Yu Nao Shi

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Larimichthys crocea (Richardson)

Not yet clinically reviewed

Pinyin: Yu Nao Shi
Yellow Croaker Ear-Stone

Traditionally used for

  • Ears & hearing
  • Nose & throat
  • Urinary & fluids
Traditional use

☯ TCM Properties

Category: clearing heat
Temperature: cold
Taste: sweet, salty
Meridians: bladder
Functions:

Dispels Heat, relieves toxicity, diminishes inflammation; Promotes diuresis, resolves stones and smooths urination

Traditional Chinese Uses

Yu Nao Shi (魚腦石, 'fish brain stone') is the otolith, the calcareous ear-stone, of the large yellow croaker, Larimichthys crocea, and related croakers. Salty and sweet with a cold nature, it enters the Bladder channel and is grouped with heat-clearing substances. Its principal use is to clear Heat, promote urination and resolve stones, treating damp-heat stranguria (lin syndrome), painful or difficult urination, and urinary calculi.

It is also applied, often powdered, to chronic nasal congestion and sinus discharge (bi yuan/rhinitis), and to inflammation and swelling. It is usually taken as a fine powder or in decoction. Note that the large yellow croaker is heavily overfished and now largely farmed; sustainably sourced material or stone-dissolving plant substitutes (e.g. Jin Qian Cao, Hai Jin Sha) are preferable where possible.

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Botanical Description

Yu Nao Shi (魚腦石), literally 'fish brain stone,' is the otolith — the calcium-carbonate ear bone — of the large yellow croaker, Larimichthys crocea (Richardson), and the small yellow croaker, Larimichthys polyactis (Bleeker) (Sciaenidae), marine fishes harvested along the coasts of eastern and southern China. The paired otoliths are recovered from the cranial cavity when the fish are processed for food, washed clean, and dried; the resulting smooth, hard, ivory-white stony bodies are 1–2 cm long with a characteristic groove. In TCM, Yu Nao Shi is classified as sweet and salty, neutral or cool, entering the Bladder and Kidney channels, and is used to promote urination, expel stones, clear heat, and detoxify, with classical and modern indications including urinary stones, painful urinary dysfunction, otitis media, and sinusitis (sometimes used topically as a powder). As an animal-derived material, plant fields do not apply.

Active Constituents

Calcium carbonate (aragonite polymorph)

Inorganic carbonate mineral

Concentration: the overwhelming bulk of the otolith; fish otoliths are generally reported as roughly 90-96% calcium carbonate by mass

Teleost otoliths are biomineralised calcium carbonate, deposited in most species as aragonite (vaterite and calcite occur as abnormal or partial polymorphs). This is the entire pharmacological basis of the drug: powdered Yu Nao Shi is an acid-neutralising, calcium-donating mineral, chemically comparable to any other carbonate mineral drug rather than to a plant medicine. No published assay of the medicinal article itself exists, so the composition given here is that of teleost otoliths in general and not a measurement of the trade drug.

Otolin and associated collagen-like organic matrix proteins

Structural glycoprotein / proteinaceous biomineral matrix

The small non-mineral fraction of an otolith is an organic matrix that templates the aragonite and forms the daily and annual growth increments fisheries scientists count. It has no established pharmacological role, and it is destroyed by the calcining (burning to ash) that the classical texts prescribe for this drug.

Strontium, barium, magnesium, sodium and other divalent trace elements

Trace elements substituting for calcium in the carbonate lattice

Trace elements enter otolith aragonite largely by substituting for calcium, which is why otolith Sr/Ca and Ba/Ca are used as environmental and stock-discrimination tags. Their concentrations therefore reflect the water the fish grew in, so farmed and wild material, and material from different coasts, are not chemically identical. Levels are trace and are not expected to be pharmacologically meaningful at the classical 3-9 g powder dose.

⚠ Drug Interactions

Larimichthys polyactis otolith (small yellow croaker, sold under the same name Yu Nao Shi)

Minor Evidence: Established

Chinese materia medica sources define Yu Nao Shi as the otolith of the sciaenid fishes Larimichthys crocea (large yellow croaker, formerly Pseudosciaena crocea) or Larimichthys polyactis (small yellow croaker), collected as a by-product of fish processing. The two are gathered and traded together and are not separated in commerce, so a batch labelled L. crocea routinely contains L. polyactis otoliths or a mixture. Because the drug is essentially aragonite in both cases, the substitution is chemically minor; it matters for provenance and for regulatory compliance rather than for pharmacology.

Clinical note: Do not treat species attribution on a label of this drug as verified. Note also that wild Larimichthys crocea is assessed as Critically Endangered on the IUCN Red List after the collapse of the East China Sea fishery, and effectively all current supply derives from aquaculture; sourcing should be confirmed.

Tetracyclines, fluoroquinolones, oral bisphosphonates and levothyroxine

Moderate Evidence: Theoretical

This interaction is inferred from the composition of the drug, not from any study of Yu Nao Shi. The article is predominantly calcium carbonate, and calcium carbonate is an established chelator of tetracycline and fluoroquinolone antibiotics and an established impairer of bisphosphonate and levothyroxine absorption; it also raises gastric pH. A 3-9 g dose of powdered otolith delivers a calcium load of the same order as a conventional calcium carbonate antacid tablet. No pharmacokinetic study of this drug has been published, so the evidence level is theoretical rather than observed.

Clinical note: Separate administration from these drugs by at least two hours, exactly as for a calcium supplement or antacid. Use with the same caution in patients on calcium-restricted regimens or with hypercalcaemia.

Historical Texts

Ri Hua Zi Ben Cao

Five Dynasties / early Song
Records taking the stone from within the head of the shi shou yu (croaker), burning it to a powder and swallowing it in liquid to treat shi lin, urinary stone with painful dribbling urination. This is the earliest clear statement of the drug's principal indication.

Kai Bao Ben Cao

Song dynasty (973-974)
States that it governs the downward expulsion of stone lin, and may be taken either by grinding the stone on a whetstone and drinking the levigate, or by burning it to ash and taking the powder.

Ben Cao Gang Mu

Ming dynasty (1578)
Li Shizhen records it powdered, or burnt and ground and taken in water, for dribbling urinary blockage and inability to urinate; and decocted and drunk to resolve arsenic poisoning and poisoning by wild mushrooms.

References

  1. Wood R. Seth, Chakoumakos Bryan C., Fortner Allison M., Gillies-Rector Kat, Frontzek Matthias D., Ivanov Ilia N., Kah Linda C., Kennedy Brian, Pracheil Brenda M.. Quantifying fish otolith mineralogy for trace-element chemistry studies . Scientific Reports (2022) [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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