Formulas · Calm the Spirit 安神 · Dangye Simbeop (丹溪心法)

Prepare for Urgency Pill (Children chapter)

Bigeup-hwan

한글 비급환 (소아) · Pinyin Bei Ji Wan

備急丸

This is not the 備急丸 already registered as `bigeup-hwan`. That one is Zhang Zhongjing's 三物備急丸, 大黃ㆍ乾薑ㆍ巴豆霜 in equal parts, cited from 仲景 for sudden death and blocked bowel; it shares no ingredient with this leaf, which is earthworm and cinnabar from 丹心. The two are homonyms and this one takes the chapter tail. The transcription writes 為 for 爲; the corpus form is printed.

Composition 構成

Jiryong Di Long
地龍 지룡 · Earthworm

—
Chief 君

白頸蚯蚓, white-necked earthworm, gathered on the fifth day of the fifth month, any amount (不拘多少), washed free of earth and dried over heat
Jusa Zhu Sha
朱砂 주사 · Cinnabar (toxic)

—
Deputy 臣

equal parts by weight with the worm powder (等分) · cinnabar, mercuric sulfide, toxic
Geumbak Jin Bo
金箔 금박 · Gold Leaf

—
Envoy 使

金箔爲衣, gold leaf as the pill coating

Total 0 g per packet (첩) · representative dosage — verify against source texts. Excludes 3 ingredients measured by count or used as a vehicle, shown as —.

Received this formula from your practitioner? Amounts shown here are classical reference values — granule and prepared products differ. Always follow your prescribed dosage and directions.

Actions 效能

Treats both acute and chronic fright wind
White-necked earthworms gathered on the fifth day of the fifth month, cleaned of earth, dried over heat and powdered, with an equal weight of cinnabar, pasted into mung-bean-sized pills coated with gold leaf
One pill at a time, down with plain hot water
A second method cuts the worms in two and sorts them by how they jump, the quick for acute fright wind and the slow for chronic, each kept in its own jar

Indications 主治

Pattern-based

急驚風 — acute fright wind, the febrile convulsion of a previously well child
慢驚風 — chronic fright wind, the depleted and cold child twitching feebly

Biomedical correlates

Febrile seizure in a child
Seizure of a depleted child after prolonged diarrhoea — dehydration, electrolyte derangement, hypoglycaemia

Source text 原文

Donguibogam 東醫寶鑑

治急慢驚風. 五月五日, 取白頸蚯蚓不拘多少, 去泥, 焙乾爲末, 加朱砂等分, 糊丸菉豆大, 金箔爲衣, 每一丸, 白湯下. ○一法, 取蚯蚓, 以竹刀中斷之, 看取急跳者治急驚, 慢跳者治慢驚, 各另硏爛, 和朱砂末作丸菉豆大, 分二器貯之, 記而用之, 神妙. 《丹心》

Translation

Treats acute and chronic fright wind. On the fifth day of the fifth month take white-necked earthworms, any quantity, wash off the earth, dry them over heat and reduce them to powder; add cinnabar in equal weight, make paste pills the size of mung beans and coat them with gold leaf. One pill a time, taken down with plain hot water. ○Another method: take the earthworms and cut each through the middle with a bamboo knife; those that jump quickly treat acute fright wind, those that jump slowly treat chronic fright wind. Grind each sort separately to a mash, mix with cinnabar powder and make pills the size of mung beans; store them in two jars, label them, and use them accordingly. The effect is marvellous. — Dansim 丹心 (Donguibogam · Soa)

Clinical commentary 臨床

Earthworms dug on the day of the Dano festival, dried, powdered and made up with an equal weight of cinnabar. The two halves of the formula answer to two different kinds of thinking. The cinnabar is the chapter's standard sedative for a convulsing child. The earthworm is sympathetic logic, and the second method makes it explicit: cut the worm in half, watch which piece writhes fast and which slowly, and give the fast ones for the sudden convulsion and the slow ones for the lingering one. Nothing in the worm differs between the two jars. This leaf heads 急慢驚風通治, the section of formulas said to serve for both kinds of convulsion at once. For the acute kind that is an empty claim in a harmless direction — a febrile seizure in a previously well child stops by itself within minutes, and no formula in this section stops one. For the chronic kind it is an empty claim in a dangerous direction: that child needs fluid and salt, which the section's full statement is given with 雙金丸 above. **The name is the problem that matters here. The 備急丸 of the 仲景 tradition, registered on this site as `bigeup-hwan`, is built on 巴豆 — croton seed, a violent purgative and a vesicant. Given to a child who is already losing fluid, which is exactly the chronic fright wind child this section also claims to treat, it can kill by dehydration alone. The two formulas carry one name and must not be confused.** **This formula contains 朱砂, cinnabar, which is mercuric sulfide, in equal weight with the worm powder. The patient is a child and the text gives no dose by weight anywhere. Mercury injures a developing nervous system irreversibly at doses that leave an adult unharmed, and the standard treatment for a convulsing child in 1613 was a mercury compound. The gold leaf of the coating is inert and harmless; the cinnabar inside it is not. This must not be prepared.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.