Supplement Within and Issue Without Elixir

The name states the design — one part supplementing within, one part issuing without — and the drug list delivers it on two axes. Red poria at the head with pinellia and tangerine peel is Ijin-tang turning the phlegm inward; kudzu root with black atractylodes releases the exterior and raises sweat; bupleurum and scutellaria hold and cool the half-exterior between the two. Dichroa is present at 3 don, a fifth of what the poria gets, enough to touch the paroxysm without being the formula's engine. The indication is precise: enduring malaria in a patient whose internal damage has been overlaid by a fresh external contraction, so the attacks come at intervals rather than on a clock. Treating only the phlegm leaves the exterior unresolved and treating only the exterior empties the patient, which is why the Immun insists on doing both in one small daily pill rather than in a decoction timed to the attack. **Contains dichroa (常山), which is a powerful emetic and is hepatotoxic, and pinellia (半夏), which is toxic raw. This must not be prepared.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.