Formulas · Purge Downward 瀉下 · Uihak Jeongjeon (醫學正傳)

Fat Qi Pill (Liver Accumulation)

Bigi-hwan

한글 비기환(간적) · Pinyin Fei Qi Wan

肥氣丸

Registered with the -gan suffix because 肥氣丸 and 痞氣丸 at 1.8.5 are both read bigi-hwan in Korean, share a source, and sit in the same section; the viscus each treats distinguishes them.

Composition 構成

Siho Chai Hu
柴胡 시호 · Bupleurum

40 g
Chief 君 1 nyang
Hwangryeon Huang Lian
黃連 황련 · Coptis

28 g
Deputy 臣 7 don
Hubak Hou Po
厚朴 후박 · Magnolia Bark

20 g
Deputy 臣 5 don
Cheoncho Chuan Jiao
川椒 천초 · Sichuan Pepper

16 g
Assistant 佐 4 don
Bongchul E Zhu
莪朮 봉출 · Zedoary

10 g
Assistant 佐 2.5 don
Insam Ren Shen
人蔘 인삼 · Ginseng

10 g
Assistant 佐 2.5 don
Gonpo Kun Bu
昆布 곤포 · Kelp

10 g
Assistant 佐 2.5 don
Jogak Zao Jiao
皂角 조각 · Gleditsia Pod

6 g
Assistant 佐 1.5 don
Baekbokryeong Fu Ling
白茯苓 백복령 · Poria (white)

6 g
Assistant 佐 1.5 don
Geongang Gan Jiang
乾薑 건강 · Dried Ginger

2 g
Assistant 佐 5 pun
Padu Ba Dou
巴豆 파두 · Croton Seed

2 g
Assistant 佐 frost (巴豆霜), 5 pun — TOXIC
Cheono Chuan Wu
川烏 천오 · Aconite Main Root

0.8 g
Assistant 佐 2 pun
Gamcho Gan Cao
甘草 감초 · Licorice

12 g
Envoy 使 3 don

Total 162.8 g per packet (첩) · representative dosage — verify against source texts.

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

Breaks up liver accumulation lodged below the left ribside
Courses the liver and softens what has hardened

Indications 主治

Pattern-based

Liver accumulation named fat qi
lying below the left ribside like an upturned cup with a head and feet
Cough with counterflow and ribside pain
Recurrent malaria continuing from year to year
Green complexion with a wiry long pulse

Biomedical correlates

Splenomegaly
Left upper quadrant mass
Chronic hepatic conditions with mass

Source text 原文

Donguibogam 東醫寶鑑

治肝積. 柴胡一兩, 黃連七錢, 厚朴五錢, 川椒四錢, 甘草三錢, 蓬朮ㆍ人參ㆍ昆布各二錢半, 皂角ㆍ白茯苓各一錢半, 乾薑ㆍ巴豆霜各五分, 川烏二分. 右爲末, 蜜丸梧子大. 初服二丸, 日加一丸, 二日加二丸, 至大便溏, 便漸減服. 周而復始, 塊減半, 勿服. 《正傳》

Translation

Treats liver accumulation. Bupleurum 1 nyang; coptis 7 don; magnolia bark 5 don; zanthoxylum 4 don; licorice 3 don; curcuma, ginseng and kelp 2.5 don each; gleditsia pod and white poria 1.5 don each; dry ginger and croton frost 5 pun each; aconite 2 pun. Powder them, make honey pills the size of a firmiana seed. Begin with two pills, adding one a day, then two on the second day, until the stool turns loose, at which point reduce gradually. Go round and begin again; when the lump is halved, stop taking it. — Uihak Jeongjeon 正傳 (Donguibogam · Jeokchwi)

Clinical commentary 臨床

Bupleurum at a full nyang is what makes this the liver formula — the same seven-medicinal core as Jeungsonojeok-hwan with the liver additions fixed in, and bupleurum promoted to chief. Kelp is the notable inclusion: salty and softening, and the classical medicinal for a mass in the ribside. The dosing schedule is the most explicit in the chapter and repeats for all five of these pills. Two, then one more each day, then two more, until the stool loosens; then taper, cycle round, and stop when the mass is halved. Stopping at half is the Neijing rule quoted at 1.8.5, not a failure of nerve. **Contains croton frost and aconite, both toxic. Not suitable for self-administration and contraindicated in pregnancy. A left upper quadrant mass requires imaging before treatment.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.