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At the initial onset of this eye disease, it may be due to rising early with Shanghan (Cold Damage), or because the Qi of the Zang and Fu organs has not fully recovered after a Re Bing (Heat Disease), leaving residual heat in the Six Fu organs. The body is deficient and easily damaged; excessive consumption of hot/spicy foods can lead to eye pathology. Symptoms may include seeing black flowers before the eyes, dilation of the pupil with irregular size, redness, swelling, and tearing. At this stage, bloodletting using a lancet should be performed to release stasis, followed by administration of Xiongdan Wan (Bear Bile Pill), Shengxijiao Yinzi (Raw Rhinoceros Horn Decoction), or Xiegan Tang (Drain Liver Decoction). Eye drops must strictly be avoided to prevent damage to the eyeball.

Poem:
After Heat Disease and Cold Damage, deficiency often lingers;
Dietary stagnation and heat cause bilateral eye afflictions.
Pain precedes dimness within a day;
Soon, spasms牵涉 (involve) both sides of the eyelids.
Redness and swelling require lancing inside the eyelid;
Shengxi Yinzi (Raw Rhinoceros Horn Decoction) best expels the pathogen.
Next, take half a dose of Jueming Wan (Cassia Seed Pill) to prevent new membranes from forming stasis.
Why are eye drops temporarily contraindicated? Fear of sores damaging the black pearl (pupil).
Sudden dilation of the pupil indicates wind-deficiency in the Liver and Kidney.
The divine formula uses Bear Bile taken internally;
Vision returns to its original clarity.
If black flowers appear before the eyes,
It may take two or three years to clear them.

Xiongdan Wan (Bear Bile Pill)
Ingredients: Xiong Dan (Bear Gallbladder, 1 unit), Shijueming (Haliotidis Concha), Cheqianzi (Plantaginis Semen), Zexie (Alismatis Rhizoma), Xixin (Asari Radix et Rhizoma) (each 1 liang); Gan Dihuang (Rehmanniae Radix Preparata), Chongweizi (Leonuri Fructus) (each 2 liang); Huangniu Dan (Bovis Gallbladder, 1 unit).
Preparation and Administration: Grind all ingredients into fine powder. Mix with refined honey to form pills the size of tung tree seeds. Take 10 pills on an empty stomach with tea water.

Shengxijiao Yinzi (Raw Rhinoceros Horn Decoction)
Ingredients: Sheng Xijiao (Rhinocerotis Cornu), Jiegeng (Platycodonis Radix) (each 2 liang); Lingyangjiao (Saigae Tataricae Cornu), Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), Fangfeng (Saposhnikoviae Radix) (each 1 liang).
Preparation and Administration: Grind into fine powder. Add 1 qian (approx. 3-5g) of powder to 1 sheng (approx. 200ml) of water. Boil down to 0.5 sheng (approx. 100ml). Strain and take warm.

Xiegan Tang (Drain Liver Decoction)
Ingredients: Shijueming (Haliotidis Concha), Chuan Dahuang (Rhei Radix et Rhizoma), Jiegeng (Platycodonis Radix), Cheqianzi (Plantaginis Semen), Mangxiao (Natrii Sulfas) (each 1 liang); Lingyangjiao (Saigae Tataricae Cornu), Fangfeng (Saposhnikoviae Radix) (each 1.5 liang).
Preparation and Administration: Grind into extremely fine powder. Add 1 qian of powder to 1 sheng of water. Boil down to 0.5 sheng. Strain and take warm.

In the initial stage of this eye disease, pain precedes itching, accompanied by a gritty sensation, tearing, and photophobia. The sclera (white part of the eye) turns red first, with paroxysmal symptoms occurring irregularly. Gradually, red vessels stand horizontally across the eye, obscuring vision like looking through gauze, making it difficult to see clearly. This is caused by toxic wind affecting the Liver and accumulated blood between the eyelids. Initially, treatment with a lancet for washing and hook-cutting is appropriate; moxibustion or cauterization should be avoided to remove the root cause. Subsequently, Liangan San (Cool Liver Powder) should be administered, Qibao Gao (Seven Treasures Ointment) applied topically, and Tuiyi Wan (Remove Membrane Pill) taken orally, yielding immediate results.

Poem:
Redness of the sclera serves as the foundation;
Pain, itching, wind exposure, tearing, and discharge occur.
Grittiness prevents opening for ten days;
Paroxysms vary but have times of remission.
Over years, the color gradually changes to greenish-blue;
Eyes filled with sticky discharge seem obstructed.
Red vessels like threads cross horizontally and vertically;
Do not doubt the diagnosis of Hunjing Waizhang (Mixed Corneal Opacity).
Toxic wind and red blood determine its severity;
Who says such cases are easy to treat?
Excellent cold/astringent medicines are required;
Apply and massage until the membrane is cleared.
Frequent lancing of both eyelids combined with combing/cauterization stops wind-heat when active.
Decoctions should be taken mildly according to age;
To remove the root, do not delay lancing.

Liangan San (Cool Liver Powder)
Ingredients: Chuan Dahuang (Rhei Radix et Rhizoma), Jiegeng (Platycodonis Radix) (each 0.5 liang); Huangqin (Scutellariae Radix), Lingyangjiao (Saigae Tataricae Cornu), Heishen (Polygonati Odorati Rhizoma - Black Ginseng), Renshen (Ginseng Radix et Rhizoma), Fuling (Poria) (each 1 liang).
Preparation and Administration: Grind into powder. Add 1 qian of powder to 1 sheng of water. Boil down to 0.5 sheng. Strain and take warm after meals.

Qibao Gao (Seven Treasures Ointment)
Ingredients: Zhenzhu (Margarita), Shuijing (Quartz), Beichi (Concha Arcae) (each 1 liang); Hupo (Amber), Shijueming (Haliotidis Concha) (each 3 fen); Kongqing (Azurite), Manao (Chalcedony), Longnao (Borneolum Syntheticum) (each 0.5 liang).
Preparation and Administration: Grind all ingredients into fine, uniform powder. Add 5 sheng of water and boil in a stone vessel down to 1 sheng. Strain, then boil again down to 1 sheng. Add 0.5 liang of honey and boil to form an ointment. Apply at night before sleep; do not apply in the morning.

Tuiyi Wan (Remove Membrane Pill)
Ingredients: Baizhi (Angelicae Dahuricae Radix), Xixin (Asari Radix et Rhizoma), Wuweizi (Schisandrae Chinensis Fructus), Zhike (Aurantii Fructus Immaturus) (each 1 liang, de-seeded and stir-fried with bran); Muli (Ostreae Concha), Chongweizi (Leonuri Fructus) (each 2 liang).
Preparation and Administration: Grind into powder. Mix with refined honey to form pills the size of tung tree seeds. Take 10 pills on an empty stomach with rice water decoction.