Formulas · Clear Heat 淸熱 · Uihak Immun (醫學入門)

Pus Piercing Powder

Tunong-san

한글 투농산 · Pinyin Tou Nong San

透膿散

蛾繭殼, the empty cocoon the moth has come out of, is the whole of the formula, taken burnt with its nature kept, one or two shells to a dose; it is registered as a part-name of 蠶繭, jamgyeon. The transcription prints 蠒 for 繭 and 癕 for 癰; the corpus forms are printed above. 燒存性, burnt with the nature kept, is charring short of ash, and 一時 is a double hour.

Composition 構成

Jamgyeon Can Jian
蠶繭 잠견 · Silkworm Cocoon

—
Chief 君

蛾繭殼(燒存性) — the empty cocoon the moth has left, burnt with its nature kept; one or two shells to a dose

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

Opens an abscess that will not burst, without needle or knife
One dose said to break it so the pus comes out within about an hour
One cocoon said to open one mouth in the sore, two cocoons two

Indications 主治

Pattern-based

諸癰瘡 — abscesses and sores of every kind
附骨疽不潰 — bone-adherent abscess that will not burst

Biomedical correlates

Osteomyelitis with subperiosteal abscess
Deep abscess requiring drainage
Septic arthritis with collection

Source text 原文

Donguibogam 東醫寶鑑

治諸癰瘡及附骨疽不潰者. 不用鍼刀, 一服卽破出膿. 取出蛾繭殼(燒存性), 好酒調下. 一時許便出瘡口. 服一枚出一口, 服兩枚出兩口, 神效. 《入門》

Translation

Treats abscesses and sores of every kind, and the bone-adherent abscess that will not burst. Without needle or knife, one dose breaks it at once and the pus comes out. Take the cocoon shells from which the moths have emerged, burnt with their nature kept, and send them down with good wine. In about an hour a mouth opens in the sore. One cocoon taken opens one mouth, two cocoons two — a divine effect. — Uihak Immun 入門 (Donguibogam · Ongjeo)

Clinical commentary 臨床

One ingredient, taken by mouth in wine, and the claim is extraordinary: that it will open a deep abscess without a blade, and that the number of openings matches the number of cocoons swallowed. 服一枚出一口, 服兩枚出兩口 is sympathetic reasoning carried as far as it goes — the cocoon is the thing a moth has broken out of, so swallowing one is expected to make the body break something open in the same way. 附骨疽, the abscess stuck to the bone, is what the formula is really aimed at, and it is the hardest thing in the chapter. It is osteomyelitis or a subperiosteal collection: deep, slow, out of reach of any plaster, and the one presentation where 不用鍼刀, no needle and no knife, would have been a real relief rather than a boast. That is why a one-drug remedy with a tall claim was kept. The principle at the bottom of it is the chapter's own and is still correct — pus that has collected has to be let out, and it will not resolve while it sits. Nothing taken by mouth does that. **Bone and deep-tissue infection needs imaging, surgical drainage and a long course of antibiotics; delay costs bone.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.