White Cake

Four powders at 1 don each — talc, calomel, typhonium, blast-fried arisaema — ground together with twenty-four croton seeds that have been skinned and boiled down to dryness in a seung of water, bound with cooked glutinous rice, and pressed into little cakes dosed by the child's age. The Dansim commentary appended to the leaf explains the design openly: arisaema for phlegm, calomel and talc to drain damp-heat, croton to take out the accumulation. For what 積癖 actually is and why a persistent abdominal mass in a child is an imaging question today, see 進食丸 (jinsik-hwan), where the differential for this batch is set out in full. The indication here is the most pointed in the section — a child with a lump who refuses solids and will take only milk — and that is a presentation that needs imaging the same day, not a purgative. **Contains calomel (輕粉), mercurous chloride, and twenty-four croton seeds, a violent purgative and vesicant. The patient is a child, dosed by age in cakes rather than by weight, and the chapter gives no dose by weight anywhere. This must not be prepared.** This is the batch's full calomel statement and 治喫泥方 refers back to it. Calomel was the standard purgative mercurial of this pharmacopoeia and the cause of its own disease: 雜方門 5.3.33 records how it was manufactured, and 諸瘡門 records the poisoning in four separate sections. Mercury in any form injures the developing nervous system irreversibly at exposures an adult survives, and it also causes the mercurial colitis and the acrodynia — pink disease — that calomel teething powders caused in children into the twentieth century, which is why those powders were withdrawn. The croton warning is written out on 進食丸 and stands here with it: a child who is already refusing food has no reserve against the fluid loss. **Also contains arisaema (南星), toxic raw; the leaf blast-fries it, which is the correct processing.** 白附子 is typhonium, not aconite, and is the mildest thing in the formula. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.