Harmonize the Centre Powder

Qian Yi's version is the Four Gentlemen — ginseng, atractylodes, poria, roasted licorice — with astragalus and hyacinth bean added for the depletion and pueraria root and agastache for the thirst and the nausea. The whole packet weighs about 8 g and is decocted with five slices of ginger and two jujubes, which makes the dose a small cup of warm, faintly sweet decoction. The Jeongjeon's four-drug version set beside it is a different thing altogether, a warming prescription for abdominal pain with diarrhoea built on magnolia bark and dried ginger. Of the ten formulas in this section this is the one whose practical effect is most defensible, and for a reason the text does not claim: it is a warm drink, given in small volume, to a child who is losing fluid. That is the right direction. Pueraria root was chosen for thirst, and thirst in this illness means dehydration. But the decoction carries no sodium and no glucose in the proportion that drives absorption, so it rehydrates only as plain water does, and plain water alone in a purging child can drop the serum sodium. **Oral rehydration solution does the same job properly, for a few cents**; the full statement is on 玉露散, the first leaf of this section. The indication is worth reading closely. 昏睡露睛 — the child sleeps with the eyes half open, the white showing — is what the section uses to separate stomach vacuity heat from stomach repletion heat, and clinically it describes a drowsy, sunken-eyed infant who no longer closes the lids fully. That is a sign of advanced dehydration, and it means the child is past the point where a decoction will do. Nothing in this formula is toxic, which is unusual in this section; the failure is one of insufficiency, not of poison. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.