寶鑑Bogam

Formulas · Transform Phlegm 化痰 · Uihak Immun (醫學入門)

Marvellously Effective Open the Binding Powder

Sinhyogaegyeol-san

한글 신효개결산  ·  Pinyin Shen Xiao Kai Jie San

神效開結散

The transcription writes 沉香; the corpus prints 沈香 in 67 places of source text against 34 and the variant-graph table gives 沉→沈, so the standard form is printed above. 猪厭肉子, the pig's thyroid gland, has no entry in this corpus's herb list and is not entered as an ingredient; it is named here. Its interlinear description 生猪項下喉嚨系一枚如棗大微扁色紅者 is a substance gloss rather than a cross-reference and is set in parentheses. The tile the drugs are dried on is apparatus and is kept in the method. The forty-nine pearls and forty-nine glands are counts and carry no weights.

Composition 構成

Total 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

  • 癭瘤皆效 — effective in both goitre and tumour
  • A goitre or tumour needing a long course rather than a single dose

Biomedical correlates

  • Endemic goitre and nodular thyroid enlargement
  • Benign soft-tissue tumours

Source text 原文

Donguibogam 東醫寶鑑

治癭瘤皆效. 沈香 二錢, 木香 三錢, 陳皮 四錢, 眞珠 四十九粒(火煆), 猪厭肉子(生猪項下喉嚨系一枚, 如棗大, 微扁色紅者) 四十九箇, 瓦上焙乾. 右爲末, 每二錢, 臥時冷酒調和, 徐徐嚥下. 輕者三五服效, 重者一料全愈. 《入門》

Translation

Treats goitre and tumour, effective in both. Agarwood, 2 don; costus, 3 don; tangerine peel, 4 don; forty-nine pearls, calcined in the fire; forty-nine pig thyroid glands (from a live pig, below the neck, attached to the throat, one body the size of a jujube, slightly flattened and red in colour), dried over heat on a tile. Powder the above; 2 don to a dose at bedtime, stirred into cold wine and swallowed slowly. In a light case three to five doses answer; in a severe one a single full batch cures it outright. — Immun 入門 (Donguibogam · Jechang)

Clinical commentary 臨床

Forty-nine pig thyroid glands, and the leaf knows exactly what it is asking for. 生猪項下喉嚨系一枚, 如棗大, 微扁色紅者 — from a live pig, below the neck, attached to the throat, a single body the size of a jujube, slightly flattened, red in colour. That is a description written by somebody who had the organ in his hand, and it is the thyroid gland, correctly located and correctly described. It is also the implicit correction of the 人參化癭丹 gloss two heads earlier, which calls the same organ the animal's testicle. Which makes this, in modern terms, desiccated thyroid: forty-nine glands dried on a tile, powdered, and taken at 2 don a night in cold wine. Thyroid extract prepared this way was the standard treatment for hypothyroid goitre from 1891 until synthetic levothyroxine replaced it, and it is still manufactured. The three aromatics and the calcined pearls carry the dose and make the powder palatable; the medicine is the gland. **An unmeasured dose of animal thyroid causes thyrotoxicosis — palpitation, tremor, weight loss, heat intolerance, atrial fibrillation in the old and bone loss over time — and the thyroid content of forty-nine pig glands cannot be estimated. The powder is raw animal glandular tissue with the infection risk that carries, and the agarwood is a CITES-listed species. This must not be prepared.** Where a thyroid has genuinely failed, levothyroxine at a dose titrated to blood tests does the same job safely; where the gland is overactive, this would be actively dangerous. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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