寶鑑Bogam

Formulas · Transform Phlegm 化痰 · Manbyeong Hoechun (萬病回春)

Disperse the Nodule Pill

Sohaek-hwan

한글 소핵환  ·  Pinyin Xiao He Wan

消核丸

The transcription writes 𥂁水拌焙 with the variant graph for 鹽, given above as 鹽. 片芩 is registered under 黃芩 by way of the alias and 生甘草節 under 甘草節, the licorice node having its own headword in this corpus. The preparations stand after their drugs in the leaf, 大黃酒煨, 梔子炒, 牡蠣煆童便淬另硏 and the rest, and are parenthesised here. 菉豆大 names only the size of the pill and is not an ingredient; the steamed cake that binds it is.

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

  • 頸項耳後結核 — nodules on the neck and behind the ears
  • 三五歲成簇 — standing three to five years and gathered into clusters
  • 不紅不腫不作膿 — not red, not swollen, not coming to pus

Biomedical correlates

  • Chronic cervical and post-auricular lymphadenopathy
  • Matted non-suppurating neck nodes

Source text 原文

Donguibogam 東醫寶鑑

治頸項耳後結核, 三五歲成簇, 不紅不腫不作膿者. 橘紅(鹽水拌焙)ㆍ赤茯苓ㆍ大黃(酒煨)ㆍ連翹 各一兩, 片芩(酒炒)ㆍ梔子(炒) 各八錢, 半夏麴ㆍ玄參(酒拌)ㆍ牡蠣(煆童便淬另硏)ㆍ天花粉ㆍ瓜蔞仁ㆍ桔梗 各七錢, 白殭蠶(炒) 六錢, 生甘草節 四錢. 右爲末, 湯浸蒸餠和丸菉豆大, 白湯下八九十丸. 《回春》

Translation

Treats nodules on the neck and behind the ears which have stood three to five years and gathered into clusters, and which are not red, not swollen and do not come to pus. Tangerine peel red part, mixed with salt water and dried over heat; red poria; rhubarb, wine-roasted; and forsythia, 1 nyang each. Scutellaria in broad lamina, wine-fried, and gardenia, stir-fried, 8 don each. Pinellia leaven; scrophularia, mixed with wine; oyster shell, calcined, quenched in child urine and ground apart; trichosanthes root; trichosanthes seed; and platycodon, 7 don each. Stiff silkworm, stir-fried, 6 don. Raw licorice node, 4 don. Powder the above and bind with steamed cake soaked in hot water into pills the size of a mung bean; take eighty or ninety pills in plain hot water. — Hoechun 回春 (Donguibogam · Jechang)

Clinical commentary 臨床

The largest of the 結核 prescriptions and the only one written as a long course. Fourteen drugs, three of them wine-prepared, bound into mung-bean pills and taken eighty or ninety at a time — a dose that only makes sense for something expected to take months. 不紅不腫不作膿 is the diagnostic clause: these are cold nodes, not an abscess, and the 回春 treats them with downward drainage rather than with the drawing-out prescriptions of the 癰疽 chapters. Wine-roasted rhubarb and wine-fried scutellaria carry the purge upward to the head and neck before it works downward, which is the standard device for a lesion above the diaphragm; calcined oyster shell quenched in urine and the two trichosanthes parts are there to soften hardness, and stiff silkworm and pinellia leaven to move phlegm. 三五歲成簇 — three to five years, gathered into clusters — is a careful observation. Matted, long-standing, painless neck nodes that never suppurate are the presentation of tuberculous lymphadenitis without breakdown, and of lymphoma, and of a group of chronic reactive conditions; the chapter puts 結核 next to 瘰癧 for exactly this reason and distinguishes them only by size and number. None of this resolves the diagnosis, and that is the point worth making. Nodes of this description in an adult need imaging, a tuberculosis workup and usually an excision biopsy. Rhubarb and gardenia taken at ninety pills a day for months is a sustained purge with the fluid and electrolyte consequences that implies, and oyster shell quenched in human urine is a human material applied by mouth. **The calcined oyster shell is quenched in child urine, a human material, and the formula is a prolonged purgative course. This must not be prepared.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

Related formulas 關聯

Look up another