Formulas · Purge Downward 瀉下 · Gogeum Uigam (古今醫鑑)

Honey and Gleditsia Pill

Miljo-hwan

한글 밀조환 · Pinyin Mi Zao Wan

蜜皂丸

The transcription writes 納糓道中 and the source label 醫鍳; 穀 and 鑑 are printed, both on the chapter's variant-glyph correction list. 熬如飴糖 is a simile — boiled down to the consistency of malt sugar — and malt sugar is therefore not entered as an ingredient. 鋌 and 錠 both stand in the leaf and are kept apart as the transcription has them: the first form is rolled into a 小鋌子, a small rod, the second made into a 錠, a lozenge. The leaf has no 治 of its own; 1.85.17 便秘 supplies it — 痘熱壅盛便閉不通蜜皂丸導之或用油醬法潤之 — which also pairs it with 油醬法. 二三兩 is a range and the corpus has no precedent for entering one, so the lower figure is given with the range recorded in the prep.

Composition 構成

Bongmil Feng Mi
蜂蜜 봉밀 · Honey

80 g
Chief 君

二三兩 — two to three nyang, 80 to 120 g; the lower figure is entered. Boiled down until it is like malt sugar
Jogak Zao Jiao
皂角 조각 · Gleditsia Pod

8 g
Deputy 臣

皂角末二錢, the pod ground to powder
Jeodamjeup Zhu Dan Zhi
猪膽汁 저담즙 · Pig Bile

—
Assistant 佐

猪膽汁, pig's bile, in the second form of the suppository only; no weight given

Total 88 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

Leads out a stool blocked by pent-up pox heat
Honey boiled down thick, powdered gleditsia pod worked into it, rolled into a small rod and inserted into the anus
In the form then in use, honey with pig's bile and gleditsia powder made into a lozenge, which is said to work faster

Indications 主治

Pattern-based

Pox heat dammed up and heavy, the stool shut and not passing (痘熱壅盛, 便閉不通)

Biomedical correlates

Constipation in a child with smallpox, treated by a rectal suppository

Source text 原文

Donguibogam 東醫寶鑑

蜜二三兩, 熬如飴糖, 入皂角末二錢, 和勻, 捻作小鋌子, 納穀道中. 今用熬蜜, 入猪膽汁ㆍ皂角末, 和勻作錠用之, 尤速效. 《醫鑑》

Translation

Honey, 2 or 3 nyang, boiled down until it is like malt sugar; put in 2 don of powdered gleditsia pod, mix it evenly, roll it into a small rod and insert it into the anus. Nowadays one boils down honey, puts in pig's bile and powdered gleditsia pod, mixes it evenly and makes it into a lozenge, and using that works still faster. — Uigam 醫鑑 (Donguibogam · Soa)

Clinical commentary 臨床

A honey suppository. Honey boiled down until it is stiff enough to hold a shape, two don of powdered gleditsia pod worked into it, rolled between the fingers into a small rod and pushed into the rectum; the leaf then records a current variant with pig's bile added and the thing cast as a lozenge, and says it works faster. 1.85.17 pairs it with 油醬法, the oil-and-soy enema, and the pairing is exact: one lubricates and irritates from inside the rectum, the other instils liquid into it. This is the most defensible item in the section and it should be said so. A glycerin suppository is still a first-line treatment for a constipated infant, and it works the same two ways this one does — osmotically, by drawing water into the rectum, and mechanically, by stimulating the rectum to empty. Honey is strongly hygroscopic and highly osmolar, so the osmotic half is real. Gleditsia pod is rich in saponins and is a mucous-membrane irritant, which supplies the other half; bile salts are irritant too, which is a plausible reason why the second form was found faster. A 1613 physician had arrived at a working rectal laxative by the correct mechanism, and a suppository has the further merit, in a vomiting child, of not needing to be swallowed. **The patient is a child and the leaf gives no measure scaled to age or weight — the same rod, rolled by hand, for an infant as for an older child.** The hazards are of the kind a modern paediatric ward is careful about. A hard hand-rolled rod pushed into an infant's rectum can tear the mucosa, and in a child with smallpox whose skin and mucous membranes are already broken that is an entry point for infection. Saponins are irritant in proportion to how much is used and how long it stays. And raw honey carries *Clostridium botulinum* spores, which is why honey is withheld from infants under twelve months: the gut of a child that age lets the spores germinate, and a honey mass placed inside the bowel is a route into exactly that gut. The boiling-down would not reliably kill spores. **This must not be prepared for an infant.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.