Accumulation-Dispersing Pill

Five drugs counted out by the piece. Clove and amomum warm and move, mume flesh astringes, quisqualis is a vermifuge, and the thing that makes the pill work is the croton: three husked croton kernels in a batch that is then divided into hemp-seed pills, of which the child gets three or five. It is a purgative pill dressed as a digestive one. **Contains croton seed (巴豆), which is a violent purgative and a vesicant, in a formula given to an infant, and the text gives no dose by weight here — the croton is counted out as three kernels and the pills are counted out as three or five, with no reference to the child's size. This must not be prepared.** Croton resin blisters skin on contact and strips the gut; the fluid and electrolyte loss it causes is dangerous in an adult and can be fatal in a baby, who has very little reserve and whose kidneys clear poorly. A batch of hand-rolled pills also cannot be made uniform, so the kernel is not evenly divided between them. **A purgative given into an obstruction is dangerous.** The indication here — 腹脹氣急, the belly distended and the breath hurried — is exactly the presentation that an obstruction, an intussusception or a perforating appendicitis can take in a small child, and purging such a bowel raises the pressure in a loop that is already failing and can perforate it. Green bilious vomiting, blood in the stool and a rigid tender abdomen are the findings that must stop this formula. For the plain overfed or constipated child the section mostly means, the answer is smaller feeds, fluid, and time. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.