Formulas · External Application 外用 · Jikji (直指)

Level the Flesh Powder (Abscess Formula)

Pyeonggi-san

한글 평기산 · Pinyin Ping Ji San

平肌散

Donguibogam carries two formulas whose names romanize alike in this corpus — 平氣散 of the Wigye Bogam, registered as `pyeonggi-san`, and this 平肌散 of the Abscesses chapter — so the sores formula takes the chapter tail. The leaf writes 老狗頭骨, an old dog's skull without the colour specified; it is entered under 黃狗頭骨, the herb list's heading, by way of the 狗頭骨 alias. 煆 is left as the transcription and the corpus both print it. The oil that the powder is worked up with when the sore is dry is a vehicle and is kept in the source text only.

Composition 構成

Hwanggudugol Huang Gou Tou Gu
黃狗頭骨 황구두골 · Yellow Dog Skull

10 g
Chief 君

老狗頭骨, the skull of an old dog, calcined (煆); 2 don 5 fun · calcined animal bone
Nobongbang Lu Feng Fang
露蜂房 노봉방 · Hornet's Nest

10 g
Deputy 臣

2 don 5 fun
Baldu Tou Fa
頭髮 발두 · Human Hair

10 g
Deputy 臣

亂髮灰, hair burnt to ash; 2 don 5 fun · human material
Sangbaekpi Sang Bai Pi
桑白皮 상백피 · Mulberry Root Bark

5 g
Assistant 佐

新桑白皮末, fresh mulberry root bark, powdered; 1 don 2 fun 5 ri
Gyeongbun Qing Fen
輕粉 경분 · Calomel (toxic)

—
Assistant 佐

少許, a little · calomel, a mercury salt, toxic
Sahyang She Xiang
麝香 사향 · Musk (prohibited)

—
Envoy 使

少許, a little · musk, a CITES-protected material

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 2 ingredients 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

Applied to a bone abscess that has become a sinus and long failed to close
Dusted on dry when the sore is weeping, worked up with oil when it is dry

Indications 主治

Pattern-based

附骨疽成漏久不合 — a bone abscess turned to a fistula that will not close
A sinus discharging over bone

Biomedical correlates

Chronic osteomyelitis with a draining sinus
Chronic non-healing wound or fistula — topical dressing powder

Source text 原文

Donguibogam 東醫寶鑑

治附骨疽成漏久不合. 老狗頭骨(煆)ㆍ露蜂房ㆍ亂髮灰各二錢半, 新桑白皮末一錢二分半. 右爲末, 入輕粉ㆍ麝香各少許. 濕則乾糝, 乾則油調付之. 《直指》

Translation

Treats a deep-rooted bone abscess that has turned to a fistula and long failed to close. The skull of an old dog, calcined, hornet's nest and hair burnt to ash, 2 don 5 fun each; fresh mulberry root bark powdered, 1 don 2 fun 5 ri. Powder the above and add a little calomel and a little musk each. If the sore is wet, dust it on dry; if it is dry, work it up with oil and apply it. — Jikji 直指 (Donguibogam · Ongjeo)

Clinical commentary 臨床

The 直指 pairs this with its own alternative 生肌散 a little further on in the chapter, and the two are plainly one method: a calcined dog's skull and fresh mulberry root bark in both, powdered, and either dusted on dry or worked up with oil. 平肌, levelling the flesh, and 生肌, engendering it, name the same aim from two sides — getting a sore that stands open to fill in and close over. The composition is almost all burnt animal material. Calcined bone, hornet's nest and hair ash make an absorbent alkaline dust that takes up discharge and leaves a crust, which is what the wet-and-dry instruction is about: dust it when the sore weeps, spread it in oil when it does not. Fresh mulberry root bark is the one plant drug and the only one that would have been thought to do anything beyond drying. Calomel and musk are added last and in trace amounts, as this chapter's powders habitually do. **Contains calomel, which is mercurous chloride and is absorbed from a raw wound surface; mercury from calomel dressings caused chronic poisoning wherever they were used. It also contains musk, a CITES-protected material, and calcined animal bone and human hair ash applied to an open sinus. This must not be prepared.** 附骨疽成漏 — a bone abscess that has become a fistula — is chronic osteomyelitis with a sinus tract, and it will not close while dead bone remains in it. It needs imaging, cultures, antibiotics and surgical debridement. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.