Formulas · Transform Phlegm 化痰 · Yeokro (易老)

Birthwort Pill

Maduryeong-hwan

한글 마두령환 · Pinyin Ma Dou Ling Wan

馬兠鈴丸

Composition 構成

Maduryeong Ma Dou Ling
馬兜鈴 마두령 · Aristolochia Fruit

40 g
Chief 君

ground separately · contains aristolochic acid
Banha Ban Xia
半夏 반하 · Pinellia

40 g
Deputy 臣

ground separately · toxic in the raw state
Haengin Xing Ren
杏仁 행인 · Apricot Kernel

40 g
Deputy 臣

ground separately
Padu Ba Dou
巴豆 파두 · Croton Seed

—
Assistant 佐

twenty-one kernels, skin, heart and oil removed, ground separately · violently purgative and toxic
Unghwang Xiong Huang
雄黃 웅황 · Realgar

—
Assistant 佐

as a coating · arsenic sulfide, toxic
Jogak Zao Jiao
皂角 조각 · Gleditsia Pod

—
Envoy 使

decocted to a paste for the pills
Omae Wu Mei
烏梅 오매 · Mume Plum

—
Envoy 使

as a decoction to take the pills down with

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

Treats long-standing cough
Said to be wonderfully effective

Indications 主治

Pattern-based

Chronic cough with phlegm that will not shift

Biomedical correlates

Intractable chronic cough — historical treatment

Source text 原文

Donguibogam 東醫寶鑑

治久嗽神效. 馬兠鈴ㆍ半夏ㆍ杏仁各一兩(另硏), 巴豆二十一粒(去皮心油, 另硏). 右細末和勻, 以皂角煎膏和丸梧子大, 雄黃爲衣, 以烏梅湯下十丸, 以利爲度. 《易老》

Translation

Treats long-standing cough, and is said to be wonderfully effective. Birthwort, pinellia and apricot kernel, 1 nyang each, ground separately; croton, twenty-one kernels, with the skin, heart and oil removed, ground separately. Grind them fine and mix evenly, make pills the size of a paulownia seed with a paste of decocted soapberry, coat them with realgar, and give ten down with smoked plum decoction, the measure being that the stool should pass. — Yeokro 易老 (Donguibogam · Haesu)

Clinical commentary 臨床

**This must not be prepared.** Birthwort contains aristolochic acid, which causes irreversible kidney failure and cancer of the urinary tract; the Balkan and Taiwanese epidemics of aristolochic acid nephropathy came from exactly this plant family, and it is banned for internal use in most countries. The pill also carries croton, a violent purgative, and a coating of realgar, which is an arsenic sulfide. 以利爲度 — the measure being that the stool should pass — shows what the formula was meant to do: drive the phlegm downward and out. The reasoning is consistent with the chapter's 久嗽 doctrine, that phlegm lodged in the lung duct has to be moved somewhere; the materials chosen to do it are the most dangerous in the chapter. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.