寶鑑Bogam

Formulas · Purge Downward 瀉下 · Uihak Immun (醫學入門)

Pus Striking Powder

Tanong-san

한글 타농산  ·  Pinyin Da Nong San

打膿散

虛者三箇, 實者五箇 — the count of momordica seeds is set by the patient rather than fixed, three for a vacuous and five for a replete one, and the seeds are therefore given without a weight. 當歸尾 is the tail roots of the angelica, registered under 當歸. 木鼈子 is printed with 鼈 here where the herb dictionary heads it 木鼈子. 三分半 is read as 3 fun 5 ri, a decimal half of a fun. The transcription prints 癕 and 為; 癰 and 爲 are printed above.

Composition 構成

Total 38.8 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

  • 癰疽不放膿出 — the swelling will not let the pus out
  • 大便見膿, 小便見血 — pus in the stool and blood in the urine, taken as the sign of effect

Biomedical correlates

  • Abscess with systemic toxicity
  • Deep abscess — historical purgative management
  • Suppurative infection with constipation

Source text 原文

Donguibogam 東醫寶鑑

治癰疽不放膿出. 大黃 五錢, 芒硝 一錢半, 金銀花ㆍ黃芩ㆍ黃連ㆍ黃栢ㆍ當歸尾 各五分, 甘草節ㆍ穿山甲(焦) 各三分半, 木鼈子 虛者三箇, 實者五箇. 右剉, 作一貼, 水煎五更服. 大便見膿, 小便見血爲效. 《入門》

Translation

Treats an abscess that will not let its pus out. Rhubarb 5 don; mirabilite 1 don 5 fun; honeysuckle, scutellaria, coptis, phellodendron and the tail roots of Korean angelica, 5 fun each; licorice node and scorched pangolin scale, 3 fun 5 ri each; momordica seed, three seeds for a vacuous patient and five for a replete one. Cut the above, make one packet, decoct in water and take at the fifth watch. Pus showing in the stool and blood in the urine is the sign that it has worked. — Uihak Immun 入門 (Donguibogam · Ongjeo)

Clinical commentary 臨床

The draining counterweight to the 托裏 formulas, and the most aggressive version of it in this part of the chapter. Rhubarb at 5 don with mirabilite behind it is a full purgative dose; the three 黃 bitters and honeysuckle are the toxin-resolving layer at a fifth of that weight; pangolin scale and momordica seed are the chapter's two piercing drugs, meant to open a path; the angelica tail roots and licorice node are the blood-moving and sore-directed forms of two ordinary medicinals. 不放膿出 — the swelling will not release its pus — is the problem the whole group of leaves around this one is addressing, and this is the only one that answers it from the inside and downward rather than by opening the skin. 五更, the fifth watch, is the standard hour for a purgative, so that it acts after waking. 大便見膿, 小便見血爲效 should be read as what it is: a historical criterion of success, not a goal. Blood in the urine after a dose of anything is a reason to stop, and pus in the stool means something quite different from a resolving abscess. **Pangolin scale is from a protected species and must not be used; momordica seed is toxic; and the purgative pair here is strong enough to be dangerous in anyone septic or dehydrated.** An abscess that is not draining needs source control, and systemic toxicity needs antibiotics and fluids, not purging. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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