Dragon Bone Salve

Fossil bone, the two resins, litharge, cuttlefish bone and five burnt gleditsia seeds, ground, mixed to a paste with sesame oil and sandwiched between two sheets of needle-pricked cotton paper, which is then bound over the ulcer and turned every second day. The construction is the interesting part: the pricked paper is a perforated dressing, holding the medicine against the ulcer while letting exudate through, and turning it every other day is a dressing interval. 膁瘡 is a venous leg ulcer. The chapter describes it exactly — on both lower legs, swollen, sloughing, foul-smelling, walking painful, worse over the shin bone where the flesh is thin and the skin bare, and therefore slow to heal. Fossil bone, cuttlefish bone and the resins are absorbent and astringent, and as a clean occlusive dressing changed on a schedule this would have helped, because a clean covered ulcer heals and an uncovered one does not. The chapter's own management advice at the head of the section is better than any of its plasters, and it is still current: 須翹足端坐, 勿多行履 — sit upright with the leg raised, and do not walk about much. Elevation and avoiding dependency are the treatment for a venous ulcer; compression, which the chapter approaches with its tight binding, is the other half. **Contains litharge, a lead oxide absorbed through an open ulcer and cumulatively nephrotoxic and neurotoxic; a chronic leg ulcer is precisely the long-term exposure that matters. Omit it.** A non-healing leg ulcer needs assessment of the arterial supply before compression, and a long-standing one needs biopsy. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.