The Spirit Goes to the Bone

On Lóng Gǔ and Mǔ Lì

Dragon and oysters, just like it says on the tin…

I got an email from a reader asking about the formulas containing Lóng Gǔ and Mǔ Lì [a.k.a Dragon Bone and Oyster Shell], specifically if the two-herb combination is somehow related to the skin. I went digging around the mulch pile, and, while I can’t say I found much of anything that directly relates to the skin, I did find some bits that might possibly be relevant. Or possibly not.

We’ll take this in stages: first we’ll look at the standard contemporary materia medica, then some formulas, and finish up by going back to some late imperial texts, including a commentary on the Divine Farmer’s Materia Medica Classic.

Contemporary Materia Medica

Wiseman & Brand (2020) describe a modern consensus view on these medicinals. To summarize:

Lóng Gǔ - 龍骨 - Fossilia Ossis Mastodi - Os Draconis - Dragon Bone

·       Category: Spirit quieting agent

·       Sweet, astringent, balanced

·       Enters heart, liver, kidney

·       Settles fright and quiets the spirit: Restlessness, insomnia, palpitations, mania-withdrawal

·       Calms the liver and subdues yáng: Agitation, irritability, dizziness, tinnitus

·       Contracts and astringes: Prevents leakage of fluids

·       Generates flesh, use topically for non-healing wounds and sores

·       [The tooth, Lóng Chi, and the horn, Lóng Jiao, are also used; their properties are similar]

Mǔ Lì - 牡蠣 - Concha Ostreae - Oyster Shell

·       Category: Liver-calming wind extinguishing agent

·       Salty, astringent, slightly cold

·       Enters liver and kidney

·       Calms the liver, subdues yáng: Dizziness, tinnitus

·       Softens hardness, disperses binds: Scrofula, goiter

·       Quiets the spirit: Insomnia, palpitations

·       Astringes and secures: Sweating, enuresis, flooding and spotting, vaginal discharge, seminal emission

Between the two ingredients, there are a couple of skin- or surface-related indications. Both have astringent properties. Lóng Gǔ treats sores and Mǔ Lì secures the exterior and checks sweating.

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Prescriptions containing Lóng Gǔ and Mǔ Lì

The question was specifically on formulas containing Lóng Gǔ and Mǔ Lì. The main ones with which everyone is familiar are:

·       Chái Hú Jiā Lóng Gǔ Mǔ Lì Tāng 柴胡加龍骨牡蠣湯 - Bupleurum Decoction plus Dragon Bone and Oyster Shell

·       Guì Zhī Jiā Lóng Gǔ Mǔ Lì Tāng - 桂枝加龍骨牡蠣湯 - Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell

Both of these formulas have their origin in Shāng Hán Zá Bìng Lùn, with of course a long and involved history since that time. I readily admit to not being a jīng fāng guy, so I won’t go too far into that and let someone who is more of a classical scholar chime in if they like.

·       Chái Hú Jiā Lóng Gǔ Mǔ Lì Tāng is indicated for “vexation fright and delirious speech that are the result of precipitation being inapproprietely used in a cold damage pattern and the evil entering the lesser yang.” (Mitchell et al., 1999). The role of Lóng Gǔ and Mǔ Lì are generally given as “heavy settlers” to anchor and calm vexation-fright. I mostly see it used nowadays for things like palpitations, panic attacks, drug withdrawal, hypertension and so forth, as long as they fit the general pattern of repletion heat in the shàoyáng with wiry rapid pulse, fullness in the chest, subcostal tightness, and red tongue.

·       Guì Zhī Jiā Lóng Gǔ Mǔ Lì Tāng is for a vacuity-type presentation. Its indications according to Wiseman & Wilms (2013) are seminal loss, stringlike tension in the lower abdomen, cold in the glans penis, clear diarrhea, dizziness, hair loss, sexual dreams, and and empty hollow [scallion-stalk] pulse from dual vacuity of yīn and yáng. Other indications I have seen are easy startle response, palpitations, insomnia and so forth. There are also indications for leakage of fluids, including sweat, which is as close as I can see to a surface indication. The formula has long fascinated me because it is still a prescription to harmonize the yíng and wèi, but with rocks attached to it to make it sink so it will work at a deeper level.

Older Materia Medica Sources

Let’s take a look at a couple of pharmacopoeias from the late imperial period. I always find it interesting to see the evolution of the medicinal information we have today, and what information didn’t get included in our modern curricula. Sometimes there are valuable insights that may have been overlooked in the centuries since their composition. First we’ll look at some excerpts from the Běn Cǎo Bèi Yào (Essentials of Materia Medica) by Wāng Áng (1694).

龍骨

澀，瀉，固腸，鎮驚

甘澀微寒。入手、足少陰（心、腎）、手陽明（大腸）、足厥陰（肝）經。能收斂浮越之正氣，澀腸益腎，安魂鎮驚，辟邪解毒。治多夢紛紜，驚癇瘧痢，吐衄崩帶，遺精脫肛。利大、小腸，固精止汗，定喘（氣不歸元則喘）斂瘡，皆澀以止脫之義（《十劑》曰：澀可去脫。牡蠣、龍骨之屬是也）。

Lóng Gǔ

Astringes, drains, secures intestines, subdues fright

Sweet, astringent, slightly cold. Enters hand and foot shàoyīn (heart and kidney). hand yángmíng (large intestine), foot juéyīn (liver) channels. Can restrain and inhibit floating and outthrusting of the correct qi, astringes intestines and boosts the kidney. calms the hún [ethereal soul] and subdues fright, wards off evil and relieves toxicity. Treats profuse confused dreaming, fright epilepsy, malarial dysentery, spitting blood, flooding and discharge, seminal emission and rectal prolapse. Disinhibits large and small intestines, secures essence and stops sweating, settles wheezing (qì unable to return to the origin resulting in wheezing), shrinks sores; as an explanation of [how] all astringents stop desertion, "Shí Jì" says astringents can eliminate desertion, this is the category of Lóng Gǔ and Mǔ Lì).

牡蠣

澀腸，補水，軟堅

咸以軟堅，化痰，消瘰癧結核，老血瘕疝；澀以收脫，治遺精崩帶，止嗽斂汗（或同麻黃根、糯米為粉撲身，或加入煎劑）固大、小腸；微寒以清熱補水，治虛勞煩熱，溫瘧赤痢，利濕止渴，為肝、腎血分之藥 。

Mǔ Lì

Astringes intestines, supplements water, softens hardness

Salty [flavor] is used to soften hardness, transform phlegm, reduce scrofula and subcutaneous nodes, old blood conglomerations and mounting [i.e. hernia]; astringents are used to astrict desertion, to treat seminal emission, flooding and vaginal discharge, stop cough and restrain sweat (or along with Má Huáng Gēn [Rx Ephedrae], Nuò Mǐ [Sm Oryzae Glutinosae, sticky rice], make a powder to apply to the body, or add to decocted prescription), secures the large and small intestine; [it is] slightly cold to clear heat and supplement water, to treat vacuity taxation vexation heat, warm malaria and red dystentery, disinhibit dampness and stop thirst, and is a medicinal of the liver and kidney blood aspect.

Comment:

• We can see here a lot of similarity with the modern pharmacopoeia in terms of the actions and indications, perhaps with a little more mention of supplementing and boosting functions.

• Lóng Gǔ has a specific action on anchoring the hún, the spirit of the liver, and is more of a calming substance, being sweet. Mǔ Lì, being salty, has more of a reducing effect. Both, of course, are astringing.

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Back to the Origin

Now let’s look at the Běn Cǎo Jīng Jiě (Materia Medica Explanation), attributed to Yè Tiānshì in 1724. I find this text fascinating for a couple of reasons. Number one, I am a big fan of Yè Tiānshì; and number two, even if Yè didn’t actually write this (which is always possible), the text consistently presents perspectives on the materia medica that aren’t usually mentioned in the standard herb manuals of today.

The book closely follows the Shen Nong Ben Cao Jing [The Divine Farmer’s Classic of Materia Medica], which is the origin of our pharmacopoeia, and explains the medicinal information in it, adding channel entry and other details that evolved later. The version here is mulched, but I couldn’t help but borrow some of the term set from Sabine Wilms’ delightful 2017 translation of the Divine Farmer’s Classic, the passages of which are italicized here.

【龍骨】

氣平味甘。無毒。主心腹鬼疰。精物老魅。咳逆。泄痢膿血。女子漏下。癥瘕堅結。小兒熱氣驚癇。

Lóng Gǔ

Its qì is balanced, its flavor sweet. Non-toxic. Masters ghost diseases of the chest and abdomen, spectral entities and old forest demons. Counterflow cough. Women’s vaginal leakage. Concretions and conglomerations, hardness and binding. Pediatric heat qì, fright and epilepsy.  

龍骨氣平。稟天秋收之金氣。入手太陰肺經。味甘無毒。得地中正之土味。入足太陰脾經。

Lóng Gǔ’s qì is balanced. It is endowed by heaven with the metal qì of the autumn harvest. It enters the hand tàiyīn lung channel. Its flavor is sweet and it is non-toxic. From the soil it [receives] the equitability and uprightness of the earth flavor. It enters the foot tàiyīn spleen channel.

龍為東方之神。鱗蟲之長。神靈之骨。入足厥陰肝經。氣味降多於升。陰也。

The dragon is the shén-spirit of the eastern direction. It is chief among scaly creatures. Its shén-líng [yīn and yáng spirit] goes to the bone. It enters the foot juéyīn liver channel. Its qì and flavor are more downbearing than upbearing. It is yīn.

心腹太陰經行之地也。太陰脾氣上升。則肺氣下降。位一身之天地。而一切鬼疰精魅不能犯之矣。龍骨氣平益肺。肺平則下降。味甘益脾。脾和則上升。升降如。而天地位焉。所以祛鬼疰精物老魅也。

The chest and abdomen are the grounds [through which] the tàiyīn channels travel. The tàiyīn spleen channel qì ascends, while lung qì descends. Heaven and earth are arranged [this way] throughout the body, and altogether ghost disease, specters and forest demons cannot attack. Lóng Gǔ’s qì is balanced which boosts the lung. If the lung is balanced then it will downbear. The flavor is sweet which boosts spleen qì. If the spleen is harmonized, then it will upbear. In accordance with this ascending and descending, heaven and earth thus take their proper places. As a result, the ghost disease, spectral entities, and old forest demons are dispelled.

咳逆者肝火炎上而乘肺也。泄痢膿血清氣下陷也。女子漏下肝血不藏也。龍骨。味甘可以緩肝火。氣溫可以達清氣。甘平可以藏肝血也。脾統血。癥瘕堅結。脾血不運而凝結也。氣溫能行。可以散結也。

Counterflow cough is liver fire blazing upward and overwhelming the lung. Dysentery with pus and blood is clear qì sinking downward. Women’s vaginal leakage is liver blood unable to be stored. Lóng Gǔ’s sweet flavor can moderate the liver fire, and the qì’s warmth can reach the clear qì. Sweet and balanced can store liver blood. Spleen controls the blood. Concretion, conglomerations and hard bindings. Spleen blood unable to transport then becomes congealed and bound. The qì’s warmth is able to move it and can scatter the binds.

小兒熱氣驚癇。心火盛。舍肝而驚癇也。驚者平之。龍骨氣平。所以可平驚也。 Children’s heat qì, and fright epilepsy. Fright epilepsy is heart fire exuberance abiding with the liver. Fright [must be] calmed and Lóng Gǔ’s qì is balanced [i.e. calm], thus it can calm the fright.

Comment:

·       “Spectral entities” is from Wilms (2017), and I can’t imagine a better translation for 精物.

·       In contrast to the other sources we consulted, Yè includes lung and spleen among the channel entries, and indicates that one of Lóng Gǔ’s mechanisms of action is normalization of the qì dynamic (ascending and descending).

·       The reference to moderating liver fire, and qì’s warmth (when Lóng Gǔ’s qì is said to be balanced, i.e. neutral) reminds me of the discussion we had about Wēn Dǎn Tāng, Warm Gallbladder Decoction; specifically, the multiple meanings of 溫 as “warm” and “mild” or “gentle”.

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【牡蠣】

氣平微寒。味鹹。無毒。主傷寒。寒熱。溫瘧洒洒。驚恚怒氣。除拘緩鼠瘻。女子帶下赤白。久服強骨節。殺邪鬼。延年。

Mǔ Lì

Its qì is balanced, and slightly cold. Its flavor is salty. Non-toxic. Masters cold damage, and cold and heat [i.e. chills and fever]. Warm malaria with shivering. Fright, rage and anger qì. Eliminates spasm and slackness, rat fistula, and women’s red and white vaginal discharge. Taken for a long time, it will strengthen the bones and joints. Kills evil ghosts and prolongs one’s life.

牡蠣氣平微寒。稟天秋冬金水之氣。入手太陰肺經、足太陽寒水膀胱經。味鹹無毒。得地北方之水味。入足少陰腎經。氣味俱降。陰也。

Mǔ Lì’s qì is balanced and slightly cold. It is endowed by heaven with the qì of autumn and winter metal and water. It enters the hand tàiyīn lung channel and foot tàiyáng cold water urinary bladder channel. Its flavor is salty, and it is non-toxic. It has the water flavor of the earth’s nothern direction. It enters the foot shàoyīn kidney channel. Its qì and flavor together are descending. It is yīn.

冬不藏精。水枯火旺。至春木火交熾。發為傷寒熱病。病在太陽寒水。所以寒熱。其主之者。鹹寒之味入太陽。壯水清火也。

If the essence is not stored in the winter, water will dry up and fire will flourish until it meets the fire of spring wood and blazes. It comes out as cold damage heat disease. The disease is at the tàiyáng cold water, therefore there is cold and heat [chills and fever]. It governs this. The salty cold flavor enters tàiyáng. Strengthen water to clear heat.

夏傷於暑。但熱不寒。名為溫瘧。溫瘧陰虛。陰者中之守。守虛所以洒洒然也。其主之者。鹹寒可以消暑熱。 氣平入肺。肺平足以制瘧邪也。

In summertime injury from summerheat there is only fever, and a lack of chills. This is called warm malaria. In warm malaria, there is yīn vacuity. Yīn keeps composure in the interior. Vacuity in keeping composure results in shivering. It governs this. Salty and cold can reduce summerheat heat. [Mǔ Lì’s] qì is balanced and it enters the lung. The balanced lung is enough to control the malarial evil.

肝虛則驚。肝實則恚怒。驚者平之。恚怒降之。氣平則降。蓋金能制木也。

Liver vacuity results in fright. Liver repletion results in rage and anger.  Fright [must be] calmed, anger and rage [must] descend. Calm [balanced] qì will descend. A metal cover can control wood.

味鹹足以軟堅。平寒可除拘緩。故主鼠瘻。

Its salty taste is enough to soften hardness. Balanced and [slightly] cold can eliminate spasm and slackness. Thus it masters rat fistula.

濕熱下注於腎。女子則病帶下。氣平而寒。可清濕熱。所以主之。

Damp heat downpours to the kidney. In women this results in the disease of vaginal discharge. [Mǔ Lì’s] qì is balanced and yet cold, so can clear the damp heat, so therefore masters it.

久服強骨節。鹹平益肺腎之功也。

Long-term taking strengthens the bones and joints. Salty and balanced boosts the lung and kidney’s efforts.

殺邪鬼。氣寒清肅熱邪之力也。能延年者。固澀精氣之全功也。

Kills evil ghosts. Its qì is cold and strongly clears and depurates heat evil. [Mǔ Lì] can prolong life. It is completely efficacious at consolidating and astringing essence qì.

Comments:

• Again entry into the hand tàiyīn lung channel is mentioned, contrary to the other sources we have checked. Foot tàiyáng bladder is also listed as a channel entered by Mǔ Lì. These associations give it some resonance with the surface.

• Rat fistula is a type of scrofulous swelling in the neck and armpits. It is described in Líng Shū 70, where it is said to be caused by “toxic qì of cold and heat lodged in the vessel and not eliminated [寒熱之毒氣也留於脈而不去者也]”. The mechanism here is pathogenic factors in the channels and vessels that come out on the surface, in the form of subcutaneous nodules. So there is another possible connection with the skin, at least in the case of Mǔ Lì.

• The associations of both Lóng Gǔ and Mǔ Lì with spectral entities, evil ghosts, forest demons, and the like, puts these substances into our mulch category of #ghostherbs

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Conclusion

So maybe we found something relevant to the reader’s question, or maybe we didn’t. But this pair of mineral substances, either in combination or alone, can really make a profound difference in a formula.

Okay, that’s all for now. As always, thanks for reading.

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Note: this publication is for information purposes only and is not intended as medical advice. Please seek the opinion of a health care professional for any specific medical issues you may have.

References

Mitchell, C., Feng, Y., & Wiseman, N. (1999). Shāng hán lùn: On cold damage. Paradigm Publications.

Wāng, A. (1694). Běn cǎo bèi yào. Retrieved October 22, 2023 from https://jicheng.tw/tcm/book/%E6%9C%AC%E8%8D%89%E5%82%99%E8%A6%81/index.html

Wilms, S. (2017). Shen Nong ben cao jing: The divine farmer’s classic of materia medica. Happy Goat Productions.

Wiseman, N., & Brand, E. (2020). Comprehensive Chinese materia medica. Paradigm Publications.

Wiseman, N., & Wilms, S. (2013). Jīn guì yào lüè: Essential prescriptions of the golden cabinet. Paradigm Publications.

Yáo, Q. (1926). Jīng xiào Yè Tiānshì běn cǎo jīng jiě. Guǎng Yì Book Company. Retrieved December 14, 2022, from https://jicheng.tw/tcm/book/%E6%9C%AC%E8%8D%89%E7%B6%93%E8%A7%A3/index.html