Shan Ci Gu
StarCremastra appendiculata (D.Don) Makino
Traditionally used for
- Cough & breathing
- Digestion
Cautions & contraindications
- Liver conditions
- Kidney conditions
- Toxic — professional use only
☯ TCM Properties
Clears Heat and Resolves Toxicity; Disperses Swelling and Dissipates Nodules; Resolves Phlegm and Disperses Accumulation
Traditional Chinese Uses
Shan Ci Gu (cremastra pseudobulb, pleione pseudobulb) is a cold herb used in Chinese medicine to clear Heat toxin, dissolve Phlegm masses, and reduce swellings. It is a primary herb for scrofula, cervical lymphadenopathy, thyroid nodules, and abdominal masses from Phlegm-Fire accumulation, as well as for carbuncles and toxic swellings. Its anti-tumor applications in modern Chinese herbal oncology protocols reflect its potent Phlegm-dispersing and toxin-clearing properties.
Relationships
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Botanical Description
Cremastra appendiculata is a terrestrial orchid of the family Orchidaceae, native to forested slopes and shaded ravines in China, Korea, Japan, and the Himalayas. It produces clustered, ovoid to conical pseudobulbs at or near the soil surface, each bearing one to two long, narrowly elliptic, plicate leaves. In late spring an erect raceme up to 60 cm tall arises from the base, carrying numerous slender, drooping, pinkish-purple to brownish flowers with elongated sepals and petals. The pseudobulbs, harvested in summer or autumn after the aerial parts wither, are the medicinal portion; they are pale, hard, and contain colchicine-related alkaloids and glucomannans. The species is slow-growing and listed on CITES Appendix II, with most material in commerce traditionally wild-collected.
Active Constituents
Glucomannan mucilage
PolysaccharideConcentration: mannose to glucose ratio reported as approximately 2:1
The bulk polysaccharide of the pseudobulb and the reason a decoction of authentic material is slimy. It is demulcent rather than pharmacologically active, and its presence is one of the simplest bedside signs that the material is an orchid pseudobulb rather than a Menispermaceae or Dioscorea root.
Phenanthrenes and dihydrophenanthrenes
PhenanthreneThe characteristic chemistry of authentic Shancigu. Comparative metabolomics separates the genuine orchid sources, which make phenanthrenes, dihydrophenanthrenes, bibenzyls, glycosides, terpenoids, anthraquinones, flavonoids and steroids, from the substitute species, whose profile is dominated instead by colchicine, polysaccharides, flavonoids and starch. Monophenanthrenes, biphenanthrenes and a triphenanthrene have all been isolated from the tubers and screened against human cancer cell lines.
Cirrhopetalanthin
BiphenanthreneA known phenanthrene dimer of this species, isolated from the tubers and assayed alongside the newer phenanthrenes against human cancer cell lines.
Flavanthrinin
DihydrophenanthreneA dihydrophenanthrene previously obtained from the tubers of this species and included in its cytotoxicity screening.
Cremastranone
HomoisoflavanoneThe homoisoflavanone named after this genus. It is antiangiogenic, and the interest it attracted as a lead for retinal neovascularisation prompted a total synthesis, since the plant itself is too scarce to be a practical source.
Bibenzyls and glucosyloxybenzyl glycosides
Bibenzyl and phenolic glycosidePart of the constituent set that comparative metabolomics assigns to the authentic orchid sources of Shancigu and not to the substitute species.
⚠ Drug Interactions
Tinospora sagittata and Tinospora sinensis (Jin Guo Lan, Qing Niu Dan) supplied as Shan Ci Gu
The substitution runs into Shan Ci Gu, not out of it. Cremastra appendiculata is the official and dominant source of Shancigu, alongside Pleione bulbocodioides and Pleione yunnanensis, and it is a slow-growing wild-collected terrestrial orchid; all Orchidaceae are listed on CITES Appendix II, so international trade requires permits, and the scarcity and price that follow are what pull cheaper roots into the supply. Market Shancigu has been shown to draw on nine species from five families, and in Guangxi, Hunan and Guizhou the tuberous roots of Tinospora sagittata and Tinospora capillipes, whose own drug name is Jin Guo Lan, are commonly mixed with and sold as Shan Ci Gu. Tinospora contributes protoberberine alkaloids such as palmatine and jatrorrhizine and clerodane furanoditerpenes, a chemistry with nothing in common with the phenanthrenes of the orchid.
Clinical note: Buy Shan Ci Gu as pseudobulb, not as root. Authentic material is a conical or ovoid pseudobulb with concentric ring nodes and a mucilaginous decoction; Jin Guo Lan is a hard, bitter, yellow-sectioned root tuber. Where the source region is Guangxi, Hunan or Guizhou, ask specifically which drug has been supplied.
Colchicine-containing substitutes: Iphigenia indica (Li Jiang Shan Ci Gu) and Tulipa edulis (Guang Ci Gu)
Guang Ci Gu and Li Jiang Shan Ci Gu are Liliaceae bulbs with broadly similar traditional heat-clearing indications, which is why they are traded under ci gu names, but they contain colchicine and are frankly toxic. Li Jiang Shan Ci Gu is dosed at 0.6 to 0.9 g precisely because of this; Shan Ci Gu proper is dosed in grams. Substitution therefore delivers a colchicine dose many times over. Colchicine has a narrow therapeutic index and is cleared by CYP3A4 and P-glycoprotein, so a patient taking clarithromycin, ciclosporin, ritonavir, verapamil or a statin is at risk of severe and sometimes fatal toxicity from a colchicine exposure that would otherwise be tolerated. Note separately that the Cremastra genome carries candidate colchicine biosynthesis genes, but comparative metabolomics attributes the colchicine found in market Shancigu to the substitute species rather than to the orchid.
Clinical note: Any patient on Shan Ci Gu who develops vomiting and diarrhoea followed by cytopenias should be managed as colchicine poisoning until the material is identified. Do not dispense Shan Ci Gu of unverified origin to a patient taking a CYP3A4 or P-glycoprotein inhibitor.
Dioscorea bulbifera (Huang Yao Zi) supplied as Shan Ci Gu
Dioscorea bulbifera is one of the nine species documented in market Shancigu, and it is also one of the better-characterised causes of herb-induced liver injury in China, with more than a hundred reported cases over the past half-century. Its toxic principles are the furanoditerpenoids diosbulbin B and 8-epidiosbulbin E acetate, which require oxidation of the furan ring by cytochrome P450, chiefly the CYP3A subfamily, to cis-enedial intermediates that bind covalently to protein and DNA. A patient given Dioscorea bulbifera in place of the orchid receives a known hepatotoxin, and CYP3A inducers would be expected to worsen rather than mitigate the injury.
Clinical note: Check liver enzymes if a patient on Shan Ci Gu develops fatigue, nausea or jaundice, and stop the herb. Do not co-prescribe with other hepatotoxic drugs where the botanical identity of the material has not been confirmed.
Aristolochiaceae substitutes reported in market Shan Ci Gu
Chinese materia medica compilations list regional substitutes for Shan Ci Gu drawn from the Liliaceae, Menispermaceae, Araceae and Aristolochiaceae. Aristolochia species contain aristolochic acids, which the IARC classifies as Group 1 human carcinogens and which cause an irreversible interstitial nephropathy and upper urinary tract urothelial carcinoma. This is a compilation-level report of family membership rather than an analysis of specific market batches, so it is recorded as possible rather than established, but the consequence is severe enough that it should govern purchasing.
Clinical note: Source Shan Ci Gu only from suppliers who can identify the species and who screen for aristolochic acid. Avoid entirely in patients with any degree of renal impairment.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 3–9 g | Daily | — | — | 中国药典 2020 【用法与用量】3～9g。外用适量。 【性味与归经】甘、微辛，凉。归肝、脾经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Evidence Tier
Limited evidence · 1 studyRecorded 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
1
0 verified · 1 unverified
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Anticholinesterase, antioxidant, and beta-amyloid aggregation inhibitory constituents from Cremastra appendiculata
Reports constituents isolated from Cremastra appendiculata that inhibited acetylcholinesterase, showed antioxidant activity and inhibited beta-amyloid aggregation in vitro. Enzyme and cell-free assays only; there is no animal or human work behind it.
⚠ Safety & Contraindications
- Liver conditions
- Kidney conditions
- Toxic — professional use only
Contraindications
Its use is cautious in patients with deficiency of healthy qi and the weak. It is not suitable for taking too much since it is cold-cool in nature.
Source: Xi S, Gong Y. Essentials of Chinese Materia Medica and Medical Formulas. Academic Press/Elsevier, 2017, pp. 53–72.
Historical Texts
Ben Cao Shi Yi
Tang dynasty (739)Jia You Ben Cao
Northern Song dynasty (1060)References
- Gao ZY, Yang YB, Liu LC, Li X, Huang YB, Zhou Q. Differential Metabolic Analysis of Rhizomes in Shancigu Based on Widely Targeted Metabolomics . Metabolites (2025) [DOI]
- Wang J, Xie J, Chen H, Qiu X, Cui H, Liu Y, Sahu SK, Fang D, Li T, Wang M, Chen Y, Liu H, Zhang J, Wang B. A draft genome of the medicinal plant Cremastra appendiculata (D. Don) provides insights into the colchicine biosynthetic pathway . Communications Biology (2022) [DOI]
- Li H, Peng Y, Zheng J. Dioscorea bulbifera L.-induced hepatotoxicity and involvement of metabolic activation of furanoterpenoids . Drug Metabolism Reviews (2020) [DOI]
- Wang Y, Zhang Y, Wang Y, Shu X, Lu C, Shao S, Liu X, Yang C, Luo J, Du Q. Using Network Pharmacology and Molecular Docking to Explore the Mechanism of Shan Ci Gu (Cremastra appendiculata) Against Non-Small Cell Lung Cancer . Frontiers in Chemistry (2021) [DOI]
- Lee B, Basavarajappa HD, Sulaiman RS, Fei X, Seo SY, Corson TW. The first synthesis of the antiangiogenic homoisoflavanone, cremastranone . Organic and Biomolecular Chemistry (2014) [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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