Coptis and Bile Pill

Five drugs and two biles. Coptis at 5 don steeped in pig bile is the whole of the bitter cold; trichosanthes root, smoked plum flesh, lotus seed flesh and apricot kernel are the moistening and astringing half, and the pills are bound on a cake soaked in ox bile and swallowed in a sweet-sour decoction of mume, ginger and honey. The design is coherent for what it names: 五乾疳 is dryness, and smoked plum and trichosanthes root are the corpus's standard pair for thirst. What the five drynesses describe is dehydration. A child with a dry tongue, a dry mouth, no tears when it cries and scant urine is a child who is volume-depleted, and in this chapter the cause is the chronic diarrhoea of 疳瀉 on top of malnutrition. The treatment for that is fluid — oral rehydration solution, which is salt, sugar and water, costs almost nothing and is the single intervention that has saved the most children's lives in the last fifty years. Fifteen bitter pills in a sweetened decoction will deliver a little water and a little sugar and no salt, which is the honest measure of this formula. On 疳 as malnutrition and why a bitter is not a treatment for it, see 五疳保童元. **The patient is a small child and the text gives no dose by weight anywhere** — fifteen pills, with no size of child attached. There is nothing acutely toxic in these six drugs, which makes this one of the safer formulas in the group; the hazard here is the one of omission, a dehydrated infant given bitters instead of fluid and salt. The two biles are raw animal gall, with the contamination risk that implies. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.