Traditional Chinese Medicine/Herb To Herb Interactions

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In Traditional Chinese Medicine, herb-to-herb interactions have been known for a long time, and include both synergistic as well as antagonistic interactions.

Synergistic Interactions edit

Synergistic Interactions are of the following two types:

  • Mutual Accentuation (Xiang Xu) - 相须
  • Mutual Enhancement (Xiang Shi) - 相使

Mutual Accentuation edit

In Mutual Accentuation, two herbs with similar functions are used together to increase their therapeutic effect. Examples include:

  1. Jing Jie (荆芥) with Fang Feng (防风) to expel wind and release the exterior
  2. Jin Yin Hua (金银花) with Lian Qiao (连翘) to reduce heat-toxin
  3. Da Huang (大黄) with Mang Xiao (芒硝) to promote bowel movement

Mutual Enhancement edit

In Mutual Enhancement, two herbs with different functions are used. The first directly targets the pathological condition, and the second increases the therapeutic effect of the first. Examples include:

  1. Zhi Mu (知母) with Huang Bai (黄柏), where Zhi Mu nourishes yin of the kidney and clears heat in the Lower-Jiao, while Huang Bai reduces empty-heat in the Lower-Jiao and is able to enhance the function of Zhi Mu.
  2. Fu Zi (附子) with Zhi Gan Cao (炙甘草), where sweet Gan Cao can moderate the speed of hot Fu Zi.
  3. Da Huang (大黄) with Zhi Gan Cao (炙甘草), where sweet Gan Cao can reduce the harsh purging effect of Da Huang.

Antagonistic Interactions edit

Antagonistic Interactions are of the following four types:

  • Mutual Counteraction (Xiang Wei) - 相畏
  • Mutual Suppression (Xiang Sha) - 相杀
  • Mutual Antagonism (Xiang Wu) - 相恶
  • Mutual Incompatibility (Xiang Fan) - 相反

Mutual Counteraction edit

In Mutual Counteraction, the characteristic side effects or toxicity of the first herb can be minimized or neutralized by the second herb. An example is:

  1. Ban Xia (半夏) with Sheng Jiang (生姜), where the toxic effects of Ban Xia can be reduced by Sheng Jiang.

Mutual Suppression edit

In Mutual Suppression, the first herb suppresses or minimizes the toxicity of the second herb. Examples include:

  1. Lv Dou (绿豆) with Ba Dou (巴豆), where Lv Dou can reduce the toxicity of Ba Dou.
  2. Ge Hua (葛花) with alcohol (酒), where Ge Hua can reduce the toxicity of ethanol.

Mutual Antagonism edit

The following is the classic list of eighteen substances that exhibit Mutual Antagonism to each other. For example, the effects of Ding Xiang will be countered by Yu Jin, and the herbs should not be taken together, although both are very common herbs.

No. Herb Name Counteracting Herb Name
1 Mercury (Shui Yin) 水银 Arsenolite (Pi Shuang) 砒霜
2 Rhizoma Euphorbiae E. (Lang Du) 狼毒 Lithargyrum (Mi Tuo Seng) 密陀僧
3 Semen Crotonis (Ba Dou) 巴豆 Semen Pharbitidis (Qian Niu Zi) 牵牛子
4 Flos Caryphyili (Ding Xiang) 丁香 Radix Curcumae (Yu Jin) 郁金
5 Nitrum Depuratum (Ya Xiao) 牙硝 Rhizoma Sparganii (San Leng) 三棱
6 Cornu Rhinoceri (Xi Jiao) 犀角 Rhizoma Aconiti Kusnezoffii (Cao Wu) 草乌
7 Cornu Rhinoceri (Xi Jiao) 犀角 Rhizoma Aconiti (Chuan Wu) 川乌
8 Radix Ginseng (Ren Shen) 人参 Rhizoma Trogopterorum (Wu Ling Zhi) 五灵脂
9 Cortex Cinnamomi (Rou Gui) 肉桂 Hallositum Rubrum (Chi Shi Zhi) 赤石脂
10 Sulfur (Liu Huang) 硫磺 Mirabilitum (Mang Xiao) 芒硝


Mutual Incompatibility edit

The following is the classic list of nineteeen substances that are incompatible with each other, and using them together can have dangerous results:

  • Gan Cao (甘草) is incompatible with the following:
No. Pinyin Simplified Chinese
1 Gan Sui 甘遂
2 Da Ji 大蓟
3 Yuan Hua 芫花
4 Hai Zao 海藻
  • All forms of Wu Tou (乌头), including Chuan Wu (川乌), Cao Wu (草乌) and Fu Zi (附子), are incompatible with the following:
No. Pinyin Simplified Chinese
1 Chuan Bei Mu 川贝母
2 Zhe Bei Mu 浙贝母
3 Gua Lou, Gua Lou Ren, Gua Lou Pi 栝楼, 栝蒌仁, 栝蒌皮
4 Ban Xia 半夏
5 Bai Lian 白蔹
6 Bai Ji 白芨
7 Tian Hua Fen 天花粉
  • Li Lu (藜芦) is incompatible with the following:
No. Pinyin Simplified Chinese
1 Ren Shen 人参
2 Bei Sha Shen 北沙参
3 Nan Sha Shen 南沙参
4 Ku Shen 苦参
5 Dan Shen 丹参
6 Xuan Shen 玄参
7 Bai Shao 白芍
8 Chi Shao 赤芍
9 Xi Xin 细辛

Single Effect edit

Although rather rare, some herbs may be used alone (单行) because they have reasonably balanced properties and functions. These include

  • Ren Shen
  • Dan Shen
  • Dang Gui
  • Gan Cao


Herbs That Are Prohibited During Pregnancy edit

No. Pinyin Simplified Chinese
1 Chuan Wu 川乌
2 Cao Wu 草乌
3 Pi Shuang 砒霜
4 Chan Su 蟾酥
5 Qing Fen 轻粉
6 Dan Fan 胆矾
7 Ba Dou 巴豆
8 E Zhu 莪术
9 Gua Di 瓜蒂
10 Jing Da Ji 京大戟
11 Yuan Hua 芫花
12 Shui Zhi 水栀
13 Shui Yin 水银
14 Gan Sui 甘遂
15 She Xiang 麝香
16 Ban Mao 斑蝥
17 Qian Niu Zi 牵牛子
18 Shang Lu 商陆
19 Xiong Huang 雄黄
20 San Leng 三棱
21 Ma Qian Zi 马钱子
22 Meng Chong 虻虫
23 Gan Qi 干漆
24 Li Lu 藜芦

Herbs That Are Used With Caution During Pregnancy edit

No. Pinyin Simplified Chinese
1 Niu Xi 牛膝
2 Rou Gui 肉桂
3 Lu Hui 芦荟
4 Jiang Huang 姜黄
5 Fu Zi 附子
6 Mu Dan Pi 牡丹皮
7 Zhi Ke 枳壳
8 Tao Ren 桃仁
9 Zhi Shi 枳实
10 Da Huang 大黄
11 Hong Hua 红花
12 Fan Xie Ye 番泻叶
13 Chuan Xiong 川芎
14 Mang Xiao 芒硝

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Ref: http://apps.who.int/medicinedocs/documents/s17556en/s17556en.pdf