寶鑑Bogam

Formulas · Drain Dampness 利水滲濕 · Uihak Immun (醫學入門)

Heavenly Unity Pill

Cheoneul-hwan

한글 천을환  ·  Pinyin Tian Yi Wan

天乙丸

The transcription writes 褁 for 裹; the corpus prints 裹 by a large majority and that form is used. The levigation of the 燈心 is a real separation step — the pith is washed in rice starch water, dried, powdered, suspended and the floating fraction skimmed — and 2 don 5 fun of the floating fraction is what enters the pill, which is the figure entered here; the 1 nyang 6 don is the raw weight before processing. The rice-flour starch water is a washing medium and is not entered as an ingredient. The leaf opens with a passage of reasoning rather than an indication, which is unusual for a formula leaf in this chapter.

Composition 構成

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 2 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

Indications 主治

Pattern-based

  • 蘊熱 — heat pent up inside
  • 丹毒 — erysipelas
  • 驚風 and 痰熱 — fright wind and phlegm-heat
  • 變蒸發熱 — the fever of the changes
  • Vomiting and diarrhoea

Biomedical correlates

  • Fever with reduced urine output in a child — historical diuretic pill
  • Erysipelas or cellulitis in a child

Source text 原文

Donguibogam 東醫寶鑑

凡小兒生理, 本天一生水之妙. 凡治病以水道通利爲捷徑, 此方淸心利小便, 所以散火也. 凡小兒蘊熱ㆍ丹毒ㆍ驚風ㆍ痰熱ㆍ變蒸發熱之病, 用之最當, 而嘔吐ㆍ瀉利無不治也. 燈心 一兩六錢(以米粉漿水洗, 晒乾爲末, 入水澄之, 浮者爲燈心, 取二錢半), 入赤茯苓ㆍ白茯苓ㆍ茯神 各一錢七分, 滑石ㆍ猪苓 各二錢半, 澤瀉 三錢. 右爲末, 用人參 一兩煎膏和丸, 如櫻桃大, 朱砂爲衣, 金箔裹之. 每一丸, 以燈心麥門冬湯或薄荷湯化下. 《入門》

Translation

In the physiology of a child, the root is the marvel by which Heaven's One gives birth to Water. In treating any illness, freeing the waterways is the short road; this formula clears the Heart and frees the urine, and so disperses fire. For a child's pent-up heat, erysipelas, fright wind, phlegm-heat and the fever of the changes, nothing is fitter than this, and vomiting and diarrhoea too are all treated by it. Rush pith 1 nyang 6 don — washed in rice-flour starch water, sun-dried and powdered, then put into water and allowed to settle, the part that floats being the rush pith, of which 2 don 5 fun is taken; add red poria, white poria and poria with wood, 1 don 7 fun each; talc and polyporus, 2 don 5 fun each; alisma 3 don. Powder the above, and using 1 nyang of ginseng decocted to a paste, form into pills the size of a cherry; coat them with cinnabar and wrap them in gold leaf. For each dose one pill, let down in a decoction of rush pith and ophiopogon, or in a mint decoction. — Immun 入門 (Donguibogam · Soa)

Clinical commentary 臨床

The leaf argues its own case before it gives its drugs, and the argument is a cosmological one: 天一生水, Heaven's One gives birth to Water, so a child's physiology is governed by water, so every illness is treated by opening the waterways. What follows from the premise is a straight diuretic — 滑石, 猪苓, 澤瀉 and three porias, with levigated rush pith as the chief — bound with a ginseng paste, and the list of things it is said to cure is as wide as the premise is. As pharmacology the diuresis is weak and the claim is not supportable: increasing urine output does not treat erysipelas, convulsions, vomiting or fever, and in a vomiting child with diarrhoea a diuretic is pointing the wrong way entirely — what that child needs is fluid in, by oral rehydration solution. 丹毒, erysipelas, is a spreading bacterial infection of the skin and needs an antibiotic; untreated in a child it can become invasive. Most fevers in a child are viral and self-limiting, and the signs that matter are how the child looks and breathes rather than the height of the temperature. See the chapter prose at 1.41 for the taxonomy. **Every pill is coated with cinnabar. The full statement on mercury in this chapter is on `jinsa-go-soa`; read it there. A coating is the worst possible place for it, because it is the first thing dissolved and the whole of it is swallowed. The formula also contains talc, which was long contaminated with asbestos in natural deposits. The text gives no dose by weight anywhere, and the patient is an infant. This must not be prepared.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

Related formulas 關聯

Look up another