Middle Grade Pellet

An escharotic pellet: three parts alum to one part arsenic, bound with resins and flour paste and pushed into the sore to destroy what is growing out of it. 中品 is the middle grade of a set — 上品錠子 of the same source, for fistulous piles, is built the same way but with a quarter of the arsenic and red alum in place of white. 飜花瘡 at 2.16 is described as flesh everted from the sore 突如菌, standing out like a mushroom, or taking a snake's shape several inches long. Some of what the section describes is exuberant granulation tissue, but a fungating lesion on the skin that keeps growing back is more often a squamous cell carcinoma or a basal cell carcinoma, and the section's own warning — 若誤用鍼刀蝕灸必危愼之, that needle, knife, corrosives and moxa used wrongly bring the patient into danger — reads as hard-won experience of that. Arsenical pastes were in fact used against skin cancer into the twentieth century and did destroy tumours; they were abandoned because the destruction cannot be controlled and the arsenic is absorbed. **Contains arsenic trioxide in quantity and cinnabar, and must not be prepared.** Sixty grams of arsenic in a batch, pushed in repeated doses into an open lesion, is a lethal quantity by any route; this is three times the arsenic of the 上品錠子 pellet. **Contains ox bezoar and sal ammoniac besides.** A fungating skin lesion needs biopsy and excision, and is very often curable when it gets them. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.