赤病属心经火，大 多实小 虚，实者洗心散归芍，麻黄连芥大黄栀，虚者九仙
芩芥芍，菊芎归草芷通宜。
【注】 赤之证，赤脉起于大 者，心经之实火也；赤脉起于小 者，心经之虚热也。
实者用洗心散，两解其实邪；虚者宜九仙散，清降其虚热也。
七宝洗心散方
当归（一钱） 赤芍药（一钱） 麻黄（八分） 黄连（一钱） 荆芥（八分） 大黄（一钱） 栀子
（一钱）
上为粗末，以水二盏，煎至一盏，食后去渣温服。
九仙散方
黄芩 荆芥 赤芍药 菊花 川芎 当归 甘草 白芷 木通（各一钱）
上为粗末，以水二盏，煎至一盏，食后服。
花翳白陷在乌睛，四围渐起漫神瞳，状如枣花鱼鳞翳，肺肝风热脑中冲，知母饮子
防风桔，知母硝黄芩细茺。
【注】花翳白陷者，乃黑睛生翳，风轮四围渐起，中间低陷，其翳状如枣花鱼鳞之形，
乌睛或白或带微黄。此因肺肝积热，风邪上冲于脑所致。宜用知母饮子。
知母饮子
防风（一钱五分） 桔梗（一钱五分） 知母（一钱） 芒硝（一钱） 大黄（一钱五分） 茯苓
（一钱） 细辛（一钱） 茺蔚子（一钱）
上为粗末，以水二盏，煎至一盏，食后去渣温服。
黑翳如珠黑睛上，形如珠子黑而圆，泪出羞涩疼痛甚。大人肝肾虚风愆，通明补肾
丸可服；小儿患此名眼疳，羚羊角饮硝黄细，知母羚防一并煎。
【注】黑翳如珠之证，黑睛上有黑翳，圆如珠子之形，泪出羞涩难开，疼痛极甚。若
大人患此证，为肝肾虚热风邪，宜用通明补肾丸；小儿患此证，为实热眼疳，宜服羚羊
角饮子，泄其实热也。
通明补肾丸（方见五风初患不足下）
羚羊角饮子
芒硝（一钱） 大黄（一钱） 细辛（五分） 知母（一钱） 羚羊角（镑，一钱） 防风（二钱）
上为粗末，以水二盏，煎至一盏，食远温服。
Red-eye diseases are attributed to Fire of the Heart Meridian, mostly Excess patterns and rarely Deficiency patterns. For Excess patterns, use Xixin San (Washing Heart Powder) containing Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Rubra), Mahuang (Ephedrae Herba), Lianqiao (Forsythiae Fructus) [Note: Text says "Lian", formula lists Huanglian, but context implies clearing heat. However, strict translation of text "Ma Huang Lian Jie Da Huang Zhi" matches ingredients in formula below which includes Huanglian. Let's stick to the formula list provided in the note for accuracy: Huanglian], Jingjie (Schizonepetae Herba), Dahuang (Rhei Radix et Rhizoma), Zhizi (Gardeniae Fructus); for Deficiency patterns, use Jiuxian San (Nine Immortals Powder) containing Huangqin (Scutellariae Radix), Jingjie (Schizonepetae Herba), Shaoyao (Paeoniae Radix Rubra), Juhua (Chrysanthemi Flos), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Baizhi (Angelicae Dahuricae Radix), Mutong (Akebiae Caulis), all of which are suitable.
[Annotation] In red-eye conditions, if the red vessels originate from the inner canthus (Da Zi), it indicates Excess Fire of the Heart Meridian; if they originate from the outer canthus (Xiao Zi), it indicates Deficient Heat of the Heart Meridian. For Excess patterns, use Xixin San to resolve both aspects of the Excess pathogen; for Deficiency patterns, use Jiuxian San to clear and descend the Deficient Heat.
Seven-Treasure Washing Heart Powder Formula
Danggui (1 qian) Chi Shaoyao (1 qian) Mahuang (8 fen) Huanglian (1 qian) Jingjie (8 fen) Dahuang (1 qian) Zhizi (1 qian)
Grind the above into a coarse powder. Add two cups of water, decoct until one cup remains. Strain and take warm after meals.
Jiuxian San Formula
Huangqin Jingjie Chi Shaoyao Juhua Chuanxiong Danggui Gancao Baizhi Mutong (each 1 qian)
Grind the above into a coarse powder. Add two cups of water, decoct until one cup remains. Take after meals.
Huayi Baixian (Flower-like Nebula with White Depression) appears on the black cornea (Heijing). The surrounding area gradually rises, obscuring the Shen Tong (pupil). The nebula resembles the shape of jujube flowers or fish scales. This is caused by Wind-Heat of the Lung and Liver rushing up to the brain. It is indicated to use Zhimu Yinzi (Anemarrhenae Decoction) containing Fangfeng (Saposhnikoviae Radix), Jiegeng (Platycodonis Radix), Zhi Mu (Anemarrhenae Rhizoma), Mangxiao (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Xixin (Asari Radix et Rhizoma), Chongweizi (Vernoniae Semen).
[Annotation] Huayi Baixian refers to a nebula forming on the black cornea. The wind wheel (black cornea) gradually rises around the periphery while the center sinks. The nebula resembles the shape of jujube flowers or fish scales, and the black cornea may appear white or slightly yellow. This results from accumulated Heat in the Lung and Liver, with Wind Pathogen rushing upward to the brain. It is indicated to use Zhimu Yinzi.
Zhimu Yinzi Formula
Fangfeng (1.5 qian) Jiegeng (1.5 qian) Zhi Mu (1 qian) Mangxiao (1 qian) Dahuang (1.5 qian) Fuling (1 qian) Xixin (1 qian) Chongweizi (1 qian)
Grind the above into a coarse powder. Add two cups of water, decoct until one cup remains. Strain and take warm after meals.
Heiyi Ruzhu (Black Nebula like a Pearl) occurs on the black cornea. Its shape is round and black like a pearl. Symptoms include tearing, photophobia, and severe pain. In adults, this condition is due to Deficiency of the Liver and Kidney combined with Wind Pathogen; Tongming Bushen Wan (Tongming Kidney-Nourishing Pill) may be taken. In children, this condition is called Yan Gan (Eye Malnutrition/Phthisis); Lingyangjiao Yin (Antelope Horn Decoction) containing Mangxiao (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma), Xixin (Asari Radix et Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Lingyangjiao (Saigae Tataricae Cornu), Fangfeng (Saposhnikoviae Radix) should be decocted together.
[Annotation] The syndrome of Heiyi Ruzhu features a black nebula on the black cornea, round like a pearl, with tearing, photophobia making eyes difficult to open, and extreme pain. If adults suffer this syndrome, it is due to Wind-Heat from Liver-Kidney Deficiency, and Tongming Bushen Wan is indicated; if children suffer this syndrome, it is Excess Heat Eye Malnutrition, and Lingyangjiao Yinzi is indicated to drain the Excess Heat.
Tongming Bushen Wan (Formula see under Five Winds Initial Onset Deficiency section)
Lingyangjiao Yinzi Formula
Mangxiao (1 qian) Dahuang (1 qian) Xixin (0.5 qian) Zhi Mu (1 qian) Lingyangjiao (scraped, 1 qian) Fangfeng (2 qian)
Grind the above into a coarse powder. Add two cups of water, decoct until one cup remains. Take warm at a time distant from meals.