Gentian Decoction for Infants

大黃 at twice the weight of anything else, roasted in ashes to soften it, with gentian, scutellaria and bupleurum against liver and gallbladder heat, red peony and red poria, platycodon to lift, uncaria bark against convulsion, and a dung beetle. It is a purge dressed as a gentian decoction: the endpoint the leaf names is 得下利卽止, stop as soon as the stool loosens. 鬾病 is the older child who sickens when the mother conceives again — yellow and wasted, the bones standing out, hair falling, fever, slight diarrhoea. The text explains it as a malevolent spirit in the womb begrudging the first child, and the Cheongeumbang is quoted for it. The honest reading is plainer and sadder: an infant abruptly cut off from the breast, or fed milk from a newly pregnant mother, loses the one reliable source of protein and fat it had, and what follows is marasmus with the diarrhoea and low fever that go with it. The treatment is food, not a purge. **This is a cathartic given to an infant, at a dose set by age rather than by weight, and the stopping point the text gives is diarrhoea. In a child already passing loose stool and already wasting, induced purging means fluid and electrolyte loss that an infant cannot tolerate — the reason diarrhoea is still a leading cause of death in small children. The dung beetle is insect material taken internally and carries an infection risk of its own. This must not be prepared or given.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.