Diffuse the Heat Elixir

Seven drugs at a nyang each, which is as flat a formula as this chapter produces, and the point of it is in the first clause: 自小便出, the toxin comes out by way of the urine. That is the 直指 doctrine the section sets out at length — 瘰癧之毒莫不有根, scrofula's toxin always has a root, and the root is driven out through the bladder, where it may be seen 或如粉片或如塊血或如爛肉, like flakes of powder, clots of blood, or rotted flesh. Mint, schizonepeta and vitex fruit are the wind drugs; forsythia and gleditsia pod the toxin-resolving pair; sparganium and polygonum multiflorum work on the node itself; and the fermented-soybean-and-vinegar paste that binds the pills is itself a dispersing agent in this tradition. The chapter places it at a specific point in the sequence: after the blister-beetle formulas, which it calls 性甚峻, extremely drastic, it says 服後量體調治, treat according to the patient's constitution afterwards, 實者宣熱丹虛者托裏益氣湯 — this for the repletion patient and Takriikgi-tang for the depleted. So it is the follow-on, milder formula, which is why it is one of the few leaves in this section with nothing hazardous in it. 瘰癧 is tuberculous lymphadenitis. The flakes and clots seen in the urine after the blister-beetle formulas are not the disease's root coming away but cantharidin-induced haemorrhagic cystitis and sloughed bladder epithelium, which is the plainest illustration in this chapter of a drug injury read as a cure. This formula itself is harmless and ineffective; the disease needs antituberculous therapy. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.