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If this syndrome presents with this pulse, administering cold-natured drugs again will inevitably cause further rupture. The ancient saying "eyes not treated do not go blind" precisely refers to this situation. Herein, I propose adopting Zhang Zhongjing's treatment method for Shaoyin Cold Damage (Shaoyin Taiyang Syndrome), using Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) to warm the meridians and disperse cold, allowing the cold to dissipate and the deficient fire to subside, so that the eyes will naturally return to normal. Shen Zaihou agreed, took two doses, and was cured.

In the winter of the Jichou year, a farmer surnamed Shen from Deqing suffered from blindness for over ten years.
He stated: When the illness first began, he experienced tinnitus like thunder, and whenever he heard people speaking, it felt as if the voices were above his head. Additionally, his eyes flickered, seeing two豆-sized flames; closing his eyes caused heat in the eyeballs and worsened the tinnitus. After administering clearing and draining agents, although the acute symptoms subsided, his vision was completely lost. All doctors he consulted diagnosed him with Qingmang Internal Cataract (Green Blindness/Internal Cataract), stating it could not be cured without acupuncture. He specifically visited here to beg for treatment. I said: Internal cataracts can be harmed by the Six Evils (Six Pathogenic Factors) and Seven Emotions (Seven Emotional States). Now, palpating your pulse, it remains deep and wiry. Your initial onset was indeed due to excessive damp-heat fire in the Liver and Gallbladder attacking upwards, causing fire in the eyes and thunder-like tinnitus. When fire attacks the ears severely, the sound resembles thunder; amidst such thunderous noise, hearing speech makes one feel it is above the head. At that time, Longdan Xiegan Tang (Gentian Liver-Draining Decoction) should have been used to drain fire and resolve stagnation. Once stagnation is resolved, dampness is removed; once dampness is removed, fire is extinguished, preventing internal cataracts. However, only cooling agents were administered without seeking the root cause, hence the pulse remains as described. One should first administer Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), removing Baizhu (Atractylodes Macrocephala Rhizome), for ten doses to clear long-standing stagnant heat, preventing re-obscuration after acupuncture. After taking the medicine, use a gold needle to manipulate the cataract, restoring vision to normal.

Another patient, Shen Fengqi from Deqing, aged over fifty, had been blind in the left eye for over ten years. Suddenly, after a fall, the right eye also became completely blind. Half a year later, he sought treatment. Observing his left eye, the pupil was dilated, and the Shen Water (ocular fluid) had solidified; no treatment was needed. The right eye had an internal cataract, which could be manipulated with a needle. Upon manipulation, vision returned to normal, with no other obstructions. The lesion originally formed above the pupil but descended due to the impact of the fall.

Someone asked: In eye diseases presenting with pupil dilation and Yellow Membrane Rushing Upward (Huangmo Shangchong), these are clearly visible within the Black Pearl (Cornea/Iris area). Why, when inserting a gold needle, is only the pupil area seen, while the needle itself is not clearly visible within the black pearl? If the black pearl were unclear, how could pupil dilation and yellow membrane rushing upward be seen? I replied: The water in the eye resembles fish brain, varying in color. In the White Pearl (Sclera), it is green; in the Black Pearl, it is gray-black. The pupil is wrapped in layers like lacquer, with Shen Water inside. The outer shell is thick like a fingernail, with pores penetrating to make the pupil visible externally. Thus, when inserting a needle into the pupil for manipulation, if the needle tip deviates slightly outward, it catches on the pore, proving the existence of natural pores connecting the pupil to the exterior. Outside these pore openings, a membrane forms, bright and full like crystal, wrapping the eye, which the pupil relies on to seal the Shen Water. In cases of pupil dilation, Shen Water is forced out through the pores, scattering between the clear membrane and the pupil. Yellow Membrane Rushing Upward often originates from the lower rim of the black pearl, located within the clear membrane but outside the pearl shell. Although this disease appears only in the black pearl, its origin lies in the white pearl, as their colors are similar, making it less distinct externally. For such cases, one must quickly disperse Lung pathogenic factors and drain fire. Although the existing membrane may not disappear, it prevents upward obscuration of the pupil, avoiding chronic disease. I treated a woman of the Sun family from my hometown who initially had a constricted pupil in the left eye and an internal cataract in the right. Since the cataract was newly formed and unsuitable for needle manipulation, I treated only the left eye, curing her in three months. About half a year later, her left eye suddenly hurt slightly, and she could not see. After sleeping briefly, she could see somewhat, then lost vision again, regaining it after another nap. This cycle continued for six or seven days before she sought treatment again. Her pupil showed turbid qi but was not constricted. The lower rim of the black pearl showed a yellow membrane rising about half a cun. I said: The pupil itself is healthy; the turbid qi around it is due to the yellow membrane within the clear membrane attempting to rush upward. This condition belongs to excessive internal fire closed by external pathogens. Stagnation prevents Qi from dispersing outward, forcing fire inward and upward. During sleep, Qi descends, carrying fire down, so turbid qi recedes, allowing vision. Upon waking, Qi rises, carrying fire up, causing blindness again. Now, one must quickly disperse external pathogens and clear internal fire. Use Su Ye (Perilla Leaf), Fang Feng (Saposhnikovia Root), Gan Ju (Chrysanthemum Flower) each 1 qian; Bai Jili (Tribulus Fruit), Shi Jue Ming (Abalone Shell) each 3 qian; Huang Qin (Scutellaria Root) 2 qian; Yu Jin (Curcuma Aromatica Rhizome) 1.5 qian; Huang Lian (Coptis Rhizome), Ling Yang Jiao (Antelope Horn), Chi Shao Yao (Red Peony Root) each 0.5 qian. Take two doses; vision gradually clears. Take two more doses; the yellow membrane disappears, and turbid qi in the pupil is fully cleared, resulting in cure. I told her: Treatment for Yellow Membrane Rushing Upward usually stabilizes the membrane. Its sudden disappearance indicates the membrane was yellowish-white, arising minimally from the black pearl, meaning the pathogen was shallow, thus easily eliminated. However, though the black pearl is clear, the white pearl may not be fully cleared; take more doses to eradicate the root.

Huanyin Jiuku Tang (Restore Yin and Save from Peril Decoction)
Shengma (Cimicifugae Rhizoma), Cangzhu (Atractylodis Rhizoma), Cao Gao (Licorice Tip), Jiegeng (Platycodon Root), Chaihu (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix) (each 5 fen); Xixin (Asari Radix et Rhizoma) (2 fen); Bencao (Ligustici Rhizoma) (4 fen); Guiwei (Angelicae Sinensis Radix End), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Shengdi (Rehmanniae Radix), Zhimu (Anemarrhenae Rhizoma), Lianqiao (Forsythiae Fructus) (each 6 fen); Honghua (Carthami Flos) (1 fen); Dancao (Gentianae Radix) (3 fen).
Decoct in clear water and take orally.

Gouteng Yinzi (Uncaria Infusion)
Gouteng (Uncariae Ramulus cum Uncis, processed with heat, 5 fen); Mahuang (Ephedrae Herba), Gancao (Licorice Root, processed with heat, each 3 fen); Chuanxiong (Ligustici Chuanxiong Rhizoma), Fangfeng (Saposhnikoviae Radix), Renshen (Ginseng Radix) (each 7 fen); Quanxie (Scorpio, stir-fried, thorns removed, 1 qian); Tianma (Gastrodiae Rhizoma) (8 fen); Jiangcan (Bombyx Batryticatus, stir-fried, 1.2 qian).
Add three slices of fresh ginger, decoct in water, and take at any time.

Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill)
Niuhuang (Calculus Bovis, 1 liang 2 qian); Shexiang (Moschus), Nao (Borneolum Syntheticum) (these three separately ground); Lingyangjiao (Saigae Tataricae Cornu, shaved, each 1 liang); Danggui (Angelicae Sinensis Radix, wine-washed), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Maidong (Ophiopogonis Radix, heart removed), Baishao (Paeoniae Radix Alba) (each 1 liang 5 qian); Chaihu (Bupleuri Radix), Jiegeng (Platycodonis Radix), Fuling (Poria), Xingren (Armeniacae Semen Amarum, skin and tip removed), Chuanxiong (Ligustici Chuanxiong Rhizoma), Rougui (Cinnamomi Cortex), Dahuang Huangjuan (Sojae Seminum Praeparatum), Ejiao (Colla Corii Asini) (each 1 liang 7 qian); Puhuang (Typhae Pollen), Renshen (Ginseng Radix), Shenqu (Massa Medicata Fermentata) (each 2 liang 5 qian); Xionghuang (Realgar, separately ground); Gancao (Licorice Root, 5 liang); Bailian (Trollii Radix) (7.5 qian); Ganjiang (Zingiberis Rhizoma) (7.5 qian); Xijiao (Rhinocerotis Cornu, shaved, 2 liang); Ganshan Yao (Dioscoreae Hypoglaucae Rhizoma) (7 qian); Jinbo (Folium Aureum) (1300 pieces total, 400 pieces for coating).
Grind all into powder. Steam 100 large dates until cooked, remove skins and pits, grind into paste. Mix with refined honey and date paste to form pills. Each liang makes ten pills. Coat with gold foil. Take one pill per dose, dissolved in warm water.

Shuyu Quanjing Dan (Relieve Stagnation and Restore Vision Pill)
Baijiezi (Sinapis Semen, 3 qian); Zhizi (Gardeniae Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria) (3 qian); Chaihu (Bupleuri Radix), Chenpi (Citri Reticulatae Pericarpium, 1 qian); Baishao (Paeoniae Radix Alba, 5 qian); Gancao (Licorice Root).
Decoct in clear water and take orally.

Jiajian Bawei Wan (Modified Eight-Ingredient Pill)
Shudihuang (Rehmanniae Radix Preparata, 8 liang; avoid iron pots and alcohol, boil until soft, mash into paste); Shanyao (Dioscoreae Rhizoma); Shanzhuyu (Corni Fructus, washed in wine, dried) (each 4 liang); Baifuling (Poria), Zexie (Alismatis Rhizoma, washed in wine, dried) (each 3 liang); Mudanpi (Moutan Cortex, washed in wine, dried) (3 liang); Wuweizi (Schisandrae Fructus, dried by fire, 0.5 liang); Rougui (Cinnamomi Cortex, bark removed, avoid direct fire, 1 liang).
Except for the Rehmannia paste added separately, grind the rest into fine powder. Mix with refined honey to form pills the size of tung seeds. Take 3 qian per dose, with salted water on an empty stomach. Avoid radishes.

Mengshi Gun Tan Wan (Calamine Rolling Phlegm Pill)
Qingmengshi (Calaminaris Lapis, 1 liang); Chenxiang (Aquilariae Lignum Resinatum, 5 qian); Huangqin (Scutellariae Radix), Dahuang (Rhei Radix et Rhizoma, steamed with wine, 8 liang).
Crush Qingmengshi. Mix with 1 liang of Yanxiao (Saltpeter) in a clay pot, seal with salt mud, dry, and calcine until the stone turns golden. Grind into powder. Mix with other herbs. Form water pills. Dosage depends on deficiency or excess. Take with ginger decoction. After ingestion, lie supine to keep the medicine in the chest and diaphragm, targeting upper jiao phlegm stagnation. Avoid drinking water or moving.

Baojian Chenxiang Tianma Wan (Precious Mirror Aquilaria Gastrodia Pill)
Chenxiang (Aquilariae Lignum Resinatum), Yizhi (Alpiniae Oxyphyllae Fructus), Chuanwu (Aconiti Radix Preparata) (each 2 qian); Tianma (Gastrodiae Rhizoma), Fangfeng (Saposhnikoviae Radix), Banxia (Pinelliae Rhizoma), Fuzi (Aconiti Lateralis Radix Preparata, processed) (each 3 qian); Qianghuo (Notopterygii Rhizoma et Radix, 5 qian); Gancao (Licorice Root), Danggui (Angelicae Sinensis Radix), Jiangcan (Bombyx Batryticatus), Duhuo (Angelicae Pubescentis Radix) (each 1 qian).
Take 5 qian per dose. Add three slices of fresh ginger. Decoct in water, strain, and take warm. Take three doses before meals.

Baohe Wan (Harmony Preservation Pill)
Shanzha (Crataegi Fructus, 3 liang, pitted); Shenqu (Massa Medicata Fermentata, stir-fried); Banxia (Pinelliae Rhizoma); Fuling (Poria) (each 1 liang); Chenpi (Citri Reticulatae Pericarpium); Laifuzi (Raphani Semen, lightly stir-fried); Lianqiao (Forsythiae Fructus) (each 5 qian).
Form pills with malt paste dough. Take with malt decoction.

Xiao Wei Dan (Minor Stomach Pill)
Yuanhua (Kadsurae Flos, mixed with vinegar, 1 liang, stir-fried in earthenware until black but not burnt); Kansui (Euphorbiae Kansui Radix, soaked in running water for half a day, boiled, dried); Daji (Euphorbiae Pekinensis Radix, boiled in running water, washed again, dried) (each 5 fen); Dahuang (Rhei Radix et Rhizoma, wrapped in wet paper, baked, sliced, stir-fried with wine, 1.5 liang); Huangbai (Phellodendri Cortex, stir-fried, 3 liang).
Grind into fine powder. Form pills the size of radish seeds using Baizhu paste. Take 1 qian with plain water before bed. For purgative effect, take on an empty stomach.

Liujunzi Tang (Six Gentlemen Decoction)
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Gancao (Licorice Root), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma) in equal parts.
Add three slices of fresh ginger and two dates. Decoct in water and take orally.

Yiyuan San (Benefit Origin Powder)
Huashi (Talcum, 6 liang); Gancao (Licorice Root, 1 liang); Chensha (Cinnabaris, 1 qian).
Grind into powder. Take 2 or 3 qian per dose, mixed with cold water. Dengxin Tang (Juncus Decoction) is also acceptable.

Erchen Tang (Two-Aged Decoction)
Banxia (Pinelliae Rhizoma, processed with ginger); Chenpi (Citri Reticulatae Pericarpium, white pith removed); Fuling (Poria, 1 qian); Gancao (Licorice Root, 0.5 qian).
Add ginger and decoct.

Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction)
Mahuang (Ephedrae Herba), Xixin (Asari Radix et Rhizoma), Fuzi (Aconiti Lateralis Radix Preparata).
Boil Mahuang first, remove foam, then add other herbs and decoct.

Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder)
Chaihu (Bupleuri Radix), Bohe (Menthae Haplocalycis Herba), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Chenpi (Citri Reticulatae Pericarpium), Gancao (Licorice Root), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Danpi (Moutan Cortex), Shanzhi (Gardeniae Fructus).
Add ginger and decoct.

Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), Siwu Tang (Four Substance Decoction) (See Head Section for formula details)