Formulas · External Application 外用 · Uihak Gangmok (醫學綱目)
The 膽 of the name is the pig's gall, 猪膽汁, and not 膽礬: there is no copper in this formula, and 膽礬 occurs nowhere in this chapter at all. Both sections that call for this paste do so by cross-reference: 1.85.11 痒痛 has 痘瘡煩痛宜硝膽膏 with 方見下, and 1.85.12 斑爛 has 痘瘡斑爛煩痛或臭爛深坑不收口並用硝膽膏 under 《海藏》, while the leaf itself is 《綱目》. The transcription writes 為 and 熖硝, printed here as 爲 and 焰硝 — the corpus has 焰硝 in 29 places and 熖硝 in none. No entry of this name stood in the database.
Composition 構成
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Mangcho Mang Xiao 芒硝 망초 · Mirabilite
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Chief 君
ground to a powder
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Deputy 臣
pig bile, mixed into the powder to a paste · raw animal material
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Assistant 佐
saltpetre, the substitute where there is no mirabilite · nitrate
Total 0 g per packet (첩) · representative dosage — verify against source texts. Excludes 3 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
- Smeared on pox lesions that have broken down with vexing pain
- Used where the sores stink and rot into deep pits that will not close
Indications 主治
Pattern-based
- Vexing pain of the pox (痘瘡煩痛)
- Lesions broken down with foul rotting and deep pits that will not close (臭爛深坑不收口)
Biomedical correlates
- Deep ulceration of smallpox lesions
- Secondarily infected necrotic skin loss
Source text 原文
Donguibogam 東醫寶鑑
芒硝 爲末, 調猪膽汁塗之. 無芒硝, 則焰硝亦可. 《綱目》
Translation
Mirabilite, ground to a powder, mixed with pig bile and smeared on. If there is no mirabilite, saltpetre will also do. — Gangmok 綱目 (Donguibogam · Soa)
Clinical commentary 臨床
Two substances and a substitute. Mirabilite — sodium sulfate — ground to a powder and worked into pig bile to a paste, or saltpetre instead if no mirabilite is at hand, smeared onto pox that have broken down, rotted and sunk into pits that will not close over. The 膽 of the name is the pig's gall and not the blue vitriol 膽礬, so — to be plain about it, since the name invites the other reading — **there is no copper in this paste**, and none of the copper hazards belongs to it.
On a raw weeping surface this is not a soothing cover. A concentrated salt paste on denuded skin is osmotically active in the wrong direction: it draws fluid out of the wound rather than holding it in, it stings fiercely, and spread over the extent of skin that 1.85.12 is describing it adds to the very fluid loss that was killing these children. Pig bile is a detergent — bile salts are surfactants that emulsify lipid — so it strips what is left of the surface film and is directly irritant to exposed dermis, and it is raw animal gall laid into an open wound, which is a contamination route in its own right. Set beside the Strange Diseases chapter's 4.1.22 渾身生燎疱, where the Bogam writes 不可治 of the same picture of whole-body blistering and skin loss and is right to, this paste belongs with the leaves that made the surface worse.
**The substitute is the sharper hazard, and the patient is a child whose skin is broken.** Saltpetre is potassium nitrate. Nitrate absorbed into the body is reduced to nitrite, and nitrite oxidises haemoglobin to methaemoglobin, which cannot carry oxygen; infants are specifically vulnerable to this — fetal haemoglobin oxidises more readily and the enzyme that reverses it is immature — and the result is cyanosis that oxygen does not correct. **Broken, weeping skin absorbs very much more readily than intact skin, the surface area here is large, and the leaf gives no dose scaled to age or weight — 爲末, powdered, and no quantity at all. This must not be prepared.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.