Formulas · Clear Heat 淸熱 · Uihak Immun (醫學入門)

Drain the Heart Decoction

Sasim-tang

한글 사심탕 · Pinyin Xie Xin Tang

瀉心湯

The Bogam carries two formulas called 瀉心湯; this is the 癰疽門 one, and the 火門 formula of coptis alone is registered as sasim-tang. The transcription prints 心癕 and 癕疽 for 心癰 and 癰疽, and 蘓木 for 蘇木, normalized here.

Composition 構成

Daehwang Da Huang
大黃 대황 · Rhubarb

6 g
Chief 君
Hwangnyeon Huang Lian
黃連 황련 · Coptis

2.8 g
Deputy 臣
Hwanggeum Huang Qin
黃芩 황금 · Scutellaria

2.8 g
Deputy 臣
Chija Zhi Zi
梔子 치자 · Gardenia

2.8 g
Deputy 臣

山梔子
Nuro Lou Lu
漏蘆 누로 · Rhaponticum Root

2.8 g
Assistant 佐
Taengnan Ze Lan
澤蘭 택란 · Bugleweed

2.8 g
Assistant 佐
Yeongyo Lian Qiao
連翹 연교 · Forsythia

2.8 g
Assistant 佐
Somok Su Mu
蘇木 소목 · Sappan Wood

2.8 g
Assistant 佐

Total 25.6 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 heart abscess and abscesses and indurations with abundant toxin and agitated thirst
Drains the fire downward by the stool with rhubarb
Cools and breaks the collected toxin with the three bitters and forsythia

Indications 主治

Pattern-based

Heart abscess (心癰) with the toxin at its height
Abscesses and indurations (癰疽) with agitation and thirst (躁渴)
Fire pattern with constipation and a full hard swelling

Biomedical correlates

Not identifiable as a modern entity; the Bogam's heart abscess does not correspond to a named diagnosis
Soft-tissue infection at its height with fever and agitation

Source text 原文

Donguibogam 東醫寶鑑

治心癰及癰疽毒盛躁渴. 大黃一錢半, 黃連ㆍ黃芩ㆍ山梔子ㆍ漏蘆ㆍ澤蘭ㆍ連翹ㆍ蘇木各七分. 右剉, 作一貼, 水煎服. 《入門》

Translation

Treats heart abscess, and abscesses and indurations with abundant toxin and agitated thirst. Rhubarb, 1 don 5 fun; coptis, scutellaria, gardenia, rhaponticum, lycopus, forsythia and sappan wood, 7 fun each. Cut up, make one packet, decoct in water and take. — Uihak Immun 入門 (Donguibogam · Ongjeo)

Clinical commentary 臨床

Not the Jingui's Sasim-tang and not the 火門 one either, though the three bitters at its centre — rhubarb, coptis, scutellaria — are the old Samhwang pattern. Rhubarb leads at a don and a half to take the fire out by the stool, gardenia carries it out by the urine, and rhaponticum, lycopus, forsythia and sappan wood are the surgical additions, drugs the chapter uses to break up a collected swelling and move the stagnant blood in it. It is the last and hardest of the Immun's four 心癰 formulas, for 毒盛躁渴 — the toxin at its height. Read it against the 托裏 formulas of this chapter, which push a suppuration outward by supplementing: this one drains instead, and the two strategies are chosen by whether the patient has strength to spare. The Bogam's 心癰 itself has no modern equivalent that can be named honestly. **A spreading infection with fever and agitation needs antibiotics and drainage, not purging, which in a dehydrated patient is dangerous.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.