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Clam meat and rooster combs are generally similar in appearance. They often grow on the margins of the eyelids and subsequently spread to the region of the black pupil (cornea). This is a disaster caused by the mutual interaction of Fire pathogen and Earth dampness, where both Yin and Yang disorders act as villains. If one does not master the knife-cautery method, one should not treat such patients.

This condition initially presents with high fever, redness, swelling, and pain in the eyes. Within twenty-four hours, purple stasis flesh grows between the inner aspects of the upper eyelids, hanging like leaves outside the eyelid margin; even when the eyes are closed, it does not retract. Its shape is indistinguishable from a fighting rooster's comb or clam meat, hence the name "Rooster Comb and Clam Meat."

Ancients divided this into two conditions, but ultimately, all stem from deficiency of the True Yuan Qi (vital energy). Excessive consumption of roasted, fried, and rich/flavorful foods leads to indigestion, causing blood heat and internal dryness/fire. Combined with the contraction of abnormal Yin-Yang pathogenic qi, it triggers high fever. Excessive heat generates Wind; Wind movement accelerates blood circulation, forcing Qi and Blood upward into the orifices, where they ferment and form this lesion. This is a common ophthalmic disease that many physicians fear. Why does it appear in the morning and grow rapidly by evening, starting soft but becoming hard? The initial treatment must involve administering a large dose of Baihu Tang (White Tiger Decoction) added with Huanglian (Coptis Rhizome), Mutong (Akebia Caulis), Maidong (Ophiopogon Tuber), and Zhuye (Bamboo Leaf). Afterward, cut away the growth completely along its root, leaving not a hair's breadth. Then, administer Fangfeng Sanjie Tang (Saposhnikovia Detumescence-Decoction) for several doses to check if the incision is flat. If the wound remains uneven and bleeding persists, and the flesh resembles chives—regrowing vigorously after being cut—emergency cauterization is required to suppress its momentum. After cauterization, decoct Huanglian Jiedu Tang (Coptis Detoxification Decoction) and sit quietly for half a day; clarity and peace should ensue.

If the patient fears the procedure and the family is skeptical, regarding it merely as an ugly growth like chicken or clam meat, the growth will inevitably expand, affecting the Qi Wheel (sclera/conjunctiva) and eventually covering the Qing Jing (black pupil/cornea). It may become solid and terrifying, making excision impossible, or if excised, it yields no benefit.

The daughter of Mr. Zhu from my neighborhood, aged six, suddenly developed a patch of irregular red flesh protruding from the outer aspect of her left inner eyelid following a Shanghan (Cold Damage) illness. I stated, "This is the Rooster Comb syndrome; it must be excised, otherwise it will fill the cornea and cause blindness." The Zhu family was doubtful and fearful. The next day, her eye transformed into a mushroom-like toxic growth, about one cun high and the size of a tea bowl, red and soft. It gradually grew up to three cun before stopping, resembling fresh ox horns. Shortly after, a wart appeared near her ear, growing to the size of a bowl within days, harder than stone. Some treated it as blood extravasation, others as constrained fire. Her pain intensified day and night, leaving her weak and near death. She sought me again. I prescribed Tuoli Xiaodu (Supporting Interior and Eliminating Toxin) methods, assisted by Sanhuang (Three Yellows) and Zishen (Nourishing Kidney) formulas. Pain subsided slightly. Soon the wart ulcerated, and the ocular flesh atrophied accordingly, though her physique and spirit were never as robust and lustrous as before. One evening during a nap, the whole family believed she needed rest and dared not wake her. When lights were lit to check on her, it was found she had been dead for some time. A strange case, a strange event. Some say, while the case and event are indeed strange, your management as a physician was not perfect. This is likely an indisputable truth. Therefore, I preserve this medical record to acknowledge my fault and broaden knowledge.