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

Pig Stomach and Coptis Pill

Jeoduhwangnyeon-hwan

한글 저두황련환 · Pinyin Zhu Du Huang Lian Wan

猪肚黃連丸

The transcription writes 䧺猪肚, 疳䖝, and 潮𤍠 ㆍ 疳𤍠 ㆍ 遍身𤍠瘡; 䧺 is normalised to 雄, 䖝 to 蟲 and 𤍠 to 熱 by the project's variant-glyph table. The cooked rice pounded into the paste and the five seung of rice used to raise the steam are preparation and stay in the source text. This is the only leaf in the batch that gives an age range and the only one that scales the dose, by the single step 冠者倍之.

Composition 構成

Hwangnyeon Huang Lian
黃連 황련 · Coptis

280 g
Chief 君

7 nyang, cut up (剉) and sewn inside the stomach
Jeodu Zhu Du
猪肚 저두 · Pig's Stomach

—
Chief 君

雄猪肚一具(洗淨), one boar's stomach, washed clean — the vehicle, and the one piece of food in the formula

Total 280 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 疳瘡 with tidal fever and recurring sores, from infancy to the age of capping
Seven nyang of coptis is sewn inside a boar's stomach, steamed over five seung of rice until thoroughly tender, pounded together with a little cooked rice and rolled into pills by many hands
The dose is doubled for a patient old enough to be capped

Indications 主治

Pattern-based

疳瘡 with 潮熱, tidal fever, and sores that come and go without end
疳 Heat pouring through the whole body after the worms have eaten the flesh hollow

Biomedical correlates

Historically used for the recurrent skin sepsis and fever of chronic childhood malnutrition
Recorded for historical reference only

Source text 原文

Donguibogam 東醫寶鑑

治疳瘡. 自孩提至弱冠, 潮熱發瘡, 乃疳氣使然. 疳蟲食其肌膚, 肌膚空虛, 疳熱流注遍身, 熱瘡發歇無已. 雄猪肚一具(洗淨), 黃連七兩(剉). 右黃連入猪肚中, 線縫密, 頓在五升米上蒸十分爛, 取入臼中, 入些飯擣千杵, 衆手丸如菉豆大. 米飮下二三十丸, 冠者倍之. 《得效》

Translation

Treats 疳 sores. From the child in arms to the youth at his capping, tidal fever with the breaking out of sores is caused by 疳 Qi. The 疳 worms eat the child's flesh and skin, the flesh and skin are left hollow, 疳 Heat pours through and spreads over the whole body, and the hot sores break out and subside without end. One boar's stomach, washed clean; coptis 7 nyang, cut up. Put the coptis inside the pig's stomach, sew it tightly shut with thread, set it over five seung of rice and steam it until thoroughly tender, then put it in a mortar, add a little cooked rice and pound it a thousand strokes, and roll it into pills the size of mung beans with many hands at once. Take twenty or thirty pills down with thin rice gruel; for one old enough to be capped, double the dose. — Deukhyo 得效 (Donguibogam · Soa)

Clinical commentary 臨床

**The patient is a child and the text gives no dose by weight anywhere.** This leaf is the exception in the section and deserves to be named as one. The point made on 立效散 — that none of these 疳 formulas is food, and that a malnourished child needs calories and protein rather than bitters and minerals — holds for the other eleven leaves in this batch. It does not hold here. **猪肚 is food.** A boar's stomach is tripe: protein, zinc, iron, vitamin B12 and fat, steamed until tender, pounded with cooked rice and eaten twenty or thirty pills at a time. Whatever the coptis is doing, the child is being fed something with real nutritional value, and in the one disease in this chapter where food is the treatment that is not a small thing. 布袋丸, five leaves back in this same section, does the same with two nyang of lean pork, and the two of them are the only places in this batch where the prescription reaches in the right direction. The reaching is not conscious — the stomach is presented as a vessel for the coptis, not as nourishment — but the effect is real and the tradition kept the practice for a long time, which is the usual sign that something worked. Seven nyang of coptis is a great deal of berberine, and berberine does have antibacterial and antidiarrhoeal activity; bitter in that quantity will also make the pills unpleasant, which is the practical limit on how much a child will take. The clinical picture the leaf opens with is the most lucid in the section. Worms eat the flesh, the flesh is left hollow, Heat pours through the whole body, and sores break out and subside without end. Strip the aetiology and what remains is accurate observation: the chronically undernourished child with a heavy worm burden, recurrent skin sepsis and intermittent fever, a cycle that repeats because malnutrition suppresses immunity and infection worsens malnutrition. On the worm drugs, which this formula does not contain, see 布袋丸 in this same section. The thing that breaks the cycle is feeding, deworming and treating the infections — and this leaf, almost by accident, does the first of the three. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.