寶鑑Bogam

Formulas · External Application 外用 · Oegwa Jeongui (外科精義)

Ten Thousand Responses Paste

Maneung-go

한글 만응고  ·  Pinyin Wan Ying Gao

萬應膏

This is the leaf 癰疽門 points at. Its entry there carries the indications but no composition, referring it away with the interlinear note 方見雜方; this leaf supplies the composition and closes that composition-less cross-reference. 右十四味 counts the fourteen drugs that are cut up and steeped — 大黃 through 生地黃ㆍ官桂ㆍ玄參 — and excludes the wax, the frankincense, the myrrh, the lead and the oil, which are added later; the count is internally consistent. The 癰疽門 entry carries no source label; this leaf gives 《精義》, the 外科精義, so the source is entered from it. 黄 is printed 黃 by the usual normalisation; 黃栢 and 白歛 keep the transcription's forms.

Composition 構成

Total 2740 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

Indications 主治

Pattern-based

  • 瘡疽 newly erupted with 焮腫 — burning swelling
  • 老瘡不差 — an old sore that does not mend
  • 一切癰腫ㆍ久瘡

Biomedical correlates

  • Early suppurative skin and soft-tissue infection — topical
  • Chronic non-healing wound or ulcer — topical

Source text 原文

Donguibogam 東醫寶鑑

大黃ㆍ黃芩 各二兩, 白歛ㆍ黃蠟 各一兩, 黃栢ㆍ芍藥ㆍ白芷ㆍ黃芪ㆍ木鼈子仁ㆍ杏仁ㆍ當歸ㆍ白芨ㆍ生地黃ㆍ官桂ㆍ玄參ㆍ沒藥ㆍ乳香 各五錢, 黃丹 一斤, 香油 二斤八兩. 右十四味剉, 浸油三宿, 慢火熬, 以柳枝攪, 以白芷焦黃色爲度, 綿濾去滓, 入黃丹再熬, 滴水成珠, 乃入乳ㆍ沒ㆍ蠟熔化, 攪勻收貯盛器, 埋土中七日取出攤用. 治一切癰腫ㆍ久瘡. 《精義》

Translation

Rhubarb and scutellaria, 2 nyang each; ampelopsis and beeswax, 1 nyang each; phellodendron, peony, angelica dahurica, astragalus, momordica kernel, apricot kernel, angelica sinensis, bletilla, fresh rehmannia, cassia bark, scrophularia, myrrh and frankincense, 5 don each; red lead 1 geun; sesame oil 2 geun 8 nyang. Cut up the fourteen drugs named above and steep them in the oil three nights; render over a slow fire, stirring with a willow twig, until the angelica dahurica has browned — that is the measure. Strain the oil through cotton wool and discard the dregs, add the red lead and boil it down again until a drop in water forms a bead; then add the frankincense, myrrh and wax and let them melt, stir evenly, store it in a vessel, bury it in the earth seven days, and take it out to spread for use. It treats every abscess swelling and every long-standing sore. — Jeongui 精義 (Donguibogam · Japbang)

Clinical commentary 臨床

The plaster named for the breadth of its application, and the only one of the six whose indication covers both ends of a sore's life: the first hot swelling, and the old ulcer that has stopped closing. 收斂早合, drawing in and closing early, is what one asks of a dressing on a chronic wound, and keeping such a wound covered and moist does in fact help it close — which is the honest part of the claim. Unlike the three great plasters that follow it here, this one is for the surface only. Nothing in the leaf licenses swallowing it, and it should not be read that way. The composition, now recovered, is the most medical of the group: 大黃 and 黃芩 at double weight, with 黃栢, 玄參 and 生地黃 behind them. That is the heat-clearing core of the internal 癰疽 formulas transposed into an oil base, and the formula is built the way a decoction would be rather than the way a plaster usually is. The burying in earth for seven days before use is a curing step; it lets the mass set hard and cool, and has no drug action. **Contains red lead (黃丹), which is lead tetroxide, a full geun of it.** The lead is the setting agent and there is no version of this plaster without it. The route that matters for an ointment on an open sore is absorption through broken skin, which no longer keeps metals out, and lead is a cumulative poison with no safe dose — a dressing left on a 久瘡 for days, renewed over weeks, is exactly the exposure pattern that causes poisoning. **This must not be prepared.** For a chronic wound the useful part of the idea — keep it clean, keep it covered, keep it moist — is available without it. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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