Sage-Like Beverage for the Sore Throat of the Pox

Four drugs and three bamboo leaves: ophiopogon and platycodon at 1 don, burdock seed and licorice at 5 pun. A small, mild, moistening decoction with the tradition's throat drug at its head, and there is nothing in it that could hurt a child. **This leaf sits over the thing that actually killed.** Smallpox erupted on the mucosa of the mouth, the tongue, the pharynx and the larynx before it erupted on the skin — the enanthem came first — and those lesions ulcerated early and shed virus, which is why the disease spread by droplet and why the first days were the most infectious. For the child it meant that swallowing hurt beyond bearing. **The child could not eat or drink, and that was the main road to fatal dehydration.** The section's own language is exact about it: 飮食如鋸挫喉 — food and drink like a saw rasping the throat — and 水漿不入, not even thin gruel will go down. Put that beside a high fever, a skin surface losing fluid through hundreds or thousands of broken lesions, and often diarrhoea as well, and the arithmetic is short. A small child has little fluid reserve and loses it fast. The intervention that would have changed this is fluid, and the full statement on oral rehydration solution is written on the 玉露散 leaf of 1.43 吐瀉 at 037b; it is cross-referenced here rather than repeated. What is specific to this leaf is the route. A child who cannot swallow for pain cannot be rehydrated by being told to drink. The modern answer to 水漿不入 is analgesia first, and then fluid by a route that bypasses the mouth — a nasogastric tube, or an intravenous line — and that, rather than any decoction, is what stood between this child and death. Measured against that, the formula is honest work in the right direction and nowhere near enough. Ophiopogon and bamboo leaf moisten, platycodon is reached for every sore throat in this tradition, burdock seed and licorice are the standard pair for a raw pharynx, and licorice is at least sweet. A cool, sweet, moist decoction sipped slowly is fluid, and it goes down more easily than food does. That is the whole of what it offered; it did not touch the lesions. The section is clear-eyed about where this ended — 咽喉有毒 … 或常乾嘔者危, and the child who retches constantly is in danger. **The patient is a child, and the leaf gives drug weights but no dose scaled to the child's age or weight — the same packet for an infant as for an older child.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.