Mud and Gold Paste for the Cinnabar Toxin

The third of the section's three topicals and the plainest: two parts earthworm castings to one of saltpetre, stirred thick with water just drawn from the well and spread on the place. The name says what it is — a mud paste with a hard bright salt in it. What it does to inflamed skin is what any cool wet mud does: it holds water against the surface, the water evaporates, and the heat and the throbbing go down while it stays wet. Beyond that, nothing. There is no antibacterial action here, and a felon or a spreading cellulitis under it goes on spreading. A hot whitlow that is pointing needs incision and drainage and an antibiotic; a wandering red swelling in a child needs a systemic antibiotic the same day, for the reasons set out at 拔毒散. **The body of this paste is earthworm castings — soil mixed with worm faeces — spread thickly on the inflamed and often broken skin of a child, and the text gives no dose by weight here beyond 2 pun to 1 pun of a mixture whose applied quantity is unstated. This must not be prepared.** Soil on a wound is a route of infection, and the specific organism to name is Clostridium tetani, which lives in soil and in the gut of animals and produces tetanus; a neonate or an unimmunised child is exactly the patient at risk, and the chapter records neonatal tetanus elsewhere under its own signs. The saltpetre carries the second hazard: nitrate absorbed across damaged skin becomes nitrite, which oxidises an infant's haemoglobin to methaemoglobin, and infants are the group that injures — the full statement is on 氷黃散. Earthworm castings belong with the soot and hearth-earth materials this chapter reaches for so often; applied to broken skin they are a contamination, not a dressing. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.