Formulas · Release the Exterior 解表 · Boncho 本草 · Byeonui 辨疑

Arnebia Beverage

Jacho-eum

한글 자초음 · Pinyin Zi Cao Yin

紫草飮

The transcription writes 隠隠; 隱隱 is printed above, the form the corpus uses. 盖 is left as the transcription prints it, following the corpus majority. The bowl of water and the half hop or hop of the draught are volumes and carry no weight. The 辨疑 clause distinguishes 茸 from 根 within the one drug, both of which are entered under 紫草 in this corpus.

Composition 構成

Jacho Zi Cao
紫草 자초 · Purple Gromwell Root

80 g
Chief 君

2 nyang, finely cut, steeped in a large bowl of furiously boiling water · Boraginaceae, pyrrolizidine-alkaloid bearing

Total 80 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

Treats pox sores that will not come out freely, faint on the third or fourth day and neither out nor not out
Steeped, not boiled — a bowl of furiously boiling water poured over the drug and covered so the steam cannot escape
Taken warm, half a hop or a hop at a time

Indications 主治

Pattern-based

痘瘡出不快 — the pox sores slow or incomplete
三四日隱隱將出未出 — day three or four, faintly showing, about to come out and not out

Biomedical correlates

Smallpox at the macular stage, the rash just appearing

Source text 原文

Donguibogam 東醫寶鑑

治痘瘡出不快, 三四日隱隱將出未出. 紫草二兩, 細剉, 以百沸湯一大椀沃之, 以物盖定, 勿令氣出, 候溫服半合或一合, 痘卽出. 《本草》 ○治痘紫草皆當用茸, 有發出之功. 今人用根反利大便, 大便泄者勿用. 《辨疑》

Translation

Treats pox sores that will not come out freely, faint on the third or fourth day, about to come out and not yet out. Arnebia, 2 nyang, finely cut; pour over it a large bowl of furiously boiling water, cover it with something so that it is sealed and do not let the steam escape; when it has cooled to warm, take half a hop or a hop, and the pox come out at once. ○ For treating the pox one should always use the downy shoot of arnebia, which has the power to bring the eruption out. People nowadays use the root, and it loosens the stool instead; do not use it in a child whose stool is already running. — Boncho 本草 · Byeonui 辨疑 (Donguibogam · Soa)

Clinical commentary 臨床

One drug and a method. Two nyang of arnebia, finely cut, scalded with a bowl of furiously boiling water and sealed under a lid so that nothing escapes, then given warm half a hop at a time. It is an infusion rather than a decoction, and the instruction 勿令氣出 — do not let the steam out — is there because the aromatic fraction is thought to be the part that moves the eruption outward. Eighty grams in a single bowl is the largest dose in this section by a wide margin. **The timing in the indication is accurate.** 三四日隱隱將出未出 — day three or four, faintly showing, about to come out and not out. In smallpox the prodromal fever ran two to four days and the rash then appeared as macules, flat dull-red spots that an observer would describe exactly as 隱隱, faintly there, before they became papules over the next day or two. The chapter has the right interval and the right appearance, and it has them because somebody watched a series of children and counted days. **The 辨疑 clause is the best piece of pharmacology in the section.** It observes that the root, as distinct from the shoot, loosens the stool instead of raising the eruption, and it draws the correct conclusion — do not give it to a child who is already purging. That is an adverse effect correctly attributed to a specific part of a specific plant, and a correct contraindication derived from it, with no theory in the way. In a disease where fluid loss was itself a cause of death, withholding a laxative from a child with diarrhoea was a genuinely protective decision. **Arnebia is in the Boraginaceae, and the Boraginaceae are the principal plant source of pyrrolizidine alkaloids, which are hepatotoxic and genotoxic. They cause hepatic sinusoidal obstruction syndrome, and infants and small children are the group in whom that has most often been fatal — the recorded outbreaks have been in children. This leaf gives 80 g of the drug to a child in a single sitting, and the leaf gives no dose scaled to the child's age or weight.** The red pigment shikonin has some antibacterial and anti-inflammatory activity in a dish, which is the whole of what can be said for it; nothing in the plant has been shown to act on an orthopoxvirus in a patient. On smallpox having no treatment at all, see sodok-eum-soa. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.