Wan Jin San (Ten-Thousand-Gold Powder) for Resolving Swelling, Activating Blood and Stopping Pain, and Its Derived Formulas
In Waike Jingyao (Essentials of External Medicine) there is a formula named "Wan Jin San" (Ten-Thousand-Gold Powder), composed of "Gualou (Trichosanthes Fructus) one whole, Da Gancao Jie (large Glycyrrhizae Caulis nodus) two qian, Moyao (Myrrhae) one qian (ground to powder)." The original preparation is: "Use two bowls of wine, decoct to one bowl, strain out the dregs, add Moyao and take." What needs to be decocted here is Gualou and Gancao Jie; Moyao is ground into powder and taken infused in the decoction. In the past, when herbs were decocted in wine, the wine used was low-alcohol yellow rice wine, not today's white liquor.
This formula resolves swelling, activates blood, drains pus, and stops pain. The original text uses it to treat "all carbuncles and sores, whether ruptured or not." Xingyuan Shengchun says it treats "malignant nodules with swelling and pain, fa nao (brain abscess), fa yi (jaw swelling), and fa bei (back abscess)." Later generations mainly used it for sores and swellings of the carbuncle, malignant nodule, and fa bei type caused by stasis-toxin. It works well for mastitis and benign breast tumors presenting with redness, swelling, heat, and pain. It may also be used for pain caused by stasis-toxin in malignant tumors. However, tumor patients should not take it decocted in yellow wine; instead, a small amount of scallion white may be added and water used in place of wine. The role of scallion white is similar to that of yellow wine — both speed up the action of the herbs.
In Waike Jingyao, there is a modified version of this formula named Shenxiao Gualou San (Miraculous Trichosanthes Powder), composed of Gualou (whole fruit) one piece, Danggui Wei (Angelicae tail) five qian, Gancao Jie five qian, and Moyao one qian. Its indications are similar to Wan Jin San, and its preparation is also similar. The only addition is five qian of Danggui Wei: Gualou, Danggui Wei, and Gancao Jie are decocted in yellow wine, and after straining the Moyao powder is taken infused in the liquid. Adding Danggui Wei not only enhances blood-activation and pain relief but also has a blood-nourishing effect.
This formula has two side effects. First, Moyao is a resin; taken as a powder it easily irritates the stomach. Some patients develop nausea, vomiting, acid regurgitation, heartburn, and stomach pain — these are symptoms of gastric ulcer, so patients with weak stomachs should not use it. Second, whole Gualou has a laxative side effect, so patients with loose stools or diarrhea also cannot take it. Pregnant women should not take this medicine either.
Another pain-relieving, swelling-resolving formula in Waike Jingyao is also derived from this one. It is called "Li Xiao San" (Immediately-Effective Powder), composed of Zaojiao Ci (Gleditsiae Spina) half a jin, Fen Gancao (prepared licorice) two liang, Ruxiang (Olibanum) one liang, Moyao one liang, and Gualou five pieces. These are together made into a powder; each time one liang (about 30 g) is decocted in yellow wine and taken. The original text uses Li Xiao San for pain from carbuncles and scrofula. Zaojiao Ci in this formula has a hemolytic side effect, so not only patients with weak digestion but also those with poor coagulation should not take it.