Formulas · Purge Downward 瀉下 · Uibang Yuchwi (醫方類聚)

Exchange Powder

Dohwan-san

한글 도환산 · Pinyin Dao Huan San

倒換散

Composition 構成

Daehwang Da Huang
大黃 대황 · Rhubarb

40 g
Chief 君

40 g where the stool will not pass, 12 g where the urine will not
Haengin Xing Ren
杏仁 행인 · Apricot Kernel

12 g
Deputy 臣

12 g where the stool will not pass, 40 g where the urine will not

Total 52 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

Treats both passages not passing

Indications 主治

Pattern-based

Obstruction of one or both passages

Biomedical correlates

Faecal impaction
Urinary retention

Source text 原文

Donguibogam 東醫寶鑑

治大小便不通. 如大便不通, 大黃一兩, 杏仁三錢; 如小便不通, 大黃三錢, 杏仁一兩. 右剉, 分二貼, 水煎服. 《類聚》

Translation

Treats both passages not passing. If the stool will not pass, rhubarb 1 nyang and apricot kernel 3 don; if the urine will not pass, rhubarb 3 don and apricot kernel 1 nyang. Cut up, divide into two packets and decoct in water. — Uibang Yuchwi 類聚 (Donguibogam · Daebyeon)

Clinical commentary 臨床

Two drugs whose quantities are simply exchanged — a nyang of rhubarb and three don of apricot kernel for the stool, the reverse for the urine — which is where the name comes from. Apricot kernel belongs to the lung, and the lung governs the water passages, so the logic is that opening above opens below. It is the most elegant statement in the chapter of a principle it uses constantly: one formula, two directions, set by the ratio. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.