An Effective Herb Pair for Hepatobiliary Disease: Houpo and Muxiang
Houpo, commonly also called Liepu, Chipu, or Chuanpu, is the dried stem bark, root bark, or branch bark of Magnolia officinalis, a plant of the magnolia family. TCM holds that it is bitter and pungent in taste and warm in nature, entering the spleen, stomach, lung, and large-intestine meridians; it moves qi, dries dampness, disperses accumulation, and calms wheezing. It is used for epigastric and abdominal fullness due to damp obstruction and qi stagnation, abdominal distension due to food accumulation or constipation, and cough and wheezing with much phlegm.
Muxiang, commonly also called Guangmuxiang, Yunmuxiang, or Weimuxiang, is the dried root of Aucklandia lappa and related plants of the daisy family. TCM holds that it is pungent and bitter in taste and warm in nature, entering the spleen, stomach, large-intestine, sanjiao, and gallbladder meridians; it moves qi, regulates the middle, and relieves pain. It is indicated for epigastric and abdominal pain due to spleen-stomach qi stagnation, tenesmus in diarrhea and dysentery, uncomfortable diarrhea due to food accumulation, abdominal distension due to spleen deficiency and qi stagnation, and—when spleen transport is deranged and the liver fails to diffuse freely—epigastric and abdominal pain, hypochondriac pain, jaundice, and hepatobiliary stones.
When Professor Qian Ying, the TCM liver specialist, was following his teacher Yao Zhengping in clinical practice, he saw Yao use the sanjiao qi-transformation theory to treat nephritic edema and other conditions. For cases belonging to middle-jiao qi stagnation with fluid retention, Yao often paired Muxiang with Houpo to move qi and promote diuresis, with very good results. Professor Qian Ying used a clinical controlled method to observe changes in patients' urine output when Muxiang and Houpo were used together. He found that after Muxiang and Houpo were used, urine output increased markedly and edema resolved rapidly; without them, urine output decreased.
Later, when treating cirrhosis ascites and hepatitis-B-related diseases, Professor Qian Ying also made a habit of adding this Muxiang-Houpo pair. After using them, patients' urine volume increased, abdominal distension and pain lessened, and ascites or edema resolved—an effect markedly better than without them. Professor Qian Ying considered this a typical embodiment of the sanjiao qi-transformation theory in the clinical management of hepatobiliary disease.
Professor Ling Yunpeng was another great modern master of TCM external medicine, also skilled in treating hepatobiliary disease. His medical work Linzhen Yide Lu records a case he treated of a patient surnamed Bao who, after surgery for gallstones, developed postoperative tissue adhesions with recurrent severe pain and vomiting.
On the patient's first visit, Ling Yunpeng, based on her symptoms, prescribed: Sugeng (Perilla stem) 9g, Baishao (white Paeonia) 24g, Yanhusuo (Corydalis) 12g, Sheng Gancao (raw Glycyrrhiza) 9g, Qingpi (green tangerine peel) 12g, Dafupi (areca husk) 12g, Chao Zhiqiao (fried Bitter Orange) 9g, Binglang (Areca) 6g, Gualou (Trichosanthes fruit) 18g, and Meiguihua (rose) 2g. After taking this formula the patient's condition did not worsen, but the pain was not markedly relieved. Ling Yunpeng then added Houpo 6g and Muxiang 9g to the formula. The patient recovered after taking just 2–3 doses.
It is evident that for this kind of hepatobiliary disease, the Muxiang-Houpo pair truly has an immediate effect. The pairing of Muxiang and Houpo is not often seen in ancient medical works; even Shi Jinmo, who was known for his skill in using herb pairs, did not record it. Yet two modern masters of liver disease are both skilled in using this combination to resolve hepatobiliary problems, with remarkable results; Professor Qian Ying even conducted a controlled clinical trial and obtained supporting clinical data. Their experience is well worth our learning from.