Formulas · Clear Heat 淸熱 · Uihak Immun (醫學入門)

Modified Sage-Reaching Powder

Gagamtongseong-san

한글 가감통성산  ·  Pinyin Jia Jian Tong Sheng San

加減通聖散

The transcription writes 蚕 for 蠶; the corpus form is printed. 梔子仁 is the gardenia kernel and is recorded under chija, and 當歸尾, the tails, under danggui, with the part kept in each prep. The name is a 加減 of 防風通聖散, which the 天疱瘡 section names twice in the lines above this leaf, but the leaf gives the composition in full rather than as additions and subtractions, so no cross-reference is needed.

Composition 構成

Total 40.4 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

  • 楊梅瘡初起 — the bayberry sore at its onset
  • 天疱瘡 — the celestial blister sore, which the chapter identifies with 楊梅瘡
  • 肝脾腎風濕熱之毒 — wind, damp and heat toxin of liver, spleen and kidney, transmitted 因男女房室

Biomedical correlates

  • Secondary syphilis — the papulosquamous eruption
  • Primary and early syphilis — historical

Source text 原文

Donguibogam 東醫寶鑑

治楊梅瘡初起. 牛蒡子 一錢二分, 防風ㆍ白鮮皮ㆍ赤芍藥ㆍ連翹ㆍ黃芩 各一錢, 金銀花 五分, 梔子仁ㆍ當歸尾 各七分, 荊芥ㆍ槐花 各六分, 白殭蠶ㆍ甘草 各四分. 右剉, 作一貼, 水煎服. 《入門》

Translation

Treats the bayberry sore at its onset. Burdock seed 1 don 2 fun; siler, dictamnus bark, red peony, forsythia and scutellaria 1 don each; honeysuckle 5 fun; gardenia kernel and the tails of Korean angelica 7 fun each; schizonepeta and pagoda tree flower 6 fun each; silkworm and licorice 4 fun each. Cut the above, make one packet, decoct in water and take. — Immun 入門 (Donguibogam · Jechang)

Clinical commentary 臨床

The first formula of the syphilis section and the one it names as the formula for the whole course: 以後用加減通聖散丸多服之, 此方爲首尾要藥, 輕者一劑, 重者十貼 — after the two opening packets of Bangpungtongseong-san, use this and its pill form freely, for it is the essential drug from first to last; a light case needs one dose, a grave one ten packets. It is Bangpungtongseong-san rebuilt. The ephedra that the section has already told the practitioner to drop, and the mirabilite and rhubarb dropped with it, are gone; what is left is the cooling and wind-dispersing core, with dictamnus bark, honeysuckle, pagoda tree flower and the tails of Korean angelica added for a skin eruption and for the blood. The doses are small — nothing above a don and two fun — which fits a formula meant to be taken for a long time. The disease is syphilis. The chapter knows how it is caught — 因男女房室傳染 — reads the lesion morphology by organ with real care, and knows what untreated disease does: 蝕傷眼鼻, 腐爛玉莖, 拳攣肢體, eyes and nose eaten away, the penis ulcerated, the limbs drawn up. Everything the section offers after this leaf is mercurial, and this one is not: it is the last mercury-free formula in the sequence. **The 天疱瘡 formulas that follow it — those with 輕粉, 水銀, 粉霜, 靈砂 or 朱砂, and the 取輕粉法 and 熏鼻方 — are mercury preparations and must not be prepared.** The chapter itself records mercury poisoning as a complication of its own treatment: 或誤服水銀輕粉而成風堆腫爛流膿出汁. Syphilis is cured with benzathine penicillin G. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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