Formulas · External Application 外用 · Dansim (丹心)

Method for Taking Out the Dead Bone in an Old Fistula

Chwigurujunghugol-bang

한글 취구루중후골방 · Pinyin Qu Jiu Lou Zhong Xiu Gu Fang

取久漏中朽骨方

The transcription writes 𥂁 for 鹽, normalized by the corpus table. 鹽泥, the salt clay luted round the bone, the 紙撚, the paper twist the pill is sent in on, and the 飯 that binds the pill are all apparatus or binder and stay in the source text. The bone itself is both container and ingredient, since it is ground up with its charge and used; it is entered under 烏骨雞 with the part in the prep, there being no herb entry for a fowl's shin bone. The leaf gives no interlinear notes.

Composition 構成

Ogolgye Wu Gu Ji
烏骨鷄 오골계 · Black-Boned Chicken

—
Chief 君

烏骨雞脛骨, the shin bone of a black-boned fowl, used as the container and calcined with the charge inside it
Bisang Pi Shuang
砒礵 비상 · Arsenic Trioxide

—
Chief 君

砒礵, packed into the bone (實之), no amount stated · arsenic trioxide, lethal

Total 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

A chicken shin bone packed with arsenic, luted, calcined red, powdered and made into grain-sized pills
Sent into the tract on a paper twist and sealed with a plaster so the dead bone comes away

Indications 主治

Pattern-based

久疽及痔漏中有朽骨 — an old abscess or a piles-fistula with dead bone inside it
宿膿朽骨停蓄其間, 皆爲之漏 — the retained pus and dead bone that make a sore a fistula

Biomedical correlates

Chronic osteomyelitis with a sequestrum and a draining sinus
Fistula-in-ano with a retained foreign body or bony fragment

Source text 原文

Donguibogam 東醫寶鑑

久疽及痔漏中有朽骨, 宜取去之. 烏骨雞脛骨, 砒礵實之, 鹽泥固濟, 火煆通紅, 取出去泥, 硏爲末, 飯丸粟米大, 以紙撚送入竅內, 外用膏藥封之, 其骨自出. 《丹心》

Translation

When an old abscess, or a piles-fistula, has dead bone inside it, that bone should be taken out. Take the shin bone of a black-boned fowl and pack it full of arsenic trioxide; lute it over with salt clay, calcine it in the fire until it glows red through, take it out and strip off the clay. Grind it to powder and make pills the size of a grain of millet with cooked rice. Send one into the opening on a twist of paper and seal it over outside with a plaster, and the bone will come away of itself. — Dansim 丹心 (Donguibogam · Jechang)

Clinical commentary 臨床

The one leaf in the section that goes at the cause rather than the discharge, and it is built on the chapter's own doctrine: 凡癕疽諸發苟有宿膿朽骨停蓄其間皆爲之漏 — any sore with retained pus or dead bone lodged in it becomes a fistula. 丹心 draws the conclusion directly. 宜取去之: the bone should be taken out. The method is an arsenical insert made by a sublimation. Arsenic trioxide is packed into a hollow fowl's bone, the bone is sealed with salt clay and calcined to red heat, and the whole is then ground and made into millet-sized pills; one is sent down the tract on a paper twist and the mouth sealed over. 其骨自出, the bone comes away of itself — meaning the escharotic eats the soft tissue holding the sequestrum until it loosens and discharges. **Contains arsenic trioxide, placed inside a sinus and sealed in under an occlusive plaster. Arsenic is readily absorbed from a wound bed, and arsenical pastes used in exactly this way caused fatal poisoning; calcining it inside a bone concentrates rather than removes it. This must not be prepared.** The diagnosis behind the leaf is right and is still the diagnosis: a sinus that will not close over bone is chronic osteomyelitis with a sequestrum, and it does not heal until the dead bone is removed. That is done by sequestrectomy, with imaging first and culture-directed antibiotics after — not by poisoning the tract. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.