Hai Piao Xiao
StarSepiella maindroni de Rochebrune
☯ TCM Properties
Restrains, holds in and stops bleeding; Secures Jing and stops discharge; Controls acidity and a lleviates pain; Resolves Dampness and p romotes healing (moves Blood)
Traditional Chinese Uses
Hai Piao Xiao is the internal cuttlebone of the cuttlefish Sepiella maindroni (or Sepia species), an animal-derived, salty, warm astringent entering the Kidney, Liver, Stomach and Spleen channels. Its principal action is to restrain and stop bleeding — used for uterine bleeding, blood in the stool, and traumatic bleeding — and to secure the Essence and stop abnormal discharge, addressing seminal emission and chronic vaginal discharge (leukorrhea). Rich in calcium carbonate, it also controls stomach acid and eases pain, a classic remedy for acid reflux and epigastric pain from peptic ulcer, often paired with Zhe Bei Mu (Fritillaria) in the powder Wu Bei San.
It is used powdered in decoctions or pills, and the powder is dusted externally on non-healing sores and weeping skin lesions to dry Dampness and promote healing.
Botanical Description
Hai Piao Xiao is the cuttlebone of cephalopod molluscs in the genera Sepia and Sepiella (family Sepiidae), and is therefore an animal- rather than plant-derived material. The cuttlebone is the internal calcareous skeleton of the cuttlefish: a buoyant, oval to elongate-elliptical structure 5 to 25 centimetres long, with a chalky-white dorsal surface and a finely layered, porous ventral surface composed of stacked aragonite chambers separated by thin organic membranes. After the animal is taken, the cuttlebone is removed, washed free of soft tissue, sun-dried, and may be pulverised for medicinal use. Source species inhabit shallow continental shelf waters of the East and South China Seas and adjoining temperate to tropical coasts.
Active Constituents
Calcium carbonate (aragonite)
Inorganic carbonate saltConcentration: ~85-91% of dry weight
The dominant component, present as the aragonite polymorph. It neutralises gastric hydrochloric acid, raises intragastric pH, reduces pepsin activity and thereby confers the antacid and anti-ulcer actions traditionally attributed to the shell (Wu Zei Gu).
beta-Chitin
Aminopolysaccharide (structural biopolymer)Concentration: Organic matrix fraction (a few percent)
Forms the organic scaffold between the calcified lamellae. After reacting with gastric contents it can form a protective coating over ulcerated mucosa and promote local haemostasis, supporting the astringent and wound-healing uses.
Calcium phosphate
Inorganic phosphate saltConcentration: Minor
Contributes to the mineral matrix; provides a source of calcium and phosphate relevant to the demonstrated bone-defect repair activity in animal models.
Sodium chloride / magnesium salts
Inorganic saltsConcentration: Minor
Naturally occurring marine salts (NaCl, MgCl2) that account for the slightly salty taste and contribute buffering capacity.
Trace elements (Sr, Fe, Mn, Zn, Cu, Ba, Si, Al, Ti)
Trace mineralsConcentration: Trace (ppm)
Strontium and other trace metals are incorporated into the aragonite lattice; their biological contribution is minor but they are used as authentication markers for the cuttlebone.
Conchiolin-type matrix proteins
Structural proteinsConcentration: Minor organic fraction
Insoluble proteins bound within the shell that, together with chitin, form the mucosa-protective film and support the tissue-healing (sheng ji) action.
⚠ Drug Interactions
Levothyroxine (thyroid hormone)
The high calcium carbonate content binds levothyroxine in the gut, forming poorly absorbed complexes and lowering serum thyroxine, an effect well documented for calcium-containing antacids.
Clinical note: Separate ingestion by at least 4 hours and monitor TSH if used long term.
Tetracycline and fluoroquinolone antibiotics
Divalent/polyvalent calcium ions chelate tetracyclines (e.g., doxycycline) and fluoroquinolones (e.g., ciprofloxacin), forming insoluble complexes that impair intestinal absorption.
Clinical note: Take the antibiotic at least 2-4 hours apart from cuttlebone-containing formulas.
Oral iron salts
Calcium carbonate raises gastric pH and competes with iron for absorption, reducing the uptake of ferrous supplements.
Clinical note: Stagger dosing; monitor in iron-deficient patients.
Calcium supplements / thiazide diuretics
Large or prolonged intake of the calcium carbonate load, combined with other calcium sources or calcium-sparing diuretics, can raise serum calcium.
Clinical note: Avoid high chronic doses in patients with hypercalcaemia or renal impairment without monitoring.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 6-15g | Daily | — | — | — |
Preparation Methods
Decoction (crushed, cooked first / xian jian)
Parts: Internal shell (cuttlebone / endoconcha)
Crush the cleaned internal shell and add it to the decoction first, cooking 20-30 minutes ahead of other herbs because the dense calcareous material dissolves slowly. Typical dose 6-12 g.
Powder (for internal use or topical application)
Parts: Internal shell
Grind the calcined or raw shell to a fine powder. Taken 1.5-3 g internally to control acidity and bleeding, or dusted onto bleeding wounds, weeping eczema and ulcers as an astringent, drying agent.
Calcined (duan) shell
Parts: Internal shell
Heat-processing enhances the astringent, drying and haemostatic properties and is preferred when the aim is to secure discharge (leukorrhea, spermatorrhea) or stop bleeding.
Clinical Studies
The efficacy and safety of cuttlebone for lowering serum phosphate in patients with end-stage renal disease: a meta-analysis of randomized controlled trials
Nine RCTs (726 participants, 2000-2019) found that cuttlebone significantly lowered circulating phosphate versus controls (mean difference -0.23 mmol/L, 95% CI -0.39 to -0.06) with a dose-dependent effect; haemodialysis patients responded better than peritoneal dialysis patients. Heterogeneity was high (I2 = 94%).
Historical Texts
Shen Nong Ben Cao Jing (Divine Farmer's Classic of Materia Medica)
Han dynasty (c. 1st-2nd century CE)Ben Cao Gang Mu (Compendium of Materia Medica), Li Shizhen
Ming dynasty (1578 CE)References
- Chen H, et al.. The efficacy and safety of cuttlebone for lowering serum phosphate in patients with end-stage renal disease: a meta-analysis of randomized controlled trials . Frontiers in Pharmacology (2023) [DOI]
- Bensky D, Clavey S, Stoger E. Chinese Herbal Medicine: Materia Medica, 3rd ed. (Hai Piao Xiao / Os Sepiae) . Eastland Press, Seattle (2004) [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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