Formulas · Purge Downward 瀉下 · Uihak Jeongjeon (醫學正傳)

Realgar Pill

Unghwang-hwan

한글 웅황환 · Pinyin Xiong Huang Wan

雄黃丸

The Donguibogam has two formulas named 雄黃丸. The other, from 易老, is registered as unghwang-hwan and is built on 雄黃ㆍ赤小豆ㆍ丹參ㆍ衛矛; this is the 正傳 formula in the abscesses chapter, built on 雄黃ㆍ鬱金ㆍ皂角ㆍ全蝎ㆍ巴豆肉ㆍ麝香, and it takes the chapter tail. The transcription writes 欝金 for 鬱金; the corpus form is printed. 全蝎 is printed as both this transcription and the corpus have it and is registered under 全蠍, and 菉豆 is the corpus form, the mung bean naming only the size of the pill and not an ingredient. The fourteen croton kernels are a count item and the musk is 少許, a quantity at discretion, so neither carries a gram figure. 治同上 refers to the indication of 飛龍奪命丹 in the leaf immediately above — 疔瘡 and 惡瘡.

Composition 構成

Unghwang Xiong Huang
雄黃 웅황 · Realgar

4 g
Chief 君

雄黃一錢 — realgar, an arsenic sulfide
Padu Ba Dou
巴豆 파두 · Croton Seed

—
Chief 君

巴豆肉十四箇 — fourteen croton kernels, a count item; violently toxic
Ulgeum Yu Jin
鬱金 울금 · Curcuma Tuber

4 g
Deputy 臣

鬱金一錢
Jogak Zao Jiao
皂角 조각 · Gleditsia Pod

4 g
Assistant 佐

皂角一錢
Jeongal Quan Xie
全蠍 전갈 · Scorpion (toxic)

4 g
Assistant 佐

全蝎一錢 — scorpion, toxic
Sahyang She Xiang
麝香 사향 · Musk (prohibited)

—
Envoy 使

麝香少許, a little — musk, a CITES-protected material

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 2 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

Treats the same as the formula above — the nail-sore and the malign sore
Drives the toxic heat down and out through the stool
Twenty mung-bean pills to a dose, sent down with clear tea

Indications 主治

Pattern-based

疔瘡 and 惡瘡 — the nail-sore and the malign sore
毒熱 — toxic heat to be taken downward
毒氣攻心 — the toxic qi attacking the heart, in the 疔疽治法 sequence this formula belongs to

Biomedical correlates

Furuncle and carbuncle with systemic signs — historical
Deep pyogenic skin infection — historical

Source text 原文

Donguibogam 東醫寶鑑

治同上. 雄黃ㆍ鬱金ㆍ皂角ㆍ全蝎各一錢, 巴豆肉十四箇, 麝香少許. 右末, 滴水爲丸菉豆大. 茶淸下二十丸. 《正傳》

Translation

Treats the same as above. Realgar, turmeric, gleditsia pod and whole scorpion, 1 don each; croton kernel, fourteen pieces; musk, a little. Powder the above, drip water in and make pills the size of a mung bean. Twenty pills sent down with clear tea. — Jeongjeon 正傳 (Donguibogam · Ongjeo)

Clinical commentary 臨床

Six drugs and a short leaf, and its place is set by the 疔疽治法 passage rather than by anything in the text: 急用飛龍奪命丹或雄黃丸下之去其毒熱, 次服化毒丸及二活散 — use 飛龍奪命丹 or this to take the toxic heat down, then 化毒丸 and 二活散 after. So this is the purging step of a four-stage sequence, and 下之 is literal. Fourteen croton kernels in a batch of pills taken twenty at a time is a working purgative dose. Realgar heads the formula and gives it the name, with turmeric, gleditsia pod and whole scorpion at a don each and a little musk. Clear tea as the vehicle is the usual direction for a pill that is meant to go down rather than disperse outward. **Contains realgar, which is an arsenic sulfide, croton kernel, which is a violent purgative and vesicant, and scorpion, which is toxic. Musk is a CITES-protected material. This must not be prepared.** Realgar converts to absorbable arsenic in the gut and accumulates; croton at this dose produces severe watery diarrhoea with the fluid and electrolyte loss that goes with it, in a patient who is already systemically unwell from an infection. The 疔 this is for needs drainage and an antibiotic. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.