Formulas · External Application 外用 · Seui Deukhyobang (世醫得效方)

Toad Plaster

Seomyeo-go

한글 섬여고 · Pinyin Chan Chu Gao

蟾蜍膏

烏豆 is the black soybean, registered here under 黑豆, and is not separately listed in the herb aliases. The toad and the hair are the two things (二物) rendered in the lard; the lard is kept in the ingredient list because it is the body of the plaster rather than apparatus. The wash of mulberry root bark and black soybean is part of the method and its two drugs are listed as such.

Composition 構成

Hama Ha Ma
蝦蟆 하마 · Toad (toxic)

—
Chief 君

大蝦蟆一枚 — one large toad, whole; raw animal material, and the parotoid secretion is the toad venom of this chapter
Baldu Tou Fa
頭髮 발두 · Human Hair

—
Deputy 臣

亂髮雞子大 — a mass of tangled hair the size of a hen's egg; human material
Jeoji Zhu Zhi
猪脂 저지 · Lard

160 g
Assistant 佐

猪脂四兩 — lard, 4 nyang, both the frying medium and the body of the plaster
Sangbaekpi Sang Bai Pi
桑白皮 상백피 · Mulberry Root Bark

—
Assistant 佐

decocted for the wash that cleans the sore before the plaster is applied
Heukdu Hei Dou
黑豆 흑두 · Black Soybean

—
Assistant 佐

烏豆 — black soybean, decocted with the mulberry root bark for the wash

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 4 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

Spread on a bone abscess that will not close, where the discharge has gone putrid or bone is coming out of the wound
A toad and a mass of hair rendered down in lard until the fat sets as a plaster
The wound first washed out with a decoction of mulberry root bark and black soybean and dried before the plaster goes on

Indications 主治

Pattern-based

附骨疽久不差 — deep-rooted bone abscess long failing to heal
膿汁敗壞 — the pus turned putrid
骨從瘡口出 — pieces of bone coming away through the mouth of the sore

Biomedical correlates

Chronic osteomyelitis with a draining sinus and sequestrum
Chronically discharging wound with slough

Source text 原文

Donguibogam 東醫寶鑑

治附骨疽久不差, 膿汁敗壞, 或骨從瘡口出. 大蝦蟆一枚, 亂髮雞子大, 猪脂四兩. 右以猪脂煎二物令稠, 去滓, 凝如膏, 貼之. 先以桑白皮ㆍ烏豆煎湯淋洗瘡口, 拭乾, 然後却貼之. 《得效》

Translation

Treats a deep-rooted bone abscess long failing to heal, with the pus turned putrid, or with bone coming away through the mouth of the sore. One large toad; a mass of tangled hair the size of a hen's egg; lard 4 nyang. Render the two things down in the lard until it thickens, strain off the dregs, and let it set like a paste; then spread it on. First pour a decoction of mulberry root bark and black soybean over the mouth of the sore to wash it, wipe it dry, and only then apply the plaster. — Deukhyo 得效 (Donguibogam · Ongjeo)

Clinical commentary 臨床

The indication is the most concrete in the 附骨疽 group and the most diagnostic: a sore over bone that has run for a long time, with putrid discharge, and pieces of bone working their way out through the opening. That is a sequestrum discharging from a chronic osteomyelitis, described exactly, and the leaf a few lines earlier in the 流注骨疽 passage says the same thing in so many words — 碎骨出盡方愈, it heals only when the fragments of bone have all come out. What is offered for it is a rendered fat. A toad and a mass of hair are fried in four nyang of lard until the fat thickens, strained, and allowed to set; the result is an occlusive dressing with some animal protein in it. The wash is the more sensible half of the instruction — mulberry root bark and black soybean decocted and poured over the sore, then dried — and irrigating a sinus before dressing it is still what is done. **The toad is used whole, and the parotoid glands of a toad carry bufadienolides, the same cardiac-glycoside poisons as the 蟾酥 of this chapter, which act on the sodium-potassium pump exactly as digoxin does and have killed people at small doses. Rendering a toad into a fat spread on an open wound over bone gives those compounds a route into the circulation, and the human hair and the unsterile fat add infection risk on top of it. This must not be prepared.** A chronic bone infection with a discharging sinus needs imaging, cultures, prolonged antibiotics and surgical removal of the dead bone. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.