Formulas · Transform Phlegm 化痰 · Uihak Immun (醫學入門)

Open the Clenched Jaw Powder

Gaegwan-san

한글 개관산 · Pinyin Kai Guan San

開關散

一字 is a quarter of a 錢 by the classical measure, about 1 g, but here it is used loosely for a pinch. The alternative name 破棺散 — Burst the Coffin Powder — is from the Jeonggam.

Composition 構成

Namseong Tian Nan Xing
天南星 천남성 · Arisaema

2 g
Chief 君

powdered · toxic
Yongnoe Long Nao
龍腦 용뇌 · Borneol

0.1 g
Deputy 臣

one ja (a pinch)

Total 2.1 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

Opens the clenched jaw in sudden wind stroke
Applied to the gums rather than swallowed

Indications 主治

Pattern-based

Wind stroke with the jaw locked and the eyes shut
Phlegm wind with trismus

Biomedical correlates

Trismus in acute stroke
Lockjaw

Source text 原文

Donguibogam 東醫寶鑑

治卒中風目瞑牙噤. 天南星(末) 五分, 龍腦一字. 右硏和, 以中指蘸藥末, 揩齒二三十度, 其口自開. 每用半錢至一字, 端午日合尤佳. 《入門》 ○一名破棺散. 《醫鑑》

Translation

Treats sudden wind stroke with the eyes closed and the teeth clenched. Powdered arisaema, 5 fun; borneol, one ja. Grind and mix; dip the middle finger in the powder and rub it over the teeth twenty or thirty times, and the mouth will open of itself. Use from half a don to one ja each time; compounded on the fifth day of the fifth month it is better still. Also called Pagwan-san. — Uihak Immun 入門 · Uihak Jeonggam 醫鑑 (Donguibogam · Pung)

Clinical commentary 臨床

A topical, not a draught, and the chapter is explicit about why: in a patient whose jaw is locked, nothing can be swallowed, so the medicine is rubbed on the gums. Arisaema is an acrid irritant and borneol a penetrating aromatic, and twenty or thirty strokes along the teeth is enough mechanical and chemical stimulus to provoke a reflex opening. The second name, Burst the Coffin Powder, tells you what sort of patient it was reached for. Arisaema is toxic raw and this preparation is raw; it is not to be swallowed. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.