Formulas · External Application 外用 · Gogeum Uigam (古今醫鑑)

Moxa-Substitute Powder

Daegu-san

한글 대구산 · Pinyin Dai Jiu San

代灸散

鈆 is left as the transcription prints it; the transcription writes 鈆 throughout this chapter and the corpus prints 鈆 more often than 鉛, so the form is kept and 鈆粉 is registered under 胡粉 as hobun by way of the 鉛粉 alias. 灸 is left as the transcription and the corpus both print it. 槐皮 is the perforated disc that carries the powder and is the reason for the name, and is entered as an ingredient rather than as apparatus because it lies on the sore. 麝香二分 is 0.8 g on this chapter's conversion.

Composition 構成

Hobun Hu Fen
胡粉 호분 · White Lead (toxic)

4 g
Chief 君

鈆粉 — white lead, toxic
Unghwang Xiong Huang
雄黃 웅황 · Realgar

4 g
Chief 君

arsenic sulfide, toxic
Gyeongbun Qing Fen
輕粉 경분 · Calomel (toxic)

2 g
Deputy 臣

5 fun — calomel, mercurial, severely toxic
Sahyang She Xiang
麝香 사향 · Musk (prohibited)

0.8 g
Assistant 佐

2 fun · CITES
Goepi Huai Pi
槐皮 괴피 · Pagoda Tree Bark

—
Envoy 使

槐皮一片 — one slice of pagoda-tree bark, pricked close with needle holes and laid on the sore to carry the powder

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

Treats scrofula broken down and ulcerating with a stench that cannot be borne
Dusted onto a slice of pagoda-tree bark pricked close with needle holes and laid on the sore
Heated with a charcoal fire above so that the drug vapour passes down into the sore

Indications 主治

Pattern-based

瘰癧潰爛 — scrofula broken down and ulcerating
臭不可聞 — a stench that cannot be borne

Biomedical correlates

Secondarily infected, foul-smelling tuberculous sinus
Malodorous chronic ulcer with anaerobic infection

Source text 原文

Donguibogam 東醫寶鑑

治瘰癧潰爛, 臭不可聞. 鈆粉ㆍ雄黃各一錢, 輕粉五分, 麝香二分. 右爲末. 用槐皮一片, 將鍼密密刺孔, 置瘡上, 上糝藥一撮, 以炭火灸熱, 其藥氣自然透入瘡中, 痛熱爲止, 二三次全愈. 《醫鑑》

Translation

Treats scrofula broken down and ulcerating with a stench that cannot be borne. White lead and realgar 1 don each; calomel 5 fun; musk 2 fun. Powder them. Take one slice of pagoda-tree bark, prick it close all over with a needle, and set it on the sore; dust a pinch of the powder on top of it and heat it with a charcoal fire, and the vapour of the drug passes into the sore of itself. Stop when it becomes painfully hot. Two or three applications and it is wholly healed. — Uigam 醫鑑 (Donguibogam · Jechang)

Clinical commentary 臨床

The name is the method: 代灸, in place of moxa. A slice of pagoda-tree bark is pricked all over like a colander, laid on the ulcerated node, the powder dusted on top of it, and a charcoal fire brought over the lot so that the heated drug is driven down through the holes into the sore. The bark is both a heat shield and a sieve, and the endpoint is the patient's own tolerance — 痛熱爲止, stop when it becomes painfully hot. The four drugs are chosen for a stench. White lead, realgar and calomel are all antiseptic in the crude sense that they poison the bacteria colonising a necrotic surface, and two fun of musk covers what is left. 臭不可聞, a smell that cannot be borne, means anaerobic overgrowth in a sinus full of caseous debris, and a powder of this kind would genuinely reduce it for a few days. **Contains white lead, realgar (arsenic sulfide) and calomel, heated and deliberately driven into an open wound — lead, arsenic and mercury are all absorbed this way and all three are cumulative poisons. Musk is from a CITES-listed species. This must not be prepared.** The underlying lesion is tuberculous lymphadenitis; deodorising the sinus does not treat it, and the claim of complete healing in two or three applications is not credible. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.