Library

After the recovery from Shanghan disease (Cold Damage), some individuals may suffer severe eye diseases again. This is because the clear Yang Qi (vital energy ascending to the head and senses) fails to ascend, while residual pathogenic factors move upward into the orifices. The symptoms include dull pain, astringency, redness, swelling, formation of corneal opacities (翳), photophobia, headache, and bone pain. It is appropriate to administer decoctions with ascending and dispersing properties; after several doses, the condition will resolve. *Shanghan Lun* (Treatise on Cold Damage) states: "In winter, when the cold is severe, all things are deeply hidden. The gentleman keeps himself secure and does not injure himself with cold. Those who are exposed to it are named as having Shanghan. Injuries caused by the Qi of the four seasons can all lead to disease." Furthermore, *Shengqi Tongtian Lun* (Treatise on the Connection between Heaven and Human Life) states: "The Qi of the four seasons alternately injures the Five Zang organs. If any of the Five Zang or Six Fu organs becomes diseased, then turbid Yin Qi cannot descend, and clear Yang Qi cannot ascend." Although the Shanghan or seasonal disease has now healed, the balance between turbid Yin and clear Yang Qi has not yet been restored. Because this balance is unrestored, residual pathogens remain vigorous and ceaseless, thus moving upward to harm the eyes. Therefore, if one recovers in one day, the residual pathogen is in the Taiyang channel; if in two days, in the Yangming channel; if in three days, in the Shaoyang channel; if in four days, in the Taiyin channel; if in five days, in the Shaoyin channel; if in six days, in the Jueyin channel. Recovery after seven days indicates that clear Yang Qi could not emerge from the upper orifices and was instead harmed by them. Treatment should focus on assisting the clear Yang Qi to ascend. The primary formulas include Renshen Buyang Tang (Ginseng Decoction for Supplementing Yang), Qianghuo Shengfeng Tang (Notopterygium Decoction for Overcoming Wind), Jiadi Dihuang Wan (Rehmannia Pill with Modifications), and Biyun San (Green Cloud Powder for the Nose) is also suitable. One must avoid bitter-cold purgatives such as Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas); using them will certainly fail to cure the disease.

"Qiang" (Strong) refers to being vigorous and powerful; "Shi" (Excess/Solid) refers to being firm and internally full. Therefore, what is powerful tends to gather and condense; what is internally full tends to contract due to its solidity. Thus, Yin and Yang do not become strong or solid simultaneously. Disease arises only when there is an imbalance of "Qiang" and "Shi." Internally condensed within the body, it manifests externally in the hollow orifices. The Foot-Shaoyin Kidney belongs to Water; the essence of the Kidney ascends to form Shen Shui (divine water, referring to the clear fluid in the eye). The Hand-Jueyin Pericardium belongs to Ministerial Fire. If Fire is strong and forces Water, Water becomes solid and contracts. The symptom is that the Shen Shui becomes tight and small, gradually shrinking until, at its extreme, it resembles the size of a vegetable seed. There may also be cases where the periphery of the Shen Shui appears similar to insect erosion. However, vision remains clear without blurriness, though there is a slight sensation of astringency or discomfort. These conditions occur because Strong Yang forces Yin, and Solid Yin resists. Although subjected to force, the impact is confined to the peripheral skin, causing no internal injury or disturbance. The treatment method is to suppress Yang and soothe Yin, which leads to recovery. Because it is "Qiang" (strong), it can be suppressed; because it is "Shi" (solid), it should only be soothed, not assisted. Assisting it would cause it to prevail further, thereby suppressing Yang. Jiulian San (Wine-Processed Coptis Powder) is the primary formula. Generally, things that are "strong" are difficult to penetrate; therefore, wine is used as a guide to ensure the medicinal flavors match and enter effectively, allowing them to exert their full effect. This is a contrary treatment method. Huanyin Jiuku Tang (Decoction for Restoring Yin and Saving from Bitterness) is the primary formula, which treats Ministerial Fire. Biyun San (Green Cloud Powder for the Nose) is also suitable. Although such diseases are occasionally seen in the world, physicians must recognize them.