Formulas · Reduce Food Stagnation 消食 · Gogeum Uigam (古今醫鑑)

Fatten-the-Child Pill

Bia-hwan

한글 비아환 · Pinyin Fei Er Wan

肥兒丸

The transcription writes 泥褁 for 泥裹, kept as written, as the corpus keeps 封褁 at 辰砂膏. 醫鍳 is normalized to 醫鑑 and 殺虫 to 殺蟲. The leaf writes 碗, not the 椀 it uses in 煮肝丸; both forms stand as transcribed, since 碗/椀 is not in the normalization table. 疳積餠 is linked because it is registered from this same chapter at 1.37.

Composition 構成

Hohwangnyeon Hu Huang Lian
胡黃連 호황련 · Picrorhiza

20 g
Chief 君

5 don
Sagunja Shi Jun Zi
使君子 사군자 · Rangoon Creeper Fruit

18 g
Chief 君

使君子肉, the shelled kernel, 4 don 5 fun · Quisqualis, an anthelmintic still in use
Insam Ren Shen
人蔘 인삼 · Ginseng

14 g
Deputy 臣

3 don 5 fun
Hwangnyeon Huang Lian
黃連 황련 · Coptis

14 g
Deputy 臣

stir-fried in ginger juice, 3 don 5 fun
Singok Shen Qu
神麴 신곡 · Medicated Leaven

14 g
Deputy 臣

stir-fried, 3 don 5 fun
Maega Mai Ya
麥芽 맥아 · Barley Sprout

14 g
Deputy 臣

stir-fried, 3 don 5 fun
Sansa Shan Zha
山楂 산사 · Hawthorn

14 g
Deputy 臣

山楂肉, the flesh of the fruit, 3 don 5 fun
Baekchul Bai Zhu
白朮 백출 · White Atractylodes

12 g
Deputy 臣

3 don
Baekbongnyeong Fu Ling
白茯苓 백복령 · Poria (white)

12 g
Assistant 佐

3 don
Nohoe Lu Hui
蘆薈 노회 · Aloe

10 g
Assistant 佐

2 don 5 fun, set in a bowl, wrapped in clay and baked through in bran ash · aloe, a stimulant laxative
Gamcho Gan Cao
甘草 감초 · Licorice

12 g
Envoy 使

roasted, 3 don
Hwangmi Huang Mi
黃米 황미 · Yellow Millet

—
Envoy 使

黃米糊, yellow millet paste, to bind the pills

Total 154 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

The chapter's first mainstay for every kind of gan, paired with 疳積餠
Disperses gan and breaks accumulation, grinds away the lodged mass, clears heat, checks the liver, supplements the spleen, brings on appetite and kills worms
Mung-bean sized pills on yellow millet paste, twenty or thirty in rice decoction

Indications 主治

Pattern-based

諸疳 — gan of every kind, as the general formula of 1.38.18 諸疳通治藥
疳積 — gan with accumulation, the belly hard and distended, appetite gone or disordered

Biomedical correlates

Protein-energy malnutrition in a young child
Ascariasis and other intestinal helminthiasis
Failure to thrive with chronic diarrhoea

Source text 原文

Donguibogam 東醫寶鑑

凡疳病以肥兒丸ㆍ<a href='/formulas/gamjeok-byeong'>疳積餠</a>爲主. 此藥消疳化積, 磨癖淸熱, 伐肝補脾, 進食殺蟲. 胡黃連五錢, 使君子肉四錢半, 人參ㆍ黃連(薑汁炒)ㆍ神麴(炒)ㆍ麥芽(炒)ㆍ山楂肉各三錢半, 白朮ㆍ白茯苓ㆍ甘草(灸) 各三錢, 蘆薈(碗盛泥褁糠灰火煨透) 二錢半. 右爲末, 黃米糊和丸菉豆大, 米飮下二三十丸. 《醫鑑》

Translation

In every case of gan disease, Fatten-the-Child Pill and Gan-Accumulation Biscuit are the mainstays. This medicine disperses gan and transforms accumulation, grinds away the lodged mass and clears heat, checks the liver and supplements the spleen, brings on the appetite and kills worms. Picrorhiza, 5 don; shelled Quisqualis kernel, 4 don 5 fun; ginseng, coptis (stir-fried in ginger juice), medicated leaven (stir-fried), malt (stir-fried) and hawthorn flesh, 3 don 5 fun each; white atractylodes, white poria and roasted licorice, 3 don each; aloe, 2 don 5 fun, set in a bowl, wrapped in clay and baked right through in bran ash. Powder the above and bind it with yellow millet paste into pills the size of a mung bean; twenty or thirty in rice decoction. — Uigam 醫鑑 (Donguibogam · Soa)

Clinical commentary 臨床

The name says what it was for and it is the most honest title in the chapter: 肥兒丸, the pill to fatten the child. Structurally it is 四君子湯 — ginseng, white atractylodes, white poria, roasted licorice — with the three food-moving drugs (medicated leaven, malt, hawthorn), picrorhiza and coptis for the heat, Quisqualis for the worms, and a baked aloe. That makes it the best-designed formula in the group: it is the only one of these that supplements at all, and ginseng with atractylodes, poria and licorice in a child who cannot eat is at least pointed at the right problem. **It is still not food.** A pill is not calories, and a child with 疳 is starving. What a wasted child needs is energy and protein by mouth in quantity, with micronutrients, and with the infections treated — today, ready-to-use therapeutic food, which reverses severe acute malnutrition in weeks and costs very little. Twenty or thirty mung-bean pills of bitters and millet paste cannot do that, and the chapter's pairing of this pill with 疳積餠 is quietly telling: of the two, it is the biscuit that carries the flour and the sugar. The full statement is on 五疳保童元. **The Quisqualis at 4 don 5 fun is a real anthelmintic and ascariasis is what it treats.** A heavy worm burden in an underfed child steals the calories it has and can obstruct the bowel; a single dose of albendazole or mebendazole now clears it at a measured dose for a few cents. **An effective drug with no stated dose is still a hazard** — enough 使君子 causes hiccup, vomiting and diarrhoea, and the only quantity for the child here is "twenty or thirty pills". **Contains aloe — a stimulant laxative — in the chapter's own first-choice pill for a malnourished child, and the text gives no dose by weight anywhere.** The clay-wrapping and bran-ash baking is a real attempt at taming it, and it would reduce the anthraquinones somewhat, but the formula is still giving a purgative to a child whose presenting sign is often diarrhoea. In an infant, fluid loss that an adult would shrug off is a circulating-volume emergency. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.