Corroding Powder

An escharotic paste, and the leaf is blunt about what it is for. 消蝕 means to corrode away, and the three things to be corroded are listed without euphemism: dead flesh, the creeping worms of a sore that has been left long enough to be infested or undermined, and rotten bone. Calcined alum at a full 兩 is the bulk of it, with calcined green vitriol and realgar; frankincense, rouge and 遠志 are small additions. It is to be used only after the wound has been washed, which is this chapter's standing order and the reason the washing section precedes this one. 杇骨 in a long-open sore is osteomyelitis, and the recognition that a wound lying over dead bone will not heal until the bone is gone is correct and is still the governing principle in that disease. What has changed is the method: dead bone is resected surgically and the infection treated with prolonged systemic antibiotics, because no topical agent reaches it. **Contains realgar, an arsenic sulphide, together with calcined alum and calcined green vitriol, which are caustic. This must not be prepared.** Arsenic is absorbed through an open wound, and a paste designed to dissolve tissue cannot be confined to the tissue one wishes dissolved — the caustic spreads into the viable margin and enlarges the wound it was meant to clean. Debridement of dead flesh and resection of dead bone are surgical procedures. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.