寶鑑Bogam

Formulas · Clear Heat 淸熱 · Gogeum Uigam (古今醫鑑)

Support the Interior and Disperse Toxin Powder

Tangnisodok-san

한글 탁리소독산  ·  Pinyin Tuo Li Xiao Du San

托裏消毒散

凣, 癕 and 鍳 are given above as 凡, 癰 and 鑑. 皂角刺 is registered under 皂角, with the part named in the prep, and the interlinear processing notes are given in parentheses. The leaf opens with 凡 rather than a 治 clause, the indications being stated as a general rule.

Composition 構成

Total 72 g per packet (첩) · representative dosage — verify against source texts.

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

  • 凡癰疽, abscess and deep-rooted sore generally
  • Not yet formed — to disperse at once; already formed — to open at once
  • Toxic qi threatening to attack inward (毒氣不致內攻)
  • Flesh slow to grow

Biomedical correlates

  • Pyogenic soft-tissue infection at any stage — historical
  • Slow granulation in a healing wound — historical

Source text 原文

Donguibogam 東醫寶鑑

凡癰疽服此, 則未成卽消, 已成卽潰, 能壯氣血, 使毒氣不致內攻, 肌肉易生. 金銀花ㆍ陳皮 各三錢, 黃芪(鹽水炒)ㆍ天花粉 各二錢, 防風ㆍ當歸ㆍ川芎ㆍ白芷ㆍ桔梗ㆍ厚朴ㆍ穿山甲(炒焦)ㆍ皂角刺(炒) 各一錢. 右剉, 作二貼, 每一貼酒水相半煎服. 病在下, 只用水煎. 《醫鑑》

Translation

In abscess and deep-rooted sore generally, take this and where it has not formed it disperses at once, and where it has formed it opens at once; it is able to strengthen the qi and blood so that the toxic qi does not come to attack inward, and the flesh grows easily. Honeysuckle and aged tangerine peel, 3 don each; astragalus (stir-fried in salt water) and trichosanthes root powder, 2 don each; saposhnikovia, Korean angelica, cnidium, angelica dahurica, platycodon, magnolia bark, pangolin scale (stir-fried till scorched) and gleditsia thorn (stir-fried), 1 don each. Cut the above and make two packets; for each packet decoct in half wine and half water and take. If the disease is on the lower body, decoct in water only. — Uigam 醫鑑 (Donguibogam · Ongjeo)

Clinical commentary 臨床

The one formula in the group that carries both halves of the chapter's argument in its name: 托裏, support the interior, and 消毒, disperse the toxin. The composition shows the join. Honeysuckle and trichosanthes root powder clear and disperse; astragalus, Korean angelica and cnidium supplement; saposhnikovia, angelica dahurica and platycodon open outward; pangolin scale and gleditsia thorn are the pair the tradition uses to pierce and break through a bound swelling. There is no rhubarb, which keeps it on the supporting side of the pair rather than with Naesohwangryeon-tang, Oridaehwang-tang and Cheongeumnuro-tang, whose measure is free movement of the bowel; but it is far more a heat-clearing formula than Sipseon-san or Takri-san, whose weight is nearly all ginseng, astragalus and Korean angelica. The stated rationale is the clearest statement of 托裏 logic anywhere in the chapter: strengthen the qi and blood so that the toxic qi does not come to attack inward, and the flesh grows easily. That is the whole idea — the body's own strength is what keeps an infection from going deep, and the formula's job is to supply it. It is not a bad intuition. Host resistance really does decide whether a soft-tissue infection stays local, and the chapter is reasoning from something true even though it had no way to act on it. The one practical instruction is nicely observed: half wine and half water, except when the sore is on the lower body, where water alone is used — wine being understood to carry drugs upward. **Contains pangolin scale, which comes from an animal protected under CITES with all commercial trade prohibited.** The formula cannot be prepared as written. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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