Formulas · External Application 外用 · Jeongyo (精要)

Numinous Response Paste

Yeongeung-go

한글 영응고 · Pinyin Ling Ying Gao

靈應膏

This is the leaf 癰疽門 points at. Its entry there carries the indications and the alternative name 一名麥飯石膏 but no composition, referring it away with the interlinear note 方見雜方; this leaf supplies the composition and closes that composition-less cross-reference, and it confirms the alternative name, since 麥飯石 is the chief drug here. 白麥飯石 has no identifier in the herb list and is left out of the ingredients, which is the one real gap in this entry — the name drug of the formula is unregistered. 猪蹄湯, the pig's-trotter broth, is the wash used before the paste is laid on and is not an ingredient; the silver or stone vessel, the bamboo paddy and the goose quill are apparatus. 凣 is printed 凡 by the usual normalisation; 白歛 keeps the transcription's form.

Composition 構成

Nokgak Lu Jiao
鹿角 녹각 · Deer Antler (ossified)

160 g
Deputy 臣

burnt with the nature preserved (燒存性) and powdered; 4 nyang of the powder · CITES-listed deer material
Baengnyeom Bai Lian
白斂 백렴 · Ampelopsis Root

80 g
Assistant 佐

白歛, powdered; 2 nyang of the powder
Cho Cu
醋 초 · Vinegar

—
Envoy 使

好米醋, good rice vinegar, simmered in a silver or stone vessel to a fish-eye boil; the vehicle the powders are worked into

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 five eruptions, 癰疽, malignant sores, scrofula, hard nodes and breast abscess — laid on as a plaster
Said to disperse what has not yet made pus and open what has, so that dead flesh lifts easily and new flesh comes early
Painted round the whole reddened area with a goose quill, one opening the size of a coin being left for the pus and blood to come out

Indications 主治

Pattern-based

五發 and 癰疽
瘰癧 and 結核 — scrofula and hard nodes
乳癰 — breast abscess

Biomedical correlates

Abscess and carbuncle — topical
Tuberculous or suppurative cervical lymphadenitis — topical
Breast abscess, including puerperal — topical

Source text 原文

Donguibogam 東醫寶鑑

白麥飯石(火煆醋淬十餘次, 硏令極細)ㆍ鹿角(燒存性)ㆍ白歛並爲細末. 右取石末ㆍ白歛末各二兩, 鹿角末四兩, 並要極細, 不細則反痛. 取好米醋入銀石器, 煎令魚眼沸, 却入三味藥末, 竹篦子不住手攪, 熬一二時, 稀稠得所, 傾出候冷. 先以猪蹄湯或藥水洗去膿血, 挹乾, 鵝翎拂藥塗四圍, 凡赤處盡塗之, 但留一口如錢大以出膿血. 如藥乾, 以醋拂濕. 初便一日洗換, 十日後兩日一換, 其效如神. 治癰疽ㆍ惡瘡ㆍ瘰癧ㆍ結核ㆍ乳癰. 《精要》

Translation

White barley-rice stone (calcined in the fire and quenched in vinegar ten times and more, then ground exceedingly fine), deer antler (burnt with its nature preserved) and ampelopsis, all made into fine powders. Take 2 nyang each of the stone powder and the ampelopsis powder and 4 nyang of the antler powder; all must be exceedingly fine, for if they are not fine they cause pain instead. Take good rice vinegar, put it in a silver or stone vessel and simmer it to a fish-eye boil, then put in the three powders and stir without letting the hand rest, with a bamboo paddy; render it one or two hours until it is neither thin nor thick but right, and pour it out to cool. First wash the pus and blood away with pig's-trotter broth or a medicated water and blot it dry; then take up the medicine with a goose quill and paint it round about, covering the whole of the reddened area, but leave one opening the size of a coin for the pus and blood to come out. If the medicine dries, wet it by brushing vinegar on. At first wash and change it once a day; after ten days, change it every second day. Its effect is as if divine. It treats 癰疽, malignant sores, scrofula, hard nodes and breast abscess. — Jeongyo 精要 (Donguibogam · Japbang)

Clinical commentary 臨床

The alternative name, 麥飯石膏, is the informative one: barley-rice stone, a speckled granitic rock whose grain was thought to look like cooked barley, ground and worked into the base. It is the plaster of this family that the tradition associated with the neck — 瘰癧 and 結核, the chains of hard glands — as much as with abscesses. 惡肉易去, 新肉早生 sets out the staging the whole chapter works by: the dead tissue has to come away before the wound can fill in. That sequence is correct and is what debridement and secondary healing describe. A plaster does not accomplish it; keeping a wound covered while it happens is the part a dressing can honestly claim. With the composition in hand, this turns out to be the odd one of the six: not an oil-and-lead plaster at all, but three mineral and bone powders worked into hot vinegar. There is no lead and no mercury in it. The repeated calcination and vinegar quenching of the stone, ten times and more, is what makes it grindable; the insistence that the powders be 極細, exceedingly fine, 不細則反痛 — not fine, and it hurts instead — is a real observation about putting a gritty paste on an inflamed surface. The dressing method is the best thing in the chapter. Paint the whole red area but leave a coin-sized opening for the pus to drain, wash and change daily at first and every second day later, and keep the paste from drying out. That is drainage plus a moist dressing plus regular wound toilet, and those are the three things that actually help an abscess that has opened. The stone and the antler are doing nothing; the regimen around them is sound. **The antler is a deer material from a CITES-listed group, and an abscess that has not opened needs incision and drainage and antibiotics, not a paste.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.