Formulas · External Application 外用 · Uihak Immun (醫學入門)

Flesh-Breeding Formula

Saenggi-bang

한글 생기방 · Pinyin Sheng Ji Fang

生肌方

A cross-reference and instruction leaf with no composition of its own, so the ingredient list is left empty. The three formulas named in the first clause are all in this chapter: 生肌散 is registered as saenggi-san-jechang and 黃蠟膏 as hwangrap-go-jechang-2, both from leaves a few lines above; the 膁瘡 section's 黃蠟膏, registered as hwangrap-go-jechang, is a different formula; 翠霞散 is not registered in this corpus and stays plain text. The interlinear 三方見上 is set in a 細註 span, as the corpus does for a cross-reference. The first clause carries no 《》 source label of its own; the two ○ clauses are both from the Immun. 砒 here is 砒礵, arsenic trioxide, and 煆砒 is the calcined form; neither is entered as an ingredient, the leaf prescribing them as stages rather than as parts of a formula.

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

Names the three flesh-breeding preparations given above — Saenggi-san, Chwiha-san and Hwangnap-go — for any malign sore that needs new flesh
Forbids the flesh-breeding powder on a sore whose inner flesh is black until an eroding drug has taken the black flesh away entirely
Sets the order of the arsenics — raw arsenic to open the mouth of the sore, calcined arsenic to take off the dead flesh, and once good flesh appears the arsenic is dropped and dry-calcined alum put in

Indications 主治

Pattern-based

惡瘡令生肌 — a malign sore in which new flesh is to be raised
瘡內肉黑色 — black flesh inside the sore
開瘡口 — a sore whose mouth has to be opened

Biomedical correlates

Wound debridement and granulation — the sequence of care
Necrotic or sloughy ulcer

Source text 原文

Donguibogam 東醫寶鑑

凡治惡瘡令生肌, 宜用<a href='/formulas/saenggi-san-jechang'>生肌散</a>ㆍ翠霞散ㆍ<a href='/formulas/hwangrap-go-jechang-2'>黃蠟膏</a><span class='sochu'>三方見上</span> ○凡看瘡內肉黑色, 勿上生肌散, 宜用消蝕之藥, 直待黑肉去盡, 方可上生肌散. 《入門》 ○如開瘡口, 用生砒; 去死肉, 用煆砒; 生好肉, 去砒加枯白礬. 《入門》

Translation

Whenever a malign sore is treated so as to raise new flesh, Saenggi-san, Chwiha-san or Hwangnap-go should be used — the three formulas are given above. ○ Whenever you look into a sore and the flesh inside it is black, do not put the flesh-breeding powder on. An eroding drug should be used, and only when the black flesh has gone entirely may the flesh-breeding powder be put on. ○ To open the mouth of a sore, raw arsenic is used; to take off the dead flesh, calcined arsenic; and when good flesh is coming up, the arsenic is dropped and dry-calcined alum put in instead. — Immun 入門 (Donguibogam · Jechang)

Clinical commentary 臨床

Not a prescription but the rule that governs all the others, and it holds up. 凡看瘡內肉黑色, 勿上生肌散 — when the flesh inside the sore is black, do not put the flesh-breeding powder on; use an eroding drug, and only when the black flesh is entirely gone may the powder go on. That is debridement before granulation, stated as a prohibition, and it is still true: a wound with dead tissue in it does not granulate, and dressing it to encourage new flesh while the slough is still there wastes the dressing and feeds the infection. The chapter has the sequence in the right order and gives the reason. The third clause sets out the escharotic ladder: raw arsenic to open a sore that has closed over, calcined arsenic to take the dead flesh off, and then — the important part — 生好肉, 去砒, when good flesh appears the arsenic is dropped and dry-calcined alum put in its place. Knowing when to stop a caustic is harder than knowing when to start one, and the leaf knows. **The drug it names for both those jobs is arsenic. 砒 is 砒礵, arsenic trioxide, and calcining it does not make it safe — it is absorbed through an open sore into the circulation, and arsenic is cumulative, a systemic poison and a carcinogen. Neither the raw nor the calcined form may be used on a wound, and this must not be prepared.** Debridement is done sharply, or with an enzymatic or autolytic dressing; the one thing in this leaf that transfers whole is the rule about not dressing a sore for granulation until the slough is out of it. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.