寶鑑Bogam

Formulas · Release the Exterior 解表 · Uihak Jeongjeon (醫學正傳)

Fetus-Shielding Powder for Pox in Pregnancy

Jotae-san

한글 조태산  ·  Pinyin Zhao Tai San

罩胎散

A formula of this name is already registered from the Women's chapter, jotae-san, and the two are different prescriptions. That one is from the 入門 and has two drugs, 嫩卷荷葉 一兩(焙) and 蛤粉 五錢, powdered and taken 二錢 at a time in honey water, for 孕婦傷寒發大熱, 或發痘疹, 恐傷胎藏. This leaf is from the 正傳, has nineteen drugs at 各三錢's third plus four added materials, is a decoction rather than a powder, and shares not one drug with the other — the lotus connection is reversed, since there the rolled lotus leaf is the chief drug while here a lotus leaf is only the lid on the pot. The indications overlap almost exactly, which is the point worth recording: both are for pox or fever in pregnancy, and they are still two different formulas, so this one takes the chapter tail. 盖 is kept as the transcription prints it, the corpus printing it four times for every 蓋. The silver vessel, the earthenware pot and the lotus-leaf lid are apparatus and stay in the source text. The leaf gives no 治 clause; the indication stands in the section prose of 1.88, 孕婦發痘瘡宜罩胎散.

Composition 構成

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 4 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

  • 孕婦發痘瘡 — a pregnant woman in whom the pox has broken out

Biomedical correlates

  • Smallpox in pregnancy — historical; high maternal mortality and usual fetal loss

Source text 原文

Donguibogam 東醫寶鑑

赤茯苓ㆍ白朮ㆍ當歸ㆍ赤芍藥ㆍ柴胡ㆍ乾葛ㆍ人參ㆍ桔梗ㆍ條芩ㆍ防風ㆍ陳皮ㆍ荊芥ㆍ枳殼ㆍ紫草ㆍ阿膠ㆍ白芷ㆍ川芎ㆍ縮砂ㆍ甘草 各三分. 右剉作一貼, 入糯米百粒ㆍ柿蔕七箇ㆍ苧根七寸ㆍ瓜蔕一箇, 以銀器用荷葉盖覆, 水煎空心服. 無銀器以砂罐煎之, 荷葉雖無不妨. 《正傳》

Translation

Red poria, white atractylodes, angelica sinensis, red peony, bupleurum, dried pueraria root, ginseng, platycodon, slender scutellaria root, saposhnikovia, tangerine peel, schizonepeta, bitter orange, arnebia, ass-hide gelatin, dahurian angelica, ligusticum, amomum and liquorice, 3 fun of each. Cut the above to make one packet, add a hundred grains of glutinous rice, seven persimmon calyxes, seven inches of ramie root and one melon stalk, and boil it in a silver vessel covered over with a lotus leaf; take it on an empty stomach. If there is no silver vessel, boil it in an earthenware pot, and it does no harm if there is no lotus leaf either. — Jeongjeon 正傳 (Donguibogam · Soa)

Clinical commentary 臨床

Nineteen drugs at 3 fun each, which is a little over a gram apiece, with four things added to the packet and a lotus leaf over the pot. The structure is readable: ginseng, white atractylodes, angelica and ligusticum to hold the mother up; scutellaria's slender root, ass-hide gelatin, ramie root and glutinous rice as the standard fetus-quieting group of the period; pueraria, bupleurum, saposhnikovia, schizonepeta, dahurian angelica and platycodon to push the eruption outward; arnebia for the pox itself. 罩 means to cover over, and the name says what the formula is trying to do. **Smallpox in pregnancy was close to the worst situation the disease produced.** Maternal mortality was far higher than in non-pregnant adults, haemorrhagic disease was more frequent, and fetal loss — miscarriage, stillbirth, or delivery of an infected infant — was the usual outcome rather than the exception. 罩胎散 is a formula written to hold a pregnancy through that, and it did not hold one. Nothing in 1613 could have. **Two cautions specific to the fetus, since this is a drug given in pregnancy.** The melon stalk, one to the packet, bears cucurbitacins and is used elsewhere in this book precisely as an emetic; violent vomiting in a febrile pregnant woman is dangerous to the pregnancy on its own. Arnebia, the 紫草 of the formula, is of the borage family, members of which carry pyrrolizidine alkaloids — hepatotoxic, and able to cross the placenta and injure the fetal liver. Bitter orange and schizonepeta are also drugs a modern practitioner would not give in pregnancy. The leaf gives no dose beyond the single packet and no account of the mother's weight or her stage of gestation. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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