Divine Swiftness Salve

An oil-and-wax plaster with pine resin cooked in until a drop beads on cold water, then eight powders stirred into the cooled base: the two resins, dragon's blood, catechu, calcined alum, calcined dragon bone, Sichuan pepper and calomel. Catechu and alum are the astringent pair, dragon bone and dragon's blood the absorbent and haemostatic pair, and the pepper the irritant that was expected to bring blood to a dead-looking ulcer edge. The dressing regimen is unusually detailed and unusually sensible. Oiled paper is pricked with a needle so that exudate can pass, the medicine is spread on that rather than on the ulcer, and the change interval steps down from three times in two days to once daily as the discharge settles. The standing instruction 每換藥必洗淨貼上 — the part must be washed clean at every change — is the single best line in the 膁瘡 section, because a chronic ulcer fails for want of exactly that discipline. **Contains calomel, a mercury salt, three don of it in the batch, applied daily to an open ulcer over months; mercury is absorbed through ulcerated skin and accumulates, and the chapter itself records the result at 2.2 as a complication of its own mercury treatments. Omit it; the rest is an oil-wax-resin occlusive with astringents, which is a defensible dressing.** And the dressing is still only support. The chapter's management advice at the head of the section is the treatment and it has not been superseded: 須翹足端坐, 勿多行履 — sit upright with the leg raised, and do not walk about much. For a venous ulcer that means elevation and compression, after the arterial supply has been checked. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.