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

Pierce the Heavens Remaking Powder

Tongcheonjaejo-san

한글 통천재조산 · Pinyin Tong Tian Zai Zao San

通天再造散

The transcription writes 欝金 for 鬱金 and 虫 for 蟲; the corpus forms are printed. 黑大者, 煨, 炒 and 生 are preparations and are given in parentheses, The transcription runs 三錢炒三錢生欝金五錢 together without a break; the 生 is read as the preparation of the second three don of morning glory seed, giving 半生半炒, half raw and half stir-fried, which is how the Immun states this formula, and the curcuma then stands plain at five don. The six don of white morning glory seed is given as two halves, 三錢炒 and 三錢生, and the gram figure is the sum. The cross-reference 方見風門 is a sochu span and 防風通聖散 is linked. The leaf carries two source labels, 入門 for the formula and 丹心 for the ○ clause.

Composition 構成

Jogak Zao Jiao
皂角 조각 · Gleditsia Pod

60 g
Chief 君

皂角刺(黑大者) 一兩半 — gleditsia spine, the big black ones
Daehwang Da Huang
大黃 대황 · Rhubarb

40 g
Chief 君

大黃(煨) 一兩 — rhubarb, roasted in ashes
Baekgyeonu Bai Qian Niu
白牽牛 백견우 · White Morning Glory Seed

24 g
Deputy 臣

白牽牛(頭末) 三錢(炒)ㆍ三錢(生) — the first flour of the seed, 3 don stir-fried and 3 don raw
Ulgeum Yu Jin
鬱金 울금 · Curcuma Tuber

20 g
Deputy 臣

鬱金五錢 — curcuma tuber
Ju Jiu
酒 주 · Wine

—
Envoy 使

好酒 — good wine as the draught, at dawn facing east

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

Treats the same as the formula above — the great wind leprous sore
Takes the bad matter and the worm accumulation out through the stool — the lower route
Two or three don in good wine at dawn, facing east, purging the same day
The colour of what comes out is read for how old the disease is

Indications 主治

Pattern-based

在下者 — disease seated below, taken by the stool route
惡物ㆍ膿ㆍ虫 — bad matter, pus and worms purged downward
Black worms for a disease of many years, red for one of recent years

Biomedical correlates

Hansen's disease (leprosy) — historical
Cathartic purging, with intestinal parasites incidentally expelled

Source text 原文

Donguibogam 東醫寶鑑

治同上. 皂角刺(黑大者) 一兩半, 大黃(煨) 一兩, 白牽牛(頭末) 三錢(炒)ㆍ三錢(生), 鬱金五錢. 右爲末, 每二錢或三錢, 早晨面東好酒調下, 當日利下惡物, 或膿或蟲. 《入門》 ○服藥後泄出蟲, 視其色, 如蟲黑色乃是多年, 赤色是爲近年. 三四日後又進一服, 直候無蟲乃止. 後取<a href='/formulas/bangpungtongseong-san'>防風通聖散</a><span class='sochu'>方見風門</span>加苦參ㆍ天麻ㆍ蟬蛻煎服調理, 痛斷滋味. 《丹心》

Translation

Treats the same as above. Gleditsia spine, the big black ones, 1 nyang 5 don; rhubarb roasted in ashes 1 nyang; the first flour of white morning glory seed, 3 don stir-fried and 3 don raw; raw curcuma tuber 5 don. Powder the above; two or three don to a dose, stirred into good wine at early morning facing east, and the same day it purges out the bad matter, either pus or worms. — Immun 入門 ○ After the medicine is taken, worms come out in the stool; look at their colour, and if the worms are black the disease is of many years, if red it is of recent years. Three or four days later give another dose, and keep on until there are no more worms, then stop. Afterwards take Bangpungtongseong-san — the formula is given in the Wind chapter — with sophora root, gastrodia and cicada moulting added, decocted and taken to set the patient in order, cutting off rich flavours strictly. — Dansim 丹心 (Donguibogam · Jechang)

Clinical commentary 臨床

The lower of the two routes: 在下者以通天再造散取惡物虫積於穀道中出. Gleditsia spine and ash-roasted rhubarb with morning glory seed, half of it raw, is a hard cathartic, and the dose is taken at dawn facing east in good wine so that it carries. The diagnostic reading of the stool is the striking part. Worms are expected, the colour is read for the age of the disease, and the course is repeated every three or four days 直候無蟲乃止, until no more come. Intestinal parasites were close to universal, so a purge would reliably produce them, and the chapter has taken that as confirmation that the 大風 was being driven out. Afterwards the patient is handed to Bangpungtongseong-san with sophora root, gastrodia and cicada moulting added. **Contains rhubarb and white morning glory seed as a drastic purgative, and must not be prepared.** Repeated cathartics on this scale in a chronically ill patient cause dehydration and electrolyte loss. Leprosy is not an intestinal worm disease; it is a mycobacterial infection of nerve and skin, treated with multidrug therapy. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.