寶鑑Bogam

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

Thousand-Gold Inner Dispersion Powder

Cheongeumnaeso-san

한글 천금내소산  ·  Pinyin Qian Jin Nei Xiao San

千金內消散

癕, 畧 and 鍳 are given above as 癰, 略 and 鑑. 白殭蚕 is kept in the transcription's form and resolves to the 白殭蠶 entry, as is 木鼈子, which is registered under 木鼈子. 皂角刺 is registered under 皂角 and 當歸尾 under 當歸, with the parts named in the preps. The clamshell powder is the medium the pangolin scale is fried in rather than an ingredient, and is recorded in that drug's prep.

Composition 構成

Total 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

Indications 主治

Pattern-based

  • 癰疽 and 腸癰ㆍ肚癰, abscess of the intestines and of the belly
  • 便毒, the toxin of the groin
  • Just risen — to disperse at once (初起卽消)
  • Already swollen — to open at once (已腫卽潰)

Biomedical correlates

  • Intra-abdominal and pelvic abscess — historical
  • Appendiceal abscess — a historical reading of 腸癰
  • Inguinal suppurative lymphadenitis — a historical reading of 便毒

Source text 原文

Donguibogam 東醫寶鑑

治癰疽及腸癰ㆍ肚癰ㆍ便毒, 初起卽消, 已腫卽潰, 血從大便中出. 大黃 三錢, 金銀花 二錢, 當歸尾(酒洗) 一錢半, 赤芍藥ㆍ白芷ㆍ木鼈子(去殼)ㆍ沒藥ㆍ乳香ㆍ皂角刺ㆍ白殭蚕ㆍ瓜蔞仁ㆍ天花粉 各一錢, 甘草節 五分, 穿山甲 三大片(蛤粉炒). 右剉, 作一貼, 酒水相半煎服. 《醫鑑》 ○此方與仙方活命飮略同. 《醫鑑》

Translation

Treats abscess and deep-rooted sore, and abscess of the intestines, abscess of the belly and the toxin of the groin: just risen, it disperses at once; already swollen, it opens at once, and the blood comes out with the stool. Rhubarb, 3 don; honeysuckle, 2 don; the tails of Korean angelica (wine-washed), 1 don 5 fun; red peony, angelica dahurica, momordica seed (husked), myrrh, frankincense, gleditsia thorn, silkworm, trichosanthes seed and trichosanthes root powder, 1 don each; licorice node, 5 fun; pangolin scale, three large pieces (stir-fried with clamshell powder). Cut the above, make one packet, and decoct in half wine and half water, and take. — Uigam 醫鑑. This formula is roughly the same as Seonbanghwalmyeong-eum. — Uigam 醫鑑 (Donguibogam · Ongjeo)

Clinical commentary 臨床

The leaf's own closing note says it: roughly the same as Seonbanghwalmyeong-eum. The two share rhubarb leading, honeysuckle second, Korean angelica tails, gleditsia thorn, frankincense, myrrh, angelica dahurica, red peony, trichosanthes root powder, licorice node and pangolin scale. What is new here is momordica seed, silkworm and trichosanthes seed, and what is dropped is fritillaria, aged tangerine peel and saposhnikovia — so the balance shifts further toward breaking and scattering a hard bound mass. The indications are what make the leaf worth having. 腸癰 and 肚癰 — abscess of the intestines and of the belly — are the chapter stepping inside the abdomen, and 便毒 is the suppurating swelling of the groin. The sentence 血從大便中出, the blood comes out with the stool, is given as a sign that the formula is working, and with 3 don of rhubarb in it that is a predictable consequence rather than a cure. An intra-abdominal abscess that begins to bleed per rectum is a deteriorating patient, not an improving one, and this is one place where the classical sign and the modern reading point in opposite directions. On the chapter's central pair this belongs with the draining side despite its 內消 name, since rhubarb leads and nothing in it supplements; the 托裏 and 內托 formulas — Sipseon-san, Naetak-san, Takri-san, Naetakcheongeum-san — answer the opposite patient, the one too spent to push the pus out. **Contains pangolin scale, prohibited under CITES, and momordica seed, which is toxic.** The formula cannot be prepared as written. 腸癰 in the modern clinic is an appendiceal or diverticular abscess and is managed by drainage and antibiotics, often surgically. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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