Three Yellows Powder (Sores Formula)

The last of the five, for 膿疥 — pustular scabies, 含漿稠膿, 色厚焮痛, holding thick pus, deep in colour and painfully inflamed. The three yellows of the name are scutellaria, coptis and rhubarb, the standard heat-clearing trio, and the leaf states its own logic: 治熱爲主, treat the heat first. Of the five 疥 formulas this is the only one organized around a herbal principle rather than around a mineral. The reading is good. A scabies eruption that has gone from papules and burrows to thick pustules has been secondarily infected, usually with Staphylococcus aureus or group A Streptococcus, and the right first move is to treat the infection rather than only the mite. Coptis and scutellaria do have in vitro antibacterial activity, and berberine from coptis is used topically for that reason. **Contains red lead, a lead oxide, and calomel, which is mercurous chloride, spread in oil over broken and weeping skin. Both are absorbed from such a surface and are cumulatively poisonous; the chapter itself records mercury poisoning as a complication of its own treatments. This must not be prepared.** Impetiginized scabies needs the infection treated with antibiotics and the mite treated with permethrin or ivermectin, and the sequelae are the reason to take it seriously: post-streptococcal glomerulonephritis and acute rheumatic fever both follow outbreaks of infected scabies. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.