蟹睛努出蟹睛形，乌珠极痛涩羞明，肝胆积热肾虚热，虚软不疼实硬疼。实者泻肝
车地骨，硝黄知母黑柴茺，虚宜镇肾味知地，山药菟辛石决灵。
【注】蟹睛之证，乌睛努出如豆如珠，形似蟹睛，疼痛极甚，涩泪羞明。初起为实，硬
而极痛；久则为虚，软而不疼。总因肝、胆积热冲睛，肾中虚热注目所致。实者宜泻肝
汤；虚者用镇肾决明丸。
泻肝汤方
车前子 地骨皮 芒硝（各一钱） 大黄
知母（各一钱半） 黑参（一钱） 柴胡（二钱） 茺蔚子（二钱）
上为粗末，以水二盏，煎至八分，去渣，空心温服。
镇肾决明丸方
五味子（半两） 知母（炒） 生地黄 山药（炒，各一两半） 菟丝子（一两） 细辛（半两） 石决明（ ，
一两）
上为细末，炼蜜为丸，桐子大，空心茶清送三钱。
旋螺尖起如螺壳，乌睛色变极痛疼，壳形尖起色青黑，肝经积热血瘀凝。轻宜泻脑
防辛梗，赤芍天冬五味茺；重者泻肝硝黄桔，柴芩知母细车行。
【注】旋螺外障，气轮之内乌珠色变青白，如螺狮之壳，其色初青久黑，其形尖圆，乃
肝经积热亢极，瘀血凝滞所致。轻者宜泻脑汤；重者用泻肝饮子。
泻脑汤方
防风（二钱） 细辛（五分） 桔梗（一钱） 赤芍药（一钱） 天门冬（去心，一钱） 五味子（五分）
茺蔚子（二钱）
上为粗末，以水二盏，煎至一盏，食后去渣温服。
泻肝饮子
芒硝 大黄 桔梗 柴胡 黄芩 知母（炒） 细辛 车前子（各一钱）
上为粗末，以水二盏，煎至一盏，食后去渣温服。
Crab-eye bulges out in the shape of a crab-eye, the black pupil is extremely painful, gritty, and photophobic. Accumulated heat in the Liver and Gallbladder, or deficiency-heat in the Kidney; deficiency presents as softness without pain, while excess presents as hardness with pain. For excess patterns, drain the Liver using Cheqianzi (Plantago Seed), Digupi (Lycium Bark), Gubenpi (Bark of Lycium Root), Xiaoshi (Halloysitum Rubrum - *Note: Context implies Mangxiao/Natrii Sulfas based on formula below, but text says 'Xiao Huang Zhi Mu Hei Chai Chong'*), Mangxiao (Natrii Sulfas), Dahuang (Rhubarb), Zhimu (Anemarrhena Rhizome), Heishen (Black Ginseng/Prepared Panax Notoginseng), Chaihu (Bupleurum Root), and Chongweizi (Leonurus Fruit). For deficiency patterns, calm the Kidney using Wuweizi (Schisandra Berry), Zhimu (Anemarrhena Rhizome), Shengdihuang (Rehmannia Root), Shanyao (Dioscorea Rhizome), Tusizi (Cuscuta Seed), Xixin (Asarum Root), and Shijueming (Concha Arcae).
[Annotation] The syndrome of Crab-eye involves the black pupil bulging out like a bean or bead, resembling a crab's eye, with extreme pain, gritty tearing, and photophobia. In the early stage, it is an excess pattern, hard and extremely painful; after a long duration, it becomes a deficiency pattern, soft and painless. This is generally caused by accumulated heat in the Liver and Gallbladder rushing to the eyes, or deficiency-heat in the Kidney affecting the eyes. For excess patterns, Xiegan Tang (Liver-Draining Decoction) is indicated; for deficiency patterns, Zhenshen Jueming Wan (Kidney-Calm Brightening Pill) is used.
Xiegan Tang Formula: Cheqianzi (Plantago Seed), Digupi (Lycium Bark), Mangxiao (Natrii Sulfas) [each 1 qian]; Dahuang (Rhubarb), Zhimu (Anemarrhena Rhizome) [each 1.5 qian]; Heishen (Black Ginseng) [1 qian]; Chaihu (Bupleurum Root) [2 qian]; Chongweizi (Leonurus Fruit) [2 qian]. Grind these into coarse powder. Add two cups of water, decoct until eight-tenths remain, remove the dregs, and take warm on an empty stomach.
Zhenshen Jueming Wan Formula: Wuweizi (Schisandra Berry) [0.5 liang]; Zhimu (Anemarrhena Rhizome, stir-fried); Shengdihuang (Rehmannia Root); Shanyao (Dioscorea Rhizome, stir-fried) [each 1.5 liang]; Tusizi (Cuscuta Seed) [1 liang]; Xixin (Asarum Root) [0.5 liang]; Shijueming (Concha Arcae, calcined) [1 liang]. Grind these into fine powder, mix with refined honey to form pills the size of tung tree seeds. Take 3 qian with clear tea on an empty stomach.
Spindle-spiral rises like a snail shell, the black pupil changes color and suffers extreme pain. The spiral shape protrudes with green-black coloration, indicating accumulated heat in the Liver channel and blood stasis condensation. For mild cases, use Xinao Tang (Brain-Draining Decoction) with Fangfeng (Saposhnikovia Root), Xixin (Asarum Root), Jiegeng (Platycodon Root), Chishao (Red Peony Root), Tiantong (Asparagus Tuber), Wuweizi (Schisandra Berry), and Chongweizi (Leonurus Fruit). For severe cases, use Xiegan Yin (Liver-Draining Infusion) with Mangxiao (Natrii Sulfas), Dahuang (Rhubarb), Jiegeng (Platycodon Root), Chaihu (Bupleurum Root), Huangqin (Scutellaria Root), Zhimu (Anemarrhena Rhizome), Xixin (Asarum Root), and Cheqianzi (Plantago Seed).
[Annotation] Spindle-spiral exogenous obstruction involves the black pupil within the Qi Wheel changing to green-white, resembling a snail shell. Its color is initially green and turns black over time, and its shape is pointed and round. This is caused by excessive accumulated heat in the Liver channel and stagnation of blood stasis. For mild cases, Xinao Tang (Brain-Draining Decoction) is indicated; for severe cases, Xiegan Yinzi (Liver-Draining Infusion) is used.
Xinao Tang Formula: Fangfeng (Saposhnikovia Root) [2 qian]; Xixin (Asarum Root) [0.5 fen]; Jiegeng (Platycodon Root) [1 qian]; Chishao Yao (Red Peony Root) [1 qian]; Tiantong Men (Asparagus Tuber, heart removed) [1 qian]; Wuweizi (Schisandra Berry) [0.5 fen]; Chongweizi (Leonurus Fruit) [2 qian]. Grind these into coarse powder. Add two cups of water, decoct until one cup remains, remove the dregs, and take warm after meals.
Xiegan Yinzi (Liver-Draining Infusion): Mangxiao (Natrii Sulfas), Dahuang (Rhubarb), Jiegeng (Platycodon Root), Chaihu (Bupleurum Root), Huangqin (Scutellaria Root), Zhimu (Anemarrhena Rhizome, stir-fried), Xixin (Asarum Root), Cheqianzi (Plantago Seed) [each 1 qian]. Grind these into coarse powder. Add two cups of water, decoct until one cup remains, remove the dregs, and take warm after meals.