Formulas · Purge Downward 瀉下 · Jeoneul (錢乙)

Drain the Fright Pill

Igyeong-hwan

한글 이경환  ·  Pinyin Li Jing Wan

利驚丸

頭末 is the first and finest powder off the sieve, the usual preparation of 黑丑 where the whole seed is too coarse; it is entered as a prep on the seed rather than as a separate drug. The section text above the leaf prescribes this formula by name twice, at 當下之宜利驚丸 and in the 虛則溫之, 實則利之, 熱則凉之 triad.

Composition 構成

Total 32 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

Indications 主治

Pattern-based

  • 急驚 — acute fright wind with the body hot and the face red
  • 口中氣熱, 大小便黃赤 — hot breath, dark yellow urine and stool: repletion heat to be drained

Biomedical correlates

  • Febrile convulsion in a child
  • Fever with constipation and concentrated urine

Source text 原文

Donguibogam 東醫寶鑑

治急驚, 身熱面赤, 口中氣熱, 大小便黃赤, 宜下, 用此. 黑丑(頭末) 五錢, 天竺黃ㆍ靑黛ㆍ輕粉 各一錢. 右爲末, 蜜丸豌豆大, 一歲兒用一丸, 薄荷湯化下. 《錢乙》

Translation

Treats acute fright with the body hot and the face red, the breath hot in the mouth, and the urine and stool dark yellow; it should be drained downward, and this is used for it. Black morning-glory seed, the first-sifted powder, 5 don; bamboo silica, indigo and calomel, 1 don each. Powder the above and make honey pills the size of a garden pea; a one-year-old takes one pill, dissolved in mint decoction. — Jeoneul 錢乙 (Donguibogam · Soa)

Clinical commentary 臨床

The 實 member of the triad the section names at 所謂溫驚丸利驚丸涼驚丸者 — depleted, warm it; replete, drain it; hot, cool it. This is the draining one, and it drains hard: five don of black morning-glory seed, which is the chapter's standard drastic purgative, with bamboo silica and indigo to cool and calomel to carry it down. **This should be said once for the whole section, and here is the place. Nothing in these formulas stops a seizure, and a simple febrile seizure does not need anything to — it stops by itself, usually within a couple of minutes, and the child is well afterwards.** Two to five children in a hundred have one. What the child needs is to be laid on their side, left alone, and then examined for the cause of the fever; what the child does not need is to be purged. **Contains calomel — 輕粉, mercurous chloride — a mercury salt, and black morning-glory seed, a violent purgative, in a pill written for a one-year-old. This must not be prepared.** This is the most dangerous single line in the batch, and not only because of the mercury. Calomel was given to children in exactly this way, as a purging and teething powder, well into the twentieth century, and it caused acrodynia — pink disease — with pain, peeling hands and feet, hypertension and deaths, until it was withdrawn from children's medicines in the 1950s. Purging a febrile, convulsing child also strips the fluid and electrolytes they are least able to spare. The mercury paragraph under Jinsa-go-soa applies to the calomel too. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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