在睛里昏暗，与不患之眼相似，唯瞳人里有隐隐青白者。无隐隐青白者亦有之。
〔丹〕一老人病目，暴不见物，它无所苦，起坐饮食如故。予曰∶大虚。急煎人参膏二斤，服二日，目方见。
一医与青礞石药。予曰∶今夜死矣。不悟，此病得之气大虚，今不救其虚，而反用礞石，不出此夜必死。果至
夜半，死。
一男子四十余岁，形实，平生好饮热酒，忽目盲脉涩，此因热酒所伤，胃气污浊之血死在其中而然也。遂
以苏木作汤，调人参膏饮之。服二日，鼻内两手掌皆紫黑。予曰∶此病退矣，滞血行矣。以四物加苏木、桃仁、
红花、陈皮，煎调人参末服，数日而愈。
一男子五十五岁，九月间早起，忽开眼无光，视物不见，急就睡片时，却能见人物，竟不能辨其何人何物，
饮食减平时之半，神思极倦，脉之缓大四至之上，重按则散而无力。予作受湿治。询之，果因卧湿地半个月得
此证，遂以白术为君，黄 、茯苓、陈皮为臣，附子为佐，十余帖而安。
上三方，治目不明，皆为气脱，而用参、术追回者也。经云∶上焦开发，宣五谷味，熏肤充身泽毛，若
雾露之溉，是谓气。脱者，目不明，即其证也。
人参补胃汤 治劳役饮食不节，内障眼病，此方神效。
黄 根（一两） 人参（一两） 甘草（炙，八钱） 蔓荆子（二钱） 白芍药（三钱） 黄柏（三钱，酒淬
四次，炒四次）
上 咀，每服三四钱，水一大盏，煎至一盏，去渣，稍热服，临卧三五服。两目广大，视物如常，惟觉两
脚踏地，不知高下，盖火伏升发故也。病减住服，七日再服。此药宜春间服之。
益气聪明汤 治饮食不节，劳伤形体，脾胃不足，内障耳鸣，或多年视物昏暗，令目广大。久服，无内障耳鸣
耳聋之患。又令精神倍常，饮食增倍，身轻体健，耳目聪明。
黄 （半两） 甘草根（炙，六钱） 人参（半两） 升麻根（三钱） 葛根（三钱） 蔓荆子（一钱半）
白芍药（一钱） 黄柏（一钱，酒洗四次，炒黄色）
上 咀，秤二钱，水二钟，煎至一钟，去渣，热服，临卧服，五更再煎服之，得睡更妙。如烦乱或有热，
春月渐加黄柏，夏月倍之。如脾胃弱去之，热减亦少用。但有热，或麻木，或上壅头目，三两服后，其热皆
除。又治老人腰以下沉重疼痛。此药久服，治人上重，反有精神。两足轻浮，不知高下，空心服之，或少加
黄柏，轻浮自减。小儿减服，多则壅滞。若治倒睫，去黄柏、芍药。忌烟火酸物。
圆明内障升麻汤 治内障，得之脾胃，元气衰弱，心火与三焦俱盛，为此疾。刘舜卿因南征，饮食失节，
形体劳役，心不得休息，眼疾复作。今拟此方，服之效。
柴胡根（七钱） 羌活根（一两半） 防风根（半两） 白术 甘草（炙） 归根（酒洗） 升麻根（各一
两） 白芍（六钱） 干姜（一钱） 五味子（二钱） 人参 葛根 黄 （各一两） 白茯苓（三钱）
上 咀，每服五六钱，水三大盏，煎至二盏，入黄芩黄连汤二钱，同煎数沸，去渣，煎至一盏，食后，热服。
黄芩黄连汤（一方有升麻五钱，柴胡一两。）
黄芩（酒洗，炒，一两） 黄连（去须，酒洗，炒，七钱） 草龙胆（一两，酒洗，炒四次） 生地（一两，酒洗）
上 咀，每服二钱，入水二盏，煎数沸去渣，再煎至一盏，热服，午后晚间俱不可服，唯午饭时服之方效。
复明散 治内障。
黄 （一钱半） 川芎（五分） 柴胡 连翘 甘草（炙。各一钱） 归身（二钱） 苍术（五分） 生地（一
钱） 陈皮（五分） 黄柏（三分）
上锉，如麻豆大。每作一服，水二大盏，煎至一盏，去渣，稍热服，食后。忌酒湿面辛热大料之物。
上四方，治目不明，皆气虚而未脱，故可与参、 中微加连、柏。若气即脱，则黄柏等凉剂不可施。经
云∶阳气者，烦劳则张。精绝，目盲不可以视，耳闭不可以听之类，是其证也。
内障瞳子散大论并方。（肾主骨之精为瞳子，散大者因肾水虚骨枯而心包络之火得以乘之也。）凡心包
络之脉，出于心中，代心君行事
也，与少阳为表里。瞳子散大者，少阴心之脉挟目系，厥阴肝之脉连目系，心主火，肝主木，此木火之势盛也。
其味则宜苦宜酸宜凉，大忌辛辣热物，是泻木火之邪也，饮食中常知此理可也。以诸辛主散，热则助火，故不
可食。诸酸主收心气，泻木火也。诸苦泻火热，则益水也。尤忌食冷水大寒之物，此物能损胃气，胃气不行，
则元气不生，元气不生，缘胃气下陷，胸中三焦之火及心火乘于肺上，入胸灼髓。火主散溢瞳子之散大者，
以此大热之物，直助火邪，尤为不可食也。药中去茺蔚子，以味辛及主益肝，是助火也，故去之。加黄芩半两，
黄连三钱，黄连泻中焦之火，黄芩泻上焦肺火，以酒洗之，乃寒因热用也。亦不可用青葙子，为助阳火也。更
加五味子三钱，以收瞳人之散大也。且火之与气，势不两立。故经曰∶壮火食气，气食少火，少火生气，壮火
散气。诸酸物能助元气，孙真人云∶五月常服五味子，助五脏气，以补西方肺金。又经云∶以酸补之，以辛泻
之。则辛泻气明矣。或曰∶药中有当归，其味亦辛甘而不去，何也？此一味辛甘者，以其和血之圣药也。况有
甘味，又欲以为乡导，为诸药之使，故不去也。
熟地黄丸 治血弱气虚，不能养心，致火旺于阴分，瞳子散大。少阴为火，君主无为，不行其令，相火代之，
与心包络之脉出心系，分为三道。少阳相火之体无形，其用在其中矣。火盛则能令母实，乙木肝旺是也。其
心之脉挟目系，肝之脉连目系，况手足少阳之脉同出耳中，至耳上角，斜起终于目外小 。风热之盛，亦从
此道来，上攻头目，致偏头肿闷，瞳子散大，视物昏花，血虚阴弱故也。法当养血凉血益血，收火散火，而
除风热，则愈矣。
熟地（一两） 归身（酒洗，五钱） 柴胡（去苗，八钱） 天门冬（去心，焙，三钱） 人参（去芦，
二钱） 甘草（炙，二钱） 地骨皮（三钱） 黄芩（半两） 枳壳（炒，二钱） 五味子（三钱）
生地黄（七钱半，酒浸焙） 黄连（三钱）
上为细末，炼蜜丸，如绿豆大。每服一百丸，茶汤送下，食后，日二服，制之缓也。大忌辛辣物而助火邪，
及食寒冷物损其胃气，药不上行也。又一论云∶瞳子黑眼法于阴，由食辛热之物，助火乘于胸中，其睛故散，
散则视物亦大也。
益阴肾气丸 此壮水之主，以镇阳光也。
山茱萸（取皮，一两） 茯神（去皮心，二钱半） 五味（五钱） 熟地（二两） 干山药（五钱）
泽泻（二钱半） 牡丹皮（五钱） 生地（酒洗，焙干，一两） 归梢（酒洗，五钱）
上为细末，炼蜜丸，如桐子大，朱砂为衣。每服五七十丸，淡盐汤送下。
滋阴地黄丸 治内障，右眼小 青白翳，大 亦微显白翳，脑痛，瞳子散大，上热恶热，大便涩后痞难，小便
如常，遇热暖处头疼暗胀，能食，日没后天阴暗则昏。此症可服熟地黄丸。翳在大 ，加葛根、升麻。翳在
小，加柴胡、羌活。
熟地（八钱） 生地（酒洗，半两） 归身（酒洗，半两） 知母（酒洗，炒，三钱） 丹参（半两） 黄柏
（酒浸焙，半两） 芍药（一两三钱） 防己（酒洗，焙，二钱） 茺蔚子（半两） 牡丹皮（三钱） 寒水
石（一钱，生用） 柴胡（半两） 黑附（一钱） 川芎（二钱）
上为细末，炼蜜丸，如小豆大。空心五十丸，白汤下。如宿食未消，候饥时服之。饵后，忌言语，随后食压之。
〔《保》〕当归汤 治翳补益，瞳子散大。
归身 黄芩（各一钱） 黄连 地黄（各三钱） 柴胡（一钱） 芍药（二钱） 甘草（炙，三钱）
上水煎临卧服。
〔罗〕甘菊花丸 治男子肾脏虚弱，眼目昏暗，或见黑花。常服明目，暖水脏，活血驻颜，壮筋骨。
甘菊花（去土，二两） 枸杞（四两） 熟地（三两） 干山药（半两）
上为细末，炼蜜丸，如桐子大。每服三四十丸，空心食后各一服，温水下。
〔《瑞竹》〕四神丸 治肾经虚损，眼目昏花，补虚益损，及两眼云翳遮睛。
甘州枸杞（一斤，拣去白醭青烧者。一味分作四分，一两四钱用川椒一两炒，一两四钱用乳香、茴香各一两
炒，一两四钱用芝麻一合炒，炒时先用好酒一
盏，将枸杞淘过）
上件炒过，将川椒等四味筛去不用，止用枸杞子加熟地、白术、茯苓各一两，同为细末，炼蜜为丸，如桐子
大。每服五七十丸，空心温酒送下。加甘菊一两尤妙。
上地黄、枸杞补肾例。按瞳子散大，不当用茺蔚、川芎、附子，今东垣滋阴地黄丸兼用者，盖有外障大
小之翳故也。
〔《保》〕柴胡散 明目益肾水。
柴胡 羌活 防风 生地 芍药 甘草（各等分）
上为粗末，水煎临卧服。
东垣云∶肝木旺，则火之胜，无所畏惧而妄行也，故脾胃先受之。或病目而生内障者，脾裹血，胃主血，
心主脉，脉者血之腑也。或曰∶心主血。又云∶脉主血，肝之窍开于目也。（治法亦前熟地黄丸之类是也。）
〔河〕目昧不明，热也。然玄腑者，无物不有，人之脏腑皮毛肌肉筋膜骨髓牙爪，至于世之万物，尽皆有
之，乃气出入升降之道路门户也。人之眼耳鼻舌身意神识，能为用者，皆升降出入之通利也。有所闭塞者，不
能为用也。若目无所见，耳无所闻，鼻不闻臭，舌不知味，筋痿骨痹，爪退齿腐，毛发堕落，皮肤不仁，肠胃
不能渗泄者，悉由热气怫郁，玄腑闭密，而致气液血脉，荣卫精神，不能升降出入故也。各随郁结微甚，而为
病之轻重。故知热郁于目，则无所见也。故目微昏者，至近则转难辨物，由目之玄腑闭小，如隔帘视物之象也。
或视如蝇翼者，玄腑有所闭合者也。或目昏而见黑花者，由热气甚而发之于目。亢则害，承乃制，而反出其泣，
气液眯之，以其至近，故虽微而亦见如黑花也。
诚哉！河间斯言也。目盲，耳聋，鼻不闻臭，舌不知味，手足不能运用者，皆由其玄腑闭塞，而神气出
入升降之道路不通利。故先贤治目昏花，如羊肝丸，用羊肝引黄连等药入肝，解肝中诸郁。盖肝主目，肝
中郁解，则目之玄腑通利而明矣。故黄连之类，解郁热也。椒目之类，解湿热也。茺蔚之类，解气郁也。
芎、归之类，解血郁也。木贼之类，解积郁也。羌活之类，解经郁也。磁石之类，解头目郁坠，邪气使下
降也。蔓菁下气通中，理亦同也。凡此诸剂，皆治气血郁结目昏之法。而河间之言，信不诬矣。至于东垣、
丹溪治目昏，用参 补血气，亦能明者，又必有说通之。盖目主气血盛，则玄腑得利，出入升降而明。虚
则玄腑无以出入升降而昏，此则必用参、 、四物等剂，助气血营运而明也。
羊肝丸三方，又散一方，并见肝条，治肝中诸郁目昏如神。
〔《本》〕治久年眼生黑花不明者。
椒目（炒，一两） 苍术（炒，二两）
上件为末，醋糊丸，如桐子大。每服二十丸，醋茶送下，不过十日取效。（丹溪云∶椒目行渗道不行也。）
〔《外》〕补肝散 治三十年失明。
蒺藜子七月七日收，阴干，捣散，饮食后，水服方寸匕。
〔崔〕但瞳子不坏者疗，十得九愈。蔓菁子六升，蒸之，看气遍，用甑下釜中热汤淋，暴干，还淋，如是三
遍，即取杵筛为末，食上，清酒调二钱送下，日再服。（本草云∶蔓菁子下气利五脏，又利大便，通中益气。）
〔《经》治虚劳目暗昧，三月蔓菁花，阴干为末，以井花水空心调下二钱匕，久服长生。
〔世〕五福还瞳丹 治目白翳。
赤石脂、川椒二味同炒，辰砂、茯神、乳香，枣肉为丸，如桐子大。空心温酒下百丸，十服见效。
按内障先患一目，次第相引，两目俱损者，皆有翳在黑睛内遮瞳子而然。今详通黑睛之脉者，目系也。
目系属足厥阴、足太阳、手少阴三经，盖此三经，脏腑中虚，则邪乘虚入经中郁结，从目系入黑睛内为
翳。《龙木谕》所谓脑脂流下作翳者，即足太阳之邪也。所谓肝气冲上成翳者，即足厥阴之邪也。故治法以
针言之，则当取三经之 穴，如天柱、风府、太冲、通里等穴是也。其有手巧心审谛者，能用针于黑眼里
拨其翳，为效尤捷也。以药言之，则当补中，疏通此三经之郁结，使邪不入目系而愈。今集《龙木谕》并
方于后。
〔《龙木论》〕羚羊角饮子 治圆翳内障，不痛不痒。
羚羊角（三两） 细辛 知母 车前子 人参 黄芩（各二两） 防风（二两半）
上为末，每一钱，以水一盏，煎至五分，食后，去渣，温服之。
补肝散 治肝风内障，不痛不痒，眼见花，发黄白黑赤，或一物二形。
羚羊角 防风（各三两） 羌活 车前子（各一两） 人参 茯苓（各二两） 细辛 玄参 黄芩（炒。各一两）
上为末，食后调服一钱，米饮汤下。
羚羊角散 治绿风内障，头旋目痛，眼内痛涩者。
Inside the eyeball, there is a sense of dimness, resembling the appearance of an unaffected eye, except that there is a faint bluish-white color within the pupil. There are also cases without this bluish-white color.
[Zhu Danxi] An elderly man suffered from an eye disease, suddenly losing his vision, while experiencing no other discomfort; his daily activities and diet remained normal. I said: This is a severe deficiency syndrome. Quickly decoct two jin (approx. 1 kg) of Ginseng Paste. After taking it for two days, his vision recovered.
Another physician administered Qingmengshi (Limonite) medicine to the patient. I said: He will die tonight. The patient did not heed my warning. This illness is caused by extreme Qi deficiency. Instead of treating the deficiency, the physician used Qingmengshi (a heavy-settling drug). He would certainly die before nightfall. Indeed, the patient died at midnight.
A man in his forties, with a robust physique who habitually drank hot wine, suddenly became blind with a choppy pulse. This was due to injury from hot wine, causing turbid blood to stagnate and die within the Stomach Qi. Therefore, Su Mu (Sappan Wood) was decocted into a soup, mixed with Ginseng Paste and drunk. After two days, both nostrils and palms turned purple-black. I said: This indicates the pathogen is receding and stagnant blood is moving. A prescription of Siwu Tang (Four Substances Decoction) added with Su Mu (Sappan Wood), Tao Ren (Peach Kernel), Hong Hua (Carthamus Flower), and Chen Pi (Tangerine Peel) was decocted and taken with Ginseng powder. He recovered after several days.
A fifty-five-year-old man, upon waking early in September, suddenly found his eyes devoid of light and unable to see objects. After lying down for a short while, he could see people and things but could not recognize them. His food intake was half of usual, and he felt extremely fatigued. His pulse was slow and large, exceeding four beats per breath, and when pressed heavily, it was scattered and weak. I diagnosed this as dampness invasion. Upon inquiry, it was confirmed that he had slept on damp ground for half a month. Thus, Baizhu (Atractylodes Macrocephala Rhizome) was used as the sovereign herb, Huangqi (Astragalus Root - *Note: Text says 'Huang', likely Astragalus based on context*), Fuling (Poria), and Chen Pi (Tangerine Peel) as minister herbs, with Fuzi (Prepared Aconite Root) as an assistant herb. After more than ten doses, he stabilized.
The above three formulas treat unclear vision due to Qi collapse, using Renshen (Ginseng) and Baizhu (Atractylodes) to restore Qi. The Classic states: The Upper Jiao opens and develops, distributing the flavors of grains, steaming the skin, filling the body, and moistening hair, like mist and dew. This is called Qi. In cases of Qi collapse, unclear vision occurs, which is its manifestation.
Renshen Bugan Tang (Ginseng Stomach-Nourishing Decoction) treats internal cataracts caused by overwork and irregular diet; this formula is miraculous.
Huangqi Root (1 liang), Renshen (Ginseng, 1 liang), Gancao (Licorice Root, roasted, 8 qian), Manjingzi (Vitex Fruit, 2 qian), Baishao (White Peony Root, 3 qian), Huangbai (Phellodendron Bark, 3 qian, soaked in wine four times, roasted four times).
All ingredients are cut. Take 3-4 qian per dose, add one large cup of water, decoct to one cup, strain, and drink slightly warm. Take 3-5 doses before bed. Vision expands, objects appear normal, but feet feel unstable regarding height/depth because fire is trapped and rising. Stop medication when symptoms improve, resume after seven days. This medicine is suitable for spring use.
Yiqi Congming Tang (Qi-Benefiting and Acuity-Enhancing Decoction) treats irregular diet, physical fatigue, Spleen-Stomach insufficiency, internal cataracts, tinnitus, or long-term dim vision, expanding visual field. Long-term use prevents internal cataracts, tinnitus, and deafness. It also doubles spirit, increases appetite, lightens the body, and sharpens hearing and vision.
Huangqi (Astragalus Root, 0.5 liang), Gancao Root (Licorice Root, roasted, 6 qian), Renshen (Ginseng, 0.5 liang), Shengma Root (Cimicifuga Root, 3 qian), Gegen (Kudzu Root, 3 qian), Manjingzi (Vitex Fruit, 1.5 qian), Baishao (White Peony Root, 1 qian), Huangbai (Phellodendron Bark, 1 qian, washed in wine four times, roasted yellow).
All ingredients are cut. Weigh 2 qian, add two zhong (approx. 400ml) of water, decoct to one zhong, strain, and take hot before bed. Decoct again at dawn (Wu Geng) and take; sleeping afterwards is ideal. If restless or hot, gradually increase Huangbai in spring, double it in summer. If Spleen-Stomach is weak, remove Huangbai; reduce if heat decreases. If heat, numbness, or upper congestion occurs, these clear after 2-3 doses. Also treats heaviness and pain below the waist in the elderly. Long-term use relieves upper heaviness and boosts spirit. Feet may feel light/unstable; take on empty stomach, optionally adding Huangbai to reduce lightness. Reduce dosage for children to avoid stagnation. For inverted eyelashes, remove Huangbai and Baishao. Avoid smoke, fire, and sour foods.
Yuanyuan Neizhang Shengma Tang (Jade-Circle Internal Cataract Cimicifuga Decoction) treats internal cataracts caused by Spleen-Stomach Yuan Qi weakness, with excessive Heart Fire and Triple Burner Fire. Liu Shunqing, during southern campaigns, had irregular diet, physical labor, and mental restlessness, leading to recurrent eye disease. This formula is effective.
Chaihu Root (Bupleurum Root, 7 qian), Qianghuo Root (Notopterygium Root, 1.5 liang), Fangfeng Root (Saposhnikovia Root, 0.5 liang), Baizhu (Atractylodes Rhizome), Gancao (Licorice Root, roasted), Danggui Root (Angelica Sinensis Root, wine-washed), Shengma Root (Cimicifuga Root, 1 liang each), Baishao (White Peony Root, 6 qian), Ganjiang (Dried Ginger, 1 qian), Wuweizi (Schisandra Berry, 2 qian), Renshen (Ginseng), Gegen (Kudzu Root), Huangqi (Astragalus Root, 1 liang each), Baifuling (White Poria, 3 qian).
All ingredients are cut. Take 5-6 qian per dose, add three large cups of water, decoct to two cups. Add 2 qian of Huangqin-Huanglian Tang (Scutellaria-Coptis Decoction), boil briefly, strain, decoct to one cup, and take hot after meals.
*Huangqin-Huanglian Tang*: Huangqin (Scutellaria Root, wine-washed, roasted, 1 liang), Huanglian (Coptis Rhizome, trimmed, wine-washed, roasted, 7 qian), Caolongdan (Gentiana Scabra Root, 1 liang, wine-washed, roasted four times), Shengdi (Rehmannia Root, 1 liang, wine-washed).
Cut all. Take 2 qian per dose, add two cups of water, boil briefly, strain, decoct to one cup, take hot. Do not take in afternoon or evening; only effective at lunchtime.
Fuming San (Vision-Recovering Powder) treats internal cataracts.
Huangqi (Astragalus Root, 1.5 qian), Chuanxiong (Ligusticum Rhizome, 0.5 qian), Chaihu (Bupleurum Root), Lianqiao (Forsythia Fruit), Gancao (Licorice Root, roasted, 1 qian each), Guishen (Angelica Sinensis Root Tip, 2 qian), Cangzhu (Atractylodes Lancea Rhizome, 0.5 qian), Shengdi (Rehmannia Root, 1 qian), Chenpi (Tangerine Peel, 0.5 qian), Huangbai (Phellodendron Bark, 0.3 qian).
Crush to size of hemp seeds. One dose per serving, two large cups of water, decoct to one cup, strain, take slightly warm after meals. Avoid alcohol, damp noodles, spicy-hot spices.
The above four formulas treat unclear vision due to Qi deficiency without collapse, allowing slight addition of Huanglian (Coptis) and Huangbai (Phellodendron) to Renshen (Ginseng) and Huangqi (Astragalus). If Qi has collapsed, cooling drugs like Huangbai are contraindicated. The Classic states: Yang Qi flares up with excessive labor. Essence exhaustion leads to blindness and deafness. This is its manifestation.
Discussion on Dilated Pupil in Internal Cataracts and Formulas. (The Kidney governs the bone essence forming the pupil. Dilation occurs due to Kidney Water deficiency and bone withering, allowing Pericardium Fire to invade.) The Pericardium Meridian originates from the Heart, acting on behalf of the Heart Sovereign, and is exterior-interior related to the Shaoyang. Dilation of the pupil involves the Shaoyin Heart Meridian connecting to the eye system and the Jueyin Liver Meridian connecting to the eye system. Heart governs Fire, Liver governs Wood; thus, Wood-Fire energy is excessive. Flavors should be bitter, sour, and cool to drain Wood-Fire evil. Avoid spicy-hot foods. Sour flavors collect Heart Qi and drain Wood-Fire. Bitter flavors drain Fire and benefit Water. Especially avoid cold water and icy foods, which damage Stomach Qi. If Stomach Qi fails, Yuan Qi does not generate. Yuan Qi deficiency leads to sinking Stomach Qi, allowing Triple Burner and Heart Fire to ascend to the Lung, burning marrow. Fire causes dispersion, leading to pupil dilation. Large hot foods directly aid Fire evil and must be avoided. Remove Chongweizi (Vernonia Seed) from the formula because its pungent flavor benefits the Liver, aiding Fire. Add Huangqin (Scutellaria, 0.5 liang) and Huanglian (Coptis, 3 qian); Huanglian drains Middle Jiao Fire, Huangqin drains Upper Jiao Lung Fire. Wine-washing makes it "cold used with heat." Do not use Qingxiangzi (Celosia Seed) as it aids Yang Fire. Add Wuweizi (Schisandra, 3 qian) to constrict the dilated pupil. Fire and Qi cannot coexist. The Classic states: Vigorous Fire consumes Qi; Qi nourishes Mild Fire; Mild Fire generates Qi; Vigorous Fire scatters Qi. Sour foods assist Yuan Qi. Sun Simiao said: Take Wuweizi in May to assist Five Zang Qi and tonify West Metal (Lung). The Classic states: Tonify with sour, drain with pungent. Thus, pungent drains Qi. Why keep Danggui (Angelica)? Its pungent-sweet nature harmonizes Blood. Sweetness acts as a guide/enforcer for other herbs.
Shudi Wan (Prepared Rehmannia Pill) treats weak Blood and Qi failing to nourish the Heart, causing Fire to flare in Yin levels, dilating the pupil. Shaoyin is Fire; the Sovereign is inactive, so Minister Fire takes over. Shaoyang Minister Fire is formless in substance but active in function. Excessive Fire makes the Mother (Wood/Liver) full. Heart and Liver meridians connect to the eye system. Shaoyang meridians exit the ear, reach the temple, and end at the outer canthus. Wind-Heat attacks head and eyes, causing unilateral swelling, pupil dilation, and blurred vision due to Blood deficiency and Yin weakness. Treatment: Nourish, cool, and benefit Blood; collect and scatter Fire; dispel Wind-Heat.
Shudi (Prepared Rehmannia Root, 1 liang), Guishen (Angelica Root Tip, wine-washed, 5 qian), Chaihu (Bupleurum Root, trimmed, 8 qian), Tianmendong (Asparagus Tuber, heart removed, dried, 3 qian), Renshen (Ginseng, rhizome removed, 2 qian), Gancao (Licorice Root, roasted, 2 qian), Digupi (Dogwood Bark, 3 qian), Huangqin (Scutellaria Root, 0.5 liang), Zhike (Bitter Orange, roasted, 2 qian), Wuweizi (Schisandra Berry, 3 qian), Shengdi (Fresh Rehmannia Root, 7.5 qian, wine-soaked and dried), Huanglian (Coptis Rhizome, 3 qian).
Grind to fine powder, make honey pills like mung beans. Take 100 pills with tea broth after meals, twice daily. Avoid spicy foods and cold items that damage Stomach Qi. Another theory: Pupil/black eye follows Yin principles. Eating spicy-hot foods aids Fire invading the chest, causing pupil dilation and magnified vision.
Yiyin Shenqi Wan (Benefit-Yin Kidney-Energy Pill) strengthens the Master of Water to suppress Solar Flare.
Shanzhuyu (Cornus Fruit, peel only, 1 liang), Fushen (Poria with Hostwood, core removed, 2.5 qian), Wuweizi (Schisandra Berry, 5 qian), Shudi (Prepared Rehmannia Root, 2 liang), Gaoyao (Dried Yam, 5 qian), Zexie (Alisma Rhizome, 2.5 qian), Mudanpi (Moutan Bark, 5 qian), Shengdi (Fresh Rehmannia Root, wine-washed, dried, 1 liang), Guishao (Angelica Root Tip, wine-washed, 5 qian).
Grind to fine powder, make honey pills like sesame seeds, coat with Cinnabar. Take 50-70 pills with light salt broth.
Ziyin Dihuang Wan (Nourish-Yin Rehmannia Pill) treats internal cataracts, blue-white nebula in inner canthus, mild white nebula in outer canthus, headache, dilated pupil, upper heat aversion to heat, constipation with post-defecation bloating, normal urination, headache/dull swelling in warmth, good appetite, dimness after sunset. This case suits Shudi Wan. Nebula in outer canthus: add Gegen (Kudzu Root), Shengma (Cimicifuga Root). Nebula in inner canthus: add Chaihu (Bupleurum Root), Qianghuo (Notopterygium Root).
Shudi (Prepared Rehmannia Root, 8 qian), Shengdi (Fresh Rehmannia Root, wine-washed, 0.5 liang), Guishen (Angelica Root Tip, wine-washed, 0.5 liang), Zhimu (Anemarrhena Rhizome, wine-washed, roasted, 3 qian), Danshen (Salvia Root, 0.5 liang), Huangbai (Phellodendron Bark, wine-soaked, dried, 0.5 liang), Shaoyao (Peony Root, 1.3 liang), Fangji (Stephania Root, wine-washed, dried, 2 qian), Chongweizi (Vernonia Seed, 0.5 liang), Mudanpi (Moutan Bark, 3 qian), Hanshuishi (Calcite, raw, 1 qian), Chaihu (Bupleurum Root, 0.5 liang), Heifu (Black Prepared Aconite, 1 qian), Chuanxiong (Ligusticum Rhizome, 2 qian).
Grind to fine powder, make honey pills like small beans. Take 50 pills on empty stomach with plain water. If undigested food remains, wait until hungry. Rest after taking; eat afterward to settle.
[Baoming Ji] Danggui Tang (Angelica Decoction) treats nebula accumulation and pupil dilation.
Guishen (Angelica Root Tip), Huangqin (Scutellaria Root, 1 qian each), Huanglian (Coptis Rhizome), Dihuang (Rehmannia Root, 3 qian each), Chaihu (Bupleurum Root, 1 qian), Shaoyao (Peony Root, 2 qian), Gancao (Licorice Root, roasted, 3 qian).
Decoct in water, take before bed.
[Luo Qianfu] Ganjuhua Wan (Chrysanthemum Pill) treats male Kidney deficiency causing dim vision or black spots. Regular use brightens eyes, warms Water Organ, invigorates Blood, preserves youth, and strengthens sinews/bones.
Ganjuhua (Chrysanthemum Flower, cleaned, 2 liang), Gouqi (Goji Berry, 4 liang), Shudi (Prepared Rehmannia Root, 3 liang), Gaoyao (Dried Yam, 0.5 liang).
Grind to fine powder, make honey pills like sesame seeds. Take 30-40 pills on empty stomach and after meals with warm water.
[Ruizhutang Jingyanfang] Sishen Wan (Four Divine Pills) treats Kidney channel deficiency, dim vision, tonifies deficiency, and cloud-like nebula obscuring pupils.
Ganzhou Gouqi (Goji Berry, 1 jin, select clean ones). Divide into four parts: Part 1 stir-fry with 1 liang Chuanjiao (Sichuan Pepper); Part 2 stir-fry with 1 liang Xuxiang (Frankincense) and 1 liang Huixiang (Fennel); Part 3 stir-fry with 1 he (approx. 100g) Sesame. Pre-soak Goji in one cup of good wine before frying.
After frying, sieve out pepper, frankincense, fennel, and sesame. Use only Goji berries plus Shudi (Prepared Rehmannia), Baizhu (Atractylodes), and Fuling (Poria), 1 liang each. Grind to fine powder, make honey pills like sesame seeds. Take 50-70 pills on empty stomach with warm wine. Adding 1 liang Ganjuhua (Chrysanthemum) is excellent.
These examples show Rehmannia and Goji tonifying Kidney. Note: For pupil dilation, Chongweizi, Chuanxiong, and Fuzi are generally contraindicated. Dongyuan's Ziyin Dihuang Wan uses them likely due to concurrent external cataract nebulae.
[Baoming Ji] Chaihu San (Bupleurum Powder) brightens eyes and benefits Kidney Water.
Chaihu (Bupleurum Root), Qianghuo (Notopterygium Root), Fangfeng (Saposhnikovia Root), Shengdi (Fresh Rehmannia Root), Shaoyao (Peony Root), Gancao (Licorice Root) in equal parts.
Grind to coarse powder, decoct in water, take before bed.
Li Dongyuan stated: When Liver Wood is excessive, Fire prevails without restraint, attacking the Spleen-Stomach first. Internal cataracts arise because Spleen envelops Blood, Stomach governs Blood, Heart governs Vessels (the mansion of Blood). Some say Heart governs Blood; others say Vessels govern Blood. The Liver orifice opens to the eyes. (Treatment follows Shudi Wan type.)
Liu Hejian stated: Dim vision is Heat. The "Xuan Fu" (mysterious cavity/orifice) exists everywhere—in organs, skin, muscles, bones, teeth, nails, and all things. It is the pathway for Qi entering/exiting and ascending/descending. Eye, ear, nose, tongue, body, mind, and spirit function only when this pathway is open. Blockage prevents function. Blindness, deafness, anosmia, ageusia, tendon atrophy, bone bi, nail degeneration, tooth decay, hair loss, skin numbness, and intestinal failure are all due to Heat stagnation blocking the Xuan Fu, preventing Qi, fluids, Blood, Ying-Wei, and Spirit from circulating. Severity depends on stagnation depth. Heat stagnating in the eye causes blindness. Mild dimness makes near objects hard to distinguish because the Xuan Fu is narrowed, like looking through a curtain. Seeing fly wings indicates partial closure. Seeing black flowers indicates severe Heat manifesting in the eye. "Excess causes harm, control follows." Tears and fluids obscure vision, appearing as black flowers nearby.
Indeed! Liu Hejian’s words are true. Blindness, deafness, etc., result from blocked Xuan Fu obstructing Spirit/Qi circulation. Ancients treated dim vision with Sheep Liver Pill, using sheep liver to guide Huanglian (Coptis) into the Liver to resolve Liver stagnation. Since Liver governs the eyes, resolving Liver stagnation clears the Xuan Fu and restores vision. Huanglian resolves Heat stagnation. Jiaomu (Sichuan Pepper Seed) resolves Damp-Heat. Chongweizi resolves Qi stagnation. Xiong-Gui (Chuanxiong-Danggui) resolves Blood stagnation. Muzei (Equisetum) resolves accumulated stagnation. Qianghuo resolves Channel stagnation. Cishi (Magnetite) resolves head/eye heaviness by descending evil. Manjing (Turnip) descends Qi and unblocks the middle. These formulas treat Qi-Blood stagnation causing dim vision. Hejian’s theory is reliable. Dongyuan and Danxi used Renshen (Ginseng) and Huangqi (Astragalus) to tonify Qi/Blood for dim vision because abundant Qi/Blood keeps the Xuan Fu open and clear. Deficiency blocks circulation, causing dimness. Thus, tonifying Qi/Blood with Renshen, Huangqi, Siwu Tang restores clarity.
Yanggan Wan (Sheep Liver Pill) and associated formulas treat Liver stagnation dim vision effectively. See Liver section.
[Bencao] Treats long-term black spots and dim vision.
Jiaomu (Sichuan Pepper Seed, roasted, 1 liang), Cangzhu (Atractylodes Lancea Rhizome, roasted, 2 liang).
Grind to powder, make pills with vinegar paste like sesame seeds. Take 20 pills with vinegar-tea. Effective within 10 days. (Danxi: Jiaomu promotes fluid metabolism where pathways are blocked.)
[Waitai Mi Yao] Bugan San (Liver-Tonifying Powder) treats 30-year blindness.
Jili Zi (Tribulus Fruit, harvested July 7th, dried, powdered). Take one cubic inch spoonful with water after meals.
[Cui Shi] If the pupil is intact, nine out of ten recover. Manjingzi (Turnip Seed, 6 sheng), steam until vapor penetrates, pour hot water from the steamer base over it, dry in sun, repeat three times. Grind to powder. Take 2 qian with clear wine before meals, twice daily. (Compendium: Manjingzi descends Qi, benefits five Zang, promotes bowel movement, unblocks middle, benefits Qi.)
[Jing] Treats consumptive dim vision. Harvest Manjing flowers in March, dry, powder. Take 2 qian with well water on empty stomach. Long-term use promotes longevity.
[Shiyi] Wufu Huantong Dan (Five Blessings Pupil-Returning Pill) treats white nebula.
Chishizhi (Red Halloysite) and Chuanjiao (Sichuan Pepper) stir-fried together. Chen sha (Cinnabar), Fushen (Poria with Hostwood), Xuxiang (Frankincense), Jujube meat. Make pills like sesame seeds. Take 100 pills on empty stomach with warm wine. Effective after ten doses.
Internal cataracts often start in one eye and spread to both, with nebula inside the black cornea obscuring the pupil. The vessels connecting to the black cornea are the Eye System (Muxi), belonging to Foot Jueyin, Foot Taiyang, and Hand Shaoyin channels. Deficiency in these channels allows Evil to invade and stagnate, entering the black cornea via the Eye System to form nebula. "Brain fat flowing down" (Foot Taiyang Evil) and "Liver Qi rushing up" (Foot Jueyin Evil) cause nebula. Acupuncture treatment: Select acupoints from these three channels, such as Tianzhu (BL10), Fengfu (GV16), Taichong (LR3), Tongli (HT5). Skilled practitioners can mechanically remove nebula with needles for faster results. Herbal treatment: Tonify the Middle, unblock stagnation in these three channels to prevent Evil from entering the Eye System. Below are collected formulas from Longmu Lun.
[Longmu Lun] Lingyangjiao Yinzi (Antelope Horn Decoction) treats round nebula internal cataract, painless and itchless.
Lingyangjiao (Antelope Horn, 3 liang), Xixin (Asarum), Zhimu (Anemarrhena Rhizome), Cheqianzi (Plantago Seed), Renshen (Ginseng), Huangqin (Scutellaria Root, 2 liang each), Fangfeng (Saposhnikovia Root, 2.5 liang).
Grind to powder. Take 1 qian, decoct in one cup water to half a cup. Strain, take warm after meals.
Bugan San (Liver-Tonifying Powder) treats Liver Wind internal cataract, painless, itchless, seeing flowers, colors yellow/white/black/red, or diplopia.
Lingyangjiao (Antelope Horn), Fangfeng (Saposhnikovia Root, 3 liang each), Qianghuo (Notopterygium Root), Cheqianzi (Plantago Seed, 1 liang each), Renshen (Ginseng), Fuling (Poria, 2 liang each), Xixin (Asarum), Xuanshen (Scrophularia Root), Huangqin (Scutellaria Root, roasted, 1 liang each).
Grind to powder. Take 1 qian after meals with rice water.
Lingyangjiao San (Antelope Horn Powder) treats Green Wind internal cataract, dizziness, eye pain, and internal eye soreness.