Formulas · Transform Phlegm 化痰 · Gogeum Uigam (古今醫鑑)

Clear Heat and Guide Out Phlegm Decoction

Cheongyeoldodam-tang

한글 청열도담탕  ·  Pinyin Qing Re Dao Tan Tang

淸熱導痰湯

Composition 構成

Total 56 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

Indications 主治

Pattern-based

  • Aversion to cold with vigorous fever
  • Clouded, heavy head and eyes
  • Qi rising with panting and haste
  • Drool running from the mouth
  • Phlegm confounding the orifices of the heart

Biomedical correlates

  • Delirium with fever
  • Acute confusional states with respiratory distress
  • Phlegm-heat agitation

Source text 原文

Donguibogam 東醫寶鑑

治憎寒壯熱, 頭目昏沈, 氣上喘急, 口出涎沫. 此因內傷七情, 以致痰迷心竅, 神不守舍. 神出則舍空, 舍空則痰自生也. 黃連ㆍ黃芩ㆍ瓜蔞仁ㆍ南星(炮)ㆍ半夏(製)ㆍ陳皮ㆍ赤茯苓ㆍ䓀莄ㆍ白朮ㆍ人參 各七分, 枳實ㆍ甘草 各五分. 右剉, 作一貼, 入薑 三片, 棗 二枚, 同煎, 和竹瀝, 薑汁服. 《醫鑑》

Translation

Treats aversion to cold with vigorous fever, clouded and heavy head and eyes, qi rising with hasty panting, and drool running from the mouth. This arises from internal damage by the seven affects, which brings phlegm to confound the orifices of the heart so that the spirit does not keep to its dwelling. When the spirit goes out the dwelling stands empty, and when the dwelling stands empty phlegm arises of itself. Coptis, scutellaria, trichosanthes seed, arisaema (blast-fried), pinellia (processed), tangerine peel, red poria, platycodon, white atractylodes and ginseng 7 pun each; bitter orange and licorice 5 pun each. Cut up, make one packet, add 3 slices of ginger and 2 jujubes, decoct together, and take mixed with bamboo sap and ginger juice. — Gogeum Uigam 醫鑑 (Donguibogam · Damum)

Clinical commentary 臨床

The etiology given here is the most quoted line in the chapter and deserves its reputation. Phlegm does not simply block the heart's orifices; the seven affects drive the spirit out first, and the phlegm fills the vacancy left behind. Cause and effect run the opposite way from the intuitive reading, and the therapeutic consequence follows — ginseng and atractylodes sit inside what is otherwise an attacking formula, because an empty dwelling has to be reoccupied, not merely swept. **Fever with confusion, laboured breathing and drooling is a presentation that requires urgent medical assessment.** The classical picture here overlaps with meningitis, encephalitis and acute delirium of many causes, and this passage should be read as a description of a pattern, not as grounds for managing such a case outside conventional care. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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