Formulas · Text · Donguibogam 東醫寶鑑

Appendix on the Aged

Bu-yangno

한글 부양로 · Pinyin Fu Yang Lao

What old age is, how the old are to be treated, and what they should eat

附養老

A short appendix to the Body chapter, and the book's only pages given to the old as a class of patient. It opens with the Immun's picture of age: the stirring qi between the kidneys, big as the head of a chopstick, that has driven the whole body day and night, and what happens when the essence and blood that fed it run down — the seven orifices go contrary, the eyes dry when they should weep and weep when they should laugh, the nose runs, the ears ring, the mouth dries with food and drools in sleep, the bladder leaks, the bowel binds or runs, the day is spent sleeping and the night awake. Then the rule of treatment, which is caution: no bitter cold medicines, no great sweating, vomiting or purging, only mild and level formulas — and the one sign that says an old person's disease is advancing, which is the urine growing scant. The appendix ends with what the exhausted should eat — congee, milk, and the tonics of the Body chapter — and with two recipes from the Jonghaeng: a woman's milk boiled with wine before dawn, and cow's milk boiled with rice.

2.1 Old Age Comes from the Decline of Blood 老因血衰

2.1.1

Source원문

夫人兩腎中間, 白膜之內, 一點動氣, 大如筯頭, 鼓舞變化, 大闔周身, 熏蒸三焦, 消化水穀, 外禦六淫, 內當萬慮, 晝夜無停. 年老, 精血俱耗, 平居七竅反常, 啼哭無淚, 笑反有淚, 鼻多濁涕, 耳作蟬鳴, 喫食口乾, 寐則涎溢, 溲尿自遺, 便燥或泄, 晝則多睡, 夜臥惺惺不眠, 此老人之病也. 《入門》

Translation영역

Between a person's two kidneys, within a white membrane, is one point of stirring qi, big as the head of a chopstick, that drums and moves and transforms, opens and closes the whole body, steams the three burners, digests water and grain, wards off the six excesses without and bears the ten thousand cares within, day and night without stopping. In old age the essence and blood are both spent, and in ordinary life the seven orifices go contrary: weeping without tears, laughing with tears instead; the nose full of turbid mucus, the ears sounding like cicadas; the mouth dry with food, drool overflowing in sleep; the urine leaking of itself, the stool dry or else loose; much sleep by day, and lying awake and alert at night. This is the disease of the old.

Clinical note임상 주석

The chapter's one description, and it is complete: dry eyes, tears at the wrong time, catarrh, tinnitus, dry mouth, drooling, incontinence, constipation or diarrhoea, and the sleep cycle turned round. 七竅反常 — the seven orifices go contrary — is the Immun's summary, and every item is what the Qi chapter's 4.6.1 stirring qi did when it was full. The section's title says blood, and the passage says essence and blood; 2.3 will say the treatment is warm supplementation of both.

Immun 入門

2.2 Treating Disease in the Old 老人治病

2.2.1

Source원문

年老之人, 雖有外感, 切忌苦寒藥, 及大汗吐下, 宜以平和之藥調治.

Translation영역

In the aged, even where there is an external contraction, bitter cold medicines are strictly forbidden, and so are great sweating, vomiting and purging; mild and level medicines should regulate and treat.

Clinical note임상 주석

The rule, and it forbids the three methods the Miscellaneous Disorders volume opens with — sweat, vomit, purge — as well as the cold formulas the Fire chapter is built on. An old person with a fever is not given the treatment a young one gets, because the qi that would carry it is the qi 2.1 said was spent. The Pulse Diagnosis chapter's 4.21 and the Medicine Use chapter's 5.33 said the same for the pulse and the dose; here it is said for the method.

Immun 入門

2.2.2

Source원문

老人覺小水短少, 卽是病進, 宜服却病延壽湯. 病後虛弱, 宜增損白朮散. 小便頻數者, 腎氣丸, 去澤瀉, 加茯神ㆍ益智方見虛勞. 大便乾燥者, 宜疏風順氣丸ㆍ蘇麻粥方幷見大便部. 痰病, 宜六君子湯方見痰飮ㆍ三子養親湯方見咳嗽ㆍ潤下丸ㆍ二賢散方幷見痰飮. 《入門》

Translation영역

Where an old person notices the urine growing short and scant, that is the disease advancing — Ward Off Disease and Extend Life Decoction should be taken. For weakness after illness, Modified White Atractylodes Powder. For frequent urination, Kidney Qi Pill with the alisma removed and poria-with-pine-root and alpinia added formula in the Vacuity Taxation chapter. For dry stool, Dispel Wind and Order the Qi Pill and Perilla and Hemp Seed Congee both formulas in the Stool chapter. For phlegm disease, Six Gentlemen Decoction formula in the Phlegm chapter, Three Seeds Nourish the Parents Decoction formula in the Cough chapter, Moisten and Descend Pill and Two Worthies Powder both formulas in the Phlegm chapter.

Clinical note임상 주석

Four complaints of age with a formula each, and the first is the one to watch: 小水短少, 卽是病進 — scant urine is the disease advancing. Falling urine output in the old is the sign the Immun chose as its early warning, and the formula for it is registered here. 三子養親湯, Three Seeds Nourish the Parents — mustard, perilla and radish seed — is the tradition's phlegm formula named for the old, and its name says who it was made for.

Immun 入門

2.3 Protecting and Nourishing the Old 老人保養

2.3.1

Source원문

若一向憊乏之人, 則當加溫補, 調停饘粥以爲養. 宜補中益氣湯ㆍ異功散方幷見內傷部ㆍ衛生湯ㆍ固眞飮子方幷見虛勞. 且於養性延年之藥, 皆可選用. 又人乳ㆍ牛乳, 常服最佳. 《入門》

Translation영역

For one who is exhausted through and through, warm supplementation should be added, and thick and thin congee arranged for nourishment. Supplement the Centre and Boost the Qi Decoction and Different Achievement Powder both formulas in the Internal Damage chapter, and Guard Life Decoction and Secure the Truth Drink both formulas in the Vacuity Taxation chapter are appropriate. And among the medicines for nurturing the nature and extending the years, any may be chosen. Also, human milk and cow's milk, taken regularly, are best of all.

Clinical note임상 주석

饘粥 — thick congee and thin — is named before any formula, and milk after all of them. The appendix's nourishment is the Essence chapter's 3.8 and the Body chapter's 1.26 put together: food first, the Body chapter's tonics second, and two recipes for the milk below.

Immun 入門

2.3.2

Source원문

服人乳法. 無病婦人乳汁二盞, 好淸酒半盞, 入銀器, 或石器內同滾, 頓服. 每日, 五更時一服. 《種杏》

Translation영역

The method of taking human milk. Two cups of milk from a woman in good health and half a cup of good clear wine, brought to the boil together in a silver or stone vessel, and taken at a draught; every day one dose at the fifth watch.

Clinical note임상 주석

Human milk boiled with wine before dawn — the fifth watch is three to five in the morning — and the Qi chapter's simples at 4.29 and the Body chapter's at 1.27 both listed human milk among the medicinals for long life. The Jonghaeng gives the dose.

Jonghaeng 種杏

2.3.3

Source원문

牛乳粥, 常服, 最宜老人.

Translation영역

Milk Congee, taken regularly, is best of all for the old.

Clinical note임상 주석

The appendix ends on rice boiled in milk, and the Body chapter's last word at 1.31 was the navel. Between them the Inner Landscape's first volume closes on the two things the Bogam thought kept an old person alive: warmth at the centre, and something plain to eat.

Jonghaeng 種杏

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 1, Appendix on the Aged chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.