Yinchenhao (Virgate Wormwood): Protecting the Liver and Gallbladder, Draining Dampness and Relieving Jaundice, Antibacterial and Anti-Cancer

Yinchenhao (also called yinchen) is the rootless seedling or above-ground part of Artemisia scoparia or Artemisia capillaris (Asteraceae), mostly harvested in the third or fourth lunar month. There is a folk saying: “March yinchen, April hao; May and June it is firewood.” Yinchen can be eaten as a vegetable; it is generally collected in March for medicinal use and in April for eating. By May and June it is too old to be used as medicine or as food, and can only be burned as firewood.

Yinchenhao is the dedicated TCM herb for protecting the liver and gallbladder and relieving jaundice. For jaundice, whether of cold or heat type, yinchenhao may be used. The Yinchenhao Tang in the Shanghan Lun (the contemporary Chinese patent medicine Yinzhihuang granules is made from this formula), the Yinchen Wuling San in the Jingui Yaolue, and the Yinchen Sini Tang in the Weisheng Baojian all take yinchen as the chief herb, combined with other drugs to treat jaundice of various causes.

The liver-protective and gallbladder-promoting action of yinchenhao has been confirmed by modern pharmacology. Various preparations of yinchen all promote bile secretion; multiple components in yinchen are choleretic. Hyperbilirubinemia caused by various hepatobiliary diseases in modern medicine can all be treated with yinchen. Yinchen markedly lowers bilirubin and transaminases, and has a clear therapeutic effect on liver damage caused by carbon tetrachloride.

Yinchen also has antipyretic and analgesic effects and anti-pathogenic-microbial action. Yinchen decoction inhibits to varying degrees Staphylococcus aureus, Corynebacterium diphtheriae, Bacillus anthracis, Salmonella typhi, Salmonella paratyphi A, Pseudomonas aeruginosa, E. coli, Shigella, Bacillus subtilis and Neisseria meningitidis.

Yinchen has a marked inhibitory effect on aflatoxin-induced liver carcinogenesis, in a dose-dependent manner. This pharmacological experiment suggests yinchen can prevent liver carcinogenesis. Yinchen can also directly kill tumor cells and inhibit their proliferation, so it is a common herb for treating tumors of the hepatobiliary system.

The Shennong Bencao Jing lists yinchen as an upper-grade medicine, holding that yinchen is bitter and neutral, “maintaining wind-damp, cold and heat evils, and heat-binding jaundice. Long-term use lightens the body, boosts qi and delays aging.” This shows that ancient Chinese physicians long recognized yinchen as the dedicated herb for jaundice. Whichever of wind-damp, cold or heat evils causes jaundice, yinchen can treat it; moreover, the Shennong Bencao Jing credited yinchen with anti-aging effects. The Bencao Jing Bielu also says yinchen “(maintains) yellowing of the whole body, difficult urination, clears head heat, removes hidden concretions; (long-term use) makes the face fair and radiant, prolonging life.” Thus both early materia medica works held that yinchen not only treats jaundice but also promotes longevity.

Yinchen both treats acute liver injury and promotes bile secretion to prevent chronic liver damage. So adding yinchen to anti-tumor formulas greatly benefits patients with hepatobiliary tumors. Ancients considered yinchen dedicated to jaundice and said it should not be used for sallow complexion from blood deficiency; in fact, sallow-from-blood-deficiency and jaundice are two different things. Although patients with blood-deficiency sallowness look yellow, their bilirubin is not elevated, and modern blood tests can distinguish them.

There was also a simple ancient method for checking elevated bilirubin: have the patient urinate onto a sheet of paper; if the paper looks as though dyed by phellodendron juice, it is jaundice. This method is simple and highly accurate. Professor Liu Duzhou mentioned that when using yinchen-series formulas, one also observes the patient’s urine, discontinuing yinchen when the urine turns from yellow to clear. In my experience, however, for patients with primary or secondary hepatobiliary tumors, even once the urine clears, yinchen should not be stopped; it should be used as a long-term medication. The maintenance dose may be somewhat lower, 6–10 g per day for adults; for acute icteric hepatitis the dose should be larger, 30–60 g or more per day.

Yinchenhao has very low toxicity; the usual clinical dose is non-toxic. Traditional TCM considers yinchenhao non-toxic (most materia medica works say so) or slightly toxic (e.g., the Yaoxing Lun). Animal experiments show that continuous use of yinchen for three months had no significant effect on body weight, blood count, urine analysis or liver tissue, causing only gastrointestinal irritation at large doses.

Combined with different herbs, yinchenhao treats all types of jaundice. The Tangtou Ge says: “Yinchenhao Tang treats yang jaundice, composed of zhizi and dahuang; zhizi baipi plus gancao, and yinchen sini treat yin jaundice.” This verse already explains several pairings: yinchenhao with zhizi and dahuang is the Yinchenhao Tang of the Shanghan Lun, dedicated to “yang jaundice” from damp-heat; yinchenhao combined with Sini Tang treats “yin jaundice” from cold-dampness.

The Depei Bencao is more detailed: “(Yinchenhao) with fuzi and ganjiang treats yin jaundice; with baixianpi treats jaundice yellow as gold; with shumi and malt, brewed into wine, treats spasms; assisted by dahuang and zhizi, treats damp-heat; assisted by taoren, treats blood jaundice; assisted by cangzhu and houpo, treats damp jaundice; assisted by zhishi and shanzha, treats jaundice from food retention; assisted by zhimu and huangbai, treats fire jaundice; assisted by cheqianzi and mutong, treats jaundice with difficult urination.”

Contemporary TCM often uses Yinchen Wuling San to treat jaundice and ascites, combining yinchenhao’s jaundice-relieving, water-draining, edema-reducing action with Wuling San’s qi-transforming, water-draining action. Yinchen Wuling San has some efficacy for ascites from cirrhosis and from liver cancer; if combined with Biejia Ruangan Pian, Renshen Biejia Jian Wan, Xihuang Wan, Dejia Banmaosu Pian or Dahuang Zhechong Wan, addressing both root and branch, the effect is more satisfactory.

Yinchenhao also treats skin itching from eczema. I often combine yinchenhao with yiyiren (Coix) to treat pruritus in advanced liver-cancer patients, with some efficacy.