Traditionally used for
- Cough & breathing
- Digestion
- Fertility & vitality
- Pain & joints
- Energy & fatigue
Cautions & contraindications
- Pregnancy
- Young children
- Kidney conditions
☯ TCM Properties
Warms Lung Qi , resolves Phlegm and calms wheezing; Tonifies the Kidneys, tonifies Yang and grasps Qi; Benefits Qi and promotes lactation
Traditional Chinese Uses
E Guan Shi (Stalactitum) is the slender, hollow "goose-tube" tip of a calcium-carbonate stalactite (calcite/aragonite), a warming mineral tonic. Sweet, pungent and warm, entering the Lung, Kidney and Stomach channels, it warms Lung Qi, transforms Phlegm and calms wheezing; tonifies the Kidneys and Yang and helps the Kidneys grasp Qi; and benefits Qi to promote lactation.
It is used for chronic cough and wheezing from Lung-Cold and for consumptive dyspnea where the Kidneys fail to grasp the Qi, and for Kidney-Yang deficiency with impotence, premature ejaculation, spermatorrhea, and cold painful obstruction. As a lactagogue it treats scanty milk. Being a hard mineral it is crushed and decocted first, usually 9-15 g. Because it is warm and drying, it is contraindicated in Yin deficiency with effulgent fire or in excess-Heat patterns.
Relationships
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Botanical Description
E Guan Shi (“goose-tube stone”) is a mineral substance, not a plant. It is a tubular, hollow stalactite of calcium carbonate (calcite/aragonite, CaCO3) formed in limestone caves by slow precipitation from dripping mineral-rich water and prized in Chinese materia medica when it occurs as a narrow, quill-like, hollow soda-straw stalactite resembling a goose feather’s shaft. Specimens are white to pale grey or yellowish, with a chalky to translucent surface, fibrous radial structure on cross-section, and a thin axial canal. Larger, dense, branched stalactites with a clearly tubular interior are also accepted under this name in some regional sources. E Guan Shi is broken into pieces and water-levigated before use; in TCM it is regarded as warm and is used to warm the Lung and direct rebellious qi downward, to consolidate descent, and to treat cold-pattern phlegm-rheum and certain wheezing conditions. Verify mineralogical authenticity before clinical use.
Active Constituents
Calcium carbonate (calcite)
Carbonate mineralConcentration: the overwhelming bulk of the drug; speleothem calcite is essentially pure CaCO3
The whole substance of the mineral. Calcite is only sparingly soluble in water, so a decoction of the crushed stone delivers far less calcium than the gross weight suggests; it dissolves in gastric acid, which is where the drug's antacid and calcium-donating behaviour comes from. Calcining, which the classical preparation calls for, converts part of the carbonate to calcium oxide and hydroxide and makes the product strongly alkaline and considerably more reactive.
Magnesium, strontium and barium
Trace alkaline earth metals substituting in the calcite latticeConcentration: small amounts, reported qualitatively in Chinese materia medica analyses rather than quantified
These substitute for calcium in the calcite lattice as the speleothem forms. Their significance is analytical rather than therapeutic: the trace element signature reflects the cave and the parent limestone, so it varies between sources and offers no consistent pharmacology. Barium in particular is a reminder that a mineral drug carries whatever its geology gave it.
⚠ Drug Interactions
Levothyroxine
Calcium carbonate binds levothyroxine in the gut lumen and measurably reduces its absorption, a well-characterised interaction for pharmaceutical calcium carbonate. Since E Guan Shi is essentially calcium carbonate, and is given as a crushed or calcined powder at 3-15 g, the same mechanism applies. No study has tested the mineral drug itself, so the evidence is by direct chemical analogy rather than direct measurement.
Clinical note: Separate the mineral from levothyroxine by at least four hours. If a patient has been taking both together, recheck TSH.
Tetracycline and fluoroquinolone antibiotics
Divalent calcium chelates tetracyclines and fluoroquinolones in the gastrointestinal tract to form poorly absorbed complexes, an interaction established for calcium carbonate and calcium-containing antacids. A calcium carbonate mineral drug taken in gram quantities in the same dosing window will do the same, and the calcined form, being more soluble, delivers more free calcium ion.
Clinical note: Do not co-administer. Give the antibiotic at least two hours before or four to six hours after the mineral, or withhold the mineral for the duration of the antibiotic course.
Oral bisphosphonates (e.g. alendronate) and oral iron salts
Both drug classes are strongly susceptible to chelation and to pH change by calcium carbonate, which is why bisphosphonate labelling requires dosing with plain water well away from any calcium product. Because E Guan Shi is a calcium carbonate powder, and because it is often used in older patients for cold wheezing and lumbar weakness, the same population is likely to be on bisphosphonates or iron.
Clinical note: Give alendronate on waking with water only and keep the mineral to later in the day; separate oral iron by at least two hours. Ask about mineral herbs specifically, since patients rarely think of a stone as a drug.
Thiazide diuretics, calcium supplements and vitamin D
Thiazides reduce renal calcium excretion, and vitamin D increases calcium absorption, so both add to the calcium load from a gram-dose carbonate. Milk-alkali syndrome is a recognised consequence of sustained high-dose calcium carbonate intake, and is more likely with the calcined form, which is a stronger alkali than the raw mineral.
Clinical note: Avoid prolonged gram-level dosing in patients on thiazides, high-dose vitamin D or calcium supplements, and in anyone with hyperparathyroidism, sarcoidosis or renal impairment. Check serum calcium if the mineral is used for more than a few weeks.
Coral-source E Guan Shi (Balanophyllia sp. skeleton) supplied in place of stalactite
Two entirely different materials are sold in China as 鹅管石. One is the slender tubular tip of a stalactite, which is what this record describes: a geological calcite deposit. The other, 珊瑚鹅管石, is the calcareous skeleton of the stony coral Balanophyllia, sold in the same 3-5 cm tubular pieces 4-7 mm across, so the two are almost indistinguishable by eye once broken up. Both are largely calcium carbonate, but the coral form is animal material from the order Scleractinia, which is listed on CITES Appendix II, so it is a controlled wildlife product; the mineral form is not a CITES-listed substance at all. Their trace element profiles and their organic content also differ.
Clinical note: State which source you intend when ordering, and treat the two as separate items in your dispensary. For patients who avoid animal-derived products, and for any practice concerned about legal supply of wildlife material, specify the stalactite form. The pinyin name alone does not settle which substance you will receive.
Heavy-metal contamination of mineral drugs
Mineral-derived Chinese drugs carry whatever their geology contains, and surveys of Chinese herbal medicine have found at least one metal over the Pharmacopoeial limit in roughly 30% of samples across 279 drug types, with lead over-limit in 5.75% and arsenic in 4.17% of more than 10,000 samples analysed by ICP-MS. No survey has reported metal content for Stalactitum specifically, so the concern is generic to unassayed mineral drugs rather than documented for this one.
Clinical note: Source mineral drugs from suppliers who provide heavy-metal certificates of analysis, and avoid open-ended use in children or pregnancy.
⚠ Safety & Contraindications
- Pregnancy
- Young children
- Kidney conditions
Contraindications
Its use is prohibited in patients with vigorous fire due to yin deficiency or cough due to lung heat.
Source: Xi S, Gong Y. Essentials of Chinese Materia Medica and Medical Formulas. Academic Press/Elsevier, 2017, pp. 357–359.
Historical Texts
Shen Nong Ben Cao Jing
Han dynastyYi Xue Ru Men, Ben Cao section
Ming dynasty (Li Chan, 1575)References
- Jue Jin. Elixir, Medicine, and Fertilizer: Stalactite (shizhong ru)'s Transformations in Premodern China . Berichte zur Wissenschaftsgeschichte (2025) [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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