Formulas · Transform Phlegm 化痰 · Tangssi (湯氏)

Snatch Back Life Powder (Children chapter)

Talmyeong-san

한글 탈명산 (소아) · Pinyin Duo Ming San

奪命散

This is a sixth distinct prescription called 奪命散. The five already registered are `talmyeong-san-buin` (沒藥ㆍ血竭, 丹心), `talmyeong-san-in` (枯白礬ㆍ白殭蠶ㆍ硼砂ㆍ皂角, 丹心), `talmyeong-san-pung` (天南星ㆍ甜葶藶ㆍ白芷ㆍ半夏ㆍ巴豆, 醫鑑), `talmyeong-san-han` (人參 alone, 丹心) and `talmyeong-san-jesang` (水蛭ㆍ大黃ㆍ黑牽牛頭末, 得效). None of them shares an ingredient with this chlorite-schist powder, and the 諸傷門 entry already anticipated this leaf in its own note, so the chapter tail follows that precedent. The 痰飮門 formula list naming 小兒方奪命散 points here. The transcription writes 㬰 for 臾, 熖 for 焰, 𤍠 for 熱, 褁 for 裹, 来 for 來, 蔵 for 藏 and 為 for 爲; the standard forms are printed, and 煆 is left as written, following the corpus. The source label 湯氏 is romanised Tangssi, as the chapter prose already does; it is the first entry in the formula database to carry it.

Composition 構成

Cheongmongseok Qing Meng Shi
靑礞石 청몽석 · Chlorite Schist

40 g
Chief 君

靑礞石, chlorite schist, 1 nyang, calcined in a pot with nitre until it turns gold
Yeomcho Yan Xiao
焰硝 염초 · Saltpetre

40 g
Deputy 臣

焰硝, nitre, 1 nyang, calcined with the chlorite schist until it is used up (待硝盡)
Bakha Bo He
薄荷 박하 · Mint

—
Assistant 佐

薄荷汁, mint juice, for the acute febrile case
Bongmil Feng Mi
蜂蜜 봉밀 · Honey

—
Assistant 佐

蜜, honey, mixed into the mint juice, and 熟蜜, boiled honey, for the chronic case
Saenggang Sheng Jiang
生薑 생강 · Fresh Ginger

—
Assistant 佐

薑汁, ginger juice, to work Cheongju-baegwonja into a paste in the chronic case
Mokhyang Mu Xiang
木香 목향 · Costus Root

—
Envoy 使

木香湯, a costus decoction, as the vehicle Immun insists on

Total 80 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

Said to control wind-phlegm, for either kind of fright wind where phlegm blocks the throat and rattles like a tide
Chlorite schist calcined with an equal weight of nitre until the nitre is gone and the stone has turned gold, then powdered fine
For acute fright wind with fever, stirred into mint juice with honey and given lukewarm, so the drug wraps the phlegm and carries it out in the stool
For the desperately ill chronic case, given with Cheongju-baegwonja reground and made into a ginger-juice paste, then down in boiled honey
Also given in a costus decoction, with a bedside test: sputum spat into a bowl of water sinks when the powder is sprinkled on it

Indications 主治

Pattern-based

急慢驚風 — either kind of fright wind
痰塞咽喉, 其響如潮 — phlegm blocking the throat with a rattle like a tide, called 潮涎
百藥不能過咽, 命在須臾 — nothing can be got past the throat and life hangs on a moment

Biomedical correlates

Noisy upper-airway secretions in a child during or after a seizure
Airway obstruction in a child — a medical emergency of positioning, suction and oxygen
Febrile seizure, and the seizure of a depleted child after prolonged diarrhoea

Source text 原文

Donguibogam 東醫寶鑑

大能控風痰. 不問急慢驚風, 痰塞咽喉, 其響如潮, 名曰潮涎, 百藥不能過咽, 命在須臾, 但用此藥入喉, 痰卽墜下, 功有萬全, 奪天地之造化也. 靑礞石一兩, 同焰硝一兩, 入鍋內火煆, 待硝盡, 候礞石如金色, 取用. 右細末, 急驚風身熱, 用薄荷汁入蜜調, 微溫服, 其藥自裹痰墜下, 從大便出, 如稠涕膠粘, 乃藥之功也. 次服去風ㆍ退熱ㆍ截驚等藥. 慢驚極危者, 用此藥以<a href='/formulas/cheongju-baegwonja'>靑州白元子</a>再硏爲末, 薑汁調煎如糊, 熟蜜調下, 其涎卽墜入腹, 次服蛇ㆍ蝎ㆍ蜈蚣ㆍ川烏等藥. ○此藥治急慢驚利痰之聖藥. 以器盛水吐痰, 水上以藥少許糝之, 痰隨藥而下, 須用木香湯調下. 《湯氏》 ○礞石雖利痰, 非胃家所好, 故以木香佐之, 能裹痰從大便出而無糞來, 不動藏府, 始知藥妙. 《入門》

Translation

It is greatly able to control wind-phlegm. Whether the fright wind is acute or chronic, when phlegm blocks the throat and rattles like a tide — this is called tidal drool — so that no medicine can be got past the throat and life hangs on a moment, only put this drug into the throat and the phlegm falls at once. Its effect is complete; it snatches back the workings of heaven and earth. Chlorite schist, 1 nyang, with nitre, 1 nyang: put them in a pot and calcine them in the fire until the nitre is used up and the schist has the colour of gold, then take it for use. Powder the above finely. For acute fright wind with a hot body, stir it into mint juice with honey added and give it lukewarm; the drug wraps the phlegm of itself and carries it down and out in the stool, thick as mucus and sticky as glue, and that is the drug working. Afterwards give the drugs that dispel wind, bring down fever and cut short convulsion. For a chronic case in extreme danger, use this drug with Cheongju-baegwonja 靑州白元子 reground to a powder, worked up with ginger juice and decocted to a paste, and send it down in boiled honey; the drool falls at once into the belly. Afterwards give snake, scorpion, centipede, aconite and the like. ○This drug is the sovereign remedy for freeing phlegm in acute and chronic fright wind. Fill a vessel with water and have the child spit phlegm into it; sprinkle a little of the powder on the water and the phlegm goes down with the drug. It must be sent down in a costus decoction. — Tangssi 湯氏 ○Chlorite schist frees phlegm, but it is not something the stomach likes, and so costus is added to assist it; it can wrap the phlegm and bring it out through the stool without faeces coming, and without disturbing the viscera — and so one comes to know the drug’s excellence. — Immun 入門 (Donguibogam · Soa)

Clinical commentary 臨床

One mineral. 靑礞石 is chlorite schist, calcined with an equal weight of saltpetre until the nitre has burnt away and the stone has taken a gold colour, then ground fine. The nitre is a processing agent and is gone from the finished powder; it is listed above because the corpus lists it in the other 礞石 formulas. The 入門 clause at the end is a piece of real pharmacological reasoning: the stone is hard on the stomach, so costus is given with it, and the claim is that the phlegm comes out without the bowel being purged. The picture it is written for is a child whose throat is full of noisy secretions and who cannot swallow — 痰塞咽喉, 其響如潮. That sound, during and after a seizure, is pooled saliva in a child who has stopped swallowing, and it clears when the child wakes. Where it is not that, it is airway obstruction, and the answer is positioning, suction and oxygen within minutes, not a mineral powder. The bowl-of-water demonstration — spit into water, sprinkle the powder, watch the sputum sink — is a clean piece of evidence about the behaviour of a dense powder in a bowl and none at all about what happens in a throat. The instruction that follows the chronic case is the one to read twice. Having given this, the text says to give snake, scorpion, centipede and 川烏 next. **The follow-on drugs named in this leaf include 川烏, aconite, which has almost no margin between an effect and a fatal arrhythmia, together with scorpion and centipede, both neurotoxic animal venoms with no measurable dose; and the chronic regimen adds 靑州白元子, which contains 川烏, 半夏 and 天南星. The patient is a child and the text gives no dose by weight anywhere. This must not be prepared.** The statement of what the chronic fright wind child actually needed is given with 雙金丸. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.