Formulas · Clear Heat 淸熱 · Dansim (丹心)

Augmented Rhinoceros Horn Resolve Toxin Beverage

Gamiseogaksodok-eum

한글 가미서각소독음  ·  Pinyin Jia Wei Xi Jiao Xiao Du Yin

加味犀角消毒飮

䑕粘子 is printed 鼠粘子 and is entered under 牛蒡子, which the alias table reaches by that form. The plain 犀角消毒飮 of this chapter is registered seogaksodok-eum-soa, and a formula of that name in another chapter is registered seogaksodok-eum. The leaf's position in 1.74 解毒 is as the second of two, following 犀角地黃湯.

Composition 構成

Total 12.4 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

  • 痘疹毒氣壅遏, 未能勻透 — the pox toxin dammed up and unable to come through evenly
  • 口舌生瘡, 不能吮乳 — sores on the mouth and tongue, the child unable to suck

Biomedical correlates

  • Oral and pharyngeal enanthem of smallpox preventing feeding — historical
  • Dehydration and starvation in an infant who cannot suck — historical

Source text 原文

Donguibogam 東醫寶鑑

治痘疹毒氣壅遏, 未能勻透, 及口舌生瘡, 不能吮乳. 鼠粘子 一錢二分, 甘草 五分, 防風ㆍ升麻 各三分, 荊芥穗ㆍ麥門冬ㆍ犀角屑ㆍ桔梗 各二分. 右剉作一貼, 水煎服. 《丹心》

Translation

Treats the pox and rash where the toxic qi is dammed up and cannot come through evenly, and sores breaking out on the mouth and tongue so that the child cannot suck. Burdock seed, 1 don 2 fun; liquorice, 5 fun; saposhnikovia and cimicifuga, 3 fun of each; schizonepeta spike, ophiopogon, shaved rhinoceros horn and platycodon, 2 fun of each. Cut the above and make one packet, decoct in water and give. — Dansim 丹心 (Donguibogam · Soa)

Clinical commentary 臨床

Eight drugs at two to five fun each — a very small decoction, the whole packet coming to about twelve grams — with burdock seed carrying almost half the weight. Burdock seed, saposhnikovia, cimicifuga, schizonepeta and platycodon are the venting and toxin-resolving group; ophiopogon moistens; liquorice harmonises; rhinoceros horn is the drug the name is built on and the one the formula is named "augmented" for. The indication is the valuable part, and it is a precise clinical observation. Sores on the mouth and tongue so that the child cannot suck: the enanthem of smallpox broke out on the oral and pharyngeal mucosa a day or two *before* the skin eruption, and those lesions ulcerated. A child with a mouth and throat full of ulcers stops feeding, and a small child who stops taking fluid for several days in a febrile illness dies of that, not of the pox on the skin. This is the mechanism the chapter has correctly identified and it names it in the indication line. The oral lesions are also why the disease was so infectious by droplet, since virus shed from the throat was being breathed out before anyone could see a rash. What such a child needed was fluid and calories by whatever route would take them — small volumes of sweetened salted water given patiently, and in modern care a nasogastric tube or a drip — together with care of the mouth. A twelve-gram decoction of eight drugs did not heal the ulcers and did not open the mouth, and on the reading set out at jacho-go-soa nothing given by mouth altered the course of the disease. The chapter's own sugar-water leaf, two sections earlier, was closer to the answer than this one. **Rhinoceros horn is keratin — structurally the same protein as hair, hoof and fingernail — and it has no pharmacological action whatever; a decoction of horn shavings is a decoction of nail clippings. All five surviving rhinoceros species are listed on CITES Appendix I and all international commercial trade is prohibited. The demand that drove them to the edge of extinction was created by this medical tradition, and the trade in horn continues to be driven by it. It must not be obtained or used. Burdock seed and the rest are not themselves hazardous, but the patient is an infant and the leaf gives one packet with no dose scaled to age or weight.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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