Library

Eye pain belongs to Fire syndromes, which are differentiated into Deficient Fire (Xu Huo) and Excess Fire (Shi Huo). Sudden onset of pain indicates an Excess syndrome (Shi Zheng), while chronic pain indicates a Deficient syndrome (Xu Zheng); swelling and protrusion indicate Excess, whereas smallness and depression indicate Deficiency. Pain in Excess conditions is accompanied by swelling and distension, while pain in Deficient conditions is accompanied by depression and dryness/stiffness. This constitutes the differentiation between Excess and Deficiency in eye pain.

To treat Excess pain, one must drain the Fire; to treat Deficient pain, one must nourish Qi and generate Blood. Draining Fire should not be done abruptly with cold and cool herbs; tonifying Qi should not be done hastily to aid growth. Since the eyes are governed by Qi and Blood, nourishing Blood must not damage Blood, and tonifying Qi must not stir up Fire. However, Qi is associated with the Yangming Fire; how can tonifying Qi fail to stir up Fire? Generally, when Qi is Excess, Heat is generated; when Qi is Deficient, Cold is generated; when Qi is balanced, it is warm. Therefore, the method of tonifying Qi without stirring up Fire lies in employing Warm Tonification (Wen Bu), thus avoiding the issue of stirring up Fire. Hence, the methods for relieving pain do not go beyond the two aspects of Tonification (Bu) and Draining (Xie). For Excess pain, externally apply Niantong San (Nianpain Powder, see Vol. 4); internally use Yuanling Dan (Yuanspirit Pill, see *Mijue*) as eye drops. For Deficient pain, apply Baiyu Ding (White Jade Tablet).

There are many methods for treating eye diseases, but one must strictly avoid dangerous practices such as using knives and needles, cutting flesh, pricking blood, and applying Shengshengxin (a toxic mineral preparation). Knives and needles easily damage Jing-Shui (Essence and Water); pricking blood easily harms the pupil (Tongren); Shengshengxin causes deep toxicity. Moreover, drugs that dissipate Blood (Bai Xue Yao) should certainly be avoided, and cooling-blood drugs should also not be used excessively. Overuse of blood-dissipating drugs leads to dark/blindness disorders; overuse of cooling-blood drugs leads to green-yellow opacities (Zhangyi). Herbs like Muzei (Equisetum Hiemale) and Jili (Tribulus Terrestris), although they relieve pain and dispel Wind, can damage the Liver and Kidney; they are suitable only as adjuvants and should not be taken for long periods. Herbs like Mimenghua (Montia chinensis) and Gujingcao (Galeopsis Spicata), although they brighten the eyes, should only be used temporarily as Chief herbs, supplemented by blood-nourishing and yang-harmonizing herbs, before they can be safely circulated/used.

Generally, heat syndromes in the eyes differ into Deficient Heat (Xu Re), Excess Heat (Shi Re), and Qi-Heat (Qi Re). If treated indiscriminately without clear understanding, Heat will close within, causing the essence and light to lose their spirit. Now, detailing them: generally, Deficiency generates Cold manifestations, and Excess generates Heat manifestations; the methods of tonification and draining should be applied according to symptoms.

Deficient Heat arises from lack of care after a new illness, or sexual exhaustion, which depletes Yuan-Yang (Primal Yang). The Ministerial Fire (Xiang Huo) flares upward, steaming the Spleen and Stomach, resulting in red, dry, and stiff eyes, photophobia, and aversion to light. The eyes are merely red without swelling. Thus, the treatment focuses on the Blood level, assists with Kidney nourishment, and simultaneously clears Stomach Heat, guiding the pathogenic Fire downward. This is the method for treating Deficient Heat.

Excess Heat occurs in individuals with strong constitution, excessive alcohol consumption, rising anger, or stirring of Heart Fire. Once Heart Fire moves, Fire controls Metal, and Metal controls Wood, resulting in red, swollen eyes that are difficult to open. The treatment should focus on draining Heart Fire, calming Liver Qi, and cooling Blood. This is the method for treating Excess Heat.

Qi-Heat refers to epidemic heat diseases. These often occur during the dog days of summer until autumn. If people are not careful and contract the pathogenic heat qi of heaven and earth, sudden redness and swelling occur, feeling like burning stinging pain, with hot tears flowing. The treatment should focus on formulas that disperse and descend Fire. Initially use herbs like Baishao (Paeonia Lactiflora), Chaihu (Bupleurum), and Gange (Pueraria Lobata), followed by blood-nourishing herbs. This is the method for treating Qi-Heat.

For Deficient Heat, apply Baiyu Ding and Yuanling Dan (see *Mijue*); for Excess Heat, apply Lizhigao (Pear Juice Paste, see Vol. 3) and Saowu Dan. Wash with Xiaozao'er (Small Date Fruit, see Vol. 3). For Qi-Heat, apply Saibao Dan (see Vol. 1) and Saikongqing (see Vol. 2).