寶鑑Bogam

Formulas · Warm the Interior 溫裏 · Seui Deukhyobang (世醫得效方)

Sulphur Powder for the Corpse-Like Faint

Yuhwang-san

한글 유황산 (구급)  ·  Pinyin Liu Huang San

硫黃散

Registered as 硫黃散 with the variant glyph corrected (the transcription writes 硫黄). The name collides with yuhwang-san-bi, the 回春's 生硫黃ㆍ杏仁ㆍ輕粉 ointment smeared on the nose at bedtime for wine-nose and washed off in the morning; that is a topical for a skin complaint and this is two minerals heated in wine and poured down an unconscious patient, so they are different formulas and this one takes the chapter tail. The transcription writes the variant 㷔 for 焰 in both places — 㷔硝 and 覺㷔起 — and leaves a space after 㷔硝; 焰 is printed, following the corpus, which writes 焰硝 in twenty-one places and has no instance of 㷔. 盖 is printed as the transcription has it, which is also the corpus majority.

Composition 構成

Total 60 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

Indications 主治

Pattern-based

  • 尸厥 — the corpse-like faint, the patient lying as if dead and knowing nothing
  • 奄然死去, 不省人事 — suddenly gone as if dead, with no awareness
  • 命在頃刻 — life hanging on the moment

Biomedical correlates

  • Sudden collapse with unresponsiveness — cardiac arrest, deep syncope, hypothermia

Source text 原文

Donguibogam 東醫寶鑑

治尸厥, 奄然死去, 不省人事, 命在頃刻. 硫黃 一兩, 焰硝 半兩. 右細硏如粉, 分作三服. 每用好酒一盞同煎, 覺焰起, 傾於盞內, 盖着, 候溫灌服之. 如人行五里, 又進一服. 不過三服卽甦. 《得效》

Translation

Treats the corpse-like faint, where the patient has suddenly gone as if dead, has no awareness, and life hangs on the moment. Sulphur 1 nyang, saltpetre 5 don. Grind them fine to a powder and divide into three doses. For each dose boil it with one cup of good wine; when the flame is seen to rise, pour it into a cup, cover it, wait until it is warm and pour it into the mouth. After the time it takes a man to walk five li, give a second dose; it takes no more than three doses before the patient revives. — Deukhyo 得效 (Donguibogam · Gugeup)

Clinical commentary 臨床

Two minerals and nothing else. Sulphur is the book's hottest yang drug, the thing reached for when the body has gone cold, and saltpetre is here as the oxidiser that makes it burn: 每用好酒一盞同煎, 覺焰起 — boil the powder in a cup of wine until the flame is seen to rise. The flame is the point of the preparation, not an accident of it, and it is how the practitioner knew the medicine was ready. Sulphur and saltpetre are two of the three ingredients of black powder, and heating them together is a deflagration, not a decoction. In alcohol the mixture burns, and what comes off is sulphur dioxide and oxides of nitrogen, which are acutely irritant to the airway; what is left in the cup is a mixture of sulphates and nitrites. Nitrite swallowed causes methaemoglobinaemia, which stops the blood carrying oxygen — exactly the wrong thing for a patient who is already not breathing. The patient described is unresponsive with life hanging on the moment, and 候溫灌服之 means waiting until the liquid is merely warm and then pouring it into the mouth. Someone in that state has no gag reflex and the liquid goes into the lungs. The airway comes first — the modern response to a collapsed, unresponsive patient is to open the airway, check for breathing, call for help and begin CPR, and to give nothing by mouth. **Contains sulphur and saltpetre, heated together until they catch light. The mixture is two thirds of black powder; preparing it as described is an ignition and a source of toxic fumes, and nitrite taken by mouth causes methaemoglobinaemia. This must not be prepared or taken.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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