Formulas · External Application 外用 · Uihak Jeongjeon (醫學正傳)

Golden Treasure Paste

Geumbo-go

한글 금보고 · Pinyin Jin Bao Gao

金寶膏

The transcription prints 穿山甲煨肨; the corpus prints 煨胖 for this preparation of pangolin scale, at 復元通氣散 among others, and 胖 outnumbers 肨 in the corpus, so 煨胖 is printed above and the transcription's glyph recorded here. 桑柴灰 is made up into lye in the leaf itself and is registered under 桑柴灰汁 as sangsihoejeup. 倂 and 靨 are left as the transcription and the corpus both print them; 倂靨 is read as the old dressing coming away together with the eschar. The pan and the jar are apparatus and are named in the method only. 信砒 is registered under 砒礵 as biseok.

Composition 構成

Sangsihoejeup Sang Chai Hui Zhi
桑柴灰汁 상시회즙 · Mulberry Wood Ash Lye

—
Chief 君

桑柴灰五椀 — five bowls of mulberry-wood ash with ten bowls of boiling water poured through and strained for the lye
Cheonsangap Chuan Shan Jia
穿山甲 천산갑 · Pangolin Scale (prohibited)

80 g
Deputy 臣

煨胖 — roasted in hot ash until puffed, 2 nyang · CITES
Bisang Pi Shuang
砒礵 비상 · Arsenic Trioxide

4 g
Deputy 臣

信砒, 1 don — arsenic trioxide, severely toxic
Haengin Xing Ren
杏仁 행인 · Apricot Kernel

—
Assistant 佐

七枚 — seven kernels, ground fine together with the pangolin scale and the arsenic
Saengjihwang Sheng Di Huang
生地黃 생지황 · Raw Rehmannia

80 g
Assistant 佐

2 nyang, the juice added with the powders
Jusa Zhu Sha
朱砂 주사 · Cinnabar (toxic)

4 g
Assistant 佐

朱砂, 1 don, put in last — mercuric sulfide
Gyeongbun Qing Fen
輕粉 경분 · Calomel (toxic)

2 g
Assistant 佐

half a don, put in after the musk — calomel, mercurial, severely toxic
Sahyang She Xiang
麝香 사향 · Musk (prohibited)

2 g
Assistant 佐

half a don, put in first of the three · CITES
Seokhoe Shi Hui
石灰 석회 · Lime (caustic)

40 g
Envoy 使

炒石灰末一兩 — dry-fried powdered lime, put in to set the block; caustic

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 2 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

Takes away rotten and malign flesh without injuring the good flesh
Cooked down in mulberry-ash lye to a block and kept out of the air in a jar
Applied on the node, the old medicine taken off with the eschar when it is renewed

Indications 主治

Pattern-based

腐肉ㆍ惡肉 — rotten and malign flesh on a broken scrofulous node
A node that stays hard after the pus has gone

Biomedical correlates

Debridement of a caseating tuberculous node — a historical escharotic
Chemical debridement of necrotic tissue in a chronic wound

Source text 原文

Donguibogam 東醫寶鑑

去腐肉ㆍ惡肉, 不傷良肉. 桑柴灰五椀, 以沸湯十椀淋濾取汁. 穿山甲(煨胖) 二兩, 信砒一錢, 杏仁七枚, 三味同硏細. 生地黃二兩, 朱砂一錢, 輕粉ㆍ麝香各半錢. 右將灰汁下鍋煎濃, 下甲末等及地黃汁, 候焦乾, 下麝香, 次下輕粉, 次下朱砂, 候將成膏, 下炒石灰末一兩, 以成塊子, 收入罐內, 勿見風. 每取付核上, 再付卽去舊藥, 倂靨卽效. 《正傳》

Translation

Takes away rotten and malign flesh without injuring the good flesh. Five bowls of mulberry-wood ash, with ten bowls of boiling water poured through and strained off for the lye. Pangolin scale (roasted in hot ash until puffed) 2 nyang, good arsenic 1 don, apricot kernels seven — grind these three fine together. Raw rehmannia 2 nyang, cinnabar 1 don, calomel and musk half a don each. Put the lye in a pan and boil it thick, put in the pangolin powder and the rest together with the rehmannia juice, and when it has cooked down dry put in the musk, then the calomel, then the cinnabar; when it is about to come to a salve put in 1 nyang of dry-fried powdered lime so that it forms a block, and keep it in a jar out of the air. Each time take some and apply it on the node; when it is applied again, take the old medicine off along with the eschar, and it answers. — Jeongjeon 正傳 (Donguibogam · Jechang)

Clinical commentary 臨床

The chapter's debriding agent, and the one place in the 瘰癧 section that says plainly what it is doing: 去腐肉ㆍ惡肉, 不傷良肉 — take away the rotten flesh and leave the good. It is built on alkali. Five bowls of mulberry-wood ash washed through with ten of boiling water gives a strong potash lye, which is boiled down with arsenic, pangolin scale and apricot kernels, then with rehmannia juice, and finally set into a solid block with a nyang of dry-fried lime. Cinnabar, calomel and musk go in at the end in half-don amounts. It is a caustic, and it works the way the leaf says: lye and lime saponify and dissolve dead tissue, the arsenic kills what is left, and the block is applied dry so that it draws. 再付卽去舊藥倂靨 — when you put on the next dose the old medicine lifts away with the eschar — is an accurate description of serial chemical debridement. The 外治法 passage reaches for it after the red-hot iron has failed to stop the node re-forming. **This is a mixture of arsenic trioxide, two mercury compounds, caustic alkali and quicklime applied to an open wound, from which arsenic and mercury are absorbed systemically. Pangolin and musk are from CITES-listed species whose trade is prohibited. This must not be prepared under any circumstances.** The lesion is a caseating tuberculous node; burning the slough out of it does not treat the infection, and the node continues to break down until antimycobacterial treatment is given. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.