Different Achievement Powder (Children, Pox Diarrhoea)

Thirteen drugs in one packet weighing under 13 g in all, built in four dose tiers. Costus root and tangkuei head it; under them sit the three four-gentlemen drugs — ginseng, white atractylodes, white poria — with tangerine peel and magnolia bark; then a warming block of cinnamon bark, clove and nutmeg; and at the bottom, in the smallest tier, roasted aconite and pinellia. There is no licorice. It is a warming, qi-raising formula for a child the chapter reads as vacuous in both interior and exterior. The sign it grades by is the one that mattered. A warm head with cold feet, and the cold climbing past the knee, is peripheral shutdown: a failing circulation cools a child from the extremities inward, and how high the cold has reached is a crude but genuine measure of how far it has gone. Shivering and teeth-grinding beside it are the chapter's other bad signs, and it is right to treat the combination as near the end. What that child has is dehydration. Smallpox erupted in the mouth and the pharynx before it erupted on the skin, so a child with a confluent pox could barely swallow; a diarrhoea on top of that takes fluid out with no route back in, and this section and 煩渴 two sections later are describing one thing — fluid going out, thirst going up. It was among the leading ways smallpox killed children. What reverses it is oral rehydration solution: salt, sugar and clean water, a few cents a sachet, given by mouth in small frequent amounts. The full statement is written on the 玉露散 leaf of 1.43 吐瀉 and is cross-referenced here rather than repeated. **Nothing in this formula replaces fluid, and nothing in the other three formulas of this section does either.** **Contains aconite — 附子, blast-fried — which is toxic. Aconitine is a cardiotoxin that causes ventricular arrhythmia, and the patient here is a child whose diarrhoea has already deranged his potassium, which is the state in which a heart arrests most readily from it. The pinellia is toxic raw and must be properly processed. The patient is an infant and the leaf gives no dose scaled to age or weight. This must not be prepared.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.