Formulas · Dispel Wind 祛風 · Uihak Immun (醫學入門)

Change the Bone Pill

Hwangol-hwan

한글 환골환 · Pinyin Huan Gu Wan

換骨丸

The transcription writes 沉香 for 沈香; the corpus form is printed. The five geun of ephedra is the binding extract rather than a drug taken at that weight, and the gram figure is given for the quantity named with the instruction kept in the prep.

Composition 構成

Gosam Ku Shen
苦參 고삼 · Sophora Root

60 g
Chief 君

苦參一兩半
Bupyeong Fu Ping
浮萍 부평 · Duckweed

60 g
Chief 君

浮萍一兩半
Mahwang Ma Huang
麻黃 마황 · Ephedra

3200 g
Deputy 臣

麻黃五斤煎膏 — five geun of ephedra boiled to an extract to bind the pills
Daehwang Da Huang
大黃 대황 · Rhubarb

50 g
Deputy 臣

大黃一兩二錢半
Goehwa Huai Hua
槐花 괴화 · Pagoda Tree Flower

50 g
Deputy 臣

槐花一兩二錢半
Baekji Bai Zhi
白芷 백지 · Dahurian Angelica

50 g
Deputy 臣

白芷一兩二錢半
Cheongung Chuan Xiong
川芎 천궁 · Cnidium

50 g
Deputy 臣

川芎一兩二錢半
Changchul Cang Zhu
蒼朮 창출 · Atractylodes Lancea

40 g
Deputy 臣

蒼朮一兩
Yuhyang Ru Xiang
乳香 유향 · Frankincense

12 g
Assistant 佐

乳香三錢
Moryak Mo Yao
沒藥 몰약 · Myrrh

12 g
Assistant 佐

沒藥三錢
Chimhyang Chen Xiang
沈香 침향 · Agarwood

12 g
Assistant 佐

沈香三錢
Mokhyang Mu Xiang
木香 목향 · Costus Root

12 g
Assistant 佐

木香三錢
Sahyang She Xiang
麝香 사향 · Musk (prohibited)

2 g
Envoy 使

麝香五分 — musk, a CITES-protected material
Ju Jiu
酒 주 · Wine

—
Envoy 使

溫酒 — warm wine, one pill melted down in it

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

Treats leprous wind
Sophora root and duckweed leading, with the four aromatics and musk
Bound with five geun of ephedra boiled to an extract into bullet-sized pills
One pill melted down in warm wine, with wind avoided for two or three days

Indications 主治

Pattern-based

癩風 — leprous wind
Among the 通用 formulas of the 大風瘡 section

Biomedical correlates

Hansen's disease (leprosy) — historical

Source text 原文

Donguibogam 東醫寶鑑

治癩風. 苦參ㆍ浮萍各一兩半, 大黃ㆍ槐花ㆍ白芷ㆍ川芎各一兩二錢半, 蒼朮一兩, 乳香ㆍ沒藥ㆍ沈香ㆍ木香各三錢, 麝香五分. 右爲末, 以麻黃五斤煎膏和丸彈子大, 每一丸, 溫酒化下, 忌風二三日. 《入門》

Translation

Treats leprous wind. Sophora root and duckweed 1 nyang 5 don each; rhubarb, pagoda tree flower, Dahurian angelica and cnidium 1 nyang 2 don 5 fun each; atractylodes lancea 1 nyang; frankincense, myrrh, agarwood and costus root 3 don each; musk 5 fun. Powder the above, boil five geun of ephedra to an extract and make pills with it the size of a bullet, and melt one down in warm wine for each dose, avoiding wind for two or three days. — Immun 入門 (Donguibogam · Jechang)

Clinical commentary 臨床

換骨, to change the bone, is the chapter's most confident name and the formula behind it is a wind-and-blood pill rather than anything skeletal. Sophora root and duckweed lead — duckweed is the chapter's lightest surface-opening drug — with rhubarb and pagoda tree flower to take heat down, and then four aromatic resins and woods with musk, which is an unusual group for a skin disease and reads as a push to carry the formula through to the deep tissue. Five geun of ephedra boiled down to an extract makes the binder, so every pill carries ephedra whether or not it is counted as an ingredient, and the instruction to avoid wind for two or three days after a dose fits a drug expected to open the pores hard. **Contains musk, a CITES-protected material, rhubarb as a purgative, and an ephedra extract as the pill binder. This must not be prepared.** Ephedrine is a sympathomimetic and the quantity here is not controllable dose by dose. Leprosy is treated with rifampicin, dapsone and clofazimine. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.