Formulas · Clear Heat 淸熱 · Jeongjeon (正傳)

Trichosanthes Root Powder for Loss of Voice after the Pox

Cheonhwa-san

한글 천화산 (소아) · Pinyin Tian Hua San

天花散

The third formula called 天花散 in the corpus, and a homonym of both the others, so it takes the chapter tail. cheonhwa-san is the 直指 leaf of the 消渴 chapter — 天花粉ㆍ生乾地黃ㆍ葛根ㆍ麥門冬ㆍ五味子ㆍ甘草 with a hundred grains of rice, called a sovereign remedy for wasting-thirst. cheonhwa-san-jechang is the 醫鑑 leaf of 諸瘡門 — nine drugs led by 金銀花 with 穿山甲 and 貝母, for scrofula that has ulcerated. This leaf is from 正傳, has six drugs in equal parts with no weights at all, and is prepared over a burning bundle; it shares only 天花粉 and 甘草 with the first and only 天花粉 with the second. 聲音門 3.4 points here with 宜馮氏天花散, formula in the Children chapter, and that pointer closes on this leaf and not on either of the other two; the 聲音 passage attributes the formula to 馮氏 where this leaf gives 《正傳》, and that discrepancy is left as the two chapters print it. 小竹 and 黃荊 are the fuel for the bundle rather than drugs taken, so they stay in the source text and are not entered as ingredients; neither has an entry in this corpus. The clause 點火在椀內 is awkward as transcribed — the fire is to be set in or at the bowl — and is rendered literally rather than smoothed. The transcription writes 碗 and the corpus prints 椀 150 times against 8, a pair bg.VAR folds, so 椀 is printed in both places. 訶子肉 resolves to gaja through the alias table. 爲 is printed for the transcription's 為.

Composition 構成

Gwarugeun Gua Lou Gen
瓜蔞根 과루근 · Trichosanthes Root

—
Chief 君

equal parts
Gilgyeong Jie Geng
桔梗 길경 · Platycodon

—
Chief 君

equal parts
Gaja He Zi
訶子 가자 · Chebula

—
Deputy 臣

訶子肉, the flesh of the fruit; equal parts
Seokchangpo Shi Chang Pu
石菖蒲 석창포 · Acorus

—
Deputy 臣

equal parts
Baekbongnyeong Fu Ling
白茯苓 백복령 · Poria (white)

—
Assistant 佐

equal parts
Gamcho Gan Cao
甘草 감초 · Licorice

—
Envoy 使

equal parts

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 6 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

Six drugs in equal parts, powdered; half a spoonful stirred into water in a bowl
Decocted over a bundle of seven small bamboo stems and seven vitex twigs bound together and set alight
Given for loss of voice after the pox has healed

Indications 主治

Pattern-based

痘愈後失音 — the voice lost after the pox has healed

Biomedical correlates

Post-variolous laryngeal scarring with dysphonia or aphonia (historical)
Hoarseness or loss of voice after a severe mucosal infection

Source text 原文

Donguibogam 東醫寶鑑

天花粉ㆍ桔梗ㆍ白茯苓ㆍ訶子肉ㆍ石菖蒲ㆍ甘草各等分. 右爲末, 用水調半匙在椀內, 外以小竹七莖ㆍ黃荊七條, 縛作一束, 點火在椀內, 煎服. 《正傳》

Translation

Trichosanthes root, platycodon, white poria, the flesh of chebulic myrobalan, acorus and licorice, equal parts of each. Powder the above; stir half a spoonful into water in a bowl. Outside, take seven small bamboo stems and seven vitex twigs, bind them into a bundle, set the fire to it in the bowl, and decoct and take. — Jeongjeon 正傳 (Donguibogam · Soa)

Clinical commentary 臨床

Six drugs in equal parts and a fire of sevens. Trichosanthes root engenders fluids, platycodon is the throat and voice drug, chebula astringes a raw throat, poria and licorice steady the rest — and acorus is the one that explains why this formula is here rather than anywhere else. Acorus is what this tradition reaches for to open the orifice of the Heart, and the Voice chapter opens by making the Heart the master of the voice; the choice is consistent across two chapters that point at each other. Only half a spoonful of the powder is used, stirred into water in a bowl, and the bowl is brought to the boil over a bundle of seven small bamboo stems and seven vitex twigs tied together and lit. The sevens are not a quantity of anything, and nothing in the formula depends on what the fire is made of. What the leaf is for is real and specific. Smallpox put lesions on the pharynx and larynx — which is also why the disease spread by droplet — and ulceration of the vocal folds during the illness left some children hoarse or voiceless afterwards, from granulation and then scarring. 痘愈後失音 is an accurate name for a genuine sequela, and the chapter has placed it among the convalescent complications where it belongs. A voice lost that way is assessed today by looking at the larynx, and treated with voice therapy and, where there is scarring or narrowing, surgically. Nothing swallowed reached the vocal folds. **Contains acorus, which carries beta-asarone; beta-asarone is genotoxic and carcinogenic in animal studies and is restricted in food for that reason, and the patient is an infant. Trichosanthes root is the source of trichosanthin, an abortifacient protein that has caused severe allergic and systemic reactions when given as an injection; little of it survives in a decoction of the dried root, but the drug should be named for what it is. The leaf gives no weight for anything — six drugs in equal parts and half a spoonful of the mixture — so there is no dose here to scale to a child at all. This must not be prepared.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.