Formulas · Purge Downward 瀉下 · Gogeum Uigam (古今醫鑑)

Upside-Down Powder

Jeondo-san

한글 전도산 · Pinyin Dian Dao San

顚倒散

Composition 構成

Daehwang Da Huang
大黃 대황 · Rhubarb

12 g
Chief 君

12 g as the base; a further 12 g added where the stool will not pass
Hwalseok Hua Shi
滑石 활석 · Talc

12 g
Chief 君

12 g as the base; a further 12 g added where the urine will not pass
Jogak Zao Jiao
皂角 조각 · Gleditsia Pod

12 g
Deputy 臣

Total 36 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 both passages not passing
or the urine alone not passing
or the stool alone
treating all of them

Indications 主治

Pattern-based

Obstruction of one or both passages

Biomedical correlates

Faecal impaction
Urinary retention

Source text 原文

Donguibogam 東醫寶鑑

治大小便不通, 或小便不通, 或大便不通, 皆治之. 大黃ㆍ滑石ㆍ皂角各三錢. 如小便不通, 滑石加三錢; 如大便不通, 大黃加三錢; 如大小便俱不通, 大黃ㆍ滑石各加三錢. 右爲末, 每取三錢, 空心, 溫酒調下. 《醫鑑》

Translation

Treats both passages not passing, or the urine alone not passing, or the stool alone — it treats all of them. Rhubarb, talc and soap-pod, 3 don each. If the urine will not pass, add 3 don of talc; if the stool will not pass, add 3 don of rhubarb; if both will not pass, add 3 don each of rhubarb and talc. Powder, and take 3 don each time on an empty stomach stirred into warm wine. — Gogeum Uigam 醫鑑 (Donguibogam · Daebyeon)

Clinical commentary 臨床

One base and three dosings: raise the rhubarb for the stool, the talc for the urine, both for both. The name — upside-down — refers to the reversal of the two components according to which passage is blocked, and it is the cleanest example in the chapter of a formula designed as an adjustable pair rather than a fixed prescription. The next entry does the same thing with two drugs instead of three. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.