Formulas · Purge Downward 瀉下 · Seonghye (聖惠)

Guide Out Stagnation Powder

Doche-san

한글 도체산 · Pinyin Dao Zhi San

導滯散

Composition 構成

Daehwang Da Huang
大黃 대황 · Rhubarb

40 g
Chief 君
Danggwi Dang Gui
當歸 당귀 · Korean Angelica

10 g
Deputy 臣
Sahyang She Xiang
麝香 사향 · Musk (prohibited)

—
Assistant 佐

a small amount (少許)

Total 50 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

Guides stagnant blood out below where the stool is blocked after an injury
Opens a congested blockage that has brought the patient to the point of death

Indications 主治

Pattern-based

Injury with stagnant blood held inside and the stool not passing
Congested blockage to the point of death

Biomedical correlates

Traumatic ileus with constipation
Retroperitoneal or intra-abdominal haematoma

Source text 原文

Donguibogam 東醫寶鑑

治傷損內有瘀血, 大便不通, 壅鬱欲死. 大黃一兩, 當歸二錢半, 麝香少許. 右爲末, 每三錢, 熱酒調下. 《聖惠》

Translation

Treats injury with stagnant blood held inside, the stool not passing, and congested blockage to the point of death. Rhubarb, 1 nyang; angelica sinensis, 2 don 5 fun; musk, a small amount. Powder them; take 3 don at a time stirred down in hot wine. — Seonghye 聖惠 (Donguibogam · Jesang)

Clinical commentary 臨床

A nyang of rhubarb carrying two and a half don of angelica and a pinch of musk — a purgative with a blood-mover and an aromatic opener attached. The thinking is the chapter's standard one: injury puts blood where it does not belong, the bowel stops, and the way out is downward. 壅鬱欲死 is the chapter's phrase for a patient whose abdomen has shut. A nyang of rhubarb in a powder taken three don at a time is a real cathartic dose and it will open the bowel. Whether that helps depends entirely on why the bowel stopped. Constipation from immobility and opiates after an injury does respond to a laxative. A paralytic ileus, or a bowel obstructed by adhesions or by a retroperitoneal bleed, does not, and purging it risks perforation. Nothing in the formula distinguishes the two, and the Bogam had no way to. **Musk is taken from a protected animal and is not available legally. Rhubarb is a purgative and must not be given where the abdomen may be obstructed or the patient may be bleeding internally.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.