Formulas · Stabilize & Astringe 固澀 · Uihak Immun (醫學入門)

Inward Flesh-Engendering Pill

Naesaenggi-hwan

한글 내생기환 · Pinyin Nei Sheng Ji Wan

內生肌丸

象牙, the elephant ivory of the second version, has no entry in the herb list and is left out of the ingredient list. The honey that binds the first version is a binder and is kept in the source text only; the beeswax of the second is listed, since it replaces the honey as a stated ingredient. The leaf gives no interlinear notes.

Composition 構成

Baekban Bai Fan
白礬 백반 · Alum

40 g
Chief 君

枯白礬, alum calcined to dryness, 1 nyang
Nokgak Lu Jiao
鹿角 녹각 · Deer Antler (ossified)

40 g
Deputy 臣

鹿角屑, deer antler raspings, 1 nyang; dropped from the second version
Baekjima Bai Zhi Ma
白脂麻 백지마 · White Sesame

40 g
Deputy 臣

脂麻, sesame seed, 1 nyang
Hwangnap Huang La
黃蠟 황랍 · Beeswax

—
Assistant 佐

黃蠟, beeswax, no amount stated — it binds the second version of the pill

Total 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

Taken as pills in warm wine to make a fistula fill in from within
Changed after the opening has closed, and then taken long to cut off the root

Indications 主治

Pattern-based

漏瘡 — a fistulous sore
竅塞後 — the stage after the mouth of the tract has closed over
A sinus held to need flesh engendered rather than toxin drawn

Biomedical correlates

Chronic sinus or fistula under conservative management
Slow-healing wound cavity after drainage

Source text 原文

Donguibogam 東醫寶鑑

治漏瘡. 枯白礬ㆍ鹿角屑ㆍ脂麻各一兩. 爲末, 蜜丸梧子大. 溫酒下三十丸. 竅塞後, 去鹿角, 加象牙一兩, 黃蠟和丸, 常服斷根. 《入門》

Translation

Treats a fistulous sore. Alum calcined to dryness, deer antler raspings and sesame seed, 1 nyang each. Powder them and make honey pills the size of a paulownia seed. Take thirty in warm wine. Once the opening has closed, drop the deer antler, add 1 nyang of elephant ivory, bind the pills with beeswax instead, and take them constantly to cut off the root. — Immun 入門 (Donguibogam · Jechang)

Clinical commentary 臨床

A three-drug pill, and the internal counterpart to the dusting powders: 生肌 is what the topical dressings of this section claim, and 內生肌 claims it from inside. Calcined alum is the active idea, with antler raspings for substance and sesame to carry it, bound with honey. The structure worth noticing is the second stage. Once the mouth of the tract has closed — 竅塞後 — the antler comes out, ivory goes in, and the binder changes from honey to wax for long-term use to 斷根, cut off the root. That is a maintenance prescription, and it shows the author understood the real problem with a fistula: it shuts and then opens again. Nothing here is toxic, and nothing here reaches a sinus. Calcined alum taken by mouth is an astringent in the gut, not in a tract in the perineum. The judgement behind the two-stage plan is sound and the means are not: a fistula that keeps reopening has something at the bottom of it, which is the chapter's own teaching at 疳瘻 — 苟有宿膿朽骨停蓄其間皆爲之漏 — and it needs the tract laid open or the dead bone taken out. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.