Formulas · Stabilize & Astringe 固澀 · Manbyeong Hoechun (萬病回春)

Settle the Centre Decoction

Jeongjung-tang

한글 정중탕 · Pinyin Ding Zhong Tang

定中湯

The 黃色土 — plain yellow earth, explicitly not from a stove or a wall — has no entry of its own in the herb dictionary and is left out of the ingredient list; it is named in the translation. 伏龍肝 is stove earth and 壁土 wall earth, and neither is substituted here. The two wine-cups measure the water the earth has stood in, not any drug. A collation note at the foot of the page records that the First Edition reads 塊 where this transcription reads 碗 — 置碗內, placed in a bowl, against 置塊內. The transcription's reading is printed, as this project's rule requires; the First Edition's makes no sense of the sentence, which has already called the earth 一塊, one lump. The note sits six lines further on, inside 1.85.6 泄瀉, and the character it annotates is in this leaf, which is the nearest preceding occurrence of 碗 anywhere in the section. The transcription writes 真, 碗 and 䧺; the corpus prints 眞, 椀 and 雄, and those forms are given above. 盖 is kept, the corpus printing it four times for every 蓋.

Composition 構成

Unghwang Xiong Huang
雄黃 웅황 · Realgar

4 g
Chief 君

水飛雄黃末, water-levigated realgar powder, 1 don · realgar, arsenic sulfide, toxic
Jusa Zhu Sha
朱砂 주사 · Cinnabar (toxic)

2 g
Chief 君

水飛朱砂末, water-levigated cinnabar powder, 5 pun · cinnabar, mercuric sulfide, toxic
Sadang Sha Tang
砂糖 사당 · Granulated Sugar

—
Envoy 使

砂糖, a little added, no weight given

Total 6 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

Gathers in and holds the Stomach Qi, and stops vomiting and diarrhoea
Given where vomiting and diarrhoea come on together in the pox
A lump of yellow earth scalded with boiling water, covered and cooled, and the water used to take down levigated cinnabar and realgar with a little sugar

Indications 主治

Pattern-based

吐瀉並作 — vomiting and diarrhoea coming on together
胃氣不收斂 — the Stomach Qi not gathered in

Biomedical correlates

Smallpox with vomiting and diarrhoea, and the fluid loss that follows

Source text 原文

Donguibogam 東醫寶鑑

收斂胃氣, 止吐瀉神妙. 取眞正黃色土不雜沙石者一塊, 置椀內, 以百沸湯泡之, 以盖合定, 候溫. 右用兩酒盞, 和水飛朱砂末五分, 水飛雄黃末一錢, 少加砂糖, 溫服. 二服立止. 《回春》

Translation

It gathers in the Stomach Qi and stops vomiting and diarrhoea, wonderfully. Take a lump of true yellow earth with no sand or stone mixed in it, put it in a bowl, scald it with water at a hundred boils, cover it close with a lid, and wait until it is warm. Take two wine-cups of the above and stir into it 5 pun of water-levigated cinnabar powder and 1 don of water-levigated realgar powder, add a little sugar, and give it warm. Two doses and it stops at once. — Hoechun 回春 (Donguibogam · Soa)

Clinical commentary 臨床

A lump of true yellow earth, with no sand or stone in it, dropped into a bowl and scalded with water at a hundred boils, then covered close and left to cool to blood heat. Two wine-cups of that water carry 5 pun of levigated cinnabar and 1 don of levigated realgar, with a little sugar; warm, twice, and the vomiting is said to stop at once. **Contains cinnabar, which is mercuric sulfide, and realgar, which is arsenic sulfide. The patient is a child, and the leaf gives no dose scaled to the child's age or weight.** Cinnabar is mercury: there is no safe intake at any age, the developing nervous system is the organ at risk, and the injury it does there is permanent — the full statement on cinnabar in this chapter is written on jinsa-go-soa. Realgar is arsenic sulfide, and inorganic arsenic is a poison and a human carcinogen with no safe intake; at 1 don it is the heaviest thing in the prescription, twice the weight of the mercury. Water-levigation — grinding the mineral under water and decanting the fine fraction — makes the powder finer and therefore more readily absorbed, not safer. Two doses of that go into a child who is vomiting. What the section is actually about is the fluid. 嘔吐 here, with 泄瀉 in the section after it, is the vomiting and diarrhoea of a child with smallpox, and in a child with a dense or confluent eruption that loss was lethal by itself: fever, a skin surface weeping through thousands of broken lesions, and then the gut emptying from both ends. The full statement on oral rehydration solution is written on the 玉露散 leaf of 1.43 吐瀉 at 037b and is cross-referenced here rather than repeated. What is specific to a vomiting child is the method — a large drink comes straight back up and a small one stays down, so the fluid goes in in small amounts, often, and is begun again after each vomit. Measured against that, there is one part of this leaf pointing the right way and it is the vehicle: warm water with a little sugar in it, given twice. That is fluid by mouth, which is the one thing that genuinely moved outcomes in severe smallpox. It carries no sodium, so it is not oral rehydration solution and does not do that work. And the vehicle is also how the harm is delivered — the sugar makes the mercury and the arsenic palatable enough for a sick child to swallow. **The earth itself is not inert either: a lump of unfired soil carries bacteria, parasite ova and whatever metals were in the ground, and pouring boiling water over it is not sterilisation.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.