Formulas · Purge Downward 瀉下 · Jeongui (精義)

Internal Dispersion Pill

Naeso-hwan

한글 내소환 · Pinyin Nei Xiao Wan

內消丸

The transcription writes 欝 for 鬱; the corpus prints 鬱 at 151 places against 4 and the corpus form is given. The mint and gleditsia pod are boiled for the binding paste rather than taken as powders, and are entered at their stated weights with that use named. The schizonepeta-and-tea draught carries no weight.

Composition 構成

Heukchuk Hei Chou
黑丑 흑축 · Black Morning Glory Seed

320 g
Chief 君

黑丑八兩, the first-grade powder taken (取頭末) · black morning-glory seed, a drastic purgative
Cheongpi Qing Pi
靑皮 청피 · Green Tangerine Peel

80 g
Deputy 臣

2 nyang
Jinpi Chen Pi
陳皮 진피 · Aged Tangerine Peel

80 g
Deputy 臣

陳皮, 2 nyang
Bakha Bo He
薄荷 박하 · Mint

120 g
Assistant 佐

3 nyang, boiled to a pulp with the gleditsia and the juice boiled down into the binding paste
Jogak Zao Jiao
皂角 조각 · Gleditsia Pod

120 g
Assistant 佐

皂角, 3 nyang, boiled to a pulp with the mint and the juice boiled down into the binding paste
Hyeonggae Jing Jie
荊芥 형개 · Schizonepeta

—
Envoy 使

荊芥茶淸, schizonepeta in clear tea, as the draught for the thirty pills

Total 720 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

Treats scrofula and nodes where heat toxin is bound and stagnant, and disperses them from within
Thirty pills after food in schizonepeta and clear tea, the pills bound with a paste boiled down from mint and gleditsia

Indications 主治

Pattern-based

瘰癧ㆍ結核 — scrofula and nodes
熱毒鬱滯 — heat toxin bound and stagnant

Biomedical correlates

Tuberculous lymphadenitis — scrofula
Reactive or suppurative cervical lymphadenopathy

Source text 原文

Donguibogam 東醫寶鑑

治瘰癧ㆍ結核, 熱毒鬱滯, 服之內消. 黑丑八兩(取頭末), 靑皮ㆍ陳皮各二兩. 右爲末, 以薄荷ㆍ皂角各三兩, 煮爛取汁, 熬膏和丸菉豆大, 以荊芥茶淸呑下三十丸, 食後服. 《精義》

Translation

Treats scrofula and nodes with heat toxin bound and stagnant, and taken it disperses them from within. Black morning-glory seed 8 nyang, the first-grade powder taken; green tangerine peel and aged tangerine peel, 2 nyang each. Powder the above; boil mint and gleditsia pod, 3 nyang each, to a pulp, take the juice and boil it down to a paste, and bind the powder into pills the size of a mung bean. Swallow thirty pills in schizonepeta and clear tea, after food. — Jeongui 精義 (Donguibogam · Jechang)

Clinical commentary 臨床

Eight nyang of black morning-glory seed against two nyang each of the two tangerine peels, which makes this a purgative with a Qi-moving garnish. The 頭末, the fine first siftings of the seed, is the most active fraction, and 320 g of it is a large batch of a drug that empties the bowel hard. 內消, dispersal from within, is the claim, and the mechanism assumed is the one the whole section works from: bound heat toxin has to be given a way out of the body, and the bowel and bladder are the two ways. The binding is done properly — three nyang each of mint and gleditsia pod boiled to a pulp, the juice reduced to a paste — so the pills carry a saponin and a volatile oil as well as the powder, and the draught adds schizonepeta. 瘰癧 is tuberculous lymphadenitis, and sustained purgation in a patient with chronic tuberculous disease does harm rather than good. **Black morning-glory seed is a drastic purgative and is unsafe in sustained use, in pregnancy, and in anyone depleted or dehydrated; the dose here is large. This should not be prepared.** A persistent neck node needs a tissue diagnosis, because the same presentation covers tuberculosis, lymphoma and metastatic carcinoma. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.