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Niuhuang (Cow-bezoar)---牛黄

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Niuhuang is the dried gall stone of Bos taurus domesticus Gmelin, pertaining to Bovidae. It is classified into Danhuang and Guanhaung. The former is better in quality. During slaughtering, when it is found that there are gall-stone inside the gallbladder, bile duct or hepatic duct, filtrate the bile to take the gallstone, remove the superficial membrane, dry in the shade, and then grind into fine powder.

[ Medicinal Properties ]: Sweet and cold; relate to heart and liver meridians.

[ Medicinal Efficacies ]: Resolve phlegm for resuscitation; cool liver, extinguish wind; clear heat and relive toxicity.

[ Clinical Applications ]: 1. Warm disease and coma     It treats entering of heat into pericardium in warm disease, wind-stroke, convulsion, and epilepsy due to blockage of heart by phlegm, manifesting as coma and trismus, usually combined with Shexian, Bingpian and Zhusha; for example in Angong Niuhuang Pills.

2. Fright epilepsy and epilepsy      In case of acute infantile convulsions, manifesting as coma, convulsion and spasm, it is combined with Zhusha and Quanxie; for example in Niuhuang Powder. It treats epilepsy due to blackage of clear orifices by phlegm, in combination with Zhenzhu, Yuanzhi and Dannanxing.

3. Aphtha, sore and swollen throat, toothache, abscess, carbuncle, deep-rooted boil and toxin         It is very effective to clear heat and relieve toxicity. For aphtha, swollen and sore throat, and headache due to accumulation of fire toxin, it is combined with Huangqin, Xionghuang and Dahuang; for example in Niuhuang Jiedu Pills. For abscess, carbuncle, deep-rooted boil, toxin and furuncle, it is in combinatin with Jinyinhua and Gancao. Also it can treat carcinoma of breast, bubo, phlegm nodule , deep multiple abscesses, scrofula and malignant sore, in combination with Shexiang and Ruxiang.

[ Usage and Dosage ]: It is used in pill and powder, with dosage of 0.15-0.35g. Also it can be ground into powder for external use.

[ Medicinal Comparison ]: Similarities: Both Lingyangjiao and Niuhuang relate to heart and liver meridians, with similar efficacies to clear liver heat, extinguish wind and stop spasms, so both can treat high fever and coma in warm disease or convulsions and spasm due to stirring of liver wind.

 Differences: Lingyangjiao is cold to pacify liver, subdue yang,improve vision, dissipate blood, relieve fever and stop pain. It can treat dizziness and dizzy vison due to hyperactivity of liver yang, reddish eyes and headache due to liver fire, macula due to warm toxinosis, wind-damp-heat arthralgia, cough and asthma due to lung heat and whooping cough. Niuhuang is cool to resolve phlegm for resucitation, clear heat and relieve toxicity. It treats epilepsy due to entering of heat into pericardium or blockage of clear orifices by phlegm, swollen and sore throat, toothache, abscess, carbuncle, deep-rooted boil and toxin.

牛黄为牛科动物牛Bos taurus domesticus Gmelin干燥的胆结石。主产于北京、天津、内蒙、陕西、新疆、青海、河北、黑龙江等地。牛黄分为胆黄和管黄二种,以胆黄质量为佳。宰牛时,如发现胆囊、胆管或肝管中有牛黄,即滤去胆汁,将牛黄取出,除去外部薄膜,阴干,研极细粉末。

       【药性】苦,凉。归心、肝经。        【功效】化痰开窍,凉肝息风,清热解毒。       
 
【应用】        1.热病神昏。本品性凉,其气芳香,入心经,能清心,祛痰,开窍醒神。故用治温热病热入心包及中风,惊风,癫痫等痰热阻闭心窍所致神昏谵语,高热烦躁,口噤,舌蹇,痰涎壅塞等症,常与麝香、冰片、朱砂、黄连、栀子等开窍醒神,清热解毒之品配伍,如安宫牛黄丸(《温病条辨》)。       
 
 2.小儿惊风,癫痫。本品入心、肝二经,有清心,凉肝,息风止痉之功。常用治小儿急惊风之壮热,神昏,惊厥抽搐等症,每与朱砂、全蝎、钩藤等清热息风止痉药配伍,如牛黄散(《证治准绳》);若治痰蒙清窍之癫痫发作,症见突然仆倒,昏不知人,口吐涎沫,四肢抽搐者,可与珍珠、远志、胆南星等豁痰、开窍醒神、止痉药配伍,如痫证镇心丹(《中医内科学讲义》上海科技出版社,1964,160)。       
 
 3.口舌生疮,咽喉肿痛,牙痛,痈疽疔毒。本品性凉,为清热解毒之良药,用治火毒郁结之口舌生疮,咽喉肿痛,牙痛,常与黄芩、雄黄、大黄等同用,如牛黄解毒丸(《全国中药成药处方集》);若咽喉肿痛,溃烂,可与珍珠为末吹喉,如珠黄散(《绛囊撮要》);治疗痈疽,疔毒,疖肿等,以牛黄与金银花、草河车、甘草同用,如牛黄解毒丸(《保婴撮要》);亦可用治乳岩、横痃、痰核、流注、瘰疬、恶疮等证,每与麝香、乳香、没药同用,如犀黄丸(《外科证治全生集》)。       
 
【用法用量】入丸、散剂,每次0.15~0.35g。外用适量,研末敷患处。        【使用注意】非实热证不宜用,孕妇慎用。       
 
【古籍摘要】        1.《神农本草经》:“主惊痫寒热,热盛狂痓。”       
 
2.《别录》:“疗小儿百病,诸痫热,口不开;大人狂癫。又堕胎。”        3.《日用本草》:“治惊痫搐搦烦热之疾,清心化热,利痰凉惊。”       
 
【现代研究】        1.化学成分:本品含胆酸、脱氧胆酸、胆甾醇,以及胆色素、麦角甾醇、维生素D、钠、钙、镁、锌、铁、铜、磷等;尚含类胡萝卜素及丙氨酸、甘氨酸等多种氨基酸;还含粘蛋白、脂肪酸及肽类(SMC)成分。       
 
 2.药理作用:牛黄有镇静抗惊厥及解热作用,可增强离体蛙心心肌收缩力;牛黄主要成分胆红素有降压及抑制心跳作用;牛黄水溶液成分SMC具有胆囊收缩作用,所含胆酸,尤其是脱氧胆酸,均能松弛胆道口括约肌,促进胆汁分泌而有利胆作用;牛黄酸对四氯化碳引起的急性及慢性大鼠肝损害有显著的保护作用;家兔静脉点滴牛黄,可使红细胞显著增加;牛黄还有抗炎、止血、降血脂等作用。       
 
3.临床研究:据报道,以牛黄、麝香为主组成的牛黄千金散,用灯心草、薄荷、金银花煎汤冲服,治疗小儿高热惊厥,仅服一帖即奏效如神(河北中医,1984,4:24);用牛黄解毒丸加生理盐水外搽,治疗带状疱疹30例,一般6~8天痊愈(中成药,1989,9:25);用安宫牛黄丸,治疗黄疸性肝炎,效果良好(江西中医药,1988,6:17)。
 
另有用牛黄等治疗乙型脑炎、冠心病、中风、急性胰腺炎、上呼吸道感染等。       
 
4.不良反应:服用牛黄解毒片可出现血小板减少,消化道出血、荨麻疹型药疹、过敏性休克、膀胱炎、支气管哮喘等。服用牛黄制剂中毒或过敏反应主要是超剂量长期服用所致;其次是服药者属特异性或过敏性体质。牛黄中毒救治:停止服药,给予抗过敏、抗休克及对症治疗。       
 
【其他】除黄牛、水牛外,牛科动物牦牛、及野牛的胆结石亦可入药。另有人工牛黄,系牛胆汁或猪胆汁,经人工提取出胆酸、胆甾醇、胆红素、无机盐等,加工制造而成;又有人工培植牛黄,根据天然牛黄的成因机理,在牛胆囊内植入异体,培植成功人工培育牛黄,以缓解天然牛黄药源之短缺。        Pr

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