天行赤眼外障 按此证初患之时，皆因天行时气受之者，两目赤肿 ，紧涩
羞明，头痛泪出，鼻塞眵多，脏腑秘结，宜芍药清肝散；（荆芥、防风、柴胡、薄荷、川芎、赤
芍、羌活、炒栀、知母、甘草、桔梗、大黄、黄芩、滑石、前胡、石膏、芒硝。）大便秘结者，服羌活胜
风汤。（羌活、前胡、荆芥、枳壳、防风、白术、黄芩、柴胡、薄荷、川芎、桔梗、大黄、白芷调治。）
赤眼生翳外障 按此证皆因患赤眼之时，不避辛苦，外受风日，内多房劳，耗
伤元气，以致缠延不愈。时常赤肿，或痒或痛，泪出难睁，风热伏积不散，上胞凝
血，磨擦睛珠，渐生翳膜，宜镰洗去上胞瘀血。
暴风客热外障 按此证皆由肺火壅塞，热气上冲，以致白睛陡红肿壅起，乌
珠内陷，日夜肿胀，疼痛泪出难睁，宜服清金桑皮散。（桑皮、元参、赤芍、防风、菊花、杏
仁、黄芩、枳壳、桔梗、旋覆花、升麻、葶苈子。）又肺经火盛热结，白珠红肿，微觉胀疼，近黑
珠边起一二小泡，大便干结者，宜泻肺汤。黄芩、羌活、桔梗、元参、大黄、芒硝、地骨皮。
两 赤脉外障 按此证皆因心与小肠膀胱经蕴热，或食五辛煎炒热物，致使亢
阳上炎，火气炽盛，故大小 赤脉贯睛，兼小便涩痛，红赤如淋，服八正散。（瞿麦、炒栀、
大黄、甘草、灯心、 蓄、木通、滑石、车前子。）
睑生 疮外障 按此证皆因脾胃二经停积，风热作痒流泪，用手搓揉，或误服
寒凉之剂，致使眼胞内瘀血凝滞不散，故生血缕，后因劳役酒色过度，渐成坚硬疙
瘩，形如花椒相似，内有白浆磨擦瞳人，即生翳膜。治法定镰洗去瘀血，轻者羌活胜
风汤，重者防风散结汤，（防风、羌活、前胡、柴胡、苍术、黄芩、黄连、独活、白芍、防己、红花、当
归尾、甘草、白茯苓、苏木，此药治上下胞内瘀血不散，
并镰洗后系从权，若多服则耗血慎之。）点乌金膏或灵光散。俟病去大半，服清热消凝丸。（治淫
热反克，风热不散，白睛如血贯，有热而血滞者，川芎、当归、荆芥、薄荷、羌活、 本、菊花、滑石、石膏、连
翘、山栀、甘草、黄芩、白术、桔梗炼蜜为丸，每丸重一钱三分，临卧时须清茶调服。）
睑生风粟外障 按此证皆因脾经受风，致使血壅热积不散；或为病已久，肿
涩难睁，亦与 疮相类。但只胞内生小窠如粟米，坚硬白色，磨擦睛珠，泪出涩痛，
渐生翳膜。治法先针刺出风粟白浆，服胜风汤、羚羊角散。（羚羊角、犀角、知母、元参、大
黄、芒硝、黄芩、桔梗、防风。）
白翳花陷外障 按此证皆因七情五贼，饥饱劳役，损伤脾胃，兼之肝血不足，
以致睛疼如刺，刺应太阳，眼睫无力，常欲垂闭，泪出羞明，珠上即生白翳陷下，如
粟米鱼鳞之状。先服柴胡复生汤；珠痛者，服当归养荣汤；（熟地、当归、白芍、川芎、羌活、防
风、白芷。）瘾涩难开服当归活血汤；（当归、黄 、甘草、升麻、柴胡、白芷、防风、蔓荆子。）元气虚弱
者服补中益气汤。花陷不起者亦可服。
蝇头蟹睛外障 按此证皆因肝肾俱劳，火邪炎热之极，兼之七情郁结，以伤
脾土，脾土既病，则失生生之职，不能含血上荣于目，故睛珠疼极，泪出难睁，或
因暴怒，乌珠上暴起蓝黑翳如蝇头蟹睛之状，离瞳人而起者，名为离睛蟹眼，当瞳
人而起者，名为蝇头，先服柴胡复生汤；（白芍、川芎、 本、柴胡、苍术、甘草、白芷、茯苓、羌
活、黄芩、蔓荆子、薄荷、独活、桔梗、五味子。）痛不止，服当归养荣汤，次服黄 汤、神效补
肝散；虚者冲和养胃汤，后服石斛夜光丸，俱加五味子以敛之；点推云散、八宝散。此
证外点内服，必要积以岁月，其翳方能收复，亦有不能去者。
黑翳如珠外障 按此证皆因肾虚肝热，子母俱亏，其病感受，大抵与前证相
仿。睛珠疼痛，泪出难睁，羞明怕日，乌珠上边生黑翳，突起如黑豆，先服黄 汤、
（人参、黄 、知母、白茯苓、远志、大黄、防风、地骨皮。）育神夜光丸。（人参、生地、熟地、天门冬、麦
门冬、钗斛、牛膝、当归、枳壳、枸杞子、地骨皮、菟丝子、菊花、远志炼蜜为丸，白汤下。）
血翳包睛外障 按此证皆因脾受风热，更兼肝肾虚劳，上胞有病，磨擦睛珠；
内因积热，外感风邪，遂使凝血不散，渐生翳膜。上有红丝纵横错贯，遮蔽瞳人，难
以视物。治法先宜镰洗去上胞瘀血，先服胜风汤兼当归散，（当归、生地、熟地、黄连、山栀、
赤芍、桑白皮、防己、龙胆草。）后服石斛夜光丸，点乌金膏。如有客热风痰之证，则宜育神夜光丸。
血灌瞳人外障 按此证皆因肝心火盛，载血上贯目中。心者君主之官，神之
舍也，属火宜静，或因大惊伤心，大怒伤肝，心神散乱，以致火性妄动，载血错经，
妄行灌注于目，遮蔽瞳人，红色不分黑白，疼痛难睁，惊狂骂詈，如见鬼神。目乃五
脏六腑之精华，荣卫魂魄之所常营也，亦神气之所主也，神乱则魂魄散，故言语狂
乱见矣。治法宜急砭迎香穴（在鼻孔内两旁。）即愈。初病一二日，红色即可砭；若日久如
圆眼核紫黄色，则不治矣。（砭法∶取粗茶叶篓上箬叶二片，以中间硬梗为脊，剪针长一寸四五分，如剑
形，头尖身阔，取其至鼻内小孔穴处即止，不能往上也。用时将针安放鼻内，向穴处余八九分，在外用手突然往
上一送，出血数匙，便勿再砭。）即令卧暖处不可惊动，久睡自醒，其妙如神。后服川芎行经
散加五灵脂数剂，行其积血自愈。
鸡冠蚬肉外障 按此证属脾胃二经热积，外受风邪，致使血凝不散，上胞内壅
瘀血一块，软而紫黑色即鸡冠；下胞内生瘀肉一条，软而淡红色即蚬肉。宜镰去瘀
血，服抽风散，（元参、黄芩、桔梗、防风、细辛、车前、大黄、芒硝。）点灵药乌金膏。
肉攀睛外障 按此证初患赤眼，临风不避辛苦，延久而成；或因热足下于冷
水，或因站立行房，致伤阳 经络者。其脉起于足，上行至头面属目内 ，此经既
伤，内 即生赤脉如缕，缕根生瘀肉，瘀肉生黄赤脂，脂则横侵黑睛，渐蚀神水，或
兼锐 而病者，合于太阳经也。治法∶如
未蚀黑珠者，服胜风汤加蔓荆子、拨云退翳丸∶（川芎、荆芥、菊花、甘草、黄连、蛇蜕、当归、
川椒、蝉蜕、密蒙花、蔓荆子、地骨皮、白蒺藜、木贼草、桃仁、薄荷、天花粉，炼蜜丸，重八分，每服一丸，
食远清茶调下。有翳米泔水调下，睛昏当归汤调下，内障者用木香汤调下。）有热兼服还阴救苦汤。已蚀
神水者，另有割法，详载《银海拨萃》。
白膜侵睛外障 按此证皆因肺热肝虚，肾水亏弱，肾水不能生肝木，故肝受
肺之邪热所克。乌珠周遭渐生白色如翳，日久渐遮瞳人，终有昏暗之患。先服泻肺汤
以泻肺经之实热，后服育神夜光丸加天冬、麦冬滋阴补肾。
膜入水轮外障 按此证皆由目病已久，抑郁不舒，更兼调理失宜，房劳太过，
以致肝肾亏虚，渐生翳膜。始而蓝色若蝇翅，日久则白浓矣。宜冲和养胃汤、石斛夜光丸。
黄膜上冲外障 按此证皆因胃经邪热凝滞气血，以致白睛下边红赤生翳，黄色
冲上黑珠，涩痛泪出，羞明难睁。脾胃属土，土色黄，胃伤则土之正色见也。先服防风通圣散泻去积热，
后服通脾泻胃汤，（天门冬、麦门冬、茺蔚子、元参、知母、黄芩、大黄。）点琥珀散。
赤膜下垂外障 按此证皆因上胞脾经风热，血积成 ，目珠被其磨擦，肿痛泪
出，羞涩不睁，热壅不能疏泄，血愈凝滞不行，乌珠即生赤膜，目上垂下红色，渐
遮瞳人。宜镰洗去上胞瘀血；散目中瘀血，宜川芎行经散，点八宝散、推云散。
逆顺生翳外障 按此证乌珠生翳，自上而下者谓之顺，属脾经；从下而上者谓
之逆，属胃经，起自脾胃，证见肝经，日久渐遮神水，皆因身体虚弱，气血不足，以
致诸经感受邪热，使血凝滞不行，磨擦而生翳膜，此翳最难去。初宜服拨云退翳丸
兼育神夜光丸，点八宝散、推云散；若翳自下而上者，服防风通圣散一二剂即去。
风吹出睑外障 按此证皆因脾胃二经感受风热，日积月累，壅滞胞睑之间。盖
睑受风则皮紧，脾受风则肉壅，皮紧肉壅，故眼皮或上或下，翻转在外，上生瘀肉红
紫色，眵泪如脓。治法先宜镰洗去瘀血，服胜风汤，点乌金膏、灵光散。久则不可也。
迎风流泪外障 按此证皆因肾肝亏损。盖肝虚则泪不收，泪者肝之液，目乃
肝之窍，液之道也，肝木生于肾水，水衰不能生木，母子两虚，邪火内燔于目，外
遇风吹，肝木为其摇动，是以液道开而泪不收。初起无他证，惟浸浸泪出，拭去又
流，经冬病者多年久，不分四季宜服四物补肝散、育神夜光丸。若不早治，两眼俱
黑色，昏暗不明者。（生地、熟地、川椒等分，炼蜜丸，每早晚淡盐汤送下二三钱。）
痒极难当外障 按此证皆因心经火邪，脾经风热，久伏不散，攻冲目中，忽
遇风邪干触，遂作痒难禁，用手揉擦，亦不能止。盖痒非谓虚也，乃火与风也，风
触则火发，风火相并故作痒耳。久则两睑赤烂，羞涩难开，眵多若糊。若胞内有瘀
血，宜镰洗，先服 本疏风散，（川芎、 本、羌活、防风、蝉蜕、细辛。）点八宝散。
偏睛脓血外障 按此证皆因肝火旺盛，积热壅毒，乌珠内有脓自下灌上，或
珠高起如疮样，流出脓水。盖肝脏生火藏血，上荣乌珠，火盛气冲血脉，凝滞不行，
阴阳相搏乃化为脓。发时苦头痛珠疼，外寒内热，涕泪交流，食眠不得，四肢倦困
昏闷，俱火之象也。宜撤脓撒火，服黄 汤；候脓净，次服柴胡复生汤，点琥珀散、八宝散。
鹘眼凝睛外障 按此证乃气血不分，混结而成。初患无痛疼，但上胞肿起如豆
许，渐渐长大，内有紫 ，大抵人身气血不欲相混，混则阻滞于皮肤之间，遂成此
病。初治须择人神所在不犯之日，翻转眼皮向外于紫斑处，用眉尖刀刺破患处，以
大指捻出黄脂后，服防风散结汤；如初起略觉有碍，用白酒煎消毒饮（归尾、甘草、白芷、
陈皮、赤芍、防风、天花粉、金银花、皂角刺。）数剂
亦消。夫名鹘眼凝睛者，盖鹘乌之眼凝视不运，此病长大坚硬，碍塞睛珠，视物不能运动，故以名之。
痛极憎寒外障 按此证皆因房劳思虑，以伤心肾阴血；劳役饥饱，以伤胃腑
阳气。气血两伤，水火不能升降，皮肤间无阳卫外护，为风寒之气乘虚以侵攻冲于
头，伏而不散。头为诸阳之会，邪正相搏，故头痛不可忍，目珠红肿流泪；火邪上逆
不降，则阴气触并于下，故足膝逆冷，身憎寒战。治法宜补阴降火，服附子猪苓汤。
打撞伤损外障 按此证皆因被物打撞。手拳打着眼珠，突出一二寸者，登时
急用手掌擦热托定眼珠，而珠系一得热气，自然紧缩就上，仍收眼眶中。但不可洗去
血。外即用熟地黄捣膏摊薄绢封贴眼上，日换三次，服除风益损汤。（川芎、白芍、当归、熟
地、 本、前胡、防风。）
打撞积血外障 按此证皆因被物打撞，胞睑凝血，肿痛难开，白睛红如血灌，
服川芎行经散。（川芎、羌活、独活、荆芥、薄荷、防风、白芷、柴胡、枳壳、桔梗、当归、
茯苓、红花、甘草、蔓荆子。）
打刺生翳外障 按此证皆因被物打刺，积血未散，或刺痕未痊，久则珠上生
白翳遮睛。有脓血者服川芎行经散；血虚者服除风益损汤；翳膜者用八宝散、推云散缓点之。
伤寒愈后外障 按此证皆因大病后清阳之气不升，余邪上炽不休而走空窍。其
病瘾涩赤胀，生翳羞明，头脑骨痛，宜服胜风汤升发清阳。
又一证乃因用辛热之剂发表太过，以致气虚身弱，时病虽愈而瞳仁渐渐散大。盖
辛主散，热则助火上乘于胸中，故睛散，经所谓壮火散气耳。先用胜风汤重加五味子
以收耗散之气，数剂之后，兼服冲和养胃汤，后用石斛夜光丸倍加五味子自愈。
痛如针刺外障 按此证皆因心经潜伏壅热，风毒上攻，故病白珠淡红，流泪瘾
涩难开，内 时时痛如针刺。宜服洗心散，（黄连、黄芩、桔梗、大黄、知母、元参、荆芥、赤芍、当
归。）点琥珀散。
瞳人干缺外障 按此证复因肾水亏损，反受火制，故瞳人小如芥子，而且缺
内有脑脂凝结，或黄或白。此系内障因头痛而起，故列于外障。初病头痛难忍，坐
卧不宁，宜补肾清肝退火为主，久则不见三光不治也。
停肉瘀血外障 按此证皆因连患时眼未愈，不避劳苦，见风太早，以致脾胃受
风，肝气不和，使瘀血凝滞胞睑之间，两胞肿涩，眵泪胶粘。先用镰洗，服胜风汤，
点琥珀散；若不愈，点乌金膏、灵光散。
羞明怕日外障 按此证皆因病目久延不愈，郁火内炎，邪风外客，致使脾家感
受，积伏于胞睑之间，但胞睑属脾，盖脾统血，邪气既盛则血无所归，故见阳气光
外障疾病主论（第一部分）
天行赤眼外障：根据此证，初起时多因感受天时流行之气所致。症状表现为双眼红肿、紧绷干涩、畏光流泪、头痛、鼻塞、眼屎增多、脏腑便秘。适宜服用芍药清肝散。（药物组成：荆芥、防风、柴胡、薄荷、川芎、赤芍、羌活、炒栀子、知母、甘草、桔梗、大黄、黄芩、滑石、前胡、石膏、芒硝。）若大便秘结严重，可服用羌活胜风汤。（药物组成：羌活、前胡、荆芥、枳壳、防风、白术、黄芩、柴胡、薄荷、川芎、桔梗、大黄、白芷，调服。）
赤眼生翳外障：根据此证，皆因患红眼病期间，不避劳累辛苦，外受风日侵袭，内房事过度，耗伤元气，导致病情缠绵难愈。时常眼睛红肿，或痒或痛，流泪难以睁眼，风热伏积不散，上眼睑充血，摩擦眼球，逐渐生成翳膜。治疗宜用镰刀清洗去除上眼睑的瘀血。
暴风客热外障：根据此证，皆由肺火壅塞，热气上冲，导致白睛突然红肿隆起，黑睛内陷，日夜肿胀，疼痛流泪难以睁眼。适宜服用清金桑皮散。（药物组成：桑白皮、玄参、赤芍、防风、菊花、杏仁、黄芩、枳壳、桔梗、旋覆花、升麻、葶苈子。）若是肺经火盛热结，白珠红肿，微觉胀痛，靠近黑珠边缘出现一两个小泡，大便干结者，适宜服用泻肺汤。药物组成：黄芩、羌活、桔梗、玄参、大黄、芒硝、地骨皮。
两眦赤脉外障：根据此证，皆因心与小肠、膀胱经蕴藏湿热，或因食用五辛及煎炒燥热食物，致使亢阳上炎，火气炽盛。因此大小眼角赤脉贯穿黑睛，兼有小便涩痛，尿色红赤如淋证。适宜服用八正散。（药物组成：瞿麦、炒栀子、大黄、甘草、灯心草、萹蓄、木通、滑石、车前子。）
睑生疔疮外障：根据此证，皆因脾胃二经停滞积热，风热作痒流泪，用手搓揉，或误服寒凉药物，致使眼睑内瘀血凝滞不散，故生出血缕，后因劳累、酒色过度，逐渐形成坚硬疙瘩，形状像花椒，内有白浆摩擦瞳孔，即生成翳膜。治疗方法定用镰刀清洗去除瘀血，轻者服用羌活胜风汤，重者服用防风散结汤。（药物组成：防风、羌活、前胡、柴胡、苍术、黄芩、黄连、独活、白芍、防己、红花、当归尾、甘草、白茯苓、苏木。此药治疗上下眼睑内瘀血不散，并配合镰洗后作为权宜之计，若多服则耗损血液，需谨慎。）点涂乌金膏或灵光散。待病去大半，服用清热消凝丸。（治疗淫热反克，风热不散，白睛如血贯，有热而血滞者。药物组成：川芎、当归、荆芥、薄荷、羌活、藁本、菊花、滑石、石膏、连翘、山栀、甘草、黄芩、白术、桔梗，炼蜜为丸，每丸重一钱三分，临睡前需用清茶调服。）
睑生风粟外障：根据此证，皆因脾经受风，致使血壅热积不散；或因病已久，肿胀干涩难以睁眼，也与疔疮相似。但只是眼睑内生小窠如粟米状，坚硬白色，摩擦眼球，流泪涩痛，逐渐生成翳膜。治疗方法先针刺放出风粟中的白浆，服用胜风汤、羚羊角散。（药物组成：羚羊角、犀角、知母、玄参、大黄、芒硝、黄芩、桔梗、防风。）
白翳花陷外障：根据此证，皆因七情五贼（指喜怒忧思悲恐惊及嗜欲），饥饱劳役，损伤脾胃，兼之肝血不足，导致眼睛疼痛如针刺，牵引太阳穴，眼睑无力，常想垂闭，流泪畏光，眼球上即生白翳凹陷，如粟米鱼鳞之状。先服用柴胡复生汤；眼球疼痛者，服用当归养荣汤；（药物组成：熟地黄、当归、白芍、川芎、羌活、防风、白芷。）感觉隐涩难开者，服用当归活血汤；（药物组成：当归、黄芪、甘草、升麻、柴胡、白芷、防风、蔓荆子。）元气虚弱者服用补中益气汤。花陷不起者也可服用。
蝇头蟹睛外障：根据此证，皆因肝肾俱劳，火邪炎热至极，兼之七情郁结，损伤脾土。脾土既病，则失去生化职能，不能含血上荣于目，故眼球疼痛剧烈，流泪难以睁眼。或因暴怒，黑睛上突然升起蓝黑色翳膜，如蝇头蟹睛之状。离开瞳孔而起的，名为离睛蟹眼；正当瞳孔而起的，名为蝇头。先服用柴胡复生汤；（药物组成：白芍、川芎、藁本、柴胡、苍术、甘草、白芷、茯苓、羌活、黄芩、蔓荆子、薄荷、独活、桔梗、五味子。）疼痛不止，服用当归养荣汤，接着服用黄芪汤、神效补肝散；虚者服用冲和养胃汤，后来服用石斛夜光丸，均加五味子以收敛；点涂推云散、八宝散。此证外用点药内服药物，必须积累岁月，其翳才能收复，也有不能去除的。
黑翳如珠外障：根据此证，皆因肾虚肝热，子母俱亏，其病感受，大体与前证相似。眼球疼痛，流泪难以睁眼，畏光怕日，黑睛上方生黑翳，突起如黑豆。先服用黄芪汤；（药物组成：人参、黄芪、知母、白茯苓、远志、大黄、防风、地骨皮。）育神夜光丸。（药物组成：人参、生地、熟地、天门冬、麦门冬、钗斛、牛膝、当归、枳壳、枸杞子、地骨皮、菟丝子、菊花、远志，炼蜜为丸，白开水送下。）
血翳包睛外障：根据此证，皆因脾受风热，更兼肝肾虚劳，上眼睑有病，摩擦眼球；内因积热，外感风邪，遂使凝血不散，逐渐生成翳膜。上面有红丝纵横交错贯穿，遮蔽瞳孔，难以视物。治疗方法先用镰刀清洗去除上眼睑瘀血，先服用胜风汤兼当归散，（药物组成：当归、生地、熟地、黄连、山栀、赤芍、桑白皮、防己、龙胆草。）后服用石斛夜光丸，点涂乌金膏。如有客热风痰之证，则适宜服用育神夜光丸。
血灌瞳人外障：根据此证，皆因肝心火盛，载血上贯目中。心是君主之官，神的居所，属火宜静，或因大惊伤心，大怒伤肝，心神散乱，以致火性妄动，载血错经，妄行灌注于目，遮蔽瞳孔，红色不分黑白，疼痛难睁，惊狂骂詈，如见鬼神。眼睛是五脏六腑的精华，营卫魂魄之所常营，也是神气所主。神乱则魂魄散，所以言语狂乱出现了。治疗方法宜急刺迎香穴（在鼻孔内两旁。）即可痊愈。初病一二日，红色即可砭刺；若日久如圆眼核紫黄色，则不治了。（砭法：取粗茶叶篓上的箬叶两片，以中间硬梗为脊，剪针长一寸四五分，如剑形，头尖身阔，取其至鼻内小孔穴处即止，不能往上。用时将针安放鼻内，向穴处余八九分，在外用手突然往上一送，出血数匙，便不再砭刺。）立即令患者卧于暖处不可惊动，久睡自醒，其妙如神。后服用川芎行经散加五灵脂数剂，行其积血自愈。
鸡冠蚬肉外障：根据此证，属脾胃二经热积，外受风邪，致使血凝不散，上眼睑内壅瘀血一块，软而紫黑色即为鸡冠；下眼睑内生瘀肉一条，软而淡红色即为蚬肉。适宜用镰刀去除瘀血，服用抽风散，（药物组成：玄参、黄芩、桔梗、防风、细辛、车前、大黄、芒硝。）点涂灵药乌金膏。
肉攀睛外障：根据此证，初患红眼病，临风不避劳累，延久而成；或因热足下于冷水，或因站立行房，致伤阳跷经络。其脉起于足，上行至头面属目内眦，此经既伤，内眦即生赤脉如缕，缕根生瘀肉，瘀肉生黄赤脂，脂则横侵黑睛，渐蚀神水，或兼锐眦而病者，合于太阳经也。治疗方法：如未蚀黑珠者，服用胜风汤加蔓荆子、拨云退翳丸∶（药物组成：川芎、荆芥、菊花、甘草、黄连、蛇蜕、当归、川椒、蝉蜕、密蒙花、蔓荆子、地骨皮、白蒺藜、木贼草、桃仁、薄荷、天花粉，炼蜜丸，重八分，每服一丸，食远清茶调下。有翳米泔水调下，睛昏当归汤调下，内障者用木香汤调下。）有热兼服还阴救苦汤。已蚀神水者，另有割法，详载《银海拨萃》。
白膜侵睛外障：根据此证，皆因肺热肝虚，肾水亏弱，肾水不能生肝木，故肝受肺之邪热所克。黑睛周遭渐生白色如翳，日久渐遮瞳孔，终有昏暗之患。先服用泻肺汤以泻肺经之实热，后服用育神夜光丸加天冬、麦冬滋阴补肾。
膜入水轮外障：根据此证，皆由目病已久，抑郁不舒，更兼调理失宜，房劳太过，以致肝肾亏虚，渐生翳膜。始而蓝色若蝇翅，日久则白浓矣。适宜服用冲和养胃汤、石斛夜光丸。
黄膜上冲外障：根据此证，皆因胃经邪热凝滞气血，以致白睛下边红赤生翳，黄色冲上黑珠，涩痛泪出，羞明难睁。脾胃属土，土色黄，胃伤则土之正色见也。先服用防风通圣散泻去积热，后服用通脾泻胃汤，（药物组成：天门冬、麦门冬、茺蔚子、玄参、知母、黄芩、大黄。）点涂琥珀散。
赤膜下垂外障：根据此证，皆因上胞脾经风热，血积成瘀，眼球被其磨擦，肿痛泪出，羞涩不睁，热壅不能疏泄，血愈凝滞不行，黑睛即生赤膜，目上垂下红色，渐遮瞳孔。适宜用镰刀清洗去除上眼睑瘀血；散目中瘀血，适宜服用川芎行经散，点涂八宝散、推云散。
逆顺生翳外障：根据此证，黑睛生翳，自上而下者谓之顺，属脾经；从下而上者谓之逆，属胃经，起自脾胃，证见肝经，日久渐遮神水，皆因身体虚弱，气血不足，以致诸经感受邪热，使血凝滞不行，磨擦而生翳膜，此翳最难去。初宜服用拨云退翳丸兼育神夜光丸，点涂八宝散、推云散；若翳自下而上者，服用防风通圣散一二剂即去。
风吹出睑外障：根据此证，皆因脾胃二经感受风热，日积月累，壅滞胞睑之间。盖睑受风则皮紧，脾受风则肉壅，皮紧肉壅，故眼皮或上或下，翻转在外，上生瘀肉红紫色，眵泪如脓。治疗方法先宜用镰刀清洗去除瘀血，服用胜风汤，点涂乌金膏、灵光散。久则不可也。
迎风流泪外障：根据此证，皆因肾肝亏损。盖肝虚则泪不收，泪者肝之液，目乃肝之窍，液之道也，肝木生于肾水，水衰不能生木，母子两虚，邪火内燔于目，外遇风吹，肝木为其摇动，是以液道开而泪不收。初起无他证，惟浸浸泪出，拭去又流，经冬病者多年久，不分四季适宜服用四物补肝散、育神夜光丸。若不早治，两眼俱黑色，昏暗不明者。（药物组成：生地、熟地、川椒等分，炼蜜丸，每早晚淡盐汤送下二三钱。）
痒极难当外障：根据此证，皆因心经火邪，脾经风热，久伏不散，攻冲目中，忽遇风邪干触，遂作痒难禁，用手揉擦，亦不能止。盖痒非谓虚也，乃火与风也，风触则火发，风火相并故作痒耳。久则两睑赤烂，羞涩难开，眵多若糊。若胞内有瘀血，宜用镰刀清洗，先服用藁本疏风散，（药物组成：川芎、藁本、羌活、防风、蝉蜕、细辛。）点涂八宝散。
偏睛脓血外障：根据此证，皆因肝火旺盛，积热壅毒，黑睛内有脓自下灌上，或珠高起如疮样，流出脓水。盖肝脏生火藏血，上荣黑睛，火盛气冲血脉，凝滞不行，阴阳相搏乃化为脓。发作时苦头痛珠疼，外寒内热，涕泪交流，食眠不得，四肢倦困昏闷，俱火之象也。适宜撤脓撒火，服用黄芪汤；候脓净，次服用柴胡复生汤，点涂琥珀散、八宝散。
鹘眼凝睛外障：根据此证，乃气血不分，混结而成。初患无痛疼，但上眼睑肿起如豆许，渐渐长大，内有紫斑，大体人身气血不欲相混，混则阻滞于皮肤之间，遂成此病。初治须择人神所在不犯之日，翻转眼皮向外于紫斑处，用眉尖刀刺破患处，以大指捻出黄脂后，服用防风散结汤；如初起略觉有碍，用白酒煎消毒饮（药物组成：归尾、甘草、白芷、陈皮、赤芍、防风、天花粉、金银花、皂角刺。）数剂亦消。夫名鹘眼凝睛者，盖鹘乌之眼凝视不运，此病长大坚硬，碍塞睛珠，视物不能运动，故以名之。
痛极憎寒外障：根据此证，皆因房劳思虑，以伤心肾阴血；劳役饥饱，以伤胃腑阳气。气血两伤，水火不能升降，皮肤间无阳卫外护，为风寒之气乘虚以侵攻冲于头，伏而不散。头为诸阳之会，邪正相搏，故头痛不可忍，眼球红肿流泪；火邪上逆不降，则阴气触并于下，故足膝逆冷，身憎寒战。治疗方法适宜补阴降火，服用附子猪苓汤。
打撞伤损外障：根据此证，皆因被物打撞。手拳打着眼珠，突出一二寸者，登时急用手掌擦热托定眼珠，而珠系一得热气，自然紧缩就上，仍收眼眶中。但不可洗去血。外即用熟地黄捣膏摊薄绢封贴眼上，日换三次，服用除风益损汤。（药物组成：川芎、白芍、当归、熟地、藁本、前胡、防风。）
打撞积血外障：根据此证，皆因被物打撞，胞睑凝血，肿痛难开，白睛红如血灌，服用川芎行经散。（药物组成：川芎、羌活、独活、荆芥、薄荷、防风、白芷、柴胡、枳壳、桔梗、当归、茯苓、红花、甘草、蔓荆子。）
打刺生翳外障：根据此证，皆因被物打刺，积血未散，或刺痕未痊，久则珠上生白翳遮睛。有脓血者服用川芎行经散；血虚者服用除风益损汤；翳膜者用八宝散、推云散缓点之。
伤寒愈后外障：根据此证，皆因大病后清阳之气不升，余邪上炽不休而走空窍。其病瘾涩赤胀，生翳羞明，头脑骨痛，适宜服用胜风汤升发清阳。
又一证乃因用辛热之剂发表太过，以致气虚身弱，时病虽愈而瞳仁渐渐散大。盖辛主散，热则助火上乘于胸中，故睛散，经所谓壮火散气耳。先用胜风汤重加五味子以收耗散之气，数剂之后，兼服用冲和养胃汤，后用石斛夜光丸倍加五味子自愈。
痛如针刺外障：根据此证，皆因心经潜伏壅热，风毒上攻，故病白珠淡红，流泪瘾涩难开，内眦时时痛如针刺。适宜服用洗心散，（药物组成：黄连、黄芩、桔梗、大黄、知母、玄参、荆芥、赤芍、当归。）点涂琥珀散。
瞳人干缺外障：根据此证，复因肾水亏损，反受火制，故瞳人小如芥子，而且缺内有脑脂凝结，或黄或白。此系内障因头痛而起，故列于外障。初病头痛难忍，坐卧不宁，适宜补肾清肝退火为主，久则不见三光不治也。
停肉瘀血外障：根据此证，皆因连患时眼未愈，不避劳苦，见风太早，以致脾胃受风，肝气不和，使瘀血凝滞胞睑之间，两胞肿涩，眵泪胶粘。先用镰刀清洗，服用胜风汤，点涂琥珀散；若不愈，点涂乌金膏、灵光散。
羞明怕日外障：根据此证，皆因病目久延不愈，郁火内炎，邪风外客，致使脾家感受，积伏于胞睑之间，但胞睑属脾，盖脾统血，邪气既盛则血无所归，故见阳气光
Main Discussion on External Obstruction Diseases (Part 1/2)
**Tianxing Chiyan Waizhang (Epidemic Red Eye External Obstruction):** Regarding this syndrome, at the initial stage, it is caused by contracting the epidemic seasonal pathogenic qi. Symptoms include redness and swelling of both eyes, tightness and dryness, photophobia, tearing, headache, nasal congestion, excessive eye discharge, and constipation of the internal organs. It is suitable to administer Shaoyao Qinggan San (Peony Liver-Clearing Powder). [Ingredients: Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Bohe (Menthae Haplocalycis Herba), Chuanxiong (Chuanxiong Rhizoma), Chishao (Paeoniae Radix Rubra), Qianghuo (Notopterygii Rhizoma et Radix), Chao Zhi (Stir-baked Gardeniae Fructus), Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Huashi (Talcum), Qianhu (Peucedani Radix), Shigao (Gypsum Fibrosum), Mangxiao (Natrii Sulfas).] If severe constipation occurs, Qianghuo Shengfeng Tang (Notopterygium Wind-Overcoming Decoction) may be taken. [Ingredients: Qianghuo, Qianhu, Jingjie, Zhike (Aurantii Fructus Immaturus), Fangfeng, Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqin, Chaihu, Bohe, Chuanxiong, Jiegeng, Dahuang, Baizhi (Angelicae Dahuricae Radix), taken with appropriate modulation.]
**Chiyan Shengyi Waizhang (Red Eye with Pterygium External Obstruction):** Regarding this syndrome, it is caused by not avoiding fatigue during the onset of red eye, being exposed externally to wind and sun, and having excessive sexual activity internally, which depletes Yuanqi (Original Qi). This leads to a lingering and non-healing condition. The eyes are frequently red and swollen, itchy or painful, with tearing making it difficult to open them. Wind-heat accumulates and does not disperse, causing blood stasis in the upper eyelid, which rubs against the eyeball, gradually forming a pterygium (membrane). Treatment involves using a scalpel to wash away the blood stasis in the upper eyelid.
**Baofeng Kere Waizhang (Violent Wind and Guest Heat External Obstruction):** Regarding this syndrome, it is caused by lung fire obstruction and rising heat, leading to sudden redness and swelling of the sclera (white part of the eye), depression of the cornea (black part), day-and-night swelling, pain, and tearing that makes opening the eyes difficult. It is suitable to take Qingjin Sangpi San (Clear Metal Mulberry Bark Powder). [Ingredients: Sangbai pi (Mori Cortex), Yuanshen (Scrophulariae Radix), Chishao, Fangfeng, Juhua (Chrysanthemi Flos), Xingren (Armeniacae Semen Amarum), Huangqin, Zhike, Jiegeng, Xuanfuhua (Inulae Flos), Shengma (Cimicifugae Rhizoma), Tinglizi (Lepidii et Descurainiae Semen), etc.] If there is excess fire and heat accumulation in the lung meridian, with redness and swelling of the sclera, slight distension and pain, one or two small blisters appearing near the edge of the cornea, and dry stool, Xiefei Tang (Draining Lung Decoction) is suitable. [Ingredients: Huangqin, Qianghuo, Jiegeng, Yuanshen, Dahuang, Mangxiao, Digupi (Lycii Cortex).]
**Liang Zi Chi Mai Waizhang (Canthal Red Vessels External Obstruction):** Regarding this syndrome, it is caused by damp-heat accumulation in the heart, small intestine, and bladder meridians, or by consuming five pungent spices and fried hot foods, causing hyperactive yang to flare upward and fire qi to become intense. Consequently, red vessels from the inner and outer canthi traverse the cornea, accompanied by dysuria and reddish urine resembling strangury. Bazheng San (Eight-Ingredient Powder for Rectification) is suitable. [Ingredients: Qumai (Dianthi Herba), Chao Zhi, Dahuang, Gancao, Dengxincao (Junci Medulla), Pianxu (Polygoni Avicularis Herba), Mutong (Akebiae Caulis), Huashi, Cheqianzi (Plantaginis Semen).]
**Jian Sheng Dingchuang Waizhang (Eyelid Carbuncle External Obstruction):** Regarding this syndrome, it is caused by stagnation and accumulation of heat in the spleen and stomach meridians. Wind-heat causes itching and tearing; rubbing with hands or mistakenly taking cold-cooling agents causes blood stasis to congeal and not disperse within the eyelids, generating blood threads. Later, due to overwork and excessive alcohol and sexual activity, hard nodules form, resembling peppercorns, containing white fluid that rubs the pupil, eventually forming a pterygium. The treatment method is to use a scalpel to wash away the blood stasis. For mild cases, Qianghuo Shengfeng Tang is used; for severe cases, Fangfeng Sanjie Tang (Wind-Protecting Knot-Resolving Powder) is used. [Ingredients: Fangfeng, Qianghuo, Qianhu, Chaihu, Cangzhu (Atractylodis Rhizoma), Huangqin, Huanglian (Coptidis Rhizoma), Duhuo (Angelicae Pubescentis Radix), Baishao (Paeoniae Radix Alba), Fangji (Stephaniae Tetrandrae Radix), Honghua (Carthami Flos), Dangguiwei (Angelicae Sinensis Radix caudex), Gancao, Baifuling (Poria cum Ligno), Sumu (Sappan Lignum). This medicine treats persistent blood stasis in the upper and lower eyelids and serves as an expedient measure after scalpel washing; take with caution as excessive use consumes blood.] Apply Wujin Gao (Black Gold Ointment) or Lingguang San (Spiritual Light Powder). When the disease has subsided by more than half, take Qingre Xiaoning Wan (Heat-Clearing and Coagulation-Resolving Pill). [Indications: Rebellious heat counteracting, wind-heat not dispersing, sclera like blood traversal, heat with blood stasis. Ingredients: Chuanxiong, Danggui, Jingjie, Bohe, Qianghuo, Gaoben (Ligustici Chuanxiong Rhizoma), Juhua, Huashi, Shigao, Lianqiao (Forsythiae Fructus), Shanzhi (Gardeniae Fructus), Gancao, Huangqin, Baizhu, Jiegeng, made into pills with refined honey, each pill weighing 1.3 qian, taken with clear tea before bed.]
**Jian Sheng Fengsu Waizhang (Eyelid Wind Millet External Obstruction):** Regarding this syndrome, it is caused by wind invading the spleen meridian, leading to blood congestion and heat accumulation that does not disperse. Or, if the illness persists, swelling and dryness make opening the eyes difficult, similar to carbuncles. However, only small pits like millet grains appear inside the eyelid, hard and white, rubbing the eyeball, causing tearing and painful dryness, gradually forming a pterygium. The treatment method is to first prick with a needle to drain the white fluid from the wind millet, then take Shengfeng Tang (Wind-Overcoming Decoction) and Lingyangjiao San (Antelope Horn Powder). [Ingredients: Lingyangjiao (Antilopis Cornu), Xijiao (Rhinocerotis Cornu - *Note: Use substitutes in modern practice*), Zhimu, Yuanshen, Dahuang, Mangxiao, Huangqin, Jiegeng, Fangfeng.]
**Baiyi Hua Xian Waizhang (White Pterygium Flower Depression External Obstruction):** Regarding this syndrome, it is caused by emotional disturbances and excessive desires, irregular diet and overwork damaging the spleen and stomach, combined with liver blood deficiency. This leads to stabbing eye pain radiating to the taiyang region, eyelid weakness, frequent desire to close the eyes, tearing, photophobia, and the immediate appearance of white pterygium depression on the eyeball, resembling millet or fish scales. First take Chaihu Fusheng Tang (Bupleurum Reviving Decoction); if the eyeball is painful, take Danggui Yangrong Tang (Angelica Nourishing Glory Decoction); [Ingredients: Shudi (Rehmanniae Radix Preparata), Danggui, Baishao, Chuanxiong, Qianghuo, Fangfeng, Baizhi.] if feeling hidden dryness and difficulty opening, take Danggui Huoxue Tang (Angelica Invigorating Blood Decoction); [Ingredients: Danggui, Huangqi (Astragali Radix), Gancao, Shengma, Chaihu, Baizhi, Fangfeng, Manjingzi (Viticis Mume Fructus).] if yuanqi is weak, take Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Those with flower depression that does not rise may also take it.
**Yingtou Xiejing Waizhang (Fly Head Crab Eye External Obstruction):** Regarding this syndrome, it is caused by exhaustion of both liver and kidney, extreme heat from fire pathogens, combined with emotional stagnation damaging spleen earth. Once spleen earth is diseased, it loses its function of generation and cannot transport blood to nourish the eyes. Thus, the eyeball suffers extreme pain, tearing makes opening difficult. Due to sudden anger, a blue-black pterygium suddenly rises on the cornea, resembling a fly head or crab eye. If it arises away from the pupil, it is called "Li Jing Xie Yan" (Departed Eye Crab Eye); if it arises directly at the pupil, it is called "Ying Tou" (Fly Head). First take Chaihu Fusheng Tang; [Ingredients: Baishao, Chuanxiong, Gaoben, Chaihu, Cangzhu, Gancao, Baizhi, Fuling (Poria), Qianghuo, Huangqin, Manjingzi, Bohe, Duhuo, Jiegeng, Wuweizi (Schisandrae Fructus).] if pain persists, take Danggui Yangrong Tang, then take Huangqi Tang (Astragalus Decoction) and Shenxiao Bugan San (Miraculous Liver-Nourishing Powder); for deficiency, take Chonghe Yangwei Tang (Harmonizing Stomach-Nourishing Decoction), followed by Shihu Yeguang Wan (Dendrobium Night-Light Pill), all added with Wuweizi to astringe; apply Tuiyun San (Pushing Cloud Powder) and Babao San (Eight-Treasure Powder). This syndrome requires long-term external application and internal medication for the pterygium to recover; some cases may not resolve.
**Heiyi Ru Zhu Waizhang (Black Pterygium Like Pearl External Obstruction):** Regarding this syndrome, it is caused by kidney deficiency and liver heat, with both mother and child organs deficient. The pathology is largely similar to the previous syndrome. The eyeball is painful, tearing makes opening difficult, photophobia and fear of sunlight exist, and a black pterygium rises on the upper cornea like a black bean. First take Huangqi Tang; [Ingredients: Renshen (Ginseng Radix et Rhizoma), Huangqi, Zhimu, Baifuling, Yuanzhi (Polygalae Radix), Dahuang, Fangfeng, Digupi.] Yushen Yeguang Wan (Nourishing Spirit Night-Light Pill). [Ingredients: Renshen, Shengdi (Rehmanniae Radix), Shudi, Tiandong (Asparagi Radix), Maidong (Ophiopogonis Radix), Chaihu (Dendrobii Caulis), Niuxi (Achyranthis Bidentatae Radix), Danggui, Zhike, Gouqi (Lycii Fructus), Digupi, Tusizi (Cuscutae Semen), Juhua, Yuanzhi, made into pills with refined honey, taken with warm water.]
**Xueyi Baojing Waizhang (Blood Pterygium Enveloping Eyeball External Obstruction):** Regarding this syndrome, it is caused by spleen affected by wind-heat, combined with liver-kidney deficiency and exhaustion. Disease in the upper eyelid rubs the eyeball; internally due to accumulated heat, externally due to wind pathogen invasion, coagulated blood does not disperse, gradually forming a pterygium. Red threads crisscross above, covering the pupil, making vision difficult. The treatment method is to first use a scalpel to wash away blood stasis in the upper eyelid, then take Shengfeng Tang combined with Danggui San (Angelica Powder); [Ingredients: Danggui, Shengdi, Shudi, Huanglian (Coptidis Rhizoma), Shanzhi, Chishao, Sangbaipi (Mori Cortex), Fangji, Longdancao (Gentianae Radix).] later take Shihu Yeguang Wan, apply Wujin Gao. If there are symptoms of guest wind-heat and phlegm-fire, Yushen Yeguang Wan is suitable.
**Xueguan Tongren Waizhang (Blood Pouring into Pupil External Obstruction):** Regarding this syndrome, it is caused by excess fire in the liver and heart, carrying blood upward into the eyes. The heart is the sovereign organ, the residence of spirit, belongs to fire and should be quiet. Due to great fright injuring the heart or great anger injuring the liver, the heart spirit becomes scattered, causing fire to move recklessly, carrying blood off course, and pouring recklessly into the eye, covering the pupil. Redness obscures black and white, pain makes opening difficult, accompanied by惊狂 (panic and madness), cursing, and hallucinations of ghosts and gods. The eye is the essence of the five zang and six fu organs, the place where ying and wei, hun and po constantly circulate, and is governed by shen (spirit). When shen is chaotic, hun and po scatter, hence the manic speech appears. The treatment method is to urgently perform bian (pricking) therapy on Yingxiang acupoint (located beside the nostrils). It will heal immediately. In the first one or two days of onset, pricking can be done for redness; if long-standing and resembling a round eye kernel purple-yellow color, it is incurable. [Bian Method: Take two leaves from the coarse tea basket lid, use the hard central vein as the spine, cut a needle 1-4.5 cun long, sword-shaped, sharp tip and broad body. Stop when reaching the small hole in the nose, do not go higher. Place the needle in the nose towards the acupoint, leaving 0.8-0.9 cun outside, and suddenly push upward with hand to bleed several spoonsful, then stop pricking.] Immediately lie the patient in a warm place without startling them; they will wake up after sleeping deeply, with miraculous results. Afterwards, take Chuanxiong Xingjing San (Chuanxiong Meridian-Activating Powder) plus Wulingzhi (Trogopterori Faeces) for several doses to move the accumulated blood and heal itself.
**Jiguan Xianrou Waizhang (Rooster Comb Clam Flesh External Obstruction):** Regarding this syndrome, it belongs to heat accumulation in the spleen and stomach meridians, compounded by external wind pathogen invasion, causing blood coagulation and not dispersing. A mass of stagnant blood blocks the upper eyelid, soft and purple-black, which is the "Rooster Comb"; a strip of stagnant flesh grows in the lower eyelid, soft and pale red, which is the "Clam Flesh". It is suitable to use a scalpel to remove blood stasis, take Choufeng San (Wind-Extracting Powder); [Ingredients: Yuanshen, Huangqin, Jiegeng, Fangfeng, Xixin (Asari Radix et Rhizoma), Cheqian, Dahuang, Mangxiao.] apply Lingyao Wujin Gao (Spiritual Medicine Black Gold Ointment).
**Rou Pan Jing Waizhang (Flesh Climbing Eye External Obstruction):** Regarding this syndrome, it originates from initial red eye infection, not avoiding wind and fatigue, prolonging until formation; or due to cooling hot feet in cold water, or standing while engaging in sexual intercourse, damaging the Yang Qiao vessel. The pulse starts from the foot, travels up to the head and face, belonging to the inner canthus. Once this vessel is injured, red vessels like threads appear at the inner canthus; the root of the thread generates stagnant flesh, which generates yellow-red lipid, which horizontally invades the cornea, gradually eroding the aqueous humor. If accompanied by the outer canthus, it combines with the Taiyang meridian. Treatment method: If the black cornea is not yet eroded, take Shengfeng Tang plus Manjingzi, Boyun Tuiyi Wan (Cloud-Pushing Cataract-Removing Pill); [Ingredients: Chuanxiong, Jingjie, Juhua, Gancao, Huanglian, Shetui (Bombyx Batryticatus), Danggui, Chuanjiao (Zanthoxyli Pericarpium), Chantui (Cicadae Periostracum), Mimenghua (Glochidionis Flos), Manjingzi, Digupi, Baijili (Tribuli Fructus), Muzeicao (Equiseti Herba), Taoren (Persicae Semen), Bohe, Tianhuafen (Trichosanthis Radix), made into pills with refined honey, weighing 8 fen, take one pill with clear tea far from meals. For pterygium, use rice water; for dim vision, use Danggui decoction; for internal obstruction, use Muxiang decoction.] If heat is present, also take Huanyin Jiuku Tang (Restore Yin and Save from Bitterness Decoction). If the aqueous humor is already eroded, surgical cutting methods apply, detailed in "Yinhai Bobei".
**Baimo Qin Jing Waizhang (White Membrane Invading Eye External Obstruction):** Regarding this syndrome, it is caused by lung heat and liver deficiency, with weak kidney water unable to generate liver wood. Thus, the liver is overcome by lung pathogenic heat. White pterygium-like growth gradually appears around the cornea, eventually covering the pupil over time, leading to dimness. First take Xiefei Tang to drain excess heat from the lung meridian, then take Yushen Yeguang Wan plus Tiandong and Maidong to nourish yin and tonify the kidney.
**Mo Ru Shuilun Waizhang (Membrane Entering Water Wheel External Obstruction):** Regarding this syndrome, it is caused by long-standing eye disease, depression and discomfort, combined with improper regulation and excessive sexual activity, leading to liver-kidney deficiency and gradual pterygium formation. Initially blue like a fly wing, it becomes thick white over time. Suitable to take Chonghe Yangwei Tang and Shihu Yeguang Wan.
**Huangmo Shangchong Waizhang (Yellow Membrane Rushing Upward External Obstruction):** Regarding this syndrome, it is caused by pathogenic heat in the stomach meridian stagnating qi and blood, leading to redness and pterygium formation below the sclera, with yellow color rushing up to the cornea, causing dryness, pain, tearing, and photophobia. The spleen and stomach belong to earth, and earth's color is yellow; stomach injury reveals the true color of earth. First take Fangtong Sheng San (Wind-Barrier Universal Powder) to drain accumulated heat, then take Tongpi Xiewei Tang (Unblocking Spleen Draining Stomach Decoction); [Ingredients: Tiandong, Maidong, Chongweizi (Leonuri Fructus), Yuanshen, Zhimu, Huangqin, Dahuang.] apply Hupo San (Amber Powder).
**Chimo Xiachui Waizhang (Red Membrane Dropping Downward External Obstruction):** Regarding this syndrome, it is caused by wind-heat in the spleen meridian of the upper eyelid, blood accumulation turning into stasis, rubbing the eyeball, causing swelling, pain, tearing, and reluctance to open. Heat obstruction prevents dispersion, blood becomes more stagnant, and red membrane forms on the cornea, drooping redness gradually covering the pupil. It is suitable to use a scalpel to wash away blood stasis in the upper eyelid; to dissipate blood stasis in the eye, take Chuanxiong Xingjing San, apply Babao San and Tuiyun San.
**Nishun Shengyi Waizhang (Reverse/Course Pterygium Formation External Obstruction):** Regarding this syndrome, pterygium on the cornea descending from top to bottom is called "Shun" (Course), belonging to the spleen meridian; ascending from bottom to top is called "Ni" (Reverse), belonging to the stomach meridian. Starting from spleen and stomach, manifesting in liver meridian, gradually covering the aqueous humor over time. All are due to physical weakness and insufficient qi and blood, causing various meridians to contract pathogenic heat, making blood stagnant and rubbing to form pterygium. This pterygium is hardest to remove. Initially, take Boyun Tuiyi Wan combined with Yushen Yeguang Wan, apply Babao San and Tuiyun San; if the pterygium ascends from bottom to top, take Fangtong Sheng San for one or two doses to remove it.
**Feng Chu Jian Waizhang (Wind Blowing Eyelid Outward External Obstruction):** Regarding this syndrome, it is caused by spleen and stomach meridians contracting wind-heat, accumulating over months and years, blocking between the eyelids. When the eyelid receives wind, the skin tightens; when the spleen receives wind, the flesh obstructs. Tight skin and obstructed flesh cause the eyelid to flip outward, either up or down, generating red-purple stagnant flesh, with eye discharge and tears like pus. Treatment method: first use a scalpel to wash away blood stasis, take Shengfeng Tang, apply Wujin Gao and Lingguang San. If long-standing, it is untreatable.
**Yingfeng Liulei Waizhang (Wind-Facing Tearing External Obstruction):** Regarding this syndrome, it is caused by kidney and liver deficiency. Liver deficiency causes inability to retain tears; tears are the fluid of the liver, and the eye is the orifice of the liver, the pathway of fluids. Liver wood is born from kidney water; if water declines, it cannot generate wood, causing mother and child deficiency. Pathogenic fire burns internally in the eye; externally encountering wind, liver wood is shaken, opening the fluid pathway so tears flow uncontrollably. Initially no other symptoms, only continuous tearing, wiping leads to more flow. Patients enduring through winter for many years, regardless of season, should take Siwu Bugan San (Four Substances Liver-Nourishing Powder) and Yushen Yeguang Wan. If not treated early, both eyes turn black and dim. [Ingredients: Shengdi, Shudi, Chuanjiao in equal parts, made into pills with refined honey, take 2-3 qian with light salt soup morning and evening.]
**Yang Ji Nan Dang Waizhang (Extreme Itching Endurable External Obstruction):** Regarding this syndrome, it is caused by heart meridian fire pathogens and spleen meridian wind-heat, lurking long-term without dispersing, attacking the eyes. Suddenly encountering wind pathogen contact causes unbearable itching, which rubbing cannot stop. Itching is not due to deficiency, but to fire and wind; wind contact ignites fire, wind and fire combine causing itching. Long-term, both eyelids become red and ulcerated, reluctant to open, with sticky discharge. If there is blood stasis in the eyelid, use scalpel washing, first take Gaoben Shufeng San (Gaoben Wind-Dispersing Powder); [Ingredients: Chuanxiong, Gaoben, Qianghuo, Fangfeng, Chantui, Xixin.] apply Babao San.
**Pian Jing Nongxue Waizhang (Off-Center Canthus Pus-Blood External Obstruction):** Regarding this syndrome, it is caused by vigorous liver fire, accumulated heat and toxin. Pus pours from bottom to top inside the cornea, or the eyeball rises like a sore, flowing pus. The liver generates fire and stores blood, nourishing the cornea. Excess fire and qi rush through blood vessels, causing stagnation. Yin and yang contend and transform into pus. Onset involves bitter headache and eyeball pain, exterior cold and interior heat, running nose and tears, inability to eat or sleep, limb fatigue and dizziness, all signs of fire. It is suitable to drain pus and extinguish fire, take Huangqi Tang; after pus clears, take Chaihu Fusheng Tang, apply Hupo San and Babao San.
**Gu Yan Ning Jing Waizhang (Hawk Eye Fixed Gaze External Obstruction):** Regarding this syndrome, it is formed by qi and blood mixing and knotting. Initially no pain, but the upper eyelid swells like a bean, gradually growing larger, containing purple spots. Generally, human qi and blood do not wish to mix; mixing causes blockage between skin layers, forming this disease. Initial treatment must choose a day when the person and god are not violated. Flip the eyelid outward, pierce the purple spot with a brow-tip knife, squeeze out yellow lipid with thumb, then take Fangfeng Sanjie Tang; if initially slightly obstructive, boil Xiaodu Yin (Detoxification Drink) in white wine [Ingredients: Guiwei (Angelicae Sinensis Radix caudex), Gancao, Baizhi, Chenpi (Citri Reticulatae Pericarpium), Chishao, Fangfeng, Tianhuafen, Jinyinhua (Lonicerae Japonicae Flos), Zaojiaoci (Gleditsiae Spina)] for several doses to resolve. Named "Hawk Eye Fixed Gaze" because the hawk's eye stares fixedly without moving; this disease grows large and hard, obstructing the eyeball, preventing movement of vision, hence the name.
**Tong Ji Zenghan Waizhang (Extreme Pain with Aversion to Cold External Obstruction):** Regarding this syndrome, it is caused by sexual exhaustion and overthinking injuring heart-kidney yin-blood; overwork and irregular diet injuring stomach-yang qi. Both qi and blood are injured, water and fire cannot ascend and descend, there is no yang protection on the skin surface, allowing wind-cold qi to invade and attack the head, lodging and not dispersing. The head is the meeting of all yang paths; evil and righteous qi contend, causing unbearable headache, eyeball redness/swelling/tearing. Fire pathogen rushes upward and does not descend, causing yin qi to touch and merge downward, resulting in cold knees/feet and body chills/shivering. Treatment method is suitable to tonify yin and descend fire, take Fuzi Zhuling Tang (Aconite Polyporus Decoction).
**Dazhuang Sunsun Waizhang (Blow/Collision Injury External Obstruction):** Regarding this syndrome, it is caused by being hit or collided. If a fist hits the eyeball protruding 1-2 cun, immediately rub palms warm and support the eyeball. Once the eye string receives warmth, it naturally contracts and returns to the orbit. Do not wash away the blood. Externally, apply mashed Shudi paste spread on thin silk to seal the eye, change three times daily, take Chufeng Yisun Tang (Remove Wind Benefit Loss Decoction). [Ingredients: Chuanxiong, Baishao, Danggui, Shudi, Gaoben, Qianhu, Fangfeng.]
**Dazhuang Jixue Waizhang (Blow/Collision Accumulated Blood External Obstruction):** Regarding this syndrome, it is caused by being hit/collided, eyelid blood coagulation, swelling/pain making opening difficult, sclera red like blood pouring. Take Chuanxiong Xingjing San. [Ingredients: Chuanxiong, Qianghuo, Duhuo, Jingjie, Bohe, Fangfeng, Baizhi, Chaihu, Zhike, Jiegeng, Danggui, Fuling, Honghua, Gancao, Manjingzi.]
**Daci Shengyi Waizhang (Prick/Puncture Pterygium Formation External Obstruction):** Regarding this syndrome, it is caused by being pricked/punctured, accumulated blood not dispersed, or puncture wound not healed, long-term white pterygium forms on the eyeball covering vision. If pus/blood exists, take Chuanxiong Xingjing San; if blood deficient, take Chufeng Yisun Tang; for pterygium, slowly apply Babao San and Tuiyun San.
**Shanghan Yu Hou Waizhang (Post-Febrile Disease External Obstruction):** Regarding this syndrome, it is caused by failure of clear yang qi to ascend after major illness, residual pathogenic heat blazing upward and entering orifices. Symptoms include hidden dryness, redness/swelling, pterygium formation, photophobia, headache/bone pain. Suitable to take Shengfeng Tang to raise clear yang.
Another syndrome is caused by excessive use of pungent-hot agents to release the exterior, leading to qi deficiency and physical weakness. Although the acute disease has healed, the pupil gradually dilates. Pungency governs dispersion, heat assists fire to ascend to the chest, hence the eye scatters. As the classics say, "Strong fire scatters qi." First take Shengfeng Tang heavily adding Wuweizi to gather scattered qi; after several doses, also take Chonghe Yangwei Tang, finally take Shihu Yeguang Wan doubling Wuweizi to heal itself.
**Tong Ru Zhen Ci Waizhang (Pain Like Needle Pricking External Obstruction):** Regarding this syndrome, it is caused by latent obstructed heat in the heart meridian, wind-toxin attacking upward. Thus, the sclera is pale red, tearing with hidden dryness making opening difficult, inner canthus stabs with pain like needles. Suitable to take Xixin San (Washing Heart Powder); [Ingredients: Huanglian, Huangqin, Jiegeng, Dahuang, Zhimu, Yuanshen, Jingjie, Chishao, Danggui.] apply Hupo San.
**Tongren Ganque Waizhang (Pupil Dryness/Defect External Obstruction):** Regarding this syndrome, it is again due to kidney water deficiency, counteracted by fire. Thus, the pupil is small like a mustard seed, and inside the defect, brain fat condenses, yellow or white. This is an internal obstruction arising from headache, hence listed under external obstruction. Initial illness involves unbearable headache, restlessness sitting or lying. Treatment focuses on tonifying kidney, clearing liver, and reducing fire. Long-term without seeing the "Three Lights" is incurable.
**Tingrou Yuxue Waizhang (Stagnant Flesh Blood Stasis External Obstruction):** Regarding this syndrome, it is caused by consecutive epidemic eye infections not healing, not avoiding labor/fatigue, exposing to wind too early, causing spleen/stomach to receive wind, liver qi disharmony, making blood stasis congeal between eyelids. Both eyelids swell and dry, discharge and tears are sticky. First use scalpel washing, take Shengfeng Tang, apply Hupo San; if not healed, apply Wujin Gao and Lingguang San.
**Xiuming Pari Waizhang (Photophobia/Fear of Sun External Obstruction):** Regarding this syndrome, it is caused by prolonged eye disease not healing, depressed fire burning internally, evil wind invading externally, causing spleen to receive it, accumulating in the eyelids. Since eyelids belong to the spleen, and spleen governs blood, when evil qi is abundant, blood has nowhere to return, thus seeing yang light...