Urine Sediment Powder

**人中白 is the dried sediment scraped from the bottom of a vessel of stale human urine — a human excretion, calcined and then laid on an open wound. The patient is a child, the text gives no dose by weight anywhere, and this must not be prepared.** The material is chiefly crystallised urea salts, calcium and magnesium phosphates and sodium chloride, with whatever bacterial residue the standing urine left behind. Calcining at red heat will have sterilised it, which is the one point in its favour, but it is still an excretion being applied to a perforating facial wound, and nothing in it has any action on the anaerobic infection destroying the cheek. 白礬 is caustic on raw mucosa, as noted on 立效散 in this section. The debridement is the part of this leaf worth taking seriously. The text says to brush the dead tissue off with a strong decoction, wash the bleeding surface clean, and only then apply the powder — and it says to do that two or three times a day. Removing slough and keeping a gangrenous wound clean is exactly what is done now, and the Bogam arrived at it by observation. Chive root and mugwort decoctions have no antiseptic power worth the name, but hot water, mechanical cleaning and repetition do real work. This is the leaf that describes advanced noma plainly — spread through the whole mouth, teeth gone, lip perforated. That child is septic and starving, and the treatment that changes the outcome is antibiotics covering oral anaerobes, fluid and nutritional rehabilitation, and later reconstructive surgery. On the disease and on the fact that none of these formulas is food, see 立效散 in this same section. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.