The Throat-Clearing, Cough-Suppressing, Hemostatic and Anticancer Effects of the TCM Herb Puffball (Mabo)
The Chinese medicine puffball (mabo) is the dried fruiting body of fungi of the Lycoperdaceae family, mainly Lasiosphaera fenzlii, Calvatia gigantea and Calvatia lilacina. It has aliases such as machibao and niushigu. Although puffball is not an edible mushroom, it was used as a medicinal herb from very early times.
The Miscellaneous Records of Famous Physicians (Mingyi Bielu) records that puffball "maintains evil sores and horse mange." When Tao Hongjing wrote his Collected Commentaries on the Materia Medica (Bencao Jizhu), he said puffball, "applied to various sores, works very well." Li Shizhen's Compendium of Materia Medica (Bencao Gangmu) records that puffball "clears the lung, disperses blood heat, and resolves toxicity," and can treat "lung-heat cough, throat bi, epistaxis, loss of voice and other disorders."
TCM holds that puffball is pungent in flavor and neutral in nature, and enters the lung meridian. It clears heat and benefits the throat, resolves toxicity and stops bleeding, and is indicated for sore swollen throat, cough with loss of voice, hematemesis and epistaxis, welling-abscesses (yongju), and chronic lower-leg ulcers (lianchuang).
Puffball is an important herb in throat medicine. Cough, sore throat and loss of voice caused by throat disorders are often treated with it. Its effective rate for infectious inflammatory throat conditions is 77.8%, for acute tonsillitis 86.6%, and its efficacy for cough also exceeds 80%. The effect is even better when combined with Physalis (suanjiang, the component of jindenglong/Chinese lantern calyx).
Puffball is also a remarkably effective hemostatic. In 113 cases of nosebleed treated with puffball ground into powder, besides 4 cases that failed because the epistaxis was caused by hypertension, aplastic anemia or leukemia, the remaining 109 cases all responded well. The Yuqiu Yaojie used it for "hematemesis from a fish bone lodged in the throat," and the Xiuzhen Fang (Pocket Prescriptions) used it for "hematemesis from accumulated heat." Contemporary TCM also uses puffball spore powder sifted through a fine mesh to treat post-prostatectomy bleeding, with good results.
Historical literature contains many records of puffball applied externally to treat malignant sores, chilblains and welling-abscesses. For example, the Bencao Congxin (New Compilation of Materia Medica) says: "I have often seen people apply cold and cooling herbs to sores; although the sore heals, heat-toxin attacks inward and gives rise to other disorders, doing no small harm. This herb (puffball) is pungent, neutral and dispersing, and is very safe." In contemporary practice, puffball powder mixed with an appropriate amount of petrolatum into a 1% or 5% ointment is applied to furuncles and changed every 2–3 days; the effective rate can exceed 80%, with the 5% ointment more effective than the 1%. There are also records of taking puffball internally for welling-abscesses; for example, the Waike Liangfang (Effective Prescriptions for External Medicine) adds a small amount of forsythia (lianqiao) to puffball and decocts them together to treat welling-abscesses. Puffball can also treat pressure ulcers (bedsores).
From these records we can broadly see that puffball reduces swelling, benefits the throat, counteracts inflammation, suppresses cough and stops bleeding. In vitro experiments show that an aqueous infusion of Lasiosphaera fenzlii indeed inhibits superficial dermatopathogenic fungi, mainly exerting varying degrees of inhibition on Microsporum audouinii and Microsporum ferrugineum. In addition, puffball substance is of very low toxicity; it inhibits Staphylococcus aureus, Bacillus anthracis, Salmonella typhi, Pseudomonas aeruginosa, Shigella (dysentery bacillus), Proteus and other pathogenic bacteria, has some antifungal activity, and also shows some activity against influenza virus and poliomyelitis virus.
Pharmacological experiments have also confirmed that the puffball compounds, puffball polysaccharides and puffball extracts contained in the herb all have antitumor effects. Puffball can inhibit the progression of liver cancer, leukemia, lung cancer, cervical cancer, breast cancer, sarcoma S180, laryngeal cancer, tongue cancer, thyroid cancer, malignant lymphoma and many other cancers. Lasiosphaera fenzlii, as a natural anticancer medicine, has already been used in the treatment of various cancers.
Puffball has certain toxic side effects; its adverse reactions are mainly allergic. After taking excessive puffball, some patients develop restlessness, nausea and vomiting, skin itching and other allergic symptoms, all of which resolve after anti-allergy treatment. Therefore, people with allergic constitutions should use puffball cautiously to avoid accidents. Puffball spore powder can cause "puffball spore disease," also called hypersensitivity pneumonitis syndrome, in which patients develop nausea, vomiting, fever and breathing difficulty; severe cases can even lead to infectious pneumonia. Since puffball spore disease is a fungal disease, it can be cured with steroids and antifungal drugs.
When puffball is used in a decoction, the usual adult dose is 2–6 g; it must be wrapped in cloth during decoction so that the spore powder does not enter the medicinal soup and cause an allergic reaction. TCM holds that puffball can only treat cough and loss of voice caused by wind-heat constraining the lung, and cannot be used for cough and loss of voice caused by wind-cold attacking the lung; it has an adverse effect on wind-cold patterns, so those whose illness is caused by wind-cold should use it cautiously.