寶鑑Bogam

Formulas · Clear Heat 淸熱 · Uihak Immun (醫學入門)

Coptis Disperse Toxin Powder

Hwangnyeonsodok-san

한글 황련소독산  ·  Pinyin Huang Lian Xiao Du San

黃連消毒散

癕, 𤍠 and 蘓 are given above as 癰, 熱 and 蘇. 黃栢 is printed as the transcription has it. 元好問 is given in the project romanisation as Won Hogan. 灸 for the moxa is the form this corpus prints throughout. 當歸尾 is registered under 當歸, with the part named in the prep.

Composition 構成

Total 48.4 g per packet (첩) · representative dosage — verify against source texts.

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

  • 癰疽 with 發腦 and 發背, effusion on the head and on the back
  • Toxic swelling flaring and effusing (腫毒焮發)
  • Numb and without pain (麻木不痛)
  • An outward pattern, to be dispersed through the surface (外證宜表散)

Biomedical correlates

  • Carbuncle of the nape and back — historical
  • Deep pyogenic infection presenting with numbness rather than pain — historical
  • Diabetic or other anaesthetic soft-tissue infection — a cautious modern reading

Source text 原文

Donguibogam 東醫寶鑑

治癰疽發腦ㆍ發背, 腫毒焮發, 麻木不痛, 宜先灸之, 服此藥. 黃連ㆍ羌活 各一錢二分, 黃芩ㆍ黃栢ㆍ藁本ㆍ防己ㆍ桔梗 各七分, 生地黃ㆍ知母ㆍ獨活ㆍ防風ㆍ連翹ㆍ當歸尾 各六分, 人參ㆍ甘草 各五分, 蘇木ㆍ陳皮ㆍ澤瀉ㆍ黃芪 各四分. 右剉, 作一貼, 水煎服. 《入門》 ○元好問嗜酒, 腦下項上出小瘡, 不痛痒, 四日後腦項麻木, 腫勢外散, 熱毒焮發, 夜不得寐, 邀東垣治之. 先灸艾百壯, 始覺痛, 次製此藥服之而愈. 一名黃連消毒飮. 《東垣》

Translation

Treats abscess and deep-rooted sore with effusion on the head and effusion on the back, where the toxic swelling flares and effuses and the place is numb and does not hurt; moxa should be applied to it first, and then this drug taken. Coptis and notopterygium, 1 don 2 fun each; scutellaria, phellodendron, ligusticum, cocculus root and platycodon, 7 fun each; raw rehmannia, anemarrhena, pubescent angelica, saposhnikovia, forsythia and the tails of Korean angelica, 6 fun each; ginseng and licorice, 5 fun each; sappanwood, aged tangerine peel, alisma and astragalus, 4 fun each. Cut the above, make one packet, decoct in water and take. — Immun 入門. Won Hogan was fond of wine. Below the back of his head and above the nape a small sore came out which neither hurt nor itched; after four days the back of his head and his nape went numb, the swelling spread outward, heat toxin flared and effused, and he could not sleep at night. He invited Dongwon to treat him. First a hundred cones of moxa were burnt, and he began to feel pain; next this drug was compounded and taken, and he recovered. Also called Hwangryeonsodok-eum. — Dongwon 東垣 (Donguibogam · Ongjeo)

Clinical commentary 臨床

The leaf is paired in the method passage with Naetakganghwal-tang as the answer to an outward pattern — 外證宜表散, disperse through the surface — against Naesohwangryeon-tang and Seonbanghwalmyeong-eum for an inward one, which are to be dredged and conducted. So this sits at the hinge of the chapter's larger pair: it carries the three yellows and raw rehmannia from the draining side and notopterygium, pubescent angelica, ligusticum and saposhnikovia from the surface-opening side, with ginseng, astragalus and Korean angelica tails in small amounts for the expressing side. Nineteen drugs on five descending weights, which is Dongwon's way of building a prescription. The case at the end is the reason the leaf is remembered. Won Hogan, the Jin poet, drank; a small sore came out on his nape that neither hurt nor itched; four days later the nape went numb, the swelling spread, and he could not sleep. Dongwon burnt a hundred cones of moxa before giving any drug, and the recorded sign of improvement is that the man began to feel pain. That is a shrewd observation. A spreading soft-tissue infection that has gone numb and painless is worse than one that hurts, and the return of sensation reads as the lesion coming back under control. A painless, spreading infection in a heavy drinker also raises necrotising infection and impaired sensation, which is an emergency; the chapter's instinct to treat it as the graver case is sound even though the treatment is not. Dongwon also notes that Seungyangigwi-san is nearly the same prescription as this one. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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