寶鑑Bogam

Formulas · External Application 外用 · Seui Deukhyobang (世醫得效方)

Toxin Chasing Cake

Chudok-byeong

한글 추독병  ·  Pinyin Zhui Du Bing

追毒餠

扱 is the character the transcription uses for pushing the pellet into the opening. 砒礵 is both this transcription's and the herb dictionary's form for 砒霜. 麥子大, a barley grain, is a size and not a drug. The leaf opens without a 治 clause, the indication being given as a case — a sore needled and then sealed over.

Composition 構成

Total 14 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

Indications 主治

Pattern-based

  • 諸惡瘡 closed over again after needling
  • 閉合脹痛不可忍 — sealed, with distending pain beyond bearing
  • 膿水 — pus and serum

Biomedical correlates

  • Abscess with premature wound closure
  • Wound requiring a drain or packing
  • Recurrent abscess from inadequate drainage

Source text 原文

Donguibogam 東醫寶鑑

諸惡瘡因鍼後又閉合脹痛不可忍, 用此放入瘡中, 永不閉, 膿水自出. 雄黃ㆍ雌黃ㆍ朱砂 各一錢, 砒礵 半錢, 輕粉少許. 右細末, 糯米糊和丸麥子大, 扱瘡口中, 膿水自出, 瘡自乾好. 《得效》

Translation

Where a malign sore of any kind has been needled and then closed over again, with distending pain beyond bearing, put this into the sore and it will never close, and the pus and serum come out of themselves. Realgar, orpiment and cinnabar, 1 don each; arsenic, half a don; a little calomel. Grind the above fine, bind with glutinous rice paste into pills the size of a barley grain, and push one into the mouth of the sore; the pus and serum come out of themselves and the sore dries and heals. — Seui Deukhyobang 得效 (Donguibogam · Ongjeo)

Clinical commentary 臨床

This is a wound drain, and the clinical reasoning behind it is correct. A sore that has been opened and then seals over at the skin while still filling beneath is the commonest reason an abscess recurs, and 永不閉, never letting it close, is precisely the right objective. A pellet pushed into the opening to hold it patent does the same job as a wick, a packing strip or a drain, and the chapter identified the problem and the answer some centuries before the materials existed to do it safely. The materials here are the difficulty. Realgar and orpiment are arsenic sulphides, arsenic trioxide is arsenic itself, cinnabar is mercuric sulphide and calomel is mercurous chloride: five of the six components are heavy-metal poisons, and they are being held in an open wound where absorption is direct and continuous. They work by keeping the tissue around them dead, which is what 永不閉 actually means. **Contains arsenic, two arsenic sulphides, cinnabar and calomel, held inside an open wound. This must not be prepared or used.** An abscess cavity that needs to stay open is packed with sterile gauze or fitted with a drain, changed on a schedule, and the packing is inert on purpose. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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