Formulas · Purge Downward 瀉下 · Uihak Gangmok (醫學綱目)

Method for the Child Who Eats Earth

Chikkingni-bang

한글 치끽니방 · Pinyin Zhi Chi Ni Fang

治喫泥方

The phonetic and semantic gloss on 䑋 is carried as a 細註 span, following 紫霜丸 where 哯音顯, 不嘔而吐也 is handled the same way. 膩粉 is the drug this leaf turns on and it is 輕粉, calomel — mercurous chloride. The Bogam settles the name itself: the 湯液篇 entry for 輕粉 reads 性冷味辛有毒 … 一名汞粉, 一名水銀粉, 亦名膩粉, 或曰峭粉. 飛煉水銀而成, and 胡粉, a few entries later, is 一名定粉, 一名光粉, 一名瓦粉, which does not include it. The corpus formerly entered 膩粉 as 胡粉, white lead, here and in five other leaves (妙香丸, 硫黃膏, 牛黃金虎丹, 松脂貼散, 木瓜丸); all six now read 輕粉 and the white-lead reading is withdrawn. The 黃金餠 of the appended Hoechun method reads as hwanggeum-byeong, which is unoccupied in the corpus; it is a named preparation inside this leaf and not a separate head, so no entry is made for it. 好土, the good earth that is its main substance, has no identifier in herbs.yaml and is not entered.

Composition 構成

Gyeongbun Qing Fen
輕粉 경분 · Calomel (toxic)

0.4 g
Chief 君

膩粉, 1 fun, calomel — mercurous chloride, toxic
Hwangnyeon Huang Lian
黃連 황련 · Coptis

—
Chief 君

in the appended method only, decocted strong and the clear liquor used to knead the earth cake
Sadang Sha Tang
砂糖 사당 · Granulated Sugar

—
Envoy 使

砂糖, granulated sugar, kneaded with the powder to bind the pills

Total 0.4 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

Treats the child who eats earth and clay, and the swollen belly that goes with it
One pill the size of a hemp seed on an empty stomach in rice water, and when the earth is purged out the child recovers
A second method appended, a cake of good earth kneaded with a strong decoction of coptis and dried in the sun

Indications 主治

Pattern-based

喫泥土 — eating earth and clay
䑋肚 — a swollen belly

Biomedical correlates

Pica, in particular geophagy, in a child
Iron deficiency
Soil-transmitted helminth infection
Lead exposure

Source text 原文

Donguibogam 東醫寶鑑

治小兒喫泥土及䑋肚<span class='sochu'>䑋音讓, 脹也</span>. 膩粉一分, 砂糖搜和丸麻子大, 空心米飮下一丸, 瀉出土卽差. 《綱目》 ○小兒食土, 取好土濃煎黃連, 取淸汁搜和, 日乾與服卽止, 名曰黃金餠. 《回春》

Translation

Treats the child who eats earth and clay, and a swollen belly — 䑋 is read 讓, and means distended. Calomel, 1 fun: knead it with granulated sugar into pills the size of a hemp seed and send one down in rice water on an empty stomach; when the earth is purged out the child recovers. — Uihak Gangmok 綱目 ○ For a child who eats earth: take good earth, decoct coptis strong, take the clear liquor and knead it with the earth, dry it in the sun and give it, and the eating stops. It is called the Golden Cake. — Manbyeong Hoechun 回春 (Donguibogam · Soa)

Clinical commentary 臨床

A single pill: 1 fun of calomel, a mercury salt, kneaded with sugar, given on an empty stomach, and the child is better when the earth comes out in the stool. Then a second method from the Hoechun that is stranger and cleverer — good earth kneaded with a strong coptis decoction, dried into cakes and fed to the child, called the Golden Cake. The first purges the earth out; the second gives the child earth to eat and makes it bitter. **The chapter noticed a real thing here.** Eating earth is geophagy, geophagy is the commonest form of pica, and pica is a classic sign of **iron deficiency** — the association is old, well documented, and runs in both directions, since the clay also binds iron and zinc in the gut and deepens the deficiency that drives the craving. It is also one of the main routes by which a child acquires the soil-transmitted helminths, the roundworm of this chapter's own 1.38.4 蛔疳 among them, and one of the main routes of **lead** exposure, which in turn causes anaemia and irreversible cognitive injury. So the explanation of the behaviour is a deficiency and the treatment is iron and deworming, with a blood lead level where the soil may be contaminated. Iron replacement often stops the pica within weeks. That is a real answer to a real observation, and the chapter is only one step away from it: the 代赭石 of 進食丸 two leaves back is iron oxide. **Contains 膩粉 — 輕粉, calomel, mercurous chloride — given by mouth to a child. The Bogam settles the identification itself: the 湯液篇 entry for 輕粉 reads 一名汞粉, 一名水銀粉, 亦名膩粉, 或曰峭粉. 飛煉水銀而成, and 胡粉, white lead, is 一名定粉, 一名光粉, 一名瓦粉 and does not carry the name. So the metal is mercury, the chapter gives no dose by weight anywhere, and this must not be prepared.** Mercurous chloride was given to children by mouth as a purgative and in teething powders into the twentieth century, and it caused acrodynia — pink disease — in infants; mercury injures a developing nervous system irreversibly at doses that leave an adult unharmed. The batch's full calomel statement is on 白餠子 (baekbyeong-ja) and the chapter's full mercury statement on 辰砂膏 (jinsa-go-soa); neither is repeated here. The irony is complete and worth stating: a child is eating earth because of iron deficiency, very possibly with lead in the earth, and the remedy is a spoonful of mercury in sugar. The Golden Cake is the gentler of the two and the coptis in it is at least a bitter the child will dislike, but feeding contaminated soil to a child with pica adds the helminth eggs and the lead rather than removing them. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.