Verdigris Powder

**Contains verdigris, a copper salt, which is caustic and poisonous. The patient is a child, the text gives no dose by weight anywhere, and this must not be prepared.** 銅靑 or 銅綠 is the green crust that forms on copper — chiefly basic copper acetate and copper carbonate — and it is being powdered and dusted into the open mouth of a child. Copper salts are corrosive to mucous membrane and violently emetic when swallowed, which is what happens to a dusting powder placed on the gums. Swallowed in quantity they cause haemolysis with jaundice, then acute kidney injury and liver necrosis; children are described in the poisoning literature at doses an adult would survive. The same shelf holds 膽礬, copper sulfate, which the 疳 sections use elsewhere for the same purpose and which is more soluble and therefore more dangerous still — it does not appear in this leaf, whose only copper is the verdigris. 馬牙硝 is sodium sulfate, an osmotic salt rather than a poison, but on ulcerated mucosa it is another irritant. **Musk is from a CITES Appendix I species.** The musk deer are endangered, and the demand this tradition created is the reason. There is no substitute that can be called the same drug, and the honest position is that the material should not be sourced. On what 走馬牙疳 is, and on the fact that none of these formulas is food, see 立效散 in this same section. The specific thing to say here is the combination: a child already dying of protein-energy malnutrition, with a gangrenous ulcer eating through the cheek, is having a copper salt rubbed into the wound. Noma kills by sepsis and by starvation, and a corrosive mineral adds to both the tissue destruction and the vomiting. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.