寶鑑Bogam

Formulas · Release the Exterior 解表 · Gogeum Uigam (古今醫鑑)

Augmented Vanquish Toxin Powder (Children chapter)

Gamipaedok-san

한글 가미패독산  ·  Pinyin Jia Wei Bai Du San

加味敗毒散

The Bogam carries this name three times and all three compositions differ. The Foot chapter's gamipaedok-san-jok is 1 nyang of Insampaedok-san with rhubarb and atractylodes lancea added, for leg qi with a hot red swollen ankle, from the Deukhyo. The Epidemic chapter's gamipaedok-san-on is eighteen drugs at six fun and three fun, with ginseng, red poria, both atractylodes, red peony, Korean angelica and raw rehmannia, from the Jeongjeon. This leaf is twelve drugs at three fun from the Uigam, with gastrodia and wolfberry root bark that neither of the others carries, and it says in so many words that ginseng and poria are struck out — the two drugs the Epidemic version keeps. Three homonyms, not one formula cited three times.

Composition 構成

Total 14.4 g per packet (첩) · representative dosage — verify against source texts. Excludes 5 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

  • Fever resembling cold damage, the case not yet distinguishable (發熱似傷寒, 未辨疑似)
  • Fever at the onset of pox, before the red points appear

Biomedical correlates

  • Smallpox, febrile prodrome — historical management
  • Undifferentiated febrile illness in a child

Source text 原文

Donguibogam 東醫寶鑑

柴胡ㆍ前胡ㆍ羌活ㆍ獨活ㆍ防風ㆍ荊芥ㆍ薄荷ㆍ枳殼ㆍ桔梗ㆍ川芎ㆍ天麻ㆍ地骨皮 各三分. 右剉, 作一貼, 宜加紫草ㆍ蟬殼ㆍ紫蘇ㆍ麻黃ㆍ葱白, 煎服, 表汗之. 本方除參苓, 恐助火也. 《醫鑑》

Translation

Bupleurum, peucedanum, notopterygium, pubescent angelica, saposhnikovia, schizonepeta, mint, bitter orange, platycodon, chuanxiong, gastrodia and wolfberry root bark, 3 fun each. Cut the above and make one packet; it is right to add arnebia, cicada moulting, perilla, ephedra and scallion white, decoct and take, and so sweat the exterior. The parent formula''s ginseng and poria are removed, for fear of feeding the fire. — Uigam 醫鑑 (Donguibogam · Soa)

Clinical commentary 臨床

The exterior-resolving base stripped down and pointed at one moment: the first three days of fever, before any red point has appeared, when nobody yet knows whether the child has cold damage or the pox. Twelve drugs at three fun is a very thin decoction, and the five additions — arnebia and cicada moulting to cool and move the blood, perilla, ephedra and scallion to open the surface — are what the formula is really for. The deletion is the telling line. Ginseng and poria come out of Insampaedok-san deliberately, 恐助火也, for fear of feeding the fire; a febrile child is not a patient to warm. The reading that matters is the plain one. **Smallpox had no treatment.** Nothing in the Donguibogam, and nothing in any materia medica of 1613, touched variola virus. What changed who lived was nursing: fluid by mouth, keeping the child cool and fed, and keeping bacteria off a skin surface that had been broken open over its whole area. A 敗毒 or 解肌 decoction given in the fever stage altered nothing about the disease, and the sweating it was meant to produce worked against the one thing that did help. **Contains ephedra, a sympathomimetic, and the formula is given to a child in order to force a sweat. Deliberate sweating in a febrile child loses fluid the child cannot spare. The leaf weighs the drugs but gives no dose by the child's weight or age — one packet is decocted whatever the child's size.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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