Aconite and Scorpion Powder

Four Gentlemen Decoction with aconite, scorpion and arisaema at a don each. 純陰證 — the pure yin pattern — is the chapter's name for the child who has gone fully cold: no fever, pale, limp, the stool still pouring out. The system reads that as yang having been extinguished and answers with the hottest drug it has. Read at the bedside, the pure yin pattern is decompensated hypovolaemic shock. The child is cold because he is not perfusing, not because heat has left him, and the one treatment is volume; see the note on `baekchul-san-soa`. The 吐瀉不止 that defines the pattern is the cause, and the chapter's own counsel elsewhere in this section — 如泄瀉不止, 且先治瀉, first stop the diarrhoea and only then treat the wind — is the better instinct. **Contains aconite (川烏), a don of it, together with scorpion and arisaema, given to a child in shock. Aconitine's margin between an effect and a fatal ventricular arrhythmia is essentially nil, the lethal and therapeutic doses overlap, and no way of measuring the dose existed; a child who is hypovolaemic and losing potassium in his stool is already arrhythmia-prone. Scorpion is a neurotoxic animal venom and arisaema a toxic acrid tuber. The text gives no dose by weight for the patient anywhere. This must not be prepared or given.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.