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

Moon Toad Pill

Wolseom-hwan

한글 월섬환 · Pinyin Yue Chan Wan

月蟾丸

糞蛆, the dung maggots that are the actual substance of the pill, has no entry in herbs.yaml and is therefore named here and in the source text rather than entered as an ingredient; the toad that serves as their feed is entered, since it is the carrier of whatever the preparation retains. The urine used to steep the toad is a step in the preparation and is left in the source text. 無辜疳 appears nowhere else in the corpus.

Composition 構成

Hama Ha Ma
蝦蟆 하마 · Toad (toxic)

—
Chief 君

蝦蟆一箇, one toad, killed and steeped in urine in a bucket as the substrate the maggots feed on · see the note
Sahyang She Xiang
麝香 사향 · Musk (prohibited)

1 g
Deputy 臣

1 ja, powdered in with the dried maggots · CITES Appendix I

Total 1 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

Given for 無辜疳, with the stated sequence that one dose relieves the vexation, a second stops the thirst and a third stops the diarrhoea
A toad is killed and steeped in urine, maggots are let feed on it for a day and a night, and the maggots are then washed in running water, dried on a tile and made into pills with musk

Indications 主治

Pattern-based

無辜疳 — wasting with glandular swelling in a young child
Deficiency vexation with thirst and diarrhoea in the course of 疳

Biomedical correlates

Historically used for the wasting and glandular disease read today as tuberculous cervical adenitis in a malnourished child
Recorded for historical reference only

Source text 原文

Donguibogam 東醫寶鑑

治無辜疳. 蝦蟆一箇, 打殺, 置桶中, 以尿浸之, 却取糞蛆一杓入內, 任蛆食一日夜, 取出, 以布袋繫之於急流水中, 浸一宿, 瓦上焙乾, 入麝香一字, 爲末, 飯丸麻子大. 每三十丸, 米飮下. 一服虛煩退, 再服渴止, 三服瀉住. 《入門》

Translation

Treats the blameless wasting disease. Take one toad, kill it, put it in a wooden bucket and steep it in urine; then take a ladleful of dung maggots and put them in, and let the maggots feed for a day and a night. Take them out, tie them in a cloth bag and steep the bag overnight in swift-running water, then dry them on a tile over heat. Add 1 ja of musk, powder it all, and make pills the size of hemp seed with cooked rice. Thirty pills each time, taken down with thin rice gruel. One dose makes the deficiency vexation withdraw, a second stops the thirst, a third stops the diarrhoea. — Immun 入門 (Donguibogam · Soa)

Clinical commentary 臨床

**Contains toad, whose skin and parotoid glands carry bufadienolides — cardiac glycosides of the same class as digitalis. The patient is a child, the text gives no dose by weight anywhere, and this must not be prepared.** This is the statement for the whole 疳瘡 section and 玉蟾散, 十全丹, 二連丸 and 化䘌丸 refer back to it. Toad venom is not a theoretical hazard: 蟾酥 and the dried-toad preparations made from it have killed healthy adults outright, by ventricular arrhythmia, within hours of a single dose — the published fatalities include aphrodisiac preparations sold as "love stone" and traditional remedies taken by mouth. Bufalin and cinobufagin block the sodium-potassium pump exactly as digoxin does, and the toxic dose sits close to any dose that does anything at all. An infant has roughly 250 ml of blood and no margin. Here the toad is dried over heat rather than reduced to ash, so the glycosides are substantially intact. **The pill is made of dung maggots.** They are taken by the ladleful from faeces, allowed to feed on a toad carcass steeped in urine, washed in a stream, dried and powdered. Rinsing and heating on a tile will kill some of what they carry; it will not sterilise them. Fly larvae raised in faeces are a route for every enteric pathogen there is, and the child being fed thirty of these pills at a time already has the diarrhoea the formula promises to stop. **Musk is from a CITES Appendix I species** — see 銅靑散 in this same section. 無辜疳 — the "blameless" wasting — reads as tuberculous cervical adenitis: the chronically ill, wasted young child with matted, eventually suppurating neck glands, fever and night sweats. In a malnourished population that is extremely common and it is curable now, with six months of standard anti-tuberculous chemotherapy, at a cost of a few dollars. Nothing in this pill touches it, and on the larger point that none of these formulas is food, see 立效散 in this same section. The stated sequence — vexation gone with the first dose, thirst with the second, diarrhoea with the third — is worth noticing as a claim rather than as evidence. It is the shape of a confident prescription, not of an observation, and no formula acts on three separate symptoms in that order. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.