寶鑑Bogam

Formulas · Dispel Wind 祛風 · Gogeum Uigam (古今醫鑑)

Cocklebur Powder for Goose-Palm Tinea

Changi-san

한글 창이산 (제창)  ·  Pinyin Cang Er San

蒼耳散

The Donguibogam carries three leaves called 蒼耳散 and they are unrelated. The 三因 formula for 鼻淵, registered as changi-san, is 白芷ㆍ辛夷ㆍ蒼耳子ㆍ薄荷; the 本草 one for 紫白癜風, registered as changi-san-pi, is cocklebur leaf alone in wine. This leaf is the 醫鑑 formula of the 鵝掌癬 section, twelve drugs with smilax and gleditsia at its head, and it shares only the cocklebur with either, so it takes the chapter tail. The transcription writes 醫鍳; the corpus prints 醫鑑. 猪牙皂角 and 皂角刺 are two different parts of the same plant, the pod and the thorn, and both resolve to the single headword 皂角; they are listed separately at their two weights with the part named in the preparation. The ginger and the Sichuan pepper are counted and measured by the pinch and carry no gram figures.

Composition 構成

Total 54 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

  • 鵝掌癬, also called 鵝掌風 — scaling of the palms that peels layer after layer without end, following calomel treatment of the pox

Biomedical correlates

  • Exfoliative palmar dermatitis after mercury treatment — mercurial erythroderma
  • Palmar psoriasis or chronic hand eczema
  • Tinea manuum

Source text 原文

Donguibogam 東醫寶鑑

治鵝掌癬. 猪牙皂角ㆍ土茯苓ㆍ甘草 各二錢, 蒼耳子ㆍ金銀花ㆍ皂角刺ㆍ防風ㆍ荊芥ㆍ連翹 各一錢, 天麻ㆍ前胡ㆍ蛇床子 各五分. 右剉, 作一貼, 薑一片ㆍ川椒一撮, 同煎服. 《醫鑑》

Translation

Treats goose-palm tinea. Pig's-tusk gleditsia pod, smilax and licorice, 2 don each; cocklebur fruit, honeysuckle flower, gleditsia thorn, siler, schizonepeta and forsythia, 1 don each; gastrodia, peucedanum and cnidium fruit, 5 fun each. Cut the above up, make one packet, add one slice of ginger and a pinch of Sichuan pepper, and decoct and drink it. — Uigam 醫鑑 (Donguibogam · Jechang)

Clinical commentary 臨床

The base here is the 土茯苓 skeleton that runs through the whole 天疱瘡 section — smilax root with gleditsia pod and thorn, honeysuckle and forsythia — and onto it are set the wind drugs, cocklebur fruit, siler, schizonepeta and gastrodia, with cnidium fruit and peucedanum. It is an internal decoction, and the section pairs it with Okji-go rubbed on the palms, so the two are meant to be used together. 鵝掌癬 is the most interesting thing in this part of the chapter, because the Bogam is describing an iatrogenic disease and knows it: 凡天疱楊梅瘡服輕粉愈後手掌上發癬退皮一層生生不絶, after calomel has been taken for the pox and the pox has healed, scaling breaks out on the palms and peels off layer after layer without end. That is a description of mercurial dermatitis — exfoliative inflammation of the palms following mercury treatment — not a fungal infection at all, whatever the name 癬 suggests. The chapter has correctly noticed that the drug caused it, and then tries to treat it with wind-dispersing herbs. Against mercurial erythroderma the formula could not have worked, and the only thing that would have was stopping the calomel. The drugs themselves are mild and carry no particular hazard, though cocklebur fruit in quantity is hepatotoxic and the Sichuan pepper and ginger are there only as the vehicle. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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