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For cases where a nebula (corneal opacity) is generated due to being hit or pierced by an object, the mechanism is the same as that of a ruptured eye. However, if pierced by sharp objects such as bamboo or wooden splinters, the wound is damaged and blood irrigates the area, thereby generating a blood nebula (hematoma of the cornea). This presents with a sensation of foreign body, astringency, tearing, and red veins covering the eyes. This condition is external trauma, which differs from internal causes of eye nebulae: those caused internally stem from toxic pathogens emanating from the five zang and six fu organs, constituting a disease with a root cause; whereas piercings are merely external injuries, unrelated to internal organs. Treatment method: Refer to the broad treatment for similar symptoms. After one week, if the scar transforms into a nebula, a small amount of Qing Dan (Light Cinnabar Powder) can be insufflated onto the lesion. Avoid sexual indulgence and anger, protect from wind, and rest to recuperate. If neglected in regulation and treatment, it may lead to ulceration, pain, swelling, and damage to the Wind Wheel (black part of the eye),酿成 serious complications, potentially leading to blindness, at which point no treatment will be effective.

Blood flooding the pupil refers to toxic blood irrigating into the water within the Golden Well (pupil). It resembles water flowing into a well, mixing clear and turbid fluids. There is intermittent pain and astringency, red light filling the eyes, and blurred vision as if viewing objects through silk gauze or in smoke. Initially affecting one eye, it subsequently affects both. This condition has three types: First, liver blood heat accumulates over days and months, flooding the pupil, where blood coagulates in the water; this relates to diseases of the Liver and Kidney meridians, and this type of blood is difficult to resolve. Second, blood from rupture is fresh and hot; although the flooding is severe, it resolves quickly. Third, during acupuncture needle cataract surgery (gold needle operation), if the white sclera is accidentally punctured, stasis blood may also flood the pupil. For these three conditions, the treatment methods are quite similar. Da Huang Dang Gui San (Rhubarb and Angelica Decoction), Moyao San (Myrrh Powder), and Zhui Yi Ming Mu Wan (Nebula-Resolving Bright-Eye Pill) are used. For previous injuries involving piercing by objects, collision-induced nebulae, and blood flooding the pupil, three doses of the aforementioned medicines can be taken, yielding significant efficacy. Alternatively, Sheng Di Huang (Rehmanniae Radix) and Fu Rong Gen (Hibisci Mutabilis Root) can be mashed and applied topically for all three conditions. Alternatively, warming with Cong Bai (Scallion White) and Ai Ye (Mugwort Leaf) is also effective. Whether using decoctions or pills, one must practice flexible adaptation rather than rigidly adhering to fixed formulas to achieve success.

Question: When a patient suffers eye injury without internal pathology, suddenly pierced by an object causing damage to the eyelids and eyeball, with accumulated blood failing to disperse, or stasis blood flooding the pupil, or accidental needle injury causing severe swelling and unbearable pain, or being punched causing the eyeball to protrude slightly, what is the treatment? Answer: Upon impact, mash Sheng Di Huang (Rehmanniae Radix) and apply it externally to dissipate the blood. First, take Zhi Tong Mo Yao San (Pain-Stopping Myrrh Powder), then take Zhui Yi Ming Mu Wan (Nebula-Resolving Bright-Eye Pill). If caused by wind invasion, take Chu Feng Tang (Wind-Expelling Decoction). If the eyeball protrudes due to trauma, use the palm of the hand to push it back, and apply Sheng Di Huang externally. If Sheng Di Huang is unavailable, Gan Di Huang (Dried Rehmanniae Radix) soaked in wine and mashed can be used instead.

Zhi Tong Mo Yao San Composition: Moyao (Myrrha), Xue Jie (Santalum Rubrum), Da Huang (Rhei Radix et Rhizoma), Pu Xiao (Natrii Sulfas).
Preparation: Grind the above ingredients into powder. Take 2 qian per dose, mixed with wine; tea can also be used for mixing.

Zhui Yi Ming Mu Wan Composition: Shi Jue Ming (Haliotidis Concha), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Wu Wei Zi (Schisandrae Chinensis Fructus), Zhi Mu (Anemarrhenae Rhizoma), Shan Yao (Dioscoreae Rhizoma) each 1 liang; Ren Shen (Ginseng Radix), Xi Xin (Asari Radix et Rhizoma).
Preparation: Grind the above ingredients into powder, mix with refined honey to form pills. Take with clear tea.

Chu Feng Tang Composition: Fang Feng (Saposhnikoviae Radix), Che Qian Zi (Plantaginis Semen), Ben Cao (Ligustici Wallichii Rhizoma - Note: Text says 'Ben', likely Ligusticum), Wu Wei Zi (Schisandrae Chinensis Fructus), Xi Xin (Asari Radix et Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Jie Geng (Platycodonis Radix).
Usage: Take 3 qian per dose, washed down with plain boiled water, or decocted in water and taken orally.