Therapeutic uses of animal biles in traditional Chinese medicine: An ethnopharmacological, biophysical chemical and medicinal review

Table 1 A chronological list of animal biles used therapeutically in China from the earliest times

Chinese name (Pin Yin)	English name	Latin nomenclature	Earliest recorded book, year and author	Bile salt and alcoholcomposition1	Bile pigment composition1
Gou Dan	Dog	Canis familiaris	Prescriptions for Fifty-two Types of diseases (c. 475 to 221 BCE); author(s) unknown	TC, TCDC, TDC[87,102,166]	BDG, BDGC, BMX[167,168]
Niu Dan	Ox	Bos taurus domesticus; Bubalus bulalis		TC, TDC, TCDC, TLC, GC, GDC, GCDC, GLC, AC[91,100,107,166]	BMG, BMGC, BDG, UCB, BV[167,169,170]
Li Yu Dan	Common carp	Cyprinus carpio	Shen Nong’s Herbal Classic (c. 475 to 206 BCE); author(s) unknown	TCDC, TC, TDC, AC, α-cyprinol-26 SO4, α-latimerol-SO4[87,91,107]	BV, BMG, PB, UCB[169-171]
Shu Dan	Mouse	Mus musculus	Variorum of Shen Nong’s Herbal Classic (c. 492 CE); Tao Hong-Jing (c. 452 to 536 CE)	TC, TCDC, TDC, T-β-MC, T-ω-MC, TUDC[172]	BMG, BDG, UCB[173]
Ran She Dan	Python	Python molurus bivittatus		TPC, TC, TDC[87,106,107]	BV, BMG, UCB[174]
Yang Dan	Goat and sheep	Capra hircus		TC, TCDC, TDC, GC, GDC[87,100,107,166]	BMG[167,168]
Zhu Dan	Pig	Sus scrofa domestica	Records of Famous Physicians (c. 510 CE); Tao Hong-Jing (c. 452 to 536 CE)	GHC, GHDC, GHOC, GC, GCDC, GDC, THC, THDC, TC, TCDC, TDC[89,94,166]	BMG, BV[167,168,170]
Fu She Dan	Pallas pit viper	Agkistrodon halys		TC, TAC, TCDC, TDC[107]	BV, BMG, UCB[174]
Ji Dan	Chicken	Gallus gallus domesticus		TAC, TC, TCDC[89,166]	BV, BMG, BMGC, BDG, BDGC, UCB[167,175]
Xiang Dan	Elephant	Elephas maximus	Lei’s Treatise on Preparation of Drugs (c. the 5th century); Lei Xiao (c. the 5th century)	3α,7α,25,26-tetrahydroxy-5β-cholestane SO4[107]	ND
Li Yu Dan	Murrel	Ophicephalus argus	Ri Hua-Zi’s Collected Materia Medica (c. the 6th century); Ri Hua-Zi (c. the 6th century)	TCDC, TC, TDC[107]	BV, BMG, PB, UCB[168,170,171]
Xiong Dan	Bear	Selenarctos thibetanus; Ursus arctos	Treatise on Properties of Drugs (c. 643 CE or earlier); Zhen Quan (c. 540 to 643 CE)	TUDC, TC, TCDC, TDC[66]	BR, BFL, BFU[70]
Ye Zhu Dan	Wild boar	Sus scrofa	A Dietetic Materia Medica (c. 710 CE); Meng Xian (c. 621 to 714 CE)	GHC[87]	BMG, BV[167,168,170]
Jiao Yu Dan	Shark	Mustelus manazo		5β-scymnol SO4[107]	BV, BMG, PB, UCB[168,170,171]
Qing Yu Dan	Black carp	Mylopharyngodon piceus		5α-cyprinol-26 SO4[107]	BV, BMG, PB, UCB [168,170,171]
Ling Yang Dan	Antelope	Saiga tatarica	Medical Secrets of an Official (c. 752 CE); Wang Tao (c. 702 to 772 CE)	TC, TCDC, TDC[87,107]	ND
Huan Yu Dan	Grass carp	Ctenopharyngodon idellus	A Supplement to Materia Medica (c. 758 CE); Chen Zang-Qi (c. the 8th century)	TCDC, TC, TDC, 5α-cyprinol-26 SO4[107]	BV, BMG, PB, UCB[168,170,171]
Hu Dan	Tiger	Panthera tigris		TC, TCDC, TDC[107]	ND
Ren Dan	Human	Homo sapiens		GC, GCDC, GDC, GUDC, GLC, TC, TCDC, TDC, TUDC, TLC, SGLC, STLC[13,176]	BDG, BMG, BMGG1, BDGC, BMGC, BMX, UCB[173]
Ta Dan	Otter	Lutra lutra	Illustrated Pharmacopoeia (c. 1061 CE); Su Song (c. 1019 to 1101 CE)	TC, TCDC, TDC, GC, GDC[87,107]	ND
Hu Dan	Fox	Vulpes vulpes		TC, TCDC, TDC[87,107]	ND
Wei Dan	Hedgehog	Erinaceus europaeus; Hemiechinus dauuricus	Amplified Materia Medica (c. 1116 CE); Kou Zong-Shi (c. the 12th century)	TCDC, TC, TDC[107]	ND
E Dan	Goose	Anser domestica	Pharmacopoeia in Southwestern China (c. in the middle of the 15th century); Lan Mao (c. 1397 to 1496 CE)	TCDC, TACDC, TPHC, TBC[107]	BV, BMG, BMGC, UCB[168]
Ya Dan	Duck	Anas domestica	Compendium of Materia Medica (1596 CE); Li Shi-Zhen (1518 to 1593 CE)	TCDC, TACDC, TPHC, TBC, 3α7α11β-trihydroxy-5β-cholan-24-oic acid[107]	BV, BDG, BDGC[177]
Lu Dan	Deer	Cervus nippon; Cervus elaphus		GC, GCDC, GDC[107]	ND
Hou Dan	Horseshoe crab	Tachypleus tridentatus		Medium-chain fatty acids conjugated with sarcosyl taurine[22,107]	ND
Ji Yu Dan	Crucian carp	Carassius auratus		α-cyprinol-26 SO4[107]	BV, BMG, PB, UCB[168,170,171]
Bie Dan	Turtle	Amyda sinensis		3α7α22-trihydroxy-5β-cholan-27-oic acid, sterocholanic acid, 3α12α22-trihydroxy-5β-cholan-27-oic acid[107]	BV, BMG, UCB[168,174]
Gui Yu Dan	Mandarin fish	Siniperca chuatsi		TCDC, TC, TDC[107]	BV, BMG, PB, UCB[168,170,171]
Wu Ya Dan	Crow	Corvus macrorhynchus		TCDC, TC, TDC[107]	BV[168]
Yuan Dan	Soft-shelled turtle	Pelochelys bibroni		TsteroC, TsteroCDC, TsteroDC[107]	BV, BMG, UCB[168,174]
Ha Ma Dan	Chinese forest frog	Rana limnocharis		Pentahydroxy C27 and C26 bile alcohol SO4, taurine conjugated C27 trihydroxy acids[107]	BV, UCB[168,170,178,179]
Wu She Dan	Black snake	Zaocys dhumnades		TC, TAC, TCDC, TDC[107]	BV, BMG, UCB[174]
Gui Dan	Tortoise	Chinemys reevesii		TsteroC, TsteroCDC, TsteroDC[107]	ND
Bian Fu Dan	Bat	Vespertilio superans; Pipistrellus abramus; Plecotus auritus; Rhinolophus ferrum-equnum		TC[107]	ND
Ci Wu Dan	Raven	Corvus monedula dauuricus	A Supplement to the Compendium of Materia Medica (c. 1765 CE); Zhao Xue-Min (1719 to 1805 CE)	TCDC, TC[107]	BV[168]
Mao Niu Dan	Yak	Bos grunniens	Jing Zhu Materia Medica (c. 1840 CE); Dan-Zeng Peng-Cuo (c. the 19th century)	TC, TCDC, TDC, GC, GCDC, GDC[107]	BMG, BMGC, BDG, UCB, BV[167,169,170]
Ye Niu Dan	Gaur	Bos gaurus		TC, TCDC, TDC, GC, GCDC, GUDC[107]	BMG, BMGC, BDG, UCB, BV[167,169,170]
Shi Long Zi Dan	Skink	Eumeces chinensis Gray; Eumeces elegans; Sphenomorphus indicus		TC, TCDC, GHDC, Tvaranic acid, T3α,7α,12α-trihydroxy-5β-cholestan-27-oic acid[90,107]	BV, BMG, UCB[170]
Ying Wu Dan	Parrot	Psittacula alexandri fasciata		TC, TCDC[107]	BV[168]
Ma Dan	Horse	Equus caballus		TC[87,107]	BDG, BDGC, BMG, BMGC[175]
Tu Jiu Dan	Vulture	Gypaetus barbatus aureus		TC, TCDC, TalloC[107]	ND
Yuan Dan	Kite	Milvus korschun lineatus	Great Dictionary of Chinese Materia Medica (1977 CE); Jiangsu New Medical College	TC, TCDC, TalloC[107]	ND
Chan Chu Dan	Toad	Bufo bufo gargarizans; Bufo melanostictus		Bufol SO4, Ranol SO4, hexahydroxy-27-nor-C26-bile alcohol SO4[107]	BV[168,170,178,179]

¹Bile salt and bilirubin compositions are shown according to the rank order of species from high to low, respectively. AC: Allocholate; C: Cholate; DC: Deoxycholate; GC: Glycocholate; GCDC: Glycochenodeoxycholate; GDC: Glycodeoxycholate; GHC: Glycohyocholate; GHDC: Glycohyodeoxycholate; GHOC: Glyco-3α-hydroxy-6-oxo-5β-cholate; GLC: Glycolithocholate; GUDC: Glycoursodeoxycholate; TAC: Tauroallocholate; TBC: Taurobitocholate; TC: Taurocholate; TCDC: Taurochenodeoxycholate; TDC: Taurodeoxycholate; THC: Taurohyocholate; THDC: Taurohyodeoxycholate; TLC: Taurolithocholate; T-β-MC: Tauro-β-muricholate; T-ω-MC: Tauro-ω-muricholate; TPC: Tauropythocholate; TPHC: Taurophocacholate; TsteroC: Taurosterocholate; TsteroCDC: Taurosterochenodeoxycholate; TsteroDC: Taurosterodeoxycholate; TUDC: Tauroursodeoxycholate; SGLC: Sulfoglycolithocholate; STLC: Sulfotaurolithocholate; BDG: Bilirubin diglucuronide; BDGC: Bilirubin diglucoside; BFL: Biliflavin; BFU: Bilifulvin; BMG: Bilirubin monoglucuronide; BMGC: Bilirubin monoglucoside; BMGG1: Bilirubin monoglucuronide monoglucoside; BMX: Bilirubin monoxyloside; BR: Bilirubin; BV: Biliverdin; PB: Phycobilin; UCB: Unconjugated bilirubin; ND: Not determined.

Table 2 A list of diseases treated by animal biles in traditional Chinese medicine

Disease	Animal bile or gallstones
Digestive system
Jaundice	Bear, ox
Biliary colic	Bear, python, yak
Epigastric pain	Fox, gaur, kite
Gastric regurgitation	Bear, dog, pig
Infantile malnutrition	Bear, dog, pig, python, tiger, wild boar
Hemorrhoids	Bear, duck, goose, hedgehog, ox, python, turtle
Anal fistula	Bear, turtle
Dysentery	Bear, dog, python, tiger
Diarrhea	Bear, dog, pig
Constipation	Pig
Intestinal parasites	Bear, ox, dog, pallas pit viper, crucian carp, horseshoe crab
Stuck fishbone	Black carp, crucian carp, grass carp, mandarin fish
Acute alcoholism	Fox
Alcoholic cirrhosis	Fox
Food poisoning	Parrot
Skin
Infectious skin diseases	Bear, chicken, common carp, crucian carp, dog, elephant, goat and sheep, horse, ox, pallas pit viper, pig, python, vulture, wild boar
Burns	Pig, human, wild boar
Traumatic injury	Deer, dog, human, mouse
Darkish complexion	Antelope, goat and sheep
Tinea versicolor	Antelope, goat and sheep
Chloasma, freckle, ephelis	Antelope, goat and sheep
Shampoo for hair	Pig
Leprosy	Black snack, horseshoe crab
Eyes
Infectious eye diseases	Black carp, chicken, common carp, crow, dog, duck, goat and sheep, hedgehog, otter, pig, python, skink, tortoise
Improving visual acuity	Bat, bear, common carp, crow, mouse, ox, pig, python, skink, tortoise
Optic atrophy	Common carp, elephant, goat and sheep, mouse, python, raven
Night blindness	Bat, common carp, mouse, pig, raven
Glaucoma and cataract	Black carp, elephant
Eye injury	Chicken, goat and sheep
Ears
Suppurative otitis media	Dog, mouse
Deafness	Crucian carp
Nose
Rhinitis	Dog
Nasal sinusitis	Bear
Rhinorrhea	Bear
Nasal polyp	Dog
Mouth
Tonsillitis	Black carp, ox gallstones, shark
Gingivitis	Python
Gingival atrophy	Python
Dental caries	Python
Halitosis	Elephant
Throat
Laryngitis	Bear, black carp, common, grass carp, pig, murrel
Pharyngitis	Shark, soft-shelled turtle
Infantile hoarseness and aphonia	Chinese forest frog
Respiratory system
Bronchitis	Ox gallstones, toad
Pneumonia	Ox gallstones
Cough	Ox gallstones, pig
High fever in children
Infantile convulsions	Bear, ox (bile), ox gallstones, tiger
High fever in children	Human, ox gallstones, pig, python
Cardiovascular system
Apoplexy	Ox gallstones
Angina pectoris	Bear
Neuropsychiatric disorders
Epilepsy	Fox, Ox gallstones, wild boar
Coma	Ox gallstones, fox
Gynecological disorders
Irregular or scanty menstruation	Otter
Amenorrhea or amenia Menostasis	Otter
Chancre	Mouse
Endocrine system
Diabetes mellitus	Crucian carp, pig
Urinary system
Diuresis	Chicken
Cystitis	Chicken
Hematuria	Bear
Strangury	Bear, chicken

Table 3 A list of animal biles according to organism groupings used therapeutically in China

Class	Animal bile
Mammals	Antelope, bat, bear, deer, dog, elephant, fox, gaur, goat and sheep, hedgehog, horse, human, mouse, otter, ox, pig, tiger, wild boar, yak
Birds	Chicken, crow, duck, goose, kite, parrot, raven, vulture
Reptiles	Black snake, pallas pit viper, python, skink, soft-shelled turtle, tortoise, turtle
Amphibians	Chinese forest frog, toad
Fish	Black carp, common carp, crucian carp, grass carp, mandarin fish, murrel, shark
Arthropods	Horseshoe crab