寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

The Posterior Yin

Hueum

한글 후음  ·  Pinyin Hou Yin

The corporeal-soul gate — why a pile is called a hill, the bright blood and the dark, twenty-four named shapes, and the one rule the whole chapter rests on

後陰

The anus has three names and each carries an argument. 廣腸, the broad intestine, because it is wider than what comes before it. 魄門, the corporeal-soul gate, because the large intestine is the lung's bowel and the lung stores the corporeal soul — and the Suwen adds the functional point: this gate is the servant of all five viscera, and its business is to send out and not to take in. And 痔 itself, which the Samin explains by the graph: 峙, a small hill standing out of a marsh, so that any small flesh standing out at any of the nine orifices is a 痔 — there are nose piles and eye piles and tooth piles too. The chapter's causes are eating to fullness, wine, and sex, and its best distinction is the blood: bright blood before the stool is intestinal wind, an evil newly come in; dark blood after it is visceral toxin, a heat long accumulated. Then five named piles, then twenty-four shapes in a mnemonic verse — lotus, chestnut, water caltrop, cock's comb, mouse nipple — and a long apparatus of washes, fumigations, caustics and suppositories for burning a pile off. Much of that is dangerous and some of it lethal. What survives is at the two ends: Dongwon's whole-chapter rule that one treats from inside and outside together, the sitz bath, and the chapter's own closing counsel — supplement the depleted patient, keep the stool soft, and moderate the appetites, or nothing here will hold.

5.1 The Measure of the Anus 肛門重數

5.1.1
Source원문

靈樞曰, 肛門重十二兩, 大八寸, 徑二寸太半, 長二尺八寸, 受穀九升三合八分合之一.

Translation영역
The Lingshu says: the anus weighs twelve nyang, is eight chon around and two and a half chon across, two cheok eight chon long, and holds nine seung three hop and an eighth of a hop of grain.

Yeongchu 靈樞

5.2 The Other Names of the Anus 肛門別名

5.2.1
Source원문

肛門者大腸之下截也. 一曰廣腸, 言其廣闊於大小腸也. 又曰魄門, 言大腸爲肺之府, 肺藏魄, 故曰魄門也. 肛者, 言其處似車釭形也. 《入門》

Translation영역
The anus is the lower cutting of the large intestine. One name is the broad intestine, meaning that it is broader than the large and small intestines. Another is the corporeal-soul gate, meaning that the large intestine is the lung's bowel and the lung stores the corporeal soul. 肛 refers to its being shaped like the hub-ring of a cartwheel.

Immun 入門

5.2.2
Source원문

內經曰, 魄門亦爲五藏使, 水穀不得久留, 主出而不納, 以傳送也. 《內經》

Translation영역
The Neijing says: the corporeal-soul gate is also the servant of the five viscera; water and grain cannot stay long there, and its business is to send out and not to take in, and so to pass things on.
Clinical note임상 주석
主出而不納 — its business is to send out and not take in. The one functional statement in the chapter's opening, and 5.25's suppositories and 5.23's washes all run against it, which may be why 5.21's treatment rule insists on treating from inside as well.

Naegyeong 內經

5.3 The Causes of Pile Disease 痔病之因

5.3.1
Source원문

小腸有熱必痔, 大腸有熱必便血. 《仲景》

Translation영역
Where the small intestine has heat there will be piles; where the large intestine has heat there will be blood in the stool.

Junggyeong 仲景

5.3.2
Source원문

內經曰, 因而飽食, 筋脈橫解, 腸澼爲痔. 又曰, 飮食不節, 起居不時者, 陰受之; 陰受之則入五藏; 入五藏則䐜滿閉塞, 下爲飱泄, 久爲腸澼. 腸澼者, 大便下血, 卽腸風藏毒也. 澼者, 腸間積水也. 《類聚》

Translation영역
The Neijing says: eating to fullness, the sinews and vessels slacken crosswise, and intestinal afflux becomes piles. It also says: where food and drink are without measure and rising and resting are out of season, the yin receives it; receiving it, it enters the five viscera; entering them there is fullness and blockage, below there is swill diarrhoea, and in time intestinal afflux. Intestinal afflux is blood passed with the stool — that is, intestinal wind and visceral toxin. 澼 means water accumulated between the intestines.

Naegyeong 內經 · Yuchwi 類聚

5.3.3
Source원문

盖飽食則脾不能運, 食積停聚大腸. 脾土一虛, 肺金失養, 則肝木寡畏, 風邪乘虛下流, 輕則腸風下血, 重則變爲痔漏. 或醉飽入房, 精氣脫泄, 熱毒乘虛下注. 或淫極入房, 致傷膀胱與腎肝筋脈. 盖膀胱筋脈抵腰絡腎貫臀走肝, 環前後二陰, 故痔乃筋脈病也. 《入門》

Translation영역
Eating to fullness, the spleen cannot move it and the food accumulates and gathers in the large intestine. Once the spleen earth is vacuous the lung metal loses its nourishment, the liver wood has little to fear, and a wind evil takes advantage of the vacuity and flows downward — lightly, intestinal wind with blood below; heavily, it turns into fistulous piles. Or one goes to the bedchamber drunk and full, the essential qi is deserted and the heat toxin pours down into the vacancy. Or excess in the bedchamber damages the bladder and the sinews and vessels of kidney and liver. The bladder's vessel reaches the waist, networks the kidney, threads the buttock and runs to the liver, circling the two yin before and behind — so piles are a disease of the sinews and vessels.
Clinical note임상 주석
醉飽入房 — going to bed drunk and full. The three causes the chapter names throughout are overeating, wine and sex, and it returns to them in 5.26's list of what to avoid.

Immun 入門

5.3.4
Source원문

痔非外邪, 乃藏內濕熱風燥四氣相合而成. 其腸頭成塊者濕也; 腸頭墮腫者濕兼熱也; 出膿血水者熱勝血也; 作大痛者火熱也; 痒者風熱也; 大便秘者燥熱也; 小便澁者肝藏濕熱也. 《入門》

Translation영역
Piles are not an outer evil but the four qi within the viscera — damp, heat, wind and dryness — combining. Where the bowel head forms a lump, it is damp; where the bowel head sags and swells, damp with heat; where pus, blood and water come out, heat overcoming the blood; where there is great pain, fire heat; where there is itching, wind heat; where the stool is bound, dry heat; where the urine is rough, damp heat in the liver viscus.
Clinical note임상 주석
Seven features, each assigned a cause. The list is worth having at the bedside whatever one makes of the causes, because it names what to ask about: lump, swelling, discharge, pain, itch, stool, urine.

Immun 入門

5.4 A Pile Is a Standing Hill 痔者峙也

5.4.1
Source원문

內經曰, 腸澼爲痔. 如大澤中有小山突出爲峙. 人於九竅中凡有小肉突出皆曰痔, 不特於肛門邊者; 有鼻痔ㆍ眼痔ㆍ牙痔等類, 其狀不一. 《三因》

Translation영역
The Neijing says: intestinal afflux becomes piles. It is as when in a great marsh a small hill stands out, which is a 峙. In a person, any small flesh standing out at any of the nine orifices is called a pile, not only one at the edge of the anus: there are nose piles, eye piles, tooth piles and the like, and their shapes are not alike.
Clinical note임상 주석
The Nose chapter's 2.14 polyp and the Teeth chapter's 4.21 proud flesh are both 痔 by this definition, and the Samin's point is that the word names a shape rather than a place.

Samin 三因

5.4.2
Source원문

漢避呂后諱, 號痔疾爲野鷄病. 《類聚》

Translation영역
Under the Han, to avoid the taboo on Empress Lü's name, pile disease was called the wild-fowl disease.

Yuchwi 類聚

5.5 The Pulse 脉法

5.5.1
Source원문

蟲蝕肛陰, 其脈虛小者生, 緊急者死. 《脈經》 凡痔脈沈小實者易治, 浮洪而軟弱者難愈. 《正傳》 便血則壓數, 則赤黃實脈, 癃閉熱在膀胱. 《醫鑑》

Translation영역
Where worms erode the anus and genitals, a vacuous small pulse means life and a tight urgent one death. In any pile, a sunken small replete pulse is easy to treat and a floating surging soft weak one hard to heal. Where there is blood in the stool the pulse is pressed and rapid; a red-yellow replete pulse with dribbling blockage means heat in the bladder.

Maekgyeong 脉經 · Jeongjeon 正傳 · Uigam 醫鑑

5.6 The Names of the Piles 諸痔名目

5.6.1
Source원문

方書有五種: 一曰牡痔, 二曰牝痔, 三曰脈痔, 四曰腸痔, 五曰氣痔. 又有酒痔ㆍ血痔ㆍ瘻痔. 《三因》

Translation영역
The formularies have five kinds: the first is the male pile, the second the female pile, the third the vessel pile, the fourth the intestinal pile, the fifth the qi pile. There are also the wine pile, the blood pile and the fistulous pile.

Samin 三因

5.6.2
Source원문

凡痔毒甚者大如鷄冠ㆍ蓮花ㆍ核桃, 毒淺者小如松子ㆍ牛乳ㆍ鷄心ㆍ鼠乳ㆍ櫻桃. 雖種種不同, 皆三陰虛也. 《入門》

Translation영역
Where the toxin of a pile is severe it is as large as a cock's comb, a lotus flower or a walnut; where the toxin is slight it is as small as a pine nut, a cow's teat, a chicken's heart, a mouse's nipple or a cherry. Though they differ in kind and kind, all are a vacuity of the three yin.

Immun 入門

5.6.3
Source원문

凡痔因酒ㆍ色ㆍ風ㆍ氣ㆍ食五事過度而變成二十四證. 歌曰, 痔證分三八, 憑君仔細看, 莫敎年月久, 見者膽心寒. 《醫鑑》

Translation영역
Piles come of five things in excess — wine, sex, wind, qi and food — and turn into twenty-four patterns. The verse says: pile patterns divide into three eights; look at them closely, and do not let the months and years run on, for one who sees them late takes a chill at the heart.
Clinical note임상 주석
莫敎年月久 — do not let the months and years go by. The mnemonic verse that follows names twenty-four shapes — water caltrop, lotus, cock's comb, mouse nipple, chestnut, coral, pierced-bowel, hooked-bowel — and its one piece of advice is not to wait, which 5.6's own last line repeats in warning against the knife and the cautery.

Uigam 醫鑑

5.6.4
Source원문

五痔宜五痔散ㆍ神應散ㆍ槐角元ㆍ神應黑玉丹.

Translation영역
For the five piles: Five Piles Powder, Divine Response Powder, Sophora Fruit Pill and Divine Response Black Jade Elixir.

Donguibogam · Hueum

5.7 Piles Have an Inner and an Outer Kind 痔有內外

5.7.1
Source원문

脈痔ㆍ腸痔ㆍ氣痔ㆍ血痔ㆍ酒痔屬內; 牡痔ㆍ牝痔ㆍ瘻痔屬外.

Translation영역
The vessel pile, intestinal pile, qi pile, blood pile and wine pile belong to the inner kind; the male pile, female pile and fistulous pile belong to the outer.
Clinical note임상 주석
Internal and external haemorrhoids are still the first division made, and for the same reason: the inner kind bleeds and the outer kind is seen and felt.

Donguibogam · Hueum

5.8 The Vessel Pile 脈痔

5.8.1
Source원문

肛門周迴生瘡, 時時發痒出血者, 脈痔也. 宜五痔散ㆍ神應散.

Translation영역
Where sores arise all round the anus and from time to time it itches and bleeds, it is the vessel pile. Five Piles Powder and Divine Response Powder are appropriate.

Gangmok 綱目

5.9 The Intestinal Pile 腸痔

5.9.1
Source원문

肛門內結核有血, 寒熱往來者, 腸痔也. 宜五痔散ㆍ槐角元.

Translation영역
Where a kernel binds within the anus with blood, and cold and heat come and go, it is the intestinal pile. Five Piles Powder and Sophora Fruit Pill are appropriate.

Donguibogam · Hueum

5.10 The Qi Pile 氣痔

5.10.1
Source원문

因憂恐悒怏, 立見腫痛, 氣散則愈者, 氣痔也. 宜加味香蘇散.

Translation영역
Where anxiety, fear and vexed discontent at once bring swelling and pain, and it heals when the qi scatters, it is the qi pile. Supplemented Cyperus and Perilla Powder is appropriate.
Clinical note임상 주석
氣散則愈 — it heals when the qi scatters. A swelling that comes and goes with the patient's state of mind, which the chapter keeps as its own kind.

Donguibogam · Hueum

5.11 The Blood Pile 血痔

5.11.1
Source원문

每遇大便淸血隨下不止者, 血痔也. 詳見下腸風藏毒條.

Translation영역
Where at every stool clear blood comes down with it and does not stop, it is the blood pile. Treated below under intestinal wind and visceral toxin.

Donguibogam · Hueum

5.12 The Wine Pile 酒痔

5.12.1
Source원문

每遇飮酒卽發腫痛流血者, 酒痔也. 宜乾葛湯.

Translation영역
Where every time one drinks wine it swells, pains and runs blood, it is the wine pile. Pueraria Decoction is appropriate.

Donguibogam · Hueum

5.13 The Male Pile 牡痔

5.13.1
Source원문

肛邊生肉如鼠乳, 時時出膿血者, 牡痔也. 宜五痔散ㆍ釣腸丸.

Translation영역
Where flesh grows at the edge of the anus like a mouse's nipple and from time to time discharges pus and blood, it is the male pile. Five Piles Powder and Hook the Bowel Pill are appropriate.

Gangmok 綱目

5.14 The Female Pile 牝痔

5.14.1
Source원문

肛邊腫痛, 生瘡突出者, 牝痔也. 宜五痔散ㆍ逐瘀湯.

Translation영역
Where the edge of the anus is swollen and painful and a sore arises and stands out, it is the female pile. Five Piles Powder and Expel Stasis Decoction are appropriate.

Donguibogam · Hueum

5.15 The Fistulous Pile 瘻痔

5.15.1
Source원문

詳見下痔漏條. 宜五痔散ㆍ神應黑玉丹ㆍ加味槐角丸ㆍ秦艽蒼朮湯.

Translation영역
Treated below under fistulous piles. Five Piles Powder, Divine Response Black Jade Elixir, Supplemented Sophora Fruit Pill and Gentiana Macrophylla and Atractylodes Decoction are appropriate.

Donguibogam · Hueum

5.16 Intestinal Wind and Visceral Toxin 腸風臟毒

5.16.1
Source원문

卽血痔也. 腸澼者, 大便下血, 所謂腸風藏毒也. 《醫鑑》

Translation영역
This is the blood pile. Intestinal afflux is blood passed with the stool — what is called intestinal wind and visceral toxin.

Uigam 醫鑑

5.16.2
Source원문

如下淸血色鮮者, 腸風也; 血濁而色黯者, 臟毒也. 《本事》 腸風者, 邪氣外入, 隨感隨見, 所以其色淸也; 臟毒者, 蘊積熱毒, 久而始見, 所以其色濁也. 治腸風以散風行濕, 治臟毒以淸熱凉血. 《丹心》

Translation영역
Where the blood that comes down is clear and bright in colour, it is intestinal wind; where it is turbid and dark, it is visceral toxin. Intestinal wind is an evil qi entering from without, seen as soon as it is felt, and so its colour is clear; visceral toxin is heat toxin gathered and accumulated, seen only after long, and so its colour is turbid. Intestinal wind is treated by scattering wind and moving damp, visceral toxin by clearing heat and cooling blood.
Clinical note임상 주석
The chapter's best distinction, and it holds up: bright blood on the surface of the stool comes from near the anus, and dark blood mixed through it from higher up. Dark blood in the stool is the one finding in this chapter that still needs looking into rather than treating.

Bonsa 本事 · Dansim 丹心

5.16.3
Source원문

腸風下血必在糞前, 是名近血, 色淸而鮮, 宜用敗毒散方見寒門; 臟毒下血必在糞後, 是名遠血, 色濁而黯, 宜用香連丸方見大便. 藏寒下血無痛, 宜用薑桂之屬; 積熱下血純下鮮血, 甚則兼痛, 宜用三黃湯丸方見火門. 《醫鑑》

Translation영역
In intestinal wind the blood comes before the stool and is named near blood, clear and bright in colour: Vanquish Toxin Powder formula in the Cold Damage chapter. In visceral toxin it comes after the stool and is named far blood, turbid and dark: Costus and Coptis Pill formula in the Stool chapter. Where visceral cold brings blood down without pain, ginger and cinnamon and their kind; where accumulated heat brings down pure bright blood, with pain in a severe case, Three Yellows Decoction or Pill formula in the Fire chapter.

Uigam 醫鑑

5.16.4
Source원문

大便下血曰腸風, 切勿止澁, 究其本末證狀, 先淸其表, 後攻其裏, 其血自止. 如脈洪大, 四物湯方見血門合黃連解毒湯方見寒門調治. 《綱目》

Translation영역
Blood passed with the stool is called intestinal wind, and on no account is it to be stopped and astringed: look into the root and branch of the pattern, first clear the surface and afterwards attack the interior, and the blood stops of itself. Where the pulse is surging and large, Four Substances Decoction formula in the Blood chapter combined with Coptis Resolve Toxin Decoction formula in the Cold Damage chapter to regulate it.
Clinical note임상 주석
切勿止澁 — on no account stop and astringe it. The chapter's warning against treating the bleeding rather than the cause, which is also why 5.26's advice is to supplement the patient and leave the blood alone.

Gangmok 綱目

5.16.5
Source원문

大便後下血, 腹中不痛者, 謂之濕毒下血, 黃連湯主之; 腹中痛者, 謂之熱毒下血, 芍藥黃連湯主之. 《易老》

Translation영역
Where blood comes after the stool and the belly does not pain, it is damp toxin bleeding, and Coptis Decoction governs it; where the belly pains, it is heat toxin bleeding, and Peony and Coptis Decoction governs it.

Yeongno 易老

5.16.6
Source원문

腸澼者, 爲水穀與血幷下, 如射桶湧出也. 長夏濕熱太甚, 正當客氣盛而主氣弱, 故腸澼之病甚也. 宜升麻補胃湯ㆍ當歸和血散ㆍ升陽除濕和血湯. 《東垣》

Translation영역
Intestinal afflux is water and grain coming down together with blood, gushing out as from a squirted tube. In the long summer when damp heat is at its height, the visitor qi is exuberant and the host qi weak, and so the disease of intestinal afflux is severe. Cimicifuga Supplement the Stomach Decoction, Angelica Harmonize the Blood Powder and Upbear Yang, Remove Damp and Harmonize the Blood Decoction are appropriate.
Clinical note임상 주석
如射桶湧出 — gushing out as from a squirted tube. Dongwon's phrase for brisk rectal bleeding, and his three formulas are all built on upbearing rather than astringing.

Dongwon 東垣

5.16.7
Source원문

腸澼下血宜香殼丸ㆍ加味香連丸方見大便ㆍ升陽補胃湯ㆍ益智和中湯. 腸風宜香附散ㆍ止血散ㆍ栢葉湯ㆍ斷紅元. 臟毒宜解毒湯ㆍ槐花散ㆍ枳殼散ㆍ絲瓜散. 腸風臟毒通用玉屑丸ㆍ剪紅元ㆍ芎歸丸ㆍ槐黃丸ㆍ槐花散ㆍ腸風黑散ㆍ槐黃湯ㆍ淸榮槐花飮.

Translation영역
For intestinal afflux with bleeding: Fragrant Bitter Orange Pill, Supplemented Costus and Coptis Pill formula in the Stool chapter, Upbear Yang and Supplement the Stomach Decoction and Alpinia Harmonize the Centre Decoction. For intestinal wind: Cyperus Powder, Stop Bleeding Powder, Arborvitae Leaf Decoction and Cut Off the Red Pill. For visceral toxin: Resolve Toxin Decoction, Sophora Flower Powder, Bitter Orange Powder and Loofah Powder. For both together: Jade Shavings Pill, Cut Off the Red Pill, Chuanxiong and Angelica Pill, Sophora and Coptis Pill, Sophora Flower Powder, Intestinal Wind Black Powder, Sophora and Ailanthus Decoction and Clear the Construction Sophora Flower Drink.

Donguibogam · Hueum

5.17 Fistulous Piles 痔漏

5.17.1
Source원문

卽瘻痔也. 痔核已破謂之痔漏. 《東垣》

Translation영역
This is the fistulous pile. Where the pile's kernel has already broken it is called a fistulous pile.

Dongwon 東垣

5.17.2
Source원문

瘻痔亦謂之蟲痔. 歲月積久, 蟲蝕其間, 痒痛不堪, 或肛門間射血如線, 乃蟲痔也. 蟲痔宜熏, 千金用蝟皮ㆍ艾者佳方見下. 《本事》

Translation영역
The fistulous pile is also called the worm pile: with months and years accumulating, worms eat within it, the itching and pain are past bearing, and at times blood spurts from the anus like a thread — this is the worm pile. The worm pile should be fumigated, and the Cheongeumbang's method with hedgehog skin and mugwort is good formula below.
Clinical note임상 주석
射血如線 — blood spurting like a thread. Arterial bleeding from an eroded vessel, described exactly, and it is the finding in this chapter that most needs a surgeon.

Bonsa 本事

5.17.3
Source원문

痔漏之源由乎酒色. 痔久成瘻, 痔輕而瘻重, 痔實而瘻虛. 治痔之法不過凉血淸熱而已; 治瘻則初宜凉血淸熱燥濕, 久則宜澁竅殺蟲而兼乎溫散. 盖初作則腸胃氣實爲熱, 久則腸胃氣虛而爲寒矣. 《丹心》

Translation영역
The source of fistulous piles is wine and sex. A pile long continued becomes a fistula; the pile is light and the fistula heavy, the pile is repletion and the fistula vacuity. The method of treating a pile is no more than cooling the blood and clearing heat; in treating a fistula, at first one should cool the blood, clear heat and dry damp, but when it is long-standing one should astringe the opening and kill the worms, together with warming and dispersing. For at first the qi of intestines and stomach is replete and makes heat, and in time it is vacuous and makes cold.
Clinical note임상 주석
痔實而瘻虛 — the pile is repletion and the fistula vacuity. Danxi's rule reverses the treatment as the disease ages, and it is the same shape as the Chest chapter's warning that an old cold pain is no longer cold.

Dansim 丹心

5.17.4
Source원문

痔瘻先須服補藥生氣血, 用參ㆍ朮ㆍ芪ㆍ芎ㆍ歸爲主, 大劑服之; 外用附子灸法方見下鍼灸條. 《丹心》 痔漏專以凉血爲主, 宜用凉血飮, 外用澁藥塞竅. 《丹心》

Translation영역
In fistulous piles one must first take supplementing medicines to engender qi and blood, using ginseng, atractylodes, astragalus, chuanxiong and angelica as the chief and taking them in large doses; outwardly use the aconite moxa method in the acupuncture section below. Fistulous piles are treated above all by cooling the blood: Cool the Blood Drink is appropriate, with astringent medicines used outwardly to plug the opening.

Dansim 丹心

5.17.5
Source원문

痔漏宜黑玉丹ㆍ蝟皮丸ㆍ活龜丸ㆍ加味槐角丸方見上ㆍ豚胃丸ㆍ秘傳神應膏ㆍ蓮花蘂散ㆍ釣腸丸方見上ㆍ取漏膿法ㆍ取痔蟲方ㆍ塞漏孔方. 狐惑亦是蟲蝕肛詳見傷寒.

Translation영역
For fistulous piles: Black Jade Elixir, Hedgehog Skin Pill, Live Tortoise Pill, Supplemented Sophora Fruit Pill formula above, Pig's Stomach Pill, Secretly Transmitted Divine Response Paste, Lotus Stamen Powder, Hook the Bowel Pill formula above, the Method of Drawing Out Fistula Pus, the Formula for Drawing Out the Pile Worm and the Formula for Plugging the Fistula Opening. Fox-delusion is likewise worms eroding the anus treated in the Cold Damage chapter.

Donguibogam · Hueum

5.17.6
Source원문

蟲蝕痒痛下膿血, 槐白皮濃煎湯盛盆中, 坐其上熏穀道, 冷則易煖湯, 良久欲大便, 當有蟲出, 三度愈. 《本草》 秘方用煉蜜半盞, 入熊膽一分, 再煉入水成珠不散, 將猪鬃綿裹撚成撚子, 將蜜塗在撚子上, 仍用片腦ㆍ熊膽各半分硏細搽在撚子上, 揷入漏眼內, 底至盡頭則止. 如眼多, 醫得一箇又醫一箇, 不可一齊上藥. 如外皮潰爛, 用黃蠟ㆍ黃丹ㆍ麻油煎膏貼瘡上, 縛緊, 一七日效. 《醫鑑》

Translation영역
Where worms erode with itching, pain and a discharge of pus and blood, decoct sophora root bark thick, put it in a basin and sit over it to fumigate the grain path, changing it for warm when it cools; after a good while one wishes to go to stool and worms should come out, and three times over heals it. A secret method: half a jan of refined honey with 1 pun of bear bile, refined again until it beads in water without dispersing; wrap a pig's bristle in cotton wool and twist it into a wick, smear the honey on the wick, grind borneol and bear bile 5 ri each and rub them on it, and insert it into the fistula's eye, stopping when it reaches the end. Where there are many eyes, treat one and then another and do not dress them all at once. Where the outer skin is ulcerated, boil beeswax, red lead and sesame oil into a paste, stick it on the sore and bind it tight, and in seven days it answers.
Clinical note임상 주석
A bristle wrapped in cotton, waxed and medicated, passed into the track until it reaches the end — and the instruction not to dress more than one track at a time. That is a seton and a staged dressing, and the handling is careful. **Red lead is toxic; the external paste should not be prepared.**

Boncho 本草 · Uigam 醫鑑

5.17.7
Source원문

澁藥塞竅, 用童便煆爐甘石ㆍ牡蠣粉ㆍ龍骨ㆍ密陀僧. 《丹心》 塞竅宜辰砂膏ㆍ生肌散ㆍ上品錠子ㆍ寸金錠子.

Translation영역
For astringent medicines to plug the opening, use calamine calcined in boys' urine, oyster shell powder, dragon bone and litharge. For plugging the opening: Cinnabar Paste, Engender the Flesh Powder, Superior Grade Pellet and Inch of Gold Pellet.

Dansim 丹心 · Donguibogam · Hueum

5.18 Prolapse of the Rectum 脫肛

5.18.1
Source원문

卽腸痔也. 脫肛者, 肛門飜出也. 肺與大腸爲表裏, 腎主大便, 肺腎虛者多有此證, 參芪湯升之. 《回春》

Translation영역
This is the intestinal pile. Prolapse of the rectum is the anus turning itself out. The lung and large intestine are outer and inner to each other and the kidney governs the stool, so those vacuous in lung and kidney mostly have this pattern: Ginseng and Astragalus Decoction raises it.

Hoechun 回春

5.18.2
Source원문

脫肛一證, 氣聚不散也. 裏急而不得出, 外脹而不得入. 先以枳殼散敷付則氣散腫消矣. 《直指》

Translation영역
Prolapse of the rectum is the qi gathered and not scattering: within there is urgency and it cannot come out, without there is distension and it cannot go in. First apply Bitter Orange Powder, and the qi scatters and the swelling goes down.

Jikji 直指

5.18.3
Source원문

難經曰, 病之虛實, 出者爲虛, 入者爲實. 肛門之脫非虛無故然哉. 其有産婦用力過多, 及小兒叫號努氣, 幷久痢不止, 風邪襲虛, 亦有此證. 《直指》

Translation영역
The Nanjing says: in the vacuity and repletion of disease, what comes out is vacuity and what goes in is repletion. Could the anus prolapse without vacuity? There are also cases from a woman in childbirth using too much force, from a child crying and straining, from long diarrhoea that does not stop, and from a wind evil falling on vacuity.
Clinical note임상 주석
小兒叫號努氣 — a child crying and straining. Three of the four causes named here are simply straining, and prolapse in a child after prolonged diarrhoea or crying is exactly what the chapter describes.

Jikji 直指

5.18.4
Source원문

脫肛者氣下陷也. 肺主魄門, 肺熱則肛門縮入, 肺寒則肛門脫出, 必須溫肺補胃, 補中益氣湯方見內傷加訶子ㆍ樗根白皮少許; 或蝟皮散ㆍ釣腸丸方見上. 血熱者四物湯加黃栢ㆍ升麻; 虛熱者縮砂散. 《入門》

Translation영역
Prolapse of the rectum is the qi fallen downward. The lung governs the corporeal-soul gate: where the lung is hot the anus draws in, where the lung is cold the anus prolapses, and one must warm the lung and supplement the stomach — Supplement the Centre and Boost the Qi Decoction formula in the Internal Damage chapter with a little chebula and ailanthus root bark added; or Hedgehog Skin Powder and Hook the Bowel Pill formula above. Where the blood is hot, Four Substances Decoction with phellodendron and cimicifuga; where the heat is vacuous, Amomum Powder.

Immun 入門

5.18.5
Source원문

脫肛宜龍骨散ㆍ二槐丹ㆍ獨虎散ㆍ蚊蛤散ㆍ浮萍散ㆍ孩兒散ㆍ熏鱉法.

Translation영역
For prolapse of the rectum: Dragon Bone Powder, Two Sophoras Elixir, Lone Tiger Powder, Gallnut Powder, Duckweed Powder, Cutch Powder and the turtle fumigation method.

Donguibogam · Hueum

5.18.6
Source원문

治肛門不收, 五倍子末入白礬ㆍ蛇床子煎湯熏洗, 後以赤石脂末敷芭蕉葉上托入. 或長尺餘者, 以兩床相接中空, 以器盛藥水滿, 架起與床平, 令病者仰臥浸器中, 逐日如此, 縮盡爲度. 《得效》

Translation영역
To treat an anus that will not draw in: powdered gallnut with alum and cnidium seed decocted, fumigated and washed with; then dust powdered halloysite on a plantain leaf and push it back in with that. Where it hangs a cheok or more, set two couches together with a space between, fill a vessel with the medicinal water, raise it level with the couches and have the patient lie on their back soaking in it; do this daily until it has drawn wholly in.
Clinical note임상 주석
A vessel of warm medicated water set level between two couches so the patient can lie back and soak the part. It is a contrivance for a long prolapse, and the daily soaking is the same measure as 5.23's sitz bath.

Deukhyo 得效

5.18.7
Source원문

一女子脫肛, 以糯米濃煎汁洗肛, 却取塼燒紅沃醋, 靑布鋪其上, 令溫坐布上, 肛自吸入. 《綱目》

Translation영역
A girl had a prolapse of the rectum: the part was washed with a thick decoction of glutinous rice, then a brick was heated red and quenched with vinegar, a blue cloth spread over it, and when it was warm she was made to sit on the cloth, and the bowel drew itself in.

Gangmok 綱目

5.19 Itching and Pain of the Anus 肛門痒痛

5.19.1
Source원문

蟲痔多痒. 肛門作痒, 乃腸中有蟲. 生艾ㆍ苦練根煎湯熏洗, 仍以乾艾ㆍ生薑煎服. 《直指》

Translation영역
The worm pile mostly itches. Where the anus itches, there are worms in the bowel: decoct fresh mugwort and chinaberry root, fumigate and wash with it, and take dried mugwort and fresh ginger decocted.

Jikji 直指

5.19.2
Source원문

肛痒宜黑玉丹方見上ㆍ秦艽羌活湯, 又宜熏法見下. 治痒, 槐白皮或五加皮濃煎湯熏洗肛門. 《本草》 蟲蝕肛痒, 萹蓄葉一握, 水一升煮取五合, 去滓, 隔夜不食, 明晨空腹飮之, 蟲卽下. 小兒同法. 《丹心》

Translation영역
For an itching anus: Black Jade Elixir formula above, Gentiana Macrophylla and Notopterygium Decoction, and the fumigation method below. For the itching, decoct sophora root bark or acanthopanax bark thick and fumigate and wash the anus. For worms eroding with itching, a handful of knotgrass leaves boiled in a seung of water down to five hop and strained; eat nothing overnight and drink it next morning on an empty stomach, and the worms come down. The same method serves for a child.
Clinical note임상 주석
An anal itch that is worse at night and answers to a fast and a morning dose is pinworm, and this is the one place in the chapter where the worms are real.

Donguibogam · Hueum · Boncho 本草 · Dansim 丹心

5.20 Piles Together with Other Diseases 痔兼諸病

5.20.1
Source원문

痔疾有兼下疳瘡者, 有莖中出白津者, 有兼瘦者. 皆肝腎不足變出, 勿專服寒凉藥. 《入門》

Translation영역
Pile disease is sometimes accompanied by chancre sores, sometimes by a white discharge from the stalk, sometimes by wasting. All of these come of liver and kidney insufficiency, and cold and cooling medicines must not be taken by themselves.
Clinical note임상 주석
勿專服寒凉藥 — do not take cold medicines alone. The caution the chapter keeps returning to: where piles come with wasting or with a genital complaint, the patient is depleted and cooling alone will make it worse.

Immun 入門

5.21 The Method of Treating Pile Disease 痔病治法

5.21.1
Source원문

痔以凉血爲主. 盖熱則傷血, 血滯則氣亦不運, 而大腸下墜作痛. 大要以槐花ㆍ槐殼ㆍ生地黃凉血, 川芎ㆍ當歸ㆍ桃仁和血生血, 枳殼行氣寬腸, 黃芩ㆍ黃連ㆍ梔子淸熱, 黃栢ㆍ防己ㆍ澤瀉去濕, 麻仁ㆍ大黃潤燥, 秦艽ㆍ荊芥疎風. 《入門》

Translation영역
Piles are treated above all by cooling the blood: heat damages the blood, the blood stagnating the qi too does not move, and the large intestine bears down and pains. The essentials are sophora flower, sophora husk and fresh rehmannia to cool the blood; chuanxiong, angelica and peach kernel to harmonize and engender it; bitter orange to move the qi and loosen the intestine; scutellaria, coptis and gardenia to clear heat; phellodendron, stephania and alisma to remove damp; hemp seed and rhubarb to moisten dryness; gentiana macrophylla and schizonepeta to course wind.
Clinical note임상 주석
Seven jobs with the medicinals for each, in one sentence. It is the chapter's whole pharmacology set out as a checklist, and every decoction in it is built from this list.

Immun 入門

5.21.2
Source원문

治法以苦寒瀉火, 芩連梔子槐花之類; 以辛溫和血, 當歸川芎桃仁之類. 風邪在下, 秦艽防風升麻之類提之; 燥熱怫鬱, 大黃枳殼麻仁之類潤之. 《正傳》

Translation영역
The method is to drain fire with the bitter and cold — scutellaria, coptis, gardenia and sophora flower and their kind; and to harmonize the blood with the acrid and warm — angelica, chuanxiong and peach kernel and their kind. Where a wind evil is below, gentiana macrophylla, saposhnikovia and cimicifuga and their kind raise it; where dry heat is pent up, rhubarb, bitter orange and hemp seed and their kind moisten it.

Jeongjeon 正傳

5.21.3
Source원문

諸痔皆由房酒過度, 久嗜甘肥, 不愼醉飽以合陰陽, 勞擾血脈, 腸澼滲漏, 衝注下部, 肛邊生瘡, 變爲痔疾. 初發便服槐角丸; 熱實服湯藥疎利藏府, 及浴洗熏熨以取內消. 若變成痔瘻, 須用寸金錠子三五次愈. 《東垣》

Translation영역
All piles come of bedchamber and wine beyond measure, a long liking for sweet and fat things, and not taking care but joining yin and yang while drunk and full, so that the blood vessels are taxed and disturbed, the intestine seeps and leaks, it surges down into the lower part, sores arise at the edge of the anus and it turns into pile disease. At the first outbreak take Sophora Fruit Pill; where there is repletion heat take decoctions to free the viscera and bowels, with bathing, washing, fumigating and ironing to disperse it from within. If it turns into a fistulous pile, Inch of Gold Pellet used three to five times heals it.
Clinical note임상 주석
浴洗熏熨以取內消 — bathing, washing, fumigating and ironing, to disperse it from within. The chapter's organizing idea: medicine by mouth and treatment at the part, working toward each other, and the four external sections that follow are all this one clause expanded.

Dongwon 東垣

5.22 The General Treatment of Pile Disease 痔病通治

5.22.1
Source원문

一切痔病通治, 宜槐膽丸方見身形ㆍ槐角丸ㆍ加味槐角丸ㆍ秦艽蒼朮湯ㆍ蝟皮丸ㆍ釣腸丸ㆍ黑玉丹ㆍ五痔散ㆍ神應散八方皆見上ㆍ水馬散ㆍ三神丸. 久痔宜用黑地黃丸ㆍ蓮花蘂散方見上.

Translation영역
For the general treatment of any pile disease: Sophora and Gall Pill formula in the Body chapter, Sophora Fruit Pill, Supplemented Sophora Fruit Pill, Gentiana Macrophylla and Atractylodes Decoction, Hedgehog Skin Pill, Hook the Bowel Pill, Black Jade Elixir, Five Piles Powder and Divine Response Powder all eight above, Water Strider Powder and Three Spirits Pill. For long-standing piles, Black Rehmannia Pill and Lotus Stamen Powder formula above.

Donguibogam · Hueum

5.22.2
Source원문

治僧道流因久坐飽食發爲諸痔. 枳殼ㆍ皂角(煆)ㆍ五倍子(炒) 各等分. 右爲末, 蜜丸梧子大, 空心溫水下五七十丸. 《東垣》

Translation영역
Treats monks and clerics in whom long sitting and full eating have brought on piles of every kind. Bitter orange, gleditsia (calcined) and gallnut (stir-fried) in equal parts. Powder them, make honey pills the size of a firmiana seed, and take fifty to seventy on an empty stomach with warm water.
Clinical note임상 주석
因久坐飽食 — from long sitting and eating to fullness. A formula aimed at an occupation, and long sitting is still named first among the things that bring on haemorrhoids.

Dongwon 東垣

5.23 The Method of Washing Piles 洗痔法

5.23.1
Source원문

凡痔疾內服湯丸疎利藏府, 外用藥水洗浴以取內消. 《東垣》 凡痔漏脫肛腸風者, 登厠後須用溫湯一洗, 江河水尤妙. 《直指》

Translation영역
In any pile disease, decoctions and pills are taken inwardly to free the viscera and bowels, and a medicinal water is used outwardly to bathe with and so disperse it from within. Anyone with fistulous piles, prolapse or intestinal wind should wash once with warm water after going to stool, and river water is better still.
Clinical note임상 주석
登厠後須用溫湯一洗 — wash with warm water after every stool. One line, and it is the single most useful thing in this chapter. The Jikji gives it as a standing instruction rather than a treatment.

Dongwon 東垣 · Jikji 直指

5.23.2
Source원문

腸虛熱湊, 脫肛紅腫, 荊芥穗ㆍ朴硝泡湯溫洗. 《直指》 治痔腫痒痛, 威靈仙ㆍ枳殼 各一兩麤末, 煎湯先熏後洗, 冷則易; 枳實亦好. 《綱目》 洗痔方, 槐花ㆍ荊芥ㆍ枳殼ㆍ艾葉煎湯入白礬, 先熏後洗. 《得效》 無花果葉煮水熏洗亦可. 《丹心》

Translation영역
Where the intestine is vacuous and heat gathers with the prolapse red and swollen, steep schizonepeta spike and mirabilite in hot water and wash warm with it. To treat piles swollen, itching and painful, grind clematis and bitter orange 1 nyang each coarse, decoct, fumigate first and wash after, changing it as it cools; immature bitter orange serves too. A washing formula: sophora flower, schizonepeta, bitter orange and mugwort leaf decocted with alum added, fumigated with first and washed with after. Fig leaves boiled in water to fumigate and wash with will also do.

Jikji 直指 · Gangmok 綱目 · Deukhyo 得效 · Dansim 丹心

5.23.3
Source원문

洗痔瘻方, 川椒ㆍ艾葉ㆍ葱白ㆍ五倍子ㆍ焰硝ㆍ馬齒莧ㆍ茄子根, 右剉水煎, 先熏後洗. 《醫鑑》 痔痛不可忍, 木綿花煎湯入焰硝熏洗, 單用硝水極妙. 《綱目》 痔痒, 取河水頻洗, 硏蝸牛塗之. 《綱目》 脫肛, 苦參ㆍ五倍子ㆍ東壁土煎湯熏洗; 又熱童尿和白礬末熏洗, 以烘熱鞋底搽入. 《回春》 痔漏宜用却毒湯.

Translation영역
A formula for washing fistulous piles: Sichuan pepper, mugwort leaf, scallion white, gallnut, saltpetre, purslane and aubergine root, cut up and decocted in water, fumigated with first and washed with after. Where the pain of piles is past bearing, decoct cotton flower with saltpetre added and fumigate and wash; saltpetre water alone is excellent. For itching piles, wash often with river water and apply ground snail. For prolapse, decoct flavescent sophora, gallnut and east-wall earth to fumigate and wash with; or mix hot boys' urine with powdered alum to fumigate and wash, and push the bowel in with a warmed shoe sole. For fistulous piles, Drive Off Toxin Decoction.

Uigam 醫鑑 · Gangmok 綱目 · Hoechun 回春 · Donguibogam · Hueum

5.24 The Method of Fumigating Piles 熏痔法

5.24.1
Source원문

治五痔及瘻漏蟲蝕下膿血. 蝟皮三指大(剉), 雄黃如棗子大, 熟艾如鷄子大. 右麤末, 入瓦缸內火燒, 坐其上熏之, 取烟氣從口中出爲佳. 三日將息, 更熏之, 三度永差. 忌鷄猪魚生冷毒物. 《三因》

Translation영역
Treats the five piles and seeping fistula with worms eroding and a discharge of pus and blood. Hedgehog skin three fingers' breadth, cut up; realgar the size of a jujube; prepared mugwort the size of a hen's egg. Grind coarse, put into an earthen jar and set alight, and sit over it to be fumigated; it is best when the smoke is felt coming out at the mouth. Rest three days and fumigate again, and three times over cures it for good. Avoid chicken, pork, fish and raw, cold and toxic things. — Samin 三因 (Donguibogam · Hueum)
Clinical note임상 주석
取烟氣從口中出爲佳 — best when the smoke comes out at the mouth. The endpoint is nonsense as anatomy and the realgar makes the smoke arsenical. **Burning realgar produces arsenic trioxide fumes. This must not be prepared.**

Samin 三因

5.24.2
Source원문

治五痔痔漏, 鰻鱺魚火燒熏肛門, 痔蟲盡死; 鱓魚亦佳. 《本草》 又法, 死蛇一條, 掘地作坑, 盤屈置其中, 火燒, 以有孔板子覆坑, 坐板孔上熏之, 瘻蟲出盡大效. 《本草》

Translation영역
Treats the five piles and fistulous piles: burn an eel and fumigate the anus with it, and the pile worms all die; a swamp eel serves too. Another method: take a dead snake, dig a pit, coil it in and set it alight; cover the pit with a board that has a hole in it and sit over the hole to be fumigated, and the fistula worms all come out — greatly effective.

Boncho 本草

5.25 Medicines Smeared on Piles 塗痔藥

5.25.1
Source원문

治諸痔, 宜塗熊氷膏ㆍ痔藥膏子ㆍ蝸牛散ㆍ田螺膏ㆍ蜈蚣油ㆍ枯痔方ㆍ黑聖散.

Translation영역
To treat piles of every kind, smear on: Bear Bile and Borneol Paste, the Pile Medicine Paste, Snail Powder, River Snail Paste, Centipede Oil, the Withering the Pile Formula and Black Sage Powder.

Donguibogam · Hueum

5.25.2
Source원문

脫肛不收, 蝸牛燒爲末, 猪脂和付之立縮; 緣桑蝸牛尤妙. 《直指》 治痔瘻, 田螺一箇, 挑開厴入片腦少許, 過一宿, 先以冬瓜煎湯洗, 後取藥塗之. 《丹心》

Translation영역
Where a prolapse will not draw in, burn snails to a powder, mix with lard and apply, and it draws in at once; snails taken from a mulberry tree are better still. To treat fistulous piles, prick open the lid of one river snail, put in a little borneol and leave overnight; first wash with a decoction of winter melon, then apply the medicine.

Jikji 直指 · Dansim 丹心

5.25.3
Source원문

治痔, 活蜈蚣一條浸香油內, 候生黴略熬, 塗痔上, 累驗, 陳久愈妙. 《綱目》 枯痔方, 赤足蜈蚣一條香油煎酥, 瀝乾, 加乳香ㆍ沒藥 各二錢, 麝香ㆍ粉霜 各五分, 人指爪甲 五錢泥裹煨乾, 爲末, 以鵝翎管吹上患處, 如有水卽時出盡不疼. 《綱目》

Translation영역
To treat piles: steep one live centipede in sesame oil, and when mould has formed boil it a little and smear it on the piles — proved over and over, and the longer it has stood the better. A withering formula: fry one red-footed centipede crisp in sesame oil and drain it; add frankincense and myrrh 2 don each, musk and sublimed calomel 5 pun each, and 5 don of human nail parings wrapped in clay and roasted dry; powder them and blow onto the affected place through a goose quill, and if there is fluid it all comes out at once without pain.
Clinical note임상 주석
**Contains sublimed calomel, a mercury compound, blown onto a raw surface; centipede is toxic. This must not be prepared.**

Gangmok 綱目

5.26 What Is Forbidden in Pile Disease 痔病禁忌

5.26.1
Source원문

久痔虛者當服補藥, 如黑地黃丸方見上ㆍ腎氣丸方見虛勞, 以滋化源; 更節嗜慾, 謹起居, 方可斷根. 《入門》

Translation영역
One with long-standing piles who is vacuous should take supplementing medicines — Black Rehmannia Pill formula above and Kidney Qi Pill formula in the Vacuity Taxation chapter — to enrich the source of transformation; and he must moderate his appetites and be careful in rising and resting before the root can be cut off.

Immun 入門

5.26.2
Source원문

治痔忌喫生冷硬物ㆍ冷藥之類, 及酒ㆍ濕麪ㆍ五辛ㆍ辛熱大料物及薑桂之類, 犯之則服藥無效. 此東垣格言也. 《綱目》

Translation영역
In treating piles, avoid raw, cold and hard foods and cold medicines, and wine, damp wheat food, the five pungents, acrid hot spices and ginger and cinnamon and their kind; offend in this and the medicine taken has no effect. This is Dongwon's maxim.

Gangmok 綱目

5.26.3
Source원문

痔根本是冷, 愼冷飮食及房勞. 鷄肉最毒, 而房勞爲尤甚. 蕎麥麪亦須忌之. 《綱目》 宜常服茯苓麪. 《入門》

Translation영역
Piles are at root a cold thing: be careful of cold food and drink and of bedchamber taxation. Chicken is the most harmful, and bedchamber taxation worse still; buckwheat noodles must also be avoided. Poria Flour should be taken regularly.
Clinical note임상 주석
房勞爲尤甚 — bedchamber taxation worse still. 5.3 named wine, food and sex as the three causes, and this section closes by naming the same three as what will undo the treatment.

Gangmok 綱目 · Immun 入門

5.27 Ominous Signs in Pile Disease 痔病凶證

5.27.1
Source원문

久痔與陰相通者死. 《甲乙》

Translation영역
Where a long-standing pile has come to communicate with the genitals, death.
Clinical note임상 주석
與陰相通 — a track opening through to the genitals. A recto-vaginal or recto-urethral fistula, which before surgery was indeed what the Gabeul says it was.

Gabeul 甲乙經

5.28 Simple Medicinals 單方

5.28.1
Source원문

凡三十四種.

Translation영역
Thirty-four kinds in all.
Clinical note임상 주석
Thirty-four simples, and they divide by use. Taken inwardly for bleeding: sophora flower and sophora fruit, which head the list and are the chapter's own medicinals; sanguisorba, gallnut, ailanthus root bark, scouring rush and cockscomb flower. Applied or washed with: stove soot, east-wall earth, plantain, mugwort, angelica dahurica and the mushroom that grows on a sophora tree. And a long tail of animal medicinals — hedgehog skin, hornet's nest, turtle head, eel, frog, woodpecker, badger, mole — most of them burnt to ash first. Two are worth keeping: the leek and radish entries, both simply eaten, and poria flour, which 5.26 recommends as a daily food rather than a medicine.

Donguibogam · Hueum

5.29 Acupuncture and Moxibustion 鍼灸法

5.29.1
Source원문

痔漏, 灸命門ㆍ長强. 又於尾閭骨尖上灸七壯. 《綱目》

Translation영역
For fistulous piles, moxa Myeongmun (命門, GV4) and Jangganggang (長强, GV1); also moxa seven cones at the tip of the coccyx.

Gangmok 綱目

5.29.2
Source원문

脫肛, 灸臍中隨年壯, 又灸橫骨百壯, 又灸百會七壯. 《得效》

Translation영역
For prolapse of the rectum, moxa the navel as many cones as the patient has years; also moxa Hoenggol (橫骨, KI11) a hundred cones, and Baekhoe (百會, GV20) seven cones.
Clinical note임상 주석
Baekhoe at the crown for a prolapse at the other end. It is the clearest instance in the Bogam of treating a sinking by lifting from above, and it follows 5.18's reading of prolapse as the qi fallen downward.

Deukhyo 得效

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Outer Form, Volume 4, Posterior Yin 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.