Formulas · Clear Heat 淸熱 · Gangmok (綱目)

Ginseng Clear the Diaphragm Powder

Insamcheonggyeok-san

한글 인삼청격산  ·  Pinyin Ren Shen Qing Ge San

人參淸膈散

The leaf carries no 治 clause; the indication is in the section prose, which pairs it with 前胡枳殼湯 for abundant phlegm and hurried breathing after the pox has come out. 膈 is printed as the transcription writes it, following the corpus's practice of not normalizing 膈/隔.

Composition 構成

Total 11.6 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

  • Heat and phlegm congesting the chest after the pox has erupted
  • Lung heat with panting

Biomedical correlates

  • Pneumonia in a child with smallpox
  • Respiratory distress with tachypnoea

Source text 原文

Donguibogam 東醫寶鑑

白朮ㆍ黃芪ㆍ紫菀ㆍ地骨皮ㆍ滑石 各三分, 石膏ㆍ桔梗ㆍ甘草 各二分, 人參ㆍ黃芩ㆍ桑白皮ㆍ前胡ㆍ當歸ㆍ白芍藥ㆍ知母ㆍ赤茯苓 各一分. 右剉, 作一貼, 水煎服. 《綱目》

Translation

White atractylodes, astragalus, aster, lycium root bark and talc, 3 fun each; gypsum, platycodon and licorice, 2 fun each; ginseng, scutellaria, mulberry root bark, peucedanum, tangkuei, white peony, anemarrhena and red poria, 1 fun each. Cut them up, make one packet, decoct in water and take it. — Gangmok 綱目 (Donguibogam · Soa)

Clinical commentary 臨床

Sixteen drugs in three dose tiers, about 11 g in one packet. The upper tier is white atractylodes, astragalus, aster, lycium root bark and talc; gypsum, platycodon and licorice sit below them; and eight more drugs, ginseng among them, take 1 fun each. The formula is named for ginseng and gives ginseng the smallest share in it — the heading drug here is not the main drug. 痰喘 is breathlessness, and in a child with smallpox it was pneumonia: variola pneumonitis in the second week of the illness, or a secondary bacterial pneumonia settling on top of it. Either killed, and together they were among the commonest proximate causes of death. The section's own prognostic signs are the right ones — a raised chest and a lost voice, and panting without phlegm in a child who cannot lie flat. Those are severe respiratory distress and orthopnoea, read straight off the patient. The sign a clinician watches for in a child today is the breathing itself: the rate, the chest wall drawing in below the ribs and between them, the grunt at the end of each breath, the head nodding with effort. And the chapter's reading of the complication as 毒攻肺, the toxin striking the lung, is descriptively where the disease actually went. As treatment this is a cooling lung formula and cannot touch a pneumonia. What treats a bacterial pneumonia in a child is an antibiotic and oxygen, and what treats the viral pneumonitis is supportive care and respiratory support. **Contains talc and gypsum, mineral powders decocted and given by mouth to an infant, and the leaf gives no dose scaled to age or weight.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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