ulcers etc., Bezoar with Rhubarb, Gypsum, Coptis Huang Lian, Scutellaria Huang Qin, Licorice and Borneol (as in Niu Huang Jie Du Pian , a commonly used Chinese Patent Medicine)
6. To clear Heat and Toxin:
i. Bezoar with Rhinoceros (Water Buffalo) horn, Realgar, Cinnabar, Pearl, Coptis, Borneo Camphor (as in An Gong Niu Huang Wan of TCM). This is used for serious infections including Encephalitis, Meningitis, acute Hepatitis, Pneumonia in cases with High Fever.
ii. Boils, Carbuncles, multiple Abscess, Lymphadenitis, Bezoar with Frankincense, Myrrh and Musk (as in Pills of Bezoar, TCM)
iii. Boils, Carbuncles, Sore Throat, Tonsillitis, Mouth Sores: Bezoar, Pearl, Musk, Toad Venom, Bear (Cow) Bile, Realgar, Cinnabar, Borax, Frankincense, Myrrh, Dragons Blood, Borneo Camphor (as in Dian She Wan)
7. Acute severe Sore Throat, Tonsillitis, Pharyngitis from Heat-Toxin:
i. Bezoar with Coptis Huang Lain, Borneo Camphor (Bing Pian), Licorice, Sophora Shan Dou Gen, Pearl, Indigo (Qing Dai) (as in Shuang Liao Hou Feng San)
ii. Bezoar with Pearl, Musk, Toad Venom (Chan Su), Realgar (Xiong Huang), Borneo Camphor (as in Liu Shen Wan)
iii. Laryngitis, Bezoar with Coptis Huang Lian, Pearl powder, Bile and Borax (TCM)
8. Toxic Boils, Carbuncles, Purulent Skin diseases, Scrofula, Bezoar with Frankincense, Myrrh, Musk (as in Xi Huang Wan)
9. Chronic Fever, Chronic Lung Infection, Bezoar with Tabasheer, Safflower, Swertia, White Sandalwood, Picrorrhiza, Aconitum heterophyllum, Adhatoda (as in Principle 8)
10. Cerebral Thrombosis, Bezoar with Leech and Antelope horn (Ling Yang Jiao) (TCM)

Major Formulas:
The White Powder
Powder for Childhood Convulsions
The Goa Stone

An Gong Niu Huang Wan
Bo Ying Compound
Dian She Wan
Liu Shen Wan
Niu Huang Jie Du Pian
Shi Xiang Fan Sheng Wan
Shuang Liao Hou Feng San
Xi Huang Wan
Zhen Xiang Jiao Nag (Precious Aromatic Capsules) (TCM)
Zhi Bao Dan

Bezoar 9 (Gi wang pa)
Bezoar 13 (Gi wan 13) (Tibetan Medicine)
Bi Ma La (Tibetan Medicine)
Chebula 18 for Urinary Incontinence (Gcin snyi a ru 18)
Crystal Moon 37 (Zla shel so bdun) (Tibetan Medicine)
Emblic 25 (Skyu ru nyer lnga) (Tibetan Medicine)
Pearl 25 (Mu tig nyer lnga) (Tibetan Medicine)
Principle 8 (Gtso bo brgyad pa) (Tibetan Medicine)
Principle 25 (Gtso bo nyer lnga) (Tibetan Medicine)
Powder for Childrens Fever (Tibetan Medicine)
Sandalwood 18 (Tibetan Medicine)
Wish-fulfilling Jewel (Bsam phel nor bu) (Tibetan Medicine)

Cautions:
1. Not used during Pregnancy
2. Only used for conditions with Heat or Poison

Main Preparations used:

Salmon, Seplasium:
It is called Belu Zaar in Hebrew ie. dominus veneni; Hager Bezaar in Arabic ie. Lapis Bezoar; Lapis or Lithos Bezoar in Latin and Bezoar in English.

It is brought from Persia, and from East and West Indies; from China, Peru, Chili, Brazil, Mexico, America and other places. It comes to Constantinople from Persia, from Calicut to Portugal, and from Peru to Spain.

Two main types are differentiated: Oriental and Occidental, the former being better. The Oriental are also differentiated by their color: Greenish-Black, Yellow, Brown and Greenish, the two latter types being best.

The Occidental are of various sizes, brown, yellowish-brown, fox-colored or 'piss burnt color', some almost olive colored. They are various sizes, typically as big as a Nutmeg, hollow, containing a little powder. The best being Greenish or Greenish-black.

The best types held in the mouth or put in water dissolve leaving no sand. These are hollow in the middle containing a little sandy dust within which also dissolves.

They are found in the stomach of the Deer-Goat. Other similar types of Goats and quadripeds were used as the source in different parts, and Salmon said those from the West Indies came from a type of Deer. In modern times, the Cow is the principle source.

Baccius said it is neither hot nor cold, nor moist or dry. Most regarded it as Cold and dry.

Used for all types of Fever: Continual, Intermittent, Malign or Pestilential [from the Plague]. Used for Plague and Epidemic Fevers, Measles, Small Pox, Spotted Fevers, and all manner of Poison and Contagion. It was also said to prevail against the poison of Napellus
(Aconite). Agricola said it is good for venomous bites
such as those of Snakes and Rabid Dogs.

'It mightily strengthens the Heart', and is good for Palpitations, Melancholy, Epilepsy, Syncope, Fainting etc. and all chronic diseases proceeding from acidity.

'It is said to restore in Consumptions, and to increase strength and flesh' ... it 'revives the Spirits, refreshes nature and strengthens the whole body'. It was recommended by some for Pneumonia and Pleurisy.

Also good for loss of Appetite, Colic, abdominal pain and Dysentery.

Amatus said it cures pain of the sides even though violent (possibly acute cholecystitis).

Acosta said it promotes Urine and the viscid matter from the Bladder. Cesalpinus said its good for Uterine diseases and obstructed Menstruation. Rod a Castro said it facilitates and hastens Labor, and the powder helps ulcerated Cancers when applied.

It is also given for Worms, killing and expelling them.

Monardus said the Occidental Bezoar form Peru could be used in the same doses as the Oriental.

Dose: 10 grains–1 dram in an appropriate vehicle such as distilled water or essence of Balm, Angelica, Borage, Blessed Thistle, or in wine etc.

Salmon said the best Oriental green Bezoar cost 30 to 50 shillings per ounce, but with the plentiful Occidental Bezoar their price had fallen to 20 shillings, the Occidental selling for 5–12 shillings per ounce.

He says they are often adulterated and counterfeited with dried blood, chalk, earth, cinnabar etc.