譯 5.3.42.1 Source원문
造煎藥法 白薑 五兩, 桂心 二兩, 丁香ㆍ胡椒 各一兩半. 已上另爲細末. 大棗蒸去核, 取肉爲膏 二鉢一鉢爲三升, 阿膠ㆍ煉蜜 各三鉢. 右先熔膠, 次入棗蜜消化, 乃入四味藥末, 攪勻煎微溫, 下篩貯器, 待凝取用. 《俗方》
Translation영역
The method for making a boiled electuary. White dried ginger 5 nyang; cinnamon heartwood 2 nyang; clove and black pepper 1 nyang 5 don each. Grind the above separately to a fine powder. Steam jujubes, discard the stones and take the flesh to make a paste, 2 bowls — one bowl is 3 seung — with donkey-hide gelatin and refined honey 3 bowls each. Of the above, first melt the gelatin, next put in the jujube paste and the honey and let them dissolve, then put in the powders of the four drugs and stir them even. Boil it until it is barely warm, pass it through a sieve and store it in a vessel; wait until it sets and then take it for use.
Clinical note임상 주석
A 煎藥 is a dosage form rather than a disease remedy: a thick, keepable electuary taken by the spoonful, and this is the Bogam's own working recipe for the base. The structure is a gelatin-and-honey matrix carrying a jujube fruit paste, with a small warming aromatic fraction — ginger, cassia, clove, pepper — milled fine and stirred in off the boil so the volatile oils are not driven off. That last instruction, 煎微溫, is the one piece of real technique here, and it is correct: clove and pepper lose their aromatics above a simmer.
Nothing in it is hazardous. Donkey-hide gelatin is collagen, honey and jujube are sugars, and the whole preparation is essentially a confection. Honey should not be given to infants under one year because of the risk of infant botulism, which is the only modern caution the base attracts.
This opening method is the reason the section exists; the fifteen leaves that follow it are ointments and incenses rather than electuaries, and six of them are the compositions that the Abscesses chapter cites as 方見雜方 without giving them.
譯 5.3.42.2 Source원문
六香膏 治冬寒凍傷皸瘃. 白檀香ㆍ沉束香ㆍ丁香ㆍ零陵香ㆍ甘松香ㆍ八角香 各一兩. 爲麄末, 入三升蜜中浸之, 封口經七日或十日, 取出於火上微溫, 下篩去滓, 乃入三乃子細末 五錢ㆍ小腦末 三錢ㆍ冬瓜仁細末 七兩或十兩, 攪勻, 再下疏篩, 貯器中用之. ○其滓作團, 於火中燒之甚佳, 謂之江梅香. 《俗方》
Translation영역
Yukhyang-go. Treats frostbite injury from winter cold, with chapping and chilblains. White sandalwood, aquilaria-and-speed wood, clove, lysimachia, nardostachys and star-anise aromatic, 1 nyang each. Make them into a coarse powder, put it into 3 seung of honey and steep it; seal the mouth of the vessel and leave it seven or ten days. Take it out, warm it gently over the fire, pass it through a sieve and discard the dregs; then put in finely powdered sand ginger 5 don, powdered lesser borneol 3 don, and finely powdered winter-melon seed 7 nyang or 10 nyang. Stir them even, pass it again through a coarse sieve, and store it in a vessel for use. ○ Make the dregs into a ball and burn it in the fire — this is very fine, and it is called Gangmae-hyang.
Clinical note임상 주석
皸瘃 is the pair of cold injuries the old texts keep separate: 皸 is the split, fissured skin of chapping, 瘃 the swollen itching lesion we call a chilblain or pernio. Both are real conditions of cold exposure, and both are managed by rewarming, keeping the skin intact and occluded, and avoiding repeated freeze-thaw. An occlusive honey-and-seed-oil salve is a reasonable barrier dressing for fissured skin, and honey itself has mild antibacterial activity, so this is one of the chapter's more defensible preparations.
It is not, however, a treatment for frostbite proper. Deep frostbite is a freezing injury to tissue, and rubbing or massaging a frozen part with any ointment worsens the damage; rewarming is done in water at body temperature and the part is then left alone.
The aromatics carry no therapeutic weight. The honest reading of the leaf is that it is a cosmetic salve: the final clause, telling the maker to press the spent dregs into a cake and burn them as an incense called 江梅香, is the same instinct as the incense leaf that follows, and tells us this came out of a perfumer's practice rather than a physician's.
譯 5.3.42.3 Source원문
衣香 茅香蜜炒 一兩, 白芷 五錢, 沉束香ㆍ白檀香ㆍ零陵香ㆍ甘松香ㆍ八角香ㆍ丁香ㆍ三乃子 各二錢. 右並爲麄末, 入小腦 二錢末, 和勻作一貼, 置衣箱中最佳, 夏月尤好. 《俗方》
Translation영역
Uihyang. Sweet grass, honey-roasted, 1 nyang; angelica dahurica 5 don; aquilaria-and-speed wood, white sandalwood, lysimachia, nardostachys, star-anise aromatic, clove and sand ginger, 2 don each. Make all of the above into a coarse powder, add 2 don of powdered lesser borneol, blend it even and make it into one packet. Placing it in a clothes chest is best; it is especially good in the summer months.
Clinical note임상 주석
Not a medicine at all, but a sachet for a clothes chest, and the chapter is right to put it here rather than in a disease chapter. Its practical function is moth and insect repellence, and it would have some: borneol and the camphoraceous terpenes in nardostachys and sand ginger are volatile insect repellents, which is why the leaf says it is best in summer, when clothes-moth larvae feed.
Sweet grass (茅香, Hierochloe odorata) is the coumarin-bearing grass used for scenting linen across Eurasia. Coumarin is a hepatotoxin in rodents at high oral doses and is restricted as a food additive, but a sachet is not eaten and the exposure is negligible. The leaf is included in this edition because the text carries it, not because anything in it is clinical.
譯 5.3.42.4 Source원문
十香膏 沉香ㆍ丁香ㆍ白檀ㆍ甘松ㆍ鬱金 各五錢. 麄剉, 入麻油 一斤中浸七日, 却入鐺內, 慢火養五日後, 以文武火煎二三十沸, 用綿濾去滓. 拭鐺下了煉油, 入黃丹, 以柳篦子不住手攪, 候色黑, 滴求中成珠, 然後乃入乳香ㆍ木香ㆍ白膠香ㆍ龍齒ㆍ蘇合油末 各五錢, 麝香末 二錢半, 攪勻三五百遍, 候凝作片. 用時攤紅絹上貼之. 《聖惠》
Translation영역
Siphyang-go. Aquilaria, clove, sandalwood, nardostachys and turmeric, 5 don each. Cut them coarsely, put them into 1 geun of sesame oil and steep seven days; then transfer to a pan and nourish it over a slow fire for five days. After that boil it over a fire alternately gentle and fierce until it has bubbled up twenty or thirty times, and strain it through cotton wool to remove the dregs. Wipe the pan, set it back and refine the oil; put in red lead and stir without ever taking the hand off, using a willow spatula, until the colour turns black and a drop let fall into water forms a bead. Then put in frankincense, costus, styrax resin, fossil teeth and powdered storax oil, 5 don each, and powdered musk 2 don 5 fun; stir it even three to five hundred turns, and when it sets make it into cakes. When using it, spread it on red silk and apply.
Clinical note임상 주석
This is the archetypal 膏藥 of the period, and the method is the method: aromatic drugs macerated in sesame oil, the oil cooked down, and red lead stirred into the hot oil until the mass blackens and passes the bead test. What is happening chemically is saponification — the lead oxide reacts with the fatty acids of the oil to form lead soaps, and it is those lead carboxylates, not the aromatics, that give the plaster its body and its adhesive, thermoplastic consistency. Every leaf in this section that calls for 黃丹 is making the same thing.
**黃丹 is red lead, lead tetroxide (Pb₃O₄). Lead is a cumulative neurotoxin and nephrotoxin with no safe level of exposure; it is absorbed across broken skin and through an open sore far more readily than through intact skin, which is precisely the use these plasters are put to, and it crosses the placenta. Children are more susceptible than adults at every dose. The manufacture described here — stirring lead oxide into hot oil over an open fire for hours — exposes the maker as well as the patient. This must not be prepared.** The same warning applies to every 黃丹-bearing leaf that follows: 琥珀膏, 神仙太乙膏, 救苦膏, 雲母膏, 神異膏, 萬應膏 and 善應膏.
Musk (麝香) is from the musk deer, a CITES Appendix I species; it cannot lawfully be traded and no substitute reproduces it. Fossil teeth (龍齒) are mineralised bone, mostly calcium phosphate and carbonate, and are pharmacologically inert.
譯 5.3.42.5 Source원문
琥珀膏 琥珀 一兩, 丁香ㆍ木香 各七錢半, 木通ㆍ桂心ㆍ當歸ㆍ白芷ㆍ防風ㆍ松脂ㆍ朱砂ㆍ木鼈子 各五錢, 麻油 一斤. 右除琥珀ㆍ丁香ㆍ木香ㆍ桂心ㆍ朱砂爲末外, 其餘並剉, 浸油三宿, 慢火煎攪, 候白芷焦黃色漉出, 次下松脂熔化, 濾去滓. 再熬, 下黃丹 一斤, 以柳篦不住手攪令黑色, 滴水中成珠, 乃入琥珀等五末攪勻, 候凝作片聽用. 《局方》
Translation영역
Hobak-go. Amber 1 nyang; clove and costus 7 don 5 fun each; akebia, cinnamon heartwood, Korean angelica, angelica dahurica, siler, pine resin, cinnabar and momordica seed, 5 don each; sesame oil 1 geun. Of the above, set aside amber, clove, costus, cinnamon heartwood and cinnabar to be powdered; cut up all the rest and steep them in the oil three nights. Boil over a slow fire, stirring, and when the angelica dahurica has gone a scorched yellow strain it out. Next put in the pine resin, let it melt, and filter out the dregs. Boil it down again and put in 1 geun of red lead; stir with a willow spatula without ever taking the hand off until it goes black and a drop let fall into water forms a bead. Then put in the five powders, amber and the rest, stir them even, and when it sets make it into cakes and keep them ready for use.
Clinical note임상 주석
One of the plasters the Abscesses chapter prescribes by name without giving a composition, and the composition is here: a lead plaster in 1 geun of oil to 1 geun of red lead, the heaviest lead-to-oil ratio in the section, with an aromatic and resinous powder stirred in at the end. Pine resin and amber are both terpenoid resins; amber is fossilised conifer resin and does nothing a fresh resin does not do.
**Contains red lead; the lead warning given at Siphyang-go applies in full, and this leaf carries the most of it. It also contains 朱砂, cinnabar, which is mercuric sulfide (HgS). Mercury is a cumulative neurotoxin and nephrotoxin with no safe dose; cinnabar is poorly soluble but is not inert, and heating or grinding it releases more bioavailable mercury species. On an open sore the absorptive route is the broken skin, not the gut. This must not be prepared.**
木鼈子, Momordica cochinchinensis seed, contains momordica saponins and is toxic by mouth; here it is only steeped in the oil and strained out, which is the safer of the two ways the book uses it.
譯 5.3.42.6 Source원문
神仙太乙膏 玄參ㆍ白芷ㆍ當歸ㆍ肉桂ㆍ赤芍藥ㆍ大黃ㆍ生地黃 各一兩. 剉, 浸麻油 二斤, 春五ㆍ夏三ㆍ秋七ㆍ冬十日, 慢火煎, 令白芷焦黃色, 去滓, 下黃丹 一斤, 極攪勻, 滴水中成珠, 乃候凝作片聽用. 《局方》
Translation영역
Sinseontaeeul-go. Scrophularia, angelica dahurica, Korean angelica, cinnamon bark, red peony, rhubarb and raw rehmannia, 1 nyang each. Cut them up and steep them in 2 geun of sesame oil — five days in spring, three in summer, seven in autumn, ten in winter. Boil over a slow fire until the angelica dahurica has gone a scorched yellow, remove the dregs, and put in 1 geun of red lead. Stir it thoroughly even until a drop let fall into water forms a bead; then wait until it sets, make it into cakes and keep them ready for use.
Clinical note임상 주석
This closes one of the oldest standing gaps in the database. 神仙太乙膏 is cited in the Abscesses chapter as an alternative name for another plaster with the bare note 方見雜方, and this is the composition it points to: seven drugs in oil, stripped out, and 1 geun of red lead to 2 geun of oil. It is the plainest lead plaster in the section — the standard 太乙膏 of the Song formularies — and the one against which the others are elaborations.
The seasonal maceration times are not superstition. Steeping times scale inversely with temperature because extraction into a fixed oil is faster when warm and the oil turns rancid sooner, so three days in summer and ten in winter is a sensible rule of thumb arrived at empirically.
**Contains red lead; the lead warning given at Siphyang-go applies. This must not be prepared.** Rhubarb and raw rehmannia applied topically do nothing systemically; the plaster's observed effect — a sore kept occluded, moist and undisturbed under an adhesive dressing — is a property of the dressing and not of the drugs in it, and is reproducible with any modern occlusive dressing at no risk.
譯 5.3.42.7 Source원문
救苦膏 治風濕痠疼. 川烏炮 三錢, 牛膝ㆍ黃丹ㆍ乳香另硏 各五錢, 白芷ㆍ貝母ㆍ白芨ㆍ白斂 各二錢, 槐潤 一錢無則代桃膠, 沒藥另硏 七錢, 白膠香另硏ㆍ杏仁泥 各三兩, 當歸 一兩, 瀝靑另硏 八兩, 香油 半盞. 右末和勻, 以香油澆潤, 火上熔化, 每二兩作一貼, 攤油紙付患處. 《類聚》
Translation영역
Gugo-go. Treats wind-damp aching pain. Aconite, the Sichuan kind, blast-fried, 3 don; achyranthes, red lead and frankincense, ground separately, 5 don each; angelica dahurica, fritillaria, bletilla and ampelopsis, 2 don each; locust-tree gum 1 don — if you have none, substitute peach gum; myrrh, ground separately, 7 don; styrax resin, ground separately, and almond paste, 3 nyang each; Korean angelica 1 nyang; pitch, ground separately, 8 nyang; fragrant oil half a jan. Powder the above and blend it even; pour the fragrant oil over to moisten it and melt it down over the fire. For each 2 nyang make one plaster, spread it on oiled paper and apply it to the afflicted place.
Clinical note임상 주석
風濕痠疼 is aching musculoskeletal pain, the sort of chronic joint and soft-tissue pain for which a counterirritant plaster is still sold today. Unlike the other leaves here this one is not cooked: it is a cold-blended pitch-and-resin mass melted together, which is to say an adhesive plaster matrix of the kind modern medicated patches still use. Pitch (瀝靑) at 8 nyang is the largest single ingredient and is the vehicle.
**Contains 川烏, aconite, the prepared root of Aconitum. Aconitine and its congeners are cardiotoxic and neurotoxic alkaloids with a very narrow margin between the dose that causes tingling and the dose that causes fatal ventricular arrhythmia, and they are absorbed through the skin. The 炮 blast-frying reduces the alkaloid content but does not abolish it. Aconite is a leading cause of serious herbal poisoning in East Asia, and the leaf also contains red lead — the lead warning given at Siphyang-go applies. This must not be prepared.**
Pitch and coal-tar products are complex mixtures containing polycyclic aromatic hydrocarbons, some of which are carcinogenic on repeated skin contact. The interlinear note offering peach gum for locust-tree gum is a straight substitution of one plant exudate for another and makes no clinical difference.
譯 5.3.42.8 Source원문
玉容膏 一名玉容西施膏, 塗燥瘡. 黃芪ㆍ當歸ㆍ白芷ㆍ川芎ㆍ藿香ㆍ零陵香ㆍ白檀香ㆍ香附子ㆍ白斂ㆍ白芍藥ㆍ白芨ㆍ杏仁 各一兩, 瓜蔞 一箇, 龍腦 二錢, 淸油 四斤, 黃蠟 一斤. 右除龍腦, 並剉浸油中, 春五ㆍ夏三ㆍ秋七ㆍ冬十日, 日滿於石器煎, 候白芷焦黃色, 乃去滓, 入蠟熔化, 又去滓, 入龍腦攪勻, 密封用之. 冬則蠟減半. 《袖珍》
Translation영역
Ongyong-go, also called Ongyong Seosi-go. Smeared on dry sores. Astragalus, Korean angelica, angelica dahurica, Sichuan lovage, agastache, lysimachia, white sandalwood, cyperus, ampelopsis, white peony, bletilla and almond, 1 nyang each; trichosanthes fruit, one; borneol 2 don; clear oil 4 geun; yellow beeswax 1 geun. Of the above, set the borneol aside; cut up all the rest and steep them in the oil — five days in spring, three in summer, seven in autumn, ten in winter. When the days are up, boil it in a stone vessel until the angelica dahurica has gone a scorched yellow, then remove the dregs; put in the wax and let it melt, remove the dregs again, put in the borneol and stir it even. Seal it tightly and use it. In winter, halve the wax.
Clinical note임상 주석
The one leaf in the section with no metal in it, and the only one that is frankly a cosmetic — the second name, 玉容西施膏, invokes the classical beauty Xi Shi, and 燥瘡 here means dry, scaling, fissured skin rather than an abscess. What it is, pharmaceutically, is a beeswax-in-oil ointment at roughly four parts oil to one of wax, which is an emollient base of exactly the kind still compounded today; halving the wax in winter is a real adjustment, since a wax-stiff ointment will not spread on cold skin.
For dry, cracked skin an occlusive emollient is the correct treatment, and this would work. None of the botanicals adds anything, and borneol, which is there for the cool sensation, is a mild irritant on broken skin at higher concentrations.
The source label 袖珍 is not among the labels used elsewhere in the corpus and is romanised here as Sujin.
譯 5.3.42.9 Source원문
雲母膏 雲母ㆍ焰硝ㆍ甘草 各四兩, 槐枝ㆍ柳枝ㆍ陳皮ㆍ桑白皮ㆍ側栢葉ㆍ水銀 各二兩, 川椒ㆍ白芷ㆍ沒藥ㆍ赤芍藥ㆍ肉桂ㆍ當歸ㆍ鹽花ㆍ黃芪ㆍ血竭ㆍ菖蒲ㆍ白芨ㆍ芎藭ㆍ木香ㆍ白斂ㆍ防風ㆍ厚朴ㆍ麝香ㆍ桔梗ㆍ柴胡ㆍ松脂ㆍ人參ㆍ黃芩ㆍ蒼朮ㆍ草龍膽ㆍ合歡ㆍ乳香ㆍ附子ㆍ茯苓ㆍ高良薑 各五錢, 黃丹 十四兩, 淸油 二斤半. 右除雲母ㆍ焰硝ㆍ血竭ㆍ沒藥ㆍ乳香ㆍ麝香ㆍ黃丹ㆍ鹽花外, 餘藥剉浸油中七日後, 文火煎, 候白芷ㆍ附子焦黃色, 以布絞去滓, 再熬. 後下黃丹等八味細末, 以柳木篦不住手攪, 直至膏凝, 滴水中成珠爲度, 傾在磁器內, 彈水銀在上. 每用刮去水銀. 凡癰疽瘡腫, 外貼內服神效. 《局方》
Translation영역
Unmo-go. Mica, saltpetre and licorice, 4 nyang each; locust twig, willow twig, tangerine peel, mulberry root bark, arborvitae leaf and quicksilver, 2 nyang each; Sichuan pepper, angelica dahurica, myrrh, red peony, cinnamon bark, Korean angelica, salt flower, astragalus, dragon's blood, acorus, bletilla, Sichuan lovage, costus, ampelopsis, siler, magnolia bark, musk, platycodon, bupleurum, pine resin, ginseng, scutellaria, atractylodes, gentian, albizia, frankincense, aconite, poria and galangal, 5 don each; red lead 14 nyang; clear oil 2 geun 8 nyang. Of the above, set aside mica, saltpetre, dragon's blood, myrrh, frankincense, musk, red lead and salt flower; cut up the remaining drugs and steep them in the oil, and after seven days boil over a low fire until the angelica dahurica and the aconite have gone a scorched yellow. Wring the dregs out through cloth and boil it down again. After that put in the fine powders of the eight drugs, red lead and the rest, and stir with a willow-wood spatula without ever taking the hand off, right up to the point where the paste sets and a drop let fall into water forms a bead. Pour it into a porcelain vessel and flick the quicksilver over the top of it. Each time you use it, scrape the quicksilver off. For all abscesses, flat abscesses, sores and swellings, applied outwardly and taken inwardly, it works marvellously.
Clinical note임상 주석
This is the composition the Abscesses chapter stands in need of when it writes 方見雜方, and it is the most dangerous formula in the chapter. Forty-odd drugs, but the three that matter are metals and an alkaloid, and the last clause — 外貼內服, applied outwardly and taken inwardly — means the text intends it to be swallowed as well as spread on an open sore.
**Contains 水銀, quicksilver: elemental mercury. Mercury is a cumulative neurotoxin and nephrotoxin with no safe dose; elemental mercury evaporates at room temperature and the vapour is absorbed almost completely through the lungs, so a jar of ointment with free mercury flicked over its surface is a continuous inhalation exposure to whoever opens it. The instruction to scrape the mercury off before each use does not remove it. Contains 黃丹, red lead (lead tetroxide), at 14 nyang to 2 geun 8 nyang of oil, absorbed through broken skin and across the placenta, cumulative, with no safe level. Contains 附子, aconite, whose alkaloids are cardiotoxic at doses barely above the therapeutic one and which is here neither blast-fried nor otherwise prepared. Any one of these three would be disqualifying; the text directs that all three be eaten. This must not be prepared, applied or taken.**
Two further hazards: 焰硝 is potassium nitrate, which with the oils and resins here makes an oxidiser-plus-fuel mixture that can deflagrate on a hot fire, and 麝香 is musk-deer musk, a CITES Appendix I material that cannot lawfully be traded. 雲母 is muscovite mica, a sheet aluminosilicate, inert in the gut but a respirable dust hazard when ground.
譯 5.3.42.10 Source원문
臘享膏 治凍瘡. 臘猪脂ㆍ猯油 各二兩半, 香油 二合半, 海松子油 一合, 明松脂ㆍ黃蠟 各三兩七錢半. 右各煉去滓, 熔化成膏, 待凝貯器中塗之. 《俗方》
Translation영역
Naphyang-go. Treats frostbite sores. Lard rendered in the twelfth month and badger fat, 2 nyang 5 don each; fragrant oil 2 hop 5 jak; pine-nut oil 1 hop; clear pine resin and yellow beeswax, 3 nyang 7 don 5 fun each. Render each of the above and remove the dregs, melt them together into a paste, and when it has set store it in a vessel and smear it on.
Clinical note임상 주석
A pure fat-and-wax ointment with no active drug in it at all — animal fats, two seed oils, pine resin and beeswax, melted and clarified. As a barrier dressing for the cracked, weeping skin of a healing cold injury this is sound in principle, and the same thing is achieved today with white soft paraffin.
**Rendered animal fat prepared without sterility and stored at room temperature is a growth medium. Applied to the broken skin of a frostbite sore it carries a real risk of wound infection, and deep frostbite wounds are the classic setting for clostridial infection and tetanus. Nothing in this ointment is antibacterial.** The twelfth-month rendering specified for the lard (臘猪脂) was a keeping measure — fat rendered in the cold and stored cold goes rancid more slowly — not a pharmacological one.
Badger fat (猯油) comes from a wild mustelid; the species of hog badger and Eurasian badger are variously protected, and wild-animal fat carries the additional hazard of zoonotic transmission from the carcass.
譯 5.3.42.11 Source원문
神異膏 露蜂房ㆍ杏仁 各一兩, 黃芪 七錢半, 蛇退鹽水洗淨ㆍ玄參 各五錢, 亂髮雞子大, 香油 十兩, 黃丹 五兩. 右先將油及髮銚中熬, 候髮烊盡, 入杏仁, 候杏仁黑色, 綿濾去滓, 乃入黃芪ㆍ玄參, 熬一二時稍停, 入蜂房ㆍ蛇退攪熬, 至紫黑色, 又濾去滓, 慢火熬, 下黃丹急攪千餘轉, 滴水不散, 膏卽成矣. 磁器收貯用, 治諸般癰癤毒. 《正傳》
Translation영역
Sini-go. Exposed wasp nest and almond, 1 nyang each; astragalus 7 don 5 fun; snake slough, washed clean in salt water, and scrophularia, 5 don each; tangled hair, the size of a hen's egg; fragrant oil 10 nyang; red lead 5 nyang. Of the above, first take the oil and the hair and boil them in a small pan; when the hair has wholly dissolved put in the almonds, and when the almonds have gone black strain it through cotton wool and remove the dregs. Then put in the astragalus and the scrophularia and boil one or two hours; let it stand a little, then put in the wasp nest and the snake slough, stirring and boiling until it reaches a purple-black colour, and strain the dregs out again. Boil over a slow fire, put in the red lead and stir briskly a thousand turns and more; when a drop let fall into water does not disperse, the paste is made. Store it in a porcelain vessel for use. It treats poison of abscesses and boils of every kind.
Clinical note임상 주석
Another of the Abscesses chapter's open cross-references, and the composition is here. The technique is worth noting independently of the formula: human hair boiled in oil until it 烊盡, wholly dissolves, is alkaline hydrolysis of keratin, and it would in fact dissolve in hot oil over hours. The resulting mass was prized as 髮灰 or 血餘 and is inert.
**Contains red lead; the lead warning given at Siphyang-go applies, at 5 nyang of red lead to 10 nyang of oil. This must not be prepared.**
**The leaf also puts human hair, a wasp nest and a snake skin into a preparation laid on an open abscess. None of them is sterilised by the cooking in any reliable sense, and a boil or abscess is precisely the wound in which a contaminated dressing causes spreading cellulitis or tetanus.** 露蜂房, the nest of a paper wasp, is mostly masticated plant fibre; 蛇退 is shed snake epidermis, keratin. Neither has any established activity. An abscess is treated by incision and drainage, and antibiotics where there is surrounding cellulitis; no plaster drains one.
譯 5.3.42.12 Source원문
萬應膏 大黃ㆍ黃芩 各二兩, 白斂ㆍ黃蠟 各一兩, 黃栢ㆍ芍藥ㆍ白芷ㆍ黃芪ㆍ木鼈子仁ㆍ杏仁ㆍ當歸ㆍ白芨ㆍ生地黃ㆍ官桂ㆍ玄參ㆍ沒藥ㆍ乳香 各五錢, 黃丹 一斤, 香油 二斤八兩. 右十四味剉, 浸油三宿, 慢火熬, 以柳枝攪, 以白芷焦黃色爲度, 綿濾去滓, 入黃丹再熬, 滴水成珠, 乃入乳ㆍ沒ㆍ蠟熔化攪勻, 收貯盛器, 埋土中七日取出攤用, 治一切癰腫久瘡. 《精義》
Translation영역
Maneung-go. Rhubarb and scutellaria, 2 nyang each; ampelopsis and yellow beeswax, 1 nyang each; phellodendron, peony, angelica dahurica, astragalus, momordica seed kernel, almond, Korean angelica, bletilla, raw rehmannia, official cinnamon, scrophularia, myrrh and frankincense, 5 don each; red lead 1 geun; fragrant oil 2 geun 8 nyang. Cut up the fourteen drugs above, steep them in the oil three nights, then boil over a slow fire, stirring with a willow twig, taking the angelica dahurica going a scorched yellow as the measure. Strain through cotton wool to remove the dregs, put in the red lead and boil it down again until a drop let fall into water forms a bead; then put in the frankincense, the myrrh and the wax, let them melt and stir them even. Store it in a vessel and bury it in the earth seven days; take it out, spread it, and it treats all abscess-swellings and chronic sores.
Clinical note임상 주석
A third standing cross-reference closed. The count holds: 右十四味 does not mean the seventeen drugs named but the fourteen that go into the oil — the beeswax, myrrh and frankincense are added after straining and the red lead and oil are not counted, which leaves exactly fourteen.
**Contains red lead at 1 geun to 2 geun 8 nyang of oil; the lead warning given at Siphyang-go applies. This must not be prepared.**
Burying the finished plaster in the earth for seven days is the one instruction worth comment. It is a cooling and curing step — the mass is left in a cool, dark place at stable temperature to finish setting, and the same practice is recorded for lead plasters in Europe, where it was said to draw out the fire. Nothing is drawn out; the plaster simply hardens and its peroxide value falls as it is kept away from light and air.
譯 5.3.42.13 Source원문
善應膏 黃丹 八兩, 白膠香ㆍ乳香ㆍ沒藥並另硏ㆍ當歸ㆍ白芷ㆍ杏仁ㆍ大黃ㆍ草烏ㆍ川烏ㆍ赤芍藥ㆍ檳榔ㆍ生乾地黃ㆍ川芎ㆍ瀝靑另硏ㆍ亂髮 各一兩. 右香油 一斤, 浸藥三宿, 慢火熬至黑色, 再入葱白ㆍ亂髮煎少時, 濾去滓, 再上慢火熬, 却入黃丹, 以柳篦不住手攪, 滴水成珠不散, 乃入乳ㆍ沒ㆍ膠香, 十分攪勻, 盛器沉水中三日取出聽用, 治諸般惡瘡腫毒及諸傷. 《得效》
Translation영역
Seoneung-go. Red lead 8 nyang; styrax resin, frankincense and myrrh, all ground separately, Korean angelica, angelica dahurica, almond, rhubarb, wild aconite, Sichuan aconite, red peony, areca, dried raw rehmannia, Sichuan lovage, pitch, ground separately, and tangled hair, 1 nyang each. Take 1 geun of fragrant oil of the above, steep the drugs in it three nights, then boil over a slow fire until it goes black; put in scallion white and tangled hair and boil a little while longer, then strain out the dregs. Set it back over a slow fire and boil it down, then put in the red lead and stir with a willow spatula without ever taking the hand off, until a drop let fall into water forms a bead and does not disperse. Then put in the frankincense, the myrrh and the styrax resin, stir it thoroughly even, and in a vessel sink it in water three days; take it out and keep it ready for use. It treats malignant sores, swellings and poison of every kind, and injuries of every kind.
Clinical note임상 주석
The fourth of the Abscesses chapter's open references, and the last line extends it to 諸傷, injuries, which is why the same name turns up in the trauma chapter. The method is the standard one, with a second pass of scallion white and hair through the hot oil before the lead goes in.
**Contains both 草烏 and 川烏 — wild aconite and Sichuan aconite, 1 nyang of each, neither of them prepared. Aconitine and the related diterpenoid alkaloids are cardiotoxic and neurotoxic, the margin between an effective and a fatal dose is very narrow, and they are absorbed through broken skin; topical aconite poisonings with arrhythmia are documented. Contains 黃丹, red lead, at 8 nyang: the lead warning given at Siphyang-go applies. This must not be prepared.**
Pitch adds polycyclic aromatic hydrocarbons to a dressing meant for prolonged skin contact, and human hair is laid into a preparation for open wounds. For an infected wound or a malignant sore the modern treatment is drainage, debridement where there is dead tissue, and systemic antibiotics when there is spreading infection.
譯 5.3.42.14 Source원문
白龍膏 白薇ㆍ白芷ㆍ白斂ㆍ黃芪ㆍ商陸根ㆍ柳白皮ㆍ桑白皮 各一兩, 輕粉 五錢另硏, 乳香 二兩另硏, 定粉ㆍ黃蠟 各八兩, 杏仁油 一斤無則代香油. 右七味剉, 浸三日, 揉熬令白芷黃色, 去滓, 下黃蠟ㆍ乳香令熔化, 出火再濾, 微冷下輕粉ㆍ定粉, 急攪至冷, 收貯. 攤緋帛上貼之, 治諸般惡瘡久瘡腫毒. 《精義》
Translation영역
Baekryong-go. Cynanchum atratum, angelica dahurica, ampelopsis, astragalus, pokeweed root, willow bark and mulberry root bark, 1 nyang each; calomel 5 don, ground separately; frankincense 2 nyang, ground separately; lead-carbonate white and yellow beeswax, 8 nyang each; almond oil 1 geun — if you have none, substitute fragrant oil. Cut up the seven drugs above, steep them three days, then work and boil them until the angelica dahurica goes yellow and remove the dregs. Put in the beeswax and the frankincense and let them melt; take it off the fire and filter it again, and when it is slightly cool put in the calomel and the lead-carbonate white and stir briskly until it is cold. Store it. Spread it on crimson silk and apply; it treats malignant sores, chronic sores, swellings and poison of every kind.
Clinical note임상 주석
The white plaster of the set, and it is white because of what is in it. Unlike the other leaves this one is not a lead-soap plaster made by cooking oxide into hot oil: it is a wax ointment into which two insoluble metal salts are stirred cold, as pigments, at 8 nyang and 5 don in roughly 1 geun of oil. That is an enormous metal load in a dressing for a chronic open sore.
**Contains 輕粉, calomel, which is mercury(I) chloride (Hg₂Cl₂), and 定粉, lead-carbonate white (basic lead carbonate). Both mercury and lead are cumulative toxins with no safe dose, both are absorbed across broken skin, and a chronic sore dressed repeatedly with them is the worst case: a large absorptive surface, re-applied over weeks. Mercury compounds applied to skin cause acrodynia and nephrotic syndrome, and the Bogam's own Sores chapter records calomel poisoning in four separate places. This must not be prepared.**
商陸, pokeweed root, is itself toxic — the saponins are irritant and emetic — though here it is only steeped and strained out. Willow bark and mulberry root bark are the two unobjectionable items; salicin in willow bark is the historical ancestor of aspirin, but not at a concentration that does anything through skin.
譯 5.3.42.15 Source원문
靈應膏 白麥飯石火煆醋淬十餘次硏令極細ㆍ鹿角燒存性ㆍ白斂, 並爲細末. 右取石末ㆍ白斂末 各二兩, 鹿角末 四兩, 並要極細, 不細則反痛. 取好米醋, 入銀石器煎令魚眼沸, 却入三味藥末, 竹篦子不住手攪, 熬一二時, 稀稠得所, 傾出候冷. 先以猪蹄湯或藥水洗去膿血, 挹乾, 鵝翎拂藥, 塗四圍, 凡赤處盡塗之, 但留一口如錢大以出膿血. 如藥乾, 以醋拂濕. 初便一日洗換, 十日後兩日一換. 其效如神, 治癰疽惡瘡瘰癧結核乳癰. 《精要》
Translation영역
Yeongeung-go. White maifanite, calcined in the fire and quenched in vinegar a dozen times and more, then ground extremely fine; deer antler, burnt with its nature preserved; and ampelopsis — all made into a fine powder. Of the above take the stone powder and the ampelopsis powder 2 nyang each and the antler powder 4 nyang; all must be extremely fine, for if they are not fine they cause pain instead. Take good rice vinegar, put it in a silver or stone vessel and boil it until it bubbles with fish-eye bubbles; then put in the powders of the three drugs and stir with a bamboo spatula without ever taking the hand off. Boil one or two hours, until the thickness is right, and pour it out to cool. First wash away the pus and blood with pig's-trotter decoction or a medicated wash, blot it dry, brush the drug on with a goose quill and smear it all round the sore — smear the whole of whatever is red — leaving only one opening the size of a coin for the pus and blood to come out. If the drug dries, brush it damp with vinegar. At first change the dressing once a day; after ten days, change it every second day. Its effect is marvellous. It treats abscesses, flat abscesses, malignant sores, scrofula, nodules and breast abscess.
Clinical note임상 주석
The last of the six references the Abscesses chapter leaves open, and the only one of the six with no metal and no alkaloid in it. It is also the best piece of wound care in the section, and the reason is in the details rather than the drugs. The sore is washed clean of pus and blood before dressing; the paste is applied around the lesion and not over it; **一口如錢大**, an opening the size of a coin, is deliberately left so that pus can continue to drain; the dressing is kept moist with vinegar rather than allowed to dry onto the wound; and the dressing interval is lengthened from daily to alternate days as the wound settles. Every one of those is current practice — drainage maintained, periwound protection, moist wound healing, de-escalating dressing frequency.
The materials are close to inert. 白麥飯石 is maifanite, a weathered porphyritic rock, mostly aluminosilicate; antler burnt 燒存性 is charred calcium phosphate; ampelopsis is a vine root. The vehicle is rice vinegar, roughly 4 to 5 per cent acetic acid, and dilute acetic acid genuinely is antibacterial — it is still used as a topical agent against Pseudomonas in wound and ear infections. The warning that insufficiently ground powder 反痛, causes pain instead, is an accurate observation about abrasive particles in a wound dressing.
What it cannot do is treat what the last line claims. 瘰癧 is cervical lymphadenopathy, most often tuberculous, and 乳癰 is usually a lactational breast abscess; both need systemic treatment, and a breast abscess needs drainage. Washing a wound in a decoction of pig's trotters introduces a contaminated fluid into it, and vinegar on healthy granulation tissue at full strength is cytotoxic.
譯 5.3.42.16 Source원문
爐灰膏 治癰疽惡瘡, 內點去瘀肉最妙. 用響糖爐內灰無則桑柴灰代之 一升半, 風化石灰 一升炒紅, 以箕子盛貯, 用滾湯三椀慢慢淋, 自然汁一椀許, 銅鍋盛, 慢火熬如稀糊. 先下巴豆末, 次下蟾酥 各二錢, 白丁香末 五分, 石灰炒 一錢, 攪勻, 再熬如乾麪糊, 取起候冷, 磁罐盛貯, 勿令泄氣. 每用時, 以簪頭挑少許, 放指甲上硏, 呵氣調勻如泥, 用鍼撥開患處, 以藥點之, 勿點好肉及眼上. 《入門》
Translation영역
Nohoe-go. Treats abscesses, flat abscesses and malignant sores; for dotting inside them to take away dead flesh it is the most excellent thing there is. Take ash from inside a sugar-boiling furnace — if you have none, substitute mulberry-wood ash — 1 seung 5 hop, and air-slaked lime 1 seung, roasted until it glows red. Hold them in a winnowing basket and pour three bowls of boiling water slowly over them; of the liquid that runs off of itself take about one bowl, hold it in a copper pan and boil it over a slow fire until it is like a thin paste. First put in powdered croton seed, next toad venom, 2 don each, powdered sparrow droppings 5 fun, and roasted lime 1 don; stir it even and boil it again until it is like a stiff flour paste. Take it off, let it cool, and store it in a porcelain jar; do not let the air get at it. Each time you use it, lift out a little on the head of a hairpin, put it on the fingernail and work it, breathe on it and blend it even until it is like mud; open the afflicted place with a needle and dot the drug onto it. Do not dot it onto good flesh, nor onto the eye.
Clinical note임상 주석
This is not an ointment but a chemical escharotic, and the text knows it. What is made in the first half of the leaf is lye: plant ash leached with boiling water gives a solution of potassium carbonate, and boiling that down with quicklime — 風化石灰 roasted 炒紅 is calcium oxide — causticises the carbonate to potassium hydroxide. The product, concentrated to a stiff paste and kept from the air so it does not take up carbon dioxide and water, is caustic potash. 去瘀肉 is the removal of dead flesh, which is to say chemical debridement, and caustic potash will do it.
**This is a corrosive alkali. Potassium hydroxide liquefies protein and saponifies fat on contact and goes on penetrating as long as it is present, so an alkali burn deepens for hours after application and cannot be judged at the time it is made. It destroys healthy tissue exactly as readily as dead tissue — the leaf's own instructions, 勿點好肉及眼上, not to dot it onto good flesh or onto the eye, are the measure of how corrosive it is — and it heals with scarring and contracture. Alkali on the eye causes rapid, often irreversible corneal destruction. Applied to a mole or a skin lesion it also destroys the tissue a pathologist would need to tell a benign lesion from a melanoma. This must not be prepared or used.**
**It carries three further hazards. 巴豆, croton seed, contains phorbol esters: these are severe vesicants and among the most potent tumour promoters known, and croton oil is the standard laboratory agent for provoking skin inflammation and promoting tumours. 蟾酥, toad venom, consists of bufadienolides, which act like cardiac glycosides; it is absorbed through broken skin and mucosa, and fatal poisonings from toad-venom preparations are documented in the modern literature. 白丁香 is sparrow droppings — raw avian faecal material placed into a wound that has just been opened with a needle, carrying an obvious risk of wound infection and of tetanus.**
The Abscesses chapter prescribes this leaf by name for dotting away dead flesh before a healing plaster is applied, and that sequence — debride, then dress — is the right one. Modern debridement is done by sharp excision, by enzymatic or autolytic dressings, or surgically under anaesthesia, with the depth controlled by the operator at every moment.