Formulas · External Application 外用 · Uihak Jeongjeon (醫學正傳)

Single Toad Pill

Dokseom-hwan

한글 독섬환 · Pinyin Du Chan Wan

獨蟾丸

A single-drug leaf with no weight given; the dose is stated as what one toad yields. 菉豆 is the corpus form and names only the size of the pill. 臥 and 嚥 are printed as the transcription has them, the corpus not normalizing 卧/臥. The paper that covers the pill in the wound is apparatus rather than an ingredient.

Composition 構成

Seomsu Chan Su
蟾酥 섬수 · Toad Venom

—
Chief 君

蟾酥取得, taken from the toad and rolled into a pill the size of a mung bean; one toad makes one pill, two at most. No weight given — toad venom, cardiotoxic

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

One drug only — toad venom rolled into a mung-bean pill, one toad yielding one pill, two at the most
Laid on the tongue while the patient lies down, the bitter water it draws then swallowed
Or put into the needled head of a 疔 and covered with paper

Indications 主治

Pattern-based

疔瘡 and 一切惡瘡 — the nail-sore and every kind of malign sore

Biomedical correlates

Furuncle and carbuncle — historical
Deep pyogenic skin infection — historical

Source text 原文

Donguibogam 東醫寶鑑

治疔瘡及一切惡瘡. 蟾酥取得, 丸如菉豆大. 一蟾或作一丸, 多者作二丸. 每取一丸, 置舌上臥片時, 其苦水滿口, 卽嚥下. 或鍼刺疔頭, 納一丸於中, 紙貼護之, 神效. 《正傳》

Translation

Treats the nail-sore and every kind of malign sore. Take the venom from the toad and roll it into a pill the size of a mung bean; one toad makes one pill, or two at the most. Each time take one pill, lay it on the tongue and lie down a short while; when the bitter water fills the mouth, swallow it at once. Or else needle the head of the nail-sore, put one pill inside it and cover it over with paper to protect it — the effect is marvellous. — Jeongjeon 正傳 (Donguibogam · Ongjeo)

Clinical commentary 臨床

One drug, and the leaf is really a note on how to dose it. The unit of measure is the animal: 一蟾或作一丸, 多者作二丸 — one toad makes one pill, a generous one two. That is the honest way to write a prescription for a substance whose strength cannot be standardised, and it tells us the venom was taken fresh from the parotoid glands rather than bought as a cake. Two routes are given. The pill can be laid on the tongue with the patient lying down until the mouth fills with bitter water, which is then swallowed; or it can be put into the needled head of a 疔 and papered over. 蟾酥 runs through the whole of this section — 蟾酥丸, 回瘡蟾酥錠子, 飛龍奪命丹, 保生錠子 and 化毒丸 all contain it — and this leaf is the drug on its own, which makes it the clearest statement of what the chapter thought it was doing with it. **Toad venom contains bufadienolides, which are cardiac glycosides acting at the same site as digoxin, and it has killed people at ordinary medicinal doses; the local anaesthetic numbing it produces is part of the same toxicity. This must not be prepared or taken, and no substitution makes it safe.** Poisonings from toad-venom preparations present as vomiting, bradycardia and ventricular arrhythmia, and there is no dependable antidote; the sublingual and buccal route the leaf prefers is the fastest way to absorb it. A furuncle or carbuncle is drained and, where there is spreading infection, covered with a systemic antibiotic. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.