寶鑑Bogam

Formulas · Tonify Qi & Blood 氣血雙補 · Jeongui (精義)

Stop the Sinus from Within Powder

Naesaek-san

한글 내색산  ·  Pinyin Nei Sai San

內塞散

The source label 精義 is the 外科精義 and is romanised Jeongui, following the corpus, which carries fifteen formulas under that label; it is a different work from the 精要, romanised Jeongyo, which the chapter also cites. 官桂 is registered under 肉桂 by way of the alias. 甘草灸 and 附子炮 run their preparations after the drug in the leaf and are parenthesised here. 一箇, one root, is a count and carries no weight, aconite roots varying in size.

Composition 構成

Total 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

Indications 主治

Pattern-based

  • 疳瘻瘡久不差 — a sores-and-fistula ulcer long failing to heal
  • A sinus in a depleted patient, with no heat signs

Biomedical correlates

  • Chronic non-healing fistula or sinus
  • Chronic wound in a malnourished or anaemic patient

Source text 原文

Donguibogam 東醫寶鑑

治疳瘻瘡久不差. 人參ㆍ黃芪ㆍ當歸ㆍ白茯苓ㆍ防風ㆍ白芷ㆍ桔梗ㆍ川芎ㆍ遠志ㆍ厚朴ㆍ官桂ㆍ赤小豆ㆍ甘草(灸) 各五錢, 附子(炮) 一箇. 右爲末, 每取二錢, 溫酒調下. 《精義》

Translation

Treats a sores-and-fistula ulcer that has long failed to heal. Ginseng, astragalus, Korean angelica, white poria, saposhnikovia, angelica dahurica, platycodon, chuanxiong, polygala, magnolia bark, cinnamon bark, adzuki bean and mix-fried licorice, 5 don each; one blast-fried aconite root. Powder the above; 2 don to a dose, stirred into warm wine. — Jeongui 精義 (Donguibogam · Jechang)

Clinical commentary 臨床

The second of the three stages the 疳瘻 section sets out, and the only one that treats the patient rather than the hole. Ginseng and astragalus head a list that is the 十宣散 line of thinking — qi and blood with aromatics and a little wind medicine — and the 內塞 of the name is the claim: the track is to be stopped from within, by flesh filling it, not sealed from outside with a plaster. One blast-fried aconite root warms the whole prescription, adzuki bean drains the discharge, and polygala and platycodon are there to lift and carry. As a reading of why a wound will not close this is not unreasonable. A chronic sinus in a wasted, anaemic, poorly fed patient does heal badly for exactly the reason the 精義 names, and feeding the patient is part of closing it. What the prescription cannot do is remove what is holding the track open, and the section's own head says what that is: 宿膿朽骨停蓄其間, old pus and dead bone lodged in it. **Contains aconite, which is toxic even blast-fried, and the dose is one whole root of unspecified size in a powder taken 2 don at a time. This must not be prepared.** A fistula that has run for months needs the track imaged and traced, cultures taken, the cause found — dead bone, a foreign body, Crohn's disease, tuberculosis, a malignancy — and the tract excised or laid open. Nutrition and anaemia are worth correcting alongside that, which is the one part of this prescription's logic that still holds. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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