Formulas · Clear Heat 淸熱 · Uihak Immun (醫學入門)

Inwardly Secure and Clear the Heart Powder

Naegocheongsim-san

한글 내고청심산 · Pinyin Nei Gu Qing Xin San

內固淸心散

The transcription prints 心癕 and 癕疽 for 心癰 and 癰疽, and 右為末 for 右爲末, normalized here. 一字 is a quarter of a 錢 and is entered as 1 g. The honey-water vehicle is not entered as an ingredient.

Composition 構成

Jusa Zhu Sha
朱砂 주사 · Cinnabar (toxic)

4 g
Chief 君

辰砂 — mercuric sulphide, toxic
Unghwang Xiong Huang
雄黃 웅황 · Realgar

4 g
Chief 君

雄黃 — arsenic sulphide, toxic
Jeokbongnyeong Chi Fu Ling
赤茯苓 적복령 · Poria (red)

4 g
Deputy 臣
Insam Ren Shen
人蔘 인삼 · Ginseng

4 g
Deputy 臣
Bakcho Pu Xiao
朴硝 박초 · Crude Mirabilite

4 g
Deputy 臣
Baekdugu Bai Dou Kou
白豆蔻 백두구 · Round Cardamom

4 g
Assistant 佐
Nokdu Lu Dou
菉豆 녹두 · Mung Bean

4 g
Assistant 佐

菉豆
Jogak Zao Jiao
皂角 조각 · Gleditsia Pod

4 g
Assistant 佐
Yongnoe Long Nao
龍腦 용뇌 · Borneol

1 g
Assistant 佐

一字, a quarter of a don
Sahyang She Xiang
麝香 사향 · Musk (prohibited)

1 g
Assistant 佐

一字, a quarter of a don — musk, a protected-species material
Gamcho Gan Cao
甘草 감초 · Licorice

4 g
Envoy 使

Total 38 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

Treats heart abscess and malign sores of abscesses and indurations with agitation
Resolves toxin, with marvellous effect, and secures the interior against it
Settles the agitated spirit with cinnabar, borneol and musk

Indications 主治

Pattern-based

Heart abscess (心癰) with vexation and agitation (煩躁)
Abscesses and indurations (癰疽) with malign sores (惡瘡)
Toxin pressing inward with restlessness

Biomedical correlates

Not identifiable as a modern entity; the Bogam's heart abscess does not correspond to a named diagnosis
Severe soft-tissue infection with delirium, the state the leaf describes
Not for use

Source text 原文

Donguibogam 東醫寶鑑

治心癰及癰疽惡瘡煩躁, 以此解毒神效. 辰砂ㆍ赤茯苓ㆍ人參ㆍ白豆蔲ㆍ雄黃ㆍ菉豆ㆍ朴硝ㆍ甘草ㆍ皂角各一錢, 龍腦ㆍ麝香各一字. 右爲末, 每一錢, 蜜水調下. 《入門》

Translation

Treats heart abscess, and malign sores of abscesses and indurations with vexation and agitation; this resolves the toxin with marvellous effect. Cinnabar, red poria, ginseng, round cardamom, realgar, mung bean, mirabilite, licorice and gleditsia pod, 1 don each; borneol and musk, one ja each. Powder them, and give 1 don at a time stirred into honey water. — Uihak Immun 入門 (Donguibogam · Ongjeo)

Clinical commentary 臨床

內固 means to secure the interior, and the formula is built on the assumption that an abscess with 煩躁 — vexation and agitation — has sent its toxin inward to the Heart. Against that it sets two mineral heart-settlers, cinnabar and realgar, with borneol and musk at a quarter-don each for the orifices, and then mirabilite and gleditsia pod to shift the mass. Ginseng, mung bean, cardamom and licorice are the counterweight, meant to keep the minerals from flattening the patient. Agitation and delirium in someone with a spreading suppuration is sepsis, and the seventeenth-century reading of it as toxin reaching the Heart is a reasonable observation badly explained. **Contains cinnabar, which is mercuric sulphide, and realgar, which is arsenic sulphide. Both are cumulative poisons and this must not be prepared or taken. Musk is a protected-species material. Sepsis from a soft-tissue infection is a medical emergency requiring intravenous antibiotics and source control.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.