Formulas · Purge Downward 瀉下 · Dansim (丹心)

Major Chest-Draining Pill

Daehamhyung-hwan

한글 대함흉환 · Pinyin Da Xian Xiong Wan

大陷胸丸

二字 is a small weight used for powders, reckoned at about a tenth of a don, so roughly 0.4 g; the dose is given here as 0.8 g for the two.

Composition 構成

Daehwang Da Huang
大黃 대황 · Rhubarb

20 g
Chief 君
Mangcho Mang Xiao
芒硝 망초 · Mirabilite

10 g
Chief 君
Jeongnyeokja Ting Li Zi
葶藶子 정력자 · Pepperweed Seed

12 g
Deputy 臣

parched
Haengin Xing Ren
杏仁 행인 · Apricot Kernel

12 g
Deputy 臣

parched
Gamsu Gan Sui
甘遂 감수 · Kansui (toxic)

0.8 g
Assistant 佐

two ja · toxic

Total 54.8 g per packet (첩) · representative dosage — verify against source texts.

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

Drains heat and water from a high chest bind
Purges gently in pill form

Indications 主治

Pattern-based

Heat-repletion chest bind with the bind high in the chest and the neck drawn stiff
Water and heat bound above the diaphragm

Biomedical correlates

Loculated pleural effusion
Empyema with restricted neck movement

Source text 原文

Donguibogam 東醫寶鑑

治熱實結胸. 大黃五錢, 葶藶子(炒)ㆍ杏仁(炒) 各三錢, 芒硝二錢半, 甘遂二字. 右爲末, 蜜丸彈子大, 每一丸, 水一盞, 煎六分, 溫服. 未利再服. 《丹心》

Translation

Treats a heat-repletion chest bind. Rhubarb, 5 don; parched lepidium seed and parched apricot kernel, 3 don each; mirabilite, 2 don 5 fun; kansui, two <span class='sochu'>ja</span> 字. Powder, make honey pills the size of a bullet, and for each dose decoct one pill in a cup of water down to six parts and take warm. If there is no purging, take again. — Dansim 丹心 (Donguibogam · Han, lower)

Clinical commentary 臨床

The same bind as the decoction, but higher in the chest and reached more slowly. Lepidium seed and apricot kernel are the additions, and both work on the lung — this is for the bind that pulls the neck stiff because it sits up under the diaphragm, where a purgative driven straight through the bowel would pass beneath it. Honey pills decocted whole release over hours instead of minutes, which is the whole reason for the pill form: Zhongjing wanted the drug to sit at the level of the obstruction. Kansui again, and again a formula to read rather than make. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.