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Why do wind-toxin and Earth/Metal qi stagnate, transforming dampness into eye discharge (Machi) and causing tears to pour? Although the seasons change, the physical manifestation remains unaltered; hence, physicians name this condition "Leaking Eyes" (Lou Jing).

Large canthus leaking (Da Zi Lou) is mostly due to excessive fire, often bleeding with fluid, accompanied by pain and distension. When Kidney qi has been nourished, it requires ascending; when Heart fire has subsided, it requires descending further for balance.

Heavenly fire ascending damages the small canthus (Xiao Zi); the leakage originates from inadequate or improper scarification/surgery, leading to blood deficiency and spirit-gum (Shen Gao) damage, resulting in daily yin-dampness infiltration and reduced vision.

This condition does not arise overnight but results from wandering wind and guest-heat stagnating in the zang-fu organs, transmitting to the ocular system without being vented. Heat is a form of qi, and wind is also a form of qi; when qi condenses into form, it transforms into phlegm, fluids, and pus, exiting through the small pores at the head of the upper and lower eyelids near the large canthus. In severe cases, a nodule forms in the inner eyelid near the nose; piercing it with a bi stone causes the nodule to dissipate, but the wound fails to close, leading to continuous pus flow. Profuse evening discharge is called "Yin Leakage" or "Dragon Fire"; worsening during the day is called "Yang Leakage" or "Fei Ji". Those with stagnant phlegm-fluids and weak congenital constitution are prone to this disease. It may also result from consuming clams or meat, injuring essence and blood, causing qi stagnation, leading to cold sores that fail to heal, congealing and rotting into pus and saliva for years. Consumption of toxic foods or exposure to wind-dampness exacerbates pain and swelling, producing foul odors. Treatment should first regulate Wood and Fire using Qing Kong San, Wei Feng Tang, or Fang Feng San Jie Tang. Subsequently, regulate Metal and Earth using Bai He Gu Jin Tang, Bai Ju Qing Jin San, or Yu Ping Feng San. Since fire is the source of toxicity, cleansing the source clears the flow naturally; since wind is the commander of pathogens, subduing the commander disperses the pathogens. Thereafter, use Zhu Ye Xie Jing Tang, Da Bu Huang Qi Tang, or Yang Yin Qing Zao Tang, or employ methods like Sheng Yang Yi Yin or Sheng Yang San Huo, tailored to the patient's constitutional strength and disease depth. I remain uncertain if this covers all profound aspects.

While walking by the reeds, Huang Zi saw a gentleman standing briefly in the woods, blinking frequently, with goosebumps on his skin. Though internally undamaged, his eyebrows were truly distressing to behold. He sighed: Alas, how sad! This person’s illness has ten causes: Sun Taiyang channel dysfunction; Taiyin channel degradation; Sovereign Fire flaming upward; Yangming dryness and urgency; indulgence in kitchen wines; weeping over coarse clothes (poverty); excessive tea smoke inhalation; insufficient nutrition; exposure to cold dew while walking alone under the bright moon; or exposure to morning winds while traveling early like a warrior. In early autumn, disease progresses due to Liuhuo overcoming Metal. If Great Cold persists, it marks the transition of Wood qi. Thus, symptoms include red eyelid margins like cinnabar, fluid discharge from the eyes, mild odor, itching with dryness, constant scratching, and wet handkerchiefs. Tonification causes bloody fissures; purgation causes swelling and pain. Why are pathogenic factors so hard to quell despite clearing heat, warming, harmonizing, and dispersing? Persistent difficulty suggests Water and Fire are not interacting. Flexibility is required; do not rigidly adhere to texts. The guest was satisfied, bowed deeply, and wished to ask for help but lacked the means. Returning home, feeling depressed, I wrote this poem to append to the chapter.

This condition presents as red and ulcerated eyelids, with itching or pain, abundant discharge and tearing. Etiologies are complex, and diagnostic signs vary: Generally, redness indicates Fire, ulceration indicates Dampness, itching indicates Wind, pain indicates Heat, abundant discharge indicates Qi deficiency, and tearing/bleeding indicates Blood deficiency. Redness dominating ulceration stems from invisible fire caused by mental labor, depression, or anger. Ulceration dominating redness stems from visible qi caused by alcohol, food, excessive crying, or smoke inhalation. Wind-heat steaming causes itching and tearing; damp-heat infiltrating causes pain and discharge. Mild swelling with ulceration blames Cold-Damp; redness with dryness blames Blood Dryness. Excessive Fire generating Wind causes sores in Gen/Kun areas (specific eye regions), leading to nebulae. Although primarily involving Heart and Spleen, diagnosis must consider left/right contours, Yin/Yang exterior-interior relations, and deficiency/excess patterns. Chronic late sleeping and early rising with cold invasion can cause stubborn diseases. One must empathize with patients to find treatments. Do not ignore cases due to poverty or chronicity. Clinically, first remove eyelid granules with an eyebrow knife, wash with steamed Zhao Rong Gao. After drying, apply Yuan Shuang to the lid margin and Yan Zhi Xue internally. Administer Qi Ju Yin decoction: add Huang Lian and Chi Shao Yao for redness, Cang Zhu for ulceration, taken hot in large doses. Otherwise, repeat cleaning and prescribe based on symptoms. Base treatment on Liu Jun Zi Tang: add Dan Pi and Dan Shen for redness, Huang Lian for pain, Fang Feng and Bo He for itching, Cang Zhu and Shi Hu for ulceration, Fu Zi and Gan Jiang for Cold-Damp. Consistent treatment for half a year ensures recovery.

My friend Kong Rongfang suffered from this stubborn disease, with redness and ulceration resembling residual wind, cured by following these methods. I prepared one jin of Di Huang, eight liang of Bai He powder, and four liang of Hua Jiao powder. Pounded, mixed, steamed until very hot, and formed into pills. He has remained symptom-free for ten years. The efficacy of medicine is indeed remarkable; thus, I record this for future reference.