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The differentiation of deficiency and excess in Shuang'e (a type of throat obstruction characterized by bilateral swelling of the tonsils resembling silkworm moths) is as follows: generally, those caused by external contraction are excess patterns, while those caused by internal injury are deficiency patterns. How then to differentiate between external contraction and internal injury? Generally speaking, in cases of external contraction, the nose must be sensitive to cold, the tongue coating must be dry, the body must first experience fever followed by chills, the phlegm must be yellow or white, and the eyes must be red and swollen; this indicates an excess of pathogenic factors. Treat with Sha'e Dan (Killing Moth Powder). Blow the powder into the throat using a goose feather; the patient will inevitably vomit about one bowlful of phlegm and saliva and recover. This is a miraculous prescription.

In cases of internal injury, although the presentation is similar with throat swelling, the swelling is slightly relieved during the day, there is excessive phlegm, the tongue coating is not dry, the expectorated phlegm flows out like a gushing spring, the body must feel aversion to cold, and both feet must be ice-cold; this indicates a deficiency of healthy Qi. Treat with Ba Wei Tang (Eight-Ingredient Decoction), which will surely achieve success. I now revise a formula named San Lu Tong Bu Tang (Three Earths Simultaneous Tonification Decoction). The brilliance of this formula lies in tonifying fire within water; when water is sufficient, the Lung Meridian is nourished, and when fire is warm, the Spleen Qi is generated, thereby providing dual nourishment to the Lung Meridian. Moreover, since the formula originally contains herbs that generate Lung Yin, how can the Metal of the Lung remain unsettled? Once the Lung, Kidney, and Spleen meridians are all stabilized, where can pathogens hide? They will naturally find it difficult to linger within the skin. As pathogens retreat, swelling subsides spontaneously, and Shuang'e loses its form entirely, recovering without conscious effort.

[Sha'e Dan]
Borax (1 fen), Cinnabar (3 fen), Calculus Bovis (1 fen), Borneolum Syntheticum (1 fen), Camellia Seed (1 qian), Moschus (1 fen), Gypsum Fibrosum (1 qian). Grind each into an extremely fine powder.

[San Lu Tong Bu Tang]
Prepared Rehmanniae Radix (1 liang), Corni Fructus (5 qian), Ophiopogonis Radix (1 liang), Schisandrae Fructus (2 qian), Coicis Semen (1 liang), Cinnamomi Cortex (2 qian), Ginseng Radix et Rhizoma (1 qian), Brassicae Semenis Albus (5 qian), Poria (5 qian), Atractylodis Macrocephalae Rhizoma (5 qian). Decoct in water and take orally.

Ocular pain can be either deficiency or excess. Symptoms of excess pain necessarily include redness, swelling, tearing, and ocular discharge, or sensations as if pierced by an awl or sand entering the eye. There is photophobia and preference for darkness; exposure to sunlight feels like being touched, and looking at light shadows feels like needle pricks. Opacities and nebulae may arise, accompanied by aversion to cold, fever, expectoration, acid regurgitation, solid stools, and yellow urine. These are all excess patterns of evil fire. The treatment method must focus on dispersing pathogens, clearing heat, and resolving phlegm. If tonifying herbs are used prematurely, they will only exacerbate the fire, preventing phlegm resolution and pathogen dispersion. Use Xie Huo Quan Ming Tang (Fire-Draining Complete Clarity Decoction). The brilliance of this formula lies in the heavy use of Scrophulariae Radix to dissipate floating fire, while other herbs primarily enter the Liver to soothe Liver Qi, eliminate damp-heat and wind pathogens, resolve phlegm nodules, and fortify Spleen Qi. Although it does not directly treat the eyes, it precisely treats them.

Symptoms of deficiency pain present with pale redness; even if red, pain is mild. There is photophobia without tearing, and fear of bright light without nebulae. Stools are normal, urine is clear and copious, phlegm is not yellow, and there is aversion to cold without nasal discharge. These are deficiency patterns of the Liver and Kidney. The treatment method must focus on nourishing Water and soothing the Liver. If expelling pathogens and clearing fire are prioritized, mild conditions will worsen, and severe conditions may lead to blindness. Use Wen Jiu Mu Mu San (Warm Rescue Eye-Nourishing Powder). This formula tonifies both Liver and Kidney, with particular emphasis on the Liver. Although Liver Wood withers due to the exhaustion of Kidney Water, leading to the Liver's inability to nourish the eyes, Liver Qi requires Kidney Water for support. However, since the eyes are nourished by the Liver, tonifying the Liver ensures visual clarity; thus, tonifying the Kidney should prioritize tonifying the Liver. Previously, there were no excellent formulas for treating deficiency-type eye diseases. Seeing ocular pain, practitioners often indiscriminately use Wind-dispelling herbs, often damaging patients' vision. If one follows my guidance to differentiate deficiency and excess, applying the former formula for excess and the latter for deficiency regardless of sequence, eye diseases will respond promptly, avoiding the lament of blindness. Thus, it is evident that deficiency and excess must be clearly differentiated, and medication must not deviate even slightly.

[Xie Huo Quan Ming Tang]
Bupleuri Radix (2 qian), Cassiae Semen (3 qian), Chrysanthemi Flos (2 qian), Scrophulariae Radix (5 qian), Gardeniae Fructus Preparatus (2 qian), Glycyrrhizae Radix et Rhizoma (1 qian), Trichosanthis Radix (3 qian), Paeoniae Radix Alba (3 qian), Alismatis Rhizoma (1 qian), Plantaginis Semen (1 qian), Gentianae Radix (1 qian). Decoct in water and take orally.

[Wen Jiu Mu Mu San]
Prepared Rehmanniae Radix (5 qian), Angelicae Sinensis Radix (5 qian), Paeoniae Radix Alba (1 liang), Corni Fructus (5 qian), Chrysanthemi Flos (5 qian), Polygonati Rhizoma (5 qian), Lycii Fructus (3 qian), Coicis Semen (5 qian), Bupleuri Radix (0.5 qian), Plantaginis Semen (2 qian), Brassicae Semenis Albus (2 qian). Decoct in water and take orally.