Warm the Channels Pill

The one warming formula among the 疳瘻 prescriptions, and the section puts it first in order of urgency: 治法溫散風冷爲急, warming and dispersing wind and cold is the urgent thing. Two nyang of aconite processed seven times over, with cinnamon, dried ginger, magnolia bark, atractylodes, costus and roasted licorice behind it — a plain interior-warming formula, closer to 理中 territory than to anything topical, aimed at a tract rather than at a gut. The indication is a quotation. 內經曰陷脉爲瘻留連肉腠者是也 — the sunken vessel becomes a fistula, lingering in the flesh and the interstices — and the section pairs it with aconite and garlic-cake moxibustion. 陷脉 names what an old sinus looks like: a tract pulled in below the skin, its edges undermined, cold to the touch and without the heat of an active abscess. That is a real clinical appearance, and the reading of it as cold rather than heat is why this formula is warm throughout. **Contains aconite, two nyang of it, which is toxic; the vinegar steeping and sevenfold roasting are a genuine detoxification step for aconitine but do not make the drug safe, and fatal poisonings from inadequately processed aconite are still reported. This must not be prepared.** An indolent cold sinus in a limb usually means poor perfusion, a retained foreign body or dead bone, or an underlying mycobacterial or fungal infection, and the first thing it needs is imaging and a tissue diagnosis. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.