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Ocular diseases are mostly caused by wind-heat pathogens. When the heat of smallpox toxins stagnates and attacks upward to the eyes, if redness, swelling, dryness, and pain occur, Xi Gan San (Washing Liver Powder) should be used for treatment; if nebulae obscure vision, Long Dan Tang (Gentian Decoction) should be used.

[Note]
Ocular diseases are indeed often initiated by wind-heat. The heat of smallpox toxins accumulates intensely, extending from the interior to the exterior. If Qi and Blood are weak, they cannot drive the main Qi downward and outward, causing fire to stagnate and attack upward, resulting in eye disease. If symptoms such as redness, swelling, pain, eyelid stiffness with tearing, and inability to open the eyes occur, Xi Gan San (Washing Liver Powder) is the primary formula. If nebulae obscure vision accompanied by stiffness and photophobia, Jia Wei Long Dan Tang (Modified Gentian Decoction) is the primary formula.

(Xi Gan San / Washing Liver Powder)
Qiang Huo (Notopterygii Rhizoma et Radix), Dang Gui Wei (Angelicae Sinensis Radix caudex), Fang Feng (Saposhnikoviae Radix), Shan Zhi Ren (Gardeniae Semen), Gu Jing Cao (Euphrasiae Herba), Bo He (Menthae Haplocalycis Herba), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma). Decoct in water, take after meals.

(Formula Song)
Xi Gan San treats ocular pain, containing Qiang Huo, Dang Gui Wei, and Fang Feng; Shan Zhi Ren combined with Gu Jing Cao, Pei Bo (Peppermint) and Gan Cao paired with Chuan Xiong.

(Long Dan Tang / Gentian Decoction)
Fang Feng (Saposhnikoviae Radix), Mu Zei Cao (Equiseti Herba), Mi Meng Hua (Callicosiae Flos), Chan Tui (Cicadae Periostracum), Man Jing Zi (Viticis Fructus), Long Dan Cao (Gentianae Radix), Ju Hua (Chrysanthemi Flos), Huang Lian (Coptidis Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Ji Li (Tribuli Fructus). Decoct in water.

(Formula Song)
For nebulae obscuring vision, Long Dan Tang is praiseworthy, containing Fang Feng, Mu Zei, and Mi Meng Hua; Chan Tui, Man Jing Zi, Long Dan Cao, and Ju Hua; Huang Lian, Bai Zhi, and Ji Li are excellent.

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Miscellaneous Syndromes in Smallpox

The meridians of the Spleen channel surround the lips and mouth. Throughout the course of smallpox eruption, it is most valuable for the lips to remain moist and reddish. If they become purple, cracked, or scorched black, urgent treatment is required, following the two formulas of Ge Gen Jie Du Tang (Kudzu Root Detoxifying Decoction).

[Note]
The meridians of the Spleen channel loop around the lips and mouth; thus, the classics state: "The splendor of the six fu organs manifests in the lips."
Only when fluids are sufficient and Qi and Blood flow smoothly can the lips and mouth appear reddish and moist. Therefore, throughout the eruption of smallpox, this condition is highly valued.
Otherwise, once constrained by toxic heat, the toxin invades the middle jiao, and heat blazes on the exterior. Not only will they fail to be reddish and moist,
but they may also turn crimson-purple or become scorched and cracked. Treatment must not be delayed.
In the early stage, Jia Wei Sheng Ma Ge Gen Tang (Modified Ephedra and Kudzu Root Decoction) should be used. After the swelling phase begins, Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity) should be used.

(Jia Wei Sheng Ma Ge Gen Tang / Modified Ephedra and Kudzu Root Decoction)
Chi Shao (Paeoniae Radix Rubra), Zhi Zi (Gardeniae Fructus), Huo Xiang (Agastaches Herba), Sheng Ma (Cimicifugae Rhizoma), Ge Gen (Puerariae Lobatae Radix), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma), Fang Feng (Saposhnikoviae Radix), Shi Gao (Gypsum Fibrosum). Decoct in water and take orally.

(Formula Song)
Jia Wei Sheng Ma Ge Gen Tang contains Chi Shao, Zhi Zi, and Huo Xiang; Sheng Ma, Ge Gen, and Sheng Gan Cao; Fang Feng and Shi Gao are decocted together for consumption.

(Huang Lian Jie Du Tang / Coptis Decoction for Resolving Toxicity) See the section on Scabbing and Scab Falling syndromes for the formula.
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Miscellaneous Syndromes in Smallpox