寶鑑Bogam

Formulas · Clear Heat 淸熱 · Uihak Immun (醫學入門)

Augmented Wax and Alum Pill

Gaminapban-hwan

한글 가미납반환  ·  Pinyin Jia Wei La Fan Wan

加味蠟礬丸

Two collation notes for this leaf sit two leaves further on, at the foot of the 040a/040b page boundary inside the 截疳散 leaf: the transcription reads 尤 where the 初刊本 reads 末 (右爲末, powder the above), and 爉 where the 初刊本 reads 蠟. The transcription's readings are printed here, as this project's base-text rule requires, and the 初刊本 readings are recorded only in this note. 象牙, elephant ivory, has no entry in the herb list and is left out of the ingredient list; so is the 衆手 of the preparation, which names the many hands needed to roll a wax pill before it sets rather than any material.

Composition 構成

Total 308 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

  • 久新諸漏 — the whole run of fistulas, long-standing and recent alike
  • 漏喜發於項腋及陰僻肛門之間 — sinuses favouring the neck, the armpit, the groin and the anus
  • Retained toxin in a tract that will not close

Biomedical correlates

  • Chronic fistula-in-ano, pilonidal sinus and other chronic sinus tracts
  • Tuberculous lymphadenitis with a discharging sinus
  • Chronic suppuration with a persistent tract

Source text 原文

Donguibogam 東醫寶鑑

治久新諸漏. 象牙 五錢, 露蜂房ㆍ白殭蠶ㆍ蛇退(燒)ㆍ血竭ㆍ木香 各三錢, 乳香 二錢, 白礬 二兩. 右爲尤, 黃蠟爉 四兩, 熔化和勻, 衆手作丸梧子大. 溫酒下二三十丸. 《入門》

Translation

Treats the whole run of fistulas, long-standing and recent. Elephant ivory 5 don; hornet's nest, silkworm killed by its own fungus, a sloughed snake skin burnt, dragon's blood resin and costus root, 3 don each; frankincense 2 don; alum 2 nyang. Powder the above. Melt 4 nyang of beeswax, mix it in evenly, and with many hands at once roll pills the size of a paulownia seed. Take twenty or thirty in warm wine. — Immun 入門 (Donguibogam · Jechang)

Clinical commentary 臨床

This is the 入門's own 蠟礬丸 — two nyang of alum in four of beeswax, registered here for 癰疽, 發背, 瘰癧, 瘻瘡 and 惡瘡 — with six drugs added and the proportions of the base reversed. The wax and alum still carry it; the additions are the resins and animal materials this chapter reaches for whenever a tract will not close. The base is worth understanding because it explains the pill. Beeswax is inert and alum is an astringent that precipitates protein, so what the 入門 means by 衛護內膜, guarding the membranes, is a wax pill that passes through carrying alum with it. Taken by mouth it cannot reach a sinus in the groin or the neck at all. The section lists it under 通治, the general treatment, which is where formulas go when nothing more specific is claimed for them. None of the ingredients is dangerous in the quantities given, which makes this one of the few leaves in the chapter that needs no warning. It is also one that could not have worked: a chronic fistula closes when the thing feeding it — retained pus, a dead fragment of bone, an epithelialised tract, a diseased gland — is removed, and the chapter's own doctrine at 疳瘻 says exactly that. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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