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

Toxin-Transforming Pill

Hwadok-hwan

한글 화독환 · Pinyin Hua Du Wan

化毒丸

䃃砂 is the form both the transcription and the corpus print for sal ammoniac, registered under 硇砂, and 蟬蛻 is registered under 蟬退. 菉豆 is the corpus form and names only the size of the pill. The twenty cicada sloughs are a count item, and the toad venom that binds the pills is given no weight. 治同上 carries over the indication of 飛龍奪命丹 two leaves above — 疔瘡 and 惡瘡.

Composition 構成

Jusa Zhu Sha
朱砂 주사 · Cinnabar (toxic)

4 g
Chief 君

朱砂一錢 — cinnabar, mercuric sulfide
Unghwang Xiong Huang
雄黃 웅황 · Realgar

4 g
Chief 君

雄黃一錢 — realgar, an arsenic sulfide
Seomsu Chan Su
蟾酥 섬수 · Toad Venom

—
Chief 君

蟾酥 — toad venom, used to bind the pills; cardiotoxic
Nosa Nao Sha
硇砂 노사 · Sal Ammoniac (toxic)

4 g
Deputy 臣

䃃砂一錢 — sal ammoniac
Gyeongbun Qing Fen
輕粉 경분 · Calomel (toxic)

1 g
Deputy 臣

輕粉一字, a quarter of a don — calomel, a mercury salt
Yongnoe Long Nao
龍腦 용뇌 · Borneol

2 g
Assistant 佐

龍腦五分 — borneol
Sahyang She Xiang
麝香 사향 · Musk (prohibited)

2 g
Assistant 佐

麝香五分 — musk, a CITES-protected material
Seontoe Chan Tui
蟬退 선퇴 · Cicada Moulting

—
Assistant 佐

蟬蛻二十枚 — twenty cicada sloughs, a count item

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

Treats the same as the formulas above — the nail-sore and the malign sore
One pill laid on the tongue and left there, not swallowed
Works by drawing saliva — 取涎而愈, the cure is in the drool

Indications 主治

Pattern-based

疔瘡 and 惡瘡 — the nail-sore and the malign sore
Taken after the purging step, in the 疔疽治法 sequence

Biomedical correlates

Furuncle and carbuncle — historical
Deep pyogenic skin infection — historical

Source text 原文

Donguibogam 東醫寶鑑

治同上. 朱砂ㆍ䃃砂ㆍ雄黃各一錢, 龍腦ㆍ麝香各五分, 輕粉一字, 蟬蛻二十枚. 右爲末, 蟾酥和丸菉豆大. 每用一丸, 放於舌上, 取涎而愈. 《正傳》

Translation

Treats the same as above. Cinnabar, sal ammoniac and realgar, 1 don each; borneol and musk, 5 fun each; calomel, one ja, a quarter of a don; cicada slough, twenty pieces. Powder the above and bind with toad venom into pills the size of a mung bean. One pill each time, laid on the tongue; the saliva is drawn and the cure follows. — Jeongjeon 正傳 (Donguibogam · Ongjeo)

Clinical commentary 臨床

A pill that is not swallowed. It is laid on the tongue and left, and the whole claim is 取涎而愈 — draw the saliva and the cure follows. That is the 涌涎 method, and it is why this leaf sits where it does: the 疔疽治法 passage puts it after the purge, 次服化毒丸及二活散, as the step that is meant to carry the remaining toxin out by a different road. The route is oral-mucosal, which is to say direct and fast. Seven drugs, six of them mineral or animal: cinnabar, sal ammoniac and realgar at a don each, borneol and musk at five fun, a quarter-don of calomel, and twenty cicada sloughs, the only drug in the formula that is not a poison. Toad venom binds them. It is the same materia medica as 飛龍奪命丹 and 獨蟾丸 either side of it, reorganised for a different route of administration. **Contains cinnabar and calomel, which are mercury compounds; realgar, which is an arsenic sulfide; and toad venom, which contains cardiac-glycoside bufadienolides and has killed at ordinary doses. Musk is a CITES-protected material. This must not be prepared.** Holding this on the tongue is the worst available route for it: the oral mucosa absorbs well and the saliva the method is designed to produce is swallowed. Mercury and arsenic both accumulate, and bufadienolide poisoning presents as the arrhythmias of digoxin toxicity without a reliable antidote. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.