Formulas · Transform Phlegm 化痰 · Bonsa (本事)

Chang Gong's Powder

Changgong-san

한글 창공산 · Pinyin Cang Gong San

倉公散

The leaf begins on the line after the 032a page marker, which stands between the leaf head and the text. The 鬱冒 prose prescribes it with 白薇湯 — 宜白薇湯ㆍ倉公散卽甦. The transcription writes 瓜蔕, which is the form herbs.yaml carries for that drug and the corpus majority over 瓜蒂, and 雄黄 for 雄黃; the standard form of the latter is printed. The name is new to the corpus and does not collide with any existing changgong- id.

Composition 構成

Yeoro Li Lu
藜蘆 여로 · Black False Hellebore Root (toxic)

—
Chief 君

藜蘆各等分 — veratrum, equal parts; emetic and cardiotoxic
Gwache Gua Di
瓜蔕 과체 · Melon Pedicel (toxic)

—
Deputy 臣

瓜蔕各等分 — melon stalk, equal parts; emetic
Unghwang Xiong Huang
雄黃 웅황 · Realgar

—
Assistant 佐

雄黃各等分 — realgar, arsenic sulfide, equal parts
Baekban Bai Fan
白礬 백반 · Alum

—
Envoy 使

白礬各等分 — alum, equal parts

Total 0 g per packet (첩) · representative dosage — verify against source texts. Excludes 4 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

Blown into the nose in the muffled collapse, to bring the patient round
A little at a time, to provoke the sneeze that opens the barrier

Indications 主治

Pattern-based

鬱冒 — the muffled collapse, lying as if dead, the eyes shut and the voice gone
血厥 — the blood reversal
Unresponsiveness where the jaw is shut and nothing can be given by mouth

Biomedical correlates

Vasovagal and orthostatic syncope
Unresponsiveness of unknown cause — a bedside rousing manoeuvre

Source text 原文

Donguibogam 東醫寶鑑

藜蘆ㆍ瓜蔕ㆍ雄黃ㆍ白礬各等分. 右爲末, 取少許吹入鼻中. 《本事》

Translation

Veratrum, melon stalk, realgar and alum in equal parts. Powder them and blow a little into the nose. — Bonsa 本事 (Donguibogam · Gugeup)

Clinical commentary 臨床

A nose powder, not a medicine to swallow, and the chapter reaches for it exactly where it cannot use the mouth: the 鬱冒 patient's jaw is shut and the voice gone. Veratrum and melon stalk are the tradition's two great emetics and both are violently irritant to mucosa; realgar and alum are the mineral astringents that make up the bulk. What the powder does is provoke a sneeze, and the sneeze is the result the practitioner was watching for — the related 通關散 says so outright, 有嚏可治, 無嚏不可治. As a rousing manoeuvre this is not nonsense. A strong nasal stimulus produces a reflex response, and the tradition used the presence or absence of that response as a prognostic test, which is a crude version of assessing responsiveness. But the collapse it is used for — syncope — resolves on its own, and the right handling is to lay the patient flat with the legs raised. The route is still a hazard. Insufflating an irritant powder into the nose of an unconscious person with no gag reflex risks it being drawn into the airway, and laryngospasm or aspiration in a patient who is already not protecting their airway is a worse problem than the faint. The airway comes first: in an unresponsive patient, open the airway, check breathing, call for help, and put nothing into the nose or the mouth. **Contains veratrum, which is a violent emetic and cardiotoxic — it is a sodium-channel poison and causes bradycardia and hypotension — and realgar, which is arsenic sulfide. This must not be prepared or taken.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.