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15. Which herbs can be used as substitutes for substances that are banned or unavailable?

Traditional Chinese herbal medicine has a long history, which dates back 5000 years to the beginning of the Chinese civilization. It is the result of people’s effort to utilize nature for survival and is developed on the basis of long-term observation, study and practice under the guidance of ancient philosophy.

However, as the relationship between humans and nature has changed with time, some ingredients in TCM have become unavailable or protected and banned by legislation. Traditional herbal medicine must accommodate such change. Beside the usage of cultivated herbs and synthetic ingredients in the clinical practice, one can also use herbs with similar actions as substitutes. However, one must always bear in mind that, due to the specific function and characteristic of each herb, the therapeutic result of the substituted herb will never be completely the same as the original one.

The suggested substitutes are as follows:

• Xi Jiao (Rhinoceri cornu) can be replaced by Shui Niu Jiao (Bubali cornu). It can be also replaced by Da Qing Ye (Isatidis folium) and Sheng Ma (Cimifugae rhizoma at a ratio of 10:1.

• Hu Gu (Tigris os) can be replaced by Qian Nian Jian (Homalomenae rhizoma) and the bones of cat, pig or ox.

• Ling Yang Jiao (Antelopis cornu) can be replaced by Shan Yang Jiao (Naemorhedis

cornu). It can also be replaced by Shi Jue Ming (Haliotidis concha) and Qing Dai (Indigo naturalis) with a small amount of Chai Hu (Bupleuri radix).

• Lu Rong (Cervi cornu) can be replaced by the combination of Ba Ji Tian (Morindae radix) and Rou Gui (Cinnamomi cassiae cortex). It will also be helpful if venison is included in the patient’s diet.

• Gui Ban (Testudinis carapax) can be replaced by the combination of Shu Di Huang (Rehmanniae radix praeparata) and Shan Zhu Yu (Corni fructus). Meat and bone-marrow are also recommended in the patient’s diet.

• Bie Jia (Trionycis carapax) can be replaced by Shu Di Huang (Rehmanniae radix praeparata) and Sheng Di Huang (Rehmanniae radix) with Mu Dan Pi (Moutan cortex).

• She Xiang (Moschus) and Niu Huang (Bovis calculus) should be replaced by synthetic ones.

• Tian Ma (Gastrodiae rhizoma) can be replaced by Gou Teng (Uncariae ramulus cum uncis), Man Jing Zi (Viticis fructus), Ju Hua (Chrysanthemi flos) or Bai Ji Li (Tribuli fructus) to pacify the Liver and extinguishLiver-Wind, or combined with Xia Ku Cao (Prunellae spica), Di Long (Pheretima) and Jiang Can (Bombyx batrycatus) to eliminate Wind-Phlegm.

• Shi Hu (Dendrobii caulis) can be replaced by the combination of Sheng Di Huang (Rehmanniae radix) and Shu Di Huang (Rehmanniae radix praeparata).

• Gou Ji (Cibotii rhizoma) can be replaced by Gu Sui Bu (Drynariae rhizoma).

• Bai Ji (Bletillae tuber) can be replaced by Zi Zhu Cao (Callicarpae folium).

• Guang Mu Xiang (Aucklandiae radix) can be replaced by Chuan Mu Xiang (Vladimirae radix), Qing Pi (Citri reticulatae viride pericarpium) or Sha Ren (Amomi xanthioidis fructus).

• Hou Po (Magnoliae cortex) can be replaced by Zi Su Geng (Perillae caulis et flos) and Chuan Mu Xiang (Vladimirae radix) to regulate Qi and reduce distension. To direct Qi downward and remove dampness and food stagnation it can be replaced by Cang Zhu (Atractylodis rhizoma), Zhi Shi (Aurantii fructus immaturus) and Ban Xia (Pinelliae rhizoma).

• The use of Zhu Sha (Cinnabaris) is forbidden. It can be replaced by Long Chi (Mastodi fossilia dentis) and Zhen Zhu (Margarita usta) with Huang Lian (Coptidis rhizoma) to calm the Mind.

• Guan Mu Tong (Hocquartiae manshurensis caulis) is a poisonous herb and its use is forbidden. It should be replaced by Chuan Mu Tong (Clematidis armandii caulis) with careful control of both the Chinese name and the Latin name, or it can be substituted by Zhi Zi (Gardeniae fructus) or Tong Cao (Tetrapanacis medulla) with Huang Lian (Coptidis rhizoma) or Long Dan Cao (Gentianae radix).

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