Wax and Alum Paper

A medicated dressing rather than a salve, and the most ingenious thing in the chapter. Twelve sheets of cotton paper are cut to the shape of the ulcer and pinned into a pad; sesame oil is cooked with Sichuan pepper and pagoda-tree twig, the dregs thrown away, and beeswax, calcined alum and calomel melted into it; the pad is soaked through with the hot medicated wax and lifted out before it scorches. It is bound on, and every day one sheet — the one against the sore — is peeled away. When the last sheet comes off, the ulcer is said to be healed. Peeling one layer a day is a clean, graded dressing change: the sore is never left open, the pad is never disturbed down to the base, and the paper count gives the course a fixed length of about a fortnight. A paraffin-gauze dressing works on the same principle and is still in use. Beeswax and oil keep the surface moist, alum astringes the weeping edge, and the twigs and pepper contribute whatever the oil has taken from them. 內膁瘡, the inner shin ulcer, is the medial gaiter-area ulcer, which is where venous ulcers overwhelmingly sit — the chapter has sorted its leg ulcers by the anatomy that actually matters. **The dressing contains calomel, a mercury salt, which is absorbed through ulcerated skin and accumulates over the weeks and months a leg ulcer takes; omit it, and the wax-and-alum paper is left, which is the useful part.** The chapter's own 須翹足端坐, 勿多行履 — sit with the leg raised and do not walk about — remains the treatment, with the dressing in support. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.