Inward Dispersing Cimicifuga Decoction

The second step of the 附骨疽 sequence, and the chapter is explicit about the order: 初起 the patient is drained with Nuro-eumja or Ohyang-yeongyo-tang, and then 次用內消升麻湯, this is used next. Six drugs at an even 1 don 5 fun with licorice beneath them — rhubarb still draining but with the volume of the purge gone, cimicifuga lifting and venting, Korean angelica and red peony moving and cooling the blood, scutellaria holding the heat down, bitter orange keeping things moving. 內消 names the aim: to disperse the gathering from within, so that it never comes to pus. That aim is also the limit of the formula. Dispersing a deep bone infection from within was the best the tradition could offer between the first purge and the hot needle, and the section's own account of what happens when it fails — 腐潰, 碎骨出盡方愈, rotting through and healing only once every fragment of dead bone has come away — is what untreated osteomyelitis does. **Deep bone pain with fever needs imaging, cultures and prolonged antibiotics, and frequently surgical debridement. Contains rhubarb and must not be used in pregnancy.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.