寶鑑Bogam

Formulas · Clear Heat 淸熱 · Uihak Immun (醫學入門)

Gardenia Liver-Clearing Decoction

Chijacheonggan-tang

한글 치자청간탕  ·  Pinyin Zhi Zi Qing Gan Tang

梔子淸肝湯

Two first-edition collation lines, 一 : 三(初刊本) and 用 : 川(初刊本), stand at the foot of page 031a among the lines of the 海藻散堅丸 leaf, a page further on, but both annotate this leaf: 各一錢一分 against the first edition's 各一錢三分, and 用芎 against 川芎. By this project's base-text rule the transcription's readings are printed — 一錢一分, 4.4 g, and 用芎 — and the variants recorded here. 用 is not a drug, and 川芎, chuanxiong, is plainly right, since the 醫學入門 formula is 赤茯苓ㆍ川芎ㆍ赤芍藥ㆍ當歸ㆍ牛蒡子 各一錢; the ingredient is resolved to cheongung, as 射王 was resolved to sagan in the abscesses chapter. A third collation line, 漳 : 淸(初刊本), also falls inside this leaf's span at the page boundary but annotates the 漳酒 of the preceding 化氣調經湯 leaf, not anything here. The transcription writes 胷 for 胸; the corpus prints 胸 at 129 places against 12, and the corpus form is given.

Composition 構成

Total 40.8 g per packet (첩) · representative dosage — verify against source texts.

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

  • 肝膽火盛 — Liver and Gallbladder fire blazing
  • Nodes swollen and painful behind the ears, on the neck and nape, on the chest and at the breast, with alternating chills and fever

Biomedical correlates

  • Acutely inflamed cervical lymphadenitis
  • Tuberculous lymphadenitis in its inflammatory phase

Source text 原文

Donguibogam 東醫寶鑑

治肝膽火盛, 耳後頸項胸乳等處結核腫痛, 寒熱. 柴胡 二錢, 梔子(酒炒)ㆍ牡丹皮 各一錢一分, 赤茯苓ㆍ用芎ㆍ赤芍藥ㆍ當歸ㆍ牛蒡子 各一錢, 靑皮ㆍ甘草(灸) 各五分. 右剉, 作一貼, 水煎服. 《入門》

Translation

Treats Liver and Gallbladder fire blazing, with nodes swollen and painful behind the ears, on the neck and nape, on the chest and at the breast, and alternating chills and fever. Bupleurum 2 don; gardenia (wine-fried) and moutan bark, 1 don 1 fun each; red poria, chuanxiong, red peony, Korean angelica and burdock seed, 1 don each; green tangerine peel and licorice (roasted), 5 fun each. Cut the above up, make one packet, and decoct it in water and drink. — Immun 入門 (Donguibogam · Jechang)

Clinical commentary 臨床

The chapter names this formula in two places, both times for fire: 當淸肝火爲主, clearing Liver fire is the main thing, where the node-chains along the sinews are hot and throbbing; and again under 瀉肝膽火宜梔子淸肝湯. It is built on the bupleurum-and-gardenia pattern — two don of bupleurum to release the Shaoyang, wine-fried gardenia and moutan bark to drain the fire out of the Blood — with a four-drug Blood-harmonising core of chuanxiong, red and no white peony, Korean angelica, and burdock seed and green tangerine peel to disperse the nodes themselves. The reasoning behind the fire reading is set out earlier in the section: 以其屬膽經主決斷有相火而且氣多血少, the disease belongs to the Gallbladder channel, which governs decision and carries the ministerial fire, and in which Qi is abundant and Blood scant. The named sites — behind the ears, the neck and nape, the chest and the breast — are the cervical and supraclavicular chains along the Gallbladder channel's course. 瘰癧 is tuberculous lymphadenitis, and the hot, tender, feverish presentation this formula addresses is the inflammatory phase, when the nodes are matted and about to break down. A node that is clearing-hot and painful may equally be an ordinary bacterial lymphadenitis, which does respond to treatment; the tuberculous kind does not respond to anything in this formula. Any persistent neck node needs tissue diagnosis, because lymphoma and metastatic carcinoma present the same way. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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