Ten Complete Elixir

**Contains aloe resin, a stimulant laxative, and flying-squirrel droppings, an animal excretion given by mouth. The patient is a child, the text gives no dose by weight anywhere, and this must not be prepared.** 蘆薈 is the dried resin of aloe leaf, whose anthraquinone glycosides are converted in the colon into an irritant that drives peristalsis. This is the statement for the section and 布袋丸 and 化䘌丸 refer back to it: a child who is wasted, whose belly is distended and who in this syndrome is already losing fluid to 疳瀉 is the worst possible recipient of a purgative. Stimulant laxatives in a dehydrated infant produce further water and potassium loss, and hypokalaemia in a starved child is one of the ways refeeding and diarrhoea kill. 蘆薈 appears in three of the twelve leaves in this batch, which is a measure of how routinely the section purges children it should be feeding. **五靈脂 is the dried droppings of the flying squirrel, and 夜明砂, in 布袋丸 and 木香元 in this same section, is bat guano.** Both are animal faeces being powdered and swallowed. Drying does not sterilise them; bat guano in particular carries fungal spores, and faecal material by mouth is a route for enteric pathogens in a child whose gut barrier and immune function are already failing from malnutrition. Say the same of the dung maggots in 月蟾丸. **Contains toad ash, which carries cardiac glycosides** — the full statement is on 月蟾丸 in this section. **Quisqualis is a genuine anthelmintic** — see 布袋丸, where it is given at the larger dose and where the point is made. 丁奚 and 哺露 are the Bogam's two names for a child wasted to the bone: 丁奚 is the stick-thin limbs, protruding ribs and swollen belly with a neck too thin to hold the head, 哺露 the child who vomits what it is fed and wastes anyway. Together with 無辜壞證, the ruined late stage, they describe marasmus with feed intolerance, and that is a condition with a modern protocol — cautious rehydration, treatment of the hidden infection, then therapeutic feeding built up slowly because fast refeeding kills by shifting phosphate and potassium. This formula does the opposite of all of it. It moves Qi, breaks accumulation and purges, and the one thing it does that would help — expelling the roundworms that commonly accompany this picture — is also the one thing it cannot dose. On the general point that none of these formulas is food, see 立效散 in this same section. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.