寶鑑Bogam

Formulas · Clear Heat 淸熱 · Gogeum Uigam (古今醫鑑)

Poria Decoction for Syphilitic Sores

Bongnyeong-tang

한글 복령탕  ·  Pinyin Fu Ling Tang

茯苓湯

Registered with the chapter suffix. Two 茯苓湯 are already in the corpus — the 古今醫鑑 formula of the Women's chapter for gestational oedema and the 宣明方 formula of the Wind chapter for painful impediment — and this is a third, unrelated prescription: a fifteen-packet decoction for syphilitic ulceration built on 土茯苓, not on 白茯苓 or 赤茯苓. Neither existing entry holds the bare id, so the chapter tail is added in the same way. Note that the formula is named 茯苓湯 although the poria in it is 土茯苓, smilax, which is a different plant from Poria cocos; the leaf at 026b likewise calls a plain smilax decoction 茯苓湯. The transcription writes 醫鍳 for 醫鑑. 皂角刺 and 皂角 are both entered under 皂角 with the part named in the prep field, so that drug takes two rows.

Composition 構成

Total 756 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

  • Damp-heat toxin rotting the flesh with running pus
  • Toxin sunk into the sinews and bones of the lower limbs

Biomedical correlates

  • Advanced ulcerating syphilis — historical treatment
  • Syphilitic bone and joint disease

Source text 原文

Donguibogam 東醫寶鑑

治遠近楊梅ㆍ天疱瘡毒, 甚至腐爛肌肉, 膿汁流出, 臭不可聞, 痛不可忍. 薏苡仁ㆍ皂角刺ㆍ木瓜ㆍ白芷ㆍ當歸尾ㆍ黃栢ㆍ生地黃ㆍ牛膝ㆍ白芍藥ㆍ防風 各一兩, 皂角ㆍ川椒ㆍ紅花 各五錢, 甘草節ㆍ羌活 各七錢, 金銀花 二兩, 土茯苓 四兩. 右剉, 分作十五貼, 每一貼, 水煎服, 日二次. 《醫鑑》

Translation

Treats the toxin of plum-blossom and heavenly blister sores, whether of long standing or recent, going so far as rotted flesh, running pus, a stench that cannot be borne and pain that cannot be endured. Coix seed, the soap-bean thorn, chaenomeles, angelica dahurica, the tails of tangkuei, phellodendron, fresh rehmannia, achyranthes, white peony and saposhnikovia, 1 nyang each; the soap-bean pod, Sichuan pepper and safflower, 5 don each; the nodes of licorice and notopterygium, 7 don each; honeysuckle 2 nyang; smilax 4 nyang. Cut up and divide into fifteen packets; decoct one packet in water and take, twice a day. — Uigam 醫鑑 (Donguibogam · Jechang)

Clinical commentary 臨床

The longest and most carefully weighted of the syphilis decoctions. Four nyang of smilax and two of honeysuckle lead; ten drugs sit at an even nyang, three at five don, two at seven. Inside that are three distinct jobs: coix, chaenomeles, achyranthes and phellodendron drain damp-heat down and out through the legs, fresh rehmannia, white peony, tangkuei tails and safflower cool and move the blood, and the soap-bean thorn and pod with angelica dahurica and licorice nodes work on the sore itself — the nodes of licorice are the part the book reserves for suppuration. The indication is written as a clinical picture rather than a diagnosis: rotted flesh, running pus, an unbearable stench, unbearable pain. That is a gummatous ulcer, and the honesty of the description is worth more than the prescription. Of everything here, only drainage and cleanliness would have helped; the one real advance, that this leaf uses no mercury at all, is probably the reason it was reached for in cases already ruined by it. **Sichuan pepper (川椒) in quantity is a gastric irritant, and the formula is a strong cold-draining one not suited to a depleted patient. Syphilis is curable with penicillin and nothing here should be substituted for it.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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