寶鑑Bogam

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

Immediate Response Powder

Ibeung-san

한글 입응산  ·  Pinyin Li Ying San

立應散

The transcription writes 䓗 for 葱, 晒 for 曬 and 觧 for 解 at both places; the corpus forms are printed. 土蜂房, the nest of a ground wasp as distinct from the hanging nest, has no entry of its own and is entered under 露蜂房 by way of the 蜂房 alias, following the abscesses chapter's Jeongjeo-ilbang; the leaf's own term and its distinction are kept in the preparation. 川烏尖, the tips of the aconite root, resolve to 川烏 with the part named, and are counted by the piece. The akebia, scallion-white and juncus draughts carry no weights, and 益元散 and 五苓散 are linked where this corpus has them.

Composition 構成

Total 164 g per packet (첩) · representative dosage — verify against source texts. Excludes 4 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

Indications 主治

Pattern-based

  • 瘰癧ㆍ馬刀瘡 — scrofula and clam-knife sore
  • 毒從小便出如粉片血塊 — the toxin coming out in the urine like flakes of powder and clots of blood
  • 尿澁 — scanty, difficult urine, for which Igwon-san or Oryeong-san is given in juncus decoction

Biomedical correlates

  • Tuberculous lymphadenitis — scrofula
  • Cantharidin haemorrhagic cystitis, which is what the flakes and clots in the urine are

Source text 原文

Donguibogam 東醫寶鑑

治瘰癧ㆍ馬刀瘡. 連翹ㆍ赤芍藥ㆍ川芎ㆍ當歸ㆍ滑石ㆍ甘草 各五錢, 黃芩ㆍ斑猫(去毒炒) 各三錢, 白丑(頭末)ㆍ生土蜂房(蜜水洗, 飯上蒸曬乾) 各二錢半, 川烏尖 七箇. 右爲末, 每一錢, 濃煎木通湯調下, 臨臥服. 毒從小便出, 如粉片血塊是也. 未效再服. 斑猫性毒, 濟以烏尖. 或衝上麻悶, 嚼葱白茶淸下以解之. 如尿澁, <a href='/formulas/igwon-san'>益元散</a>或<a href='/formulas/oryeong-san'>五苓散</a>, 燈心煎湯調下. 宣毒後, 繼服<a href='/formulas/bakha-dan'>薄荷丹</a>, 解其風熱. 《入門》

Translation

Treats scrofula and clam-knife sore. Forsythia, red peony, chuanxiong, Korean angelica, talc and licorice, 5 don each; scutellaria and blister beetle (the toxin removed and the beetles fried), 3 don each; white morning-glory seed (the first-grade powder) and a raw ground-wasp nest (washed in honey water, steamed over rice and dried in the sun), 2 don 5 fun each; seven aconite tips. Powder the above and take 1 don to a dose, stirred into a strongly decocted akebia draught, at bedtime. The toxin comes out in the urine, like flakes of powder and clots of blood. If it has not answered, take it again. The blister beetle is toxic by nature, and the aconite tips are there to temper it. If there is a rush of numbness and oppression upward, chew scallion white and swallow it with clear tea to resolve it. If the urine is scanty, give Igwon-san or Oryeong-san stirred into a juncus decoction. Once the toxin has been diffused, follow with Bakha-dan to resolve the wind-heat. — Immun 入門 (Donguibogam · Jechang)

Clinical commentary 臨床

The chapter's central and most dangerous formula, named in two places — 滲泄小便以瀉心火立應散是也, draining through the urine to drain Heart fire, and again under 瀉毒 — and the section immediately warns 然性甚峻, its nature is extremely drastic. Six Blood-and-heat drugs at five don each make up the bulk, with scutellaria behind them, but the formula turns on three don of trimmed and fried blister beetle, two and a half don of white morning-glory seed and a honey-washed, rice-steamed, sun-dried ground-wasp nest. Akebia carries it to the bladder; the seven aconite tips are put in, the leaf says outright, because 斑猫性毒, the blister beetle is toxic by nature, and need tempering — one poison set against another. Read the leaf as a clinical record and it is a description of acute poisoning with its antidotes written in. 毒從小便出如粉片血塊是也, the toxin comes out in the urine like flakes of powder and clots of blood: that is cantharidin haemorrhagic cystitis, with blood and sloughed bladder epithelium. 或衝上麻悶, a rush of numbness and oppression upward: that is aconitine, and chewing scallion white with tea will not touch it. 如尿澁, if the urine turns scanty: that is the beginning of acute kidney injury, and Igwon-san or Oryeong-san in juncus decoction is being given for renal failure. Every adverse effect the two drugs produce has been recorded here and reinterpreted as the disease leaving the body. 瘰癧 is tuberculous lymphadenitis, and none of this reaches it. **Contains blister beetle (cantharidin — a severe vesicant, acutely nephrotoxic and corrosive, with a narrow margin between medicinal and fatal doses), aconite tips (aconitine — cardiotoxic and neurotoxic, and lethal in small amounts), and white morning-glory seed, a drastic purgative. The combination is capable of killing, and the leaf's own instructions show that it did harm. This must not be prepared under any circumstances.** Scrofula is treated with multidrug antituberculous therapy. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

Related formulas 關聯

Look up another