寶鑑Bogam

Formulas · Tonify Yin 補陰 · Bang Gwang (方廣)

Three-in-One Kidney Qi Pill

Samilsingi-hwan

한글 삼일신기환  ·  Pinyin San Yi Shen Qi Wan

三一腎氣丸

The transcription prints 熟地黄, 山茱茰, 濕熟 for 濕熱, 𥂁炒 for 鹽炒, 隂 for 陰 and 胷滿 for 胸滿; these are normalised. 𤨏陽 is kept as printed, as the corpus does elsewhere, for 鎖陽. A first-edition footnote 回 : 囬 falls inside this leaf's line range but concerns a graph the formula text does not contain. Gobon-hwan, one of the three parent formulas named in the commentary, is not yet registered.

Composition 構成

Total 1800 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

Indications 主治

Pattern-based

  • Deficiency taxation with the essence and blood emptied (虛勞)
  • Essence and blood once vacuous, evil water taking advantage and turning to damp-heat (精血一虛, 邪水乗之而爲濕熱)

Biomedical correlates

  • Chronic debility with night sweats
  • Age-related decline with urinary irritation

Source text 原文

Donguibogam 東醫寶鑑

治虛勞, 補心腎諸藏精血, 瀉心腎諸藏火濕. 熟地黃ㆍ生乾地黃ㆍ山藥ㆍ山茱萸 各四兩, 牡丹皮ㆍ白茯苓ㆍ澤瀉ㆍ𤨏陽ㆍ龜板 各三兩, 牛膝ㆍ枸杞子ㆍ人參ㆍ麥門冬ㆍ天門冬 各二兩, 知母ㆍ黃栢(幷鹽炒)ㆍ五味子ㆍ肉桂 各一兩. 右爲末, 蜜丸梧子大, 溫酒或鹽湯下七九十丸. ○此藥有補有瀉. 夫五藏, 藏精血者也, 精血一虛, 邪水乗之而爲濕熱. 補者所以補其精血, 瀉者所以瀉其濕熱也. 此方旣有知母ㆍ黃栢以瀉火, 茯苓ㆍ澤瀉以滲濕, 尤爲備也. ○古方如腎氣丸ㆍ固本丸ㆍ補陰丸, 俱是滋陰補血之劑. 然固本丸胸滿有痰者忌之, 補陰丸脾虛有濕者忌之. 惟腎氣丸專於補腎滋陰而兼理痰濕, 最爲切當. 但品味數少, 不足以盡其變. 今將三方合而爲一, 名曰三一腎氣丸, 其間補瀉兼施, 庶乎可也. 《方廣》

Translation

Treats deficiency taxation; it supplements the essence and blood of the heart, the kidney and all the viscera, and drains their fire and damp. Prepared rehmannia, dried raw rehmannia, dioscorea and cornus, 4 nyang each; moutan bark, white poria, alisma, cynomorium and turtle plastron, 3 nyang each; achyranthes, lycium fruit, ginseng, ophiopogon and asparagus, 2 nyang each; anemarrhena and phellodendron, both salt-fried, with schisandra and cinnamon bark, 1 nyang each. Powder the above, bind with honey into pills the size of parasol-tree seeds, and take seventy to ninety pills with warm wine or salted broth. This medicine both supplements and drains. The five viscera are what store the essence and blood; once the essence and blood fall vacuous, evil water takes advantage of them and turns to damp-heat. The supplementing is to supplement the essence and blood, and the draining is to drain that damp-heat. Since this formula already has anemarrhena and phellodendron to drain fire, and poria and alisma to percolate the damp away, it is the more complete for it. Among the old formulas, Singi-hwan, Gobon-hwan and Boeum-hwan are all preparations that enrich the yin and supplement the blood. But Gobon-hwan is to be avoided where the chest is full and there is phlegm, and Boeum-hwan where the spleen is vacuous and there is damp. Only Singi-hwan is devoted to supplementing the kidney and enriching the yin while also putting phlegm and damp in order, and it is the most apt of them; but its ingredients are too few to meet every turn of the illness. Now the three formulas are joined into one and named the Three-in-One Kidney Qi Pill, and with supplementing and draining applied together it may about answer. — Bang Gwang 方廣 (Donguibogam · Heoro)

Clinical commentary 臨床

A compiler's formula, and it says so itself: three older kidney formulas folded into one because each of them failed a particular patient. The commentary is the most useful part of the leaf — Gobon-hwan refused where the chest is full of phlegm, Boeum-hwan refused where the spleen is damp, Singi-hwan preferred and then judged too thin — and it ends in the author's own hedge, 庶乎可也, it may about answer. What came out is eighteen drugs and the old three-tonify-three-drain core of the Yukmijihwang family with a great deal built onto it: two rehmannias instead of one, cynomorium and turtle plastron for the lower back and the deep yin, the two gentlemen of the lungs and ginseng across the middle, salt-fried anemarrhena and phellodendron to drain the fire, and a single nyang of cinnamon bark at the bottom to keep the whole cold mass moving. Seventy to ninety pills a dose is a large dose even for this chapter. Its honesty is in the mechanism it proposes: once the essence is spent, water that should move stagnates and turns to damp-heat, so draining is part of supplementing. That is a sound observation about depleted, oedematous, infection-prone patients, whatever one makes of the terms. **Turtle plastron is from a CITES-listed species and is not used in contemporary practice.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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