Medicating the Milk Method (Fetal Heat)

Three of the five drugs of 五苓散 — 澤瀉, 猪苓, 赤茯苓 — with 茵蔯 added, which makes it essentially 茵蔯五苓散 without the 白朮 and 桂枝, and then 生地黃 and 天花粉 for the heat and the thirst. It is a diuretic, and the reasoning is the same one behind 天乙丸 in this section: heat is to be sent out through the urine. The route is what the name is about. The nurse takes it, the child gets it in the milk. Drugs do pass into breast milk, but the amount is small and variable, and a bland diuretic decocted into one packet and filtered through a nurse's plasma will not measurably increase a newborn's urine output. The method is set out with far more care in the other 釀乳方 of this chapter; see the note there. There is one reading worth taking seriously. 茵蔯 in a newborn with 胎熱 is close to a treatment for neonatal jaundice, and artemisia capillaris is still used for that in East Asian practice. The modern answer is phototherapy, which is cheap, safe and decisive, and exchange transfusion where the bilirubin threatens the brain. A jaundiced newborn needs the bilirubin measured, because kernicterus is preventable and permanent. **The text gives no dose by weight anywhere, and the patient is a newborn.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.