Formulas · Transform Phlegm 化痰 · Gogeum Uigam (古今醫鑑)

Modified Warm the Gallbladder Decoction

Gagamondam-tang

한글 가감온담탕  ·  Pinyin Jia Jian Wen Dan Tang

加減溫膽湯

Cut and made into one packet with 3 slices of ginger, 2 jujubes, and one dark plum, decocted in water; 5 fun of powdered cinnabar and half a cup of bamboo sap are stirred in before taking. Note on modern practice: cinnabar (辰砂/朱砂) is a mercury sulfide, restricted in contemporary practice and omitted from modern preparations; presentations of this severity require psychiatric assessment.

Composition 構成

Total 59.2 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

Indications 主治

Pattern-based

  • Phlegm confounding the Heart's orifices with the spirit not keeping to its dwelling (痰迷心竅 神不守舍)
  • Constraint from worry with fright and fear damaging the Heart
  • Agitation with raving
  • weeping song
  • shouting
  • running
  • and not recognizing people

Biomedical correlates

  • Acute agitated states — historical management
  • Severe anxiety with disorganization
  • Psychotic-spectrum presentations of the era

Source text 原文

Donguibogam 東醫寶鑑

治痰迷心竅, 神不守舍. 因憂思鬱結, 驚恐傷心, 心不自安, 神出舍空, 使人驚悸怔忡, 煩亂悲歌, 叫罵奔走, 不識人. 茯神ㆍ半夏(製)ㆍ陳皮ㆍ枳實ㆍ梔子(炒)ㆍ白朮ㆍ麥門冬ㆍ黃連 各一錢, 當歸ㆍ酸棗仁(炒)ㆍ竹茹 各八分, 人參 六分, 辰砂(末) 五分, 甘草 三分. 右剉, 作一貼, 薑三片, 棗二枚, 烏梅一箇, 水煎, 調辰砂末五分ㆍ竹瀝半盞服. 《醫鑑》

Translation

Treats phlegm confounding the Heart's orifices, the spirit not keeping to its dwelling — arising from constraint bound up by worry and thought, and from fright and fear damaging the Heart, so that the Heart cannot settle itself, the spirit goes out and the dwelling stands empty, leaving the person with fright palpitations and fearful throbbing, vexed confusion and grieving song, shouting and cursing and running about, not recognizing people. Hostwood poria, prepared pinellia, tangerine peel, unripe bitter orange, dry-fried gardenia, white atractylodes, ophiopogon, and coptis, 1 don each; Korean angelica, dry-fried sour jujube seed, and bamboo shavings, 8 fun each; ginseng 6 fun; powdered cinnabar 5 fun; licorice 3 fun. Cut the above, make one packet, add 3 slices of ginger, 2 jujubes, and one dark plum, decoct in water, and take with 5 fun of powdered cinnabar and half a cup of bamboo sap stirred in. — Uigam 醫鑑 (Donguibogam · Sin)

Clinical commentary 臨床

The chapter's fullest description of an acute disturbed state — raving and confusion, singing in grief, shouting and running, no longer recognizing people — and a formula built to meet it on two fronts: clear the phlegm that has clouded the orifices, and refill the Heart that emptied first. The etiology named is worth noting: constraint from worry, and fright that damaged the Heart, so that the spirit went out and the dwelling stood empty. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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