寶鑑Bogam

Formulas · Dispel Wind 祛風 · Uihak Jeongjeon (醫學正傳)

Change the Flesh Powder

Hwangi-san

한글 환기산  ·  Pinyin Huan Ji San

換肌散

紫參 has no entry in the herb list and is left out of the ingredients; the leaf itself says 其中紫參ㆍ不灰木雖無不妨, that it and the asbestos may be wanting without harm. 赤箭 is the gastrodia stalk and is recorded under cheonma on the corpus alias, so cheonma appears twice, once for 天麻 and once for 赤箭, as the leaf lists both. 灸 is printed as the transcription has it, the corpus not normalising 灸/炙. 荊芥穗, the schizonepeta spikes, is recorded under hyeonggae with the part kept in the prep.

Composition 構成

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 1 ingredient 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

  • 大風年深, 毛脫鼻塌 — great wind of years' standing, hair fallen, nose collapsed
  • 深重者 — the deep and grave case
  • 鼻崩者 — for the broken nose, with Bogisayeong-tang

Biomedical correlates

  • Advanced lepromatous Hansen's disease with saddle-nose deformity and madarosis — historical

Source text 原文

Donguibogam 東醫寶鑑

治大風年深, 毛脫鼻塌深重者, 取效如神. 烏蛇ㆍ白花蛇ㆍ地龍 各一兩, 當歸ㆍ細辛ㆍ白芷ㆍ天麻ㆍ蔓荊子ㆍ威靈仙ㆍ荊芥穗ㆍ甘菊ㆍ苦參ㆍ紫參ㆍ沙參ㆍ木賊ㆍ不灰木ㆍ甘草(灸)ㆍ白蒺藜ㆍ天門冬ㆍ赤芍藥ㆍ赤箭ㆍ何首烏ㆍ石菖蒲ㆍ胡麻子ㆍ草烏ㆍ蒼朮ㆍ木鼈子ㆍ川芎 各三錢半. 右爲末, 每五錢, 溫酒調下, 酒多爲妙. 其中紫參ㆍ不灰木雖無不妨. 《正傳》

Translation

Treats great wind of years' standing, with the hair fallen and the nose collapsed, the deep and grave case; it works like a god. Black-striped snake, pit viper and earthworm, 1 nyang each; Korean angelica, asarum, Dahurian angelica, gastrodia, vitex fruit, clematis, schizonepeta spikes, chrysanthemum, sophora root, 紫參, adenophora, horsetail, asbestos, roasted licorice, tribulus, asparagus root, red peony, gastrodia stalk, fleeceflower root, acorus, black sesame seed, wild aconite, atractylodes lancea, momordica seed and cnidium, 3 don 5 fun each. Powder the above; 5 don to a dose stirred into warm wine, and the more wine the better. Among them, 紫參 and asbestos may be wanting without harm. — Jeongjeon 正傳 (Donguibogam · Jechang)

Clinical commentary 臨床

The chapter's longest leprosy formula and the one it reserves for the case that has gone furthest: 年深, 毛脫鼻塌 — years in, the eyebrows and hair gone, the nose fallen in. That is lepromatous disease with madarosis and a saddle-nose deformity, and the 大風瘡 section sends two formulas to it, this one and Bogisayeong-tang. It is also the formula given 夫上下同得者甚重, for the grave case that has the disease both above and below, when Chwiseon-san and Tongcheonjaejo-san have both been used. Three snakes and the earthworm at a nyang each lead it, which is the chapter's signature for 大風 — 白花蛇 is still the drug most associated with leprosy in the East Asian materia medica. The remaining twenty-five drugs at three don five fun each are a wind-and-damp sweep with two mineral oddities, asbestos and the 紫參 the leaf is unbothered about losing. **Contains wild aconite, which is toxic, momordica seed, which is toxic, asbestos, which is carcinogenic by inhalation, asarum, which carries aristolochic acid, and pit viper, a CITES-listed material. This must not be prepared.** Grinding asbestos to a powder and dosing it is the single worst instruction in the chapter. The chapter's own verdict on its leprosy treatment stands: 嘗治四五百人, 終無一人免於死. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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