Formulas · Purge Downward 瀉下 · Jeongui (精義)

Dongwon's Support the Interior Powder

Dongwontangni-san

한글 동원탁리산 · Pinyin Dong Yuan Tuo Li San

東垣托裏散

The transcription prints 胃脘癕 for 胃脘癰, normalized here, and keeps 脉 for 脈, which the corpus prints as transcribed. The source label is 《精義》, the 外科精義, distinct from the 《精要》 of other leaves. Despite the name 托裏, the composition is a draining one; see the note.

Composition 構成

Geumeunhwa Jin Yin Hua
金銀花 금은화 · Honeysuckle

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

8 g
Chief 君
Daehwang Da Huang
大黃 대황 · Rhubarb

2.4 g
Deputy 臣
Moryeo Mu Li
牡蠣 모려 · Oyster Shell

2.4 g
Deputy 臣
Yeongyo Lian Qiao
連翹 연교 · Forsythia

2.4 g
Deputy 臣
Bakcho Pu Xiao
朴硝 박초 · Crude Mirabilite

2.4 g
Deputy 臣
Gwarugeun Gua Lou Gen
瓜蔞根 과루근 · Trichosanthes Root

2.4 g
Assistant 佐
Jogak Zao Jiao
皂角 조각 · Gleditsia Pod

2.4 g
Assistant 佐

皂角刺
Jeokjagyak Chi Shao
赤芍藥 적작약 · Red Peony

1.6 g
Assistant 佐
Hwanggeum Huang Qin
黃芩 황금 · Scutellaria

1.6 g
Assistant 佐

Total 33.6 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 abscess of the stomach cavity, internal induration and all malign sores at their first swelling and pain
Disperses the whole of it in three doses, before the pus has formed
Breaks and drains the collection with rhubarb, mirabilite, oyster shell and gleditsia thorn

Indications 主治

Pattern-based

Abscess of the stomach cavity (胃脘癰) and internal induration (內疽)
Malign sores (惡瘡) newly swollen and painful, about to form pus
A flooding, rapid, wiry and replete pulse (脉洪數弦實)

Biomedical correlates

Not identifiable as a modern entity; the Bogam's abscess of the stomach cavity and internal induration do not correspond to named diagnoses
Early soft-tissue infection before an abscess has collected

Source text 原文

Donguibogam 東醫寶鑑

治胃脘癰ㆍ內疽及一切惡瘡, 始發腫痛, 脉洪數弦實, 將欲作膿者, 三服消盡. 金銀花ㆍ當歸各二錢, 大黃ㆍ牡蠣ㆍ瓜蔞根ㆍ皂角刺ㆍ連翹ㆍ朴硝各六分, 赤芍藥ㆍ黃芩各四分. 右剉, 作一貼, 酒水相半煎服. 《精義》

Translation

Treats abscess of the stomach cavity, internal induration and all malign sores at the first swelling and pain, where the pulse is flooding, rapid, wiry and replete and the pus is about to form: three doses disperse it entirely. Honeysuckle and Korean angelica, 2 don each; rhubarb, oyster shell, trichosanthes root, gleditsia thorn, forsythia and mirabilite, 6 fun each; red peony and scutellaria, 4 fun each. Cut up, make one packet, and decoct in half wine and half water and take. — Jeongui 精義 (Donguibogam · Ongjeo)

Clinical commentary 臨床

Honeysuckle and Korean angelica lead at two don and everything else is in sixths and tenths, which makes the formula lighter than its drug list suggests. Rhubarb and mirabilite take the heat out by the stool, oyster shell and trichosanthes root soften the mass, gleditsia thorn drives into it, and forsythia, red peony and scutellaria cool. The claim is narrow and precise: 將欲作膿者, 三服消盡 — if the pus has not yet formed, three doses will disperse the whole of it. The name is worth noticing, because it is misleading. 托裏 in this chapter means supporting from within with ginseng, astragalus and Korean angelica so the pus is pushed out, as in Takri-san and the 內托 family; but this formula is really on the draining side, with the rhubarb and mirabilite of 內疏黃連湯 and 五利大黃湯. It carries the Dongwon name and the 托裏 label because it is given before suppuration, where the Bogam's rule is to disperse rather than support. The categories 胃脘癰 and 內疽 themselves have no modern counterpart that can honestly be named. **Rhubarb and mirabilite are purgatives. An early spreading soft-tissue infection needs antibiotics, and a collected abscess needs drainage.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.