Notopterygium and Sinomenium Decoction

A channel-division formula, and that is the whole of its logic. The 附骨疽 group of this chapter sorts a deep bone abscess by which division of the leg it has effused in, and prescribes a different decoction for each: this one for the 太陽ㆍ厥陰ㆍ太陰 divisions, and 托裏黃芪湯 for the foot lesser-yang and yang-brightness. Notopterygium leads it into the greater-yang, cnidium and atractylodes lancea open the yin divisions, and the leading three are given at 1 don 2 fun against 7 fun for everything else, so the guiding drugs are deliberately weighted above the body of the formula. Behind them the structure is unusual for a sores formula. There is almost no heat-clearing in it — only forsythia and blackberry lily — and no supplementation at all. What fills the list instead is a moving and draining set: sinomenium and akebia to drain damp downward, costus root to move Qi, and sappan wood with the tail of the Korean angelica root to break Blood stasis in the limb. The wine-and-water decoction is the same reasoning carried into the method. 附骨疽 as described in this chapter — deep fixed pain over bone, slow swelling, pus that finally comes away with pieces of bone in it — is osteomyelitis or a subperiosteal abscess. It needs imaging, cultures, prolonged antibiotics and usually surgical debridement; a channel-guided decoction will not reach it. **防己 is a drug name that has covered more than one plant, and material sold as 防己 has repeatedly turned out to be Aristolochia fangchi, which contains aristolochic acid and caused irreversible kidney failure and urothelial cancer in the Belgian slimming-clinic cases. Only authenticated Sinomenium should ever be dispensed under this name.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.