Formulas · Purge Downward 瀉下 · Uihak Immun (醫學入門)

Left-Coiling Dragon Pill

Jwaryong-hwan

한글 좌룡환 · Pinyin Zuo Long Wan

左龍丸

The single batch is divided into three parts and made up as two different pills, so that the croton can be titrated separately — twenty cinnabar pills with one croton pill, then two, and so on. 巴豆霜 is croton frost, the defatted powder.

Composition 構成

Baekhapbun Bai Ge Fen
白鴿糞 백합분 · Pigeon Droppings

20 g
Chief 君

stir-fried
Ogong Wu Gong
蜈蚣 오공 · Centipede (toxic)

—
Chief 君

two
Eopyo Yu Biao
魚鰾 어표 · Isinglass (Fish Swim Bladder)

20 g
Deputy 臣

burnt
Baekgangjam Bai Jiang Can
白殭蠶 백강잠 · Silkworm

20 g
Deputy 臣
Cheonma Tian Ma
天麻 천마 · Gastrodia

8 g
Deputy 臣
Unghwang Xiong Huang
雄黃 웅황 · Realgar

4 g
Assistant 佐

toxic
Jusa Zhu Sha
朱砂 주사 · Cinnabar (toxic)

—
Assistant 佐

as a coating on two of the three parts · toxic
Padu Ba Dou
巴豆 파두 · Croton Seed

2 g
Envoy 使

as croton frost in the third part · toxic

Total 74 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

Treats lockjaw entered the interior with convulsion
the eyes staring straight ahead and both stools bound
Purged in two pill strengths to the measure of a loosening

Indications 主治

Pattern-based

Wind toxin in the interior with convulsion and bind
Lockjaw with opisthotonos and constipation

Biomedical correlates

Tetanus with convulsion
Severe tetanus

Source text 原文

Donguibogam 東醫寶鑑

治破傷風入裏, 發搐ㆍ目直視ㆍ二便秘澁, 宜此下之. 野鴿糞(炒, 一名左蟠龍)ㆍ江鰾(燒)ㆍ白殭蚕各五錢, 雄黃一錢, 蜈蚣二條, 天麻二錢. 右爲末, 分作三貼. 先將二貼, 燒飯爲丸梧子大, 朱砂爲衣; 次將一貼, 加巴豆霜半錢, 飯丸梧子大. 每用朱砂丸子二十丸, 加巴豆丸子一丸, 二服加二丸, 溫酒呑下, 至便利爲度. 只服朱砂丸, 病愈卽止之. 若搐痓不已, 宜服<a href='/formulas/gangma-tang'>羌麻湯</a>. 《入門ㆍ丹心》 ○一名江鰾丸. 《入門》

Translation

Treats lockjaw that has entered the interior, with convulsion, the eyes staring straight ahead and both stools bound and rough; this should be used to purge. Stir-fried wild pigeon droppings — also called left-coiling dragon — burnt isinglass and silkworm, 5 don each; realgar, 1 don; centipede, two; gastrodia, 2 don. Powder and divide into three parts. Take two of the parts, make pills the size of a paulownia seed with cooked rice, and coat with cinnabar; take the remaining one part, add half a don of croton frost, and make rice pills the same size. For each use, take twenty of the cinnabar pills with one croton pill added; at the second dose add two, swallowed with warm wine, to the measure of the stools loosening. Where only the cinnabar pills are taken, stop as soon as the disease is cured. If convulsion and tetany do not cease, Gangma-tang should be taken. Also called Gangpyo-hwan. — Uihak Immun 入門 · Danggye Simbeop 丹心 (Donguibogam · Pung)

Clinical commentary 臨床

**This must not be prepared.** Cinnabar, realgar and croton frost in one prescription. The compounding, however, is the most sophisticated in the chapter and deserves recording: one batch of powder is divided in three, two parts made into cinnabar-coated pills and one part into croton pills, so that the purgative can be added one pill at a time to a fixed base — twenty plus one, then twenty plus two, titrated until the stools loosen. That is dose-titration of the dangerous component while holding the rest constant, and it is a genuinely clever piece of pharmacy. The instruction to stop as soon as the disease is cured, and to switch to Gangma-tang if convulsion continues, completes a properly staged protocol. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.