寶鑑Bogam

Formulas · Tonify Blood 補血 · Piryong (必用)

Modified Four Substances Decoction

Gagamsamul-tang

한글 가감사물탕  ·  Pinyin Jia Jian Si Wu Tang

加減四物湯

Cut and made into one packet with 3 slices of ginger, decocted in water and taken. The chapter prefaces this section with a warning: Yin vacuity brings chills and fever every afternoon, resolving toward evening with a slight chill, and the pulse is vacuous, soggy, and frequently interrupted — close enough to malaria to be mistaken for it. The malarial pulse is wiry; the vacuous pulse is large and wiry. Treat it as malaria by mistake and most cannot be saved.

Composition 構成

Total 48 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

  • Yin vacuity with fire stirring (陰虛火動證)
  • Afternoon chills and fever resolving toward evening
  • Blood vacuity heat requiring both building and cooling

Biomedical correlates

  • Chronic low-grade fevers with fatigue
  • Perimenopausal heat with dryness
  • Blood-deficiency heat patterns

Source text 原文

Donguibogam 東醫寶鑑

治陰虛火動證. 白芍藥ㆍ當歸 各一錢三分, 白朮 一錢二分, 川芎ㆍ熟地黃ㆍ知母ㆍ天門冬 各一錢, 陳皮ㆍ黃柏 各七分, 生地黃ㆍ甘草 各五分, 乾薑 三分. 右剉, 作一貼, 薑三片, 煎服. 《必用》

Translation

Treats the pattern of Yin vacuity with fire stirring. White peony and Korean angelica, 1 don 3 fun each; white atractylodes 1 don 2 fun; cnidium, prepared rehmannia, anemarrhena, and asparagus root, 1 don each; tangerine peel and phellodendron, 7 fun each; raw rehmannia and licorice, 5 fun each; dried ginger 3 fun. Cut the above, make one packet, add 3 slices of ginger, decoct and take. — Piryong 必用 (Donguibogam · Heoro)

Clinical commentary 臨床

The Four Substances given both a cooling wing and a warming anchor at once — anemarrhena, phellodendron, and asparagus above, and three fun of dried ginger at the bottom. That last measure is the formula's judgment: a Yin-vacuity patient treated with cold alone loses the stomach that has to absorb the medicine. Tangerine peel and atractylodes are there for the same reason. The head note is what makes this entry matter clinically — the pattern counterfeits malaria, and the pulse is the only thing that tells them apart. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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