Formulas · Purge Downward 瀉下 · Jeoneul (錢乙)

Hundred Auspices Pill

Baeksang-hwan

한글 백상환 · Pinyin Bai Xiang Wan

百祥丸

The drug is 紅芽大戟 and not 芫花; 芫花 occurs once in this chapter and not in this leaf or in 棗變百祥丸. 紅芽大戟 has no entry of its own in the herb dictionary and is entered against `daegeuk` 大戟 with the sprout name carried in `prep`, following the corpus’s own handling of it in 太乙紫金丹. 不以多少 gives no quantity, so the row carries no grams. The transcription writes 黑䧟, 隂, 晒 and 為; printed 黑陷, 陰, 曬 and 爲 as the corpus prints them, and 硏 is kept. 戞 is left as the transcription writes it, having no entry in the variant table. The two formulas named at the close are this chapter’s own and are linked; 脂麻湯 is the vehicle for swallowing the pill and takes no link.

Composition 構成

Daegeuk Da Ji
大戟 대극 · Peking Spurge (toxic)

—
Chief 君

紅芽大戟, the red-sprout kind, 不以多少 in any quantity; shade-dried, boiled soft in fermented millet water, the woody core removed, sun-dried, returned to the liquor and boiled until the liquor is gone, then baked dry and powdered · violent purgative, toxic

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 1 ingredient measured by count or used as a vehicle, shown as —.

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

Given for the grave case where the pox is purple-black, sunk and lying flat, with shivering, locked jaw and grinding teeth
Red-sprout spurge root alone, long processed, made into millet-sized water pills, 10 to 20 at a time in a sesame decoction
The leaf declares the formula too drastic and directs that it be replaced by Jobyeonbaeksang-hwan or Gamiseonpung-san

Indications 主治

Pattern-based

痘紫黑陷伏 — the pox purple-black, sunk and lying flat
寒戰ㆍ口噤ㆍ戞齒 — shivering, the jaw locked, the teeth grinding

Biomedical correlates

Haemorrhagic smallpox

Source text 原文

Donguibogam 東醫寶鑑

治痘紫黑陷伏ㆍ寒戰ㆍ口噤ㆍ戞齒危證. 紅芽大戟不以多少, 陰乾, 漿水煮軟, 去骨, 曬乾, 復納汁中煮, 汁盡, 焙乾爲末. 右水丸黍米大, 每一二十丸, 硏脂麻湯下. 此方太峻, 宜代以<a href='/formulas/jobyeonbaeksang-hwan'>棗變百祥丸</a>ㆍ<a href='/formulas/gamiseonpung-san'>加味宣風散</a>. 《錢乙》

Translation

Treats the grave case in which the pox is purple-black, sunk and lying flat, with shivering, the jaw locked and the teeth grinding. Red-sprout spurge root, in any quantity. Dry it in the shade, boil it soft in fermented millet water, take out the woody core, dry it in the sun, put it back into the liquor and boil it again until the liquor is gone, then bake it dry and make it into a powder. Make the above into water pills the size of millet grains, 10 to 20 at a time, ground and taken down in a sesame decoction. This formula is too drastic; it should be replaced by the Jujube-Transformed Hundred Auspices Pill or by the Augmented Disperse Wind Powder. — Jeoneul 錢乙 (Donguibogam · Soa)

Clinical commentary 臨床

One drug, processed at length. Red-sprout spurge root is dried in the shade, boiled soft in fermented millet water, stripped of its woody core, sun-dried, returned to the same liquor and boiled until the liquor is gone, then baked dry and powdered into millet-sized water pills. Ten to twenty go down in a sesame decoction. Every step of that is an attempt to take the edge off the material, and the quantity of the drug is not even stated — 不以多少, in whatever amount. **And then the leaf stops and says so itself: 此方太峻, 宜代以棗變百祥丸加味宣風散 — this formula is too drastic, it should be replaced by the jujube-transformed version or by the augmented Disperse Wind Powder.** That is the best thing in this group of leaves. The warning is not being brought to the text from outside; the physician who set the formula down also set down that he would rather it were not used, and named the two milder things to use instead. 棗變百祥丸 then explains what it does to moderate it. Taken together the two leaves are a worked example of a tradition keeping its own account of a drug’s danger. 大戟 is the root of Euphorbia pekinensis. Its active constituents are ingenol-type diterpene esters: they burn mucous membrane on contact and produce violent vomiting and watery diarrhoea. The indication is a child whose eruption has gone purple-black and sunk, which is haemorrhagic smallpox, and who is shivering with a locked jaw. **A drastic purgative given to a child who is already losing fluid is the wrong direction, and fluid loss was itself one of the things that killed children with a confluent eruption** — the one thing modern care would have corrected with nothing more than fluid. The chapter treats the black sinking as a poison shut inside that must be driven out below, and this is the drug it reaches for to do it. **Contains 大戟, spurge root, a violent purgative and a mucosal caustic, given by mouth to an infant in a quantity the leaf does not state. This must not be prepared or given.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.