Human Substances

The 人部 opens on hair, and that is not an accident of arrangement. The Shennong Bencao's own 人部 held hair and almost nothing else, a point the book itself makes at the end of 1.8 — and the fourteen items that follow are the accretion of later ages. Hair is also the one drug in this chapter with a long afterlife: charred hair, 血餘炭, continued to be listed and used as a haemostatic in Chinese materia medica long after the rest of the 人部 had been abandoned. What the drug is, is keratin charred at a temperature low enough to leave carbon rather than ash — 燒存性 in 1.1#3 and 畧存性 in 1.1#4 are both instructions to stop short of complete calcination. A carbonised protein is a porous adsorbent, and a topically applied char is mildly astringent and drying on a weeping surface; that is the whole of what can be said for it mechanistically, and it does not reach the internal indications given here. **Not used in practice.** Human hair is not an approved medicinal substance and there is no regulated, quality-controlled supply of it; anyone preparing it would be charring material of unknown origin with no way to know whose it was or what it carried. Hair is, however, not in the same position as the bone of 1.8 or the tissue of 1.10 — it is lawfully traded as a commodity in most countries and its possession is not restricted — so the objection to it is a professional and pharmacological one rather than a criminal one. A clinician who wants the action claimed here has charcoal, alum and the ordinary haemostatic herbs, all of them supplied to a standard.

轉胞, shifted bladder, is retention of urine in late pregnancy attributed to the womb pressing on the bladder, and 關格 is the paired block of stool and urine above with vomiting. The indications are all of the urinary tract, which is why the next chapter of the book keeps hair ash in the strangury and retention formulas; the mechanism offered for it, that a channel-like fibre opens a blocked passage, is a resemblance argument and not a pharmacological one.

或無病人髮 is a donor screening rule, and it is the only safeguard the 人部 ever offers for a material taken from another person. It is worth noticing what it can and cannot do: visible health excludes nothing that matters, and the categories the passage trusts — one's own hair, a healthy person's, a boy's first cutting — are chosen for ritual cleanness rather than for safety. The one genuinely sound option in the list is 自己, one's own.

血餘, blood remainder, rests on the doctrine that hair is the surplus of the blood (髮者血之餘), which is why a blood-moving and blood-stanching action is expected of it. 勿令絶過 — do not let it burn right through — is the operative instruction and a real one: charring and ashing give different materials, and complete combustion would leave only mineral ash.

血暈 is the faintness and whirling that follows heavy blood loss, classically postpartum, and 血悶 the oppression in the chest that goes with it. The indication therefore belongs to haemorrhage, and it is the same ground as 1.1 — the two entries are the same substance under two modes of collection, as 1.2#3 says outright.

Both washes are chosen for what they do to grease. Gleditsia pods are saponin-bearing and were the ordinary detergent of the period; 苦參, sophora root, is bitter and also surfactant. Degreasing keratin before charring is a sensible preparatory step and the one technically defensible instruction in the entry.

The book draws the distinction and then withdraws it: 療體相似, their healing substance is alike. That sentence is the reason 1.1 and 1.2 are linked to the same entry in the materia medica here — they are one drug collected two ways, and the Bogam keeps them apart as headwords because the Bencao did. 髢 is a false switch of hair, so 髮髲 includes hair that had already been worn as a hairpiece before it was burnt.

The two anecdotes are historical and well known, and they are the reason this entry exists at all — the drug is hair, already covered by 1.1 and 1.2, and what the beard adds is the imperial story. Li Shiji (李世勣, 594–669) was Tang Taizong's great general, better known as Li Ji 李勣 because he dropped the 世 from his name after Taizong's death to avoid the taboo on the emperor's personal name 李世民; the transcription prints the earlier form. Lü Yijian (呂夷簡, 979–1044) was Song Renzong's chief councillor. In both cases a prescription called for beard ash and the emperor cut his own and sent it, which the histories record as an extraordinary mark of favour — a sovereign's body given to a subject as medicine. What the stories are evidence of is the standing of the drug at court, not its action. **Not used.** Beyond the objections that apply to hair generally, the substance here is taken from a named living person for a named recipient, which is the sympathetic logic this chapter runs on and has no pharmacology behind it. 癕 is the transcription's form of 癰.

頭垢 is the sebum, sweat residue, desquamated scalp and dirt scraped off the head or out of a comb. 勞復 is the relapse of an acute illness brought on by exertion during convalescence, a category the Cold Damage literature treats at length; 噎 here is obstruction at the throat on swallowing. **Not used, and not preparable.** This is a human secretion collected without any sterile procedure, and scalp surface material carries skin flora as a matter of course — staphylococci, including resistant strains, and Malassezia yeasts — along with whatever the person has been in contact with. Taken internally it is an inoculum. Hair grime is not a regulated substance in any jurisdiction I know of, so the bar against it is not a criminal one; it is that there is no indication for which this is a reasonable thing to give a patient, and a plain infective hazard if one did.

蕈毒 is mushroom poisoning and 馬肝毒 the toxicity attributed to horse liver; 蠱毒 and 百邪鬼魅 are the possession and bewitchment categories. The range — poisoning, bewitchment, bites — is the signature of a drug used as a universal counter-toxin rather than for any one action. **A dog bite is a rabies exposure and a serious bacterial wound, and a centipede bite can cause marked local reaction.** The modern management is wound irrigation, assessment for rabies post-exposure prophylaxis and tetanus, and antibiotics where indicated. Applying scalp grime to a bite wound would introduce skin flora into a deep inoculation injury, which is the specific way dog-bite wounds become infected. This passage must not be followed.

The leaf has no Korean gloss, the only one of the twenty-two items in this chapter that lacks one. Its substance is 1.4 at one remove — the grime is taken from the cloth that has been in contact with the head rather than from the head itself — and the same objections apply with the addition of whatever the cloth has picked up in two years of wear.

𢄼 is a rare graph with the cloth radical and is read with 帛 in the gloss that follows it — 卽縛髻帛也, it is the cloth for binding the topknot — so the compound 頭𢄼 is a head wrapping. The number of years is doing the work in the indication: an old cloth is held to be more potent, which is the same reasoning as the two or three years demanded of 人中白 at 1.11.1. **Not used; not preparable.**

泥丸, the mud pellet, is the Daoist name for the upper cinnabar field in the head, so 泥丸脂 means the grease of the brain's own palace — the name is the whole of the argument for the indication. Earwax is sebum and apocrine secretion with desquamated keratin, and it has no action on psychiatric illness or on alcohol craving. **Not used.** 癲狂 covers what would now be assessed as psychosis, mania and epilepsy, and 嗜酒 as alcohol use disorder; all three have treatments that work and for which an untreated patient pays a high price in delay. There is no legal restriction on earwax, but there is nothing to recommend it and the usual hazard of an unsterilised human secretion given internally.

痘瘡不起脹 is smallpox in which the pocks fail to fill and raise, read in the period as a failure of the body to push the toxin outward and therefore as grave; the Bogam's smallpox chapter uses several of this chapter's items for it. A calcined tooth is calcium phosphate — the same material as calcined bone — and has no action on malaria or on a viral exanthem. **Not used, and this one is not merely inadvisable.** A tooth is human skeletal tissue. In most jurisdictions the acquisition, retention, trade and use of human bodily tissue is governed by human-tissue and anatomical-gift legislation, and dealing in it outside that framework is an offence; a shed deciduous tooth given by a parent is not usually treated as a trafficked specimen, but a clinician collecting or dispensing human teeth has no lawful footing and no sterile product. Smallpox is eradicated; malaria is a notifiable, treatable, and without treatment frequently fatal disease for which this passage offers nothing.

生人骨, living-person bone, names the thing plainly and marks the boundary the chapter is working along — this is bone from a living donor, where 1.8 is bone from a dead one, and the book treats the two very differently. 鍳 is the transcription's form of 鑑.

垽 is dregs or a settled deposit, so 齒垽 is dental calculus. 出惡刺, drawing out a malign splinter, is a drawing indication of the kind given to poultices. **Not used, and the hazard here is specific.** Dental calculus is a mineralised biofilm: its bulk is bacteria, including the anaerobic periodontal organisms, and applying it to an abscess or to a puncture wound is a direct inoculation of exactly the flora that make such wounds dangerous. An abscess is managed by drainage and antibiotics; a retained foreign body is removed.

平明未語 — at daybreak, before a word has been spoken — is a collection rule of the same family as the morning urine of 1.11, and it is about ritual purity rather than composition. Saliva does carry lysozyme, lactoferrin, defensins and secretory IgA, so an antimicrobial action is not nothing in principle; it is also the basis of the universal human reflex of licking a wound. But the concentrations are low, the oral flora come with it, and 癬 (tinea) and 疥 (scabies) are a dermatophyte infection and a mite infestation respectively, neither of which saliva clears. **Not used.** Tinea is treated with topical or oral antifungals, scabies with permethrin or ivermectin and treatment of household contacts. Saliva is the vehicle for a long list of transmissible organisms — herpes simplex, EBV, CMV, and the respiratory viruses — so another person's saliva applied to broken skin is an exposure. One's own saliva on one's own skin is a different and essentially harmless act, and that is probably what the entry describes.

俗方 marks this as the Bogam's own addition from Korean domestic practice rather than a quotation, and 卽消, they disperse at once, is the register of folk remedy. The claim is not true of swellings of every kind, and a swelling that is an abscess, a cellulitis or a tumour needs to be identified rather than smeared.

尸疰 is one of the 疰 or infixion disorders, held to be contracted from the dead and to pass within a family, and 久瘴勞瘧 is chronic relapsing malaria. The two indications share a logic: an illness thought to come from the dead is met with a drug taken from the dead. 醎 is the transcription's form of 鹹. **This is the drug this chapter is remembered for, and it must not be prepared, dispensed, possessed or used.** The acquisition, retention and trade of human remains is criminal conduct in most jurisdictions, under statutes on the abuse or desecration of a corpse, interference with a grave, and the unlawful trafficking of human remains and tissue; where a human-tissue act governs, removal of tissue from a body without lawful authority is a separate offence. The exact offence and its name differ from country to country and I do not state which applies where, but there is nowhere I know of in which a practitioner may lawfully obtain a human skull for compounding. Relapsing fever that behaves like the 瘧 of this entry needs a blood film or rapid diagnostic test and antimalarial treatment, promptly; falciparum malaria kills within days.

The book states what the material is without euphemism, and the Korean gloss does the same, naming it as the crown bone of a long-dead skull. 年深陳久 is the same preference for age that runs through 1.4.1 and 1.11.1.

一伏時 is a full day and night, and 腥氣 the smell of putrefaction. The whole procedure is deodorising — ashing, then an aromatic wash, then roasting — and what it tells us is that the material being handled was not clean bone. 灸 stands for 炙, to roast.

This is the most important passage in the chapter, and three things about it have to be kept straight. First, what it says. The Basic Canon — the Shennong Bencao — carried hair in its 人部 and little else; everything else in the chapter is later accretion; and the accretion is 殊非仁人之用心, very far from the mind of a humane man. That is a moral judgement on the contents of the very section it stands in. It is then pressed with an argument from the harder case: Sun Simiao (孫思邈, c. 581–682), author of the Beiji Qianjin Yaofang and the physician most honoured in the tradition for refusing to use living creatures as drugs, is nevertheless said to have incurred 隂責, censure in the unseen world, for having taken life in the course of treating disease at all. If that was held against Sun Simiao, how much more against this. Finally the practical argument, which is the weakest of the three and the one a modern reader should trust least: that the toxic qi of a dying person gathers in the crown, so the drug harms rather than helps. Second, whose voice it is. The passage carries the source mark 《入門》, so the words are Li Chan's, from the Yixue Rumen of 1575, and not Heo Jun's own composition. What is Heo Jun's is the editorial decision — to carry the objection, in full, at the foot of the worst entry in the chapter, where a compiler minded to present his materia medica as a closed authority would simply have left it out. The Bogam is a compilation, and a compiler's argument is made by what he chooses to print. This is the clearest instance of it in the Decoctions chapter. Third, the substitution. 虎頭骨, tiger skull bone, is offered as the humane alternative, and today it is a worse problem than the thing it replaces. The tiger is listed on CITES Appendix I and international commercial trade in its parts is prohibited; China banned domestic trade in tiger bone and removed it from its pharmacopoeia in 1993, and demand for it is a direct driver of the poaching that keeps wild tiger populations at a few thousand animals. Tiger bone must not be sought, bought, prescribed or substituted, and a practitioner offered it is being offered contraband. 黃犬頭骨, the skull of a yellow dog, raises the separate questions of animal welfare and of the very different legal standing of dog slaughter from country to country. The honest reading of the passage is that its ethics are an advance on its pharmacology and that its own proposed remedy has not survived either.

Human milk is the one item in this chapter whose standing today is not simply negative, and it must not be lumped in with the rest. It is the normal food of the human infant; it is given to infants in neonatal units from screened, pasteurised donor milk; and its composition — roughly 1 per cent protein, 4 per cent fat, 7 per cent lactose, with secretory IgA, lactoferrin, lysozyme, oligosaccharides and live cells — makes the indication here, nourishing a wasted person, pharmacologically unremarkable rather than absurd. A patient who cannot keep down solid food and is given milk is being fed. The distinction that matters is the source. **Milk from an established milk bank is screened for HIV, HTLV, hepatitis B and C and syphilis and is pasteurised; milk obtained informally — bought online, or taken from an unscreened donor — is neither.** HIV, HTLV-1 and CMV are transmitted in breast milk; so are drugs and alcohol taken by the donor; and surveys of milk bought over the internet have repeatedly found high bacterial counts and cow's-milk adulteration, which is why the US Food and Drug Administration has advised against feeding infants milk acquired that way. Adult therapeutic use of human milk has no evidence base at all, and taking milk from a nursing mother for an adult patient also takes it from her child. So: a real substance with a real place in neonatal medicine, no established adult indication, and a sharp dependence on provenance.

首生男乳 — milk from a woman nursing her first son — is a specification of exactly the kind the chapter favours, and it is the same binder named in the 陰煉秋石 method of the Miscellaneous Formulas chapter. It has no compositional basis: milk does not differ by the sex or birth order of the child in any way that bears on an eye complaint. As an eye preparation, instilling unsterile milk into an inflamed eye risks bacterial keratitis; red, painful eyes with tearing need to be distinguished between conjunctivitis, keratitis, uveitis and acute glaucoma, and the last two threaten sight.

Zhang Cang (張蒼, d. 152 BCE) was chancellor under the early Han, and the Shiji records that he had lost his teeth and lived on human milk to a great age. The anecdote is the whole argument of the passage, and read as evidence it is worth little: a toothless man kept alive on a liquid diet is an unsurprising outcome, the longevity is uncorroborated, and 置乳婦十餘人 — keeping ten and more nursing women for the purpose — describes an arrangement in which women's milk, and the labour of producing it, were a wealthy household's commodity. That is the part of the story worth naming rather than admiring. 緫 is the transcription's form of 總. 《食物》 is the Shiwu Bencao, the materia medica of foods, and this is the only passage in the chapter from that source; it is also the only passage in the chapter that reads as dietetics rather than pharmacy.

Placenta, under the name 紫河車, is the second item in this chapter whose position today is not simply closed, and it has to be separated from the tissue drugs around it. Where it stands. It was removed from the Pharmacopoeia of the People's Republic of China in the 2015 edition, having been listed in earlier ones, and is no longer an official Chinese drug. In Japan, human placenta extract remains available as a licensed injectable preparation, and people who have received it are permanently deferred from blood donation there as a precaution against transmissible spongiform encephalopathy — which tells you how the regulator weighs it. Placental products are also sold as cosmetics and supplements in a number of markets, and encapsulated placenta is taken by some women after their own birth. So this is not a drug that has simply vanished. What is actually in it. Placental tissue at term is mostly protein and connective tissue with blood; the hormone content of the delivered organ is small and is in any case digested, and no component of it has been shown to produce the tonifying action claimed here. The published evidence for maternal placentophagy, which is the one modern use with any study behind it, shows no benefit for mood, lactation or iron status. **Why it must not be used in practice.** Placenta is blood-rich human tissue from a specific, identifiable donor. It carries whatever is in her blood — HIV, hepatitis B and C, HTLV, CMV, syphilis — and ordinary drying or encapsulation does not inactivate those. The US Centers for Disease Control reported a case in which a newborn developed recurrent group B streptococcal sepsis traced to the mother's own placenta capsules, which had been processed at a temperature too low to kill the organism. Beyond infection, the placenta is tissue of both mother and infant: taking it for use in another patient engages consent and human-tissue law, and in most jurisdictions tissue removed at delivery is clinical waste that may be released to the mother but not trafficked. A practitioner must not source, prepare or dispense it.

紫河車 is the name the drug is known by, and 1.10#7 will explain it character by character. 混沌皮 and 混元衣, chaos-skin and primal-origin robe, are cosmological names: the membrane that wrapped the undifferentiated beginning of a person. The preparation — a running-water steep to take up 生氣, washing, deveining, a slow bake, then a vinegar steep before use — is careful, and none of it sterilises. 長流水 steeping and the paper seal 使不泄氣 are there to keep a vital quality in, which is a doctrine, not a method. 凈 is the transcription's form of 淨.

自卯至酉 is from about five in the morning to about seven in the evening, so this is twelve hours of steaming. Sustained moist heat at steaming temperature is the one preparation in the entry that would in fact reduce the microbial load, which is worth noting precisely because the authors were not aiming at it; it would not inactivate a bloodborne virus with any reliability, and it does not make the material safe.

似爲有理, it seems to have some reason in it, is the Jeongjeon weighing a popular rule against the silence of the old formularies and coming down cautiously on the side of the rule. The reasoning is the yin-yang complementarity of donor and recipient, and it is worth marking as a case where the tradition is visibly adding a specification the earlier texts did not have — the same movement 1.8 complains of.

One don is about 3.75 g. 斷血脉, cutting away the vessels, is the one step with a hygienic rationale behind it, since the vessels hold the clotted blood. Musk is itself a prohibited material today: the musk deer is CITES-listed and natural musk must not be sourced.

Pure alchemical cosmology, and it should be read as such rather than flattened into a pharmacological claim. 槖籥 is the bellows of the Daodejing's heaven and earth; 鈆汞 are lead and mercury, the two principles of the outer alchemy, and 匡廓 their containing frame; 九九數足, the fulfilling of nine nines, is the eighty-one-day reckoning of gestation in this literature. 鈆 is the transcription's form of 鉛. The passage explains the drug's name and nothing else, and its presence shows how far the placenta had been assimilated to the language of the elixir.

A drug that does whatever the formula around it does is a drug with no action of its own, and the passage states that as its principal merit. 雖病危將絶, 一服更活一二日 — a dose buys a day or two at the end of life — is the sentence to be most careful with: it is the claim that would have been hardest to test and easiest to believe, and it is the kind of claim that still attracts money to placental products. 非金石草木之比, not to be compared with mineral or plant, is the explicit statement of why the human origin was thought to make the drug superior, and it is the doctrine 1.8 is arguing against. 乗 is the transcription's form of 乘.

Seven or eight years of burial of blood-rich tissue produces grave liquor, and the entry is giving it as a cooling drug for 丹毒 — erysipelas, the spreading red streptococcal cellulitis, which in a child is a serious infection. **This must never be prepared or used, and the reason is worth stating exactly.** Buried decomposing human tissue and the fluid around it are a reservoir of soil and enteric organisms, including clostridia — which is to say tetanus and gas gangrene — and the indication given here is a breached, inflamed skin barrier in a child. That is the most dangerous possible pairing of material and route in this entire chapter. Erysipelas needs prompt antibiotic treatment; in a child it can progress to necrotising infection and sepsis. The item also sits within the same tissue and burial law as 1.8: disinterring material from a grave is an offence quite apart from what is done with it.

Urine, usually as 童便, a boy child's urine, is one of the most heavily used drugs in the whole Bogam — it appears across the three clinical chapters as a vehicle, a processing medium (1.5 of the Preface on Decoctions prescribes it for drugs that are to enter the heart) and a drug in its own right. It is roughly 95 per cent water; the solutes are urea in bulk, with creatinine, uric acid, and sodium, potassium, chloride, phosphate, sulfate and ammonium salts. Nothing in that inventory treats lung wilting, mania or haemorrhage, and its reputation for 降火, bringing fire down, rests on its coolness and its salty taste rather than on any constituent. **Not used.** Urine is not sterile: it carries organisms from the lower urinary tract and perineum even in health, and in a person with a urinary or systemic infection it carries the pathogen. Collected in bulk and left standing, as the refining methods in the Miscellaneous Formulas chapter require, it becomes a culture medium. There is no legal restriction on a person's own urine and no criminal question here, unlike 1.8 or 1.10 — the objection is that there is no action to be had and a real infective risk in giving another person's urine by mouth. 醎 is the transcription's form of 鹹.

The Danxi line is a gloss and a claim in six characters, and 降火極速 is why urine was reached for in the fire and bleeding emergencies — speed, in a doctrine where heat rising had to be pulled down at once. The modern reading of such an emergency is that the time spent on this is time not spent on the treatment that works.

This is the sentence that makes 人尿 and 童便 one drug in practice, and it is why this entry is linked to the 童便 record in the materia medica. Composition does not differ in any relevant way by the donor's age or sex; what the specification does is pick a donor who is healthy, drug-free and sexually inexperienced, which is incidentally the lowest-risk urine available — the only defensible part of the scheme, and arrived at for the wrong reason. The Miscellaneous Formulas chapter carries the full version of it, with children housed and fed under supervision for collection, and that is not a procedure to be reproduced on any grounds.

A single-case testimonial of the oldest kind, and it is instructive about how such reports are built: the illness is unnamed, the recovery is undated, the comparison with a forty-year-old face is the observer's impression, and the forty years of taking urine are credited with an outcome that is survivorship. 云, so it is said, is Danxi's own hedge. 徤 is the transcription's form of 健.

The Korean gloss is what tells 人中白 apart from 1.14.1 人中黃, and the two are easily confused because the names differ by one character. White is the crust that settles and dries at the bottom of a chamber pot, and the gloss says so: the deposit congealed under an old earthenware chamber pot. Yellow, at 1.14.1, is a liquid drawn off through a bamboo tube stood in a dung vat. Sediment of urine, and leachate of faeces: not the same material and not the same hazard. Chemically this is the urinary scale — calcium and magnesium phosphates with urates and ammonium salts, the same deposit that forms in any vessel urine stands in. **Not used.** 湯火灼瘡, burns, is the worst of the indications to follow: a burn is a large area of destroyed barrier and the classic route for invasive infection, and dried urinary deposit applied to it is an inoculation. Burns are cooled with running water, covered, and assessed for depth and extent.

又名秋白霜, also called autumn white frost, is worth marking because it is nearly the name of the next leaf: 秋石 at 1.11.2 is autumn mineral, prepared by boiling urine down, while 秋白霜 here is the deposit that forms by itself. The two are related products of the same starting material and the names cross. 火煆, calcination on a tile, is the one step that would sterilise what it treats, and it is the last step rather than the first, so everything before it — two or three years of standing, scraping, handling — is unprotected. 隂 is the transcription's form of 陰.

秋石, autumn mineral, is urine boiled down repeatedly to a salt. The Bogam does not give the method here but points to it at 1.11.2#3, and the Miscellaneous Formulas chapter of the Miscellaneous Disorders part carries both procedures in full as 陽煉秋石法 and 陰煉秋石法. What the product is. Urine's solute load is urea with the inorganic salts. The yang method, which ends in a calcination, drives off the organic fraction and leaves a fused cake of chiefly sodium and potassium chloride; the yin method, which uses repeated suspension and decantation and no fire, washes the soluble fraction away and leaves mostly the phosphate sediment. Either way the product is an inorganic salt with trace organic residues, and the stated actions — supplementing essence and blood, strengthening the marrow — have no basis in it. In an elderly or debilitated patient, which is exactly whom 久年虛損 names, a salt cake taken as a medicine is a sodium load, and that matters in heart failure, hypertension and renal impairment. **On the steroid claim, which is the one thing most often said about this drug: it does not hold, and this site's note at 陰煉秋石法 sets out why.** Urine does carry conjugated steroid metabolites — androsterone, etiocholanolone, pregnanediol glucuronides — but at the order of micrograms per litre, so that even a very large volume reduced to a few nyang of salt would carry residues far below any physiologically active dose, and in the yang method the firing would destroy what little survived. The claim that autumn mineral was the first human concentration of a steroid hormone has been made in the history-of-chemistry literature and is sometimes repeated as settled; it is not, and the arithmetic of the concentrations is against it. I state the reasoning rather than the verdict of any one authority, and I would not want a clinician to take either side of this from a single note. **Not to be prepared or taken.** Urine collected and stored in bulk for weeks is not sterile and carries whatever the donors carry; the handling is prolonged and open; and the final firing of the yang method comes after all of it.

還元, returning to the origin, is alchemical language, and 衛生之寶, a treasure for guarding life, places the drug in the regimen-for-longevity literature rather than in therapeutics. A salt does not penetrate to the marrow.

The cross-reference resolves: the two methods are 陽煉秋石法 and 陰煉秋石法 in the Miscellaneous Formulas chapter, which this site translates in full, together with the 龍虎水 passage that describes the collection of children's urine for them. The names are literal — 陰煉 is the cold process, 陽煉 the hot one. This passage carries no source mark of its own in the transcription and takes the 《入門》 of the passage before it.

女勞復 is the relapse of a febrile illness brought on by sexual intercourse during convalescence, a category the Cold Damage literature treats in detail and which the next entry, 1.13, also addresses under the name 陰陽易. The passage carries no source mark of its own and takes the 《本草》 that closes the group at 1.12#2. **Not used, and the hazard is categorical.** Menstrual blood is blood. It transmits what blood transmits — HIV, hepatitis B and C, HTLV — and no preparation described in this chapter inactivates any of it. There is no indication for which it would be given and no lawful, screened supply of it. This is one of the items in the chapter where the modern objection is not fastidiousness but bloodborne pathogen exposure.

扶南 is Funan, the early state of the lower Mekong, and the passage is a traveller's report of invulnerability magic and its one counter. What matters is the inference drawn from it: 汚穢壞神氣, the filth destroys the spirit qi, and therefore 人合藥所以忌觸之 — those compounding medicines keep away from it. So the entry argues, in the same breath, that the substance is a drug and that it is a pollutant whose touch ruins other drugs. That contradiction is the pollution doctrine of menstruation showing through the pharmacy, and it is worth naming as such: the ritual uncleanness of menstruating women, which this sentence records in a medical register, did real harm to real women over a very long period. A clinician reading this chapter should recognise the doctrine and not carry any part of it forward.

俗方 marks a Korean domestic addition rather than a quotation from a Chinese source. 隂 is the transcription's form of 陰.

This is the sentence that links the entry to the 月經衣 record in the materia medica — the cloth and the flow are treated as one drug, the cloth being the practical means of collection. The same device appears at 1.13, where the undergarment stands in for what has been on it.

紅鈆, red lead, is a cover name of the alchemical kind — 鈆 is the transcription's form of 鉛, and the name sets the material beside the lead and mercury of the outer elixir, as 1.10#6 does for the placenta. The entry is explicit that it means menarcheal blood from a girl who has not been ill, which is the same purity-of-donor requirement as the 童便 of 1.11 and the 龍虎水 passage of the Miscellaneous Formulas chapter. 有毒, toxic, is the Bogam's own marking, and it is the only item in this chapter so marked. Whatever the compilers meant by it, the modern reading is harder: this is blood from an identified adolescent donor and it carries bloodborne pathogens. **It must not be sought, prepared or used.** The donor is a child; the material is unscreened human blood; and the indications it is offered for — paralysis, aphonia, amenorrhoea — are presentations that need a diagnosis. On the historical context the coordinator asks about, I will say only what I am reasonably confident of: preparations named 紅鉛 are documented in Ming-period court and alchemical practice, where menarcheal blood was collected from girls for elixirs of longevity and sexual vigour, and the Jiajing reign is the case usually cited. I do not know how far that practice stood behind this particular Yixue Rumen entry, which presents the drug soberly as a tonic for depletion and makes no alchemical or sexual claim; the name is the only trace of that world in the text as the Bogam prints it. I would not want the historical association stated as though the Bogam endorsed it.

This cross-reference does not resolve. 紅鈆 and 紅鉛 occur nowhere else in the Bogam as transcribed for this project, and the Miscellaneous Formulas chapter carries no section on preparing it; what it does carry is the pair of 秋石 refining methods, which are a different material. Either the referent is lost from the chapter as transmitted, or the Yixue Rumen's own cross-reference was carried over without a corresponding section. The absence is recorded rather than patched, and nothing is supplied for it.

陰陽易 is a Cold Damage category: the illness passed between a convalescent and a healthy partner through intercourse, the name meaning that yin and yang have changed places. The classical formula for it is 燒裩散, burnt-undergarment powder, which is this material, and the Cold Damage chapter of the Miscellaneous Disorders part prescribes it by name. **Not used.** The hazard is modest compared with the tissue and blood items in this chapter — worn cloth is not human tissue and is not regulated as such — but the material is soiled undergarment from another person's genital area, and burning it to char does not make the ash a medicine. What is actually being treated under the name 陰陽易 is in modern terms a sexually transmitted infection or a relapse of a febrile illness, both of which need diagnosis and treatment.

男病用女裩, 女病用男裩 — the man takes the woman's and the woman the man's — is the operative rule and makes plain what kind of remedy this is. The disease is held to have crossed between the sexes, so the cure crosses back; the undergarment carries the other person's qi because it has been against their body. This is sympathetic treatment of the clearest kind, and it is the same reasoning as the beard of 1.3 and the well-mouth of 1.13#3. No pharmacology is claimed and none should be read in.

Pure sympathetic magic, and the Bogam prints the parallel in its Women's Disorders chapter with the instruction 勿令産母知之, without letting the mother know — the act must be concealed from the patient, which is as clear a statement as one could want that the effect was expected elsewhere than in the body. **Retained placenta is an obstetric emergency.** It causes major postpartum haemorrhage and sepsis and is managed by active third-stage measures, uterotonics and manual or surgical removal, with the mother in a place that can transfuse. Anything done at a well-head instead of that is lethal delay. This passage is translated as a historical record and must not be acted on.

**This is not used, and the matter is not arguable.** Human faeces taken by mouth is the deliberate ingestion of enteric pathogens: the organisms of typhoid and paratyphoid, cholera, shigellosis, campylobacter and pathogenic E. coli, hepatitis A and E, norovirus, and the intestinal parasites and their eggs. Drying does not kill them — hepatitis A and the helminth ova in particular survive it well — and the patient the entry describes, delirious with a high fever in an epidemic, is the least able to tolerate an added enteric infection. Nothing in this entry should be prepared, dispensed or taken under any circumstances. One honest qualification, because a reader will think of it. Faecal microbiota transplantation is a real and effective modern therapy for recurrent Clostridioides difficile infection, and it is also the reason this entry is sometimes claimed as a premonition of modern medicine. The claim does not stand. Modern transplantation uses stool from a donor screened by a long protocol of serology, stool pathogen and parasite testing and questionnaire, prepared under controlled conditions and delivered into the colon or in a standardised encapsulated form, for one narrowly defined indication, and it is regulated as a biological product; serious infections, including fatal ones, have been transmitted when screening failed. What this entry describes is dried faeces of unknown origin taken by mouth as a febrifuge. The resemblance is in the material only, and treating the one as precedent for the other is how a reader comes to harm.

破棺湯, Coffin-Breaking Decoction, is named for what it claims to do — bring back a patient already given up for dead. Two preparations are given, a dry powder doused with boiling water and a char steeped and drunk; of the two, 燒存性 at least applies heat to the material, while 沸湯沃服 pours boiling water over a raw powder and does not reliably reach a lethal temperature for anything. Neither is safe and neither should be made.

俗方 marks this as the Bogam's record of Korean practice in its own day, and 今人, people today, dates it to about 1613 — so this was current, not antiquarian, when the book was written. 野人乾, wild-man dry, is a euphemism and the only euphemism in the chapter; everywhere else the 人部 names its materials plainly. 以男人糞爲良, a man's is better, is the same unfounded donor specification as elsewhere in the chapter.

The Korean gloss distinguishes this from 1.11.1, naming it as the water that enters a bamboo tube thrust into faeces. 人中白 is the dried deposit of urine; 人中黃 is the liquid that seeps into a bamboo tube standing in a dung vat, or in the second method the licorice soaked in it. The names differ by one character and the materials entirely, and the two are easy to transpose. **Not used, for the reasons given at 1.14, and with one addition: this preparation is a faecal leachate, which is to say a liquid suspension of enteric pathogens, and nothing in either method heats it at any point.** The 1.14 preparations at least char or scald the material; this one does not.

臘月, the twelfth lunar month, is specified for the cold, which would slow putrefaction; the Preface on Decoctions makes the same point about animal parts at 1.2. Bamboo is porous enough at the cut ends for liquid to seep in, which is the whole of the mechanism.

The second method is the one usually meant by 人中黃 in later formularies: licorice sealed in bamboo and left a month in the vat, then dried, so that the drug dispensed is licorice carrying what has diffused into it. 淡竹 is Phyllostachys nigra var. henonis, the bamboo of 竹葉 and 竹茹. A month of diffusion at ambient temperature is a month of microbial growth, and the licorice is not sterilised before use; sun-drying does not sterilise it either. **Not to be prepared.**

糞淸, dung-clear, is the plain name under the euphemism, and the entry gives it. 本經 is the Shennong Bencao, which is the same authority 1.8 invokes to say that none of this belongs in the 人部 at all. The passage carries no source mark in the transcription and takes the 《入門》 of the passage before it.

Nail is keratin, the same material as the hair of 1.1 and 1.2, and the chapter treats it the same way — charred and powdered. It has no uterotonic action of any kind. **Obstructed labour kills mothers and babies, and it kills them quickly.** It is managed by obstetric assessment and, where needed, assisted delivery or caesarean section, in a place equipped to do both and to transfuse. A powder given to hasten a birth is a delay in getting there. Like hair, nail is not a regulated substance and its possession raises no legal question, so the objection here is wholly a clinical one — but on this indication it is as serious an objection as any in the chapter.

瞖障 is opacity and screening of the sight — corneal scarring and cataract. **Nothing powdered should ever be placed in an eye.** A particulate foreign body on the cornea abrades it and the abrasion becomes a bacterial or fungal keratitis, which is a sight-threatening infection; this is among the most directly harmful instructions in the chapter. Corneal opacity and cataract are surgical problems with good modern outcomes. 取姙婦爪甲 — the nails of a pregnant woman — is the donor rule again, and here it is doing the work of the indication: the woman carrying a child supplies the drug that brings a child out, and her nails are also what clears a film from the eye. The specification has no compositional basis. The same material appears in the Bogam's 燒裩散 as 人手足指爪甲 二十片, twenty pieces of a person's finger and toe nails, which is the record this entry is linked to in the materia medica.

斷者 is the severed cord stump, which dries and separates in the first week or two of life. The chapter closes on the newest human material in it, having opened on hair and passed through the skull of the long dead — an arrangement that is probably not deliberate but is worth noticing. **Not used.** The stump is human tissue from an infant, and it is tissue whose disposal belongs to the parents and to clinical waste procedure, not to a dispensary; taking it for medicine engages consent and human-tissue law in the same way as 1.10, and an infant cannot consent. The separating stump is also the site of neonatal omphalitis and is colonised. Malaria needs a blood film or rapid test and antimalarial drugs; this entry offers nothing for it. The one modern practice in this vicinity — cord blood banking for haematopoietic stem cells — is a regulated activity with its own consent framework and has no relation to what is described here.

胎中屎 is meconium, the first stool, which is passed in the first day or two and is sterile in utero but not after passage; 蝕瘜肉, eating away polypous flesh, is an escharotic indication, applied to granulation tissue or a polyp. 候初生 — watch for the moment of birth — means the material is to be collected at a delivery, which places a third party at the bedside of a labouring woman for the purpose of taking something from her newborn. **Not used, and this is the clearest consent problem in the chapter.** Beyond that, applying any unsterile material to an open sore is an inoculation, and an escharotic applied to tissue that has not been diagnosed may be applied to a malignancy. The passage is translated as a record of what the book contains.