Pine Pollen Elixir for the Tortoise Back

Four drugs at a nyang — pine pollen, bitter orange, siler and pubescent angelica — against four at half that, ephedra, rhubarb, hogfennel and cinnamon heart, honey-bound into millet-sized pills and given ten at a time in gruel. The build follows the section's reasoning exactly: 風入於脊骨, wind got into the spinal bone because the newborn's back was left unguarded or the child was sat up too early, so the formula is a surface-opening wind-dispeller with a purgative set into it. The section adds a second measure beside the pills, dripping tortoise urine along the spinous processes, and claims the back flattens at once. What the section is describing is rickets. The humped back and the pigeon chest of 1.53, the skull that will not close in 1.49 解顱, and the hair and teeth that do not come in 1.52 髮不生齒不生 are one disease — nutritional vitamin D deficiency — and the chapter, having no concept of a nutrient, records the findings in three separate places and never joins them. The full statement, with what the deficiency does to bone and how little it costs to prevent, is written on the 解顱 leaves of 1.49 and is not repeated here. The one thing rickets does not explain is the shape of the hump, and this section is the back. A rachitic spine gives a smooth, long kyphosis that softens when the child is lifted and straightens as the bone mineralises. A **sharp angular hump over one or two vertebrae — a gibbus — is spinal tuberculosis, Pott's disease**: the tubercle bacillus destroys the vertebral bodies, the column collapses forward at a point, and the deformity is fixed. It comes with night pain, fever, weight loss and a long history, and its danger is not cosmetic — the collapsing bone and the abscess beside it can compress the spinal cord and leave the child paraplegic. It is curable, with a long course of antituberculous drugs and sometimes surgery, and a child with an angular hump needs imaging and a tuberculosis workup rather than a wind formula. **Contains ephedra and rhubarb, given by mouth to a small child, and the text gives no dose by weight here — ten pills the size of a millet grain, whatever those weigh. This must not be prepared.** Ephedra is ephedrine: a cardiac and central nervous stimulant with a narrow margin, and an infant's is not a body in which to find that margin. Rhubarb is a stimulant laxative, and a small child who purges loses fluid faster than the loss can be noticed. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.