Yinchen Wuling Powder: Protecting the Liver, Promoting Bile Flow, and Relieving Jaundice
Patients with hepatobiliary disease or tumors who present with abnormal liver function and hepatosplenomegaly often develop acute icteric hepatitis, accompanied by abdominal distension, dark urine, difficult urination, edema, grayish stools, yellowish skin, scleral icterus, yellow eyes, a bitter taste in the mouth, dry throat, and fever. Western medical examination reveals abnormal liver function and elevated bilirubin. In TCM this is differentiated as a damp-heat jaundice pattern, and Yinchen Wuling Powder (Yinchen Wuling San) or Yinchen Wuling Decoction (Yinchen Wuling Tang) is used for treatment.
Yinchen Wuling Powder first appears in the Jin Gui Yao Lue (Essential Prescriptions from the Golden Cabinet). It is prepared by grinding Herba Artemisiae Scopariae (Yin Chen Hao) into powder and mixing it with Wuling Powder powder at a ratio of 2:1, to treat "damp-heat jaundice where dampness predominates over heat." In modern practice it is usually given as a water-decocted formula: Herba Artemisiae Scopariae (Yin Chen Hao) 20–60 g, Poria (Fu Ling) 10 g, Polyporus (Zhu Ling) 10 g, Atractylodis (Cang Zhu) 10 g (or Rhizoma Atractylodis Macrocephalae (Bai Zhu) 10 g), Alismatis Rhizoma (Ze Xie) 15 g, Cinnamomi Cortex (Rou Gui) 6 g, decocted in water. Take 1–2 doses per day, divided into two administrations per dose. The author often adds Gardeniae Fructus (Zhi Zi) 10 g when using this formula for better efficacy. If the patient's condition is acute with constipation, Rhei Radix et Rhizoma (Da Huang) 6–10 g may be added.
Volume 11 of Song Zun Sheng (Venerable Teachings from Song Mountain) records a "Yinchen Wuling Tang" that is also derived from this base formula with additions. Its composition is: Atractylodis (Cang Zhu) 2 qian, Poria (Chi Fu Ling) 2 qian, Polyporus (Zhu Ling) 2 qian, Alismatis Rhizoma (Ze Xie) 2 qian, Cinnamomi Cortex (Guan Gui) 1 qian, Herba Artemisiae Scopariae (Yin Chen) 5 qian, Plantaginis Semen (Che Qian) 1.5 qian, Akebiae Caulis (Mu Tong) 1.5 qian, Bupleuri Radix (Chai Hu) 1.5 qian, decocted in water. If the jaundice is caused by alcohol—that is, what is now called "alcoholic liver disease"—add Puerariae Radix (Gan Ge, i.e., Ge Gen) 2 qian and a pinch of Junci Medulla (Deng Cao); Pueraria (Ge Gen) has the effect of counteracting alcohol. The dosage recorded in this book is unconventional: it instructs the patient to "take it continuously until the urine becomes clear," meaning it is decocted and drunk like water until the urine turns from yellow to clear. Here, Mu Tong must be Sichuan Mutong (Caulis Akebiae), not Guanmutong (Aristolochia manshuriensis).
Yinchen Wuling Powder is a representative formula of TCM disease differentiation and treatment; the disease it treats is precisely jaundice, and Herba Artemisiae Scopariae (Yin Chen Hao) is the TCM specialty herb for jaundice. In modern practice, Yinchen Wuling Powder combined with glucose lactone (0.3 g) injection has been used to treat jaundice, with an effective rate as high as 96.7% and a cure rate of 50%. After treatment, the main symptoms in most patients basically resolved, the enlarged liver and spleen markedly shrank, there was no obvious tenderness or percussion pain in the liver area, and liver function returned to normal.
If inpatient treatment progresses slowly or the patient is unwilling to be hospitalized, the author often combines the liver-protective drug glutathione (Atopolan) tablets with Yinchen Wuling Powder. It is likewise taken frequently without a fixed number of doses, while observing the color of the urine. Once the urine turns from yellow to clear, it may be reduced to one dose per day, divided into 2–3 administrations, and continued for two or three days to consolidate. Yinchen Wuling Powder can significantly shorten the hospital stay of jaundice patients and reduce treatment costs.