Aloe Pill

Nohoe-hwan

한글 노회환 · Pinyin Lu Hui Wan

蘆薈丸

蘆薈 is read nohoe, not rohoe: word-initial 蘆 takes the n- form under the Korean initial-sound rule, so the id is `nohoe-hwan`. The automatic romaniser happens to get this one right, but the reading was checked by hand because the corpus already holds 爐灰膏 (`nohoe-go`), the Immun hearth-lime caustic, whose entirely different name romanises onto the same stem; the two are distinguished only by the dosage-form syllable, and a 爐灰丸 would have collided outright. 1.38.17 諸疳通治藥 names a 十味蘆薈丸, ten-ingredient aloe pill, which is a separate and larger formula registered elsewhere in this chapter. The leaf writes 為 for 爲, normalized. The next leaf, 露星膏 (`noseong-go`), opens 治同上 and inherits this leaf's 脊疳.

Composition 構成

Yongdamcho Long Dan Cao
龍膽草 용담초 · Gentian

40 g
Chief 君

1 nyang, fried to red with the coptis after the elm paste
Hwangnyeon Huang Lian
黃連 황련 · Coptis

40 g
Chief 君

1 nyang, fried to red with the gentian after the elm paste
Mui Wu Yi
蕪荑 무이 · Elm Fruit Paste

40 g
Deputy 臣

蕪荑, elm fruit paste, 1 nyang, fried first to a yellow colour · an anthelmintic
Nohoe Lu Hui
蘆薈 노회 · Aloe

10 g
Deputy 臣

2 don 5 fun, stirred in separately and unfried (另入) · aloe, a stimulant laxative

Total 130 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 spine gan — the wasted child whose back stands out, with the sores of gan over the body
Elm fruit paste is fried to yellow, the two bitters fried with it to red, the aloe stirred in cold afterwards
Millet-sized pills: ten for a one-year-old, twenty for a two-year-old, in rice water

Indications 主治

Pattern-based

脊疳 — spine gan: the child emaciated to the backbone, with sores and itch

Biomedical correlates

Severe wasting — marasmus — in a young child
Ascariasis as a contributing cause

Source text 原文

Donguibogam 東醫寶鑑

治脊疳. 龍膽草ㆍ黃連ㆍ蕪荑各一兩, 先炒蕪荑黃色, 次入二味同炒赤色. 右爲末, 另入蘆薈二錢半, 和勻, 爛飯和丸黍米大, 一歲兒十丸, 二歲兒二十丸, 米飮下. 《湯氏》

Translation

Treats spine gan. Gentian, coptis and elm fruit paste, 1 nyang each: first fry the elm fruit paste to a yellow colour, then add the other two and fry them together to a red colour. Powder the above, stir in aloe, 2 don 5 fun, separately, and mix evenly; bind with soft-cooked rice into pills the size of millet grains. A one-year-old takes ten pills, a two-year-old twenty, down in rice water. — Tangssi 湯氏 (Donguibogam · Soa)

Clinical commentary 臨床

Three drugs fried in sequence — the elm paste first to yellow, then the gentian and coptis with it to red — and the aloe stirred in afterwards, cold, so that the frying does not spoil it. The dosing by age is unusually explicit for this section: ten pills at one year, twenty at two. 脊疳 is the wasting that shows the spine, which is marasmus plainly described. For the elm fruit paste, see the anthelmintic statement on 使君子丸 (`sagunja-hwan`). The point made in full on 胡黃連丸 (`hohwangryeon-hwan`) is at its starkest on this leaf: a child emaciated to the backbone needs energy and protein, and this is two bitters and a purgative. **Contains aloe — 蘆薈 — a stimulant laxative, given to a child whose presenting illness includes diarrhoea, and the text gives no dose by weight anywhere. This must not be prepared.** Aloe's anthraquinones act directly on the colon. In a wasted child who is already losing water and potassium to 疳瀉 or 吐瀉, adding a purgative is the mechanism by which a treatable malnutrition becomes a fatal dehydration. The intervention that saves this child is oral rehydration solution and feeding, and a laxative is its opposite. It is given here at 2 don 5 fun against three nyang of the other drugs, deliberately kept out of the frying pan so as to keep its strength, and twenty pills of it go to a two-year-old. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.