Formulas · External Application 外用 · Uihak Immun (醫學入門)

Method for Treating a Fatty Tumour

Chijiyu-bang

한글 치지유방 · Pinyin Zhi Zhi Liu Fang

治脂瘤方

A method leaf with no composition, so no ingredients are entered. The 藥 dabbed on the stalk is not named; this chapter's escharotics are 砒礵 and 石灰, and the 枯瘤方 leaf immediately following is the named prescription for withering a tumour away. 生肌膏 is not registered in this corpus and stays plain text; it is part of the running instruction and carries no 細註 marks in the transcription. 竢 is printed as the transcription has it, the corpus having the same graph in its one other instance.

Composition 構成

Total 0 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

Opens a fatty tumour with a needle and expresses the fatty matter, which cures it
For one that hangs down like an aubergine on a very small root, a drug is dabbed on the stalk, and when the aubergine falls a flesh-engendering plaster is put on at once to guard against bleeding

Indications 主治

Pattern-based

脂瘤 — the fatty tumour, one of the six 瘤
粉紅色全是痰結 — pink in colour, entirely a binding of phlegm
如茄垂下根甚小者 — hanging down like an aubergine on a very small root

Biomedical correlates

Sebaceous (epidermoid) cyst
Lipoma
Pedunculated skin lesion or large skin tag

Source text 原文

Donguibogam 東醫寶鑑

一種脂瘤, 粉紅色, 全是痰結. 用鍼決去脂粉則愈. 或有如茄垂下, 根甚小者, 用藥點其蔕, 竢茄落, 卽用生肌膏貼之, 防其出血. 《入門》

Translation

There is a kind of fatty tumour, pink in colour, which is entirely a binding of phlegm. Open it with a needle and take away the fatty matter, and it is cured. Or there are those that hang down like an aubergine on a very small root; dab a drug on the stalk, wait for the aubergine to fall, and then at once put on a flesh-engendering plaster to guard against bleeding. — Immun 入門 (Donguibogam · Jechang)

Clinical commentary 臨床

The one leaf in the 癭瘤 section that is surgery rather than pharmacy, and the one that works. 用鍼決去脂粉則愈 — open it with a needle, take away the fatty matter, and it is cured — is the treatment of a sebaceous cyst, and it is still broadly the treatment: incise, express the contents, and the swelling goes. The 入門 even has the description right. A pink, soft, fluctuant lump full of a fatty paste is an epidermoid cyst, and 全是痰結, nothing but bound phlegm, is as good a sixteenth-century account of its contents as one could ask. The second half is ligature-and-escharotic removal of a pedunculated lesion: dab a caustic on the narrow stalk, wait for the mass to drop off, dress the base at once because a stalk bleeds. That too is a real technique, and the sequencing — the plaster ready before the lesion falls — shows the writer had done it. The section's own general rule warns against this everywhere else: 五癭皆不可決破, none of the five goitres may be cut, 肉瘤尤不可破, 破則殺人, and the flesh tumour least of all, for opening it kills. 惟脂瘤決去其脂則愈 — only the fatty tumour may be opened. That is a correct and hard-won distinction between a cyst, which can be emptied, and a vascular or deep tumour, which cannot. **An unnamed caustic applied to the skin at home causes burns and scarring, and the chapter's caustics are arsenic and quicklime. Expressing a cyst without removing its capsule leaves it to refill, and incising the wrong lump — a vascular malformation, a lymph node, a thyroid mass — can bleed badly or seed infection.** Minor excision under clean conditions is a short procedure that resolves these lesions properly and gives a specimen if there is any doubt what the lump is. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.