Formulas · Release the Exterior 解表 · Uihak Gangmok (醫學綱目)

Return to Life Powder

Hoesaeng-san

한글 회생산 · Pinyin Hui Sheng San

回生散

This is not the 回生散 already registered as `hoesaeng-san`. That one is the 入門 formula from 霍亂門, patchouli and tangerine peel at 5 don each, decocted and taken warm for sudden turmoil with excessive vomiting and diarrhoea. It shares no drug and no indication with this leaf, which is a calcined human tooth powder for smallpox, so the two are homonyms and this one takes the chapter tail `-soa`. The alias 人齒散 romanises to `inchi-san`, which is unoccupied in the database. 人齒, the chief drug, has no entry in the herb dictionary — `yongchi` 龍齒 is fossil tooth and a different material — and is left out of `ingredients` and named in the translation, so the ingredient list carries no chief. 麻黃薄荷湯 and 升麻紫草湯 are vehicles and take no cross-reference link. The transcription writes 雲歧子; printed 雲岐子, since the corpus prints 岐 in all eight places it carries that name and never 歧. 雲岐子 is the physician Jang Byeok 張璧. 戞 in 百祥丸’s leaf is the first occurrence of either 戞 or 戛 in this database and is left as the transcription writes it. The source label 虞世 appears once before in this database, romanised U Sein; it is not in the standard label list. The transcription writes 黑䧟 and 為; printed 黑陷 and 爲 as the corpus prints them, and 硏 and 煆 are kept.

Composition 構成

Ganghwal Qiang Huo
羌活 강활 · Notopterygium

4 g
Deputy 臣

from the variant for severe black sinking
Cheonsangap Chuan Shan Jia
穿山甲 천산갑 · Pangolin Scale (prohibited)

—
Assistant 佐

(炮) blast-fried, 少許 a little; from the variant for severe black sinking · CITES Appendix I
Sahyang She Xiang
麝香 사향 · Musk (prohibited)

—
Assistant 佐

少許, a little · CITES Appendix I

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

Given where the pox comes out slowly, or has turned over and gone black and sunken
Calcined human tooth ground fine, one tooth to a dose in weak wine, with a little musk
Where the black sinking is severe, human tooth with notopterygium, blast-fried pangolin scale and musk, 1 don in a mahuang and mint decoction
Never more than 1 don of human tooth; beyond that the yang is all driven to the surface and Sagunja-tang with chuanxiong and tangkuei is given to rescue it

Indications 主治

Pattern-based

痘出不快 — the pox slow to come out
倒靨黑陷 — the eruption turned over and gone black and sunken

Biomedical correlates

Haemorrhagic smallpox

Source text 原文

Donguibogam 東醫寶鑑

生人齒(小兒齒自落者佳), 火煆, 硏爲細末, 每齒一箇作一服, 淡酒調下, 入麝香少許尤妙. 黑陷甚則用人齒五分, 羌活一錢, 穿山甲(炮)ㆍ麝香各少許, 爲末, 每一錢, 麻黃薄荷湯調下, 一服便起. 凡人齒不可過用一錢, 過則陽盡出表, 急以<a href='/formulas/sagunja-tang'>四君子湯</a><span class='sochu'>方見氣門</span>加芎ㆍ歸救之. 《綱目》 ○一名人齒散. 治痘出不快, 或倒靨黑陷. 《入門》 ○錢氏方用溫酒調下, 雲岐子方用升麻紫草湯調下. 凡痘瘡最怕麝香與酒氣, 然則只用紫草湯自好. 《虞世》

Translation

Raw human tooth — a tooth a child has shed of itself is best — calcined in the fire and ground to a fine powder; one tooth makes one dose, stirred down in weak wine, and a little musk added to it is better still. Where the black sinking is severe, use human tooth, 5 fun; notopterygium root, 1 don; pangolin scale, blast-fried, and musk, a little of each. Powder them, and give 1 don at a time stirred down in a decoction of mahuang and mint; one dose and the eruption rises. Human tooth must never be used beyond 1 don: beyond that the yang is all driven out to the surface, and Four Gentlemen Decoction — the formula is given in the Qi chapter — with chuanxiong and tangkuei added must be given at once to rescue it. — Uihak Gangmok 綱目. ○ Also called the Human Tooth Powder. Treats the pox slow to come out, or the eruption turned over and gone black and sunken. — Immun 入門. ○ Jeonssi’s formulary gives it stirred down in warm wine, and Ungija’s formulary gives it stirred down in a decoction of cimicifuga and gromwell. The pox fears musk and the smell of wine above all things, so plain gromwell decoction is best of all. — U Sein 虞世 (Donguibogam · Soa)

Clinical commentary 臨床

A human tooth, calcined and ground, one tooth to a dose in weak wine. A tooth the child shed naturally is said to be best. Where the black sinking is severe the tooth is cut to 5 fun and joined by notopterygium, blast-fried pangolin scale and a little musk, and the dose goes down in a decoction of mahuang and mint. The whole formula is aimed at one thing: making a pox that has sunk come back out to the surface. **Two things in this leaf argue against itself, and both are worth more than the formula.** The first is an explicit ceiling: 凡人齒不可過用一錢 — never use more than 1 don of human tooth — with the consequence named (過則陽盡出表, the yang is all driven out to the surface) and the rescue named too, 四君子湯 with chuanxiong and tangkuei. A stated maximum dose with a stated toxidrome and a stated antidote is rare anywhere in this chapter. The second is the closing clause: 凡痘瘡最怕麝香與酒氣, 然則只用紫草湯自好 — the pox fears musk and the smell of wine above all, so plain gromwell decoction is best. The leaf has just prescribed both musk and wine, and it ends by telling the reader to leave them out. What the drugs are. Calcined tooth is calcium phosphate and inert. 穿山甲, pangolin scale, is keratin — the same protein as fingernail — and has no demonstrated pharmacological activity; **it is listed on CITES Appendix I and the demand for it has made pangolins the most heavily trafficked wild mammals in the world.** 麝香, musk, is also CITES Appendix I and the demand this tradition created is why the musk deer are endangered. Notopterygium and mahuang are the only drugs here with real activity, and mahuang is an ephedrine-bearing stimulant. Nothing in the powder could have raised a haemorrhagic eruption or altered its outcome. **Contains human tooth, a human material; musk and pangolin scale, both CITES Appendix I and prohibited in trade; and weak wine as the vehicle, which is alcohol given to a child. This must not be prepared or given.** The leaf states a ceiling of 1 don of tooth but the patient is an infant and the ceiling is not scaled to age or weight. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.