Support the Interior and Warm the Centre Decoction

The most alarming indication in the section and the most forceful formula answering it. Blast- fried aconite at two don with dried ginger behind it is the standard rescue of a collapsed yang, and around that core sit six aromatics at five fun each — alpinia, clove, agarwood, costus root, fennel and tangerine peel — which are there to hold the centre and stop the hiccough. 羌活 is the odd one, and it is in the name's first two characters: 托裏, the chapter's principle of pressing outward, so that the medicine is not merely warming inward but lifting what has fallen. 陽氣下陷 with 腹痛泄瀉 and 咳逆昏憒 — abdominal pain, diarrhoea, hiccough and clouded consciousness in a patient with an abscess — is a recognisable picture, and the 泄瀉 leaf above says 急用, use it urgently, which is unusual language for the Bogam. What is being described is septic shock: hypotension, gut hypoperfusion, failing mentation. The chapter's reading of it as the yang falling away is not a bad metaphor for circulatory collapse, and the instinct to treat it as an emergency is right. The treatment is not. A patient in this state needs fluids, vasopressors and source control within the hour, and an aconite decoction given instead would be fatal twice over. **Contains aconite accessory root, which is toxic. This must not be prepared.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.