寶鑑Bogam

Formulas · Release the Exterior 解表 · Gogeum Uigam (古今醫鑑)

Arnebia Salve for the Pox That Will Not Rise

Jacho-go

한글 자초고  ·  Pinyin Zi Cao Gao

紫草膏

蚕 is printed as the transcription gives it; the corpus writes both 蚕 and 殭蠶 and 蚕 is the slight majority. 䧟 is printed 陷, following the corpus, which gives 陷 nineteen times against one. 紫草茸 is entered under 紫草 with the downy young shoot named in the preparation, as the corpus does elsewhere, and the further 1 nyang of plain 紫草 boiled down for the binder is entered as a second row of the same drug. 紫草湯, the vehicle, is not a formula registered in this corpus. The 癰疽 chapter has a different formula of this name, registered jacho-go.

Composition 構成

Total 204 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

  • 痘疹不起脹 — the pox that will not rise and swell
  • 紅紫黑陷 — a red, purple or blackened eruption that sinks instead of rising
  • 淡白灰陷 — a pale, white or ashy eruption that sinks

Biomedical correlates

  • Smallpox at the vesicular stage with lesions failing to become raised and tense — historical
  • Flat, dusky, non-raising lesions, that is the malignant and haemorrhagic forms — historical

Source text 原文

Donguibogam 東醫寶鑑

治痘疹不起脹. 白附子ㆍ麻黃ㆍ紫草茸ㆍ甘草 各五錢, 蟾酥 一錢, 全蝎 二十箇, 白殭蚕(炒) 八箇. 右細末, 另將紫草一兩剉, 熬成膏. 又用蜜二兩, 入酒半盞煉過, 同紫草膏攪勻, 調藥末丸如皂角子大. 一歲兒半丸, 三歲兒一丸用之. 紅紫黑陷者, 紫草湯化下. 淡白灰陷者, 好酒化熱服. 《醫鑑》

Translation

Treats the pox and rash that will not rise and swell. White typhonium root, ephedra, the downy shoot of arnebia and liquorice, 5 don of each; toad venom, 1 don; whole scorpion, twenty; white stiff silkworm, parched, eight. Make the above into a fine powder. Separately take 1 nyang of arnebia, cut it, and boil it down to a paste. Then take 2 nyang of honey, add half a jan of wine and refine it, stir it together evenly with the arnebia paste, work the drug powder into it and roll pills the size of a soap-bean seed. For a child of one year, half a pill; for a child of three years, one pill. Where the eruption is red, purple or blackened and sinking, wash it down dissolved in arnebia decoction; where it is pale, white or ashy and sinking, dissolve it in good wine and take it hot. — Uigam 醫鑑 (Donguibogam · Soa)

Clinical commentary 臨床

Nine drugs and a binder, aimed at one sign: an eruption that will not rise. White typhonium root and ephedra to push outward, arnebia shoot and liquorice against the toxin, and then the three animal drugs the formula really turns on — toad venom, twenty whole scorpions and eight parched silkworms. The powder is bound with a paste boiled down from a further nyang of arnebia and two nyang of honey refined with wine, rolled into pills the size of a soap-bean seed, and dosed by age; the vehicle is chosen by what the eruption looks like, arnebia decoction for the dark sinking kind and wine for the pale one. Smallpox had no treatment. What moved outcomes was nursing — fluid, warmth, a mouth and eyes kept clean, and keeping secondary bacterial infection off skin the child had broken. Nothing given by mouth changed whether the lesions rose, filled with pus, crusted and separated, or whether the child lived; that was settled by the virus and by the child's own immune response. And this formula is prescribed for exactly the sign that could not be reversed. An eruption that stays flat and dusky and never becomes raised and tense is the mark of the malignant and haemorrhagic forms, which killed very nearly everyone who had them, usually before the pustular stage. The chapter is right that this is the gravest thing it can see at this point in the course, and right that it is the thing to watch for; it is wrong that anything in a pill could answer it. **Toad venom is the dried parotid-gland secretion of the toad and contains bufadienolides, which act on the heart in the manner of digitalis and cause arrhythmia and cardiac arrest; fatal poisonings are on record at doses of this order. Scorpion is a neurotoxic venom, and twenty whole scorpions go into one batch of pills. White typhonium root is toxic unless properly processed, and ephedra contains ephedrine, which raises heart rate and blood pressure. The patient is a child. This leaf does scale by age — half a pill at one year, a whole pill at three — but not by weight, and the amount of toad venom in any single pill of a hand-rolled batch cannot be known. This must not be prepared.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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