Augmented Atractylodes and Aconite Decoction for Chronic Fright

Aconite and atractylodes at a nyang each, with nutmeg, costus root and mix-fried licorice, taken two don at a time in ginger and jujube. The logic is straightforward within the system: the child is cold through, the stool is gushing out of him, so warm the centre hard and bind the gut. Nutmeg and costus root were standard for watery diarrhoea and nutmeg in particular does slow transit. What the child actually has, and what would have saved him, is in the note on `baekchul-san-soa`. 洞泄 — gushing diarrhoea — in a child who has gone pale and cold and limp is hypovolaemic shock, and the coldness the formula is trying to warm is poor perfusion. Warming drugs do not restore circulating volume. **Contains aconite, a nyang of it, blast-fried but in quantity, given to a child. Aconitine has almost no margin between an effect and a fatal cardiac arrhythmia; the lethal dose overlaps the therapeutic one, processing reduces the alkaloid content unpredictably, and no method of measuring the dose existed. The text gives no dose by weight for the patient anywhere, only a weight of powder. A child in hypovolaemic shock is already at risk of arrhythmia from potassium derangement. This must not be prepared or given.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.