Brown Pellets

**Contains black morning-glory seed, a drastic purgative. The patient is a child, the text gives no dose by weight anywhere, and this must not be prepared.** 黑丑 is 黑牽牛, the seed of the black-flowered morning glory, and it works by the same route as the other violent purges on this shelf: resinous glycosides that are not absorbed, draw water into the gut and empty it. At 7 don 5 fun it is the second largest drug in the formula, and the first-milled powder is the most concentrated fraction of it. Fifteen pills at a time go into a child whose belly is swollen and whose flesh is wasted, and the formula is additionally recommended for 八痢, the dysenteries — that is, for a child already losing fluid and electrolytes through the bowel. Purging a dehydrated infant is how a survivable illness becomes a fatal one. **巴豆, croton seed, is the same argument at a greater intensity and does not appear in this batch.** **五靈脂 is flying-squirrel droppings** — see 十全丹 in this section. 疳腫 with a distended belly is the oedematous pole of protein-energy malnutrition: kwashiorkor. The child has pitting oedema of the feet and legs, a swollen face, a big liver and a distended abdomen, and is not fat but hypoalbuminaemic and very sick. The oedema looks like water to be drained, and that is exactly what this formula sets out to do — radish seed, morning glory, bur-reed and zedoary to break the accumulation and drive the water down. It is a reasonable inference from the appearance and it is the wrong treatment. The fluid is there because the plasma protein that holds it in the vessels is gone, and the treatment is careful feeding — energy and protein built up slowly, with potassium and magnesium, and antibiotics for the infection that is usually hidden underneath. Diuresis and purging in kwashiorkor kill. The modern protocol specifically warns against treating the oedema as a fluid problem. On the general point that none of these formulas is food, see 立效散 in this same section. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.