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

Toxin-Pursuing Elixir

Chudok-dan

한글 추독단 · Pinyin Zhui Du Dan

追毒丹

The transcription reads 白丹香; the collation line at the foot of this page records 丁 as the first edition's reading for that 丹, so the drug is 白丁香, sparrow droppings. That reading is confirmed by the Dongwon note appended to the Geoak-san leaf a few lines later, which prescribes 白丁香 for the same purpose. The transcription's 白丹香 is printed and the ingredient resolved to 白丁香. The seven croton seeds and the barley-grain pill size are count and measure items and carry no gram figure. 䧟 is printed as 陷, 為 as 爲 and 麫 as 麪, following the corpus forms.

Composition 構成

Padu Ba Dou
巴豆 파두 · Croton Seed

—
Chief 君

七箇, 去皮心, 不去油, 硏細 — seven seeds, skin and germ removed, the oil deliberately left in, finely ground; croton seed, violently toxic
Unghwang Xiong Huang
雄黃 웅황 · Realgar

8 g
Chief 君

二錢; realgar, an arsenic sulphide
Hwangdan Huang Dan
黃丹 황단 · Red Lead (toxic)

8 g
Deputy 臣

二錢; minium, lead tetroxide
Gyeongbun Qing Fen
輕粉 경분 · Calomel (toxic)

4 g
Deputy 臣

一錢; calomel, a mercury salt
Baekjeonghyang Bai Ding Xiang
白丁香 백정향 · Sparrow Droppings

4 g
Assistant 佐

一錢; printed 白丹香, read 白丁香 — sparrow droppings
Baengmyeon Bai Mian
白麪 백면 · White Wheat Flour

12 g
Envoy 使

白麪三錢, as the binder

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 1 ingredient 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

A caustic pill put into a needled abscess, not swallowed
Breaks down the sunken abscess so that spoiled flesh can be cleared and pus expelled
Draws pus, blood and toxic matter out under a plaster
Takes away the dead flesh lining the walls of a fistulous sore

Indications 主治

Pattern-based

癰疽黑陷 — an abscess gone black and sunken
漏瘡四壁死肌不去 — a fistulous sore whose four walls of dead flesh will not come away
敗肉 to be removed before the wound can be nourished closed

Biomedical correlates

Gangrenous or necrotising soft-tissue infection — historical escharotic
Chronic sinus or fistula with a necrotic lining

Source text 原文

Donguibogam 東醫寶鑑

治癰疽黑陷者. 用鍼開瘡口, 納此丹使之潰, 然後去敗肉排膿, 隨證治之. 巴豆七箇(去皮心, 不去油, 硏細), 白丹香ㆍ輕粉各一錢, 雄黃ㆍ黃丹各二錢. 右爲末, 和白麪三錢, 滴水丸如麥粒大. 鍼後納其中, 貼以膏藥, 追出膿血毒物. 漏瘡四壁死肌不去則不可治, 亦以此追毒去死肌, 乃養肉令愈. 《得效》

Translation

Treats an abscess that has gone black and sunken. Open the mouth of the sore with a needle, put this elixir in to make it break down, then remove the spoiled flesh and expel the pus, treating according to the presentation. Croton seed, seven pieces, skin and germ removed, the oil left in, finely ground; sparrow droppings and calomel, 1 don each; realgar and minium, 2 don each. Powder them, mix with 3 don of white wheat flour, drip water in and roll pills the size of a barley grain. After needling, put one inside the sore, paste a plaster over it, and it draws out pus, blood and the toxic matter. A fistulous sore whose four walls of dead flesh cannot be removed is untreatable; here too use this to pursue the toxin and take away the dead flesh, and then nourish the flesh and let it heal. — Deukhyo 得效 (Donguibogam · Ongjeo)

Clinical commentary 臨床

A caustic pill, and not a medicine to swallow. The abscess is opened with a needle, the pill is pushed into the opening and a plaster laid over it, and the pill is left to eat its way through the dead flesh and draw out pus. The 寶鑑 is explicit about the order of operations — needle first, pill second, then clear the spoiled flesh and dress the wound according to what is found — and about the case it is aimed at: 黑陷, an abscess gone black and sunken, which is a gangrenous one. Four of the five active drugs are poisons chosen for exactly that. The croton seed has its oil deliberately left in, 不去油, where every other formula in the chapter takes the oil out; realgar, minium and calomel follow, bound with wheat flour into a pill the size of a barley grain so that it will fit into a needle hole. The second indication, a 漏瘡 whose walls of dead flesh cannot be cleared, is called untreatable before the method is offered for it anyway. **Contains croton seed with its oil retained, realgar which is an arsenic sulphide, minium which is lead tetroxide, and calomel which is a mercury salt. This must not be prepared.** Three heavy-metal poisons placed inside an open wound are absorbed straight into the circulation, and arsenic, lead and mercury all accumulate; the formula's own target, a black sunken abscess, is the presentation that most urgently needs surgery and systemic antibiotics rather than a caustic left under a dressing. Necrotic tissue is removed now by surgical debridement, and necrotising infection is a surgical emergency. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.