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**Red Membrane Drooping Syndrome** is caused by the accumulation of heat in the brain; if there is pain in the black pearl (pupil/cornea area) accompanied by blood stasis, one must promptly resolve the blood stasis in the upper eyelid before pathological changes occur.

This condition initially presents with very mild symptoms, which subsequently become severe. In severe cases, there are opacities, redness, and numerous red vessels extending from the white part of the eye (sclera) downwards across the upper edge of the black pearl, forming a patch of opacity still tethered by red filaments. The vessels are distended and thickened, with intense redness, tearing, astringency, pain in the black pearl, and headache; this indicates an acute disease process with the risk of transformation. If the filaments are fine and few, the color is slightly red, the black pearl is not painful, and there is no headache, the course is slow and less likely to transform. There are also cases where the black pearl is not painful and the head does not hurt; if there are no other symptoms, or only slight redness with thin opacity, with fine filaments tethering it, or several "star-like" spots appearing under the filaments at the edge of the opacity, these "stars" are also minor manifestations of **Nourishing Fat Disease** (Corneal Ulcer). These conditions are all due to the stagnation of fire within, representing a relatively mild pathology that should be treated properly. This is because formless fire has secretly penetrated into the essence/gel, causing such symptoms, which differs from the severity of tangible blood-heat. If filaments exist on the opacity, and star-like spots arise at the tips of the filaments, these are diseases that recede slowly because they draw upon the vital energy (Sheng Qi) within the vessel network; thus, they are easy to generate but difficult to resolve. Although recession is slow, successful resolution is the ideal outcome; for severe cases, guidance/dredging (surgical or strong unblocking methods) is employed as a last resort. Generally speaking, if red vessels arise from the upper half of the white part of the eye and droop over the black pearl, regardless of quantity, if there is pain and tortuous deep redness, it is a ominous sign. Even if the filaments are few and redness is slight, or if they are continuous or interrupted, penetrating the pupil, or presenting as thin or dense opacities, these are all malignant signs. Even if treatable, it requires a long duration. This syndrome is caused by damp-heat in the brain and hidden fire lurking deeply in the collaterals, resulting in redness of the vessels. Although there may be no obvious blood stasis around the periphery, there is stagnation and accumulation in the depths. Therefore, deep stagnation and intense fire, once triggered, cause the disease to erupt violently. Internally there is astringency and stagnation, externally this disease manifests; mild cases are dispersed, severe cases are dredged—this is a fixed treatment principle. Suitable to take:

**Zaojiao Wan (Gleditsia Sinensis Pill)**: Treats all internal and external opacities and membranes. This medicine can dissolve membrane obstructions and treat sixteen types of internal cataracts. It is used together with **Sheng Shu Dihuang Wan** (Raw and Cooked Rehmannia Pill) with miraculous effects.
Ingredients: *Scales Pangolin* (Chuan Shan Jia, stir-fried), *Cicada Slough* (Chan Tui), *Atractylodes Macrocephala Rhizome* (Bai Zhu, stir-fried in soil), *Xuanjing Stone* (used raw), *Valerian Flower Head* (Gu Jing Cao), *Angelica Sinensis Root* (Dang Gui, washed in wine), *Poria Cocos* (Fu Ling), *Equisetum Hiemale Herb* (Mu Zei Cao), *Red Peony Root* (Chi Shao Yao) (each 1 liang), *Dragon Slough* (Long Tui, 7 strips, stir-fried), *Forsythia Fruit* (Lian Qiao) (1.5 liang), *Tribulus Terrestris Pericarpium* (Ci Ji Li Pi, stir-fried with clam powder), *Gentiana Scabra Root* (Long Dan Cao, stir-fried), *Chrysanthemum Morifolium Flower* (Ju Hua) (each 2.5 liang), *Ginseng Radix et Rhizoma* (Ren Shen), *Ligusticum Chuanxiong Rhizome* (Zhen Chuan Xiong) (each 5 qian), *Porcinus Pes* (Zhu Zhao, 30 pieces, stir-fried with clam powder).
Preparation: Grind the above ingredients into a fine powder. Take half of the powder and mix it evenly with the ash of two strips of *Gleditsia Sinensis Fruit* (Zhu Ya Zao Jiao) burned to ash. Form pills using refined honey, sized like paulownia seeds. Take 30 pills each time, administered on an empty stomach with Apricot Kernel Decoction. Take the remaining half of the powder and mix it evenly with 1 liang of *Epimedium Leaf* (Xian Ling Pi) ground into powder. Take 1 qian each time. Wrap the medicine in pig liver, cook until done, chew thoroughly, and swallow with the original cooking broth. Administer three times daily.

**Xiyan Jin Si Gao (Eye-Washing Golden Silk Ointment)**: Treats long-standing opacities obscuring the vision, pterygium (fleshy growth), dim vision with excessive tearing, unclear gaze, or attacks by wind-pathogens causing wind-millet bumps on the eyelids, redness and ulceration of the orbital rim, photophobia, astringency, and difficulty opening the eyes.
Ingredients: *Coptis Chinensis Rhizome* (Huang Lian, remove stamens, 5 qian), *Realgar* (Xiong Huang, finely ground and floated, 2 qian), *Musk* (She Xiang, separately ground, 5 fen), *Red Peony Root* (Chi Shao Yao), *Cinnabar* (Zhu Sha, separately ground), *Frankincense* (Ru Xiang, separately ground), *Borax* (Peng Sha, separately ground), *Angelica Sinensis Tail* (Dang Gui Wei) (each 2.5 qian).
Preparation: Grind the above ingredients into a fine powder. Then add the separately ground medicines, mix well, and grind again. Form pills using refined honey, sized like soap bean pods. Use one pill each time. Place it in a clean cup, brew with boiling water. Wash the eyes in a draft-free place. When the medicine cools, close the eyes for a short while. Wait for two to three shichen (4–6 hours), then re-warm the solution. Wash according to the previous method. One pill can be used for three to five washes. Do not wash in copper or iron vessels. This method is contraindicated for acute red and swollen eyes.