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Formulas · External Application 外用 · Uihak Immun (醫學入門)

Willow Branch Bath Decoction

Suyang-tang

한글 수양탕  ·  Pinyin Shui Yang Tang

水楊湯

The bath's own drug, 楊柳, has no entry in the herb dictionary and so is left out of the ingredient list; it is named in the translation and carries the formula's whole weight of 五斤. The herb list holds 柳枝梢, the willow twig tip, as a separate headword, and 水楊 — the sallow of the formula's name — has no entry either; neither is substituted here. The three drugs listed are the additions the leaf makes to 保元湯 for the decoction taken by mouth before the bath. 保元湯 is not yet registered, so the cross-reference is left as plain text. The transcription writes 搗, 𤍠, 䧟 and 踈; the corpus prints 擣, 熱 and 陷, and those forms are given above. 踈 and 疏 are evenly divided in the corpus and the transcription's 踈 is kept. 纍纍 is printed exactly as the transcription has it.

Composition 構成

Total 0 g per packet (첩) · representative dosage — verify against source texts. Excludes 3 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

Indications 主治

Pattern-based

  • 不能起脹成漿貫膿 — the eruption unable to swell, fill with fluid or suppurate
  • 枯燥陷伏 — the pox dry and sunken
  • 氣血虛弱, 爲風寒所剋 — Qi and Blood weak, overcome by wind and cold

Biomedical correlates

  • Smallpox, the swelling and suppurating stages, with lesions failing to raise

Source text 原文

Donguibogam 東醫寶鑑

楊柳 五斤, 春冬用枝, 夏秋用葉, 洗淨擣碎. 取長流水一大釜, 煎六七沸, 去渣, 將三分之一注盆中. 先用保元湯<span class='sochu'>方見上</span>加川芎ㆍ桂皮ㆍ糯米煎服, 乃乘熱洗浴良久. 以油紙撚點燈照之, 纍纍然有起勢, 陷處有圓暈紅絲, 此漿影也. 漿必滿足, 如不滿, 又如前浴. 弱者只浴頭面手足, 勿浴背. 如燈照而無起勢, 則必添湯久浴, 使透徹肌肉, 踈通內外, 令毒氣隨煖氣而發也. 此藥升提開豁萬竅, 枯者轉潤, 白者轉紅, 陷伏者自起矣. 冬寒則溫房內浴之. 《入門》

Translation

Willow, 5 geun — in spring and winter use the branches, in summer and autumn the leaves. Wash it clean and pound it fine. Take a great cauldron of long-flowing water, boil it to six or seven boilings, strain off the dregs, and pour a third of it into a tub. First give the Preserve the Origin Decoction — the formula is given above — with chuanxiong, cinnamon bark and glutinous rice added, decocted and taken; then, while the water is hot, bathe the child in it for a good while. Light a twist of oiled paper as a lamp and look at the skin by it: where the pocks stand up one upon another, and where a sunken place has a round halo with red threads in it, that is the shadow of the fluid, and the fluid will certainly fill. If it has not filled, bathe again as before. For a weak child bathe only the head, face, hands and feet, and do not bathe the back. If the lamp shows no sign of rising, more decoction must be added and the bath prolonged, so that it penetrates through to the flesh and opens the inside and the outside, and lets the toxic Qi come out along with the warm Qi. This medicine lifts and raises and throws open the ten thousand pores: what was withered turns moist, what was white turns red, and what had sunk and hidden rises of itself. In the cold of winter, bathe the child in a warmed room. — Immun 入門 (Donguibogam · Soa)

Clinical commentary 臨床

Five pounds of willow — the branches in spring and winter, the leaves in summer and autumn — washed, pounded, and boiled in a cauldron of running water; a third of the decoction at a time goes into the tub and the child is bathed in it hot. Before the bath a decoction is given by mouth. Afterwards a twist of oiled paper is lit and held so the light rakes across the skin, and the physician looks to see whether the pocks are standing up and whether the sunken ones have a halo and red threads in them. If not, more hot decoction goes in and the bath goes on longer. **1.83 浴法 is one of the few parts of this block that helped, and it should be said plainly.** Smallpox had no treatment. What moved outcomes was nursing — fluid, warmth without overheating, the eyes and mouth kept clean, and the broken skin kept clean — and a warm bath in a plain plant decoction belongs to that half of the chapter rather than to the pharmacy. It loosens crusts, carries off exudate and the matter the child has scratched loose, and a child bathed and kept clean was less likely to develop the boils and abscesses the chapter records separately at 1.87.2 痘後癰癤. Secondary bacterial infection of the pocks was common and was a real cause of death, so this is not a small thing. What the bath did not do is what the leaf claims for it. It did not make the lesions raise, fill or suppurate. Whether a pock vesiculated and went on to pustulate depended on the amount of virus and the form of the disease, and a flat, dusky eruption that failed to raise was the haemorrhagic form, which killed very nearly everyone who had it. Adding more hot decoction and bathing longer when the lamp showed no rising was doing more of something that could not work, to the child least able to stand it. The lamp is worth its own sentence. Holding a small flame so that the light crosses the skin obliquely shows up elevation and depth that straight-on light does not, and the chapter sets the method out on its own at 1.77.1 照燈影法. That is side-lighting, and a dermatologist still uses it. The instrument was a paper spill and the observation was correct. Two cautions, both honest. Willow is the salicylate plant — salicin in the bark is the ancestor of aspirin — and although a decoction of branches and leaves used as a bath is nowhere near a dose of anything, broken skin absorbs, and aspirin is the one antipyretic withheld from a febrile child because of Reye's syndrome. And a long hot bath in a febrile child who is already losing fluid through a broken skin surface adds to that loss; the instruction to bathe a weak child only on the head, face, hands and feet shows the chapter had noticed that a frail child did badly in the tub, without being able to say why. **The patient is a child, and the leaf gives no measure scaled to the child's age or weight — the same cauldron, the same heat and the same length of bath for an infant as for an older child.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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