Sulphur Cake

The fourth of the five, and the one that would have worked. 虫疥 is the kind the chapter defines by contagion — 痒不知痛, 易於傳染, itching rather than painful and easily passed on — which is scabies proper, and this formula is sulphur and almost nothing else. The method is an elaborate way of preparing it: alum-treated sulphur worked into a cake with water, stuck inside an inverted porcelain bowl, and dried in the smoke of burning mugwort floss and Sichuan pepper, then ground and rubbed in with sesame oil after the part has been washed. **Sulphur is the one drug in this chapter with a straightforward modern endorsement. It is a true scabicide: precipitated sulphur at 5 to 10 per cent in an ointment base, applied for three consecutive nights, remains a standard treatment and is the agent of choice in infants under two months and in pregnancy, where permethrin and ivermectin are avoided.** Sulphur in sesame oil rubbed over washed skin is, in substance, that ointment. The 丹心 even states the matching rule a few lines earlier: 喜溫熱加硫黃, add sulphur for those who want heat on the part. The smoking step does nothing a modern pharmacist would recognize, and crude sulphur is a skin irritant at the strengths implied here, which is part of why precipitated sulphur replaced it. But the drug, the vehicle, the washing beforehand and the indication are all correct, which cannot be said of anything else in the section. Scabies still needs all household contacts treated at once and bedding laundered hot, or it returns. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.