Burdock Seed Decoction for the Dense Pox

Eight drugs and about 11 g in all, which is Dongwon's manner: a long list at tiny weights with the leading drug at double the smallest. Lycium root bark heads it for the deep fever, bupleurum, forsythia and scutellaria clear heat, astragalus and the body of the angelica root hold the qi and blood, burdock seed vents outward and licorice moderates. **以防後患 — to forestall the later trouble — is the phrase that makes this leaf worth attention.** The later trouble in smallpox was real and specific. A dense eruption meant a large area of broken skin, and the broken skin became infected: 痘後癰癤, the abscesses and boils of 1.87.2, were secondary bacterial infection of the pocks, usually staphylococcal or streptococcal, and they were a genuine cause of death in children who had survived the virus itself. Corneal ulceration during the illness left the scarring of 1.87.1, and smallpox was a leading cause of blindness. So a physician who looked at a crowded eruption with the fever still running and decided to act immediately against what was coming rather than against what was in front of him was making a correct risk assessment: **density predicted the complications as well as the death**, and the window in which anything could be done was before they arrived. What would have answered is not in the formula. Secondary infection of the pocks is prevented by keeping the skin clean and the child from scratching, and treated with antibiotics; the fluid lost through a confluent eruption is replaced by mouth. Lycium root bark and scutellaria do neither. The 身表熱, heat still on the surface as the eruption comes out, is the same sign read at seogaksodok-eum-soa — a fever that did not settle with the rash was a bad sign — and the reading is right there too. On smallpox having no treatment at all, see sodok-eum-soa. **The patient is a child with smallpox, and the leaf gives drug weights but no dose scaled to the child's age or weight.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.