皮急紧小。膏血损了。筋脉不舒。视瞻亦渺。
此症谓目皮紧急缩小之患。若不曾治。而渐自缩小者。乃膏血津液涩耗。筋脉缩急之故。若治急而小
者。治之之故。患者多因皮宽倒睫。或只夹外皮。失于内治。则旋复。复倒复夹。遂致精液损而脉不舒。皮
肉坏而血不足。目故急小。有不当割而频数开导。又不能滋其内。以致液耗而急小者。凡因治而损者。
若不乘时滋返。则络定气滞。虽治不复愈。宜服∶
神效黄 汤（治两目紧急缩小。羞明畏日。或瘾涩难开。或视物无力。睛痛昏花。手不得近。
或目少睛光。或目中热如火。服五六次。神效。）
蔓荆子（八分） 黄 （一钱） 人参 甘草（炙） 白芍药（各一钱） 陈皮（五分）
上锉剂。白水二钟。煎至八分。去滓再煎。临睡温服。如小便淋涩。加泽泻五分。如有大热症。加黄柏七分。
酒炒四次。如麻木不仁。虽有热不用黄柏。再加黄 五分。如眼紧小。去芍药。忌酒醋湿面大料物。葱蒜
韭及食生冷硬物。
东垣拨云汤（戊申六月。徐总管患眼疾。于上眼皮下。出黑白翳二颗。瘾涩难开。两目紧缩。
而不疼痛。两手寸脉细紧。按之洪大无力。知足太阳膀胱为命门相火煎熬。逆行作寒水翳及寒膜遮睛。
与拨云汤一服神效。外症呵欠善悲。健忘。喷嚏。时自泪下。面赤而白。能食不便。小便短数而少。气上而喘。）
黄 （蜜炙） 柴胡（各七分） 细辛叶 干葛根 川芎（各五分） 本 当归身
荆芥穗 知母 升麻（各一钱） 甘草梢（三分） 川羌活 黄柏（盐水炒） 防风（各一钱五分）
上锉剂。白水二钟。生姜三片。煎至八分。去滓再煎。食后温服。
The skin of the eyelids is tight and contracted. The *Gao Xue* (nutritive essence and blood nourishing the eyes) is damaged, causing the sinews and vessels to be unrelaxed. Vision appears narrow and indistinct.
This condition refers to the affliction where the eyelid skin is tight and contracted, making the eye appear shrunken. If left untreated and gradually shrinking on its own, it is due to the dryness and consumption of *Gao Xue* and body fluids, leading to the contraction and tension of sinews and vessels. If the shrinkage occurs after treatment, it is caused by improper treatment. Patients often suffer from lax eyelids with inverted eyelashes, or only external symptoms are addressed while internal regulation is neglected, leading to recurrence: the lashes invert again and pinch the eyelid. This results in damage to the essential fluids and obstruction of the vessels, deterioration of muscle tissue, and insufficiency of blood, causing the eye to become tight and small. In cases where incision and drainage were performed unnecessarily and repeatedly, without nourishing the interior Yin fluids, the fluid consumption leads to tightness and shrinkage. For any damage caused by treatment, if timely nourishment and restoration are not undertaken, the collaterals will become fixed and Qi stagnation will occur; even with further treatment, recovery will not be achieved. It is suitable to take:
Shenxiao Huangqi Tang (Divine Effect Astragalus Decoction) [Treats bilateral eye tightness and shrinkage, photophobia and aversion to sunlight, or adhesion of eyelids making opening difficult, or weak vision, pain and blurriness of the eyeballs, inability to tolerate touch near the eye, lack of luster in the eyes, or a sensation of heat like fire within the eyes. After taking five or six doses, divine effects are observed.]
Jing Jie Zi (Fructus Viticis Expensae, 8 fen), Huang Qi (Radix Astragali Membranacei, 1 qian), Ren Shen (Radix Ginseng), Zhi Gan Cao (Fried Radix Glycyrrhizae Uralensis), Bai Shao Yao (Radix Paeoniae Lactiflorae) [each 1 qian], Chen Pi (Pericarpium Citri Reticulatae, 5 fen).
Crush the ingredients. Add two zhong of clear water, decoct until eight fen remains. Remove the dregs and decoct again. Take warm before sleep. If there is dribbling and涩 (astringency/difficulty) in urination, add Ze Xie (Rhizoma Alismatis, 5 fen). If there are signs of severe heat, add Huang Bo (Cortex Phellodendri Amurensis, 7 fen), stir-fried four times with wine. If there is numbness and insensitivity, do not use Huang Bo even if heat is present; instead, add an additional 5 fen of Huang Qi. If the eye is tight and small, remove Shao Yao. Avoid alcohol, vinegar, damp wheat noodles, strong spices, green onions, garlic, leeks, and cold, hard foods.
Dongyuan Boyun Tang (East Slope Cloud-Parting Decoction) [In the sixth month of Wushen year, Commander Xu suffered from an eye disease. Two black and white nebulae appeared under the upper eyelid, causing adhesion and difficulty in opening the eyes. Both eyes were contracted but painless. The cun pulse on both wrists was fine and tight, but forceful and empty upon deep pressure. This indicates that the Foot-Taiyang Bladder channel was scorched by the Ministerial Fire of the Gate of Vitality, reversing its flow to create cold-water nebulae and cold membranes obscuring the pupil. One dose of Boyun Tang produced divine effects. External symptoms included yawning, propensity for sorrow, forgetfulness, sneezing, spontaneous tearing, a complexion alternating between red and white, normal appetite but constipation, short and frequent scanty urination, rebellious Qi causing asthma/wheezing.]
Zhi Huang Qi (Honey-fried Radix Astragali Membranacei), Chai Hu (Radix Bupleuri) [each 7 fen], Xi Xin Ye (Herba Asari), Ge Gen (Radix Puerariae Lobatae), Chuan Xiong (Rhizoma Chuanxiong) [each 5 fen], Ben Cao (Rhizoma Ligustici Wallichii), Dang Gui Shen (Radix Angelicae Sinensis), Jing Jie Sui (Capitum Schizonepetae), Zhi Mu (Rhizoma Anemarrhenae Asphodeloidis), Sheng Ma (Rhizoma Cimicifugae Foetidae) [each 1 qian], Gan Cao Shao (Apex Radix Glycyrrhizae Uralensis, 3 fen), Chuan Qiang Huo (Rhizoma et Radix Notopterygii), Yan Shui Chao Huang Bo (Salt-water fried Cortex Phellodendri Amurensis), Fang Feng (Radix Saposhnikoviae) [each 1 qian 5 fen].
Crush the ingredients. Add two zhong of clear water and three slices of fresh ginger. Decoct until eight fen remains. Remove the dregs and decoct again. Take warm after meals.