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Calculus bovis sativus is an artificially cultivated substitute for natural calculus bovis (cattle gallstones) used in traditional Chinese medicine. It is produced by culturing fresh bovine bile with added cholic acid, deoxycholic acid, and other compounds to mimic the natural stone formation process in cattle via physical and biochemical pathways. The resulting product has similar physical and chemical properties to natural calculus bovis but differs somewhat in the content of bilirubin and bile acids. According to the Pharmacopoeia of the People's Republic of China, it must contain at least 6% total bile acids and 35% bilirubin by dry weight. Calculus bovis sativus is used as a substitute for scarce natural gallstones for indications such as high fever, convulsions, stroke recovery support, liver protection, anti-inflammatory effects, neuroprotection after cerebral ischemia/reperfusion injury (CI/RI), immunomodulation including inhibition of M2 tumor-associated macrophage polarization (potentially relevant for cancer therapy), among others[1][2][4]. Its mechanism involves modulation of immune responses and signaling pathways such as Wnt/β-catenin.
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