寶鑑Bogam

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

Support in Peril Powder

Buwi-san

한글 부위산  ·  Pinyin Fu Wei San

扶危散

The transcription reads 去翅足 and the First Edition reads 趐 for 翅; the transcription's reading is printed, following the 底本 rule. The collation note 真 : 眞 standing beside it belongs to the 狂犬傷 prose leaf above, where 玉眞散 is named, not to this leaf. 雄黃 and 溫 are printed with the standard glyphs for the transcription's 雄黄 and 温, and 《醫鑑》 for 醫鍳. The 狂犬傷出毒法 section's own prose names 扶危散 and then gives, after a ○, a differently composed powder from the 入門 — saposhnikovia, rhubarb, black morning-glory seed head-powder, blister beetle, musk and realgar — so the section carries two prescriptions for the same purpose; the composition here is the 醫鑑 one.

Composition 構成

Total 45 g per packet (첩) · representative dosage — verify against source texts. Excludes 2 ingredients 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

Indications 主治

Pattern-based

  • 風狗咬 — the bite of a mad dog
  • Toxin held in the body after a rabid bite, to be driven out below

Biomedical correlates

  • Rabid or suspect animal bite — a medical emergency requiring immediate post-exposure prophylaxis
  • Animal bite wound

Source text 原文

Donguibogam 東醫寶鑑

治風狗咬. 斑猫 七日內用七箇, 七日外每日加一箇, 十日十箇, 百日百箇(去翅足, 糯米同炒), 滑石 一兩, 雄黃 一錢, 麝香 一字. 右爲末, 溫酒調服. 不飮酒者, 米飮下. 毒從大小便出卽愈. 《醫鑑》

Translation

Treats the bite of a mad dog. Blister beetles — within seven days of the bite use seven; past seven days add one for each day, so ten at ten days and a hundred at a hundred days (wings and feet removed, dry-fried together with glutinous rice); talc 1 nyang; realgar 1 don; musk 1 ja. Powder the above and take it stirred into warm wine; for one who does not drink wine, send it down in rice water. The toxin comes out by the stool and the urine and he is cured at once. — Gogeum Uigam 醫鑑 (Donguibogam · Jesang)

Clinical commentary 臨床

The chapter's set-piece formula for a rabid dog bite, and its most striking feature is the arithmetic: seven blister beetles if the patient comes within seven days of the bite, one more for every day beyond that, ten at ten days, a hundred at a hundred. With them go talc, realgar and a little musk, taken in warm wine, and the claim is that the toxin leaves by the stool and the urine. The escalating count shows the compiler knew the interval between a bite and the illness could be very long, and the neighbouring sections escalate the same way — twenty-one beetles in one place, seven in another, rising toward a hundred. The section also wants a proof that the cure has worked, and the proof it gives is worth reading carefully: the patient urinates into a jar and the physician looks for a cloudy mass settling in the shape of a dog. Cantharidin is a severe irritant of the kidney and the urinary tract, and what that cloudy urine most plausibly is, is blood and protein shed from a kidney the treatment has injured. The sign read as the toxin leaving the body is a sign of harm being done by the drug. This is the place in the chapter where the modern reading must be stated flatly. **Rabies is essentially 100% fatal once symptoms begin, and nothing in this formula changes that.** A bite or scratch from a rabid or suspect animal is a medical emergency. The wound is washed immediately and thoroughly with soap and running water for fifteen minutes, and post-exposure prophylaxis is started as soon as possible: rabies vaccine, together with rabies immunoglobulin infiltrated around the wound for anyone not already immunised. Prophylaxis is almost completely effective — but only while the person is still well. Once the disease declares itself, care is palliative. So the hundred beetles at a hundred days are the saddest line in the chapter: by then there was nothing to be done, and there would not be for another three centuries. **Contains blister beetle (斑猫), which is cantharidin — a vesicant lethal in small doses and in doses rising to a hundred insects here — realgar (雄黃), an arsenic sulfide, and musk (麝香) from a CITES-protected animal. This must not be prepared.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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