Formulas · Clear Heat 淸熱 · Seui Deukhyobang (世醫得效方)

Twin Coptis Pill

Iryeon-hwan

한글 이련환 · Pinyin Er Lian Wan

二連丸

The transcription writes 乾蝦蟆 where 玉蟾散, five leaves on, writes 乾蟾 for what is the same material; the corpus has 乾蟾 in two places and 乾蝦蟆 in none, and the transcription's form is printed. The paste that binds the pills is written simply 糊, with no flour named, and is left in the source text rather than entered as an ingredient.

Composition 構成

Hwangnyeon Huang Lian
黃連 황련 · Coptis

20 g
Chief 君

5 don
Hohwangnyeon Hu Huang Lian
胡黃連 호황련 · Picrorhiza

20 g
Chief 君

胡黃連, 5 don
Mui Wu Yi
蕪荑 무이 · Elm Fruit Paste

20 g
Deputy 臣

蕪荑, elm seed, 5 don · anthelmintic
Cheongdae Qing Dai
靑黛 청대 · Natural Indigo

20 g
Assistant 佐

5 don
Hama Ha Ma
蝦蟆 하마 · Toad (toxic)

—
Envoy 使

乾蝦蟆一箇, one dried toad, wine-steeped, boned and roasted · see 月蟾丸

Total 80 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

Given for 無辜疳, three times a day
Pairs the two coptises with elm seed and indigo and carries them on a dried toad, wine-steeped, boned and roasted

Indications 主治

Pattern-based

無辜疳 — wasting with glandular swelling and 疳 Heat in a young child
Heat in the Stomach and Intestines in the course of 疳, with worms

Biomedical correlates

Historically used for the wasting and glandular disease read today as tuberculous cervical adenitis in a malnourished child
Recorded for historical reference only

Source text 原文

Donguibogam 東醫寶鑑

治無辜疳. 黃連ㆍ胡黃連ㆍ蕪荑ㆍ靑黛各五錢, 乾蝦蟆一箇(酒浸, 去骨, 焙). 右爲末, 糊丸粟米大. 米飮下二三十丸, 日三次服之. 《得效》

Translation

Treats the blameless wasting disease. Coptis, Indian coptis, elm seed and indigo, 5 don each; one dried toad, steeped in wine, boned and roasted. Powder them and make pills with flour paste the size of millet grains. Take twenty or thirty pills down with thin rice gruel, three times a day. — Deukhyo 得效 (Donguibogam · Soa)

Clinical commentary 臨床

**Contains dried toad, which carries bufadienolides, cardiac glycosides.** The full statement is on 月蟾丸 in this same section, and it applies with more force here because this toad is only wine-steeped and roasted, not burnt to ash — the glycosides survive that. The patient is a child, the text gives no dose by weight anywhere, and this must not be prepared. **蕪荑 is a genuine anthelmintic** — see 布袋丸 in this section, where the point is made. The two coptises are the body of the formula. 黃連 and 胡黃連 are both intensely bitter berberine-bearing roots, and berberine does have real antibacterial and antidiarrhoeal activity, demonstrated in controlled trials against the secretory diarrhoeas. That is the honest best case for this pill: a bitter antidiarrhoeal with a worm drug attached, given to a child with chronic diarrhoea and worms. The dishonest part is what it is named for. 無辜疳 reads as tuberculous cervical adenitis — see 月蟾丸 — and berberine has no action on tuberculosis. On the point that none of these formulas is food, see 立效散 in this same section. A child with the matted neck glands, fever and wasting of this diagnosis needs six months of anti-tuberculous chemotherapy and enough to eat; three doses a day of a bitter pill for as long as it takes is simply time the child does not have. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.