寶鑑Bogam

Formulas · Clear Heat 淸熱 · Dongwon (東垣)

Dissipate Swelling and Break Hardness Decoction (Scrofula Leaf)

Sanjonggwegyeon-tang

한글 산종궤견탕 (제창)  ·  Pinyin San Zhong Kui Jian Tang

散腫潰堅湯

The corpus already carries a 散腫潰堅湯 under the bare identifier, sourced to 蘭室秘藏 — Li Dongyuan's own book, so the same lineage as this 東垣 leaf — but it has no source_hanja and is a clinic entry, so by house rule it keeps the bare identifier and this Bogam leaf takes the chapter tail. The compositions are close but not the same: the clinic entry has sixteen drugs and no weights, and this leaf has eighteen, adding 海藻 and 黃連 to that list. The transcription writes 搗; the corpus prints 擣 and the corpus form is given. 栢 is left as the transcription has it, the corpus printing the transcription's form for 栢/柏. 當歸梢, the tail ends of the root, resolves to the single 當歸 headword with the part named in the preparation.

Composition 構成

Total 40.8 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

  • 瘰癧及馬刀瘡堅而不潰 — scrofula and clam-knife sore hard and not breaking
  • 或潰出膿水 — or broken, running pus and watery discharge

Biomedical correlates

  • Tuberculous lymphadenitis, matted or with a discharging sinus
  • Chronic suppurative cervical adenitis

Source text 原文

Donguibogam 東醫寶鑑

治瘰癧及馬刀瘡堅而不潰, 或潰出膿水. 黃芩 一錢(酒洗半生半炒), 草龍膽(酒洗) 六分, 瓜蔞根(酒洗)ㆍ黃栢(酒炒)ㆍ知母(酒炒)ㆍ桔梗ㆍ昆布ㆍ海藻 各七分, 柴胡 六分, 灸甘草ㆍ三稜(酒洗)ㆍ蓬朮(酒炒)ㆍ連翹 各五分, 葛根ㆍ白芍藥ㆍ當歸梢 各四分, 黃連(酒洗)ㆍ升麻 各三分. 右剉, 作一貼, 水浸半日, 煎服. 食後去枕低頭而臥, 含一口作十次嚥下, 徐徐服之. 另擣一料爲細末, 蜜丸菉豆大, 每取百丸, 以煎藥湯送下. 《東垣》

Translation

Treats scrofula and clam-knife sore that is hard and will not break, or that has broken and runs pus and watery discharge. Scutellaria 1 don (wine-washed, half raw and half fried); gentian (wine-washed) 6 fun; trichosanthes root (wine-washed), phellodendron (wine-fried), anemarrhena (wine-fried), platycodon, kelp and sargassum, 7 fun each; bupleurum 6 fun; roasted licorice, sparganium (wine-washed), curcuma (wine-fried) and forsythia, 5 fun each; pueraria, white peony and the tail ends of Korean angelica, 4 fun each; coptis (wine-washed) and cimicifuga, 3 fun each. Cut the above up, make one packet, steep it in water half a day, then decoct and drink. Take it after food, lying with the pillow taken away and the head low; hold a mouthful in and swallow it in ten small swallows, taking it slowly. Pound a second batch to a fine powder, bind it with honey into pills the size of a mung bean, and take a hundred pills to a dose, sent down with the decoction. — Dongwon 東垣 (Donguibogam · Jechang)

Clinical commentary 臨床

Eighteen drugs, almost all of them wine-treated, and the weights descend in a careful ladder from a don of scutellaria to three fun of coptis and cimicifuga. The wine-washing and wine-frying throughout is Li Dongyuan's device for carrying cooling drugs upward to the head and neck, which is where the disease is; the bupleurum, cimicifuga and pueraria do the same work by their nature. Under that is a bitter-cold core — scutellaria, coptis, phellodendron, anemarrhena, gentian — and over it the softening and breaking drugs: kelp and sargassum for the hardness, sparganium and curcuma for the mass, trichosanthes root, forsythia and platycodon for the pus. The method is the most specific instruction in the section. 食後去枕低頭而臥含一口作十次嚥下 — after food, lie down with the pillow taken away and the head low, hold a mouthful and swallow it in ten small swallows, slowly. The posture and the slow swallowing are meant to keep the decoction in contact with the throat and neck as long as possible, which is a thoughtful piece of practical pharmacy even though nothing in the formula is absorbed where it matters. The second batch made into pills and sent down with the decoction doubles the dose. 瘰癧 is tuberculous lymphadenitis, and 堅而不潰 and 潰出膿水 are its two faces — the matted, rubbery stage and the cold abscess that has opened into a sinus. A sinus from a tuberculous node can run for years and heals with antituberculous therapy, not with topical or bitter-cold drugs. The formula itself is comparatively safe, though the seaweeds carry an iodine load that matters in thyroid disease, and licorice at this dose taken long-term raises blood pressure and drops potassium. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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