Formulas · Transform Phlegm 化痰 · Jesaeng (濟生)

Break the Binding Powder

Pagyeol-san

한글 파결산 · Pinyin Po Jie San

破結散

A cross-reference head with no composition of its own, so no ingredients are entered. The interlinear 卽上海藻散堅丸也 is set in a 細註 span as the corpus does for this kind of note; 海藻散堅丸, the formula it points back to in the 瘰癧 section, is not registered in this corpus and stays plain text. 松蘿, the lichen that the appended case drops, and 眞桑寄生, the mulberry mistletoe put in at double weight in its place, are modifications of the referred formula rather than ingredients of this leaf; mistletoe is registered as 桑寄生 and the lichen is now registered as 松蘿. The head carries two source labels, the 濟生 attribution of the formula and the 正傳 attribution of the case; both are given.

Composition 構成

Total 0 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 the five goitres and the tumours
Named here as the same prescription as the Haejo Sangyeon-hwan given earlier in the chapter
In the case appended to it, the lichen is dropped and true mulberry mistletoe put in at double weight

Indications 主治

Pattern-based

五癭及瘤 — the five goitres and the tumours
A goitre as large as an aubergine, with tidal fever and a wasted frame, that a hundred treatments had not touched

Biomedical correlates

Endemic goitre and thyroid nodules
Benign soft-tissue tumours

Source text 原文

Donguibogam 東醫寶鑑

治五癭及瘤. <span class='sochu'>卽上海藻散堅丸也</span> 《濟生》 ○有人生癭大如茄子, 潮熱形瘦, 百治不效, 得此方去松蘿, 代眞桑寄生一倍, 服三五日, 其癭自消散而愈. 《正傳》

Translation

Treats the five goitres and the tumours — this is the Haejo Sangyeon-hwan given above. ○ There was a man who grew a goitre as large as an aubergine, with tidal fever and a wasted frame, and a hundred treatments had not touched it. He got this formula, left out the lichen and put in true mulberry mistletoe at double weight instead, took it for three or five days, and the goitre dispersed of itself and he was cured. — Jesaeng 濟生 · Jeongjeon 正傳 (Donguibogam · Jechang)

Clinical commentary 臨床

Not a prescription so much as a pointer and a case. The name 破結散, breaking what has bound, is given to a formula the chapter has already set out under another name in the 瘰癧 section, and the whole content of this leaf is the identification plus one patient's story. The case is worth the space it takes. A goitre the size of an aubergine with tidal fever and wasting is a toxic goitre, and the 正傳 records the modification that worked — out with the lichen, in with double mulberry mistletoe — and the timescale, three to five days. A goitre does not disperse in three to five days; what can change that fast is the fever and the patient's sense of himself. The chapter's own general rule, 五癭皆不可決破, that none of the five goitres may be cut open, is sound surgical advice for its period and is why the 癭瘤 section is a section of internal and topical remedies only. Where this matters is the drug that the referred formula is built on. 海藻散堅丸 is a seaweed prescription, and seaweed is iodine. Endemic goitre is iodine deficiency, so a seaweed powder taken for a swelling of the neck is, uniquely in this chapter, the right drug for the right reason by the wrong theory. A goitre with tidal fever and weight loss, though, is thyrotoxicosis, and iodine given in that state can make it worse. **A goitre with fever, weight loss, tremor or palpitation needs thyroid function tested and treated, not iodine.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.