Four Sages Pill

Saseong-hwan

한글 사성환 · Pinyin Si Sheng Wan

四聖丸

The two-medicinal variant named 塌氣丸 is defined within this entry as the same formula without costus and green tangerine peel; it is recorded in the source text rather than registered separately.

Composition 構成

Jeongal Quan Xie
全蠍 전갈 · Scorpion (toxic)

40 g
Chief 君

stir-fried (炒) · toxic
Hocho Hu Jiao
胡椒 호초 · Black Pepper

10 g
Deputy 臣
Mokhyang Mu Xiang
木香 목향 · Costus Root

10 g
Deputy 臣
Cheongpi Qing Pi
靑皮 청피 · Green Tangerine Peel

10 g
Assistant 佐

white pith removed (去白)

Total 70 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

Treats vacuity distension of the heart and abdomen in children

Indications 主治

Pattern-based

Vacuity distension of the heart and abdomen in a child
Spleen and lung both vacuous with swelling of the eyelids and cheeks and a yellow colour in the four limbs

Biomedical correlates

Abdominal distension in children
Failure to thrive with bloating

Source text 原文

Donguibogam 東醫寶鑑

治小兒心腹虛脹. 全蝎(炒) 一兩, 胡椒ㆍ木香ㆍ靑皮(去白) 各二錢半. 右爲末, 飯和作丸菉豆大. 薑橘湯下五七丸. 腹脹, 由脾胃虛, 氣攻作也. 肺與脾爲子母, 肺主目胞腮之類, 脾主四肢, 子母皆虛則, 目胞腮腫, 四肢黃色, 用塌氣丸, 漸消之, 塌氣丸, 卽四聖丸, 去木香ㆍ靑皮也. 《錢乙》

Translation

Treats vacuity distension of the heart and abdomen in children. Scorpion (stir-fried) 1 nyang; pepper, costus and green tangerine peel (white pith removed) 2.5 don each. Powder them, make rice pills the size of a mung bean, and take five or seven down with a decoction of ginger and tangerine peel. Abdominal distension arises from vacuity of spleen and stomach, the qi assailing and producing it. Lung and spleen stand as child and mother; the lung governs the eyelids and cheeks and their kind, the spleen governs the four limbs. When child and mother are both vacuous, the eyelids and cheeks swell and the four limbs take on a yellow colour. Use the Settle the Qi Pill to disperse it by degrees; the Settle the Qi Pill is this Four Sages Pill with the costus and green tangerine peel removed. — Jeon Eul 錢乙 (Donguibogam · Changman)

Clinical commentary 臨床

The only paediatric formula in the chapter, and the reasoning attached is worth following. Lung and spleen stand as child and mother; when both are vacuous, the swelling shows where the lung governs — the eyelids and cheeks — while the limbs take on the spleen's yellow. Two organs, two visible sites, one deduction. Scorpion at a nyang in a formula for children is striking, and the variant for milder cases removes the two qi-movers rather than the scorpion, which suggests it was held to be the essential ingredient. **Scorpion is toxic and this is not suitable for children or for self-administration. Persistent abdominal distension in a child requires medical assessment.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.