Traditionally used for
- Cough & breathing
- Nerves & recovery
Cautions & contraindications
- Pregnancy
- Breastfeeding
- Young children
- Seizure disorders
- Allergy risk
- Toxic — professional use only
☯ TCM Properties
Clears Heat, dissolves Phlegm, calms Wind and stops convulsions
Traditional Chinese Uses
Dan Nan Xing (Arisaema cum Bile) is a processed substance made by combining the powdered prepared rhizome of Tian Nan Xing (Arisaema erubescens and related species) with animal bile, which transforms the raw herb's warm, drying, toxic nature into a cool, moistening remedy. Bitter and cool, entering the Lung, Liver and Spleen channels, it clears Heat and dissolves Phlegm, and extinguishes internal Wind to stop convulsions.
It is a key herb for thick, sticky yellow Phlegm-Heat, and for Phlegm-Heat obstructing the channels or clouding the Heart: productive cough with viscous sputum, and Wind-Phlegm patterns such as childhood convulsions with fright, epilepsy, and windstroke with copious phlegm, hemiplegia or facial deviation. It is commonly given in pill and powder form (roughly 3-6 g). Although the bile-processing greatly reduces the toxicity of raw Arisaema, it is still used cautiously and is generally avoided in pregnancy.
Western Herbalism Properties
Relationships
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Botanical Description
Dan Nan Xing (膽南星) is a processed compound substance prepared by combining the powdered, prepared rhizome of Arisaema (Tian Nan Xing, typically Arisaema erubescens, A. heterophyllum, or A. amurense, family Araceae) with bovine, porcine, or caprine bile and aging the mixture for an extended period. The bile-processing transforms the warm, drying, and toxic Tian Nan Xing into a cool-natured drug suitable for clearing phlegm-heat. The finished product is dark brown to black, has a characteristic bitter-fishy odor, and is shaped into bricks or pieces. In TCM, Dan Nan Xing is bitter and cool, entering the Liver, Lung, and Spleen channels, and is used to clear phlegm-heat, calm wind, and arrest convulsions, particularly in childhood convulsions, stroke with phlegm, epilepsy, and phlegm-heat cough. Because it combines plant and animal components, plant_type and parts_used are left null.
Active Constituents
Bovine bile acids (cholic acid, chenodeoxycholic acid, deoxycholic acid and their conjugates)
Steroidal bile acid, contributed by the processing adjuvant rather than by the plantConcentration: Introduced by fermenting Arisaema powder with bovine, porcine or caprine bile; the proportion is set by the processing method and is not standardised across producers
These are what make Dan Nan Xing a different drug from Tian Nan Xing rather than merely a processed version of it. In the rat febrile-seizure study, chenodeoxycholic acid and ursodeoxycholic acid appeared among the faecal biomarkers of response and the primary bile acid metabolic pathway was implicated alongside FXR signalling, so the bile fraction is pharmacologically active in its own right and not an inert vehicle.
Calcium oxalate raphides (needle crystals) with associated protein
Inorganic crystal, calcium oxalate, bundled with proteinConcentration: About 90% calcium oxalate by mass in the isolated needle-crystal fraction of the raw drug; substantially reduced by processing
The irritant principle of the raw tuber and the reason processing is mandatory. Electron microscopy shows needles sharp at both ends, grooved along both sides and in some cases barbed. They inflict mechanical injury and deliver the lectin into the wound. In the raw drug the isolated crystals were far more toxic than the whole powder, with LD50 values of 42.53 mg/kg for the needle crystals against 1062 mg/kg for raw powder and 2788 mg/kg for processed powder.
Arisaema erubescens lectin
Plant lectin (carbohydrate-binding protein)The protein toxin carried in the raphide bundles. In the snail model, intact raphides were more toxic than the calcium oxalate crystals alone, which were in turn more toxic than the isolated lectin, showing that the crystals and the protein act together rather than independently: the crystals breach the tissue and the lectin is injected through the breach.
Schaftoside and isoschaftoside
Flavone C-glycoside (apigenin di-C-glycosides)The principal flavonoid markers of Arisaematis Rhizoma and among the compounds enriched by processing in comparative work on the genus. They carry anti-inflammatory activity and are the usual analytical handles for the non-toxic fraction of the drug.
Trigonelline
Pyridine alkaloid (N-methylnicotinic acid betaine)A minor alkaloid of Arisaematis Rhizoma, reported alongside choline and stachydrine. Present in small amounts and not thought to drive either the therapeutic or the toxic profile of the drug.
beta-Sitosterol
PhytosterolA routine sterol of the tuber, isolated with palmitic, stearic and linoleic acids among the lipid constituents of the drug.
⚠ Drug Interactions
Tian Nan Xing (Arisaematis Rhizoma, raw or ginger-and-alum processed)
Dan Nan Xing and Tian Nan Xing share a source plant and a name fragment but are separate pharmacopoeial drugs. Tian Nan Xing is the tuber processed with ginger juice and alum; it is warm and drying and treats Wind-Phlegm and Damp-Phlegm. Dan Nan Xing is that powder then fermented with animal bile; the bile inverts the thermal nature to cool and redirects the drug to Phlegm-Heat, childhood convulsion and Liver Wind. The bile fraction is not a diluent: the rat work shows it participates in the FXR and bile acid pathways through which the anticonvulsant effect is mediated. Substituting either way delivers a drug with the wrong thermal nature and, if raw material is supplied, a drug that has not been detoxified at all.
Clinical note: Order by the full name and check the Latin pharmaceutical name on the label: Arisaema cum Bile for Dan Nan Xing, Arisaematis Rhizoma Praeparatum for processed Tian Nan Xing. Dan Nan Xing is dark brown to greyish-brown with a bile odour; if a batch of Dan Nan Xing looks and smells like plain processed tuber, reject it. Never accept raw Arisaematis Rhizoma for internal use.
Pinellia ternata tuber (Ban Xia, Pinelliae Rhizoma)
An ITS2 nucleotide-signature assay of 56 Pinelliae Rhizoma products on the Chinese market found about 66% adulterated, with Arisaema erubescens present in 9% of the products tested, second only to Pinellia pedatisecta. Untargeted metabolomics separately confirms that the metabolite profiles of Pinelliae Rhizoma and Arisaema erubescens differ, with the discriminating metabolites enriched in tyrosine and phenylalanine metabolism. The two drugs have different dose ranges and different processing requirements.
Clinical note: Buy neither drug as powder, and treat unusually cheap Ban Xia as suspect. Where a patient on a Ban Xia-containing formula develops unexpected oropharyngeal irritation, consider aroid substitution as a cause.
Antiepileptic drugs (for example valproate, phenobarbital, levetiracetam)
Dan Nan Xing is used for childhood convulsion and febrile seizure, and the rat febrile-seizure work found it lengthened seizure latency, shortened duration, reduced hippocampal neuronal damage and TNF-alpha, IL-1beta, IL-6 and HMGB1, and significantly modulated GABA and glutamate. A drug that measurably moves GABA and glutamate is a drug to watch alongside prescribed antiepileptics, but the finding is in rats and no pharmacokinetic or clinical interaction study exists.
Clinical note: Do not use Dan Nan Xing as a substitute for prescribed anticonvulsant therapy or allow a family to reduce antiepileptic medication because a herbal formula has been started. If it is used as an adjunct in a child with epilepsy, tell the treating neurologist and monitor seizure frequency.
Ursodeoxycholic acid and bile acid sequestrants (for example colestyramine)
Unlike almost every other herb, this drug delivers exogenous bile acids by design. The mechanistic work on it implicates FXR signalling and the primary bile acid metabolic pathway, and identifies chenodeoxycholic and ursodeoxycholic acid among the response biomarkers. A patient already on ursodeoxycholic acid is receiving an FXR-pathway-relevant agent, and a patient on a bile acid sequestrant may bind the bile fraction of the herb in the gut. Neither direction has been studied.
Clinical note: Ask about bile acid therapy and about cholestatic liver disease before prescribing. Separate administration from a bile acid sequestrant by several hours. Also disclose the animal-bile content to patients with dietary, religious or allergy-related reasons to avoid bovine material, since the name does not make it obvious.
Pregnancy
Arisaematis Rhizoma and its processed forms are among the toxic drugs of the Chinese Pharmacopoeia and are traditionally contraindicated in pregnancy. Four weeks of crude Arisaematis Rhizoma extract at 1 g/kg caused renal damage in rats through inflammation and oxidative stress, with raised IL-1beta, TNF-alpha and malondialdehyde and lowered superoxide dismutase, glutathione ratio and glutathione peroxidase. Processing reduced but did not abolish the kidney injury. There is no reproductive toxicology adequate to overturn the contraindication.
Clinical note: Do not prescribe in pregnancy or lactation. In children, whose febrile convulsions are the drug's classical indication, keep to short courses at pharmacopoeial doses and do not extend treatment on a parent's initiative.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 3–6 g | — | — | — | ChP 2025. 胆南星 (bile-processed arisaema). Corrected from a generic 6-15g decoction filler value generated from tcm_category. |
Dui Yao — Herb Pairs
The classical two-herb combinations this herb appears in, each with an action neither herb has alone.
Clears heat and transforms thick phlegm while moistening and directing phlegm downward.
Phlegm-heat cough with thick yellow sputum.
Core pair of a classical formula — Qing Qi Hua Tan Wan, Yi Fang Kao (Wu Kun)
Clears and transforms phlegm-heat while draining fire from the lungs at its source.
Phlegm-heat cough. Dan Nan Xing is Tian Nan Xing processed with bile, which moderates its toxicity; the raw root is toxic.
Core pair of a classical formula — Qing Qi Hua Tan Wan, Yi Fang Kao (Wu Kun)
Evidence Tier
Moderate evidence · 5 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
0
Randomized controlled trial
0
Other clinical trial
0
Observational / case report
0
In vitro / animal
4
3 verified · 1 unverified
Show 4 studies
- Arisaema cum Bile Mitigate Febrile Seizure in Rats via Inhibition of Neuroinflammation, Regulation of FXR and GABA Signaling Pathway
- Insight into Nephrotoxicity and Processing Mechanism of Arisaema erubescens (Wall.) Schott by Metabolomics and Network Analysis
- Revealing the mechanisms of Arisaema cum Bile on allergic asthma with systematic pharmacology approach-experimental validation
- Main active constituents and mechanism of toxicity of raphides from Arisaema erubescens against Oncomelania hupensis
Other / unclassified
1
1 verified · 0 unverified
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Arisaema cum Bile Mitigate Febrile Seizure in Rats via Inhibition of Neuroinflammation, Regulation of FXR and GABA Signaling Pathway
The best mechanistic study of the bile-processed drug specifically. Constituents profiled by LC-MS, then a hot-water-bath febrile seizure model in rats given Dan Nan Xing at 2.8 and 0.7 g/kg by gavage for two weeks. Seizure duration shortened and latency lengthened, hippocampal neuronal damage and TNF-alpha, IL-1beta, IL-6 and HMGB1 fell, and GABA and glutamate were significantly regulated. Gut Lactobacillus and Lachnospiraceae rose while Tenericutes fell, and twenty faecal metabolites including GABA, chenodeoxycholic acid and ursodeoxycholic acid emerged as biomarkers, with primary bile acid metabolism and FXR signalling implicated. Rodent work only, but it directly addresses the bile-processed form rather than the plant.
Insight into Nephrotoxicity and Processing Mechanism of Arisaema erubescens (Wall.) Schott by Metabolomics and Network Analysis
The study that tests whether processing actually works, and the one that includes bile juice as an adjuvant. Rats received crude or processed Arisaematis Rhizoma extract at 1 g/kg daily for four weeks. Crude material caused renal damage through inflammation and oxidative stress, with raised blood urea nitrogen, creatinine, IL-1beta, TNF-alpha and malondialdehyde and reduced superoxide dismutase, glutathione to glutathione-disulfide ratio and glutathione peroxidase, confirmed histologically. Processing with ginger juice, alumen and bile juice alleviated the kidney damage. Thirty-five potential biomarkers were enriched in amino acid and glycerophospholipid metabolism. The processed drug was less nephrotoxic, not non-nephrotoxic.
Revealing the mechanisms of Arisaema cum Bile on allergic asthma with systematic pharmacology approach-experimental validation
Ovalbumin-sensitised rat model of allergic asthma given Dan Nan Xing at 450 mg/kg orally for two weeks. Treatment prevented the irregular arrangement and bronchial epithelial necrosis seen in model lung tissue, lowered IL-4, IL-5 and IL-13 in serum and bronchoalveolar lavage fluid and raised IL-12 and interferon gamma, and reduced JNK, ERK and p38 MAPK protein expression in lung. Network pharmacology built on only twenty-one identified compounds, so the target attribution is weak; the animal outcomes are the substantive part.
Main active constituents and mechanism of toxicity of raphides from Arisaema erubescens against Oncomelania hupensis
Molluscicide study whose real value here is that it dissects the raphide toxicity of the raw drug. Raphides purified from Arisaema erubescens tubers killed Oncomelania hupensis snails with 48-hour and 72-hour LC50 values of 70.95 and 44.25 mg/L. Potency ranked intact raphides above isolated calcium oxalate crystals above the lectin alone, so crystal and protein act together. Electron micrographs showed needles sharp at both ends with a groove down each side and some barbed. Snail liver peroxidase, superoxide dismutase and catalase rose at 24 hours then collapsed by 120 hours, falling 82.5%, 62.9% and 84.7% at half the LC50. An invertebrate model, but the physical mechanism it demonstrates is the same one that injures human oropharyngeal mucosa.
Processing-induced detoxification of toxic Traditional Chinese Medicines: a systematic review of attenuation mechanisms at physical, chemical, and in vivo levels
Reviews the toxic drugs of the 2025 Chinese Pharmacopoeia and the mechanisms by which processing attenuates them. For the raphide-bearing Araceae drugs it names the toxic principle as calcium oxalate needle crystals carrying protein toxins, and describes each adjuvant's action: aluminium ions from alum complex oxalate and dissolve the crystals, ginger extracts denature the lipophilic crystal complex, alkaline treatment above pH 12 disrupts the crystalline structure, and microwave irradiation reduces crystal content within ten minutes. Note what this does not establish: the review offers mechanism, not quantified reduction of raphide content or of irritation score, for these specific drugs.
⚠ Safety & Contraindications
- Pregnancy
- Breastfeeding
- Young children
- Seizure disorders
- Allergy risk
- Toxic — professional use only
Contraindications
Use with caution in pregnancy.
Safety Warnings
- Bile processing substantially lowers the irritancy, but the Pharmacopoeia still grades the drug 有毒.
⚠ Toxicity Information
Far milder than the raw drug — occasional oral irritation. Bile processing is what makes the drug usable.
Historical Texts
Ben Cao Shi Yi (Supplement to the Materia Medica)
Tang dynasty, 739 CE, Chen CangqiBen Cao Gang Mu (Compendium of Materia Medica)
Ming dynasty, 1596, Li ShizhenChinese Pharmacopoeia, 2020 edition
Modern, 21st centuryReferences
- Qi Cy, Wang J, Wu X, He Sr, Zhang Q, Wu Jh, Zhao Cb. Botanical, Traditional Use, Phytochemical, and Toxicological of Arisaematis rhizoma . Evidence-Based Complementary and Alternative Medicine (2021) [DOI]
- Su F, Sun Y, Zhu W, Bai C, Zhang W, Luo Y, Yang B, Kuang H, Wang Q. A comprehensive review of research progress on the genus Arisaema: Botany, uses, phytochemistry, pharmacology, toxicity and pharmacokinetics . Journal of Ethnopharmacology (2022) [DOI]
- Zhang T, Xu F, Ruhsam M, Feng L, Zhang M, Wang Z, Wang X. A nucleotide signature for the identification of Pinelliae Rhizoma (Banxia) and its products . Molecular Biology Reports (2022) [DOI]
- Wang J, Cui J, Liu Z, Yang Y, Li Z, Liu H. Untargeted Metabolomics Based on Ultra-High-Performance Liquid Chromatography Coupled with Quadrupole Orbitrap High-Resolution Mass Spectrometry for Differential Metabolite Analysis of Pinelliae Rhizoma and Its Adulterants . Molecules (2024) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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