Aquilaria and Gastrodia Decoction

**Contains two aconites and pinellia, all toxic. The patient is a child, the text gives no dose by weight anywhere, and this must not be prepared.** 附子 and 川烏 are both *Aconitum* — the daughter root and the mother root of the same plant — and they appear together here, roasted, at 3 fun and 2 fun. Roasting reduces the aconitine but does not make the dose knowable, and aconite has almost no margin between an effect and a fatal arrhythmia. 半夏 is severely irritant raw and no processing is specified for it. The wind drugs — notopterygium, angelica pubescens, siler, gastrodia — and the aquilaria, angelica and liquorice are harmless at these amounts. See 定魄丸 for what epilepsy in a child actually is and what treats it: roughly one child in two hundred is affected, most become seizure-free on anticonvulsant medication, and a child having repeated seizures needs assessment and medication now rather than a decoction. Two details in this leaf deserve notice. The clinical picture it lists — 目多白睛, the eyes showing mostly white, with 項背强急, the neck and back rigid, and a dulled mind between episodes — is upward gaze deviation with neck stiffness and an altered conscious level, which is the triad that should send an infant to hospital for meningitis and raised intracranial pressure, not to the pharmacy. And the formula is to be preceded by moxibustion, fourteen cones at each of the two Qiao vessels: twenty-eight burning cones on the skin of a small child, which in that quantity means real burns, and burns on an infant carry their own risk of infection and fluid loss. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.