Picrorhiza Pill

Two bitter cold rhizomes, picrorhiza and coptis, with cinnabar; sealed in a pig's gallbladder and steamed, then reground with aloe, indigo, toad ash and musk. The construction is entirely cooling and draining, which is what 熱疳 asks for in the chapter's logic: a child with a red face, scorched lips, heat like fire and a bound stool. The honest thing to say about this whole run of 疳瘡 leaves, and it is said here once for all twelve: **none of these formulas is food.** 疳 is childhood malnutrition — the protein-energy malnutrition complex of a young child, marasmus at the wasting pole and kwashiorkor at the oedematous one that the chapter calls 疳腫 — and a malnourished child needs calories and protein. What this section gives is bitters, minerals and worm drugs. The child described here, with the sores over the body, the fever, the sunken face and the running stool, recovers on milk, eggs, oil and a therapeutic feeding formula, and on treatment of the infections that malnutrition lets in. Nothing in a bitter cold pill supplies an energy or a protein deficit, and bitter cold drugs suppress what appetite the child has left. Where this block does reach for food — the pig's stomach of 猪肚黃連丸, the animal liver of the 疳眼 formulas — it is reaching in the right direction; these pills are not. **Contains cinnabar — 朱砂, mercuric sulfide, 2 don 5 fun of it — in a pill for a malnourished child, and the text gives no dose by weight anywhere. This must not be prepared.** The full mercury statement is written out on 辰砂膏 (`jinsa-go-soa`) and stands here unchanged. **Contains 胡黃連, Picrorhiza kurroa, in unmeasured quantity in a formula for a small child.** It is the bitterest of the cooling rhizomes and the one of these drugs with a real modern literature, in liver disease; its iridoid glycosides are hepatically active, which is the reason to be careful with it rather than a reason for confidence. The text gives no dose by weight anywhere. It also contains aloe, for which see 蘆薈丸 (`nohoe-hwan`); toad ash, for which see 如聖丸 (`yeoseong-hwan`); and musk — **Contains musk — 麝香 — from a CITES Appendix I deer.** It cannot legally be traded, and the demand this tradition created is a direct cause of the musk deer's decline. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.