State Elder Paste

Gukro-go

한글 국로고 (현옹) · Pinyin Guo Lao Gao

國老膏

The Bogam carries two leaves called 國老膏 and they are different preparations of the same single drug: the Abscess chapter's upper half has the 綱目 paste, 2 geun of large licorice steeped in river water and reduced over a slow fire, registered as gukro-go, while this is the 精要 preparation from the 懸癰 section, 1 nyang of nodded licorice roasted in stream water and then decocted in wine. The transcription prints 癕 for 癰 twice, normalized here, and 灸 where 炙, to roast, is meant; the transcription's 灸 is kept, as the corpus does not normalize that pair. The first-edition collation reads 山潤 for the transcription's 山澗, mountain stream; 澗 is printed. The bowl, the fire and the stream water are preparation rather than ingredients.

Composition 構成

Gamcho Gan Cao
甘草 감초 · Licorice

40 g
Chief 君

橫紋大甘草, the large cross-grained grade with the nodes left on, 1 nyang, cut into four-inch lengths, dipped and roasted over the water from morning to midday until the heart of the root is soaked through, then finely cut and decocted in wine

Total 40 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

Treats 懸癰, the abscess between the anus and the scrotum
Taken from first to last throughout the illness, so that the swelling is lighter and any rupture shallower
Decocted in good wine and drunk on an empty stomach, one dose every three days

Indications 主治

Pattern-based

懸癰 — abscess between the anus and the external genitals, beginning the size of a pine nut and growing to a peach
The abscess that must not be met with cold and cooling drugs
An abscess already ruptured, where the sore will not close

Biomedical correlates

Perianal and perineal abscess
Ischiorectal abscess progressing to fistula-in-ano
Scrotal or perineal cellulitis

Source text 原文

Donguibogam 東醫寶鑑

治懸癰. 橫紋大甘草(帶節) 一兩, 四寸切. 以山澗長流水一椀, 文武火慢慢蘸水灸, 自早至午, 乾則投前水再灸, 直待水盡, 看甘草中心潤透爲度. 細剉, 好酒二升, 煎取一升, 空心隨量飮之. 三日一服, 二三服可保無虞. 此藥雖不卽消, 過二十日後必盡消. 有人患此癰已破, 服兩貼, 瘡卽合, 甚妙. 《精要》

Translation

Treats the hanging abscess. Large cross-grained licorice with the nodes left on, 1 nyang, cut into four-inch lengths. Take one bowl of long-running water from a mountain stream, and over a fire now gentle now strong dip the licorice in the water and roast it slowly from morning until midday; when it dries, put it back into the same water and roast it again, waiting until the water is used up, and take the heart of the licorice being soaked through as the measure. Cut it up fine, decoct it in 2 seung of good wine down to 1 seung, and drink it on an empty stomach, as much as can be managed. One dose every three days, and two or three doses are enough to be safe. Although this drug does not disperse the swelling at once, after twenty days have passed it is certain to disperse it entirely. There was a man suffering from this abscess which had already broken, and after two packets the sore closed — most wonderful. — Jeongyo 精要 (Donguibogam · Ongjeo)

Clinical commentary 臨床

Licorice and nothing else again, but prepared the other way round from the paste in the upper half of the chapter: there the drug is steeped cold and reduced to an extract, here it is roasted dry over a bowl of stream water until the water is gone and the root is soaked through to its heart, then decocted in wine. 國老, the state elder, is the old byname for licorice. The 帶節 instruction — nodes left on — matters to the tradition, which treated the node as the part that works on sores, and the dosing is slow and long: one dose every three days, with the leaf admitting outright that nothing happens quickly and that twenty days should pass before the swelling is gone. 懸癰 is the abscess in the perineum, between the anus and the genitals, and the section describes its course exactly — starting as a hard itchy lump the size of a pine nut, becoming a lotus seed, then after some weeks a red swelling like a peach that bursts. That is a perianal or ischiorectal abscess, and the section's own worst outcome, 破而大小便皆從中出者爲難治, stool and urine coming through the opening, is a fistula. The warning 誤用寒凉則不可救 — that cold cooling drugs here cannot be recovered from — is the section's reason for reaching for licorice rather than rhubarb. **A perianal or perineal abscess needs surgical drainage; it does not resolve on a decoction, and an undrained one spreads. Glycyrrhizin in this quantity is not harmless: sustained high-dose licorice causes potassium loss, sodium and water retention and hypertension, and is a problem in anyone on diuretics or with heart or kidney disease.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.