Formulas · External Application 外用 · Uihak Jeongjeon (醫學正傳)

Toad Venom Paste

Seomsu-go

한글 섬수고 · Pinyin Chan Su Gao

蟾酥膏

The leaf gives no 治 clause of its own; the indication comes from the 外治法 passage at 033b that prescribes it, which has the node pierced with a fire needle, this paste packed into the hole, and Nogun-go plastered over the outside. 寒食麵, the flour kept from the Cold Food festival, is registered under 白麪 as baengmyeon by way of the 寒食麪 alias. Only count amounts and 少許 are given, so no gram figures are entered.

Composition 構成

Seomsu Chan Su
蟾酥 섬수 · Toad Venom

—
Chief 君

如大豆許 — as much as a large bean; toad venom, severely toxic and cardiotoxic
Baekjeonghyang Bai Ding Xiang
白丁香 백정향 · Sparrow Droppings

—
Deputy 臣

十五枚 — fifteen pieces of sparrow droppings
Padu Ba Dou
巴豆 파두 · Croton Seed

—
Deputy 臣

巴豆肉五粒 — five kernels; a violent purgative and a vesicant
Hansuseok Han Shui Shi
寒水石 한수석 · Glauberite

—
Assistant 佐

少許 — a little
Baengmyeon Bai Mian
白麪 백면 · White Wheat Flour

—
Envoy 使

寒食麵少許 — a little of the flour kept from the Cold Food festival

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 5 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

Packed as honey pills into the needle hole driven into a scrofulous node
Corrodes and draws out the thick pus in the core of the node
More pills put in while pus remains, until the pus is finished

Indications 主治

Pattern-based

瘰癧 — a scrofulous node opened with a fire needle
Thick pus held in the core of the node

Biomedical correlates

Caseating tuberculous lymph node opened and packed — a historical escharotic dressing
Chronic abscess cavity requiring drainage

Source text 原文

Donguibogam 東醫寶鑑

蟾酥如大豆許, 白丁香十五枚, 巴豆肉五粒, 寒水石ㆍ寒食麵各少許. 右各另硏, 合和再硏, 蜜丸菉豆大. 每一丸或二丸三丸, 納入鍼竅中. 如膿未盡, 再納數丸, 以膿盡爲度. 《正傳》

Translation

Toad venom as much as a large bean; sparrow droppings fifteen pieces; kernels of croton five; glauberite and the flour kept from the Cold Food festival, a little of each. Grind each one separately, combine them and grind again, and make honey pills the size of a mung bean. One pill, or two or three, packed into the needle hole. If the pus is not finished, pack in several more, taking the finishing of the pus as the measure. — Jeongjeon 正傳 (Donguibogam · Jechang)

Clinical commentary 臨床

Not a paste in the plaster sense but a plug. The node is pierced with a red-hot needle, and these mung-bean pills are pushed down the hole, one to three at a time, and renewed until nothing more comes out. Toad venom the size of a bean, fifteen sparrow droppings, five croton kernels, a little glauberite and a little wheat flour as the body of the pill — three corrosives and two fillers. It is an escharotic wick, and as a procedure that is not absurd: a caseating tuberculous node has to be drained, and packing a tract to keep it open and let it discharge is what the 外治法 passage is reaching for when it says 絍之, to wick it. What the chapter did not have was any way to stop the node from re-forming, which is why the same passage goes on to the red-hot iron and then to 金寶膏. **Contains toad venom, which carries bufadienolide cardiac glycosides and is severely toxic and cardiotoxic even by absorption through a wound, and croton kernels, which are a violent purgative and a vesicant. Sparrow droppings on an open sore carry an infection risk. This must not be prepared.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.