漏睛者。 头结聚生疮。流出脓汁。或如涎水粘睛。上下不痛。仍无翳膜。此因风湿停留睑
中所致。久而不治。致有乌珠坠落之患。
大 漏证 大 之间生一漏。时流血水。紫晕肿胀而痛。病在心火实毒。金花丸加羌活、蝎尾。
小 漏证 小 间生一漏。时流血色鲜红。病由心胞络而来。相火横行之候。导亦散加透风清热药。
阴漏证 不论何部生漏。但从黄昏至天晓。则痛胀流水。作青黑色。或腥臭不可闻。日间则
稍可。乃幽阴中有伏火为患。四物加细辛、香附、连翘之类。
阳漏证 不论何部生漏。但日间胀痛流水。其色黄赤。遇夜则稍可。乃阳络中有湿热留着所
致。人参漏芦散去当归。加羌、防、生甘草。
正漏证 生于风轮。或正中。或略偏。为肝肾风热伏陷所致。若初发破浅。则流出如痰白膏。
日久而深。则流出青黑膏汁。瞳神已损。急用泻肝药。如龙胆、羌活、生地、大黄之类下夺之。
偏漏证 生于气轮。痰湿流于肺经而成。较正漏为害稍迟。其流如稠粘白水。重则流脓。急
用泻肺药。如贝母、桔梗、桑皮、生甘草、黄芩、山栀之类凉解之。久而失治。水泄膏枯。目亦损矣。
外漏证 生于两睥之外。或流稠脓。或流臭水。胀痛则流出。不胀则略止。先与人参漏芦散。
后用千金托里散加葱白。
窍漏证 乃目傍窍中流出薄稠水。如脓腥臭。拭之即有。久则目亦模糊也。嗜燥耽酒。痰火
湿热者。每多患此。竹叶泻经汤、千金托里散。先后收功。久不治。亦有暗伤神水。耗损神膏之患。
Liu Qing (Leaking Pupil) syndrome refers to the accumulation and formation of sores at the canthus, discharging pus, or secreting viscous fluid resembling saliva that adheres to the eye. There is no pain in the upper or lower eyelids, nor is there any pannus (翳膜). This condition is caused by the retention of Wind-Dampness pathogens within the eyelids. If left untreated for a long time, it may lead to the ulceration and loss of the cornea (Wu Zhu, black pupil).
Da Liu Zheng (Large Leaking Syndrome): A fistula forms between the inner canthus (Da Zi) and the orbital rim, intermittently discharging bloody fluid. The surrounding area presents with purple discoloration, swelling, and pain. The pathogenesis involves Excess-Toxicity of Heart-Fire. Treatment utilizes Jin Hua Wan (Golden Flower Pill) augmented with Qiang Huo (Notopterygii Rhizoma et Radix) and Xie Wei (Scorpio).
Xiao Liu Zheng (Small Leaking Syndrome): A fistula forms near the outer canthus (Xiao Zi), intermittently discharging bright red blood. The pathology originates from the Pericardium Collateral, manifesting as rampant Phase Fire (Xiang Huo). Treatment employs Dao Chi San (Guide Out Red Powder) augmented with herbs that dispel Wind and clear Heat.
Yin Liu Zheng (Yin Leaking Syndrome): Regardless of the location of the fistula, pain, swelling, and discharge occur from dusk until dawn. The discharge is bluish-black or has an unbearable fishy odor. Symptoms alleviate slightly during the day. This is caused by latent Fire hidden within the Yin aspects. Treatment utilizes Si Wu Tang (Four Substances Decoction) augmented with Xi Xin (Asari Radix), Xiang Fu (Cyperi Rhizoma), Lian Qiao (Forsythiae Fructus), and similar herbs.
Yang Liu Zheng (Yang Leaking Syndrome): Regardless of the location of the fistula, distending pain and discharge occur during the day, with yellowish-red discharge color, alleviating slightly at night. This results from Damp-Heat stagnation in the Yang collaterals. Treatment uses Ren Shen Lou Lu San (Ginseng and Rhapontic Rhizome Powder) without Dang Gui, augmented with Qiang Huo, Fang Feng (Saposhnikoviae Radix), and Sheng Gan Cao (Raw Licorice Root).
Zheng Liu Zheng (Regular Leaking Syndrome): Occurs on the Cornea (Feng Lun), either centrally or slightly eccentric. It is caused by latent Wind-Heat sinking into the Liver and Kidney. If initially superficial, the discharge resembles white, phlegm-like paste. If chronic and deep, the discharge becomes bluish-black paste. The pupil spirit (Tong Shen) is damaged; urgent treatment requires Liver-draining herbs such as Long Dan Cao (Gentianae Radix), Qiang Huo, Sheng Di Huang (Rehmanniae Radix), and Da Huang (Rhei Radix et Rhizoma) to purge downward.
Pian Liu Zheng (Eccentric Leaking Syndrome): Occurs on the Sclera (Qi Lun). It is formed by Phlegm-Dampness flowing into the Lung Meridian. Its harm is slightly slower than Zheng Liu Zheng. The discharge is thick, viscous, and white-water-like; in severe cases, pus is discharged. Urgent treatment requires Lung-draining herbs such as Bei Mu (Fritillariae Bulbus), Jie Geng (Platycodonis Radix), Sang Bai Pi (Mori Cortex), Sheng Gan Cao, Huang Qin (Scutellariae Radix), and Shan Zhi (Gardeniae Fructus) to cool and resolve. If neglected for a long time, water leakage and depletion of ocular essence occur, damaging the eye.
Wai Liu Zheng (External Leaking Syndrome): Occurs outside the eyelids. Discharge may be thick pus or foul-smelling fluid. Discharge occurs with swelling and pain, and stops slightly when not swollen. Initially treated with Ren Shen Lou Lu San, followed by Qian Jin Tuo Li San (Thousand Gold Formula to Support the Interior) augmented with Cong Bai (Allii Fistulosi Bulbus).
Qiao Liu Zheng (Orifice Leaking Syndrome): Thin or viscous fluid flows from the orifices beside the eye, resembling smelly pus; wiping it away leads to immediate reaccumulation. Over time, vision becomes blurred. Individuals who indulge in spicy, dry foods and alcohol, and have internal Phlegm-Fire and Damp-Heat, are prone to this condition. Zhu Ye Xie Jing Tang (Bamboo Leaf Decoction to Drain the Eye Meridian) and Qian Jin Tuo Li San are used sequentially to achieve recovery. If untreated for a long time, there is a risk of secretly damaging Shen Shui (Divine Water) and depleting Shen Gao (Divine Paste).