寶鑑Bogam

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

Four Teeth Powder

Sachi-san

한글 사치산  ·  Pinyin Si Chi San

四齒散

None of the four drugs has an entry in the herb dictionary — 人齒, 猫齒, 狗齒 and 猪齒 are all absent, and `yongchi` 龍齒 is fossil tooth and a different material — so `ingredients` is left bare and the four are named in the translation. The transcription writes 黑䧟 and 為; printed 黑陷 and 爲 as the corpus prints them. 觧 is printed 解 and 𤍠 is printed 熱, both being clear variant corrections. 砂鍋, the sand crucible, is apparatus and stays in the transcription and the translation. 盖 and 硏 and 煆 are kept as the transcription writes them.

Composition 構成

Total 0 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

  • 痘不紅不起發 — the pox not red and failing to rise and erupt
  • 黑陷焦枯 — black sinking, scorched and withered

Biomedical correlates

  • Haemorrhagic smallpox

Source text 原文

Donguibogam 東醫寶鑑

治痘不紅不起發, 或黑陷焦枯. 人齒ㆍ猫齒ㆍ狗齒ㆍ猪齒 各等分. 盛砂鍋內, 火煆候冷, 硏爲細末, 每取五分, 熱酒調下. 一二歲兒服二三分, 五六歲兒服四五分, 取效如神. 盖黑證屬腎, 四齒亦屬腎, 故能發腎毒. 又猫齒能解熱毒, 若無猫齒, 只用人齒亦可, 但不如四齒全方. 《入門》

Translation

Treats the pox that is not red and will not rise and erupt, and the pox gone black and sunken, scorched and withered. Human tooth, cat’s tooth, dog’s tooth and pig’s tooth, equal parts of each. Put them in a sand crucible, calcine them in the fire, wait until they are cold, and grind them to a fine powder. Take 5 fun at a time, stirred down in hot wine. A child of one or two years takes 2 or 3 fun; a child of five or six takes 4 or 5 fun. It takes effect marvellously. For the black sign belongs to the kidney, and the four teeth also belong to the kidney, and so they can bring out the kidney toxin. Cat’s tooth, further, can resolve heat toxin. If there is no cat’s tooth, human tooth alone will also do, but it is not the equal of the complete four-tooth formula. — Immun 入門 (Donguibogam · Soa)

Clinical commentary 臨床

Four kinds of tooth in equal parts, calcined to ash in a sand crucible and ground fine, 5 fun in hot wine. The leaf argues for its own composition by correspondence, and states the argument plainly: the black sign belongs to the kidney, teeth also belong to the kidney, therefore teeth can drive out the kidney toxin. Cat’s tooth is then given a second property, that it resolves heat toxin, and is the one of the four the leaf is least willing to do without — though it concedes that human tooth alone will serve. Calcined tooth is calcium phosphate, essentially hydroxyapatite with the organic matrix burnt out of it. It is inert. There is nothing in this powder that could act on a viral exanthem, and the reasoning that selected it is a chain of correspondences — black to kidney, kidney to bone, bone to tooth — rather than anything observed of the material. **This leaf does scale its dose to the child’s age**, 2 to 3 fun at one or two years against 4 to 5 fun at five or six, and that is worth noting because most of this chapter does not. Age is not weight, and a graded dose of an inert ash matters less than a graded dose of a poison would; but the leaf shows that the chapter could scale when it chose to. **Human tooth is a human material, taken from the dead, and the powder is given by mouth to a child whose skin is broken by the eruption.** Calcined bone and tooth are not sterile unless the calcination is complete, and the vehicle is hot wine — alcohol given to a child of one or two years. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.

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