Costus and Tangerine Peel Cake

Seven aromatics and two digestive ferments, all of them food or close to it: costus root, the two tangerine peels and magnolia bark to move the stomach, medicated leaven and malt sprout for the milk held to be standing undigested, amomum to warm. Bound with honey into cakes the size of a euryale seed and sent down in a perilla decoction or rice water. There is nothing poisonous in it, which makes it one of the two or three leaves in this section that could be prepared without doing harm, and the rice-water vehicle is in the right direction — rice water is the folk ancestor of oral rehydration and rice-based ORS is still used. **Honey must not be given to a child under twelve months of age.** It can carry Clostridium botulinum spores, which germinate in the immature infant gut and cause infant botulism — descending paralysis, poor feeding and respiratory failure. This leaf, 助胃膏 later in the same section, and 牛黃奪命散 in 1.45 are all bound or taken with honey, and all three name the newborn or the small child as the patient. Everything else in this formula is food; the binder is the hazard. What it cannot do is treat the illness. Vomiting and diarrhoea in an infant is acute gastroenteritis and the intervention that saves life is oral rehydration solution; the full statement is on 玉露散, the first leaf of this section. One point in the indication deserves taking literally rather than as pattern language: 大便色白, white stool, in an infant is not stopped milk. Persistently pale or clay-coloured stool in a baby is a sign of obstructed bile flow — biliary atresia above all — and it is time-critical, because the surgery that can save the liver works best in the first two months of life. A baby with pale stools needs investigation the same week. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.