Formulas · Clear Heat 淸熱 · Dongwon (東垣)

Dahurian Angelica and Cimicifuga Decoction

Baekjiseungma-tang

한글 백지승마탕  ·  Pinyin Bai Zhi Sheng Ma Tang

白芷升麻湯

The leaf's own text prints 臂癕; 癰 is printed above. The collation line reading 癰 against the 初刊本's 癕 falls inside this leaf's span in the transcription, at the foot of page 002a, but the word it annotates is the 臂癰 of the section head and the section text a few lines earlier, not anything in this leaf. Scutellaria appears twice, wine-treated and raw, and is listed twice at its two weights.

Composition 構成

Total 66 g per packet (첩) · representative dosage — verify against source texts.

Received this formula from your practitioner? Amounts shown here are classical reference values — granule and prepared products differ. Always follow your prescribed dosage and directions.

Actions 效能

Indications 主治

Pattern-based

  • 臂癰 — abscess on the arm along the hand yangming division
  • Wind-heat received in the upper body, where what is damaged by wind is struck above first
  • Channel heat with swelling and pain of the arm

Biomedical correlates

  • Abscess or cellulitis of the forearm or upper arm
  • Infected wound of the arm with surrounding inflammation
  • Suppurative lymphangitis of the limb

Source text 原文

Donguibogam 東醫寶鑑

治臂癰. 黃芪ㆍ酒黃芩 各四錢, 生黃芩 三錢, 白芷 一錢半, 升麻ㆍ桔梗ㆍ連翹 各一錢, 酒紅花ㆍ甘草 各五分. 右剉, 分二貼, 每取一貼, 酒水各半煎服. 《東垣》

Translation

Treats abscess on the arm. Astragalus and wine-treated scutellaria, 4 don each; raw scutellaria, 3 don; dahurian angelica, 1 don 5 fun; cimicifuga, platycodon and forsythia, 1 don each; wine-treated safflower and licorice, 5 fun each. Cut the above and divide into two packets; for each dose take one packet and decoct it in half wine and half water. — Dongwon 東垣 (Donguibogam · Ongjeo)

Clinical commentary 臨床

Dongwon's formula for an abscess on the arm, and the clearest case in the chapter of a formula built from where the lesion is rather than from what it is. The arm's outer aspect is the hand yangming division, so cimicifuga and platycodon lift the formula upward and outward into the limb, dahurian angelica opens the yangming and is the tradition's standing drug for pus in the upper body, and scutellaria — most of it wine-treated so that it rises rather than sinks — carries the heat-clearing. Astragalus at 4 don is there to hold the qi while all that happens, and the wine-treated safflower moves the blood in a small dose. The section's aetiology is 八風之變, the changes of the eight winds, with the gloss 傷於風者上先受之 — what is damaged by wind is struck first above. That is channel reasoning rather than a reading of the lesion; what is actually in front of the physician is an abscess or a cellulitis of the arm, which in the pre-antibiotic era was a limb- and life-threatening thing. **A spreading infection of a limb needs antibiotics and surgical assessment; abscesses need drainage, and lymphangitis tracking up the arm is an emergency.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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