Quisqualis Pill

Quisqualis fruit, a full nyang of it, roasted in a flour jacket and shelled, with magnolia bark and chebula peel to hold the bowel, licorice and tangerine peel to make it tolerable. It is the plainest formula in the section and the one with the clearest claim to work. The dosing is also the most careful: one pill in rice water, half a pill in breast milk for a child under three, which is the only place in these twelve leaves where the age of the patient changes the dose. The worm drugs in this section are the part of it that works. 使君子 (Quisqualis indica fruit), 苦練根 (Melia root bark) and 蕪荑 (elm fruit paste) are genuine anthelmintics, and 使君子 is still in use: its active quisqualic acid paralyses Ascaris, which is exactly the 蛔虫 the chapter names. 蛔疳 is ascariasis, and 下蟲丸 — bring-down-the-worms pill — says so in its name. A child with a heavy Ascaris burden really is malnourished by it, and clearing the worms really does help. The modern version is one 400 mg dose of albendazole, or 500 mg of mebendazole, given once; it costs a few cents, works better, and is measured. **An effective drug with no stated dose is still a hazard, and the text gives no dose by weight anywhere: enough 使君子 causes hiccup, vomiting and diarrhoea, which is the last thing a child already losing fluid to 疳瀉 can afford.** The point made in full on 胡黃連丸 (`hohwangryeon-hwan`) is the other half of the reading. Clearing a worm burden helps a malnourished child, sometimes dramatically — which is why Qian Yi's cases turn on these pills — but it does not feed the child, and a child who is wasted from want of food is not cured by deworming. The dose is a pill of unstated weight dissolved in milk. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.