Ling Yunpeng's Xiaozhong Gao (Swelling-Reducing Paste)
In his work Linzhen Yide Lu, the senior physician Ling Yunpeng recorded an empirical formula called "Xiaozhong Gao" (Swelling-Reducing Paste): 5 jin of white kaolin (or talcum powder), 1 jin of magnesium sulfate, 0.5 jin of boric acid, 3 jin of glycerin, 10 ml of eucalyptus oil, and an appropriate amount of 0.1% rivanol solution, mixed thoroughly and applied thickly to the local area (see p. 3 of the book).According to Dr. Ling, this is an empirical formula he used clinically for decades. It is suited to yang-excess local swellings with redness, swelling, heat, and pain, and has definite efficacy for local bruising and swelling from traumatic injury.This formula applies the TCM idea of treating disease with a composite formula, combining several commonly used Western medicines. Of the ingredients, apart from white kaolin (or talcum powder), all are commonly used in Western medicine.The most familiar internal effect of magnesium sulfate is purgation; it is the laxative commonly used in Western medicine to clear the bowel before colonoscopy. It also has cholagogue and anticonvulsant effects and can treat eclampsia, tetanus, and hypertension. Applied externally as a solution or powder, magnesium sulfate reduces inflammation and swelling; it can treat limb swelling after injury and help improve rough skin. Dr. Ling used magnesium sulfate in this formula for its swelling-reducing and pain-relieving effect.Boric acid is an external medicine used in both TCM and Western medicine. TCM holds that boric acid dries dampness, so it is often used for skin diseases such as eczema. Western medicine uses boric acid as a bactericide, disinfectant, astringent, and preservative. Boric acid inhibits many bacteria and fungi; its mechanism is binding to amino groups in bacterial proteins. Clinically it is often used to irrigate and disinfect skin, mucosa, wounds, the mouth, vagina, and bladder, and can also be used for otitis, burns, scalds, and eczema.But both boric acid and magnesium sulfate are somewhat irritating to the skin, while glycerin applied externally protects the skin and can also repair damaged skin tissue. So Dr. Ling combined glycerin with boric acid and magnesium sulfate in this formula, protecting the skin while reducing swelling and pain.Eucalyptus oil has a strong camphor-like fragrance; applied to the skin it produces a cool, pungent sensation, and it also reduces inflammation and kills bacteria. So it has some therapeutic effect on local redness, swelling, heat, and pain caused by inflammation.Rivanol solution is an external bactericidal disinfectant with strong action against Gram-positive bacteria and a few Gram-negative bacteria, especially cocci and streptococci. A 0.1% rivanol solution is a surgical debridement agent; in this formula it serves as an antibacterial adjunct.White kaolin (or talcum powder) in this formula acts mainly as an adsorbent or excipient, its function similar to the gypsum commonly used in orthopedics.Western medicine rarely uses Dr. Ling's treatment approach, because Western medicine usually treats disease with a single drug, whereas TCM commonly combines multiple herbs to act together. TCM also rarely uses this method, because the ingredients here are mostly not Chinese herbs; this can be considered Dr. Ling's original creation. He cleverly applied the TCM composite-formula logic to combine Western medicines, achieving effects no single Western drug could. Dr. Ling said that in decades of clinical practice he repeatedly obtained quick results with this formula.This is a fine external analgesic and swelling-reducing paste; it may be tried in tumor patients with protruding superficial lesions, as an auxiliary for reducing swelling and pain.