Source 出处 · Taiping Huimin Hejiju Fang · Doses are not given here: they are set by a licensed practitioner for the individual.
Safety. Zhi Bao Dan is recorded in the Taiping Huimin Hejiju Fang, the Song-dynasty official formulary, and it belongs to a group that later texts call the three cool-opening treasures: An Gong Niu Huang Wan, Zi Xue, and this one. What the three share is not a disease. It is a state: a person who is not conscious in the way they should be, in the course of a febrile illness, and a classical reading that heat and phlegm have sealed the orifices and must be opened.
That state has a modern name and a modern clock attached to it, and this entry has to start there. Altered consciousness is not a pattern a reader can sort at the bedside. It is a presentation with a differential: hypoglycaemia, hypoxia, sepsis, meningitis or encephalitis, stroke, seizure and the post-ictal state, head injury, metabolic encephalopathy from liver or kidney failure, intoxication or withdrawal from drugs and alcohol, carbon monoxide, thyroid storm, hyponatraemia. Several of these cause death or permanent injury within hours, and each has a specific treatment that works only if it is given early. Stroke in particular is measured in minutes: thrombolysis and thrombectomy have windows, and the window starts at onset, not at the point where someone decides which pattern this is. Sudden failure of speech, face or a limb is an emergency pathway, and nothing here delays it.
There is a second reason not to put anything in that mouth. A person whose consciousness is impaired may have an impaired gag reflex. Anything given orally — pill, powder, dissolved tablet, liquid — can enter the airway instead of the oesophagus. Aspiration is a mechanical event, not a pharmacological one, and it does not care what the substance was.
The composition carries its own weight of difficulty. Cinnabar is mercuric sulfide. Realgar is a sulfide of arsenic. Both are in the formula deliberately, and both are cumulative toxins for which no modern assessment supports long-term daily use. The original list also includes rhinoceros horn and hawksbill turtle shell. Rhinoceros horn trade has been prohibited in China since 1993; the hawksbill turtle is critically endangered and CITES-listed; both are routinely substituted in modern manufacture, the horn most often with water buffalo horn. Musk comes from a CITES-listed animal and is now frequently synthetic. Gold and silver leaf are formulation and cost questions rather than toxicological ones. Benzoin is a recognised contact allergen.
This page is not a recommendation. The library records that this formula exists in the literature; it gives no dose, no preparation, no regimen, and makes no claim that it helps anything. Pregnancy, breastfeeding, children, older adults, liver or kidney impairment, and any anticoagulant, antiplatelet, antiepileptic or sedative medicine taken on medical advice each remove whatever room there was. If a preparation like this has been taken and there is vomiting, abdominal pain, tremor, numbness, confusion, or reduced urine output, treat it as an emergency and bring the original packaging.
至宝丹著录于《太平惠民和剂局方》，属后世所谓「凉开三宝」之一（安宫牛黄丸、紫雪、至宝丹）。三首共有的不是一种病，而是一种状态：热病过程中神志不应有地蒙蔽，古典的解释是热与痰闭阻清窍，方为开窍而设。
这个状态在今天有名字，也有时间尺度，本条必须先写这一层。意识改变不是读者可以在床边自行归类的证候，它是一串需要鉴别的情形：低血糖、缺氧、脓毒症、脑炎或脑膜炎、卒中、癫痫发作及其发作后状态、颅脑外伤、肝性或肾性脑病、药物与酒精的中毒或戒断、一氧化碳、甲亢危象、低钠血症。其中若干项在数小时内即可致死或造成永久损伤，且各有只在早期才有效的特异处理。卒中尤其以分钟计：溶栓与取栓有时间窗，起算点是发病时刻，而不是某人判断它是何证的时刻。突发的言语不清、面瘫或肢体无力走的是急救路径，本页不在这条路径上添任何延迟。
第二个不该经口给任何东西的理由：神志受损者的咽反射可能同时受损。丸、散、溶化后的片剂、汤液，都可能进入气道而不是食管。误吸是一个机械事件，不是药理事件，它不关心咽下去的是什么。
组成本身另有一层难度。朱砂是硫化汞，雄黄是砷的硫化物。两味都是有意入方的，两者都是蓄积性毒物，现代安全性评估给不出一个「安全的长期用量」。原方还列犀角与玳瑁：犀角贸易自 1993 年起在中国被禁止；玳瑁为极危物种并列入 CITES；现代生产多作替代，犀角常以水牛角代。麝香亦来自 CITES 所列物种，今多为人工麝香。金箔银箔作为金属是惰性的，属于制剂与成本问题而非毒性问题。安息香是已知的接触性过敏原。
本页不是建议。本库记录的是文献中有此方：不列用量、不列制法、不列服法，也不主张它对任何情况有益。妊娠、哺乳、儿童、老年、肝肾功能受损，以及正在使用抗凝／抗血小板／抗癫痫／镇静类处方药，任何一项都足以抹去残余的空间。若已服用此类制剂并出现呕吐、腹痛、震颤、麻木、意识改变或尿少，属急症：立即就医，并把原包装带上。