Jade Toad Powder

**Contains dried toad, whose skin carries bufadienolides, cardiac glycosides. The patient is a child, the text gives no dose by weight anywhere, and this must not be prepared.** The full statement is on 月蟾丸 in this same section. Two things soften it here and neither removes it: the toad is burnt to ash, which destroys most of the glycosides, and the powder is applied to the skin rather than swallowed. But the sores it is smeared into are open, a child's skin absorbs far more readily than an adult's, and the 疳瘡 the leaf is written for include the mouth, from which anything applied is swallowed. **Musk is from a CITES Appendix I species** — see 銅靑散 in this section. Washing the sores with a liquorice decoction before dressing them is the sound part, for the same reason as the debridement on 尿白散 in this section: warm water and cleaning do real work on an infected ulcer, whatever is dissolved in them. Coptis contributes berberine, which has genuine antibacterial activity on a surface. Against that, the sores of a child in this condition are the surface sign of starvation and sepsis, and no dressing closes them while the child is still starving. On that point see 立效散 in this same section. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.