Rhaponticum Beverage

A close relative of Cheongeum-nuro-tang, built on the same plan: rhubarb and crude mirabilite to drain, rhaponticum as the chapter's standing drug for a deep toxic swelling, scutellaria and red peony to cool the heat and the blood, and then ephedra and cimicifuga to push outward so that the draining does not pull the toxin deeper. Bitter orange breaks the stagnation and ampelopsis root is the surgical tradition's cooling drug for sores. 附骨疽 is the chapter's name for a suppuration that sits on the bone: pain deep in the limb like an awl going in, with nothing to see on the surface — 外則全無赤腫突起 — brought on by sleeping exposed to cold wind or bathing in cold water, the cold smouldering until it turns to heat and then to pus. That is acute osteomyelitis, and the section's own account of its end stage, bone rotting and fragments coming away before the patient heals, is sequestrum. 初起, at the first rising, is where this formula belongs, and once pus had formed the chapter turned to the hot needle. **Deep unexplained bone pain with fever is osteomyelitis until proved otherwise; it needs imaging, blood cultures and prolonged antibiotics, and often surgery. It is not treatable by decoction. Contains rhubarb, crude mirabilite and ephedra, which is a stimulant and is restricted in many countries.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.