Fresh Rehmannia Decoction (Children)

This is 四物湯 with the warm 熟地黃 and 白芍藥 swapped for the cooling 生地黃 and 赤芍藥, and 瓜蔞根 added for thirst — a blood-cooling version of the standard blood tonic. What makes it worth reading is the route: it is given to the nurse, and the child gets it in the milk, with only a little given directly. Drugs do pass into breast milk, so the idea is not absurd, but transfer is low and highly variable — for most drugs the relative infant dose is a few per cent of the mother's and often a fraction of a per cent. A single packet of a mild decoction reaching a newborn through one feed delivers close to nothing. That is also what makes the route safe here, and dangerous elsewhere in this chapter where a mineral or a venom is passed the same way. The fuller treatment of the method is on `yangyu-bang` and `yangyu-bang-heoyeol`. 胎熱 is a diagnosis the biomedical record does not have. A newborn who is febrile is a different problem from an older child who is febrile: fever in the first month is treated as possible sepsis, meningitis or herpes until proven otherwise, and it is investigated and treated in hospital rather than at the breast. **The text gives no dose by weight anywhere, and the patient is a newborn.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.