Draw Out the Toxin Powder for the Child's Cinnabar Toxin

Two cold minerals carrying two herbs: glauberite at 2 nyang 3 don and gypsum at 1 nyang against phellodendron and licorice at 3 don apiece, ground to powder and stirred into water, or into the watery sap of the banana plant, and spread on the skin. What it does to inflamed skin is physical. A thick wet mineral paste holds water against the surface, and the evaporation carries heat away — it is a cooling compress, and it will take the burning down for as long as it stays wet. The two herbs do very little through it: the berberine in phellodendron has weak antibacterial activity in a dish and none worth counting across skin, and the glycyrrhetinic acid in licorice is mildly anti-inflammatory. Glauberite and gypsum are inert. Nothing in it is caustic, which is more than can be said for several of this chapter's topicals, and nothing in it reaches the infection. That is the point to be plain about. 丹毒 in a child is erysipelas or spreading cellulitis, and the organism is usually group A streptococcus or Staphylococcus aureus. The section's whole attention is on the redness **moving** — 遊走遍身, wandering over the whole body; 自四肢入腹則難治, from the limbs into the belly and it is hard to treat; 毒氣入裏腹脹則死 — and that is ascending lymphangitis, infection travelling up the lymphatics toward the trunk. The fear is justified and the chapter's own figure records why: 小兒丹毒百日內發者必死, in a child under a hundred days old it is always fatal. Before antibiotics, omphalitis and spreading skin sepsis in a newborn killed, and the section's 金絲瘡 — a red line, fine or thick, running up the limb — is the same sign 癰疽門 下 1.10.3 紅絲疔 records in an adult. What changed the outcome was antibiotics: penicillin for the streptococcus, an antistaphylococcal agent where that is the organism, given systemically and early. A child with spreading redness, a red streak, fever or any sign of being unwell needs them that day, and a paste of any kind is at best something applied while waiting. The section's other answers are worse than this one. Needling along the advancing edge to let out the bad blood — 急以細鍼刺出惡血 — opens the infected tissue; the leech applied to suck it out does the same; and pounded shrimps, hearth dirt mixed with egg white, carp and eel blood laid on inflamed skin are routes of further infection. This paste at least adds nothing. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.