寶鑑Bogam

Formulas · Tonify Qi & Blood 氣血雙補 · Manbyeong Hoechun (萬病回春)

Ginseng Angelica and Turtle Carapace Drink

Samgwibyeolgap-eum

한글 삼귀별갑음  ·  Pinyin Shen Gui Bie Jia Yin

參歸鼈甲飮

Composition 構成

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 3 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

Indications 主治

Pattern-based

  • Old malaria (老瘧) with a lump in the abdomen and flank formed into a malaria mother (瘧母)
  • Mass with qi and blood both depleted by long illness
  • Hardened accumulation in a patient too weak for attacking medicines

Biomedical correlates

  • Splenomegaly in chronic malaria
  • Anaemia with abdominal mass in chronic relapsing fever
  • Malaria

Source text 原文

Donguibogam 東醫寶鑑

治老瘧腹脇有塊, 成瘧母. 鼈甲(醋煮) 一錢三分, 黃芪(蜜水炒)ㆍ靑皮ㆍ當歸ㆍ白茯苓ㆍ白朮ㆍ厚朴ㆍ川芎ㆍ香附子 各八分, 人參ㆍ縮砂ㆍ山査子ㆍ枳實 各五分, 甘草 三分. 右剉, 作一貼, 入薑三棗二梅一, 水煎, 空心服. 《回春》

Translation

Treats old malaria with a lump in the abdomen and flank that has formed into a malaria mother. Vinegar-boiled turtle carapace 1 don 3 fun; astragalus fried in honey water, green tangerine peel, Korean angelica, white poria, white atractylodes, magnolia bark, cnidium and cyperus, 8 fun each; ginseng, amomum, hawthorn and immature bitter orange, 5 fun each; licorice 3 fun. Cut up, make one packet, add 3 slices of ginger, 2 jujubes and 1 mume plum, decoct in water and take on an empty stomach. — Hoechun 回春 (Donguibogam · Haehak)

Clinical commentary 臨床

The third of the chapter's turtle-carapace formulas and the one written for the most depleted patient. The name puts ginseng and Korean angelica before the turtle carapace, and the doses bear the name out: nothing in the formula goes above one don three fun, and the supplementing drugs — ginseng, astragalus fried in honey water, white atractylodes, white poria, Korean angelica — outweigh the dispersing ones. What is interesting is what has been left out. There is no sparganium, no zedoary, no safflower, no peach kernel; the only things attacking the mass are vinegar-boiled turtle carapace, cyperus, green tangerine peel and immature bitter orange, with cnidium moving blood. Amomum and hawthorn are there for a stomach that has stopped working. The formula is the chapter admitting that in a patient this far gone the mass cannot be the first target, and that supplementing qi and blood is the precondition for shifting it at all — which is sound clinical thinking. A lump in the flank with years of relapsing fever and this degree of depletion needs imaging, a parasitological diagnosis and a blood count; anaemia and splenomegaly together in that setting are not something a decoction will reach. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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