寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

Worms

Chung

한글 충  ·  Pinyin Chong

The three corpses, the nine worms, and the consumption worm — what damp heat breeds in the gut, how it is read from the lip and the pulse, and the one disease in the book the tradition knew was caught from another person

蟲

The longest chapter of the Inner Landscape and the strangest. It opens with the Daoist three corpse-worms that live in brain, chest and belly and are said to want a person to fail, and ends with moxa on the lumbar dimples at midnight on a gyehae day. Between the two lies a careful parasitology: the nine worms of the Waitai with their shapes and the symptom each causes, the five viscera's worms, the damp heat that breeds them, the pulses that find them, and the signs on the face — the crab's-claw thread on the lip, the blue-black ring under the eye, the mass that cannot be felt when pressed, the child who eats well and gains nothing. The dosing rules are the chapter's own: worms rise in the first half of the month and sink in the second, so take the medicine before the full moon; bait them up with fat meat and sugar first; and tell the patient nothing, because the worm is held to understand. The last third turns to 勞瘵, taxation consumption — tuberculosis — which the Bogam treats as a worm and as an infection: it passes from the dead to the living, a household can be wiped out by it, the weak should not enter a consumptive's house, and when the worm comes out it is to be burnt with tongs, bottled, buried in the mountains, and the bedding burnt after it.

14.1 The Three Corpse-Worms 三尸蟲

14.1.1
Source원문

中黃經曰, 一者上蟲居腦中, 二者中蟲居明堂, 三者下蟲居腹胃, 名曰彭琚ㆍ彭質ㆍ彭矯也. 惡人進道, 喜人退志. 上田乃元神所居之宮, 惟人不能開此關, 被尸蟲居之, 故生死輪廻, 無有了期. 若能握元神棲于本宮, 則尸蟲自滅, 眞息自定. 所謂一竅開而萬竅齊開, 大關通而百骸盡通, 則天眞降靈, 不神之神所以神也. 《養性書》

Translation영역
The Zhonghuang Jing says: the first is the upper worm, which lives in the brain; the second is the middle worm, which lives in the bright hall; the third is the lower worm, which lives in the belly and stomach. They are named Peng Ju, Peng Zhi and Peng Jiao. They hate a person to advance in the Way and delight in a person's resolve failing. The upper field is the palace where the original spirit dwells; only because a person cannot open this pass is it occupied by the corpse-worms, and so there is the wheel of birth and death with no end to it. If one can grasp the original spirit and settle it in its own palace, the corpse-worms perish of themselves and the true breath settles of itself. As the saying goes: when one orifice opens the ten thousand orifices open together, and when the great pass is through the hundred bones are all through — then the heavenly truth descends in numinous power, and what is not spirit is thereby spirit.
Clinical note임상 주석
The three corpses of Daoist practice, surnamed Peng — parasites of the spirit rather than the gut, and they are said to want the practitioner to give up. The Body chapter's 1.9 gave the three cinnabar fields they occupy, and 上田, the upper field, is the brain of 1.9.1. The cure here is not a drug: hold the original spirit in its palace and they die.

Yangseongseo 養性書

14.1.2
Source원문

去三尸蟲, 宜去三尸蟲元ㆍ又方.

Translation영역
To expel the three corpse-worms, Expel the Three Corpse-Worms Pill and the second formula are appropriate.
Clinical note임상 주석
Both registered, and both built on raw lacquer — the chapter's answer to a spiritual parasite is a violent vermifuge. The Bogam prints the Daoist account and the drug side by side without reconciling them.

Donguibogam · Chung

14.2 The Nine Worms 九蟲

14.2.1
Source원문

諸蟲皆因飮食不節, 或過飡腥膾生冷, 以致積久成熱, 濕熱熏蒸, 痰瘀凝結, 隨五行之氣變化而爲諸般奇怪之形, 其名有九.

Translation영역
All the worms come from food and drink without measure, or from eating too much raw fish and cold things, so that what has accumulated long turns to heat; the damp heat steams and fumes, phlegm and stasis congeal, and following the qi of the five phases they transform into all manner of strange shapes. Their names are nine.
Clinical note임상 주석
腥膾生冷 — raw fish and cold food. The cause is right even if the mechanism is not: freshwater fish eaten raw is how the liver fluke and the broad tapeworm are caught, and the Bogam names it first.

Oedae 外臺

14.2.2
Source원문

一曰伏蟲, 長四寸許, 爲諸蟲之長卽長蟲也. 二曰蚘蟲, 長尺許, 貫心卽殺人卽食蟲也. 三曰白蟲, 長一寸, 母子相生, 其形轉大而長, 亦能殺人卽寸白蟲. 四曰肉蟲, 狀如爛杏, 令人心煩滿悶. 五曰肺蟲, 其狀如蠶, 令人咳嗽. 六曰胃蟲, 狀如蝦蟆, 令人嘔吐噦逆嘈雜, 愛喫泥炭生米茶鹽薑椒等物. 七曰弱蟲, 又名膈蟲, 狀如瓜瓣, 令人多唾. 八曰赤蟲, 狀如生肉, 令人腸鳴. 九曰蟯蟲, 狀如菜蟲, 形至細微, 居廣腸, 多則爲痔, 劇則爲癰癘疥癩. 宜貫衆丸. 《外臺》

Translation영역
The first is the lurking worm, about four chon long, the eldest of the worms that is, the long worm. The second is the roundworm, about a cheok long; when it threads the heart it kills that is, the eating worm. The third is the white worm, one chon long; mother and child engender each other, its form growing larger and longer, and it too can kill that is, the inch-white worm. The fourth is the flesh worm, shaped like a rotten apricot, which makes the heart vexed and oppressed. The fifth is the lung worm, shaped like a silkworm, which makes one cough. The sixth is the stomach worm, shaped like a toad, which makes one vomit, retch and feel gnawing hunger, and long to eat clay, charcoal, raw rice, tea, salt, ginger and pepper. The seventh is the weak worm, also called the diaphragm worm, shaped like a melon seed, which makes one spit much. The eighth is the red worm, shaped like raw flesh, which makes the bowels rumble. The ninth is the pinworm, shaped like a cabbage grub, extremely fine in form, living in the broad gut; where they are many there are haemorrhoids, and at their worst abscesses, sores and scabies. Dryopteris Pill is appropriate.
Clinical note임상 주석
The Waitai's nine worms, and three of them are real: 蚘蟲 the roundworm at a cheok long, 寸白蟲 the tapeworm that grows by segments — 母子相生, mother and child engendering each other, which is exactly what a proglottid chain does — and 蟯蟲 the pinworm, fine as a thread, in the rectum, causing itching and piles. The stomach worm's sign is the best observation in the list: 愛喫泥炭生米 — craving clay, charcoal and raw rice. That is pica, and it is the classic sign of hookworm anaemia.

Oedae 外臺

14.3 The Worms of the Five Viscera 五臟蟲

14.3.1
Source원문

人勞則生熱, 熱則生蟲. 心蟲曰蛔, 脾蟲曰寸白, 腎蟲如方截絲縷, 肝蟲如爛杏, 肺蟲如蠶, 皆能殺人. 惟肺蟲爲急, 肺蟲居肺葉內, 蝕肺系, 故成瘵疾, 咯血聲嘶, 藥所不到, 爲難治也. 《千金》

Translation영역
When a person is taxed, heat is engendered, and heat engenders worms. The heart's worm is the roundworm; the spleen's is the inch-white worm; the kidney's is like lengths of silk thread cut square; the liver's is like a rotten apricot; the lung's is like a silkworm. All of them can kill. Only the lung worm is urgent: it lives within the lobes of the lung and gnaws the lung's cords, and so it becomes the consumption disease, with blood in the sputum and a hoarse voice. Medicines do not reach it, and it is hard to treat.
Clinical note임상 주석
肺蟲 — the lung worm — is tuberculosis, and Sun Simiao's sentence is the chapter's hinge: the worm that lives in the lung and gnaws it produces 瘵疾, consumption, with haemoptysis and hoarseness, and drugs cannot reach it. 14.16 to 14.22 are all about this one worm.

Cheongeum 千金

14.3.2
Source원문

宜服獺爪散方見下.

Translation영역
Otter's Claw Powder should be taken the formula appears below.
Clinical note임상 주석
The cross-reference leads to the simples at 14.24, where otter's claw is the last entry: powdered and taken in warm wine for the lung worm that drugs cannot reach.

Donguibogam · Chung

14.4 Damp Heat Engenders Worms 濕熱生蟲

14.4.1
Source원문

濕熱鬱積則生蟲, 藏府虛則侵蝕. 《丹心》

Translation영역
Where damp heat gathers and stagnates, worms are engendered; where the viscera and bowels are vacuous, they invade and gnaw.
Clinical note임상 주석
Danxi in twelve graphs: damp heat makes them and vacuity lets them in. Every treatment in the chapter is one of those two — dry the damp heat, or supplement the vacuity.

Dansim 丹心

14.4.2
Source원문

濕熱生蟲, 正如今人俗驗禾苗, 雨朝日照, 禾節生蟲, 此說明矣. 人患蟲積者, 或飢餓失攝, 或腥膾白酒, 或灸食牛羊, 或啖蛙鱉, 中脘氣弱, 濕熱少運, 故生寸白ㆍ蛔ㆍ蟯諸蟲, 形如蚯蚓, 又相似團魚曰血鱉, 小兒最多. 《回春》

Translation영역
That damp heat engenders worms is just as people today prove it in the rice seedlings: a rainy morning and then the sun on them, and worms breed at the nodes of the stalk — the saying is clear. In a person with worm accumulation, it comes from hunger and failure of regulation, or raw fish and white wine, or grilled beef and mutton, or eating frogs and turtles; the qi of the middle cavity is weak and the damp heat moves little, and so the inch-white worm, roundworm, pinworm and the rest are engendered, shaped like earthworms — and some, resembling a soft-shelled turtle, are called blood turtles. In children it is commonest.
Clinical note임상 주석
The rice-stalk analogy is the chapter's method of argument: rain and then sun breeds maggots in the field, so damp and heat breed worms in the gut. The list of foods — raw fish, wine, grilled meat, frogs and turtles — is a list of how parasites are actually acquired, arrived at by observation rather than theory.

Hoechun 回春

14.5 The Pulse 脉法

14.5.1
Source원문

關上脈緊而滑者, 蛔毒.

Translation영역
Where the pulse at the bar is tight and slippery, there is roundworm toxin.

Maekgyeong 脉經

14.5.2
Source원문

脈沈而滑者, 寸白蟲.

Translation영역
Where the pulse is sunken and slippery, there is the inch-white worm.

Maekgyeong 脉經

14.5.3
Source원문

關上脈微浮, 積熱在胃中, 嘔吐蛔蟲, 心健忘. 《脈經》

Translation영역
Where the pulse at the bar is slightly floating, accumulated heat is in the stomach, roundworms are vomited, and the heart is forgetful.

Maekgyeong 脉經

14.5.4
Source원문

諸蟲脈沈實者生, 虛大者死.

Translation영역
In the various worm diseases, a sunken and replete pulse means life; an empty and large one, death.

Jeongjeon 正傳

14.5.5
Source원문

尺脈沈而滑者, 爲寸白蟲.

Translation영역
Where the cubit pulse is sunken and slippery, it is the inch-white worm.

Jeongjeon 正傳

14.5.6
Source원문

蟲脈當沈弱而弦, 今反洪大, 卽知蛔蟲甚也. 《正傳》

Translation영역
The worm pulse should be sunken, weak and stringlike; where it is surging and large instead, one knows the roundworms are severe.

Jeongjeon 正傳

14.5.7
Source원문

勞瘵脈數, 或細細如潮, 汗咳血肉脫者死. 《回春》

Translation영역
In taxation consumption the pulse is rapid, or fine and faint as a tide; where there is sweating, coughing of blood and the flesh deserting, death.

Hoechun 回春

14.5.8
Source원문

狐蝕陰肛, 脈虛小者生, 勁急者死. 《正傳》

Translation영역
Where fox-gnawing attacks the genitals and anus, an empty small pulse means life; a taut urgent one, death.
Clinical note임상 주석
Eight readings, and the pair that matters is 14.5.4: sunken and replete lives, empty and large dies — the worms have taken the qi when the pulse goes hollow. 狐蝕陰肛 is the 狐惑 of 14.11, Behçet's-like ulceration, which the Cold Damage chapter treats.

Jeongjeon 正傳

14.6 The Outer Signs of Worms 蟲外候

14.6.1
Source원문

肘後麤以下三四寸熱者, 腸中有蟲.

Translation영역
Where the skin three or four chon below the coarse place behind the elbow is hot, there are worms in the bowel.

Yeongchu 靈樞

14.6.2
Source원문

胃中有熱則蟲動, 蟲動則胃緩, 胃緩則廉泉開, 故涎下. 《靈樞》

Translation영역
Where there is heat in the stomach the worms stir; when the worms stir the stomach slackens; when the stomach slackens the Yeomcheon point opens, and so drool comes down.
Clinical note임상 주석
The Lingshu's chain from stomach heat to drooling, and 14.6.9 will make the drool the one sign common to all the worms. Yeomcheon (廉泉, CV23) is under the chin at the root of the tongue.

Yeongchu 靈樞

14.6.3
Source원문

凡蟲痛之證, 腹中有塊起, 以手按之不見, 鍾聚往來, 痛無休止. 五更心嘈, 牙關强硬, 嘔吐涎沫, 或吐淸水, 夢中嚙齒, 面色靑黃, 飮食雖多, 不生肌膚. 《得效》

Translation영역
In the pattern of worm pain a lump rises in the abdomen, but pressed with the hand it is not found; it gathers and comes and goes, and the pain does not let up. At the fifth watch the heart gnaws, the jaw is clenched hard, drool and foam are vomited, or clear water is brought up; the teeth grind in sleep; the complexion is blue-yellow; and though one eats much, no flesh grows.
Clinical note임상 주석
以手按之不見 — press it and it is gone. The mass that moves away under the hand is the chapter's best diagnostic sign, and the rest of the list is a child with worms exactly: night waking, grinding teeth, drooling, sallow face, and eating without gaining.

Deukhyo 得效

14.6.4
Source원문

凡蟲證, 眼圏鼻下靑黑, 面色萎黃, 脣上有幾條血絲如蟹爪分明.

Translation영역
In worm patterns the rings of the eyes and under the nose are blue-black, the complexion sallow and yellow, and on the lip are several threads of blood clear as a crab's claw.

Immun 入門

14.6.5
Source원문

面上白斑, 脣紅, 能食心嘈, 顔色不常, 脣上有蟹爪路者, 便有蟲也. 《入門》

Translation영역
White patches on the face, red lips, a good appetite with gnawing in the heart, a complexion that does not stay the same, and crab's-claw tracks on the lip — there are worms.
Clinical note임상 주석
蟹爪, the crab's claw — fine branching red lines on the lip. Together with the white patches on the cheek, it is what the tradition looked for, and the white patches are pityriasis alba, which does go with the malnourished child the chapter is describing.

Immun 入門

14.6.6
Source원문

蟲痛之證, 時作時止, 痛則咬心, 口吐淸水, 人中鼻脣一時靑黑者是也.

Translation영역
In the pattern of worm pain it comes and goes; when it pains it bites at the heart, clear water is vomited, and the philtrum, nose and lips turn blue-black all at once.

Uigam 醫鑑

14.6.7
Source원문

腹痛肚大靑筋者, 蟲痛也. 《醫鑑》

Translation영역
Abdominal pain with a big belly and blue veins on it is worm pain.

Uigam 醫鑑

14.6.8
Source원문

小兒腹痛, 口中出淸水者, 蟲痛也. 《回春》

Translation영역
A child with abdominal pain who brings clear water up from the mouth has worm pain.

Hoechun 回春

14.6.9
Source원문

三蟲之證, 皆口流涎也. 《綱目》

Translation영역
In the patterns of the three worms, all of them drool from the mouth.

Gangmok 綱目

14.7 Things That Turn into Worms 諸物變蟲

14.7.1
Source원문

山澗中蛇虺水蛭遺精, 誤飮其水, 或果苽蔬菜蟲聚其下, 人誤食之, 則心腹刺痛, 時作時止, 諸藥不效, 宜雄砂丸. 《入門》

Translation영역
Where snakes, vipers and leeches have shed their seed in a mountain stream and one drinks the water unawares, or where worms have gathered beneath fruit, gourds and vegetables and one eats them unawares, there is stabbing pain in the heart and abdomen that comes and goes, and no medicine works. Realgar and Cinnabar Pill is appropriate.
Clinical note임상 주석
Unfiltered stream water and unwashed vegetables — the two commonest ways of acquiring waterborne parasites, identified correctly even though the mechanism offered is wrong.

Immun 入門

14.7.2
Source원문

夜間飮水, 誤呑水蛭而入腹, 能食人肝血, 腹痛不可忍, 面目黃瘦, 全不進食, 不治則死. 取田中乾泥一小塊, 小死魚三四箇去殼, 巴豆十粒, 同硏爛, 將猪脂熔化和丸菉豆大, 以田中冷水呑下十丸, 須臾大小蛭皆瀉出. 却以四物湯方見血門加黃芪煎服調補. 《得效》

Translation영역
Drinking water at night and swallowing a leech unawares, it enters the belly and can eat a person's liver blood: the abdomen pains unbearably, the face and eyes turn yellow and wasted, no food is taken at all, and untreated it kills. Take a small lump of dry mud from a field, three or four small dead fish with the shells removed, and ten croton seeds; grind them together to a pulp, melt lard and bind into pills the size of a mung bean, and swallow ten with cold water from the field. In a short while the leeches large and small are all purged out. Then regulate and supplement with Four Substances Decoction formula in the Blood chapter with astragalus added.
Clinical note임상 주석
Field mud, dead fish and croton seed — the bait is the whole design: the leeches are drawn to the mud and fish and go out with the purge. Croton is violently toxic, and the follow-up with Samul-tang is for the blood the leeches took. **Croton seed (巴豆) is a drastic purgative and highly toxic.**

Deukhyo 得效

14.7.3
Source원문

李道念有疾, 徐嗣伯診之曰, 非冷非熱, 當是食白瀹鷄子過多所致. 取蒜一升煮食之, 吐一物大如升, 涎裹之, 開視則是鷄雛, 羽翅爪足皆具, 旣而病差. 《本草》

Translation영역
Li Daonian was ill, and Xu Sibo examined him and said: it is neither cold nor heat; it must come of eating too many poached hen's eggs. He had him boil and eat a seung of garlic, and he vomited a thing the size of a seung wrapped in drool; opened and looked at, it was a chick, with feathers, wings, claws and feet all complete — and thereupon the illness mended.

Boncho 本草

14.7.4
Source원문

一人患腰痛牽心, 每至輒氣欲絶. 徐文伯視之曰, 此髮瘕也. 以油投之, 卽吐物如髮, 稍引之長三尺, 頭已成蛇, 能動, 掛門下滴盡, 惟一髮而已.

Translation영역
A man suffered lumbar pain pulling on the heart, and whenever it came his breath seemed about to fail. Xu Wenbo looked at him and said: this is a hair conglomeration. He gave him oil, and at once he vomited a thing like hair; drawn out little by little it was three cheok long, its head already formed into a snake and able to move. Hung under the door until it had finished dripping, it was nothing but a single hair.

Uiseol 醫說

14.7.5
Source원문

一道人心腹煩滿彌二歲, 甄立言診曰, 腹有蠱, 誤食髮而然. 令餌雄黃一劑, 少頃吐一蛇, 無目, 燒之有髮氣, 乃愈. 《醫說》

Translation영역
A Daoist had vexation and fullness of heart and abdomen for two years. Zhen Liyan examined him and said: there is a gu in the belly; it comes of swallowing a hair unawares. He had him take a dose of realgar, and in a little while he vomited a snake with no eyes; burnt, it smelt of hair, and he was healed.
Clinical note임상 주석
Two case histories of the 髮瘕, the hair conglomeration, and both are trichobezoars — the hairball that forms in the stomach of someone who eats hair, which does come out looking like a long tapering thing with a head. The physicians are famous ones, and the cases were probably real.

Uiseol 醫說

14.7.6
Source원문

春秋二時, 蛟龍帶精入芹菜中, 人偶食之, 得病發則似癎, 手足靑, 腹滿痛不可忍. 取寒食糖一云飴糖三升, 日三服, 遂吐出蛟龍, 有兩頭三五枚, 乃差. 《仲景》

Translation영역
In spring and autumn dragons carry their seed into the water-dropwort, and a person eating it by chance falls ill: it breaks out like epilepsy, the hands and feet turn blue, and the abdomen is full and painful beyond bearing. Take three seung of cold-food sugar one version says malt sugar three times a day, and the dragons are vomited out, three or five of them with two heads each, and it mends.
Clinical note임상 주석
Zhongjing's dragon in the water-dropwort is fasciolopsiasis: the giant intestinal fluke encysts on aquatic plants, water-dropwort and water chestnut among them, and is caught by eating them raw. The treatment — malt sugar — is the Jingui's, and sugar solutions are still used to float flukes off the gut wall.

Junggyeong 仲景

14.7.7
Source원문

誤飮蛇交水成瘕, 腹滿痛, 雄黃服之. 《入門》

Translation영역
Where one drinks unawares water in which snakes have coupled and a conglomeration forms, with the abdomen full and painful, realgar is taken.

Immun 入門

14.7.8
Source원문

通用七轉靈應丹方見下ㆍ萬應丸.

Translation영역
For general use, Seven Turnings Numinous Response Elixir the formula appears below and Ten Thousand Responses Pill.

Donguibogam · Chung

14.8 Roundworm Reversal and Vomiting of Worms 蛔厥吐蟲

14.8.1
Source원문

心疼, 靜而復煩, 須臾復止, 得食而嘔又煩, 吐蛔蟲, 爲蛔厥.

Translation영역
Heart pain that is quiet and then vexed again, stopping after a moment; on taking food, retching and vexation again, and roundworms vomited — this is roundworm reversal.

Junggyeong 仲景

14.8.2
Source원문

蛔厥者, 當吐蛔. 病者靜而復時煩, 此爲藏寒, 蛔上入膈故煩, 須臾復止. 得食而嘔又煩者, 蛔聞食臭出, 其人當自吐蛔, 烏梅丸主之.

Translation영역
In roundworm reversal the patient vomits roundworms. He is quiet and then vexed from time to time: this is cold in the viscera, and the roundworms rise into the diaphragm, hence the vexation, which stops after a moment. That on taking food he retches and is vexed again is because the roundworms smell the food and come out; such a person will vomit roundworms of himself. Mume Pill governs it.
Clinical note임상 주석
Zhongjing's account from the Cold Damage treatise, and the mechanism is exactly right: roundworms migrate when the gut is cold and empty, and the smell of food brings them up into the bile duct. The pain that stops after a moment and returns is biliary colic.

Junggyeong 仲963景

14.8.3
Source원문

病人有寒, 復發汗, 胃中冷, 必吐蛔. 先用理中湯方見寒門入烏梅三箇煎服, 次服烏梅丸. 《仲景》

Translation영역
Where a patient has cold and is made to sweat again, the stomach turns cold and he will surely vomit roundworms. First use Regulate the Centre Decoction formula in the Cold Damage chapter with three mume added and decocted, then take Mume Pill.

Junggyeong 仲景

14.8.4
Source원문

蛔厥者, 胃寒所生. 經曰, 蛔者長蟲也. 胃中冷則吐蛔, 不可用冷藥. 宜理中湯加炒川椒ㆍ檳榔煎水, 呑下烏梅丸最效. 《丹心》

Translation영역
Roundworm reversal is engendered by cold in the stomach. The classic says: the roundworm is the long worm. Where the stomach is cold, roundworms are vomited, and cold medicines may not be used. Regulate the Centre Decoction with fried Sichuan pepper and areca added, decocted in water and used to swallow Mume Pill, is most effective.
Clinical note임상 주석
不可用冷藥 — cold medicines may not be used. Danxi's rule, and the reason Omae-hwan has aconite and cinnamon in it: a cold stomach is what let the worms rise, and cooling it further sends more of them up.

Dansim 丹心

14.8.5
Source원문

經云, 蟲貫心則殺人. 欲驗之, 心腹大痛不可忍, 或吐靑汁黃綠水, 出涎沫, 或吐蟲出, 發有休止, 宜蕪荑散ㆍ化蟲丸. 《得效》

Translation영역
The classic says: when a worm threads the heart it kills. To test it — the heart and abdomen pain greatly beyond bearing, or blue juice and yellow-green water are vomited, drool and foam come out, or worms are vomited out, and the attacks let up between times. Elm Fruit Powder and Transform the Worms Pill are appropriate.
Clinical note임상 주석
吐靑汁黃綠水 — vomiting blue juice and yellow-green water. That is bile, and biliary ascariasis is what the whole section describes.

Deukhyo 得效

14.8.6
Source원문

小兒蟲痛欲絶, 宜靈礬散. 《回春》

Translation영역
For a child whose worm pain is unbearable, Pteropus and Alum Powder is appropriate.

Hoechun 回春

14.8.7
Source원문

蛔厥心痛, 宜安蟲散ㆍ化蟲散ㆍ追蟲取積散. 蟲不療則子母相生, 無有休止.

Translation영역
For roundworm reversal with heart pain, Quiet the Worms Powder, Transform the Worms Powder and Chase the Worms and Take Out the Accumulation Powder are appropriate. If the worms are not treated, mother and child engender each other and there is no end to it.

Deukhyo 得效

14.8.8
Source원문

小兒口鼻中出黑色蟲, 不治. 《得效》

Translation영역
A child from whose mouth and nose black worms come out is not to be treated.
Clinical note임상 주석
Worms coming out of the nose is a real terminal sign of massive ascariasis in a starved child, and the Deukhyo's verdict is the one the tradition gave: 不治.

Deukhyo 得效

14.9 Warming the Stomach to Quiet the Worms 溫胃安蟲

14.9.1
Source원문

一女患惡心吐蟲, 累治不差. 每用殺蟲藥則吐愈多. 孫兆診之曰, 六脈皆細, 非蟲脈也, 乃藏寒而蟲不安, 因而吐出. 復用殺蟲藥, 蟲爲藥所苦, 不能自安, 所以吐愈多也. 取硫黃ㆍ附子(炮) 各一兩爲末, 米糊和丸麻子大, 米飮下三十丸, 遂不吐, 後不復作. 《綱目》

Translation영역
A woman suffered nausea and vomiting of worms, and repeated treatment did not mend it; whenever worm-killing medicines were used she vomited more. Sun Zhao examined her and said: all six pulses are fine — this is not a worm pulse. It is cold in the viscera, so that the worms are not at ease and are therefore vomited out; and using worm-killing medicines again, the worms are tormented by the drug and cannot settle, which is why she vomits still more. He took sulphur and aconite (blast-fried) 1 nyang each, powdered them, bound them with rice paste into pills the size of a hemp seed, and gave thirty with rice water — and she stopped vomiting, and it did not come back.
Clinical note임상 주석
The section that argues against the rest of the chapter. Sun Zhao's reasoning is that killing the worms made them fight, and warming the stomach made them settle — 安蟲, quieting them rather than expelling them, which is Omae-hwan's principle taken to its conclusion. The fine pulse is what told him. **Contains sulphur and aconite, both toxic.**

Gangmok 綱目

14.9.2
Source원문

楊仲臣病心痛. 此人常好飮酒, 初飮二三盃必奔走頓兩足三五十次, 其酒稍散, 方能復席. 飮至前量, 一醉必五七次, 至明嘔靑黃水, 數日後變魚腥臭, 六七日始安. 戴人曰, 酒蟲也, 宜涌之. 乃吐蟲一條, 赤黃色, 長六七寸, 口目鼻皆全, 狀如蛇, 其疾卽愈. 《子和》

Translation영역
Yang Zhongchen suffered heart pain. This man was always fond of wine; at the first two or three cups he had to run about and stamp both feet thirty or fifty times, and only when the wine had dispersed a little could he return to his seat. Drinking on to his usual measure, he would do this five or seven times in a bout, and by morning he vomited blue-yellow water, which after several days turned to a fishy stench, and only after six or seven days did he settle. Zhang Zihe said: it is a wine worm; it should be made to well up. So he vomited one worm, red-yellow, six or seven chon long, with mouth, eyes and nose all complete, shaped like a snake — and the illness was healed at once.
Clinical note임상 주석
Zhang Zihe's case, and it is his method throughout — the Ejection chapter's emetic school. The man's stamping after two cups is the tradition's observation of a real alcohol-flush reaction, though the worm is what got the credit.

Jahwa 子和

14.10 The Inch-White Worm 寸白蟲

14.10.1
Source원문

寸白蟲, 色白形扁, 居腸胃中, 時或自下, 乏人筋力, 耗人精氣. 宜碧金散.

Translation영역
The inch-white worm is white in colour and flat in form, living in the intestines and stomach; at times it comes down of itself. It drains a person's sinew strength and wastes the essential qi. Jade-Green Powder is appropriate.
Clinical note임상 주석
色白形扁 — white and flat. The tapeworm described exactly, and 時或自下, at times segments come away by themselves, which is how it is usually noticed.

Donguibogam · Chung

14.10.2
Source원문

療寸白蟲, 錫灰ㆍ蕪荑ㆍ檳榔爲末, 每二錢, 空心取米飮調下, 極佳. 予每覺心中多嘈雜, 疑是蟲, 漫服此藥. 翌日下寸白一果, 中有長蟲二條, 長二尺五寸, 一則皆寸斷矣. 《本事方》

Translation영역
To treat the inch-white worm: tin ash, elm-fruit paste and areca powdered, 2 don at a time on an empty stomach stirred into rice water — excellent. I often felt much gnawing in the heart and suspected worms, so I took this medicine idly. The next day a mass of inch-white worm came down, and in it two long worms two cheok five chon long, one of them broken into inch lengths throughout.
Clinical note임상 주석
Xu Shuwei on himself, and the description settles what 寸白蟲 is: a strobila two and a half cheok long, one of them shed as separate segments. The chapter's one first-person account.

Bonsa 本事

14.10.3
Source원문

下寸白蟲, 當晩勿食飯, 五更空心時, 取東引石榴根皮一握, 濃煎湯, 調檳榔末一錢. 先取灸猪肉一塊, 細嚼嚥汁去肉, 却取藥頓服, 午間蟲盡下. 《得效》

Translation영역
To bring down the inch-white worm: that evening eat no rice, and at the fifth watch on an empty stomach take a handful of east-facing pomegranate root bark, decoct it thick, and stir in 1 don of powdered areca. First take a piece of grilled pork, chew it fine, swallow the juice and spit out the meat; then take the medicine at a draught, and by noon the worms all come down.
Clinical note임상 주석
Pomegranate root bark and areca, fasted overnight, with grilled pork chewed and spat out first to bring the worm's head up. Both drugs are genuine taenicides and this is close to how they were used into the twentieth century.

Deukhyo 得效

14.11 The Echo Worm 應聲蟲

14.11.1
Source원문

人每言語時, 喉中有物作聲相應, 名曰應聲蟲. 昔有人患此病, 醫者敎誦本草, 隨物皆應, 至雷丸則無聲, 遂服數枚而愈. 《入門》

Translation영역
Whenever a person speaks, something in the throat makes a sound answering him: this is called the echo worm. Once a man suffered from this, and the physician had him recite the materia medica; at every item it answered, but at omphalia there was no sound — so he took several pieces of it and was healed.
Clinical note임상 주석
The chapter's one joke, and it is told straight: the worm is made to name the drug that kills it by falling silent at its name. The tale is old and widely told, and the Bogam prints it as a case.

Immun 入門

14.11.2
Source원문

腹中有物作聲, 隨人言語, 名曰應聲蟲. 用板藍汁一盞, 分三次服之, 卽愈. 《得效》

Translation영역
Where something in the belly makes a sound following a person's speech, it is called the echo worm. Take a cup of isatis juice divided into three doses, and it is healed at once.

Deukhyo 得效

14.12 The Fox-Delusion Worm 狐惑蟲

14.12.1
Source원문

見傷寒門.

Translation영역
See the Cold Damage chapter.
Clinical note임상 주석
狐惑 — ulceration of mouth and genitals with a confused mind, which modern medicine reads as Behçet's disease. The Bogam keeps it with Cold Damage and cross-refers from here because the tradition held it to be caused by a worm.

Donguibogam · Chung

14.13 Wasting Thirst Has Worms 消渴有蟲

14.13.1
Source원문

見消渴門.

Translation영역
See the Wasting Thirst chapter.

Donguibogam · Chung

14.14 Haemorrhoids and Fistula Have Worms 痔瘻有蟲

14.14.1
Source원문

見後陰門.

Translation영역
See the Anus chapter.

Donguibogam · Chung

14.15 The Various Sores Have Worms 諸瘡有蟲

14.15.1
Source원문

見諸瘡門.

Translation영역
See the Sores chapter.

Donguibogam · Chung

14.16 Toothache Has Worms 齒痛有蟲

14.16.1
Source원문

見牙齒門.

Translation영역
See the Teeth chapter.
Clinical note임상 주석
Five cross-references in a row, and together they say what the chapter is claiming: that dental caries, piles, chronic sores, diabetes and Behçet's are all worm diseases. The tooth worm is the oldest of them — it is in Mesopotamian tablets — and it is the one the tradition held longest.

Donguibogam · Chung

14.17 The Taxation Consumption Worm 勞瘵蟲

14.17.1
Source원문

勞瘵又名傳尸. 病人死後, 復易家親一人, 故曰傳尸. 亦名傳疰, 其病自上注下, 與前人相似, 故曰疰. 有屋傳ㆍ服傳ㆍ食傳之異, 死後又注易傍人, 乃至滅門是也. 《綱目》

Translation영역
Taxation consumption is also called corpse transmission. After the patient dies it passes to another member of the household, and so it is called corpse transmission. It is also called transmitted infixation: the disease pours down from above and is like the one before, and so it is called infixation. There are the differences of transmission by house, by clothing and by food; and after death it pours over to those nearby, to the point of wiping out a household.
Clinical note임상 주석
屋傳ㆍ服傳ㆍ食傳 — transmission by house, by clothing, by food. The Gangmok is describing contagion, four hundred years before the tubercle bacillus, and 至滅門, to the wiping out of a household, is what untreated tuberculosis does in a family.

Gangmok 綱目

14.17.2
Source원문

瘵蟲之形, 或似絲線, 或似紅絲馬尾, 或似蝦蟆, 或似刺蝟, 或似鼠形, 或如爛麵, 或有足無頭, 或有頭無足, 或化精血歸於元陽之內, 種種形狀實難辨之. 若傳至三人, 則如人形如鬼狀. 《得效》

Translation영역
The consumption worm's form may be like silk thread, or like red silk or a horse's tail, or like a toad, or like a hedgehog, or like a mouse, or like rotted dough; some have feet and no head, some a head and no feet; some transform into essence and blood and return within the original yang. The shapes are so various that they are truly hard to tell apart. Where it has passed to a third person, it is like a human figure or a ghost.

Deukhyo 得效

14.17.3
Source원문

瘵疾之因, 多有少年時血氣未定, 酒色傷損, 其熱毒鬱積, 生異物惡蟲, 蝕人藏府精血, 變生諸般奇怪之物. 其侍奉之人, 熏陶日久, 受其惡氣, 多遭傳染. 是以氣虛腹虛最不可入勞瘵之門, 吊喪問疾, 衣服器用中皆能乘虛而染觸焉. 《直指》

Translation영역
The cause of the consumption disease is mostly that in youth, when blood and qi were not yet settled, wine and sex injured them; the heat toxin gathers and stagnates, engendering strange things and foul worms that gnaw the essence and blood of the viscera and bowels and turn into all manner of curious things. Those who attend the sick, fumigated by it day after day, take in its foul qi and are often infected. Therefore one whose qi is vacuous and whose belly is empty must above all not enter the house of taxation consumption; in paying condolences and visiting the sick, clothing and utensils can all take advantage of the vacuity to infect by contact.
Clinical note임상 주석
氣虛腹虛最不可入勞瘵之門 — the weak and the hungry must not enter a consumptive's house. The Jikji has both halves of it: the disease is transmitted by contact with the sick and their belongings, and susceptibility depends on the host's state. Both are true.

Jikji 直指

14.18 The Method of Testing for Consumption 驗瘵法

14.18.1
Source원문

勞瘵傳尸皆有蟲. 先燒安息香令烟出, 病人吸之, 不嗽非傳尸也. 若烟入咳嗽不止, 乃傳尸也. 宜服太乙明月丹方見下.

Translation영역
Taxation consumption and corpse transmission all have worms. First burn benzoin so that the smoke comes off and have the patient breathe it in: if he does not cough, it is not corpse transmission; if the smoke goes in and the coughing does not stop, it is corpse transmission. Great Unity Bright Moon Elixir the formula appears below should be taken.
Clinical note임상 주석
A provocation test: irritant smoke, and a cough that will not stop means the lung is already damaged. As a bedside test for tuberculosis it is crude and not useless.

Gangmok 綱目

14.18.2
Source원문

又法, 用乳香燒熏病人之手, 乃仰手掌, 以帛覆其上, 熏良久, 手背上出毛長寸許, 白而黃者可治, 紅者稍難, 靑黑者死, 最驗. 若熏之良久無毛者, 卽非此證也. 《綱目》

Translation영역
Another method: burn frankincense and fume the patient's hand; turn the palm up, cover it with a cloth, and fume it a good while. Hairs about a chon long come out on the back of the hand: white and yellow can be treated, red is somewhat difficult, blue-black means death — this is the most reliable test. If after long fuming no hairs come out, it is not this pattern.

Gangmok 綱目

14.19 The Patterns of Taxation Consumption 勞瘵病證

14.19.1
Source원문

瘵有六證, 潮熱ㆍ盜汗ㆍ咯血ㆍ痰嗽ㆍ遺精ㆍ泄瀉也. 輕者六證間作, 重者六證兼作. 盖火炎於上則爲潮熱咯血, 火動於下則爲遺精泄瀉. 《入門》

Translation영역
Consumption has six signs: tidal fever, night sweats, blood in the sputum, phlegmy cough, seminal emission and diarrhoea. In the light case the six appear by turns; in the grave case they appear together. Where the fire flames above there is tidal fever and blood in the sputum; where it stirs below there is seminal emission and diarrhoea.
Clinical note임상 주석
Six signs, and the first four are tuberculosis as any clinician would list it: afternoon fever, night sweats, haemoptysis, productive cough. 輕者間作, 重者兼作 — in the mild case they come one at a time, in the severe all at once — is a good severity scale.

Immun 入門

14.19.2
Source원문

瘵病初得, 半臥半起, 號爲尸疰. 氣急痰嗽, 名曰肺痿. 骨髓中熱, 稱爲骨蒸. 內傳五藏, 名爲復連. 因虛損而得, 名爲勞極. 男子自腎傳心, 心傳肺, 肺傳肝, 肝傳脾. 女人自心傳肺, 肺傳肝, 肝傳脾, 脾傳腎, 腎傳盡則死. 《入門》

Translation영역
When the consumption disease is newly got and one is half lying and half rising, it is called corpse infixation. With hurried breath and phlegmy cough it is named lung wilting. With heat in the marrow it is called steaming bones. Passing inward to the five viscera it is named recurrent linking. Got through vacuity detriment it is named taxation at its limit. In a man it passes from the kidney to the heart, heart to lung, lung to liver, liver to spleen; in a woman from the heart to the lung, lung to liver, liver to spleen, spleen to kidney — and when the kidney has passed it on there is nothing left, and death.
Clinical note임상 주석
Five names for five stages of one disease, and then the Ojangyukbu chapter's 1.15 control cycle used as a staging system — the organ it has reached tells you how far along the patient is. Man and woman start at different organs, on the Kidney chapter's 6.1.2 rule that the man's master is the left kidney and the woman's the right.

Immun 入門

14.19.3
Source원문

病證大槪, 令人寒熱盜汗, 夢與鬼交, 遺精白濁, 髮乾而聳, 或腹中有塊, 或腦後兩邊有小結核, 心胸滿悶, 肩背疼痛, 兩目不明, 四肢無力, 膝股攣疼, 多臥少起, 狀如佯病. 每至平旦精神尙好, 日午向後四肢微熱, 面無顔色, 喜見人過, 常懷忿怒, 行立脚弱, 睡臥不安, 夢見先亡, 或多驚悸. 有時咳嗽痰涎稠粘, 或咯膿血如肺痿狀, 或時下痢, 羸瘦困乏, 口燥鼻乾, 唇紅頰赤, 雖思飮食不能多飡, 死在須臾, 精神尙好, 猶若秃魚不覺死矣. 《得效》

Translation영역
The pattern in outline makes a person have cold and heat and night sweats, dream of coupling with ghosts, emit semen and pass white turbidity; the hair is dry and stands up; there may be a lump in the belly or small nodes on both sides behind the head; the heart and chest are full and oppressed, the shoulder and back ache, both eyes are dim, the four limbs are without strength, the knees and thighs cramp and ache, and one lies much and rises little, looking like a malingerer. Every morning the spirits are still good; from noon onward the four limbs are slightly hot, the face has no colour, one is glad to see others' faults and harbours anger, the legs are weak in walking and standing, sleep is unquiet, one dreams of the dead, and there is much fright and palpitation. At times there is coughing with thick sticky phlegm, or pus and blood spat up as in lung wilting, or at times diarrhoea; one is emaciated and exhausted, the mouth parched and the nose dry, the lips red and the cheeks flushed; though one thinks of food one cannot eat much. Death is at hand, and the spirits are still good — like a fish gone bald, one does not notice dying.
Clinical note임상 주석
The chapter's set piece, and almost every item is clinical: afternoon fever, night sweats, the cervical nodes behind the ear, weight loss, the flushed cheek in a bloodless face, appetite without eating. 腦後兩邊有小結核 is scrofula — tuberculous cervical lymphadenitis. The last line is the tradition's observation of what modern medicine calls spes phthisica: the consumptive stays clear-headed and hopeful to the end. 不覺死矣 — one does not notice dying.

Deukhyo 得效

14.19.4
Source원문

勞瘵主陰虛. 盖自子至巳屬陽, 自午至亥屬陰. 陰虛則熱在午後子前. 寤屬陽, 寐屬陰. 陰虛則汗從寐時盜出也. 升屬陽, 降屬陰. 陰虛則痰涎上逆而連綿吐出也. 《丹心》

Translation영역
Taxation consumption is governed by yin vacuity. From the ja hour to the sa hour belongs to yang, and from the o hour to the hae hour to yin; where the yin is vacuous the heat is after noon and before midnight. Waking belongs to yang and sleeping to yin; where the yin is vacuous the sweat steals out during sleep. Rising belongs to yang and descending to yin; where the yin is vacuous the phlegm and drool counterflow upward and are brought up without cease.
Clinical note임상 주석
Danxi deriving the three cardinal signs — afternoon fever, night sweats, productive cough — from one principle, and the derivation holds: they are the signs that appear when the body's yin half is in deficit. The Fire chapter's whole doctrine of yin vacuity heat comes out of consumption.

Dansim 丹心

14.20 Signs of Untreatable Consumption 瘵不治證

14.20.1
Source원문

身瘦屬火, 因火燒爍也. 肉脫盡者難治. 《丹心》

Translation영역
A wasted body belongs to fire, because fire has scorched and melted it. Where the flesh is wholly gone it is hard to treat.

Dansim 丹心

14.20.2
Source원문

瘵疾至於骨痛骨痿ㆍ聲沈聲啞ㆍ色枯面黑, 斷不可治. 《直指》

Translation영역
Where the consumption disease has come to aching and wilting bones, a sunken and hoarse voice, and a withered complexion and blackened face, it is decidedly not to be treated.
Clinical note임상 주석
Hoarseness in consumption is tuberculous laryngitis, and it does mark the late disease. The Jikji's three signs are bone involvement, laryngeal involvement and cachexia — and together they were, before antibiotics, the end.

Jikji 直指

14.20.3
Source원문

勞瘵咽瘡失音者死, 虛勞泄不止者亦死. 《入門》

Translation영역
In taxation consumption, one with throat sores and loss of voice dies; in vacuity taxation, one whose diarrhoea does not stop also dies.

Immun 入門

14.21 How to Take Medicine for Killing Worms 殺諸蟲服藥法

14.21.1
Source원문

道藏經中載, 諸蟲頭皆向下行, 自初一日至初五日以前頭上行. 故服藥多取月望以前, 盖爲此也. 《綱目》

Translation영역
The Daoist Canon records that the heads of all the worms point downward, but from the first to the fifth of the month they point upward. So medicine is mostly taken before the full moon, and this is why.

Gangmok 綱目

14.21.2
Source원문

上半月蟲頭向上易治, 下半月蟲頭向下難治. 先以肉汁及糖蜜食下引蟲頭向上, 然後用藥打出. 《得效》

Translation영역
In the first half of the month the worms' heads point up and it is easy to treat; in the second half they point down and it is hard. First send down meat broth and honeyed sugar to draw the worms' heads upward, then use the medicine to drive them out.
Clinical note임상 주석
The baiting rule that runs through every formula in the chapter — broth and sugar first, drug second. The lunar half is astrology; the bait is sound practice, and it is why Hwachung-san is served on grilled pork.

Deukhyo 得效

14.21.3
Source원문

瘵蟲靈異, 所用藥物永不得與病人知之. 《直指》

Translation영역
The consumption worm is numinous and uncanny; what medicines are being used must never be let known to the patient.

Jikji 直指

14.21.4
Source원문

三尸九蟲種種靈異, 用藥及灸莫令病人知之, 恐蟲覺悟永難取下也. 盖此蟲性已通靈, 務在精審, 勿令有悟可也. 《得效》

Translation영역
The three corpses and nine worms are of all sorts numinous and uncanny; in using medicine and moxa do not let the patient know, for fear the worms become aware and it is for ever hard to bring them down. The nature of these worms has already reached the numinous, so one must be exact and careful and let them get no inkling.
Clinical note임상 주석
The strangest rule in the book, and it is given twice: keep the treatment secret from the patient, because the worm listens through them. Taeeulmyeongwol-dan's dosing instruction carries it — 勿令人知.

Deukhyo 得效

14.21.5
Source원문

凡服取蟲藥, 前日勿食晩飯, 明朝極飢時, 先嚼燒肥肉一片, 嚥汁後乃服藥. 《綱目》

Translation영역
Whenever taking a medicine to take out worms, eat no evening meal the day before; next morning, at the height of hunger, first chew a piece of grilled fat meat and swallow the juice, and then take the medicine.

Gangmok 綱目

14.22 Medicines for Treating the Various Worms 治諸蟲藥

14.22.1
Source원문

凡取蟲作藥之法, 禁聲勿語道作藥, 則蟲便下驗. 《本草》

Translation영역
In the method of making a medicine to take out worms, keep silence and do not speak of making the medicine; then the worms come down, proven.

Boncho 本草

14.22.2
Source원문

諸蟲在人腹中, 子母相生, 漸至滋盛, 當破積殺蟲. 宜木香三稜散ㆍ下蟲散ㆍ追蟲取積散方見上ㆍ妙應丸ㆍ七轉靈應丹ㆍ萬應丸方見上ㆍ遇仙丹ㆍ追蟲丸ㆍ萬病解毒丹方見解毒ㆍ五仙丸.

Translation영역
The various worms in a person's belly engender each other, mother and child, and gradually grow abundant; the accumulation should be broken and the worms killed. Costus and Sparganium Powder, Bring Down the Worms Powder, Chase the Worms and Take Out the Accumulation Powder formula above, Wondrous Response Pill, Seven Turnings Numinous Response Elixir, Ten Thousand Responses Pill formula above, Meeting the Immortal Elixir, Chase the Worms Pill, Ten Thousand Diseases Resolve Toxin Elixir formula in the Resolving Toxins chapter and Five Immortals Pill are appropriate.

Donguibogam · Chung

14.22.3
Source원문

治瘵之法, 一則殺其蟲以絶其根本, 一則補其虛以復其眞元. 若病勢已劇, 元氣已脫, 雖依法取蟲, 亦無一生, 只可絶後人之傳注耳. 《正傳》

Translation영역
The method of treating consumption is twofold: one is to kill the worm and so cut off its root; the other is to supplement the vacuity and so restore the true origin. If the disease is already severe and the origin qi already deserted, then though one takes out the worm by the method, not one in a hundred lives — it can only cut off the transmission to those who come after.
Clinical note임상 주석
只可絶後人之傳注 — it can only stop the passing on. Yu Tuan's honesty about what treating late consumption achieves: nothing for this patient, something for the household. It is the clearest statement of public-health reasoning in the book.

Jeongjeon 正傳

14.22.4
Source원문

勞瘵主陰虛, 痰與血病. 四物湯方見血門加炒黃栢ㆍ竹瀝ㆍ童便ㆍ薑汁. 《丹心》

Translation영역
Taxation consumption is governed by yin vacuity, a disease of phlegm and blood. Four Substances Decoction formula in the Blood chapter with fried phellodendron, bamboo sap, child's urine and ginger juice added.

Dansim 丹心

14.22.5
Source원문

勞瘵傳尸, 寒熱交攻, 久嗽咯血, 日漸羸瘦, 先服三拗湯方見咳嗽, 次與蓮心散, 萬不失一. 《丹心》

Translation영역
For corpse-transmitted taxation consumption, with cold and heat attacking by turns, long cough and blood in the sputum, and daily increasing emaciation: first take Three Unbindings Decoction formula in the Cough chapter, then give Lotus Heart Powder — not one in ten thousand fails.

Dansim 丹心

14.22.6
Source원문

勞瘵殺蟲, 宜太乙明月丹ㆍ天靈盖散ㆍ紫金錠子ㆍ五枝散ㆍ神授散.

Translation영역
To kill the worm in taxation consumption, Great Unity Bright Moon Elixir, Skull-Cap Powder, Purple Gold Lozenge, Five Twigs Powder and Spirit-Transmitted Powder are appropriate.
Clinical note임상 주석
紫金錠子 is the Resolving Toxins chapter's 萬病解毒丹 under another name; the chapter records two cases for it — a woman who vomited a dozen small worms after one lozenge, and three surviving brothers of five in a household where the other two had died.

Donguibogam · Chung

14.22.7
Source원문

勞瘵補虛, 宜瓊玉膏ㆍ紫河車丸ㆍ凝神飮子. 《入門》

Translation영역
To supplement the vacuity in taxation consumption, Precious Jade Paste, Placenta Pill and Congeal the Spirit Drink are appropriate.
Clinical note임상 주석
14.22.3's second half, in three formulas. Gyeongok-go is the Body chapter's own — 以一料分 十劑, 可救十人勞瘵, one batch divided ten ways can save ten consumptives.

Immun 入門

14.22.8
Source원문

古人云, 勞瘵三十六種, 惟陰德可以斷之. 人患此疾, 或入山林, 或居靜室, 淸心靜坐, 叩齒焚香, 節食斷慾, 專意保養, 庶乎可免. 若不遵此禁忌, 雖服藥無效. 《入門》

Translation영역
The ancients said: of the thirty-six kinds of taxation consumption, only hidden virtue can cut them off. One who suffers this disease should go into the mountains or dwell in a quiet room, clear the mind and sit still, click the teeth and burn incense, restrain food and cut off desire, and give his whole mind to protecting and nourishing — then he may perhaps escape. If he does not keep these prohibitions, medicine taken will have no effect.
Clinical note임상 주석
Mountains, a quiet room, rest, restraint and clean air. Before streptomycin this was the treatment everywhere, and the sanatorium of the nineteenth century prescribed the same things for the same disease.

Immun 入門

14.22.9
Source원문

勞瘵傳尸之疾, 熏治之藥非一, 而鮮有驗者. 惟取末後死者焚之, 可以無傳矣. 《箕期》

Translation영역
For the disease of corpse-transmitted taxation consumption the fumigating medicines are many, but few are proven. Only by burning the body of the last to die can transmission be prevented.
Clinical note임상 주석
Cremation to stop transmission, at the end of a section of drugs that the author admits mostly do not work. It is the chapter's last word on prevention, and it is correct about the disease if not about the corpse.

Gigi 箕期

14.23 Telling the Form and Colour of the Consumption Worm 辨瘵蟲形色

14.23.1
Source원문

取下之後, 先視蟲色, 自知輕重. 盖蟲先食藏府脂膏, 故其蟲色白. 次食血肉, 故其蟲色黃赤. 次食精髓, 故其蟲紫色. 精髓盡, 故其蟲黑色, 傳入腎中, 病人方思死. 其蟲白色, 可三十日服補藥. 其蟲黃赤色, 可六十日服補藥. 其蟲紫黑色, 此疾已極, 可百二十日服補藥, 十中可活一二.

Translation영역
After it has been brought down, first look at the worm's colour and you will know whether the case is light or grave. The worm first eats the fat of the viscera and bowels, and so it is white; next it eats the blood and flesh, and so it is yellow-red; next it eats the essence and marrow, and so it is purple; when the essence and marrow are gone it is black, having passed into the kidney, and the patient then thinks of death. Where the worm is white, supplementing medicine may be taken for thirty days; where yellow-red, for sixty days; where purple-black, the disease is already at its limit, and supplementing medicine may be taken for a hundred and twenty days, with one or two in ten living.
Clinical note임상 주석
A staging system read off the expelled worm: white, yellow-red, purple, black, with a course of tonics and a survival figure for each. The prognostic scale is the most systematic thing in the chapter, and it rests on something that was never there.

Deukhyo 得效

14.23.2
Source원문

一云, 蟲頭赤, 食人肉, 其病可治. 蟲頭白, 食人髓, 其病難治. 《得效》

Translation영역
One version says: where the worm's head is red it eats a person's flesh and the disease can be treated; where its head is white it eats the marrow and the disease is hard to treat.

Deukhyo 得效

14.23.3
Source원문

蟲嘴靑赤黃色可療, 黑色與白色乃食精髓, 不可療也. 又云, 蟲紅色可治, 肚下黑色者難治, 肚下白色者萬不一差. 《聖效》

Translation영역
Where the worm's mouth is blue, red or yellow it can be treated; black and white mean it has eaten the essence and marrow and it cannot be treated. It is also said: a red worm can be treated; one black on the underside is hard to treat; one white on the underside — not one in ten thousand mends.

Seonghyo 聖效

14.23.4
Source원문

瘵蟲嘴黑則已入腎藏, 不可治. 《醫鑑》

Translation영역
Where the consumption worm's mouth is black, it has already entered the kidney and cannot be treated.

Uigam 醫鑑

14.24 The Medicines the Worms Fear and Shun 諸蟲畏忌藥

14.24.1
Source원문

凡蟲病忌用甘草. 盖蟲聞甘則起, 聞酸則止一作靜, 聞苦則定, 聞辣則頭伏而下. 《入門》

Translation영역
In worm diseases licorice is to be avoided. Worms rise at the smell of sweetness, stop one version says grow still at sourness, settle at bitterness, and at acridity bury their heads and go down.
Clinical note임상 주석
The rule that explains Omae-hwan: sour stops them, bitter settles them, acrid drives their heads down, and sweet is the one thing that brings them up — which is why 14.21.2 uses sugar as bait and forbids it as medicine.

Immun 入門

14.24.2
Source원문

治蛔不可用甘草甜物. 盖蛔得甘則動於上, 得酸則靜, 見苦則安, 得辛辣則頭伏於下. 《回春》

Translation영역
In treating roundworms, licorice and sweet things may not be used. Roundworms stir upward at sweetness, grow still at sourness, settle at bitterness, and at acridity bury their heads downward.

Hoechun 回春

14.24.3
Source원문

蛔聞酸則靜, 見苦則安. 《醫鑑》

Translation영역
Roundworms grow still at the smell of sourness and settle at the sight of bitterness.

Uigam 醫鑑

14.24.4
Source원문

甘謂甘草ㆍ飴糖ㆍ蜂蜜ㆍ砂糖之類, 酸謂醋ㆍ烏梅ㆍ石榴之類, 苦謂熊膽ㆍ猪膽ㆍ黃栢ㆍ苦參之類, 辣謂芥子ㆍ川椒ㆍ生薑之類也.

Translation영역
Sweet means licorice, malt sugar, honey, sugar and their kind; sour means vinegar, mume, pomegranate and their kind; bitter means bear bile, pig bile, phellodendron, sophora root and their kind; acrid means mustard seed, Sichuan pepper, fresh ginger and their kind.
Clinical note임상 주석
The four flavours with their medicinals listed out — the chapter's own key to every formula in it. Mume is sour, coptis and phellodendron bitter, pepper and ginger acrid: that is Omae-hwan, and the Bogam sets out the reasoning here rather than at the formula.

Donguibogam · Chung

14.25 Simple Medicinals 單方

14.25.1
Source원문

凡四十一種.

Translation영역
Forty-one kinds in all.
Clinical note임상 주석
The largest set of simples in the Inner Landscape. The vermifuges the pharmacopoeia kept are all here — areca, chinaberry root bark, quisqualis, carpesium, omphalia, pomegranate root bark, dried lacquer, torreya, elm-fruit paste — and so are the ones for consumption: sea eel, black cat's liver, woodpecker, otter's liver and otter's claw. Two entries are worth the reading. 鰻鱺魚, the sea eel: a woman ill of consumption was put in a coffin and floated down the river; a fisherman took her out still alive, fed her much of this fish, she was healed, and became the fisherman's wife. And 童子尿, child's urine, with the line the Blood chapter's 1.28 also carries — 服凉藥百無一生, 飮溲尿萬無一死: of those who take cold medicines not one in a hundred lives, of those who drink urine not one in ten thousand dies.

Donguibogam · Chung

14.26 Acupuncture and Moxibustion 鍼灸法

14.26.1
Source원문

骨蒸傳尸勞瘵, 宜早灸崔氏四花穴詳見鍼灸, 晩則無及矣. 《入門》

Translation영역
For steaming bones and corpse-transmitted taxation consumption, the Cui family's four-flower points should be moxaed early treated in detail in the Acupuncture volume; late, it is too late.

Immun 入門

14.26.2
Source원문

瘵蟲居肺間蝕肺系, 故咯血聲嘶. 此所謂膏之上肓之下, 針之不到, 藥之不及, 宜早灸膏肓兪ㆍ肺兪ㆍ四花穴爲佳. 《入門》

Translation영역
The consumption worm lives between the lungs and gnaws the lung's cords, and so there is blood in the sputum and a hoarse voice. This is what is meant by above the fat and below the vitals, where the needle does not reach and medicine does not arrive; it is best to moxa Gohwangsu, Pyesu and the four-flower points early.
Clinical note임상 주석
膏之上肓之下 — above the fat and below the vitals: the Zuo Zhuan's phrase for a disease beyond reach, and the origin of the point name 膏肓 (BL43). The Immun's answer to a place the needle cannot get to is to burn over it.

Immun 入門

14.26.3
Source원문

治勞瘵, 癸亥夜三更六神皆聚之時, 解去上體衣服, 於腰上兩傍微陷處, 謂之腰眼. 直身平立, 以筆點定, 然後上床合面而臥, 每灼小艾炷灸七壯, 蟲或吐出或瀉下卽安, 名曰遇仙灸. 《得效》

Translation영역
To treat taxation consumption: on the night of a gyehae day at the third watch, when the six spirits are all gathered, take off the upper clothing and find the slight hollows on either side above the lumbus, called the lumbar eyes. Stand straight and level, mark them with a brush, then get on the bed and lie face down, and burn seven small cones of moxa at each. The worms are either vomited out or purged down, and it settles at once. It is called the meeting-the-immortal moxa.
Clinical note임상 주석
腰眼, the lumbar eyes — the dimples over the sacroiliac joints — marked standing and moxaed lying, at midnight on one particular day of the sixty. 遇仙灸 is still a known method, and the Kidney chapter's 6.15.2 rubbed the same region every night for a colder reason.

Deukhyo 得效

14.26.4
Source원문

先一日點定腰眼穴, 至半夜子時交癸亥日期便灸七壯, 或九壯或十一壯尤妙. 其蟲從大便出, 卽焚之. 《醫鑑》

Translation영역
Mark the lumbar eye points the day before; at midnight, at the ja hour, as it turns to the gyehae day, moxa seven cones — or nine, or eleven, which is better still. The worms come out in the stool, and are burnt at once.

Uigam 醫鑑

14.26.5
Source원문

骨蒸勞熱, 灸膏肓ㆍ三里.

Translation영역
For steaming bones and taxation heat, moxa Gohwang and Samni.

Immun 入門

14.26.6
Source원문

勞瘵骨蒸, 或板齒乾燥, 大顀ㆍ鳩尾各灸二七壯. 又膏肓ㆍ肺兪ㆍ四花ㆍ大顀等穴, 若灸之早, 百發百中.

Translation영역
For taxation consumption with steaming bones, or the front teeth dry, moxa Daechu and Gumi fourteen cones each. And at Gohwang, Pyesu, the four flowers and Daechu — if moxaed early, a hundred shots hit a hundred times.

Immun 入門

14.26.7
Source원문

傳尸勞瘵, 涌泉鍼三分, 瀉六吸, 有血可治, 無血必危. 豐隆治痰, 針入一寸, 瀉十吸. 丹田治氣喘, 鍼入三分, 補二呼. 《入門》

Translation영역
For corpse-transmitted taxation consumption, needle Yongcheon three pun and drain for six inhalations: if there is blood it can be treated, if no blood it is surely grave. Pungnyung treats phlegm, needled one chon, drained for ten inhalations. Danjeon treats panting, needled three pun, supplemented for two exhalations.
Clinical note임상 주석
The chapter ends on a prognosis taken at the needle: bleeding at Yongcheon on the sole means there is still blood to work with, and no bleeding means there is not. The Inner Landscape's third volume closes here.

Immun 入門

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 3, Worms 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.