寶鑑Bogam

Formulas · External Application 外用 · Dansim (丹心)

One Application Powder

Ilsang-san

한글 일상산  ·  Pinyin Yi Shang San

一上散

黑狗脊(卽貫衆) is a substance gloss and takes parentheses rather than a 細註 span, following the corpus's 椒粉散, which prints 黑狗脊(卽貫衆也) and enters the drug under 貫衆; 黑狗脊 is not 狗脊. The 蒼耳 decoction is a preliminary wash used before the powder and not part of the powder, so it is kept in the source text only, as are the lard and sesame oil it is worked up with. The blister beetles are given by count, so no weight is recorded.

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

  • 疥癬痛痒 — the pain and itch of scabies and ringworm
  • 濕疥 — wet scabies, 焮腫作痛, 流汁淋漓, red and swollen and running
  • 通治疥癬 — the general treatment of both

Biomedical correlates

  • Scabies, including the exudative excoriated presentation
  • Tinea corporis and other dermatophyte infections
  • Infected eczematous dermatitis with crusting

Source text 原文

Donguibogam 東醫寶鑑

治疥癬痛痒. 蛇床子(炒)ㆍ黑狗脊(卽貫衆)ㆍ白膠香ㆍ寒水石 各一兩, 枯白礬ㆍ黃連 各五錢, 雄黃 三錢半, 硫黃ㆍ吳茱萸 各三錢, 斑猫 十四箇(去翅足). 右爲末, 臘猪脂或香油調. 先以蒼耳煎湯洗去痂後, 掌中擦藥令熱, 鼻中嗅二三次, 却擦瘡上, 一擦卽愈. 《丹心》

Translation

Treats the pain and itch of scabies and ringworm. Dry-roasted cnidium fruit, black dog-spine — which is dryopteris root — sweetgum resin and glauberite, 1 nyang each; alum calcined to dryness and coptis, 5 don each; realgar 3 don 5 fun; sulphur and evodia, 3 don each; fourteen blister beetles with the wings and feet taken off. Powder the above and work it up with twelfth-month lard or with sesame oil. First wash off the crusts with a decoction of cocklebur; then rub the medicine between the palms until it is warm, sniff it up the nose two or three times, and rub it on the sore. One application and it is cured. — Dansim 丹心 (Donguibogam · Jechang)

Clinical commentary 臨床

Named for its claim — 一擦卽愈, one rub and it is cured — and the section cites it twice, for 濕疥, the weeping kind, and again among the 通治 formulas for scabies and ringworm together. Ten drugs, four of them at a full nyang, with the crusts washed off first with a cocklebur decoction so that the powder reaches skin. The odd step is the sniffing: rubbed warm between the palms and inhaled two or three times before it is applied. **Sulphur is the drug here that genuinely works. It is a true scabicide, and precipitated sulphur ointment is still in use — the first-line treatment in infants and in pregnancy.** Washing the crusts off before treating is also correct practice: scabietic crusts and the hyperkeratosis of long infestation harbour mites and keep topical treatment from reaching them. **Contains realgar, which is arsenic sulphide, and cantharides — blister beetles, whose cantharidin is a potent vesicant and nephrotoxin absorbed through broken skin, and which has caused fatal poisoning. Both are being rubbed into excoriated skin in rendered pig fat. This must not be prepared.** Scabies responds to topical permethrin or oral ivermectin, with every household contact treated simultaneously; left untreated, the scratched excoriations become impetiginized, and in some populations post-streptococcal glomerulonephritis and rheumatic fever follow scabies outbreaks. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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