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The eyelid margins suffer from redness and ulceration. This condition is common to all individuals. Due to the varying degrees of dryness and dampness associated with Fire and Earth, the severity of the illness differs. In severe cases, the eyelids crack and bleed; in mild cases, the eyelid margins are red and ulcerated, making it difficult to open or relax them. Treatment should focus on clearing heat and moistening; there is no need to worry about the failure to cure the disease.

This section specifically discusses redness and ulceration of the eyelid margins, assuming no other eye diseases are present. If redness and ulceration occur alongside other eye diseases, it is due to injury caused by other pathogenic fire factors, which is a different scenario. When redness predominates over ulceration, it is often caused by "formless fire" resulting from mental exertion, depression, anger, and frustration. When ulceration predominates over redness, it is often caused by "material fire" resulting from excessive consumption of dry/hot foods, alcohol, excessive crying, exposure to smoke and fire, and steaming by wind-heat. The pathology belongs to the Heart collaterals. In severe cases, excessive fire may generate sores on the eyelid margins. One must distinguish between the upper and lower eyelids. The patterns involve Ministerial Fire and Sovereign Fire, as well as deficiency and excess syndromes. It is appropriate to take internal medicine and use external washing/dropping therapies.

Fangfeng Tongsheng San (Windproof Unblocking Powder) [Formula] (Also treats stroke, all types of wind-heat, constipation, dysuria, red and painful eyes, or acute heat generating wind, stiff tongue and locked jaw, purple-red acne-like rashes on the nose leading to Lung Wind, or Fengli [wind leprosy], commonly known as leprosy, intestinal wind causing hemorrhoids and fistulas, intestinal stagnation causing various heat syndromes, delirium, mania, and convulsions.)

Fangfeng (Saposhnikoviae Radix), Chuanxiong (Ligusticum Chuanxiong Rhizoma), Dahuang (Rhei Radix et Rhizoma), Chishao (Paeoniae Radix Rubra), Lianqiao (Forsythiae Fructus), Mahuang (Ephedrae Herba - nodes removed), Mangxiao (Natrii Sulfas), Subohetie (Menthae Haplocalycis Herba), Danggui (Angelicae Sinensis Radix), Huashi (Talcum - washed), Gancao (Glycyrrhizae Radix et Rhizoma), Chao Zhiren (Gardeniae Semen - fried), Baizhu (Atractylodis Macrocephalae Rhizoma), Jiegeng (Platycodonis Radix), Shigao (Gypsum Fibrosum), Jingjie Sui (Schizonepetae Spica), Huangqin (Scutellariae Radix) (all in equal proportions).

Grind the above into a coarse powder. For each dose, take 4 qian, add 3 slices of ginger, and decoct in 2 zhong of water. Take warm before meals.

Note: Fangfeng and Mahuang are exterior-releasing herbs. For wind-heat located in the skin, they induce sweating to expel the pathogen. Jingjie and Bohetie are superior-clearing herbs. For wind-heat located at the vertex, they expel the pathogen via the nasal cavity. Dahuang and Mangxiao are purgative/laxative herbs. For wind-heat located in the stomach and intestines, they expel the pathogen via the posterior orifice. Huashi and Zhizi are diuretic/herbs affecting the water passages. For wind-heat located in the Sanjiao (Triple Burner), they expel the pathogen via urination. When wind pathogens overflow the diaphragm, affecting the Lung and Stomach, Shigao and Jiegeng clear the Lung and Stomach. Meanwhile, Lianqiao and Huangqin dispel wandering fire from the meridians. Pathologies of wind are governed by Liver Wood. Chuanxiong and Danggui harmonize Liver blood. Gancao and Baizhu harmonize Stomach Qi and strengthen the Spleen. Liu Shouzhen was skilled in treating fire; the intent of this formula is thoroughly detailed here.

If both eyelids are ulcerated or develop millet-like bumps, the sclera is red, and the cornea has opacities, add Juhua (Chrysanthemi Flos), Huanglian (Coptidis Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), and Baijili (Tribuli Fructus). This is named Juhua Tongsheng San (Chrysanthemum Unblocking Powder). For patients who are weak or have non-dry stools, reduce or omit Mangxiao and Dahuang.

Dongyuan Bitian Wan (East Garden Blue Sky Pill) [Formula] (Treats eye diseases that do not improve after repeated use of cold/cooling herbs, characterized by a steaming heat sensation in both eyes like being smoked by fire, redness without pain, red vessels filling the eyeballs, blurred vision and dizziness, photophobia, redness and ulceration of upper and lower eyelids, or intolerance to local climate causing erosion of the inner and outer canthi. Wash with this preparation.)

Wafen (Tile Powder - stir-fried, 1 liang), Tonglv (Malachite - ground to powder, 7 fen), Kubai Fan (Calcined Alum - 2 fen).

Grind Tonglv and Kubai Fan finely. Gradually mix in Wafen until uniform. Blend with hot water to form pills the size of soybeans. Use one pill per application. Soak in half a cup of hot water for 1-2 shichen (2-4 hours). Wash the eyes. Stop when a slight astringent sensation is felt. Close the eyes for about half an hour. Wash again before sleep. Closing the eyes to sleep afterwards is particularly miraculous. One pill can be used for 2-3 days; it can be warmed in the water bath. This medicine treats the branch (symptoms), indicating that the interior heat has been cleared. It is not suitable for interior excess conditions; instead, purge the excess heat.

Zijin Gao (Purple Gold Ointment) [Formula]

Use Guadan (Lead Oxide - processed by water flotation). Use more honey and less water. Simmer using moderate and strong heat. Store in a vessel. Apply to the eyes.