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**Syndrome of Ulcers Caused by Excess Heat.** Ulcers arise in specific meridians. Tears flow like boiling water; the eyes feel gritty, urgent, and photophobic. The eyelids or canthi may become stringy and ulcerated, with pepper-like granules forming within the palpebral conjunctiva. Ulcers occurring on the upper part of the eye (cornea) indicate blazing Heart Fire. Dryness in the external eyelids belongs to Spleen heat; the lips also correspond to the Earth element (Spleen). Lung and brain pathologies manifest at the nose; excessive heat in the six meridians affects the whole body. Heat in the ears indicates Kidney dryness; a flushed face reflects steaming of the six Yang meridians. Sanjiao (Triple Burner) inflammation rises to the neck, while the lower part is affected by the six Yin meridians.
If untreated, complications will arise, leading to impaired vision.

This syndrome refers to the etiology of ocular ulcers, varying in severity and presenting with different degrees of pain and itching. Severe cases feature raised ulcers, purulent discharge, purple blood, putrefaction, and foul odor. This results from disharmony of Qi and Blood, with excess Fire pathogens causing severe heat in the Blood level, similar to stasis syndromes. Turbid fluid mixes with clear water, often flowing into the eyelids to form ulcers. Once blood stasis dissipates, the ulcers heal spontaneously. Individuals engaged in labor under damp-heat conditions often suffer from eyelid ulcers without other painful swelling symptoms; these are mild and harmless. However, if fire is excessive and ulcers present with significant redness, swelling, and pain, urgent treatment is required to prevent turbid pathogens from entering the eye interior and damaging the cornea (Pearl). If an ulcer appears after an existing eye disease, it implies that heat has followed another pathology. Upon observing an ulcer, one must examine its location to determine the internal origin. Treatment should be tailored to the severity. Recommended formula:
**Modified Siwu Decoction (Four Substance Decoction)**
* *Rehmanniae Radix Preparata* (Sheng Di Huang)
* *Sophorae Flavescentis Radix* (Ku Shen)
* *Menthae Haplocalycis Herba* (Su Bo He)
* *Chuanxiong Rhizoma* (Chuan Xiong)
* *Arctii Fructus* (Shu Nian Zi / Niu Bang Zi)
* *Forsythiae Fructum* (Lian Qiao)
* *Trichosanthis Radix* (Tian Hua Fen)
* *Saposhnikoviae Radix* (Fang Feng)
* *Paeoniae Radix Rubra* (Chi Shao Yao)
* *Angelicae Sinensis Radix* (Dang Gui)
* *Schizonepetae Spica* (Jing Jie Sui)
(All ingredients in equal proportions.)
Decoct the crude drugs in two cups of plain water until reduced to 80%. Take after meals.

**Xiongui Decoction**
* *Chuanxiong Rhizoma* (Chuan Xiong)
* *Angelicae Sinensis Radix* (Dang Gui)
* *Paeoniae Radix Rubra* (Chi Shao Yao)
* *Saposhnikoviae Radix* (Fang Feng)
* *Notopterygii Rhizoma et Radix* (Qiang Huo)
(All ingredients in equal proportions.)
Decoct the crude drugs in two cups of plain water until reduced to 80%. Strain and wash the eyes frequently with the decoction to activate blood circulation and dispel wind.

**External Application Formula** (For ulcers covering the entire outer eyelid, with ulceration and pain.)
* *Draco Sanguis* (Xue Jie)
* *Boswelliae Resina* (Ru Xiang)
* *Myrrha Resina* (Mo Yao)
* *Calomelas* (Qing Fen)
* *Cupri Carbonas* (Tuo Seng)
(All ingredients in equal proportions.)
Grind into a fine powder and apply directly to the ulcerated area.

**Another Formula** (For ulcers on the upper or lower eyelids, breaking and oozing yellow fluid.)
* *Atriplae Semen* (Qing Dai) - 1.2 qian
* *Phellodendri Cortex* (Huang Bai Mo)
* *Borneolum Syntheticum* (Chao Nao / Bing Pian)
* *Calomelas* (Qing Fen)
(Each 1 qian)
* *Pini Rosin* (Song Xiang) - 1.5 qian
Grind into a fine powder. Wrap the medicine in old blue cloth, soak thoroughly in sesame oil, and burn to ash. Allow the oily ash to drip into a teacup and dip/applicate as needed.