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Chinese Medical Terms | Single Herbs | Prescriptions | Source Of Materia Medica | Herb To Herb Interactions


In Traditional Chinese Medicine, herb-to-herb interactions have been known for a long time, and include both synergistic as well as antagonistic interactions.

Synergistic Interactions

Synergistic Interactions are of the following two types:

  • Mutual Accentuation (Xiang Xu) - 相须
  • Mutual Enhancement (Xiang Shi) - 相使

Mutual Accentuation

In Mutual Accentuation, two herbs with similar functions are used together to increase their therapeutic effect. Examples include:

  1. Jing Jie (荆芥) with Fang Feng (防风) to expel wind and release the exterior
  2. Jin Yin Hua (金银花) with Lian Qiao (连翘) to reduce heat-toxin
  3. Da Huang (大黄) with Mang Xiao (芒硝) to promote bowel movement

Mutual Enhancement

In Mutual Enhancement, two herbs with different functions are used. The first directly targets the pathological condition, and the second increases the therapeutic effect of the first. Examples include:

  1. Zhi Mu (知母) with Huang Bai (黄柏), where Zhi Mu nourishes yin of the kidney and clears heat in the Lower-Jiao, while Huang Bai reduces empty-heat in the Lower-Jiao and is able to enhance the function of Zhi Mu.
  2. Fu Zi (附子) with Zhi Gan Cao (炙甘草), where sweet Gan Cao can moderate the speed of hot Fu Zi.
  3. Da Huang (大黄) with Zhi Gan Cao (炙甘草), where sweet Gan Cao can reduce the harsh purging effect of Da Huang.

Antagonistic Interactions

Antagonistic Interactions are of the following four types:

  • Mutual Counteraction (Xiang Wei) - 相畏
  • Mutual Suppression (Xiang Sha) - 相杀
  • Mutual Antagonism (Xiang Wu) - 相恶
  • Mutual Incompatibility (Xiang Fan) - 相反

Mutual Counteraction

In Mutual Counteraction, the characteristic side effects or toxicity of the first herb can be minimized or neutralized by the second herb. An example is:

  1. Ban Xia (半夏) with Sheng Jiang (生姜), where the toxic effects of Ban Xia can be reduced by Sheng Jiang.

Mutual Suppression

In Mutual Suppression, the first herb suppresses or minimizes the toxicity of the second herb. Examples include:

  1. Lv Dou (绿豆) with Ba Dou (巴豆), where Lv Dou can reduce the toxicity of Ba Dou.
  2. Ge Hua (葛花) with alcohol (酒), where Ge Hua can reduce the toxicity of ethanol.

Mutual Antagonism

The following is the classic list of eighteen substances that exhibit Mutual Antagonism to each other. For example, the effects of Ding Xiang will be countered by Yu Jin, and the herbs should not be taken together, although both are very common herbs.

No.Herb NameCounteracting Herb Name
1Mercury (Shui Yin) 水银Arsenolite (Pi Shuang) 砒霜
2Rhizoma Euphorbiae E. (Lang Du) 狼毒Lithargyrum (Mi Tuo Seng) 密陀僧
3Semen Crotonis (Ba Dou) 巴豆Semen Pharbitidis (Qian Niu Zi) 牵牛子
4Flos Caryphyili (Ding Xiang) 丁香Radix Curcumae (Yu Jin) 郁金
5Nitrum Depuratum (Ya Xiao) 牙硝Rhizoma Sparganii (San Leng) 三棱
6Cornu Rhinoceri (Xi Jiao) 犀角Rhizoma Aconiti Kusnezoffii (Cao Wu) 草乌
7Cornu Rhinoceri (Xi Jiao) 犀角Rhizoma Aconiti (Chuan Wu) 川乌
8Radix Ginseng (Ren Shen) 人参Rhizoma Trogopterorum (Wu Ling Zhi) 五灵脂
9Cortex Cinnamomi (Rou Gui) 肉桂Hallositum Rubrum (Chi Shi Zhi) 赤石脂
10Sulfur (Liu Huang) 硫磺Mirabilitum (Mang Xiao) 芒硝


Mutual Incompatibility

The following is the classic list of nineteeen substances that are incompatible with each other, and using them together can have dangerous results:

  • Gan Cao (甘草) is incompatible with the following:
No.PinyinSimplified Chinese
1Gan Sui甘遂
2Da Ji大蓟
3Yuan Hua芫花
4Hai Zao海藻
  • All forms of Wu Tou (乌头), including Chuan Wu (川乌), Cao Wu (草乌) and Fu Zi (附子), are incompatible with the following:
No.PinyinSimplified Chinese
1Chuan Bei Mu川贝母
2Zhe Bei Mu浙贝母
3Gua Lou, Gua Lou Ren, Gua Lou Pi栝楼, 栝蒌仁, 栝蒌皮
4Ban Xia半夏
5Bai Lian白蔹
6Bai Ji白芨
7Tian Hua Fen天花粉
  • Li Lu (藜芦) is incompatible with the following:
No.PinyinSimplified Chinese
1Ren Shen人参
2Bei Sha Shen北沙参
3Nan Sha Shen南沙参
4Ku Shen苦参
5Dan Shen丹参
6Xuan Shen玄参
7Bai Shao白芍
8Chi Shao赤芍
9Xi Xin细辛

Single Effect

Although rather rare, some herbs may be used alone (单行) because they have reasonably balanced properties and functions. These include

  • Ren Shen
  • Dan Shen
  • Dang Gui
  • Gan Cao


Herbs That Are Prohibited During Pregnancy

No.PinyinSimplified Chinese
1Chuan Wu川乌
2Cao Wu草乌
3Pi Shuang砒霜
4Chan Su蟾酥
5Qing Fen轻粉
6Dan Fan胆矾
7Ba Dou巴豆
8E Zhu莪术
9Gua Di瓜蒂
10Jing Da Ji京大戟
11Yuan Hua芫花
12Shui Zhi水栀
13Shui Yin水银
14Gan Sui甘遂
15She Xiang麝香
16Ban Mao斑蝥
17Qian Niu Zi牵牛子
18Shang Lu商陆
19Xiong Huang雄黄
20San Leng三棱
21Ma Qian Zi马钱子
22Meng Chong虻虫
23Gan Qi干漆
24Li Lu藜芦

Herbs That Are Used With Caution During Pregnancy

No.PinyinSimplified Chinese
1Niu Xi牛膝
2Rou Gui肉桂
3Lu Hui芦荟
4Jiang Huang姜黄
5Fu Zi附子
6Mu Dan Pi牡丹皮
7Zhi Ke枳壳
8Tao Ren桃仁
9Zhi Shi枳实
10Da Huang大黄
11Hong Hua红花
12Fan Xie Ye番泻叶
13Chuan Xiong川芎
14Mang Xiao芒硝

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Ref: http://apps.who.int/medicinedocs/documents/s17556en/s17556en.pdf

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