寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

Sores

Jechang

한글 제창  ·  Pinyin Zhu Chuang

The sores — leprosy, syphilis, scrofula, the itches, and what was laid on them

諸瘡

The longest chapter of the volume and the one whose diseases are easiest to name now. 大風瘡 is Hansen's disease, and its five deaths — skin, flesh, blood, sinew, bone — are a staging of nerve damage. 天疱瘡, also called 楊梅瘡 after the mulberry, is syphilis, and the chapter says in its first line that it passes between men and women in the bedchamber. 瘰癧 is tuberculous lymphadenitis, 疥癬 the scabies and the ringworms, 蛇纏瘡 herpes zoster, 漆瘡 lacquer dermatitis, 湯火瘡 burns and 凍瘡 frostbite. It is also the chapter where the treatment does the most harm. Syphilis is treated with mercury from one end of 天疱瘡 to the other — calomel swallowed, mercury burnt under a sheet and breathed, mercury held in the eye by lamplight — and the chapter records the poisoning that followed as its own sections: a method for getting the calomel back out of the belly, and the palms that peel and will not stop peeling once the course is done. The physicians who wrote this knew their medicine was hurting people and went on, because against syphilis it was the only thing that seemed to work at all. That is the honest shape of the chapter, and the notes keep it.

2.1 The Great Wind Sore 大風瘡

2.1.1
Source원문

脉風成爲癩. 癩者, 榮衛熱腐, 其氣不淸, 故使鼻柱壞而色敗, 皮膚瘍潰. 《內經》

Translation영역
Vessel wind becomes the lichen. In the lichen the constructive and defensive are hot and putrid and their qi is not clear, and so the bridge of the nose is ruined and the colour spoilt, and the skin breaks out and ulcerates.
Clinical note임상 주석
鼻柱壞 — the bridge of the nose is ruined. Collapse of the nasal bridge from destruction of the septum is the single most recognizable sign of lepromatous leprosy, and the Inner Classic names it first. 癩 is Hansen's disease, caused by Mycobacterium leprae, and the chapter's account of it is the most clinically accurate long description in the book.

Naegyeong 內經

2.1.2
Source원문

大風之源, 有三種五死. 一種風水, 二種傳變, 三種者自不調攝.

Translation영역
The sources of the great wind are of three kinds and five deaths. The first kind is the wind and water of a place, the second transmission and mutation, the third a man's own failure to regulate himself.

Donguibogam · Jechang

2.1.3
Source원문

五死者, 一曰皮死麻木不仁, 二曰肉死割切不痛, 三曰血死潰爛成濃, 四曰筋死手足脫落, 五曰骨死鼻梁崩塌ㆍ眼斷ㆍ唇翻ㆍ聲啞.

Translation영역
As to the five deaths: the first is called the death of the skin, numbness and loss of feeling; the second the death of the flesh, that cutting it gives no pain; the third the death of the blood, ulcerating and rotting into pus; the fourth the death of the sinews, the hands and feet dropping away; the fifth the death of the bone, the ridge of the nose falling in, the eyes severed, the lips turned back and the voice gone dumb.
Clinical note임상 주석
This is the best passage in the chapter and one of the best in the book. Read in order, the five deaths are a staging of leprosy by what has been lost: numbness, then analgesia — 割切不痛, cutting gives no pain — then ulceration, then loss of the digits, then collapse of the face. And the order is the right one, because it is the order in which the disease destroys peripheral nerves. The hands and feet do not rot off of themselves; they are lost to injuries the patient cannot feel, and to the infections that follow. 皮死麻木不仁 and 肉死割切不痛 are the two findings a modern examination still begins with, and the Bogam has put them at the head of the sequence where they belong.

Donguibogam · Jechang

2.1.4
Source원문

又曰, 一風者肺受病, 先落眉毛; 二風者肝受病, 面起紫疱; 三風者腎受病, 脚底先穿; 四風者脾受病, 遍身如癬; 五風者心受病, 先損其目.

Translation영역
It is also said: in the first wind the lung receives the disease and the eyebrows fall first; in the second the liver receives it and purple blisters rise on the face; in the third the kidney receives it and the soles are pierced first; in the fourth the spleen receives it and the whole body is as though ringwormed; in the fifth the heart receives it and the eyes are harmed first.
Clinical note임상 주석
A second scheme, by viscus, and three of its five signs are the classical presentation: 先落眉毛, loss of the eyebrows, is madarosis; 脚底先穿, the soles pierced, is the plantar ulcer of an insensate foot; 先損其目, the eyes harmed, is the iritis and corneal damage that blind untreated patients. The viscus each is assigned to is doctrine; the signs are observation.

Donguibogam · Jechang

2.1.5
Source원문

或有墳墓居址風水不吉, 或父母夫妻家人遆相傳染, 或在外不謹糞坑ㆍ房室ㆍ床鋪ㆍ衣被ㆍ橋上ㆍ樹下歇息去處, 命値委死凶星, 遭此惡疾. 宜服消風散ㆍ追虱散ㆍ磨風元, 兼用洗藥ㆍ敷藥. 《翛然子》

Translation영역
It may be that the wind and water of the graves or of the dwelling-place are unlucky; or that parents, husband and wife, and the household pass the contagion to one another in turn; or that abroad he is careless of the privy, the lodging, the bedding, the clothes and quilts, the bridge-top and the resting-place under a tree; or that his fate falls under a malign star of death — and he meets with this foul disease. Sopung-san 消風散, Chuisil-san 追虱散 and Mapung-won 磨風元 should be given, with the washing drugs and the dusting drugs used alongside.
Clinical note임상 주석
父母夫妻家人遆相傳染 — parents, husband and wife and the household infect one another in turn. Between the geomancy and the malign star sits a correct statement of how leprosy spreads: prolonged close household contact, which is still the chief risk factor known. The chapter cannot separate that from the unlucky grave, and lists both; but it has the observation.

Soyeonja 翛然子

2.1.6
Source원문

大風病是受得天地間殺物之風, 古人謂之癘風者, 以其酷烈暴悍可畏也. 得之者須分在上在下. 夫在上者, 以醉仙散取臭涎惡血於齒縫中出; 在下者, 以通天再造散取惡物虫積於穀道中出. 所出雖有上下之殊, 然皆不外乎陽明一經. 盖陽明者胃與大腸, 無物不受, 乃脾肺二藏之府也. 脾主肌肉而肺主皮毛, 乃府及於藏病也. 《丹心》

Translation영역
The great wind disease is the taking on of that wind between heaven and earth which kills living things, and the ancients called it the pestilent wind because it is cruel, fierce, violent and to be feared. In one who has it, whether it is above or below must be distinguished. Where it is above, Jwiseon-san 醉仙散 draws the foul drool and malign blood out through the seams of the teeth; where below, Tongcheonjaejo-san 通天再造散 draws the malign matter and worm accumulation out through the grain road. Though what comes out differs as above from below, neither falls outside the single Yangmyeong channel. For Yangmyeong is the stomach and the large intestine, which receive everything, and are the bowels of the two viscera spleen and lung; the spleen governs the flesh and the lung the skin and hair, and so it is the bowel reaching the viscus in disease.

Dansim 丹心

2.1.7
Source원문

服藥下虫積後, 用防風通聖散方見風門調之. 重者又與換肌散. 夫上下同得者甚重, 自非醫者神手ㆍ病者鐵心, 罕能免此. 若遇此疾, 切須戒鹽及一切口味, 公私世務悉宜屛去. 《丹心》

Translation영역
After the drug has brought down the worm accumulation, Bangpungtongseong-san 防風通聖散 — the formula is given in the Wind chapter — is used to settle him. In the grave case Hwangi-san 換肌散 is given besides. Where he has it above and below together it is very grave, and unless the physician has a divine hand and the patient a heart of iron, few escape it. Whoever meets with this disease must strictly abstain from salt and from every savour, and put away all business public and private.

Dansim 丹心

2.1.8
Source원문

此疾雖治得愈, 若不絶味斷慾, 皆不免再發而終於不救. 孫眞人曰, 嘗治四五百人, 終無一人免於死. 非眞人不能治, 盖無人能守禁忌耳. 《丹心》

Translation영역
Though this disease be treated and healed, if he does not give up savour and break off desire he will not escape its rising again, and will end beyond saving. Master Sun said: I have treated four or five hundred, and in the end not one escaped death. It is not that the master could not treat it — rather that no one could keep the prohibitions.
Clinical note임상 주석
嘗治四五百人, 終無一人免於死 — four or five hundred treated and not one escaped death. It is the plainest admission of therapeutic failure anywhere in the Donguibogam, and the Dansim prints it without softening. The explanation offered, that the patients would not keep the diet, is wrong: nothing in the chapter treats Mycobacterium leprae, and leprosy was not curable until the sulfones of the 1940s. But the number is honest, and a physician who records four hundred deaths against his own method has told the truth about it.

Dansim 丹心

2.1.9
Source원문

初起白屑紫雲如癜風然, 或有遍身白皮脫落如蛇蛻狀. 《得效》

Translation영역
At its rising there are white scales and purple clouding as in the dapple wind, or the white skin over the whole body peels away like a snake's sloughing.

Deukhyo 得效

2.1.10
Source원문

起白屑者白花蛇丸, 眉鬚落者三蛇丹, 鼻崩者換肌散ㆍ補氣瀉榮湯. 通用凌霄花散ㆍ加味苦參丸ㆍ換骨丸ㆍ大麻風丸ㆍ紫雲風丸ㆍ返魂追命再造散ㆍ烏蛇苦參元可選用. 《諸方》

Translation영역
Where white scales rise, Baekhwasa-hwan 白花蛇丸; where the eyebrows and beard fall, Samsa-dan 三蛇丹; where the nose has fallen in, Hwangi-san 換肌散 and Bogisayeong-tang 補氣瀉榮湯. For general use one may choose among Neungsohwa-san 凌霄花散, Gamigosam-hwan 加味苦參丸, Hwangol-hwan 換骨丸, Daemapung-hwan 大麻風丸, Jaunpung-hwan 紫雲風丸, Banhonchumyeongjaejo-san 返魂追命再造散 and Osagosam-won 烏蛇苦參元.

Jebang 諸方

2.1.11
Source원문

治癩, 以蒼耳葉爲君, 更以酒煮烏蠡魚代補蛇之或缺, 爲末糊丸梧子大, 茶淸下七八十丸. 更入紫萍尤捷, 數月而安. 《丹心》

Translation영역
In treating the lichen, cocklebur leaf is made the sovereign, and a black snakehead fish boiled in wine is used besides to supply the place of the snake where it is wanting; powder them and roll them with paste into pills the size of a paulownia seed, and send down seventy or eighty in clear tea. Putting in purple duckweed as well is quicker still, and in a few months he is well.

Dansim 丹心

2.1.12
Source원문

服藥瘳後, 終身不得食牛ㆍ馬ㆍ驢ㆍ騾等肉, 犯者復發必死. 《得效》

Translation영역
After the drug has cured him he may never for the rest of his life eat the flesh of cattle, horses, donkeys or mules; he who transgresses has it again and must die.

Deukhyo 得效

2.1.1 The Bathing Method 浴法

2.1.1.1
Source원문

治遍身癩瘡. 桃ㆍ柳ㆍ桑ㆍ槐ㆍ楮五般枝多水濃煎湯, 盛大桶, 浸坐沒頸一日, 竢湯如油安矣. 《正傳》

Translation영역
Treats the lichen sore over the whole body. Boil branches of the five kinds — peach, willow, mulberry, pagoda tree and paper mulberry — thick in a quantity of water, fill a large tub, and let him sit steeping in it up to the neck for a day; wait until the water is like oil and he is well.
Clinical note임상 주석
A whole-body immersion for a day. Soaking does soften the thickened, scaling skin of lepromatous disease and makes it more comfortable, and warm water on an insensate limb is also how such a limb gets scalded — the patient cannot feel the temperature. That is the one caution the chapter does not give.

Jeongjeon 正傳

2.1.2 The White Lichen Sore 白癩瘡

2.1.2.1
Source원문

癩風初起白屑剝落, 又一種每朝瘡上退白皮一升許, 如蛇蛻. 宜服解毒雄黃元方見咽喉, 兼服白花蛇丸. 《得效》

Translation영역
At the rising of the lichen wind white scales flake away; and there is another kind in which about a seung of white skin comes off the sore every morning, like a snake's sloughing. Haedokunghwang-won 解毒雄黃元 — the formula is given in the Throat chapter — should be given, with Baekhwasa-hwan 白花蛇丸 taken alongside.

Deukhyo 得效

2.1.3 The Needling Method 鍼法

2.1.3.1
Source원문

癘風者, 素刺其腫上, 已刺, 以銳鍼鍼其處, 按出其惡氣, 腫盡乃止. 常食方食, 無食他食. 《靈樞》

Translation영역
In the pestilent wind, prick plainly over the swelling; and the pricking done, needle the place with a sharp needle and press out its malign qi, stopping only when the swelling is gone. Let him always eat proper food and eat no other.

Yeongchu 靈樞

2.1.3.2
Source원문

病大風, 骨節重, 鬚眉墮, 名曰大風, 刺肌肉爲故, 汗出百日; 刺骨髓, 汗出百日; 凡二百日, 鬚眉生而止鍼. 《內經》

Translation영역
Where he is sick of the great wind, the bone joints heavy and the beard and eyebrows fallen, it is called the great wind: needle the flesh as the rule is, sweating a hundred days; needle the marrow, sweating a hundred days; two hundred days in all, and when the beard and eyebrows grow again the needling stops.
Clinical note임상 주석
鬚眉生而止鍼 — stop when the brows grow back. Taking the return of hair as the endpoint is a reasonable thing to watch for, since madarosis is one of the signs that remits when lepromatous disease is controlled. Two hundred days of needling and sweating is not what controls it.

Naegyeong 內經

2.1.3.3
Source원문

癩風, 以三稜鍼看肉紫黑處及委中穴名紫脉出死血, 但不可令出太過, 恐損眞氣. 《正傳》

Translation영역
In the lichen wind, use the three-edged needle at the places where the flesh is purple-black, and at the purple vessel at Wijung — the name of a point — to let out the dead blood; only it must not be let out to excess, for fear of harming the true qi.
Clinical note임상 주석
**Needling the purple-black patches of a leprosy patient must not be done.** Those areas are anaesthetic, so the patient cannot report pain, and the skin over them heals badly; puncturing insensate tissue is how the chronic ulcers of this disease begin. The chapter's own 五死 passage explains why, two sections earlier.

Jeongjeon 正傳

2.2 The Heavenly Blister Sore 天疱瘡

2.2.1
Source원문

一名楊梅瘡, 與癩大同. 多由肝ㆍ脾ㆍ腎風濕熱之毒, 因男女房室傳染. 形如楊梅, 焮紅濕爛, 痒痛者屬心, 多生乳脇.

Translation영역
Also named the mulberry sore, and much the same as the lichen. It comes mostly of the wind, damp and heat toxin of the liver, spleen and kidney, passing by contagion through the bedchamber between man and woman. Where it is shaped like a mulberry, inflamed red, wet and rotting, and itches and hurts, it belongs to the heart, and arises mostly on the breast and flanks.
Clinical note임상 주석
因男女房室傳染 — passing by contagion through the bedchamber between man and woman. The Immun's first sentence on this disease names it as sexually transmitted, and 楊梅瘡, the mulberry sore, is syphilis: the name is for the raised, red, mulberry-like papules of the secondary stage. Syphilis reached East Asia at the turn of the sixteenth century, within living memory of this chapter's sources, and the Bogam is describing a new disease whose route of transmission it has correctly worked out.

Immun 入門

2.2.2
Source원문

形如鼓釘ㆍ黃豆者屬脾, 多生滿面.

Translation영역
Where it is shaped like a drum-stud or a yellow bean it belongs to the spleen, and arises mostly over the whole face.

Immun 入門

2.2.3
Source원문

形如綿花者屬肺, 多生毛髮.

Translation영역
Where it is shaped like cotton-wool it belongs to the lung, and arises mostly in the hair.

Immun 入門

2.2.4
Source원문

形如紫蒲萄, 按之緊痛者屬肝腎, 多䕺生於尻臀ㆍ兩陰ㆍ筋骨之處.

Translation영역
Where it is shaped like a purple grape and hurts tightly when pressed it belongs to the liver and kidney, and clusters mostly at the buttocks, the two yin parts, and the places of sinew and bone.
Clinical note임상 주석
兩陰 — the genitals, and 筋骨之處, the places of sinew and bone. The genital lesion is the primary chancre and the condylomata of the secondary stage; pain in the bones is the periostitis and the nocturnal bone pain of later syphilis, which 2.2's formula list addresses under 筋骨痛 with its own set of prescriptions. The chapter is sorting the stages of one disease by where the lesion sits.

Immun 入門

2.2.5
Source원문

形如魚疱, 內多白水, 按之不緊者謂之天疱瘡, 乃此類之輕者. 《入門》

Translation영역
Where it is shaped like a fish blister, holding much clear water within, and is not tight when pressed, it is called the heavenly blister sore, and is the lighter of this kind.

Immun 入門

2.2.6
Source원문

初起卽服防風通聖散一貼去麻黃以去內毒, 再用一貼去硝黃發汗以去外毒. 以後用加減通聖散ㆍ丸多服之. 此方爲首尾要藥, 輕者一劑, 重者十貼. 後宜服化毒散三日, 却用吹藥三日, 瘡乾欲落, 欲落再服化毒散三日, 後量用通聖散加減. 《入門》

Translation영역
At its rising give at once one packet of Bangpungtongseong-san 防風通聖散 with the ephedra taken out, to clear the inward toxin, and then one packet with the mirabilite and rhubarb taken out, to raise a sweat and clear the outward toxin. Afterwards Gagamtongseong-san 加減通聖散 and its pill are given in quantity. This prescription is the essential drug from beginning to end: one course for the light case, ten packets for the grave. Then Hwadok-san 化毒散 should be given for three days, and the blowing drug used for three days, until the sores dry and are about to fall; as they are about to fall, Hwadok-san 化毒散 again for three days, and after that Tongseong-san 通聖散 used in a measured way with additions and subtractions.

Immun 入門

2.2.7
Source원문

失治久, 則風毒流入經絡而成頑癬, 或氣血虛敗而成漏, 或誤服水銀ㆍ輕粉而成風堆腫爛ㆍ流膿出汁. 病至於此, 治之爲難. 亦有蝕傷眼鼻ㆍ腐爛玉莖ㆍ拳攣肢體, 與癩無異. 《入門》

Translation영역
Where it is long untreated, the wind toxin flows into the channels and network vessels and makes a stubborn ringworm; or the qi and blood fail in vacuity and make a fistula; or, from mistakenly taking quicksilver and calomel, it makes wind-heaps swollen and rotting, running pus and weeping fluid. Once the disease has come to this, treating it is hard. There is also eating away of the eyes and nose, rotting of the jade stalk, and clenching and contracture of the limbs, no different from the lichen.
Clinical note임상 주석
誤服水銀ㆍ輕粉而成風堆腫爛ㆍ流膿出汁 — from mistakenly taking quicksilver and calomel, wind-heaps swollen and rotting, running pus and weeping fluid. **This is the chapter describing mercury poisoning as a complication of its own treatment**, and it is the most important sentence in the section. Everything 2.2 prescribes below is built on mercury, and the Immun has set out in advance what mercury does: a weeping, ulcerating skin eruption, which is the exfoliative dermatitis and mercurial stomatitis of chronic exposure. The chapter goes on to prescribe it anyway, and later gives two whole sub-sections — 取輕粉法 for getting the calomel back out and 鵝掌癬 for the palms that will not stop peeling afterwards — to the damage. Against untreated syphilis, which does the 鼻ㆍ眼ㆍ玉莖ㆍ肢體 destruction listed in this same passage, mercury was the only thing that appeared to answer, and it stayed in use for four centuries for that reason. **None of these mercury preparations may be made or taken.**

Immun 入門

2.2.8
Source원문

初起宜服消風敗毒散ㆍ加減通聖散ㆍ加減通聖丸. 從肚皮起者, 裏熱發於外, 速服防風通聖散方見風門.

Translation영역
At its rising, Sopungpaedok-san 消風敗毒散, Gagamtongseong-san 加減通聖散 and Gagamtongseong-hwan 加減通聖丸 should be given. Where it begins from the skin of the belly, interior heat is breaking out, and Bangpungtongseong-san 防風通聖散 — the formula is given in the Wind chapter — should be given at once.

Immun 入門

2.2.9
Source원문

成頑癬者宜皂根丸.

Translation영역
Where it has become a stubborn ringworm, Jogeun-hwan 皂根丸 should be given.

Immun 入門

2.2.10
Source원문

成腫塊者宜仙遺粮丸ㆍ西聖復煎丸ㆍ消腫遺粮湯.

Translation영역
Where it has become swollen lumps, Seonyuryang-hwan 仙遺粮丸, Seoseongbokjeon-hwan 西聖復煎丸 and Sojongyuryang-tang 消腫遺粮湯 should be given.

Immun 入門

2.2.11
Source원문

筋骨痛宜香鰾湯ㆍ通仙五寶丹ㆍ仙遺粮湯ㆍ換骨散ㆍ回生保命丹ㆍ茯苓湯.

Translation영역
For pain of sinew and bone, Hyangpyo-tang 香鰾湯, Tongseonobo-dan 通仙五寶丹, Seonyuryang-tang 仙遺粮湯, Hwangol-san 換骨散, Hoesaengbomyeong-dan 回生保命丹 and Bokryeong-tang 茯苓湯 should be given.
Clinical note임상 주석
筋骨痛 as a heading of its own, with six prescriptions for it. Bone pain worst at night, years after the sore, is the periostitis of tertiary syphilis, and it is the complaint that made this disease so feared. The chapter has given it its own treatment line.

Immun 入門

2.2.12
Source원문

成漏宜象牙丸.

Translation영역
Where it has become a fistula, Sangameurhwan 象牙丸 should be given.

Immun 入門

2.2.13
Source원문

通治宜用活魂丹ㆍ水硃丸ㆍ六六丸ㆍ天疱丸ㆍ三黃敗毒散ㆍ取輕粉法.

Translation영역
For general treatment, Hwalhon-dan 活魂丹, Sujusa-hwan 水硃丸, Yungnyuk-hwan 六六丸, Cheonpo-hwan 天疱丸, Samhwangpaedok-san 三黃敗毒散 and the method for drawing out the calomel should be used.

Immun 入門

2.2.14
Source원문

外治宜洗方ㆍ搽方ㆍ熏鼻方ㆍ吹藥方ㆍ照藥方ㆍ滅瘢法ㆍ禁忌法ㆍ鵝掌癬治方.

Translation영역
For outward treatment, the washing method, the smearing method, the nose-fumigating method, the blowing method, the lamp method, the scar-removing method, the prohibitions, and the method for treating the goose-palm ringworm.

Immun 入門

2.2.1 The Method of Drawing Out the Calomel 取輕粉法

2.2.1.1
Source원문

取出腹內輕粉之毒, 可免後患. 用開口川椒, 每空心以土茯苓煎湯呑下三十粒, 卽利輕粉於椒內從大便出. 洗起川椒, 服至椒內無輕粉乃止. 《入門》

Translation영역
Drawing the toxin of the calomel out of the belly, that the later trouble may be escaped. Take split-mouthed Sichuan pepper and swallow thirty grains each time on an empty stomach with a decoction of smilax, and the calomel is at once freed into the peppercorns and comes away with the stool. Wash the peppercorns and look; keep taking them until there is no calomel inside the pepper, and then stop.
Clinical note임상 주석
A whole section for getting the treatment back out of the patient. 可免後患 — that the later trouble may be escaped — is the chapter admitting that the calomel it has just prescribed will cause the trouble, and the endpoint, 椒內無輕粉乃止, is a crude assay: keep going until no metal is visible in the washed pepper. The reasoning is sound and the method cannot work. Mercury is absorbed and deposited in the kidney and the nervous system; it does not sit in the gut waiting to be collected in peppercorns, and what the patient saw in the stool was unabsorbed drug. Modern treatment of mercury poisoning is chelation, and it has to be given early. **Neither the calomel nor this remedy for it should be prepared.**

Immun 入門

2.2.2 The Washing Method 洗藥方

2.2.2.1
Source원문

治楊梅瘡爛. 防風ㆍ蒼耳子ㆍ地骨皮ㆍ荊芥ㆍ苦參ㆍ細辛 各三兩. 剉, 以河水煎, 盛大桶, 浸浴熏洗通身, 出汗出血爲效. 《醫鑑》

Translation영역
Treats the mulberry sore when it is rotting. Saposhnikovia, cocklebur fruit, lycium root bark, schizonepeta, sophora root and asarum, 3 nyang each. Cut them, boil them in river water, fill a large tub, and let him steep and bathe, fuming and washing the whole body; sweat coming out and blood coming out is the sign of effect.

Uigam 醫鑑

2.2.2.2
Source원문

又方, 苦參ㆍ蛇床子ㆍ白礬ㆍ荊芥濃煎湯浸洗. 《得效》

Translation영역
Another method: boil sophora root, cnidium fruit, alum and schizonepeta thick and let him steep and wash in it.

Deukhyo 得效

2.2.2.3
Source원문

又桃ㆍ柳ㆍ桑ㆍ槐ㆍ楮濃煎湯浸浴亦佳. 《入門》

Translation영역
Again, boiling peach, willow, mulberry, pagoda tree and paper mulberry thick and steeping and bathing in it is also good.

Immun 入門

2.2.3 The Smearing Method 搽藥方

2.2.3.1
Source원문

治楊梅ㆍ天疱遍身瘡爛. 杏仁 十四枚(鍼挑火上燒半生半熟), 輕粉 一錢, 片腦 二釐. 爲末, 猪膽汁或香油調搽. 《入門》

Translation영역
Treats the mulberry and heavenly blister sores when they are rotting over the whole body. Fourteen apricot kernels, picked on a needle and burnt over the fire half raw and half done; calomel 1 don; borneol 2 ri. Powder them and smear them on, stirred with pig's gall or with sesame oil.
Clinical note임상 주석
**Calomel is mercurous chloride and must not be applied to broken skin.** A rotting sore over the whole body is a very large absorbing surface, and this is the route by which the mercurial dermatitis of 2.2 and the peeling palms of 2.2.9 followed. The apricot kernel and the borneol are the vehicle; the mercury is what the recipe is for.

Immun 入門

2.2.3.2
Source원문

又野菊花ㆍ棗木根煎湯洗後, 防風通聖散同蚯蚓糞爲末, 略炒蜜調付之極妙. 《入門》

Translation영역
Again, after washing with a decoction of wild chrysanthemum flower and jujube-tree root, powder Bangpungtongseong-san 防風通聖散 together with earthworm castings, parch it a little, stir it with honey and apply it; this is excellent.

Immun 入門

2.2.3.3
Source원문

又用千金散ㆍ麝香輕粉散.

Translation영역
Again, Cheongeum-san 千金散 and Sahyanggyeongbun-san 麝香輕粉散 are used.

Immun 入門

2.2.4 The Nose-Fumigating Method 熏鼻方

2.2.4.1
Source원문

治楊梅ㆍ天疱瘡熏鼻甚奇. 黑鈆ㆍ水銀 各一錢, 朱砂ㆍ乳香ㆍ沒藥 各五分, 血竭ㆍ雄黃ㆍ沉香 各三分. 右爲末和勻, 捲作紙撚七條, 用香油點燈放床上, 令病人放兩脚包住, 上用單被通身盖之, 口噙凉水頻換則不損口頭. 初日用三條, 後日每用一條熏之. 《丹心》

Translation영역
Treats the mulberry and heavenly blister sores; fuming the nose with it is most marvellous. Black lead and quicksilver, 1 don each; cinnabar, frankincense and myrrh, 5 fun each; dragon's blood, realgar and aquilaria, 3 fun each. Powder the above and mix them even, roll them into seven paper spills, light them with sesame oil and set them on the bed; have the patient put his two legs about them to enclose them, cover his whole body over with a single quilt, and let him hold cold water in his mouth and change it often, and then the mouth and head are not harmed. On the first day use three spills, and on the days after one each time.
Clinical note임상 주석
**This must not be attempted.** Lead, mercury, cinnabar and realgar are burnt under a quilt and the patient breathes the fume for as long as the spills last. Inhaled mercury vapour is the most dangerous route of all — it crosses the lung almost completely and then the blood-brain barrier — and this preparation adds lead and arsenic to it. The instruction to hold cold water in the mouth 則不損口頭, so that the mouth and head are not harmed, shows that the physicians had seen the stomatitis and the salivation that mercury vapour causes and were trying to shield the one part they could see. The damage they could not see was being done at the same time.

Dansim 丹心

2.2.4.2
Source원문

又方, 水銀ㆍ白錫ㆍ百草霜 各一錢. 先將錫熔化, 入二味和勻, 硏末捲作紙撚九條, 每早ㆍ午ㆍ晩各一條, 用紙作罩, 勿令泄氣, 熏鼻孔, 男左女右. 口噙凉水, 溫則易之. 一日熏三次, 三日九次全愈. 《醫鑑》

Translation영역
Another method: quicksilver, tin and soot of the hundred herbs, 1 don each. First melt the tin, put in the other two and mix them even, grind them to powder and roll them into nine paper spills; one each morning, noon and evening. Make a hood of paper so that none of the vapour escapes, and fume the nostril — the left for a man, the right for a woman. Let him hold cold water in his mouth and change it when it warms. Three fumings a day, nine in three days, and he is wholly healed.
Clinical note임상 주석
勿令泄氣 — let none of the vapour escape. The hood is there to make sure the patient receives the whole dose, and that is precisely what makes it lethal. **Mercury must never be heated or inhaled.** 三日九次全愈, healed in nine fumings over three days, is also worth reading as an observation: the sores of secondary syphilis do remit, with or without treatment, which is how a drug this harmful kept its reputation.

Uigam 醫鑑

2.2.5 The Blowing Method 吹藥方

2.2.5.1
Source원문

治楊梅ㆍ天疱瘡. 黑鈆 八分熔化, 入水銀 一錢, 同結成餠, 銀珠卽輕粉 一錢半炒, 白礬ㆍ雄黃 各一錢. 爲末, 棗肉搗勻, 分作六丸. 每取一丸放火籠內, 令病人以由包頭, 口吹眼看其藥丸, 待烟盡卽止. 當日早ㆍ午ㆍ晩各吹一丸, 次日早ㆍ午吹二丸, 第三日只早吹一丸. 吹後三五日或口流涎, 以黃連ㆍ菉豆煎湯解之, 又服化毒散方見上三日, 後以加減通聖散ㆍ丸方見上調理斷根. 《入門》

Translation영역
Treats the mulberry and heavenly blister sores. Black lead 8 fun, melted, with quicksilver 1 don put into it and set together into a cake; silver vermilion — that is, calomel — 1 don 5 fun, parched; alum and realgar, 1 don each. Powder them, pound them even with jujube flesh, and divide into six pills. Take one pill each time and set it in a brazier; have the patient cover his head with a cloth, blow with his mouth and watch the pill with his eyes, and stop when the smoke is spent. On the day itself blow one pill each morning, noon and evening; on the next day two pills morning and noon; on the third day only one in the morning. If three or five days after the blowing the mouth runs with drool, resolve it with a decoction of coptis and mung bean, and give Hwadok-san 化毒散 — the formula is given above — for three days; afterwards settle him and cut off the root with Gagamtongseong-san 加減通聖散 and its pill, the formula given above.
Clinical note임상 주석
**This must not be attempted.** 吹後三五日或口流涎 — three or five days after the blowing the mouth may run with drool. Ptyalism is the cardinal early sign of mercury poisoning, and the Immun has not only seen it but timed it, and prescribes a remedy for it as a routine part of the course. Taken with 2.2's 誤服水銀輕粉, 2.2.1's method for recovering the calomel, and 2.2.9's peeling palms, this chapter records four separate manifestations of mercurialism in its own patients.

Immun 入門

2.2.6 The Lamp Method 照藥方

2.2.6.1
Source원문

服茯苓湯後次用照藥. 水銀ㆍ黃丹炒ㆍ白錫 各一錢, 血竭末 五錢, 京香 二分(無麝香者). 右爲末, 用熟艾鋪紙, 入藥在中, 捲作條, 放盞內入香油一椀, 將藥條作燈心點火, 安木桶內, 四圍用單被圍住, 勿泄氣, 眼看燈, 口噙凉水, 熱則換水, 盡藥條爲度. 《醫鑑》

Translation영역
After taking Bokryeong-tang 茯苓湯, the lamp drug is used next. Quicksilver, minium parched and tin, 1 don each; powdered dragon's blood 5 don; capital incense 2 fun, for want of musk. Powder the above, spread prepared mugwort on paper, put the drug in the middle, roll it into a wick, set it in a bowl with a cupful of sesame oil, light the drug-wick as the lamp's wick, place it in a wooden tub, screen it all round with a single quilt so that none of the vapour escapes, and have him watch the lamp with his eyes and hold cold water in his mouth, changing the water when it warms; the measure is the spending of the whole wick.
Clinical note임상 주석
**This must not be attempted.** It is the same mercury-and-lead fumigation as 2.2.4 and 2.2.5, with the patient's eyes held open over the burning wick — 眼看燈 — inside a curtained tub. Mercury vapour reaches the conjunctiva and the respiratory tract alike, and the quilt is again there to keep the dose in.

Uigam 醫鑑

2.2.7 The Scar-Removing Method 滅瘢法

2.2.7.1
Source원문

治天疱ㆍ楊梅瘡愈後瘢痕紅黑. 用大黃ㆍ白礬等分同硏, 擦患處, 其痕卽去如常. 《回春》

Translation영역
Treats the red-black scars left after the heavenly blister and mulberry sores have healed. Grind rhubarb and alum together in equal parts and rub the affected place, and the marks go at once and it is as it was.

Hoechun 回春

2.2.8 The Prohibitions 禁忌法

2.2.8.1
Source원문

天疱ㆍ楊梅瘡忌食牛ㆍ馬ㆍ狗肉ㆍ雞ㆍ猪ㆍ魚ㆍ生冷及酒ㆍ麵ㆍ茶ㆍ油膩ㆍ辛熱等物. 痛斷酒色. 鹽宜炒食. 《回春》

Translation영역
In the heavenly blister and mulberry sores, beef, horse and dog flesh, fowl, pork, fish, what is raw and cold, and wine, wheat-flour food, tea, what is oily and rich and what is pungent and hot are all to be avoided. Wine and women must be sharply broken off. Salt should be parched before it is eaten.
Clinical note임상 주석
痛斷酒色 — wine and women sharply broken off. Of all the instructions in 天疱瘡 this is the one that would have done the most good, and for the reason the chapter could not state: abstinence stops the patient infecting others. The Hoechun gives it as a regimen for the patient's own recovery.

Hoechun 回春

2.2.9 The Goose-Palm Ringworm 鵝掌癬

2.2.9.1
Source원문

凡天疱ㆍ楊梅瘡服輕粉愈後, 手掌上發癬, 退皮一層, 生生不絶, 名曰鵝掌癬, 亦曰鵝掌風. 宜服蒼耳散, 擦玉脂膏. 《醫鑑》

Translation영역
Wherever the heavenly blister and mulberry sores have healed after calomel has been taken, a ringworm breaks out on the palms of the hands and a layer of skin comes away, growing and growing without end; it is named the goose-palm ringworm, and also the goose-palm wind. Changi-san 蒼耳散 should be given and Okji-go 玉脂膏 rubbed on.
Clinical note임상 주석
服輕粉愈後, 手掌上發癬, 退皮一層, 生生不絶 — after the calomel, a scaling of the palms that peels layer after layer and never stops. **The chapter has given a section of its own to a side effect, and named the cause in the first clause.** Palmar and plantar desquamation that will not settle is a classical feature of chronic mercury poisoning — in children the same exposure produces acrodynia, with peeling, painful, pink hands and feet. 生生不絶, growing without end, is the right description: it continues while the metal is still in the body, and no ointment reaches it. There is a second reading worth keeping alongside, because it does not displace the first: secondary syphilis itself produces a scaly papular eruption on the palms and soles, and it is one of the few rashes that favours those surfaces. A patient who had been given calomel for syphilis could have either, or both. What is not in doubt is that the Uigam attributed this one to the drug.

Uigam 醫鑑

2.2.9.2
Source원문

一方, 猪前蹄爪破開, 入菊花ㆍ蒼耳末, 以線縛定, 煮爛食之. 次日用白鮮皮ㆍ皂角ㆍ雄黃 各五分, 鈆炒ㆍ水銀 三分. 爲末, 臨臥以鵝脂ㆍ薑汁調擦, 次早以磁鋒磨刮去麄皮, 服蒼耳散, 擦玉脂膏, 更灸勞宮或內關穴斷根. 《入門》

Translation영역
One method: split open the claw of a pig's forefoot, put in powdered chrysanthemum flower and cocklebur, bind it fast with thread, boil it soft and eat it. The next day take dittany bark, gleditsia pod and realgar, 5 fun each, and parched lead and quicksilver, 3 fun; powder them and rub them on at bedtime stirred with goose fat and ginger juice, and next morning grind and scrape the coarse skin away with a porcelain edge, give Changi-san 蒼耳散 and rub on Okji-go 玉脂膏, and burn moxa at Nogung or at Naegwan to cut off the root.
Clinical note임상 주석
**More mercury, lead and arsenic, rubbed into the hands that the mercury has already damaged.** This is the clearest instance in the chapter of a treatment made of the same thing as the disease it treats, and nothing in it may be prepared.

Immun 入門

2.2.9.3
Source원문

又方, 黃丹ㆍ輕粉等分爲末, 猪油調擦.

Translation영역
Another method: powder minium and calomel in equal parts and rub them on stirred with lard.

Immun 入門

2.2.9.4
Source원문

川烏ㆍ草烏ㆍ何首烏ㆍ天花粉ㆍ赤芍藥ㆍ防風ㆍ荊芥ㆍ蒼朮ㆍ地丁 各一兩, 艾葉 四兩. 煎水熏洗立效. 《回春》

Translation영역
Sichuan aconite, wild aconite, fleeceflower root, trichosanthes root, red peony, saposhnikovia, schizonepeta, atractylodes and viola, 1 nyang each; mugwort leaf 4 nyang. Boil them in water and fume and wash with it, with immediate effect.
Clinical note임상 주석
**Contains both Sichuan and wild aconite, which are toxic, and this must not be prepared.** Even as a wash, aconite alkaloids are absorbed through skin that has lost its barrier — which is the whole presentation here.

Hoechun 回春

2.3 Scrofula 瘰癧

2.3.1
Source원문

瘰癧之證, 內經謂之結核是也. 生頸前項側, 結核如大豆ㆍ如銀杏曰瘰癧; 生胸脇腋下, 堅硬如石, 形如馬刀蛤曰馬刀. 《入門》

Translation영역
The scrofula pattern is what the Inner Classic calls the bound kernel. Arising at the front of the neck and the side of the nape, with kernels bound like large beans or ginkgo nuts, it is called scrofula; arising on the chest, the flanks and under the armpit, hard as stone and shaped like a razor-clam, it is called the horse-knife.
Clinical note임상 주석
A chain of firm, painless nodes at the side of the neck in a young person is tuberculous cervical lymphadenitis, and 瘰癧 is that disease — the scrofula of European medicine, the king's evil. The distinction drawn here is by site: nodes in the neck are 瘰癧, nodes in the axilla and chest wall, hard and elongated, are 馬刀. Axillary and supraclavicular nodes of that description are the same infection tracking along its lymphatic chain.

Immun 入門

2.3.2
Source원문

結核連續者爲瘰癧, 形長如蛤者爲馬刀. 《綱目》

Translation영역
Where the bound kernels run on one after another it is scrofula; where the shape is long like a clam it is the horse-knife.

Gangmok 綱目

2.3.3
Source원문

繞項起核, 名曰蟠蛇癧, 多生肩項. 或赤或白, 或沉或浮, 初生如豆, 久似核, 年月浸久, 其大如梅, 或如雞卵, 排行成列, 或生二三, 或生六七是也. 用性努力ㆍ思慮過久, 則疼痛赤腫, 早治爲上. 《綱目》

Translation영역
Where the kernels rise encircling the nape it is named the coiled-snake scrofula, and arises mostly on the shoulder and nape. It may be red or white, sunken or floating; at first it arises like a bean, in time it is like a kernel, and as months and years soak on it grows as big as a plum or a hen's egg, ranked in a row — two or three of them, or six or seven. Where he exerts his nature in hard effort, or broods too long, there is pain and red swelling; treating it early is best.
Clinical note임상 주석
排行成列 — ranked in a row, two or three or six or seven of them, encircling the nape. That is the matted chain of nodes along the posterior cervical and supraclavicular groups that tuberculous adenitis makes, and 蟠蛇, the coiled snake, is an exact picture of it. The progression given — bean, kernel, plum, hen's egg over months and years — is also the right timescale for this infection rather than for a bacterial one.

Gangmok 綱目

2.3.4
Source원문

流注癧者, 婦人多有之. 其性急躁, 其氣怫鬱, 其心熱着, 初生在項, 破後流注四肢, 遍體結毒如梅李狀, 不療自破, 孔竅相穿, 寒熱疼痛, 或流膿汁是也. 又名千歲瘡, 化氣調經湯主之. 《綱目》

Translation영역
The flowing-and-pouring scrofula is found mostly in women. Their nature is hasty and irritable, their qi sullen and depressed, their heart settled in heat. It arises first on the nape, and after breaking open pours into the four limbs, binding toxin over the whole body in the shape of plums and damsons; untreated it bursts of itself, the openings pierce one into another, there are chills and fever and pain, and sometimes pus runs. It is also named the thousand-year sore, and Hwagijogyeong-tang 化氣調經湯 governs it.
Clinical note임상 주석
孔竅相穿 — the openings pierce one into another. Multiple nodes breaking down and connecting through sinus tracks under the skin is exactly what untreated tuberculous adenitis does, and the result is the scarred, bridged, undermined skin that surgeons still call scrofuloderma. 千歲瘡, the thousand-year sore, names its chronicity fairly.

Gangmok 綱目

2.3.5
Source원문

瘰癧始起於少陽, 不守禁忌, 延及陽明. 大抵食味之厚ㆍ鬱氣之積, 皆此二端招引變換. 以其屬膽經主決斷, 有相火而且氣多血少. 婦人見此, 若月經行ㆍ寒熱不作則可生; 稍久轉爲潮熱, 危矣. 自非斷慾絶慮食淡, 雖神聖不可治也. 《丹心》

Translation영역
Scrofula rises first in Soyang, and where the prohibitions are not kept it spreads to Yangmyeong. In general the richness of flavour in the food and the accumulation of depressed qi are the two things that draw it on and change it about. For it belongs to the gallbladder channel, which governs decision, and has the ministerial fire, with much qi and little blood. Where a woman has it, if her monthly courses come and no chills and fever arise, she may live; where it goes on a while and turns to tidal fever, it is dangerous. Unless desire is broken off, brooding ended and the diet kept bland, even a divine sage cannot treat it.
Clinical note임상 주석
月經行ㆍ寒熱不作則可生 … 轉爲潮熱, 危矣 — if the courses come and there is no fever she may live; once it turns to tidal fever it is dangerous. That is a prognostic rule and it is the right one. Localized tuberculous adenitis in an otherwise well patient is survivable; once there is a hectic afternoon fever and the periods stop, the infection has become systemic — miliary or pulmonary disease, with the amenorrhoea of wasting. 2.3.4 states the same rule again and names the destination, 勞瘵.

Dansim 丹心

2.3.6
Source원문

膽與肝合, 且主筋. 病則筋累累如貫珠, 寒熱焮痛, 乃肝氣動而爲病也. 當淸肝火爲主, 宜淸肝益榮湯方見入門ㆍ柴胡淸肝湯方見癰疽ㆍ梔子淸肝湯. 《入門》

Translation영역
The gallbladder pairs with the liver and governs the sinews besides. In disease the sinews are knotted one after another like beads on a string, with chills and fever and inflamed pain; this is the liver qi stirring and making the disease. Clearing the liver fire should be made the chief aim, and Cheongganigyeong-tang 淸肝益榮湯 — the formula is given in the Immun — Sihocheonggan-tang 柴胡淸肝湯 — the formula is given in the Abscesses chapter — and Jijacheonggan-tang 梔子淸肝湯 should be given.

Immun 入門

2.3.7
Source원문

肝燥火動而筋攣, 補中勝毒餠爲主. 多怒火, 宜淸肝解鬱湯方見乳部. 有寒熱, 單夏枯草散. 通用猫頭丸ㆍ海藻散堅丸. 《入門》

Translation영역
Where the liver is dry, the fire stirs and the sinews cramp, Bojungseungdok-byeong 補中勝毒餠 is made the chief. Where there is much fire from anger, Cheongganhaeeul-tang 淸肝解鬱湯 — the formula is given in the Breast section. Where there are chills and fever, Hagochosan 夏枯草散 alone. For general use, Myodu-hwan 猫頭丸 and Haejosangyeon-hwan 海藻散堅丸.

Immun 入門

2.3.8
Source원문

治法大槩以地膽ㆍ斑猫爲主, 滲泄小便以瀉心火, 立應散是也. 然性甚峻, 服後量體調治. 實者宣熱丹, 虛者托裏益氣湯方見癰疽ㆍ入門. 《入門》

Translation영역
As to the method of treatment, in general ground beetle and blister beetle are made the chief, draining and seeping through the urine so as to drain the heart fire, and Ibeung-san 立應散 is such a one. But their nature is very harsh, and after taking them one treats according to the measure of the body. For the replete, Seonyeol-dan 宣熱丹; for the vacuous, Takriigi-tang 托裏益氣湯 — the formula is given in the Abscesses chapter and in the Immun.
Clinical note임상 주석
**Blister beetle and ground beetle are cantharidin-bearing and must not be taken internally.** The Immun's own 性甚峻, their nature is very harsh, is an understatement: cantharidin is a vesicant that destroys the renal tubules, and the dose that produces the effect described in the next passage is close to the dose that kills.

Immun 入門

2.3.9
Source원문

瘰癧之毒莫不有根. 地膽ㆍ斑猫製度如法, 能使其根從小便中出, 或如粉片, 或如塊血, 或如爛肉, 皆其驗耳. 但毒根之行, 小便必澁, 當以木通ㆍ滑石輩導之. 然是毒必從小便出者何哉. 盖諸痛痒瘡瘍皆屬於心故也. 《直指》

Translation영역
The toxin of scrofula never lacks a root. Ground beetle and blister beetle, prepared as the rule directs, can make that root come out through the urine — now like flakes of powder, now like clots of blood, now like rotted flesh — and all these are the proof of it. Only, as the toxic root passes, the urine is sure to be rough, and plantain-leaf and talc and their like should be used to lead it through. But why must this toxin come out through the urine? Because all pains, itchings and sores belong to the heart.
Clinical note임상 주석
如塊血 … 小便必澁 — clots of blood in the urine, and the urine sure to be rough. The Jikji is describing haematuria and dysuria and reading them as the disease's root being expelled. They are cantharidin poisoning: the drug is excreted by the kidney and damages it on the way out, producing exactly this haemorrhagic cystitis and, at higher doses, acute tubular necrosis. **This must not be done.** It is the same reasoning error as the mercury sections of 天疱瘡 — the harm the treatment does is counted as evidence that it is working.

Jikji 直指

2.3.10
Source원문

通治宜化氣調經湯ㆍ猫頭丸ㆍ海藻散堅丸ㆍ宣熱丹ㆍ三聖丸ㆍ小犀角丸ㆍ散腫潰堅湯ㆍ內消丸ㆍ琥珀散ㆍ蠟礬元ㆍ天花散ㆍ夏枯草散.

Translation영역
For general treatment, Hwagijogyeong-tang 化氣調經湯, Myodu-hwan 猫頭丸, Haejosangyeon-hwan 海藻散堅丸, Seonyeol-dan 宣熱丹, Samseong-hwan 三聖丸, Soseogak-hwan 小犀角丸, Sanjonggwegyeon-tang 散腫潰堅湯, Naeso-hwan 內消丸, Hopak-san 琥珀散, Napban-won 蠟礬元 and Cheonhwa-san 天花散, Hagocho-san 夏枯草散.

Jebang 諸方

2.3.11
Source원문

瀉肝膽火宜梔子淸肝湯.

Translation영역
To drain the liver and gallbladder fire, Jijacheonggan-tang 梔子淸肝湯.

Jebang 諸方

2.3.12
Source원문

瀉毒宜立應散ㆍ薄荷丹ㆍ白蛇散ㆍ四聖散.

Translation영역
To drain the toxin, Ibeung-san 立應散, Bakha-dan 薄荷丹, Baeksa-san 白蛇散 and Saseong-san 四聖散.

Jebang 諸方

2.3.13
Source원문

補虛補中勝毒餠ㆍ益氣養榮湯.

Translation영역
To supplement vacuity, Bojungseungdok-byeong 補中勝毒餠 and Igiyangyeong-tang 益氣養榮湯.

Jebang 諸方

2.3.14
Source원문

馬刀瘡宜連翹散堅湯ㆍ消腫湯ㆍ柴胡通經湯. 《諸方》

Translation영역
For the horse-knife sore, Yeongyosangyeon-tang 連翹散堅湯, Sojong-tang 消腫湯 and Sihotonggyeong-tang 柴胡通經湯.

Jebang 諸方

2.3.1 The Method of Outward Treatment 外治法

2.3.1.1
Source원문

凡瘰癧ㆍ馬刀荏苒日久, 內必成膿. 若腫高消軟, 其人面色萎黃, 皮膚壯熱上蒸, 膿已成也. 可以鍼決核中, 用追毒蝕肉錠子絍之, 用膏貼之. 《精義》

Translation영역
Wherever scrofula or the horse-knife drags on for many days, pus must form within. If the swelling is high and has softened as it subsided, the man's face sallow and yellow, and the skin fiercely hot and steaming upward, the pus has formed already. The kernel may then be opened with the needle, packed on a wick with a toxin-drawing, flesh-eating stick, and covered with a plaster.
Clinical note임상 주석
面色萎黃 with 皮膚壯熱 — a sallow face and a hot skin, given as the sign that the node has suppurated. The constitutional change is the real finding here: a patient with a cold abscess who becomes anaemic-looking and febrile has active disease. The 蝕肉錠子, the flesh-eating stick, is an escharotic of the kind this chapter uses throughout, and a tuberculous node opened this way drains indefinitely.

Jeongui 精義

2.3.1.2
Source원문

治法, 以火鍼刺入核中, 納蟾酥膏于中, 外用綠雲膏貼之. 三日後取去核中稠膿, 膿盡取去核外薄膜. 先破初起之核一枚, 以絶其源, 服藥則後出者皆愈. 或不能收如銀杏者, 盡皆開了, 用藥取之. 其自潰者猶如木果之腐熟, 肉雖潰而核猶存, 故膿水淋漓, 久難得愈. 治法用鐵烙燒赤, 烙去其破核猶存者倂肉潰處, 次用金寶膏追去蠹惡之根, 遂能長肉而愈. 《正傳》

Translation영역
The method: pierce into the kernel with the fire needle, put Seomsu-go 蟾酥膏 inside it, and cover it outwardly with Nogun-go 綠雲膏. After three days take away the thick pus within the kernel, and when the pus is spent take away the thin membrane outside it. Break the first-risen kernel first, one of them, so as to cut off its source, and when the drug is taken those that come later all heal. Where they cannot be closed and are like ginkgo nuts, open them all and take them out with the drug. Those that burst of themselves are like a tree-fruit rotted ripe: though the flesh has burst the kernel remains, and so the pus and fluid run on and it is long before it heals. For that, heat an iron red and cauterize away the burst kernel that yet remains, together with the place where the flesh is broken down, and then use Geumbo-go 金寶膏 to drive out the gnawing malign root; so the flesh can grow and it heals.
Clinical note임상 주석
肉雖潰而核猶存, 故膿水淋漓, 久難得愈 — though the flesh has broken down the kernel remains, and so it runs on and is long in healing. This is the single most useful clinical observation in the section: a scrofulous sinus will not close while the diseased node is still in it. That is why excision of the node, not drainage of the sinus, is the surgical answer, and the Jeongjeon has reasoned its way to removing 其破核猶存者 for the right reason. **The red-hot iron and the toad-venom paste must not be used**; the node comes out with a scalpel, under antituberculous drugs, which is what finally closes it.

Jeongjeon 正傳

2.3.2 The Prohibitions 禁忌法

2.3.2.1
Source원문

人有此患, 不惟懲忿窒慾, 其於飮食百味, 一切戒之. 《直指》

Translation영역
Where a man has this affliction, not only must he curb his rage and stop up his desires; as to the hundred savours of food and drink, he must abstain from all of them.

Jikji 直指

2.3.2.2
Source원문

切忌毒藥點蝕及妄用鍼刀割破, 必死, 戒之. 《資生》

Translation영역
Strictly avoid dabbing it with poisonous caustics and avoid using needle and knife to cut it open at random: he must die of it. Beware.
Clinical note임상 주석
切忌毒藥點蝕及妄用鍼刀割破, 必死 — strictly avoid caustics and random cutting; he must die of it. The Jasaeng is contradicting the two sub-sections printed either side of it, and it is nearer right than they are. Incising a tuberculous node leaves a sinus that will not close, and the escharotics of 2.3.3 destroy skin without touching the infection. 妄, at random, is the word doing the work: the warning is against cutting without knowing what is in the lump, which is why a node like this is now sampled before anything else is done to it.

Jasaeng 資生

2.3.3 Dusting and Plastering Drugs 糝貼藥

2.3.3.1
Source원문

凡瘰癧ㆍ馬刀惡瘡, 宜用蠶蠒散ㆍ猫蝠散ㆍ代灸散ㆍ龍泉散ㆍ蝸牛散ㆍ燒灰散ㆍ生獾散選用.

Translation영역
For scrofula, the horse-knife and malign sores generally, one chooses among Jamgyeon-san 蠶蠒散, Myobok-san 猫蝠散, Daegu-san 代灸散, Yongcheon-san 龍泉散, Wau-san 蝸牛散, Sohoe-san 燒灰散 and Saenghwan-san 生獾散.

Jeongui 精義

2.3.3.2
Source원문

初起未破, 十香膏ㆍ琥珀膏二方見雜方常貼之可自消. 《精義》

Translation영역
At its rising, before it has broken, Siphyang-go 十香膏 and Hopak-go 琥珀膏 — both formulas are given in the Miscellaneous chapter — laid on constantly may let it disperse of itself.

Jeongui 精義

2.3.3.3
Source원문

治瘰癧神效方, 白膠香ㆍ海螵蛸ㆍ降眞香等分爲末, 糝患處, 外以水紙掩之, 一夕而退.

Translation영역
A marvellously effective method for treating scrofula: powder storax, cuttlebone and rosewood in equal parts, dust it on the affected place, cover it outwardly with wet paper, and in a night it goes down.

Gangmok 綱目

2.3.3.4
Source원문

又方, 未破者, 蜜蜂 二十一箇, 蛇蛻 七分半, 蜈蚣 二條(端午前收者). 右用香油四兩同熬成, 入光粉 二兩, 以桑枝七條急攪, 候冷出火氣七日, 收貯. 每用攤紙上, 貼患處.

Translation영역
Another method, for one not yet broken: twenty-one honeybees, snake slough 7 fun 5 ri, and two centipedes gathered before the Dano festival. Boil them down together in 4 nyang of sesame oil, put in 2 nyang of lead white, stir briskly with seven mulberry twigs, let it stand seven days to let the fire qi out, and store it. Each time, spread it on paper and lay it on the affected place.
Clinical note임상 주석
**Contains lead white and centipede, and must not be prepared.** Lead carbonate spread on skin over weeks is absorbed, and this plaster is meant to be worn continuously.

Gangmok 綱目

2.3.3.5
Source원문

此二方不須服藥, 只貼上五七日可便消. 《綱目》

Translation영역
With these two methods no drug need be taken: laid on for five or seven days it may disperse at once.

Gangmok 綱目

2.3.4 The Signs Hard to Treat and Those Treatable 難治可治證

2.3.4.1
Source원문

帝曰, 寒熱瘰癧生於頸腋者, 何氣使然. 歧伯曰, 此皆鼠瘻寒熱之毒氣留於脉而不去者也. 帝曰, 決死生柰何. 歧伯曰, 反其目視之, 其中有赤脉上下貫瞳子, 見一脉一歲死, 見一脉半一歲半死, 見二脉二歲死, 見二脉半二歲半死, 見三脉三歲而死. 見赤脉不下貫瞳子者, 可治也. 《靈樞》

Translation영역
The Emperor said: scrofula with chills and fever arising in the neck and armpit — what qi brings it about? Qibo said: all these are the toxic qi of the mouse fistula's chills and fever, lodged in the vessels and not departing. The Emperor said: how is life or death decided? Qibo said: turn back the eyelid and look; where within there are red vessels running up and down across the pupil, if one vessel is seen he dies in a year, if one and a half in a year and a half, if two in two years, if two and a half in two and a half, if three in three years. Where red vessels are seen that do not run down across the pupil, it can be treated.
Clinical note임상 주석
鼠瘻, the mouse fistula, is the Yeongchu's own name for this disease, and the vessels crossing the pupil are the signs it reads the prognosis from. Counting years of life from the number of vessels is not something the eye can tell. But the underlying judgement — that scrofula with chills and fever is a years-long illness that commonly ends in death — was accurate for an untreated patient, and 不下貫瞳子者可治 draws the line where the chapter draws it everywhere: the localized case may do well, the systemic one will not.

Yeongchu 靈樞

2.3.4.2
Source원문

婦人患瘰癧, 經調及經閉無潮熱者可治; 經閉有潮熱或咳者死. 玉燭散方見胞門治瘰癧通經, 日服一貼, 七八日自消.

Translation영역
Where a woman suffers scrofula, if her courses are regular, or stopped but without tidal fever, it can be treated; if they are stopped and there is tidal fever or a cough, she dies. Okchok-san 玉燭散 — the formula is given in the Uterus chapter — treats scrofula and opens the courses: one packet a day, and in seven or eight days it disperses of itself.

Immun 入門

2.3.4.3
Source원문

男子患瘰癧, 有潮熱ㆍ有咳, 乃瘰癧傷證之標也. 故勞瘵類有曰, 腹中有塊ㆍ頸上有核最爲難治. 《入門》

Translation영역
Where a man suffers scrofula with tidal fever and with a cough, these are the outward signs that scrofula has done its damage. And so it is said among the consumptions: a lump in the belly and a kernel on the neck are hardest of all to treat.
Clinical note임상 주석
**This is the chapter's best single inference.** 腹中有塊ㆍ頸上有核 listed among the 勞瘵, the consumptions, with afternoon fever and cough as the sign that the neck lump has gone further: the Immun has put the cervical node, the abdominal mass and pulmonary consumption together as one illness. They are one illness — Mycobacterium tuberculosis in the cervical nodes, the mesenteric nodes or peritoneum, and the lung — and nothing in seventeenth-century medicine could have shown that they shared a cause. The clinicians saw the three travel together often enough to say so.

Immun 入門

2.3.4.4
Source원문

瘰癧延及胸中ㆍ中府ㆍ雲門肺經部分者死. 《得效》

Translation영역
Where scrofula spreads into the chest, to Jungbu and Unmun, the region of the lung channel, he dies.
Clinical note임상 주석
Jungbu and Unmun lie in the infraclavicular hollow, over the apex of the lung. Disease spreading from the neck to that region, called fatal, is the supraclavicular node and the apical lung lesion — the route and the site of pulmonary tuberculosis. The topography the Deukhyo warns about is the topography of the disease.

Deukhyo 得效

2.3.5 The Moxibustion Method 灸法

2.3.5.1
Source원문

治瘰癧, 以手仰置肩上, 微擧肘取之, 肘骨尖上是穴. 隨患邊灸七壯, 或二七壯, 神效. 《得效》

Translation영역
To treat scrofula: lay the hand palm-up on the shoulder, raise the elbow a little and take the point there — it is at the tip of the elbow bone. Burn seven cones on the side of the affliction, or fourteen, with marvellous effect.

Deukhyo 得效

2.3.5.2
Source원문

又法, 於掌後手腕盡處橫紋量起, 向臂中心直上三寸半是穴, 灸三壯卽效. 《丹心》

Translation영역
Another method: measure from the transverse crease where the wrist ends behind the palm, straight up the middle of the forearm three chi and a half, and that is the point; burn three cones and it answers at once.

Dansim 丹心

2.3.5.3
Source원문

秘法, 肩尖ㆍ肘尖二穴, 卽肩髃ㆍ肘髎二穴, 宜灸此穴, 疏通經絡. 《良方》

Translation영역
A secret method: the two points at the tip of the shoulder and the tip of the elbow — that is, Gyeonu and Juryo — should be burnt, to thin and open the channels and network vessels.

Yangbang 良方

2.3.5.4
Source원문

癧核上每灸七壯, 隔蒜片灸之尤妙. 《資生》

Translation영역
Burn seven cones on each scrofulous kernel; burning over a garlic slice is better still.

Jasaeng 資生

2.4 The Bound Kernel 結核

2.4.1
Source원문

獨形而小核者爲結核. 《綱目》

Translation영역
A single small kernel standing alone is the bound kernel.

Gangmok 綱目

2.4.2
Source원문

結核者, 火氣熱甚則鬱結堅硬如果中核也. 不須潰破, 但熱氣散則自消. 《河間》

Translation영역
In the bound kernel, where the fire qi is very hot it is depressed and bound and hard as the kernel inside a fruit. It need not be burst open; only let the hot qi disperse and it goes away of itself.
Clinical note임상 주석
不須潰破 — it need not be opened. Hejian is distinguishing a solitary mobile lump from the suppurating chains of 瘰癧 and declining to cut it, which is the right call: a single small subcutaneous nodule is usually a lipoma, an epidermal cyst or a reactive node, and most need nothing done. The chapter's whole 結核 section is unusual in recommending restraint.

Hagan 河間

2.4.3
Source원문

結核在一身如腫毒者, 在皮裏膜外, 多是濕痰流注作核不散. 問其平日好食何物, 吐下後用藥散核. 《丹心》

Translation영역
Where the bound kernel is somewhere on the body like a swelling toxin, lying inside the skin and outside the membrane, it is mostly damp phlegm pouring down and making a kernel that will not disperse. Ask what he has liked to eat day by day, and after vomiting and purging him use drugs to disperse the kernel.

Dansim 丹心

2.4.4
Source원문

痰癧推動滑軟. 《入門》

Translation영역
The phlegm scrofula is slippery and soft and moves when pushed.
Clinical note임상 주석
推動滑軟 — mobile, slippery and soft when pushed. That is the examination finding that separates a benign lump from a malignant or tuberculous one, and it is still the first thing a hand on a neck lump is testing for. The chapter uses it to decide against cutting.

Immun 入門

2.4.5
Source원문

結核在頸項, 二陳湯方見痰門加酒炒大黃ㆍ桔梗ㆍ柴胡ㆍ連翹煎服.

Translation영역
Where the bound kernel is in the neck and nape, Ijin-tang 二陳湯 — the formula is given in the Phlegm chapter — with wine-parched rhubarb, platycodon, bupleurum and forsythia added, boiled and taken.

Dansim 丹心

2.4.6
Source원문

結核在臂, 二陳湯加連翹ㆍ防風ㆍ川芎ㆍ酒芩ㆍ蒼朮ㆍ皂角刺ㆍ白殭蠶, 煎水入麝香少許服, 行太陰ㆍ厥陰之積痰則自消. 《丹心》

Translation영역
Where the bound kernel is in the arm, Ijin-tang 二陳湯 with forsythia, saposhnikovia, Sichuan lovage, wine-prepared scutellaria, atractylodes, gleditsia spine and silkworm added, boiled in water with a little musk put in and taken; move the accumulated phlegm of Taeeum and Gyeoreum and it disperses of itself.

Dansim 丹心

2.4.7
Source원문

遍身有核, 多是痰注. 宜加味小胃丹ㆍ竹瀝達痰丸二方見痰門. 通用海帶丸ㆍ含化丹. 《入門》

Translation영역
Where there are kernels over the whole body it is mostly phlegm pouring down. Gamisowi-dan 加味小胃丹 and Jungnyeokdaldam-hwan 竹瀝達痰丸 — both formulas are given in the Phlegm chapter — should be given. For general use, Haedae-hwan 海帶丸 and Hamhwa-dan 含化丹.

Immun 入門

2.4.8
Source원문

結核宜用消風化痰湯ㆍ開氣消痰湯ㆍ內托白斂散ㆍ消解散ㆍ消核丸.

Translation영역
For the bound kernel, Sopunghwadam-tang 消風化痰湯, Gaegisodam-tang 開氣消痰湯, Naetakbaekryeom-san 內托白斂散, Sohae-san 消解散 and Sohaek-hwan 消核丸 should be used.

Immun 入門

2.5 Goitre and Tumour 癭瘤

2.5.1
Source원문

人身氣血凝滯, 結爲癭瘤. 癭則憂恚所生, 多着於肩項; 瘤則隨氣凝結. 此等皆年數深遠, 浸大浸長. 堅硬不可移者, 名曰石癭; 肉色不變, 名曰肉癭; 筋脉露結, 名曰筋癭; 赤脉交結, 名曰血癭; 隨憂愁消長, 名曰氣癭. 五癭皆不可決破, 決破則膿血崩潰, 多致夭枉. 《三因》

Translation영역
Where the qi and blood of a man's body congeal and stagnate, they bind and become goitre and tumour. The goitre arises of grief and rage and settles mostly on the shoulder and nape; the tumour congeals and binds as the qi goes. Both of these are of many years' standing and soak larger and longer. Hard and immovable, it is named the stone goitre; unchanged in the colour of the flesh, the flesh goitre; with the sinews and vessels standing out and knotted, the sinew goitre; with red vessels crossing and knotted, the blood goitre; waxing and waning with sorrow, the qi goitre. None of the five goitres may be cut open; cut open, the pus and blood break down in a flood, and death before one's time generally follows.
Clinical note임상 주석
五癭 sorted by what the hand and eye find, and the five are recognizable: 石癭 hard and fixed is the thyroid carcinoma or the fibrosed gland; 肉癭 with normal overlying skin a simple goitre or a nodule; 筋癭 and 血癭 with vessels standing out and crossing are vascular — a venous or arteriovenous malformation; 氣癭 waxing and waning with mood is a goitre that seems to change size, or a soft fatty swelling. 決破則膿血崩潰, 多致夭枉 — cut it open and the blood breaks out in a flood, and death before one's time follows. That is the right instruction for the wrong reason, and it is **the best piece of surgical judgement in the chapter**. A vascular mass in the neck, or a thyroid dense with vessels, bleeds catastrophically when incised; and the neck is where the carotid and the jugular lie. Forbidding the knife here, in a book that reaches for it freely elsewhere, saved lives.

Samin 三因

2.5.2
Source원문

瘤亦氣血凝滯結聚而成. 初作梅李, 皮嫩而光, 漸如盃卵. 瘤名有六, 骨瘤ㆍ肉瘤ㆍ膿瘤ㆍ血瘤ㆍ石瘤ㆍ脂瘤, 亦不可決潰. 肉瘤尤不可破, 破則殺人. 惟脂瘤決去其脂則愈. 《三因》

Translation영역
The tumour too is made of qi and blood congealing, stagnating, binding and gathering. At first it makes a plum or a damson, the skin over it tender and shining, and gradually it is like a cup or an egg. The names of the tumour are six — bone tumour, flesh tumour, pus tumour, blood tumour, stone tumour and fat tumour — and these too may not be cut open. The flesh tumour above all must not be broken, for breaking it kills a man. Only in the fat tumour, cutting away its fat heals it.
Clinical note임상 주석
惟脂瘤決去其脂則愈 — only the fat tumour is cured by cutting away its fat. The 脂瘤 is the sebaceous or epidermoid cyst and the lipoma, and excising the contents, or better the whole sac, is exactly what cures it; nothing else does. The Samin has sorted the lumps of the body into the one kind to operate on and the five not to, and it is close to how a surgeon would sort them now. 肉瘤 — soft tissue sarcoma, among other things — is the one singled out as fatal if broken into, and incising a sarcoma does disseminate it.

Samin 三因

2.5.3
Source원문

癭瘤總皆氣血凝滯結成. 惟憂恚耗傷心肺, 故癭多着頸項及肩也; 勞慾邪氣乘經之虛而住, 故瘤隨處有之. 《入門》

Translation영역
Goitre and tumour are all alike made of qi and blood congealing and stagnating. It is grief and rage that waste and harm the heart and lung, and so the goitre settles mostly on the neck, nape and shoulder; it is the evil qi of toil and desire lodging where the channel is vacuous, and so the tumour is found anywhere.

Immun 入門

2.5.4
Source원문

通治癭瘤, 蠟礬元久服則自然消縮, 最妙方見癰疽. 《直指》

Translation영역
For the general treatment of goitre and tumour, Napban-won 蠟礬元 taken long will shrink it away of itself, and is the best — the formula is given in the Abscesses chapter.

Jikji 直指

2.5.5
Source원문

五癭六瘤, 或軟或硬, 無痛無痒, 宜破結散ㆍ人參化癭丹ㆍ海帶丸方見上ㆍ䑛掌散ㆍ神效開結散ㆍ治脂瘤方ㆍ枯瘤方ㆍ化瘤膏ㆍ南星膏. 《諸方》

Translation영역
For the five goitres and six tumours, whether soft or hard, without pain and without itching: Pagyeol-san 破結散, Insamhwayeong-dan 人參化癭丹, Haedae-hwan 海帶丸 — the formula is given above — Jijang-san 䑛掌散, Sinhyogaegyeol-san 神效開結散, the method for the fat tumour, the method for withering a tumour, Hwaryu-go 化瘤膏 and Namseong-go 南星膏.
Clinical note임상 주석
無痛無痒 — without pain and without itching, given as the common feature of all eleven. A painless, slowly growing neck or body lump is the presentation that most needs to be identified rather than medicated, and the chapter is right that it is quiet; it has no way to tell which of these are the ones that will kill. **Two of these formulas are the best pharmacology in the chapter, and the chapter does not know it.** 人參化癭丹 and 神效開結散 are built on 猪靨ㆍ羊靨ㆍ鹿靨, and 神效開結散 describes the organ it wants exactly: 生猪項下喉嚨系一枚如棗大微扁色紅者 — one piece on the cord of the throat below a pig's neck, the size of a jujube, slightly flat and red. That is the **thyroid gland**, and swallowing dried animal thyroid is organotherapy that works: desiccated thyroid is still a licensed treatment, and a hypothyroid or iodine-deficient goitre does shrink on thyroid hormone. The 又方 of this section adds the other effective treatment — 凡海中菜皆療癭瘤結氣, all the sea vegetables treat goitre, with 海藻 and 昆布 named — and those are iodine. Endemic goitre is iodine deficiency. The chapter arrived at both by the doctrine of treating like with like: a lump in the neck treated with the lump from an animal's neck. It is also why the gloss the Bogam attaches to 靨 in 人參化癭丹 — ≪卽猪羊外腎乃囊中之卵也≫, that it is the testicle — is wrong, and wrong in a way that would have destroyed the effect for anyone who followed it. Two leaves later the same chapter has the anatomy right.

Jebang 諸方

2.5.6
Source원문

服治癭瘤藥, 先須斷厚味. 《丹心》

Translation영역
Before taking the drugs that treat goitre and tumour, rich flavours must first be given up.

Dansim 丹心

2.5.7
Source원문

凡癭瘤ㆍ疣贅等, 至年衰皆自內潰, 理於年壯可無後憂也. 《精義》

Translation영역
Goitres, tumours, warts and excrescences all break down from within when the years decline; dealt with while the years are strong, there need be no later trouble.
Clinical note임상 주석
至年衰皆自內潰, 理於年壯可無後憂 — left into old age they break down from within, so deal with them while the patient is strong. Removing a lesion while the patient can tolerate the procedure, rather than waiting until it ulcerates, is the right principle, and it is the reasoning behind elective rather than emergency surgery.

Jeongui 精義

2.5.8
Source원문

癭瘤初起, 通用十六味流氣飮方見癰疽ㆍ單蜘蛛方, 久服蠟礬元, 外付南星膏. 《入門》

Translation영역
At the rising of goitre and tumour, Sibyungmiyugi-eum 十六味流氣飮 — the formula is given in the Abscesses chapter — and the single spider method are used generally, with Napban-won 蠟礬元 taken long and Namseong-go 南星膏 applied outwardly.

Immun 入門

2.5.1 The Moxibustion Method 灸法

2.5.1.1
Source원문

治癭, 灸天突三七壯. 又灸肩髃, 男左十八壯ㆍ右十七壯, 女右十八壯ㆍ左十七壯, 妙. 《得效》

Translation영역
To treat goitre, burn twenty-one cones at Cheoncheol. Burn also at Gyeonu — for a man eighteen on the left and seventeen on the right, for a woman eighteen on the right and seventeen on the left; this is excellent.
Clinical note임상 주석
天突 sits in the hollow above the sternum, directly over the thyroid isthmus, so the chapter is treating a goitre at the goitre. Burning the skin there does nothing for an enlarged thyroid, but the choice of point shows the physicians knew precisely where the swelling lay.

Deukhyo 得效

2.6 The Gnawing Fistula 疳瘻

2.6.1
Source원문

漏者, 諸瘻之潰漏也. 狼瘻ㆍ鼠瘻ㆍ螻蛄瘻ㆍ蜂瘻ㆍ蚍蜉瘻ㆍ蠐螬瘻ㆍ浮疽瘻ㆍ瘰癧瘻ㆍ轉筋瘻是爲九瘻. 其證穿孔一深, 膿汁不盡, 風冷倂入, 涓涓而成漏矣. 《直指》

Translation영역
The leak is the breaking down and leaking of the several fistulas. The wolf fistula, the mouse fistula, the mole-cricket fistula, the wasp fistula, the ant fistula, the grub fistula, the floating-abscess fistula, the scrofula fistula and the sinew-turning fistula — these are the nine fistulas. Their sign is that once the hole is pierced deep the pus is not spent, wind and cold enter together, and trickling on it becomes a leak.

Jikji 直指

2.6.2
Source원문

漏喜發於項腋及陰僻ㆍ肛門之間. 療治失節, 卽生寒熱. 凡癰疽諸發, 苟有宿膿ㆍ朽骨停蓄其間, 皆爲之漏. 《直指》

Translation영역
The leak likes to break out at the nape, the armpit, the hidden yin parts and about the anus. Where the treatment loses its measure, chills and fever arise at once. In abscesses and eruptions of every kind, wherever old pus or rotted bone is held and stored within, it all becomes a leak.
Clinical note임상 주석
**The best general statement of the principle in the book.** 苟有宿膿ㆍ朽骨停蓄其間, 皆爲之漏 — wherever retained pus or dead bone is held inside, it becomes a fistula. That is the sequestrum, and it is still why a chronic sinus does not heal: a track with dead bone, a foreign body or an undrained cavity at the bottom of it will keep discharging until that is removed. The sites listed are the sites — nape, axilla, perineum and perianal region, where sinuses and fistulas actually occur, the last being the anal fistula that this section's 肛漏 passages are about.

Jikji 直指

2.6.3
Source원문

內經曰, 陷脉爲瘻, 留連肉腠者是也. 可用附子灸法ㆍ蒜餠灸法二方見鍼灸灸之, 瘡口絍翠霞散, 或翠霞錠子絍之, 外貼膏藥. 《精義》

Translation영역
The Inner Classic says: a sunken vessel makes a fistula — that is, one that lingers on in the flesh and its interstices. The aconite moxibustion method and the garlic-cake moxibustion method — both given in the Acupuncture chapter — may be used to burn it; the mouth of the sore is packed on a wick with Chwiha-san 翠霞散, or a Chwiha-jeongja 翠霞錠子 is packed in, and a plaster laid over it.

Jeongui 精義

2.6.4
Source원문

治法溫散風冷爲急, 宜溫解散ㆍ內塞散.

Translation영역
As to the method of treatment, warming and dispersing the wind-cold is urgent, and Onhae-san 溫解散 and Naesae-san 內塞散 should be given.

Jeongui 精義

2.6.5
Source원문

收水次之, 宜牽牛酒.

Translation영역
Taking up the water comes next, and Gyeonu-ju 牽牛酒 should be given.

Jeongui 精義

2.6.6
Source원문

生肌又次之, 宜龍骨ㆍ牡蠣ㆍ人齒ㆍ犬牙加血竭ㆍ乳ㆍ麝ㆍ髮灰, 內外相維, 生肌必矣. 或平肌散方見癰疽ㆍ人牙散ㆍ蜂房散選用.

Translation영역
Breeding flesh comes next again: dragon bone, oyster shell, human tooth and dog's tooth with dragon's blood, frankincense, musk and hair ash added, inside and outside holding to one another, and the flesh must breed. Or one chooses among Pyeonggi-san 平肌散 — the formula is given in the Abscesses chapter — Ina-san 人牙散 and Bongbang-san 蜂房散.
Clinical note임상 주석
**Human tooth and hair ash are human materials and must not be used on a wound.** The sequence set out across these three passages — warm and disperse, then take up the discharge, then breed flesh — is a staged plan for a chronic sinus, and the staging is reasonable even though none of the drugs does what the stage requires. A fistula closes when its track is laid open or excised and whatever lies at its base is removed, which the section's own second passage has already explained.

Jeongui 精義

2.6.7
Source원문

通治宜加味蠟礬丸ㆍ內生肌丸ㆍ乳麝雲母膏ㆍ溫經丸.

Translation영역
For general treatment, Gaminapban-hwan 加味蠟礬丸, Naesaenggi-hwan 內生肌丸, Yusaunmo-go 乳麝雲母膏 and Ongyeong-hwan 溫經丸 should be given.

Jeongui 精義

2.6.8
Source원문

外治宜截疳散ㆍ雄黃膏ㆍ黑靈散.

Translation영역
For outward treatment, Jeolgam-san 截疳散, Unghwang-go 雄黃膏 and Heukryeong-san 黑靈散 should be given.

Jeongui 精義

2.6.9
Source원문

熏方ㆍ洗方ㆍ取久漏中朽骨方ㆍ治心漏方ㆍ取漏蟲法ㆍ禁忌法.

Translation영역
The fumigating method, the washing method, the method for taking the rotted bone out of a long-standing leak, the method for treating the heart leak, the method for taking out the fistula worm, and the prohibitions.
Clinical note임상 주석
取久漏中朽骨方 — a method, with a section to itself, for getting the dead bone out of a long-standing sinus. The chapter has not only stated the sequestrum principle but set up a procedure for acting on it. Removing the sequestrum is what cures chronic osteomyelitis, and this is the right operation named for the right reason.

Jeongui 精義

2.6.1 The Method of Taking Out the Fistula Worm 取漏蟲法

2.6.1.1
Source원문

取泡鱔魚數條, 令盤屈, 以竹簽串定, 香油塗上下, 覆瘡上, 以布巾繫定. 良久覺痒痛不可忍, 取鱔入水中, 有蟲如線出焉. 未盡再覆, 蟲盡後, 以艾湯入白礬洗淨, 黃連ㆍ檳榔末糝付. 治膁瘡亦妙. 《入門》

Translation영역
Take several eels, let them coil, skewer them fast with a bamboo pin, smear them with sesame oil above and below, lay them over the sore and tie them on with a cloth. After a good while, when the itching and pain cannot be borne, take the eels and put them in water, and worms like threads come out of them. If they are not all out, lay them on again; and when the worms are spent, wash it clean with a mugwort decoction with alum in it, and dust it with powdered coptis and areca. It is excellent for the shin sore too.
Clinical note임상 주석
**Live animals must not be bound onto an open sore.** The threads said to come out of the eels were strands of the eels themselves, or fibrin and debris from the wound; a discharging fistula has no worms in it. What the method does achieve is a warm moist occlusive dressing, which loosens slough — and in exchange it introduces the whole bacterial load of a river fish into an open track.

Immun 入門

2.6.2 The Prohibitions 禁忌法

2.6.2.1
Source원문

凡漏切忌七情ㆍ房勞, 尤戒怒氣. 不然則核則大, 漏則水多. 《直指》

Translation영역
In the leak generally, the seven affects and bedchamber exhaustion are strictly to be avoided, and the qi of anger most of all; otherwise the kernel grows large and the leak runs with much water.

Jikji 直指

2.6.3 Simple Medicinals 單方

2.6.3.1
Source원문

治漏瘡ㆍ疳瘻瘡, 橡斗子 十二箇, 一實黃丹, 一實白礬, 兩藥相合定, 麻皮纏了, 燒存性, 硏細, 入麝香少許, 洗淨糝之. 名曰烏金散. 《濟生》

Translation영역
Treats the leaking sore and the gnawing-fistula sore. Twelve acorn cups, half of them filled with minium and half with alum, the two drugs set together and bound round with hemp bark; burn them with their nature kept, grind them fine, put in a little musk, and dust it on when the sore has been washed clean. It is named Ogeum-san 烏金散.
Clinical note임상 주석
**Contains minium, which is lead tetroxide, and must not be dusted into an open sore.** A fistula absorbs directly, and the dressing is meant to be renewed.

Jesaeng 濟生

2.6.3.2
Source원문

取蠐螬蟲, 剪去兩頭, 安瘡口上, 以艾炷灸之七壯, 一易, 不過七枚, 無不效. 《東垣》

Translation영역
Take a grub, cut off both ends, set it on the mouth of the sore and burn seven moxa cones over it, changing it once; not more than seven grubs are needed, and it never fails.

Dongwon 東垣

2.6.3.3
Source원문

鼴鼠燒取膏塗之, 最妙. 《本草》

Translation영역
Burn a mole, take the grease and spread it on; this is the best.

Boncho 本草

2.6.3.4
Source원문

鰻鱺魚取膏塗之, 幷食其肉, 甚效. 《本草》

Translation영역
Take the grease of an eel and spread it on, eating its flesh besides; this is very effective.

Boncho 本草

2.6.3.5
Source원문

鯉魚腸火灸, 封瘡口半日許, 覺痒, 開看蟲出差. 《本草》

Translation영역
Roast a carp's gut over the fire, seal it over the mouth of the sore for half a day, and when itching is felt, open it and look: the worms come out and it is cured.

Boncho 本草

2.6.3.6
Source원문

煉松脂塡瘡口令滿, 日三易, 卽效. 《本草》

Translation영역
Fill the mouth of the sore full with refined pine resin, changing it three times a day, and it answers at once.
Clinical note임상 주석
Packing a sinus full and renewing it three times a day is a wick dressing, and of the seven remedies in this section it is the only one that would help: resin is sticky, largely sterile after heating, and keeps the track open so that it drains from the bottom rather than sealing over at the skin. The same principle is in 癰疽 下 1.14's 絍入鍼孔.

Boncho 本草

2.6.3.7
Source원문

蝮蛇膽取汁塗之. 《本草》

Translation영역
Take the juice of a pit-viper's gall and spread it on.

Boncho 本草

2.6.3.8
Source원문

肛漏多孔, 熟犬肉蘸藍汁食之, 七日差. 《得效》

Translation영역
Where the anal leak has many openings, dip cooked dog flesh in indigo juice and eat it; in seven days it is cured.
Clinical note임상 주석
肛漏多孔 — the anal fistula with many openings. A complex fistula-in-ano with several external openings is what is being described, and it is one of the few conditions in this chapter for which nothing but surgery has ever worked. It does not heal in seven days.

Deukhyo 得效

2.6.4 The Moxibustion Method 灸法

2.6.4.1
Source원문

久漏瘡, 足內踝上一寸灸三壯. 在上則灸肩井ㆍ鳩尾. 《東垣》

Translation영역
For the long-standing leaking sore, burn three cones one chi above the inner ankle of the foot. Where it is above, burn Gyeonjeong and Gumi.

Dongwon 東垣

2.6.4.2
Source원문

冷漏多在腿足之間, 先雖積熱所注, 久則爲寒, 宜用附子灸法ㆍ硫黃灸法二法並見針灸. 久瘡成漏ㆍ膿水不絶者亦宜灸. 《丹心》

Translation영역
The cold leak is mostly between the thigh and the foot; though at first it was poured there by accumulated heat, in time it becomes cold, and the aconite moxibustion method and the sulphur moxibustion method — both methods are given in the Acupuncture chapter — should be used. Where a long-standing sore has become a leak and the pus and fluid do not stop, burning is also appropriate.

Dansim 丹心

2.7 Scabies and Ringworm 疥癬

2.7.1
Source원문

疥瘡有五. 一曰乾疥, 皮枯屑起, 宜吳茱萸散.

Translation영역
The scab sore is of five kinds. The first is called the dry scab: the skin is withered and scales rise, and Ojuyu-san 吳茱萸散 should be given.

Immun 入門

2.7.2
Source원문

二曰濕疥, 焮腫作痛, 流汁淋漓, 宜一上散.

Translation영역
The second is called the damp scab: inflamed and swollen and painful, running with fluid, and Ilsang-san 一上散 should be given.

Immun 入門

2.7.3
Source원문

三曰砂疥, 細如砂子, 或痛或痒, 宜剪草散.

Translation영역
The third is called the sand scab: fine as grains of sand, now painful and now itching, and Jeoncho-san 剪草散 should be given.

Immun 入門

2.7.4
Source원문

四曰蟲疥, 痒不知痛, 易於傳染, 宜硫黃餠.

Translation영역
The fourth is called the worm scab: it itches and does not hurt, and passes easily by contagion; Yuhwang-byeong 硫黃餠 should be given.
Clinical note임상 주석
**The one place in this chapter where the disease, the mechanism and the drug all line up.** 蟲疥, the worm scab — itching without pain and easily caught — is scabies, and the chapter has named it after a creature, marked it as the contagious one of the five, and treated it with sulphur. Sulphur is a scabicide. Precipitated sulphur ointment is still used, and it is the treatment of choice in infants and in pregnancy, where permethrin and ivermectin are avoided. Sarcoptes scabiei was not seen under a lens for another century and a half; the Immun could not know there was a mite, but it had the transmission and the cure.

Immun 入門

2.7.5
Source원문

五曰膿疥, 含漿稠膿, 色厚焮痛, 宜三黃散.

Translation영역
The fifth is called the pus scab: it holds thick pus, the colour heavy, inflamed and painful; Samhwang-san 三黃散 should be given.
Clinical note임상 주석
Thick pus in a scabietic eruption is impetiginized scabies — the mite's burrows scratched open and infected with staphylococcus or streptococcus. It is the complication that makes scabies dangerous, and the chapter has given it its own grade and its own drug.

Immun 入門

2.7.6
Source원문

癬瘡亦有五. 一曰濕癬, 狀如蟲行, 搔之汁出.

Translation영역
The ringworm sore too is of five kinds. The first is called the damp ringworm: in appearance as though worms were walking, and scratching it brings fluid out.

Immun 入門

2.7.7
Source원문

二曰頑癬, 全然不知痛痒.

Translation영역
The second is called the stubborn ringworm: it knows neither pain nor itching at all.

Immun 入門

2.7.8
Source원문

三曰風癬, 又名乾癬, 搔生白屑.

Translation영역
The third is called the wind ringworm, also named the dry ringworm: scratching it raises white scales.

Immun 入門

2.7.9
Source원문

四曰馬癬, 微痒白點相連.

Translation영역
The fourth is called the horse ringworm: faintly itching, with white spots joined one to another.

Immun 入門

2.7.10
Source원문

五曰牛癬, 如牛領皮, 厚且堅.

Translation영역
The fifth is called the ox ringworm: like the hide of an ox's neck, thick and hard.
Clinical note임상 주석
The five 癬 are the scaling, non-contagious or slowly contagious eruptions, and three are recognizable: 風癬 with dry white scales is the tinea of the trunk or psoriasis; 牛癬 like ox-neck hide, thick and hard, is lichenification from years of scratching, what is now called lichen simplex chronicus; 頑癬, feeling neither pain nor itch, is a patch that has lost sensation, which in this chapter's company raises leprosy — 2.1's first death is exactly 皮死麻木不仁.

Immun 入門

2.7.11
Source원문

疥癬皆血分熱燥, 以致風毒剋於皮膚. 浮淺者爲疥, 深沉者爲癬. 疥多挾熱, 癬多挾濕. 疥狀如被介甲, 癬狀如走苔蘚, 大槩相同. 《入門》

Translation영역
Scab and ringworm are both heat and dryness in the blood aspect, bringing the wind toxin to overwhelm the skin. What is shallow and floating is the scab, what is deep and sunken the ringworm; the scab mostly carries heat with it and the ringworm damp. The scab looks as though one were covered in shell-armour, the ringworm as though moss and lichen were spreading; in general they are much alike.

Immun 入門

2.7.13
Source원문

治癬宜麻豆膏ㆍ蝎猫膏ㆍ胡粉散ㆍ連粉散.

Translation영역
To treat the ringworm, Madu-go 麻豆膏, Galmyo-go 蝎猫膏, Hobun-san 胡粉散 and Yeonbun-san 連粉散 should be given.

Jebang 諸方

2.7.14
Source원문

通治疥癬宜一上散ㆍ秘傳一擦光ㆍ艾葉ㆍ當歸飮子ㆍ何首烏散ㆍ蕪荑散ㆍ浮萍散. 《諸方》

Translation영역
For the general treatment of scab and ringworm, Ilsang-san 一上散, Bijeonilchalgwang 秘傳一擦光, mugwort leaf, Danggui-eumja 當歸飮子, Hasuo-san 何首烏散, Mui-san 蕪荑散 and Bupyeong-san 浮萍散 should be given.

Jebang 諸方

2.7.15
Source원문

凡疥痛甚加寒水石, 痒加黑狗脊, 微痒加蛇床子, 有蟲加雄黃, 喜溫熱加硫黃. 《丹心》

Translation영역
In the scab generally: where the pain is severe add calcite; where it itches add black woodfern; where it itches faintly add cnidium fruit; where there are worms add realgar; where he likes warmth and heat add sulphur.
Clinical note임상 주석
有蟲加雄黃, 喜溫熱加硫黃 — add realgar where there are worms, sulphur where he likes warmth. The two additions for the mite case are the two mineral parasiticides in the pharmacopoeia, and of them sulphur works and realgar is arsenic sulphide. **Realgar must not be used.** That the chapter reaches for an antiparasitic precisely when it thinks a creature is present is the logic working correctly on a correct premise.

Dansim 丹心

2.7.1 Washing Drugs 洗藥

2.7.1.1
Source원문

治疥癬瘙痒生瘡. 細辛ㆍ荊芥ㆍ白芷ㆍ川芎ㆍ黃芩ㆍ防風ㆍ地骨皮ㆍ甘草 各等分. 右麄末, 每取二兩, 水二大椀煎十餘沸, 乘溫淋溻患處. 名曰八仙散. 《精義》

Translation영역
Treats scab and ringworm that itch and break into sores. Asarum, schizonepeta, angelica, Sichuan lovage, scutellaria, saposhnikovia, lycium root bark and licorice, equal parts of each. Powder the above coarsely, take 2 nyang each time, boil it in two large bowls of water some ten times, and while it is warm pour and bathe the affected place with it. It is named Palseon-san 八仙散.

Jeongui 精義

2.7.1.2
Source원문

何首烏ㆍ陳艾等分濃煎浸洗, 治遍身疥癬. 《本草》

Translation영역
Boil fleeceflower root and old mugwort in equal parts thick and steep and wash with it; it treats scab and ringworm over the whole body.

Boncho 本草

2.7.1.3
Source원문

冬瓜藤煎湯浸洗亦佳. 《本草》

Translation영역
Boiling wax-gourd vine and steeping and washing in it is also good.

Boncho 本草

2.7.1.4
Source원문

溫泉浴最妙. 《本草》

Translation영역
Bathing in a hot spring is the best of all.
Clinical note임상 주석
Many Korean hot springs are sulphurous, so a course of bathing in one delivers the same agent as 2.7's 硫黃餠 over the whole skin. It is the gentlest effective treatment in the section, and the only one with no warning attached.

Boncho 本草

2.7.2 Simple Medicinals 單方

2.7.2.1
Source원문

硫黃 生用治疥癬及惡瘡. 嗅其臭不止, 可愈疥瘡. 《本草》

Translation영역
Sulphur (硫黃): Used raw it treats scab and ringworm and malign sores. Smelling its smell without ceasing can heal the scab sore.

Boncho 本草

2.7.2.2
Source원문

雄黃 治疥癬殺蟲, 爲末付之. 《本草》

Translation영역
Realgar (雄黃): Treats scab and ringworm and kills the worms; powder it and apply it.
Clinical note임상 주석
**Realgar is arsenic sulphide and must not be applied to broken skin.** Arsenic is absorbed through excoriated skin, and a scabietic eruption is excoriated everywhere.

Boncho 本草

2.7.2.3
Source원문

水銀滓 硏臘猪脂擦疥, 殺蟲立效. 《得效》

Translation영역
Quicksilver dross (水銀滓): Ground with winter lard and rubbed on the scab, it kills the worms with immediate effect.
Clinical note임상 주석
**Mercury must not be applied to the skin.** Mercurial ointments were genuinely parasiticidal, which is why they stayed in use for scabies as well as syphilis, and they poisoned the people who used them. Sulphur, three entries above, does the same job without that.

Deukhyo 得效

2.7.2.4
Source원문

藜蘆 治疥癬, 作末, 生麻油調塗. 《本草》

Translation영역
Veratrum (藜蘆): Treats scab and ringworm; make it into powder and spread it on stirred with raw sesame oil.
Clinical note임상 주석
**Veratrum is a cardiotoxin and must not be prepared.** Its alkaloids are absorbed through damaged skin and slow the heart.

Boncho 本草

2.7.2.5
Source원문

羊蹄根 治疥癬, 爛搗和醋付之, 妙. 《本草》

Translation영역
Rumex root (羊蹄根): Treats scab and ringworm; pound it to a pulp, mix with vinegar and apply; this is excellent.

Boncho 本草

2.7.2.6
Source원문

治頑癬, 槿樹皮加巴豆ㆍ斑猫, 入砒少許, 爲末水調付. 《丹心》

Translation영역
To treat the stubborn ringworm: rose-of-Sharon bark with croton and blister beetle added and a little arsenic put in, powdered and applied stirred with water.
Clinical note임상 주석
**Contains croton, blister beetle and arsenic, and must not be prepared.** Three escharotics together, applied to a patch of skin that 2.7 has just said feels neither pain nor itch, so the patient cannot report the burn.

Dansim 丹心

2.7.2.7
Source원문

脂麻 生取油, 付疥癬及惡瘡, 甚妙. 《本草》

Translation영역
Sesame (脂麻): Take the oil raw and apply it to scab and ringworm and malign sores; this is very good.

Boncho 本草

2.7.2.8
Source원문

牛皮癬久, 皮鞋底燒灰, 入輕粉少許, 油調付. 《入門》

Translation영역
For the long-standing ox-hide ringworm: burn a leather shoe-sole to ash, put in a little calomel, and apply it stirred with oil.

Immun 入門

2.7.2.9
Source원문

田螺 煮熟取肉, 用酒酵炒熟食, 除一生瘡疥. 《回春》

Translation영역
Field snail (田螺): Boil it done, take the flesh, parch it with wine leaven and eat it; it rids one of sores and scab for a lifetime.

Hoechun 回春

2.7.2.10
Source원문

臘猪脂ㆍ生礬ㆍ杏仁加輕粉少許搗擦, 治疥癬, 妙. 《綱目》

Translation영역
Winter lard, raw alum and apricot kernel with a little calomel added, pounded and rubbed on, treats scab and ringworm; this is excellent.

Gangmok 綱目

2.7.2.11
Source원문

鵓鴿 治久患瘡疥, 食之甚良. 《本草》

Translation영역
Pigeon (鵓鴿): Treats long-suffered sores and scab; eating it is very good.

Boncho 本草

2.7.2.12
Source원문

治遍身疥癬, 硫黃ㆍ蛇床子ㆍ白礬 各二錢, 水銀滓 三錢. 右爲末, 薑汁調擦, 立效. 《回春》

Translation영역
To treat scab and ringworm over the whole body: sulphur, cnidium fruit and alum, 2 don each, and quicksilver dross 3 don. Powder the above and rub it on stirred with ginger juice, with immediate effect.
Clinical note임상 주석
**Contains mercury and must not be prepared.** The sulphur, the cnidium and the alum would have done the work on their own; the mercury only added poisoning. 立效, immediate effect, is also fair as an observation — a scabicide stops the itching of scabies within days, which is why these rubs had such a reputation.

Hoechun 回春

2.7.3 The Acupuncture and Moxibustion Method 鍼灸法

2.7.3.1
Source원문

治瘡疥ㆍ頑癬, 取絶骨ㆍ三里ㆍ間使ㆍ解谿ㆍ委中, 或鍼或灸. 《綱目》

Translation영역
To treat sores and scab and the stubborn ringworm, take Jeolgol, Samri, Gansa, Haegye and Wijung, and either needle or burn.

Gangmok 綱目

2.7.3.2
Source원문

手疥取勞宮, 灸大陵. 《綱目》

Translation영역
For scab of the hand take Nogung, and burn Daeryeung.

Gangmok 綱目

2.7.3.3
Source원문

渾身瘡疥取曲池ㆍ合谷ㆍ三里ㆍ絶骨ㆍ行間ㆍ委中. 《綱目》

Translation영역
For sores and scab over the whole body take Gokji, Hapgok, Samri, Jeolgol, Haenggan and Wijung.

Gangmok 綱目

2.7.3.4
Source원문

治癬, 八月八日日出時, 令患人正當東向戶長跪, 擧兩手持戶兩邊, 取肩頭小垂際骨解宛宛中, 左右兩火俱下, 灸七壯, 七日愈.

Translation영역
To treat the ringworm: on the eighth day of the eighth month, at sunrise, have the patient kneel upright facing due east at the door, raise both hands to hold the two sides of the doorway, and take the hollow in the joint of the bone where the shoulder-top hangs a little; set the two fires down together left and right and burn seven cones, and in seven days he is healed.

Gangmok 綱目

2.7.3.5
Source원문

一女子兩股間濕癬, 下至膝, 痒痛流黃水, 百藥不效. 戴人以鍼當痒時刺百餘處, 血出盡, 煎鹽湯洗之, 四次方除. 盖濕淫於血, 不可不鍼也. 《子和》

Translation영역
A woman had a damp ringworm between both thighs reaching down to the knees, itching and painful and running with yellow water, and a hundred drugs had no effect. Daeren, with a needle at the time of the itching, pricked it in more than a hundred places and let the blood out to the last; then he boiled brine and washed it, and after four such treatments it was gone. For where damp floods the blood, one cannot but needle.
Clinical note임상 주석
A case record, and the only one in this chapter. A weeping, itching, intertriginous eruption from both groins to the knees that no drug touched is a severe flexural eczema, or candidal and bacterial intertrigo in the skin folds. What Daeren did was prick it a hundred times and then wash it with hot brine, four times over — and the brine is probably what worked: a warm hypertonic wash dries a macerated flexure and reduces its surface organisms, which is the principle behind the astringent soaks still used for exactly this. **Needling an infected, macerated flexure a hundred times should not be done**; the hundred punctures are the part to leave behind.

Jahwa 子和

2.8 The Lichen Head Sore 癩頭瘡

2.8.1
Source원문

頭上生瘡如癩, 防風通聖散方見風門爲末, 酒浸焙三次, 食後白湯調服, 日三. 《丹心》

Translation영역
Where sores arise on the head as in the lichen: powder Bangpungtongseong-san 防風通聖散 — the formula is given in the Wind chapter — steep it in wine and bake it dry three times, and give it stirred in plain hot water after meals, three times a day.
Clinical note임상 주석
Crusted, scaling, hair-losing sores over the scalp, called 癩 because they look like leprosy: this is tinea capitis, with impetigo on top of it. It is a children's disease mostly, as the section's own 小兒癩頭瘡 passage acknowledges, and the 白禿 of the fourth passage is its classic bald scaling patch.

Dansim 丹心

2.8.2
Source원문

鹽湯溫洗, 一上散方見上付之, 久不愈者神效. 《丹心》

Translation영역
Wash it warm with brine and apply Ilsang-san 一上散 — the formula is given above; for one long unhealed the effect is marvellous.

Dansim 丹心

2.8.3
Source원문

頭瘡宜服酒歸飮, 外用雄黃ㆍ水銀等分爲末, 臘猪脂半生半熟調付之. 濕爛者, 燕窠土ㆍ黃栢爲末乾糝. 《入門》

Translation영역
For the head sore, Jugwi-eum 酒歸飮 should be taken, and outwardly realgar and quicksilver in equal parts powdered and applied stirred with winter lard, half raw and half rendered. Where it is wet and rotting, powder swallow's-nest earth and phellodendron and dust it on dry.
Clinical note임상 주석
**Mercury and realgar must not be rubbed into a child's scalp.** The scalp is thin, highly vascular and here already broken; this is among the most dangerous applications in the chapter precisely because the patients were small. The dry dusting powder in the same passage — phellodendron and earth on a weeping surface — would have done more good and no harm.

Immun 入門

2.8.4
Source원문

白禿頭瘡宜神應膏. 《醫鑑》

Translation영역
For the white bald head sore, Sineung-go 神應膏 should be used.

Uigam 醫鑑

2.8.5
Source원문

頭面瘡, 密陀僧ㆍ硫黃 各二錢, 輕粉少許. 右爲末, 猪脂調付. 《丹心》

Translation영역
For sores of the head and face: litharge and sulphur, 2 don each, and a little calomel. Powder the above and apply it stirred with lard.
Clinical note임상 주석
**Litharge is lead monoxide and the calomel is mercury; neither may be applied.** The sulphur alone is the part of this that treats a fungal scalp infection.

Dansim 丹心

2.8.6
Source원문

又方, 臘月馬脂油塗擦, 極妙. 《丹心》

Translation영역
Another method: rub it with horse fat rendered in the twelfth month; this is excellent.

Dansim 丹心

2.8.7
Source원문

又方, 松皮灰 五錢, 黃丹ㆍ白膠香 各二錢半, 枯白礬ㆍ大黃ㆍ黃栢 各一錢二分. 右爲末, 熱油調付. 《丹心》

Translation영역
Another method: pine-bark ash 5 don; minium and storax, 2 don 5 fun each; calcined alum, rhubarb and phellodendron, 1 don 2 fun each. Powder the above and apply it stirred with hot oil.

Dansim 丹心

2.8.8
Source원문

小兒癩頭瘡, 松脂 一兩, 懸龍尾ㆍ黃丹 各三錢, 白芷 五錢, 松樹皮ㆍ水銀ㆍ雄黃ㆍ白礬 各二錢. 右爲末, 另用香油入亂髮煎爛, 調勻付之. 《丹心》

Translation영역
For the lichen head sore in a child: pine resin 1 nyang; soot from the rafters and minium, 3 don each; angelica 5 don; pine bark, quicksilver, realgar and alum, 2 don each. Powder the above; separately boil tangled hair soft in sesame oil, stir it even with the powder and apply it.
Clinical note임상 주석
**This must not be made.** Mercury, lead, arsenic and human hair, in one ointment, for a child's broken scalp. It is the worst single prescription in the chapter.

Dansim 丹心

2.8.9
Source원문

又方, 爛木耳爲末, 蜜調付.

Translation영역
Another method: powder rotted wood-ear fungus and apply it stirred with honey.

Dansim 丹心

2.8.10
Source원문

又炭燒紅, 淬長流水令熱, 洗之.

Translation영역
Again, burn charcoal red, quench it in long-flowing water to make the water hot, and wash with it.

Dansim 丹心

2.8.11
Source원문

又胡荽子ㆍ伏龍肝ㆍ懸龍尾ㆍ黃連ㆍ白礬爲末, 油調付. 連床散ㆍ如聖黑膏亦佳. 《丹心》

Translation영역
Again, powder coriander seed, furnace earth, rafter soot, coptis and alum and apply it stirred with oil. Yeonsang-san 連床散 and Yeoseonghuk-go 如聖黑膏 are also good.

Dansim 丹心

2.8.12
Source원문

又兔絲子或蒺藜子煎湯洗之. 《本草》

Translation영역
Again, boil cuscuta seed or tribulus fruit and wash with the decoction.

Boncho 本草

2.9 The Human-Face Sore 人面瘡

2.9.1
Source원문

多生膝上, 亦有臂上生者. 古書云寃業所生, 須淸心悔過. 內服十六味流氣飮方見癰疽, 久者大苦參丸ㆍ腎氣丸方見虛勞. 外用貝母爲末付之, 着痂而愈. 《入門》

Translation영역
It arises mostly on the knee, and there are some that arise on the arm. The old books say it is born of a karmic wrong, and that the heart must be cleared and the fault repented. Inwardly, Sibyungmiyugi-eum 十六味流氣飮 — the formula is given in the Abscesses chapter; for a long-standing one, Daegosam-hwan 大苦參丸 and Singi-hwan 腎氣丸, the formula given in the Vacuity chapter. Outwardly, powder fritillaria and apply it, and it scabs over and heals.

Immun 入門

2.9.2
Source원문

人身有瘡如人面, 面ㆍ目ㆍ口ㆍ鼻皆具. 昔有一人左膊上生瘡, 以物食之皆能食, 灌以酒則面亦赤色. 醫者敎以歷試諸藥, 皆無苦; 至貝母, 其瘡乃聚眉閉口. 其人喜曰可治, 卽取貝母末和水灌入口中, 數日成痂而愈. 《本事》

Translation영역
There are sores on a man's body like a human face, with face, eyes, mouth and nose all complete. There was once a man with such a sore arisen on his left upper arm: whatever was fed to it, it could eat, and when wine was poured in the face too turned red. A physician taught him to try all the drugs in turn, and none troubled it — until he came to fritillaria, at which the sore drew its brows together and shut its mouth. The man said with delight that it could be cured, and at once took powdered fritillaria mixed with water and poured it into the mouth, and in a few days it scabbed over and healed.
Clinical note임상 주석
The one story in this chapter that is a story. What a chronic ulcer with heaped granulation at its margins looks like is a crater with a rim, and a person looking at one on his own arm for months may well find a face in it; fluid poured in runs into the cavity, and alcohol on a raw surface reddens it. 歷試諸藥 — trying all the drugs in turn — is the method, and it is a crude drug trial, with the sore's "closing its mouth" as the endpoint. Fritillaria has no special action on an ulcer. What the account records faithfully is the shape of the search. 古書云寃業所生, 須淸心悔過 — the old books say it is born of a karmic wrong, and the heart must be cleared and the fault repented. It is worth noticing that the Immun prints that and then prescribes anyway.

Bonsa 本事

2.10 The Eroding Sore of the Genitals 陰蝕瘡

2.10.1
Source원문

夫陰瘡大槩有三等. 一曰濕陰瘡, 二曰妬精瘡, 三曰陰蝕瘡, 亦曰下疳瘡也.

Translation영역
The genital sore is in general of three grades. The first is called the damp genital sore, the second the jealous-essence sore, the third the eroding genital sore, which is also called the lower gnawing sore.

Immun 入門

2.10.2
Source원문

濕陰瘡者, 由腎虛風濕邪氣乘之, 瘙痒成瘡, 浸淫汁出, 狀如疥癬.

Translation영역
The damp genital sore comes of the kidney being vacuous and the evil qi of wind and damp overwhelming it: it itches and breaks into sores, soaking and weeping fluid, looking like scab and ringworm.

Immun 入門

2.10.3
Source원문

妬精瘡者, 由壯年久曠房室, 思色動慾, 以致敗精流入莖內, 陰上生瘡, 赤腫潰爛作臼, 痛痒妨悶.

Translation영역
The jealous-essence sore comes of a man in his strong years long deprived of the bedchamber, who dwells on beauty and stirs his desire, so that the spoilt essence flows into the stalk; sores arise on the yin part, red and swollen, breaking down and rotting into a crater, painful and itching and oppressive.

Immun 入門

2.10.4
Source원문

陰蝕瘡者, 由熱結下焦, 經絡澁滯; 或婦人子宮有敗精停留; 或月水未斷與之交合; 房勞後又不洗浴, 邪穢留滯. 遂令陰莖連睾丸腫痛, 小便如淋, 經久潰爛, 侵蝕肌肉, 膿血不止, 遂成下疳瘡. 久不愈則必成楊梅瘡, 宜服仙遺粮湯方見上預防之. 寒熱尿澁, 宜八正散方見小便. 濕熱甚則腫痛ㆍ尿澁ㆍ莖中痒痛, 或出白津, 宜龍膽瀉肝湯方見前陰. 腫潰後八物湯方見虛勞加柴胡ㆍ梔子ㆍ知母久服. 《入門》

Translation영역
The eroding genital sore comes of heat binding in the lower burner and the channels and network vessels growing rough and stagnant; or of spoilt essence lodging in a woman's uterus; or of coupling with her before the monthly water has ended; or of not washing after exhaustion in the bedchamber, so that evil filth stays and lodges. Thereupon the stalk and the testicles with it grow swollen and painful, the urine comes as in strangury, and in time it breaks down and rots, eating into the flesh with pus and blood that will not stop, and so becomes the lower gnawing sore. Long unhealed it must become the mulberry sore, and Seonyuryang-tang 仙遺粮湯 — the formula is given above — should be given to forestall it. Where there are chills and fever and rough urine, Paljeong-san 八正散 — the formula is given in the Urine chapter. Where the damp heat is severe, with swelling and pain, rough urine, itching and pain within the stalk, or a white discharge, Yongdamsagan-tang 龍膽瀉肝湯 — the formula is given in the Genitals chapter. After the swelling has broken down, Palmul-tang 八物湯 — the formula is given in the Vacuity chapter — with bupleurum, gardenia and anemarrhena added, taken long.
Clinical note임상 주석
久不愈則必成楊梅瘡 — long unhealed it must become the mulberry sore. **The chapter has connected the genital ulcer to syphilis, and connected them in the right order.** 下疳 is the primary chancre; 楊梅瘡, the subject of 2.2, is the secondary eruption that follows it by weeks. A clinician who watched enough patients would see the one turn into the other, and the Immun writes it as a certainty — 必 — and prescribes to forestall it. The rest of the passage holds together too: 陰莖連睾丸腫痛 with 小便如淋 and a 白津 discharge is urethritis with epididymitis, which is gonorrhoea or chlamydia and travelled with syphilis in the same patients. 房勞後又不洗浴, 邪穢留滯 — not washing after intercourse, so that the filth stays — is as close to a hygiene theory of venereal infection as the period came.

Immun 入門

2.10.5
Source원문

下疳瘡日久不愈, 或成便毒, 或損爛陽物, 多致危篤. 俗云疳瘡未已, 便毒復來生也. 《醫鑑》

Translation영역
Where the lower gnawing sore goes long unhealed it may become the groin toxin, or may ruin and rot the yang member, and generally brings him to grave danger. The common saying is that the gnawing sore is not yet done before the groin toxin comes again.
Clinical note임상 주석
便毒 is the inguinal bubo of 癰疽 下 1.6 — the draining lymph nodes of the groin, swollen and suppurating. A genital ulcer followed by a bubo is chancroid or lymphogranuloma venereum, and the sequence named in the proverb is the sequence of the disease.

Uigam 醫鑑

2.10.6
Source원문

陰頭腫痛生瘡, 名爲下疳, 乃督ㆍ任ㆍ衝三脉之會. 其瘡一生, 則便毒ㆍ厲風瘡次第而來. 先宜升麻葛根湯方見寒門發出, 繼服凉血解毒丸卽愈, 不必服輕粉毒藥. 《醫鑑》

Translation영역
Where the head of the yin part swells and hurts and breaks into a sore it is named the lower gnawing sore, and it is the meeting of the three vessels Dok, Im and Chung. Once that sore has arisen, the groin toxin and the pestilent wind sore come one after another. First Seungmagalgeun-tang 升麻葛根湯 — the formula is given in the Cold chapter — should be given to bring it out, and then Yanghyeolhaedok-hwan 凉血解毒丸 taken after it, and it heals; there is no need to take the poisonous calomel drugs.
Clinical note임상 주석
不必服輕粉毒藥 — there is no need to take the poisonous calomel drugs. **A physician inside this chapter refusing its own central treatment**, and calling it poison in the same breath. The Uigam is wrong that its own pills cure syphilis, and right about the mercury. Set beside 2.2's record of mercurial dermatitis, 2.2.1's method for recovering the calomel, and 2.2.9's peeling palms, this is the fourth place where the book registers that the cure was doing harm — and the only one where someone says to stop.

Uigam 醫鑑

2.10.7
Source원문

妬精瘡初發在陰頭如粟, 拂之卽痛甚, 出淸膿, 作臼孔, 蝕之大痛. 婦人有生於玉門內, 正似疳蝕瘡, 但不痛爲異. 《醫鑑》

Translation영역
The jealous-essence sore breaks out first on the head of the yin part like a grain of millet, and brushing it gives severe pain at once; clear pus comes out, it makes a crater, and the eroding of it is very painful. In women there are those that arise within the jade gate, just like the gnawing eroding sore, differing only in that they do not hurt.
Clinical note임상 주석
婦人 … 但不痛爲異 — in women the only difference is that it does not hurt. **That is the clinical hallmark of the syphilitic chancre, and the reason syphilis went undetected in women.** A painless ulcer inside the vagina or on the cervix is not noticed, is not brought to a physician, and goes on being infectious. The Uigam has recorded the single most consequential asymmetry in this disease, as a passing remark about a difference.

Uigam 醫鑑

2.10.8
Source원문

治法, 以大豆甘草湯漬之, 洗毒散煎湯浴之, 磨風膏溫潤之. 《精義》

Translation영역
The method of treatment: steep it in Daedugamcho-tang 大豆甘草湯, bathe it in a decoction of Sedok-san 洗毒散, and warm and moisten it with Mapung-go 磨風膏.

Jeongui 精義

2.10.9
Source원문

通用消疳敗毒散ㆍ凉血解毒丸. 《回春》

Translation영역
For general use, Sogampaedok-san 消疳敗毒散 and Yanghyeolhaedok-hwan 凉血解毒丸.

Hoechun 回春

2.10.1 Sore-Washing Drugs 洗瘡藥

2.10.1.1
Source원문

凡下部諸瘡, 常須藥湯淋洗, 以去膿汁惡水. 宜洗疳湯ㆍ大豆甘草湯ㆍ洗毒散ㆍ洗下疳瘡方. 《諸方》

Translation영역
For all sores of the lower parts, a medicinal decoction must constantly be poured over them to wash the pus and foul water away. Segam-tang 洗疳湯, Daedugamcho-tang 大豆甘草湯, Sedok-san 洗毒散 and the method for washing the lower gnawing sore should be used.
Clinical note임상 주석
常須藥湯淋洗, 以去膿汁惡水 — a wash constantly, to carry the pus and foul water away. For a genital ulcer this is the soundest instruction in the section: keeping the area clean and dry is still the whole of local care, and the four washes named are mild. The chapter's own harm comes from what it put on afterwards, not from this.

Jebang 諸方

2.10.2 Dusting and Applying Drugs 糝付藥

2.10.2.1
Source원문

藥水淋洗後, 乃用糝付之藥. 宜栢蛤散ㆍ津調散ㆍ鳳衣散ㆍ旱螺散ㆍ截疳散方見上ㆍ珍珠散ㆍ磨風膏, 或糝或付. 《諸方》

Translation영역
After the medicinal water has been poured over it, the dusting and applying drugs are used: Baekhap-san 栢蛤散, Jinjo-san 津調散, Bongui-san 鳳衣散, Hanra-san 旱螺散, Jeolgam-san 截疳散 — the formula is given above — Jinju-san 珍珠散 and Mapung-go 磨風膏, either dusted on or applied.

Jebang 諸方

2.10.3 The Signs Not To Be Treated 不治證

2.10.3.1
Source원문

下疳瘡重者, 心中㽲痛ㆍ悶絶ㆍ虛煩甚者不治. 《入門》

Translation영역
Where the lower gnawing sore is grave, and there is griping pain in the heart, fainting away in oppression, and severe vacuous vexation, it is not to be treated.

Immun 入門

2.11 The Shin Sore 膁瘡

2.11.1
Source원문

生於兩脚, 腫爛臭穢, 步履艱辛. 此瘡生於膁骨爲重, 以其骨上肉少皮薄, 故難愈. 治法當先取蟲, 然後外貼膏藥, 內服蠟礬丸方見癰疽之類. 須翹足端坐, 勿多行履, 庶可全愈. 《醫鑑》

Translation영역
It arises on both legs, swollen and rotting and foully stinking, so that walking is hard. This sore is graver when it arises over the shin bone, because there is little flesh over that bone and the skin is thin, and so it is slow to heal. The method of treatment should be first to take out the worms, then lay a plaster on outwardly and take Napban-hwan 蠟礬丸 — the formula is given in the Abscesses chapter — and the like inwardly. He must sit upright with the foot raised and not walk about much, and then it may heal wholly.
Clinical note임상 주석
**The best management advice in the chapter, and still the treatment.** 須翹足端坐, 勿多行履 — sit with the leg raised and do not walk about. A chronic ulcer over the shin is a venous leg ulcer, and elevation plus compression is what heals it; walking about with the leg dependent is what keeps it open. The reason given for the shin being worst — 骨上肉少皮薄, little flesh over the bone and thin skin — is also correct, and it is why the medial malleolar area is where these ulcers sit. The worms are flies' larvae in a neglected ulcer, or nothing at all.

Uigam 醫鑑

2.11.2
Source원문

膁瘡生兩膁上, 初起焮腫作痛, 三陰虛也, 宜八物湯方見虛勞. 若患處黑黯ㆍ惡寒ㆍ少食, 屬肝腎虛, 宜八味丸方見虛勞. 久不愈者大苦參丸方見上ㆍ入門. 《入門》

Translation영역
Where the shin sore arises on both shins, inflamed and swollen and painful at its rising, it is vacuity of the three yin, and Palmul-tang 八物湯 — the formula is given in the Vacuity chapter — should be given. If the affected place is black and dull, with aversion to cold and little appetite, it belongs to liver and kidney vacuity, and Palmi-hwan 八味丸 — the formula is given in the Vacuity chapter. For one long unhealed, Daegosam-hwan 大苦參丸 — the formula is given above, and in the Immun.
Clinical note임상 주석
患處黑黯ㆍ惡寒ㆍ少食 — the place black and dull, the patient cold and off his food. A leg ulcer whose base turns dusky in a patient who is systemically unwell is an ischaemic or infected ulcer rather than a venous one, and the distinction the Immun draws from the first passage's inflamed swelling is the distinction that still decides the treatment.

Immun 入門

2.11.3
Source원문

外膁瘡先以葱湯洗, 次貼龍骨膏或馬齒膏. 濕熱者窰土膏.

Translation영역
For the outer shin sore, wash first with a scallion decoction and then lay on Yonggol-go 龍骨膏 or Machi-go 馬齒膏; where there is damp heat, Yoto-go 窰土膏.

Immun 入門

2.11.4
Source원문

內膁瘡先以鹽湯洗, 次貼蠟礬紙.

Translation영역
For the inner shin sore, wash first with brine and then lay on Napban-ji 蠟礬紙.

Immun 入門

2.11.5
Source원문

內外通用爐灰膏方見雜方點去瘀肉, 後貼黃蠟膏. 《入門》

Translation영역
For inner and outer alike, Nohoe-go 爐灰膏 — the formula is given in the Miscellaneous chapter — is dabbed on to take away the stagnant flesh, and Hwangnap-go 黃蠟膏 laid on afterwards.
Clinical note임상 주석
點去瘀肉 — dabbing away the dead flesh. Removing slough from the floor of a leg ulcer is a necessary step and the only way it granulates; a caustic paste is a crude way to do it, and it burns the healthy margin along with the slough. **Nohoe-go is a lye caustic and must not be applied.** Sharp or enzymatic debridement does the same work under control.

Immun 入門

2.11.6
Source원문

膁瘡及脚膝生瘡, 局方虛損門黃芪丸方見虛勞服之卽愈. 《海藏》

Translation영역
For the shin sore and sores arising on the leg and knee, the Hwanggi-hwan 黃芪丸 of the Vacuity and Damage section of the Gukbang — the formula is given in the Vacuity chapter — taken, heals it at once.

Haejang 海藏

2.11.7
Source원문

內外膁瘡宜粉麝散ㆍ神捷膏ㆍ馬齒膏ㆍ翠玉膏ㆍ白膠香散ㆍ貼藥三方ㆍ鍼法ㆍ洗法ㆍ取蟲法. 《諸方》

Translation영역
For the inner and outer shin sores, Bunsa-san 粉麝散, Sinchep-go 神捷膏, Machi-go 馬齒膏, Chwiok-go 翠玉膏, Baekgyohyang-san 白膠香散, the three plastering methods, the needling method, the washing method and the method for taking out the worms.

Jebang 諸方

2.11.1 Simple Medicinals 單方

2.11.1.1
Source원문

治膁瘡, 黃蠟 一兩, 猪膽 一箇, 輕粉 二錢. 右熔化和勻, 攤油紙上貼之. 《丹心》

Translation영역
Treats the shin sore. Beeswax 1 nyang, one pig's gall, calomel 2 don. Melt them, mix them even, spread them on oiled paper and lay it on.
Clinical note임상 주석
**Contains calomel and must not be prepared.** A beeswax plaster on oiled paper is itself a reasonable occlusive dressing for a leg ulcer; the mercury in it is absorbed through the ulcer floor, and the first edition's smaller dose makes no difference to that.

Dansim 丹心

2.11.1.2
Source원문

又方, 白膠香ㆍ黃栢ㆍ軟石膏 各一兩, 靑黛 五錢, 龍骨 一錢. 右爲末, 香油調付. 《丹心》

Translation영역
Another method: storax, phellodendron and soft gypsum, 1 nyang each; indigo 5 don; dragon bone 1 don. Powder the above and apply it stirred with sesame oil.

Dansim 丹心

2.11.1.3
Source원문

又方, 羯羊屎燒存性 五錢, 石膏 二錢半, 赤石脂 一錢二分. 右爲末, 香油調付, 以巾包定除根. 《丹心》

Translation영역
Another method: wether's dung burnt with its nature kept, 5 don; gypsum 2 don 5 fun; red halloysite 1 don 2 fun. Powder the above, apply it stirred with sesame oil, and bind it up with a cloth to root it out.
Clinical note임상 주석
**Dung must not be put on an open ulcer.** A shin ulcer bound up under a cloth with sheep's dung in the dressing is a direct route to tetanus and to deep infection of the exposed bone.

Dansim 丹心

2.11.1.4
Source원문

冷膁瘡, 鹿角灰ㆍ油髮灰ㆍ乳香爲末, 淸油調付. 《得效》

Translation영역
For the cold shin sore, powder deer-horn ash, oiled-hair ash and frankincense and apply it stirred with clear oil.

Deukhyo 得效

2.11.1.5
Source원문

膁瘡成臼久不乾, 好砂糖屑津調塗付, 日二次, 三日愈. 《得效》

Translation영역
Where the shin sore has made a crater and is long in drying, stir good sugar crumbs with saliva and spread them on, twice a day, and in three days it heals.
Clinical note임상 주석
Sugar packed into a cavitating ulcer is the one remedy in this section with a modern counterpart: sugar and honey dressings draw fluid osmotically out of the wound bed, lower the water available to bacteria, and deodorize a sloughy ulcer, and they are still used where modern dressings are scarce. The saliva is the part to leave out — the mouth's organisms are what cause the worst of this chapter's hand and face infections.

Deukhyo 得效

2.11.1.6
Source원문

紅絹ㆍ蠶空蠒並燒灰ㆍ胡粉 各三分, 眞珠煆 二分, 枯礬ㆍ髮灰ㆍ白麵 各一分. 右爲末, 黃蠟 二兩熔化調勻貼之, 神效. 《回春》

Translation영역
Red silk and empty silkworm cocoons, both burnt to ash, and lead white, 3 fun each; calcined pearl 2 fun; calcined alum, hair ash and wheat flour, 1 fun each. Powder the above, melt 2 nyang of beeswax, stir it even and lay it on; the effect is marvellous.
Clinical note임상 주석
**Contains lead white and human hair ash and must not be prepared.**

Hoechun 回春

2.11.2 The Needling Method 鍼法

2.11.2.1
Source원문

膁瘡色紫黑, 先以三稜鍼刺去惡血, 冷水洗淨, 乃貼膏藥. 忌日光ㆍ火氣ㆍ陽氣. 如有黑腫未盡, 可再出血, 以紫黑血盡爲度. 《綱目》

Translation영역
Where the shin sore is purple-black in colour, first prick the malign blood away with the three-edged needle, wash it clean with cold water, and then lay on the plaster. Sunlight, fire qi and yang qi are to be avoided. If there is black swelling not yet gone, blood may be let again, and the measure is the spending of the purple-black blood.
Clinical note임상 주석
The purple-black colour around a chronic shin ulcer is haemosiderin staining from venous hypertension, not blood waiting to be let out; it is a sign of the cause, and it does not clear with bleeding. **Needling repeatedly around an ulcer on an ischaemic or venous-congested leg should not be done** — each puncture is a new ulcer on skin that heals badly.

Gangmok 綱目

2.11.3 The Fuming and Washing Method 熏洗方

2.11.3.1
Source원문

治膁瘡臭爛, 先以海桐皮ㆍ石榴皮煎湯洗, 後牛蒡子 半兩硏爲末, 燒熏之. 無海桐皮則地骨皮代之. 《得效》

Translation영역
Treats the shin sore when it stinks and rots: wash it first with a decoction of erythrina bark and pomegranate rind, then grind half a nyang of burdock seed to powder and burn it to fume the sore. For want of erythrina bark, lycium root bark serves instead.
Clinical note임상 주석
Pomegranate rind is heavily tannic, and a tannin wash astringes and deodorizes a sloughy ulcer. Of the local treatments for this sore it is among the few that help, and it carries no warning.

Deukhyo 得效

2.11.3.2
Source원문

槐枝ㆍ葱白ㆍ川椒煎湯, 或茶淸淋洗, 挹乾後乃貼膏藥. 《得效》

Translation영역
Boil pagoda-tree twig, scallion white and Sichuan pepper, or use clear tea, to pour over and wash it; blot it dry and then lay on the plaster.

Deukhyo 得效

2.11.4 The Method of Taking Out the Worms 取蟲方

2.11.4.1
Source원문

久膁瘡宜取蟲. 生鱔魚數條, 以淸油塗腹下, 置瘡上盤屈, 以帛繫定. 少頃覺痒不可忍, 然後取視, 腹下有小竅, 皆蟲也. 未盡再付, 却用死人脚脛骨燒灰, 油調付. 《得效》

Translation영역
For the long-standing shin sore the worms should be taken out. Take several live eels, smear their bellies with clear oil, set them coiled on the sore and tie them on with silk. After a little while an unbearable itching is felt; then take them and look, and there are small holes under their bellies — these are all worms. If they are not all out, apply them again; then burn the shin bone of a dead man to ash and apply it stirred with oil.
Clinical note임상 주석
**Neither live eels nor human bone may be put on an open ulcer.** The small holes in the eels' bellies were there before the dressing. This is the same method as 2.6.1, which the text there says is good for the shin sore too.

Deukhyo 得效

2.11.4.2
Source원문

久膁瘡, 蠡魚腸以五味火上灸, 貼, 蟲出卽去之. 《本草》

Translation영역
For the long-standing shin sore, roast a snakehead's gut with the five flavours over the fire, lay it on, and when the worms come out take them away.

Boncho 本草

2.12 The Kidney-Viscus Wind Sore 腎臟風瘡

2.12.1
Source원문

初起兩足時熱, 脚跟作痛, 多於內脛或膁上生瘡如癬, 漸大. 失治則延及脛股, 遍身者有之. 以腎氣丸方見虛勞爲主, 佐以四生散方見前陰ㆍ黃芪丸方見虛勞, 外付白膠香散方見上.

Translation영역
At its rising both feet are hot from time to time and the heels ache, and sores like ringworm arise mostly on the inner shin or over the shin, growing gradually larger. Untreated it spreads to the shin and thigh, and there are those whose whole body is covered. Singi-hwan 腎氣丸 — the formula is given in the Vacuity chapter — is made the chief, with Sasaeng-san 四生散 — the formula is given in the Genitals chapter — and Hwanggi-hwan 黃芪丸, the formula given in the Vacuity chapter, as assistants, and Baekgyohyang-san 白膠香散 — the formula is given above — applied outwardly.
Clinical note임상 주석
兩足時熱, 脚跟作痛 with a slowly spreading scaling eruption of the lower legs: burning feet and aching heels together with skin changes on the shins is how a peripheral neuropathy and a stasis dermatitis present side by side, and in a man with long-standing 腎虛 by this book's reckoning the modern reading is diabetes.

Immun 入門

2.12.2
Source원문

四生散末每取二錢, 入猪腎內煨熟, 空心鹽湯嚼下, 尤妙. 《入門》

Translation영역
Take 2 don of powdered Sasaeng-san 四生散 each time, put it inside a pig's kidney and bake it done, and chew it down on an empty stomach with brine; this is better still.

Immun 入門

2.12.3
Source원문

血風瘡與腎藏風瘡相類, 乃三陰經風熱鬱火血燥所致. 瘙痒不常, 膿水淋漓, 潮熱盜汗, 宜四物湯方見血門加浮萍ㆍ黃芩, 或當歸拈痛湯方見足部. 外治磨風膏方見上ㆍ大馬齒膏塗之. 《入門》

Translation영역
The blood wind sore is of a kind with the kidney-viscus wind sore, and is brought about by wind-heat, depressed fire and dryness of the blood in the three yin channels. The itching is not constant, pus and fluid run, and there is tidal fever and night sweating; Samul-tang 四物湯 — the formula is given in the Blood chapter — with duckweed and scutellaria added, or Dangguinyeomtong-tang 當歸拈痛湯 — the formula is given in the Foot section. For outward treatment, Mapung-go 磨風膏 — the formula is given above — and Daemachi-go 大馬齒膏 are spread on.

Immun 入門

2.12.4
Source원문

下疰瘡亦與腎藏風瘡相類, 生於脚脛, 或打撲而成. 其瘡口狹, 皮內極闊, 皮薄如竹膜, 極痒痛, 黃水淋漓, 積年不愈, 又染易他人. 患者須忌房室. 取韭菜地地龍糞爲末, 入輕粉, 淸油調付. 或白犬血塗之, 又付檳榔散. 《入門》

Translation영역
The downward-pouring sore too is of a kind with the kidney-viscus wind sore. It arises on the leg and shin, or comes of a blow or a fall. Its mouth is narrow and the space under the skin very wide, the skin thin as a bamboo membrane, intensely itching and painful, running with yellow water, unhealed for years on end, and it passes readily to others besides. The sufferer must abstain from the bedchamber. Take earthworm castings from a chive bed, powder them, put in calomel, and apply it stirred with clear oil; or spread white dog's blood on it; or apply Binrang-san 檳榔散.
Clinical note임상 주석
其瘡口狹, 皮內極闊, 皮薄如竹膜 — a narrow mouth with a very wide space beneath, the skin over it thin as a bamboo membrane. **That is an undermined ulcer**, and the description is exact: the visible opening is far smaller than the cavity, so the hole must be laid open to its edges before anything will heal. It is the finding that distinguishes this from an ordinary venous ulcer, and 積年不愈 follows from it. 又染易他人 — it passes readily to others — fits a secondarily infected or ecthymatous ulcer rather than the stasis kind. **Calomel and dog's blood must not be put into such a cavity.**

Immun 入門

2.12.5
Source원문

腎藏風宜服活血驅風散, 外用雞心散. 《得效》

Translation영역
For the kidney-viscus wind, Hwalhyeolgupung-san 活血驅風散 should be taken and Gyesim-san 雞心散 used outwardly.

Deukhyo 得效

2.12.1 Simple Medicinals 單方

2.12.1.1
Source원문

脚肚上生瘡漸大, 爬搔不已, 痒不可忍, 石榴根皮煮取濃汁, 稍冷拂瘡上, 冷如氷雪, 卽成痂. 《得效》

Translation영역
Where a sore arises on the calf and grows larger, scratched without ceasing and itching beyond bearing: boil pomegranate root bark, take the thick liquid, let it cool a little and dab it on the sore; it is cold as ice and snow, and it scabs over at once.
Clinical note임상 주석
冷如氷雪 — cold as ice and snow, as the sensation the patient reports. A cool tannin astringent on an excoriated, itching surface does exactly that and does stop the itch, and the relief is why 爬搔不已 then ceases: breaking the itch-scratch cycle is how the skin gets a chance to heal.

Deukhyo 得效

2.13 The Soaking and Flooding Sore 浸淫瘡

2.13.1
Source원문

初生甚小, 先痒後痛, 汁出浸淫, 濕爛肌肉, 延至遍身. 用苦練根燒存性爲末, 猪脂調付; 濕則乾糝. 先用苦參ㆍ大腹皮煎湯洗之. 《入門》

Translation영역
At first it arises very small, itching before it hurts, weeping fluid that soaks and floods, sodden and rotting the flesh, and spreading until it covers the whole body. Burn chinaberry root with its nature kept, powder it and apply it stirred with lard; where it is wet, dust it on dry. Wash it first with a decoction of sophora root and areca husk.
Clinical note임상 주석
A small weeping patch that itches first and then hurts, spreading outward until it covers the body, is impetigo or infected eczema, and 浸淫, soaking and flooding, is a fair name for how it moves. 濕則乾糝 — where it is wet, dust it on dry — is a sound dressing principle and still the rule for a weeping surface: wet lesions get dry preparations, dry lesions get greasy ones.

Immun 入門

2.13.2
Source원문

浸淫瘡從口流向四肢者可治, 從四肢流來入口者不可治. 《仲景》

Translation영역
Where the soaking and flooding sore flows from the mouth outward to the four limbs it can be treated; where it flows in from the four limbs to the mouth it cannot be treated.
Clinical note임상 주석
A prognosis read from the direction of spread, from the Jingui Yaolue. Centrifugal spreading is called treatable and centripetal fatal — the same instinct as the red thread of 癰疽 下 1.10.3, where what moves toward the trunk is the dangerous one. What Zhang Ji could not know is which organisms do that; there is no rule by which a rash's direction decides its outcome.

Junggyeong 仲景

2.13.3
Source원문

小兒浸淫瘡宜用苦瓠散. 《綱目》

Translation영역
For the soaking and flooding sore in a child, Gohobak-san 苦瓠散 should be used.

Gangmok 綱目

2.13.1 Simple Medicinals 單方

2.13.1.1
Source원문

卒得浸淫瘡, 不早治周身則殺人. 胡麻生爛嚼付之. 《本草》

Translation영역
Where the soaking and flooding sore is got suddenly, if it is not treated early and goes over the whole body it kills a man. Chew raw sesame to a pulp and apply it.

Boncho 本草

2.13.1.2
Source원문

小薊爛搗, 新水調付, 乾則易. 《本草》

Translation영역
Pound small thistle to a pulp, apply it stirred with fresh water, and change it when it dries.

Boncho 本草

2.13.1.3
Source원문

秫米熬黃杵末, 水調付之. 《本草》

Translation영역
Parch glutinous millet yellow, pound it to powder and apply it stirred with water.

Boncho 本草

2.13.1.4
Source원문

雞冠熱血付之. 《本草》

Translation영역
Apply the warm blood of a cock's comb.
Clinical note임상 주석
**Blood must not be applied to a weeping, broken skin surface.** This eruption is already infected in most cases, and fresh blood is a culture medium.

Boncho 本草

2.13.1.5
Source원문

胡燕窠中土, 水和付之. 《本草》

Translation영역
Take earth from inside a swallow's nest, mix it with water and apply it.

Boncho 本草

2.14 The Frost Sore 凍瘡

2.14.1
Source원문

冬月凍傷成瘡流水, 俗呼爲凍瘡. 宜用生附散ㆍ白斂散ㆍ如神散ㆍ臘享膏. 《諸方》

Translation영역
Where in the winter months the frost injures and makes a sore that weeps, it is commonly called the frost sore. Saengbu-san 生附散, Baekryeom-san 白斂散, Yeosin-san 如神散 and Naphyang-go 臘享膏 should be used.
Clinical note임상 주석
The frost sore covers both chilblains — the itching, swollen, broken skin of repeated cold exposure — and true frostbite. The two need opposite handling: chilblains want warmth and protection, while a frostbitten part needs rapid rewarming in water near body temperature and no rubbing at all. The chapter's remedies are all local applications and do not distinguish them.

Jebang 諸方

2.14.2
Source원문

凍耳瘡爛, 貝母末乾糝之. 《入門》

Translation영역
Where the frost sore of the ear is rotting, dust powdered fritillaria on it dry.

Immun 入門

2.14.3
Source원문

足凍爛生瘡, 黃丹ㆍ猪脂調付. 《得效》

Translation영역
Where the foot is frost-rotted and breaks into sores, apply minium stirred with lard.
Clinical note임상 주석
**Minium is lead tetroxide and must not be applied to broken skin.**

Deukhyo 得效

2.14.4
Source원문

足跟凍瘡潰破, 以川椒煎湯洗, 刮去腐肉, 鍼刺出血, 馬勃末調牛骨髓付之. 《綱目》

Translation영역
Where the frost sore of the heel has broken down and burst, wash it with a decoction of Sichuan pepper, scrape the rotted flesh away, prick it with a needle to let blood, and apply powdered puffball stirred with ox marrow.
Clinical note임상 주석
刮去腐肉 — scrape the rotted flesh away. Debriding dead tissue from a frostbite injury is correct, and puffball spore powder is a traditional haemostatic that does stem capillary bleeding. **Needling to let blood from a frostbitten heel must not be done**: the tissue there is already ischaemic, and the modern rule is to delay any surgical decision until the line between living and dead tissue has declared itself over weeks.

Gangmok 綱目

2.14.5
Source원문

凍瘡, 雄雉雞腦 一枚入黃蠟等分, 淸油減半, 熬膏塗之. 《入門》

Translation영역
For the frost sore, take the brain of one cock pheasant with an equal part of beeswax and half as much clear oil, boil it into a paste and spread it on.

Immun 入門

2.14.6
Source원문

五倍子煎湯洗後, 取兔腦髓ㆍ雀腦髓付之. 《本草》

Translation영역
After washing with a decoction of gall-nut, take the brain and marrow of a hare and of a sparrow and apply them.

Boncho 本草

2.15 Scalds and Burns 湯火瘡

2.15.1
Source원문

凡湯火燒傷, 初時强忍痛, 急向火灸, 强忍一時卽不痛. 愼勿以冷物搨之, 使熱毒不出, 免爛人筋骨. 用寒水石 三兩半, 黃栢ㆍ黃連ㆍ黃芩ㆍ梔子ㆍ大黃ㆍ赤石脂 各五錢, 片腦少許. 右爲末, 鴨子淸調付; 酒調亦可. 《入門》

Translation영역
In scalds and burns generally, at the outset let him bear the pain hard and hold it at once to the fire; bearing it hard for a while, it stops hurting. Take care not to press anything cold on it, which keeps the heat toxin from coming out, so that the sinews and bones are spared from rotting. Take calcite 3 nyang 5 don; phellodendron, coptis, scutellaria, gardenia, rhubarb and red halloysite, 5 don each; a little borneol. Powder the above and apply it stirred with duck's egg white; stirred with wine will serve too.
Clinical note임상 주석
**This is the most harmful single instruction in the chapter, and it concerns the commonest injury in it.** 愼勿以冷物搨之 — take care not to press anything cold on it — and 急向火灸, hold it to the fire at once, are both exactly backwards. The first thing a burn needs is twenty minutes of cool running water, within the first three hours; it reduces the depth of the injury, limits the progressive damage that continues after the heat source is gone, and relieves pain. Further heat extends the burn. The reasoning behind the error is visible — 使熱毒不出, lest the heat toxin be kept from coming out — and it is the same humoral logic that makes this chapter read the harm its treatments do as the disease departing. The powder itself is harmless and faintly useful: red halloysite and calcite are drying, and the four bitter-cold drugs are the ones a burn clinic would recognize as traditional antiseptics. It is the first aid that is dangerous, and anyone reading this chapter should know it.

Immun 入門

2.15.2
Source원문

湯火瘡宜赤石脂散ㆍ保生救苦散ㆍ黃栢散ㆍ氷霜散ㆍ四黃散. 《諸方》

Translation영역
For scalds and burns, Jeokseokji-san 赤石脂散, Bosaenggugo-san 保生救苦散, Hwangbaek-san 黃栢散, Bingsang-san 氷霜散 and Sahwang-san 四黃散 should be used.

Jebang 諸方

2.15.3
Source원문

火燒以好酒洗之, 以鹽付上.

Translation영역
For a burn, wash it with good wine and lay salt on it.

Dansim 丹心

2.15.4
Source원문

皮脫者, 酒熬牛皮膠付之.

Translation영역
Where the skin has come away, boil ox-hide glue in wine and apply it.
Clinical note임상 주석
皮脫者 — where the skin has come away. A burn that has lost its epidermis is at least partial thickness, and what it needs is a clean non-adherent dressing and fluid replacement if it is extensive. Glue is at least a barrier; wine and salt poured on raw dermis, two passages above, is agony to no purpose.

Dansim 丹心

2.15.5
Source원문

湯傷者, 以淋過第二次灰滓付之.

Translation영역
For a scald, apply the lees of ash that has been leached a second time.
Clinical note임상 주석
**Ash lees are alkaline and must not be put on a burn.** Leached wood ash is lye; adding an alkali burn to a thermal one deepens the wound. Of all this section's applications this is the one that would do the most harm.

Dansim 丹心

2.15.6
Source원문

熱酒傷者, 糯米粉炒黑末, 酒調付之. 《丹心》

Translation영역
Where hot wine has done the injury, parch glutinous rice flour black, powder it and apply it stirred with wine.

Dansim 丹心

2.15.7
Source원문

湯火燒瘡, 大黃ㆍ當歸油調付. 《丹心》

Translation영역
For the sore of a scald or burn, apply rhubarb and Korean angelica stirred with oil.

Dansim 丹心

2.15.1 Simple Medicinals 單方

2.15.1.1
Source원문

湯火瘡, 黃蜀葵花爲末油調付, 妙; 或滴水硏爛付亦佳. 《正傳》

Translation영역
For scalds and burns, powder yellow hollyhock flower and apply it stirred with oil; this is excellent. Or grind it to a pulp with a drop of water and apply it, which is also good.

Jeongjeon 正傳

2.15.1.2
Source원문

經霜桑葉焙爲末, 香油調付. 《正傳》

Translation영역
Bake frost-touched mulberry leaf dry, powder it and apply it stirred with sesame oil.

Jeongjeon 正傳

2.15.1.3
Source원문

側栢葉搗爛如泥, 冷水調塗, 以帛繫定, 二三日愈. 《本草》

Translation영역
Pound arborvitae leaf to a pulp, spread it on stirred with cold water, bind it with silk, and in two or three days it heals.

Boncho 本草

2.15.1.4
Source원문

生梨切片貼之, 不爛止痛. 《本草》

Translation영역
Cut a fresh pear into slices and lay them on; it does not rot and the pain stops.

Boncho 本草

2.15.1.5
Source원문

生胡麻爛搗如泥付之. 《本草》

Translation영역
Pound raw sesame to a pulp and apply it.

Boncho 本草

2.15.1.6
Source원문

生白礬爲末, 香油調塗. 《醫鑑》

Translation영역
Powder raw alum and spread it on stirred with sesame oil.

Uigam 醫鑑

2.15.1.7
Source원문

湯火傷及熱油傷, 白蜜塗之, 竹中白膜貼之, 日三, 痛立止卽愈. 《本草》

Translation영역
For the injury of scalds and burns and of hot oil, spread white honey on it and lay the white membrane from inside a bamboo over it, three times a day; the pain stops at once and it heals.
Clinical note임상 주석
**The one remedy in this section with modern evidence behind it.** Honey on a burn is antibacterial, draws fluid out of the wound osmotically, keeps the surface moist so that it re-epithelializes, and comes away without tearing the new skin; medical-grade honey dressings are used for exactly this. 痛立止, the pain stops at once, is also true — a honey dressing on a superficial burn is markedly soothing. The bamboo membrane over it is a non-adherent layer, which is what a honey dressing needs.

Boncho 本草

2.15.1.8
Source원문

醋泥付之無痕; 豆醬汁付之妙. 《本草》

Translation영역
Vinegar mud applied leaves no scar; bean-paste liquor applied is excellent.

Boncho 本草

2.16 The Everted-Flower Sore 飜花瘡

2.16.1
Source원문

翻出一肉, 突如菌, 或如蛇形長數寸. 雄黃爲末付之, 內服十全大補湯或八物湯二方並見虛勞倍參ㆍ芪ㆍ歸ㆍ朮. 外用藜蘆爲末, 猪脂調塗, 日一易. 候元氣漸復ㆍ腫毒將盡時塗之, 則努肉自入; 否則雖入復出. 若誤用鍼刀蝕灸, 必危, 愼之. 《入門》

Translation영역
A piece of flesh is turned out, standing up like a mushroom, or like a snake several chi long. Powder realgar and apply it, and inwardly give Sipjeondaebo-tang 十全大補湯 or Palmul-tang 八物湯 — both formulas are given in the Vacuity chapter — with the ginseng, milkvetch, Korean angelica and atractylodes doubled. Outwardly powder veratrum and spread it on stirred with lard, changing it once a day. Spread it when the original qi is gradually recovering and the swelling toxin is nearly spent, and the proud flesh goes in of itself; otherwise, though it go in, it comes out again. If needle, knife, caustic or cautery are used wrongly, danger must follow: beware.
Clinical note임상 주석
突如菌, 或如蛇形長數寸 — standing up like a mushroom, or like a snake several chi long. A fungating, everted mass growing out of a sore is either exuberant granulation tissue — proud flesh, which is what 努肉 means and which does flatten as the wound matures — or a squamous carcinoma arising in a chronic ulcer, which does not. The chapter cannot tell them apart, and that is the whole difficulty of this section. 若誤用鍼刀蝕灸, 必危 — use needle, knife, caustic or cautery wrongly and danger must follow. Again the chapter counsels against cutting, and again it is right for the wrong reason: a fungating malignancy handled this way bleeds and spreads. 候元氣漸復 — wait until the patient's strength is returning — is also the correct instinct about timing. **Realgar is arsenic sulphide and veratrum a cardiotoxin; neither may be applied.**

Immun 入門

2.16.2
Source원문

中品錠子專治翻花瘡. 《入門》

Translation영역
Jungpum-jeongja 中品錠子 treats the everted-flower sore specifically.

Immun 入門

2.16.3
Source원문

一名綿花瘡, 一名廣東瘡. 川芎ㆍ天花粉 各五錢, 輕粉 二錢半, 朱砂ㆍ雄黃 各一錢二分半, 麝香 五分. 右爲末, 蒸餠和丸菉豆大, 每服七丸至九丸, 溫酒下. 《正傳》

Translation영역
Also named the cotton-flower sore, and also the Canton sore. Sichuan lovage and trichosanthes root, 5 don each; calomel 2 don 5 fun; cinnabar and realgar, 1 don 2 fun 5 ri each; musk 5 fun. Powder the above, roll them with steamed cake into pills the size of a mung bean, and give seven to nine pills a dose, sent down in warm wine.
Clinical note임상 주석
一名廣東瘡 — also named the Canton sore. The name places the disease's arrival: syphilis came into China through Guangzhou at the turn of the sixteenth century, and 綿花瘡, the cotton-flower sore, is one of 2.2's own five shapes of 天疱瘡. So this section's third passage is a syphilis prescription, and the pill is mercury, cinnabar and realgar taken by mouth. **It must not be prepared.** The eversion the section is named for, read this way, is the condyloma latum of secondary syphilis rather than proud flesh — which is a fourth possibility the chapter is holding together with the other three.

Jeongjeon 正傳

2.16.1 Simple Medicinals 單方

2.16.1.1
Source원문

治翻花瘡, 馬齒莧燒灰, 猪脂調付. 《本草》

Translation영역
Treats the everted-flower sore: burn purslane to ash and apply it stirred with lard.

Boncho 本草

2.16.1.2
Source원문

柳枝葉濃煎作膏塗之. 《本草》

Translation영역
Boil willow twig and leaf thick, make a paste of it and spread it on.
Clinical note임상 주석
Willow bark and leaf carry salicylates, and a strong willow decoction is mildly keratolytic and analgesic. It is the gentlest thing offered for this lesion.

Boncho 本草

2.17 The Lacquer Sore 漆瘡

2.17.1
Source원문

人有惡漆者, 因見漆中毒生瘡, 面痒而腫, 遍身焮痛. 生蟹取黃塗之. 《得效》

Translation영역
There are people who cannot abide lacquer: on seeing lacquer they are poisoned by it and break into sores, the face itching and swelling and the whole body inflamed and painful. Take the yellow of a live crab and spread it on.
Clinical note임상 주석
人有惡漆者 — there are people who cannot abide lacquer. **That is an allergy, stated as individual susceptibility rather than as a property of the poison**, and it is a real insight: the same lacquer harms one worker and not the next. Lacquer dermatitis is a type IV hypersensitivity to urushiol, the same compound that is in poison ivy, and it does exactly what the passage describes — facial swelling and itching first, since the hands carry it to the face, then a spreading eruption. 因見漆 — on seeing it — overstates the exposure, but a sensitized worker reacts to vapour and to dust, so even that is not absurd.

Deukhyo 得效

2.17.2
Source원문

石蟹取汁頻塗之. 《本草》

Translation영역
Take the juice of a stone crab and spread it on often.

Boncho 本草

2.17.3
Source원문

臘茶末油調付, 柳枝葉煎湯洗. 《入門》

Translation영역
Apply powdered winter tea stirred with oil, and wash with a decoction of willow twig and leaf.

Immun 入門

2.17.4
Source원문

芒硝湯浸冷洗之. 《千金》

Translation영역
Steep mirabilite in water, let it cool and wash with it.
Clinical note임상 주석
A cool saline wash on an acute weeping contact dermatitis is sound and still done, as a cool compress; it relieves the itch and dries the surface without irritating it.

Cheongeum 千金

2.17.5
Source원문

鐵漿頻洗卽差. 《本草》

Translation영역
Wash it often with iron water and it is cured.

Boncho 本草

2.17.6
Source원문

井中苔搗付之. 《本草》

Translation영역
Pound the moss from inside a well and apply it.

Boncho 本草

2.17.7
Source원문

川椒煎湯洗之卽愈. 《本草》

Translation영역
Boil Sichuan pepper and wash with it and it heals.

Boncho 本草

2.17.8
Source원문

生薑眞汁付之亦可. 《丹心》

Translation영역
Applying the pure juice of fresh ginger will also serve.

Dansim 丹心

2.17.9
Source원문

雞子黃塗之. 《本草》

Translation영역
Spread egg yolk on it.

Boncho 本草

2.17.10
Source원문

韭葉硏付之. 《本草》

Translation영역
Grind chive leaf and apply it.

Boncho 本草

2.17.11
Source원문

紫蘇葉搗爛擦之. 《綱目》

Translation영역
Pound perilla leaf to a pulp and rub it on.

Gangmok 綱目

2.18 The Soft Boil 軟癤

2.18.1
Source원문

痤, 小癤也. 世謂之熱癤, 大如酸棗, 或如豆, 色赤而內有膿血也. 《綱目》

Translation영역
The pimple is the small boil. The world calls it the hot boil; it is as big as a sour jujube, or as a bean, red in colour, and holds pus and blood within.
Clinical note임상 주석
A red lump the size of a bean or a small jujube with pus inside is the furuncle — a single infected hair follicle. It is the commonest of all the sores in this chapter and the one with the mildest course: most point and discharge and resolve.

Gangmok 綱目

2.18.2
Source원문

宜用猪頭散ㆍ三物散ㆍ大黃膏.

Translation영역
Jeodu-san 猪頭散, Sammul-san 三物散 and Daehwang-go 大黃膏 should be used.

Jebang 諸方

2.18.3
Source원문

雞抱卵殼燒灰, 入輕粉少許, 油調付之. 《得效》

Translation영역
Burn the shell of an egg that a hen has brooded to ash, put in a little calomel, and apply it stirred with oil.
Clinical note임상 주석
**Contains calomel and must not be applied.** A furuncle needs warmth and time, or incision when it is pointing; nothing applied to it shortens it, and mercury on it is a systemic risk taken for a self-limiting lump.

Deukhyo 得效

2.18.4
Source원문

大枳殼 一枚去瓤, 磨令口平, 以稠麵糊塗四唇, 覆貼癤上, 自破膿出, 甚妙. 《得效》

Translation영역
Take one large bitter-orange husk, remove the pith, grind its mouth flat, smear thick wheat paste round its rim, and cover the boil with it; it bursts of itself and the pus comes out. This is excellent.
Clinical note임상 주석
A hollowed fruit husk sealed to the skin with paste is a suction cup, and as the air inside cools the negative pressure lifts the roof off a pointing boil and draws the pus out. It is the same mechanism as the bamboo tube of 癰疽 上 4.23 and 癰疽 下 1.10.7, and the same as a modern negative-pressure dressing. Of everything offered for a boil in this chapter it is the only thing that would actually drain one — and draining it is the treatment.

Deukhyo 得效

2.19 The Malign Sores, Named and Nameless 有名無名諸惡瘡

2.19.1
Source원문

蒲萄瘡ㆍ天行斑瘡ㆍ月蝕瘡ㆍ內疳瘡ㆍ瘑瘡ㆍ走皮㿐瘡ㆍ白蛇纏瘡ㆍ魚目瘡ㆍ熱毒瘡ㆍ火斑瘡, 此皆有名瘡也.

Translation영역
The grape sore, the epidemic blotch sore, the moon-eaten sore, the inner gnawing sore, the twin sore, the skin-running sore, the white snake-coiling sore, the fish-eye sore, the heat-toxin sore and the fire-blotch sore — these are all the named sores.

Donguibogam · Jechang

2.19.2
Source원문

此外皆無名諸惡瘡也.

Translation영역
Besides these, all are the nameless malign sores.

Donguibogam · Jechang

2.19.3
Source원문

又有洗瘡法ㆍ殺蟲法ㆍ生肌法ㆍ諸瘡中風水作痛法.

Translation영역
There are also the method of washing a sore, the method of killing the worms, the method of breeding flesh, and the method for sores that take wind and water and turn painful.

Donguibogam · Jechang

2.19.1 The Grape Sore 蒲萄瘡

2.19.1.1
Source원문

瘡頭如蒲萄色, 四圍腫起. 先追膿盡, 次用氷梅罨之, 神愈. 《綱目》

Translation영역
The head of the sore is of the colour of a grape and the four sides rise swollen. First draw the pus until it is spent, then cover it with iced plum, and it heals marvellously.

Gangmok 綱目

2.19.2 The Epidemic Blotch Sore 天行斑瘡

2.19.2.1
Source원문

人身發天行斑瘡, 一身周匝如火瘡, 皆戴白漿. 不治則數日必死. 差後瘡瘢黯, 一歲方滅. 此惡毒之氣所爲. 取好蜜煎升麻, 數數洗拭塗之. 《本草》

Translation영역
Where the epidemic blotch sore breaks out on a man's body, it goes right round the whole body like a burn, every one of them carrying a white matter. Untreated, he must die in a few days. After he recovers the scars are dark, and a whole year passes before they fade. This is the work of a malign toxic qi. Take good honey, boil cimicifuga in it, and wash, wipe and spread it on again and again.
Clinical note임상 주석
一身周匝 … 皆戴白漿 … 瘡瘢黯, 一歲方滅 — pustules over the whole body, each carrying white matter, leaving dark scars that take a year to fade, in an epidemic, fatal within days untreated. That is smallpox, and the chapter is describing it with the pockmarks included. 天行, epidemic, is doing real work in the name: the Bogam separates the sores that come to one person from the one that comes to everyone. Smallpox was eradicated in 1980; the honey wash was all that could be offered here, and 2.15.1 shows the chapter knew honey soothed a blistered skin.

Boncho 本草

2.19.2.2
Source원문

又煮葵菜葉, 以蒜虀啖之, 數日卽止. 《綱目》

Translation영역
Again, boil mallow leaves and eat them with garlic pickle, and in a few days it stops.

Gangmok 綱目

2.19.3 The Moon-Eaten Sore 月蝕瘡

2.19.3.1
Source원문

小兒多有之, 生耳後, 隨月盛衰. 胡粉炒黃ㆍ枯白礬ㆍ黃丹ㆍ黃連ㆍ輕粉 各二錢, 乾臙脂 一錢, 麝香少許. 右爲末, 香油調塗. 《入門》

Translation영역
Children mostly have it; it arises behind the ear and waxes and wanes with the moon. Lead white parched yellow, calcined alum, minium, coptis and calomel, 2 don each; dried rouge 1 don; a little musk. Powder the above and spread it on stirred with sesame oil.
Clinical note임상 주석
生耳後 — behind the ear, in a child: the moist fissured crack in the retroauricular fold is infantile eczema, or a streptococcal intertrigo. 隨月盛衰, waxing and waning with the moon, is how a condition that comes and goes gets explained when the cycle is noticed and the cause is not. **The ointment is lead white, minium and calomel — lead twice and mercury once — and must not be put on a child's skin.** Of this chapter's several prescriptions for children's sores, this and the scalp ointment of 2.8 are the two worst.

Immun 入門

2.19.3.2
Source원문

又黃連ㆍ枯礬末付之, 妙. 《本草》

Translation영역
Again, powder coptis and calcined alum and apply it; this is excellent.
Clinical note임상 주석
The same section's second remedy, without the metals, would have served: alum is astringent and coptis is the chapter's standard antibacterial bitter. It is the one to take from this section.

Boncho 本草

2.19.4 The Inner Gnawing Sore 內疳瘡

2.19.4.1
Source원문

生於口上㬽, 初發如蓮花, 根蔕小而下垂乃大. 治法以鉤刀決其根, 燒鐵烙以止其血, 次以雄黃ㆍ輕粉ㆍ粉霜ㆍ白芷ㆍ白斂爲末付之. 以槐枝作枕, 支其牙頰間, 毋使口合一兩時許, 瘡瘢定ㆍ合口自便. 次日出膿, 生肌散付之. 《入門》

Translation영역
It arises on the palate of the mouth; at its first appearance it is like a lotus flower, with the root and stalk small and the hanging part large. The method of treatment: cut its root through with a hooked knife, heat an iron and cauterize to stop its bleeding, and then powder realgar, calomel, mercury sublimate, angelica and ampelopsis and apply it. Make a prop of a pagoda-tree twig and set it between the teeth and the cheek so that the mouth cannot close for an hour or two; then the raw place settles and closing the mouth is easy of itself. The next day pus comes out, and Saenggi-san 生肌散 is applied.
Clinical note임상 주석
A pedunculated growth hanging from the palate on a narrow stalk, taken off at its base and the base cauterized to stop bleeding, with a bite-block to keep the mouth open while it settles: this is an operation, and the sequence is a real one. A narrow-stalked palatal lesion is usually a fibroepithelial polyp or a pyogenic granuloma, and excision at the stalk is still the treatment; it is also how a squamous carcinoma of the palate can look, and that needs the specimen examined rather than burnt. **The dressing powder is realgar, calomel and mercury sublimate and must not be put into a fresh wound in the mouth** — the oral mucosa absorbs faster than skin, and mercurial stomatitis is the direct consequence.

Immun 入門

2.19.5 The Twin Sore 瘑瘡

2.19.5.1
Source원문

生手足間, 相對如新茱萸, 痒痛拆裂, 有孔如蝸, 久不愈. 杏仁ㆍ乳香 各三錢, 硫黃ㆍ輕粉 各一錢半. 右爲末, 麻油三錢入黃蠟五錢熔化, 入前藥末攪煎成膏塗之. 《入門》

Translation영역
It arises between the hands and feet, facing one another like fresh evodia fruits, itching and painful, splitting and cracking, with holes like a snail's, and long unhealed. Apricot kernel and frankincense, 3 don each; sulphur and calomel, 1 don 5 fun each. Powder the above; melt 3 don of sesame oil with 5 don of beeswax, put in the powder, stir and boil it into a paste, and spread it on.
Clinical note임상 주석
生手足間, 相對 — between the hands and feet, facing one another. Symmetrical, itching, fissured lesions of the hands and feet that will not heal is dyshidrotic eczema or a dermatophyte infection of both palms and soles, and the symmetry the chapter names it for is the clue: an infection spread by contact is not usually mirror-image, while an eczema and a tinea of the feet-and-one-hand pattern are. The sulphur in the paste treats the fungal case. **The calomel in it must not be used**, and the sulphur would have sufficed.

Immun 入門

2.19.6 The Skin-Running Sore 走皮㿐瘡

2.19.6.1
Source원문

生滿頰項, 發如豆梅, 蔓延兩耳, 流汁濕爛. 先用桑寄生無則桑耳代之ㆍ桑根皮 各一握, 白芷ㆍ黃連 各少許, 煎湯洗之, 候血盡. 次用皂莢ㆍ竹笋皮燒存性ㆍ黃栢ㆍ白芷ㆍ藍葉等分爲末, 淸油調塗, 神效. 《入門》

Translation영역
It arises over the whole cheek and neck, breaking out like beans and plums, creeping to both ears, running fluid and sodden and rotting. First take mistletoe — for want of it, mulberry ear serves instead — and mulberry root bark, a handful each, with a little angelica and coptis, boil them and wash with it until the blood is spent. Then burn gleditsia pod and bamboo-shoot skin with their nature kept, powder them in equal parts with phellodendron, angelica and indigo leaf, and spread it on stirred with clear oil; the effect is marvellous.
Clinical note임상 주석
滿頰項 … 蔓延兩耳, 流汁濕爛 — over the cheek and neck, creeping to both ears, weeping and sodden. A rapidly spreading, crusting, exudative eruption of the face in this company is impetigo, and 走皮, running over the skin, is the right name for how it travels.

Immun 入門

2.19.6.2
Source원문

手㿐瘡, 皂角ㆍ枯礬ㆍ輕粉ㆍ黃栢ㆍ黃連爲末, 敷之. 《入門》

Translation영역
For the skin-running sore of the hand, powder gleditsia pod, calcined alum, calomel, phellodendron and coptis and dust it on.

Immun 入門

2.19.6.3
Source원문

小兒胎㿐, 頭生紅餠瘡, 先以艾葉ㆍ白芷ㆍ大腹皮ㆍ葱白煎湯洗後, 生藍葉ㆍ生艾葉入蜜搗付. 《入門》

Translation영역
For the fetal skin-running sore in a child, where red cake-like sores arise on the head, first wash with a decoction of mugwort leaf, angelica, areca husk and scallion white, then pound fresh indigo leaf and fresh mugwort leaf with honey and apply them.
Clinical note임상 주석
Red crusted plaques on an infant's scalp is cradle cap with impetigo on it, and this is the one children's recipe in the section with no metal in it — a wash and a honey poultice. It is also the safest thing offered to a child anywhere in the chapter.

Immun 入門

2.19.7 The Snake-Coiling Sore 蛇纏瘡

2.19.7.1
Source원문

身上生瘡, 有頭尾, 儼似蛇形. 初起宜隔蒜於頭上灸之. 雄黃爲末, 醋調付之, 又酒調服之. 《入門》

Translation영역
Sores arise on the body having a head and a tail, solemnly like the shape of a snake. At its rising, moxa should be burnt over garlic at the head of it. Powder realgar, stir it with vinegar and apply it, and also take it stirred in wine.
Clinical note임상 주석
有頭尾, 儼似蛇形 — with a head and a tail, like the shape of a snake. **That is herpes zoster.** The rash of shingles follows one dermatome as a band across the trunk, with a beginning and an end, and every tradition that saw it named it for a creeping animal: shingles from Latin cingulum, a girdle, and 蛇纏瘡, the snake-coiling sore, here. The chapter has it right down to the detail of treating the head of the band first. What it needs is an antiviral within seventy-two hours, and in an older patient that is also what reduces the lasting nerve pain afterwards. **Realgar is arsenic sulphide and must not be taken or applied.**

Immun 入門

2.19.7.2
Source원문

遍身生瘡, 狀如蛇頭, 取蠟礬丸方見癰疽每服百丸, 大有神效. 《入門》

Translation영역
Where sores arise over the whole body shaped like a snake's head, take Napban-hwan 蠟礬丸 — the formula is given in the Abscesses chapter — a hundred pills a dose, and there is great and marvellous effect.

Immun 入門

2.19.8 The Fish-Eye Sore 魚目瘡

2.19.8.1
Source원문

遍身生瘡如魚目, 無膿, 又名征虜瘡. 升麻剉水濃煎, 入蜜二三匙, 鵝翎蘸拭洗瘡. 《得效》

Translation영역
Sores arise over the whole body like fishes' eyes, without pus; it is also named the campaign sore. Cut cimicifuga, boil it thick in water, put in two or three spoonfuls of honey, dip a goose quill and wipe and wash the sores with it.
Clinical note임상 주석
如魚目, 無膿 — like fishes' eyes, and without pus. Round, umbilicated lesions over the whole body that do not suppurate, in a disease named for a military campaign, points the same way as 2.19.2: a pox eruption carried by armies. The honey-and-cimicifuga wash is the same remedy the chapter gives there.

Deukhyo 得效

2.19.9 The Heat-Toxin Sore 熱毒瘡

2.19.9.1
Source원문

遍身生熱毒瘡, 痛而不痒, 粘着衣被, 夜不得睡. 菖蒲作末, 厚布席上, 恣臥其間, 不五七日其瘡如失, 應手神驗. 《本草》

Translation영역
Heat-toxin sores arise over the whole body, painful and not itching, sticking to the clothes and bedding so that he cannot sleep at night. Powder acorus, spread it thick on the mat, and let him lie at ease among it; in not five or seven days the sores are as though lost, and it answers to the hand marvellously.
Clinical note임상 주석
粘着衣被, 夜不得睡 — sticking to the clothes and bedding so that he cannot sleep. That is the misery of an extensive exudative eruption, and it is the reason the remedy works as well as it does: a thick layer of dry powder on the bedding keeps the weeping surface from adhering, which is exactly what a non-adherent dressing is for. The relief is real even though the acorus is incidental.

Boncho 本草

2.19.9.2
Source원문

宜用紫草膏ㆍ葵花散. 《諸方》

Translation영역
Jacho-go 紫草膏 and Gyuhwa-san 葵花散 should be used.

Jebang 諸方

2.19.10 The Fire-Blotch Sore 火斑瘡

2.19.10.1
Source원문

人常近火, 則多生火斑瘡, 出汁痛痒. 黃栢ㆍ薄荷葉爲末糝之卽安, 或煎湯洗亦佳. 《得效》

Translation영역
Where a man is always near a fire, the fire-blotch sore often arises, weeping fluid and painful and itching. Powder phellodendron and peppermint leaf and dust it on and he is well at once; or boil them and wash with the decoction, which is also good.
Clinical note임상 주석
人常近火 — someone who is always near a fire. Prolonged exposure to radiant heat without burning produces a mottled brown discoloration of the shins and thighs called erythema ab igne, and in people who sat at braziers it was common; broken, weeping skin over it follows from scratching. The chapter has the cause exactly, because the cause was in the room.

Deukhyo 得效

2.19.11 Malign Sores of Every Kind 諸般惡瘡

2.19.11.1
Source원문

諸般遍身瘡及惡瘡出膿血ㆍ痛痒, 宜凉血飮, 又平血飮合人參敗毒散方見寒門ㆍ連翹飮ㆍ疏風解毒散ㆍ合掌散ㆍ松脂貼散ㆍ二黃膏ㆍ貝母膏ㆍ金華散ㆍ爐灰膏ㆍ靑金錠子ㆍ一掃光ㆍ生肌散ㆍ黃蠟膏ㆍ洗藥方ㆍ殺蟲方ㆍ生肌方ㆍ諸瘡中風水方ㆍ單方. 《諸方》

Translation영역
For sores of every kind over the whole body and for malign sores running pus and blood, painful and itching: Yanghyeol-eum 凉血飮; and Pyeonghyeol-eum 平血飮 combined with Insampaedok-san 人參敗毒散 — the formula is given in the Cold chapter — Yeongyo-eum 連翹飮, Sopunghaedok-san 疏風解毒散, Hapjang-san 合掌散, Songjicheop-san 松脂貼散, Ihwang-go 二黃膏, Paemo-go 貝母膏, Geumhwa-san 金華散, Nohoe-go 爐灰膏, Cheonggeum-jeongja 靑金錠子, Ilsogwang 一掃光, Saenggi-san 生肌散, Hwangnap-go 黃蠟膏, the washing method, the worm-killing method, the flesh-breeding method, the method for sores that take wind and water, and the simple medicinals.

Jebang 諸方

2.19.12 Sores That Take Wind and Water and Swell and Hurt 諸瘡中風水發腫痛

2.19.12.1
Source원문

凡瘡瘍未合, 風入爲破傷風, 濕入爲破傷濕. 二者害人最急, 宜愼之. 《三因》

Translation영역
Wherever a sore is not yet closed, wind entering makes the wound-breaking wind and damp entering makes the wound-breaking damp. These two harm a man most urgently; be careful of them.
Clinical note임상 주석
**The most important sentence in the section, and nearly the last in the chapter.** 破傷風 — wound-breaking wind — is the tradition's name for tetanus, and the Samin has placed it exactly where it belongs: at an open, unhealed wound, as what enters from outside, and as the thing that kills fastest. The mechanism is wrong and the epidemiology is right. Clostridium tetani lives in soil and in animal faeces, and the dressings this chapter has recommended — dung, soil, dog faeces, human faeces, river eels, bird droppings — are the very things that carry it. 二者害人最急, 宜愼之 is a warning the book did not follow. A wound at risk now needs cleaning, debridement and tetanus immunisation. The disease is preventable by vaccine and has been for a century.

Samin 三因

2.19.12.2
Source원문

諸瘡入皂角水及惡水, 熱痛不止, 皂角子燒存性硏 二錢半, 砂糖末 五錢, 和勻如膏, 貼瘡上. 《本草》

Translation영역
Where gleditsia water or foul water has got into a sore of any kind and the hot pain will not stop: gleditsia seed burnt with its nature kept and ground, 2 don 5 fun, with 5 don of powdered sugar, mixed even like a paste, laid on the sore.

Boncho 本草

2.19.12.3
Source원문

諸瘡中風水疼腫, 鯉魚目燒灰硏付, 汁出卽愈. 諸魚目並得. 《本草》

Translation영역
Where a sore of any kind has taken wind and water and aches and swells, burn a carp's eye to ash, grind it and apply it, and when the fluid comes out it heals. The eyes of any fish will serve.

Boncho 本草

2.19.12.4
Source원문

又方, 川椒 一升和麵作餠, 灰火煨熟, 斷開口, 封合瘡上, 冷則易, 出水卽差. 《本草》

Translation영역
Another method: mix a seung of Sichuan pepper with flour and make a cake, bake it done in the ashes, break it open, and seal it over the sore; change it when it cools, and when the water comes out it is cured.

Boncho 本草

2.19.12.5
Source원문

又方, 桑柴灰淋汁漬之, 冷復易. 《本草》

Translation영역
Another method: leach mulberry-wood ash for its liquor and steep it in that, changing it again when it cools.
Clinical note임상 주석
**Leached wood ash is lye and must not be put on an open wound**, for the same reason as 2.15's ash lees: an alkali burn on top of a wound.

Boncho 本草

2.19.12.6
Source원문

又方, 葱白連鬚煮湯洗之, 或連莖葉煨硏罯付. 《本草》

Translation영역
Another method: boil scallion white with its roots and wash with the decoction, or bake the stem and leaf with it, grind them and lay them on as a compress.

Boncho 本草

2.19.12.7
Source원문

又方, 薤白搗爛, 火灸令熱, 付瘡上, 以帛褁定, 冷則易, 出水卽差. 《本草》

Translation영역
Another method: pound shallot to a pulp, heat it over the fire, apply it to the sore and bind it with silk; change it when it cools, and when the water comes out it is cured.
Clinical note임상 주석
Four of this section's six remedies are warm moist compresses changed as they cool, with the discharge of fluid taken as the endpoint. A warm compress on an inflamed wound does relieve pain and bring a collection to a head, and the repeated 冷則易 is the instruction that makes it work. It is a gentle close to a chapter that was rarely gentle.

Boncho 本草

2.19.13 Simple Medicinals 單方

2.19.13.1
Source원문

治惡瘡及諸瘡, 生胡麻油塗之妙, 生麻油亦可. 《本草》

Translation영역
Treats malign sores and sores of every kind: spreading raw sesame oil on is excellent, and raw hemp oil will serve too.

Boncho 本草

2.19.13.2
Source원문

馬齒莧 爛搗付上便愈. 《本草》

Translation영역
Purslane (馬齒莧): Pound it to a pulp and apply it, and it heals at once.

Boncho 本草

2.19.13.3
Source원문

熊膽 汁塗之妙, 犬膽亦可. 《本草》

Translation영역
Bear's gall (熊膽): Spreading the juice on is excellent, and dog's gall will serve too.
Clinical note임상 주석
**Bear bile is taken from a protected species and must not be used.** Bears are farmed for it under conditions that are the reason the trade is banned in most jurisdictions, and the dog's gall named in the same line does the same nothing.

Boncho 本草

2.19.13.4
Source원문

蟾蜍 燒灰油調付諸惡瘡, 甚妙. 《本草》

Translation영역
Toad (蟾蜍): Burn it to ash and apply it stirred with oil to malign sores of every kind; this is very good.

Boncho 本草

2.19.13.5
Source원문

久遠惡瘡不差, 蛇蛻皮燒灰, 猪脂調付. 《本草》

Translation영역
Where a malign sore of long standing will not be cured, burn snake slough to ash and apply it stirred with lard.

Boncho 本草

2.19.13.6
Source원문

朝生暮落花 一名鬼盖, 卽朝菌也. 生糞穢處如菌, 作末和油塗之甚佳. 牛糞上黑菌尤佳. 《本草》

Translation영역
The flower born at dawn and fallen at dusk (朝生暮落花): Also named the ghost's canopy; it is the morning mushroom. It grows like a fungus in filthy and dunged places; powder it, mix it with oil and spread it on, which is very good. The black fungus on cow dung is better still.
Clinical note임상 주석
**A fungus grown on dung must not be applied to an open sore.** It is the same material as 癰疽 下 1.10.7's dung fungus, and the same objection: it carries soil and faecal organisms into a wound, which the chapter's own 2.19.12 has just named as the cause of tetanus.

Boncho 本草

2.19.13.7
Source원문

一切惡瘡, 蜣蜋 十枚(端午日收乾)作末, 油調付. 《本草》

Translation영역
For all malign sores: ten dung beetles, gathered and dried on the Dano festival, powdered and applied stirred with oil.

Boncho 本草

2.19.13.8
Source원문

臘猪脂 療惡瘡, 和雄黃ㆍ輕粉付之妙. 《正傳》

Translation영역
Winter lard (臘猪脂): Cures malign sores; mixed with realgar and calomel and applied, it is excellent.
Clinical note임상 주석
**Contains realgar and calomel and must not be prepared.**

Jeongjeon 正傳

2.19.13.9
Source원문

鼴鼠膏 主惡瘡, 塗之妙. 《本草》

Translation영역
Mole grease (鼴鼠膏): Governs malign sores; spreading it on is excellent.

Boncho 本草

2.19.13.10
Source원문

經霜芭蕉葉爲末, 香油調付. 《丹心》

Translation영역
Powder frost-touched banana leaf and apply it stirred with sesame oil.

Dansim 丹心

2.19.13.11
Source원문

石灰 淋取汁溫洗妙. 《本草》

Translation영역
Lime (石灰): Leach it for its liquor and wash warm with it; this is excellent.
Clinical note임상 주석
**Slaked lime liquor is strongly alkaline and must not be used as a wash on broken skin.** It is the third caustic alkali the chapter recommends, after 2.15's ash lees and 2.19.12's mulberry-ash liquor.

Boncho 本草

2.19.13.12
Source원문

雄黃ㆍ硫黃 治惡瘡爲第一. 《本草》

Translation영역
Realgar and sulphur (雄黃ㆍ硫黃): For treating malign sores they are first of all.
Clinical note임상 주석
Of the pair, sulphur earns the praise and realgar does not. **Realgar is arsenic sulphide.** The Boncho has put them together because they look and smell alike and come out of the same ground, and the chapter's successes with sulphur against the itches of 2.7 carried realgar along beside it for three centuries.

Boncho 本草

2.19.13.13
Source원문

一婦人臍下連二陰患惡瘡, 熱痒而痛, 大小便澁, 出黃汁, 百治不差. 有人敎先以溫水洗拭, 取馬齒莧 四兩, 靑黛 一兩, 同硏勻付瘡上, 乾則易新者, 仍服八正散方見小便, 二十日全愈. 《本草》

Translation영역
A woman suffered a malign sore from below the navel down to the two yin parts, hot and itching and painful, with the stool and urine rough and a yellow fluid running, and a hundred treatments had not cured it. Someone taught her first to wash and wipe it with warm water, then to take 4 nyang of purslane and 1 nyang of indigo, grind them even together and apply them to the sore, renewing it when it dried, and with that to take Paljeong-san 八正散 — the formula is given in the Urine chapter — and in twenty days she was wholly healed.
Clinical note임상 주석
The chapter closes with a case, and it is a plain one. A hot, itching, weeping eruption from below the navel to the genitals with difficult micturition, unhealed through a hundred treatments and then healed in twenty days: what changed was 先以溫水洗拭, washing it with warm water first, and a cool moist dressing renewed as it dried. Purslane is soothing and indigo mildly astringent; neither is the point. **Washing a macerated flexure, keeping it clean and changing the dressing is what healed it**, and it is the same lesson as 2.10.1's 常須藥湯淋洗 and the brine of 2.7.3. After everything the chapter has put on people — the mercury, the arsenic, the lead, the lye and the dung — the last thing it records working is soap and water and patience.

Boncho 本草

2.19.13.14
Source원문

諸惡瘡, 貝母末入雄黃少許糝之. 《本草》

Translation영역
For malign sores of every kind, powder fritillaria with a little realgar put in and dust it on.

Boncho 本草

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Miscellaneous Disorders, Volume 8, Sores chapter. The Chinese text is collated against the Kyujanggak transcription of the 1613 edition; collation notes are given on the passages they concern. The chapter opens on leaf 019b, which the binder placed out of order: leaves 019a and 019b belong after 020b, so the 大風瘡 section's first passage breaks off at 得之者須分在 on 019b and resumes at 上在下 on 021a. The intervening leaves 020a and 020b carry the closing Single Remedies of the preceding chapter, Abscesses Part 2, and are read there. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.