寶鑑Bogam

Formulas · Clear Heat 淸熱 · Dongwon (東垣)

Inner Expression Notopterygium Decoction

Naetakganghwal-tang

한글 내탁강활탕  ·  Pinyin Nei Tuo Qiang Huo Tang

內托羌活湯

癕 is given above as 癰 and 黃栢 is printed as the transcription has it. 當歸尾 is registered under 當歸, with the part named in the prep. The interlinear 酒製 is given in parentheses.

Composition 構成

Total 43.2 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

Indications 主治

Pattern-based

  • Abscess effusing on the sacrum and buttock in the division of the foot 太陽 channel (足太陽經分尻臀)
  • Hard swelling with pain (堅硬腫痛)
  • An outward pattern, to be dispersed through the surface

Biomedical correlates

  • Gluteal and sacral abscess — historical
  • Pilonidal or ischial abscess and surrounding cellulitis — historical
  • Pressure-sore infection over the sacrum — a cautious modern reading

Source text 原文

Donguibogam 東醫寶鑑

治足太陽經分尻臀發癰疽, 堅硬腫痛. 羌活ㆍ黃栢(酒製) 各二錢, 黃芪 一錢半, 防風ㆍ藁本ㆍ當歸尾 各一錢, 連翹ㆍ蒼朮ㆍ陳皮ㆍ甘草 各五分, 肉桂 三分. 右剉, 作一貼, 水二盞ㆍ酒一盞, 同煎服. 《東垣》

Translation

Treats an abscess or deep-rooted sore effusing on the sacrum and buttock, in the division of the foot taeyang channel, hard and swollen and painful. Notopterygium and phellodendron (wine-processed), 2 don each; astragalus, 1 don 5 fun; saposhnikovia, ligusticum and the tails of Korean angelica, 1 don each; forsythia, atractylodes lancea, aged tangerine peel and licorice, 5 fun each; cinnamon bark, 3 fun. Cut the above, make one packet, and decoct together in 2 cups of water and 1 of wine, and take. — Dongwon 東垣 (Donguibogam · Ongjeo)

Clinical commentary 臨床

Dongwon's channel prescription, and the clearest example in the chapter of a formula chosen by where the swelling sits rather than by what it is. The sacrum and buttock lie in the division of the foot taeyang, so the formula is built on notopterygium and ligusticum, which are the drugs the Yi-shui school uses to reach that channel, with phellodendron processed in wine to carry it downward and cinnamon bark in a 3-fun trace at the bottom. Its sibling is Naetakseungma-tang, also Dongwon's, which does the same thing for the breast — cimicifuga and pueraria for a 乳癰, and the alternative name 升麻托裏湯 says the same. The method passage pairs this with Hwangryeonsodok-san as the answer to an outward pattern, dispersed through the surface, against Naesohwangryeon-tang and Seonbanghwalmyeong-eum for an inward one, which are dredged and conducted downward. Behind that lies the chapter's larger pair: the 托裏 and 內托 group, with ginseng, astragalus and Korean angelica, thrusting the swelling outward from a depleted body, set against the 疏 and 利 group, with rhubarb and mirabilite, carrying the toxin down out of a repleted one. This leaf has astragalus and Korean angelica tails for the expressing side and no rhubarb at all, which is why it is named 內托 despite the surface-opening drugs that lead it. A hard, painful gluteal or sacral abscess is a drainage problem, and the site matters today for a different reason than channel theory — it is where pressure sores and pilonidal disease arise, and both can be deceptively deep. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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