寶鑑Bogam

Formulas · Expel Worms 驅蟲 · Uihak Immun (醫學入門)

Cloth Bag Pill

Podae-hwan

한글 포대환  ·  Pinyin Bu Dai Wan

布袋丸

The transcription writes 隂乾 at the drying step; 隂 is normalised to 陰 by the project's variant-glyph table. The silk bag is apparatus and stays in the source text.

Composition 構成

Total 420 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

Indications 主治

Pattern-based

  • 丁奚 and 哺露 — extreme wasting with a distended belly, and wasting with vomiting after feeds
  • 無辜疳 with worms and failure to grow

Biomedical correlates

  • Historically used for severe childhood malnutrition with intestinal worms
  • Recorded for historical reference only

Source text 原文

Donguibogam 東醫寶鑑

治丁奚ㆍ哺露ㆍ無辜疳. 夜明砂ㆍ蕪荑ㆍ使君子 各二兩, 蘆薈ㆍ人參ㆍ白朮ㆍ白茯苓ㆍ甘草 各五錢. 右爲末, 湯浸蒸餠和丸彈子大. 每一丸, 用絹袋盛之, 次用精猪肉 二兩同煮, 候肉爛熟, 提起藥掛風前陰乾, 只用肉和汁與兒食之. 次日依前煮服, 藥盡爲度. 《入門》

Translation

Treats the wasting of 丁奚 and 哺露 and the blameless wasting disease. Bat guano, elm seed and quisqualis fruit, 2 nyang each; aloe, ginseng, white atractylodes, white poria and liquorice, 5 don each. Powder them, soak steamed cake in hot water and make pills with it the size of a bullet. For each dose take one pill, put it in a silk bag, then take 2 nyang of lean pork and boil it together with the bag; when the meat is thoroughly tender, lift the medicine out and hang it in the wind to dry in the shade, and give the child only the meat and the broth to eat. The next day boil and give it again as before, and continue until the medicine is used up. — Immun 入門 (Donguibogam · Soa)

Clinical commentary 臨床

**The three chief drugs are at two nyang each and the text gives no dose by weight anywhere for the child who swallows them. The patient is a child, and this must not be prepared.** This is the leaf on which to say what the anthelmintics are, and 十全丹, 二連丸 and 化䘌丸 in this same section refer back to it. **使君子, the fruit of Quisqualis indica, and 苦練根, the root bark of Melia, and 蕪荑, elm seed, are genuine anthelmintics — not folk belief but drugs with a real mechanism**, and 使君子 is still in use in parts of Asia. What they treat is ascariasis, the roundworm burden that is near-universal in the undernourished children this section describes, and which both causes and aggravates the malnutrition by competing for what little the child eats. The chapter's reading of 蛔疳 as a worm disease is simply correct. That makes the dosing the hazard rather than the excuse. **An effective drug with no stated dose is more dangerous than an inert one, not less.** Enough 使君子 produces hiccup, vomiting, diarrhoea and hiccup again — the classic over-dose picture — and the margin in a 10 kg child is narrow. Today a single 400 mg dose of albendazole, or 500 mg of mebendazole, clears ascaris in one swallow at a cost of a few cents, with a known dose by weight and a known safety profile. That is the whole of what this formula's best idea amounts to, done safely. **蘆薈 is a stimulant laxative** and **夜明砂 is bat guano, an animal excretion given by mouth** — both are dealt with on 十全丹 in this section, and both are wrong in a wasted child losing fluid. And then the thing this leaf does right. One pill is tied in a bag, boiled with two nyang of lean pork, and the child is given the meat and the broth; the pill is dried and used again the next day. **The child gets fed.** Two nyang of pork is roughly 80 g of meat — perhaps 20 g of protein and 200 kilocalories, every day, in the one disease in this chapter where protein and calories are the treatment. Alongside 猪肚黃連丸 in this same section, this is one of the two leaves in the batch that reaches in the right direction, and it does so for a reason the text does not state: the bag and the reused pill make the drug last, but the pork is what keeps the child alive. On the general point, see 立效散 in this same section. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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