寶鑑Bogam

Formulas · Transform Phlegm 化痰 · Seui Deukhyobang (世醫得效方)

Open the Gate Powder for Fright Wind

Gaegwan-san

한글 개관산 (소아)  ·  Pinyin Kai Guan San

開關散

Donguibogam carries a second 開關散, the Immun powder of the Wind chapter for sudden wind stroke with the eyes closed and the teeth clenched — arisaema and borneol only, also called 破棺散 — registered as `gaegwan-san`. The two share the name, the purpose and the arisaema, but nothing else: this leaf is from the Deukhyo, adds centipede, silkworm, musk and soap-pod, and is written for a child, so it takes the chapter tail. 灸 is printed where the sense is 炙, roasted, as the transcription and the corpus both have it. The section text above the leaf prescribes it by name, 截風定搐先與開關散嚏驚散.

Composition 構成

Total 9 g per packet (첩) · representative dosage — verify against source texts. Excludes 3 ingredients 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

Indications 主治

Pattern-based

  • 驚風口噤不開 — fright wind with the mouth clamped shut

Biomedical correlates

  • Trismus in a convulsing child

Source text 原文

Donguibogam 東醫寶鑑

治驚風口噤不開. 蜈蚣 一條(灸), 白殭蚕ㆍ南星(炮) 各一錢, 麝香 一字, 猪牙皂角 三錠(畧燒存性). 右爲末, 以手點薑汁, 蘸藥少許擦牙. 或用物引滴入藥三兩點於口中, 涎出自開. 《得效》

Translation

Treats fright wind with the mouth clamped and not opening. One centipede, roasted; white silkworm and blast-fried arisaema, 1 don each; musk, one ja; three sticks of pig-tusk soap-pod, lightly charred with the nature kept. Powder the above; wet a finger with ginger juice, dip it in a little of the powder and rub it over the teeth. Or use something to carry it and drip two or three drops of the medicine into the mouth — the drool runs and the mouth opens of itself. — Seui Deukhyobang 得效 (Donguibogam · Soa)

Clinical commentary 臨床

A topical, not a draught, and the chapter is clear about why: the jaw is locked, so nothing can be swallowed and the medicine goes on the gums. The mechanism is not mysterious. Soap-pod saponins are a powerful local irritant and sialagogue, and 涎出自開 — the drool runs and the mouth opens — is an accurate description of what happens when you rub them along a child's gums. Ginger juice and musk add to the stimulus. **Contains centipede, a toxic animal material, raw-processed arisaema and musk, rubbed into the mouth of a convulsing child with no dose by weight stated anywhere. This must not be prepared.** And the procedure is worse than the drugs: putting a finger, a powder or a few drops of liquid into the mouth of a child who is convulsing or obtunded is a direct route to aspiration, and forcing the jaw risks injury to the teeth and to the person doing it. The modern instruction is the opposite of this one — nothing goes in the mouth of a seizing child. Trismus is also the wrong thing to treat symptomatically. A clamped jaw in an infant is neonatal tetanus until proved otherwise, and in an older child it points to a deep neck or dental infection or to tetanus again; all of those need antitoxin, antibiotics and airway care. See Jinsa-go-soa on 噤口風. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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