蚬肉与鸡冠，形容总一般，多生睑 畔，后及风轮间，火土交为祸，阴阳并作奸，不精刀烙法，莫向病家看。
此症初起，壮热目赤痛。一昼夜，大 内睑之间，生瘀肉紫色，垂叶胞外，目闭亦不收，形与斗鸡冠、蚌蚬
肉无异，
故曰鸡冠蚬肉。昔人分为二症，究竟皆真元素虚，炙爆浓味之物食多不化，致血热火燥，感以阴阳乖戾之气，则
发为壮热，热盛生风，风动血行，上逼空窍，酝酿而成。此物盖目疾所常有，而怕医者亦多。何为是证朝生夕长，
始软终硬？发手须白虎汤加黄连、木通、麦冬、竹叶，大进一剂，然后沿根割净，不可少留毫发。再与防风散结
汤几服，看刀口平否，未平，血且不止，其肉如韭莱，剪去处勃勃生发上来，急用烙以杀其势。烙已，煎黄连解
毒汤，净坐半日，当必清宁。倘病者畏法，家人将信将疑，所譬鸡、蚬恶物，决渐长渐大，害及气轮，而尽掩青
睛，甚则坚实骇人，欲割不能，能割无益矣。
同里朱氏女，甫六龄，左目内睑伤寒后忽生参差一片红肉，吐于目外。余曰∶此鸡冠症也，法当割去，否则
长大，浑睛满而丧明。朱疑畏未定。明日，其睛化为菌毒，高寸许，大如盏，色红微软，后渐上至三寸乃已，状
类牛斗角鲜。居无何，又于耳畔生一疣，不数日大如碗，硬于石。有作血溢而治者，有作火郁而治者，转日夜痛
楚，恹恹欲绝，复延余，主以托里消毒，佐三黄、滋肾等剂，痛稍止。既而疣遂溃，眼肉亦随萎，但形神不若从
前之肥而且润。一日午睡向晚，举家皆谓安神，莫敢惊觉。及张灯视之，死已久矣。一奇症也，一奇事也。或曰，
症、事固奇，而子之为政，未为尽善，盖金石之语。因存此案，以志吾过，以广见闻云。
蚬肉与鸡冠，在形态描述上大体相似，多生长在眼睑边缘，随后波及黑睛（角膜）区域。这是火邪与土湿相互交结为祸，阴证与阳证同时作祟的结果。如果不精通刀烙疗法，就不要轻易面对此类病患进行诊治。
此症初起时，表现为高热、眼睛红肿疼痛。在一昼夜之间，在大眼睑内侧生出紫色的瘀肉，像垂下的叶片一样突出于胞睑之外，即使闭上眼睛也无法收回。其形状与斗鸡的鸡冠、蚌蛤的蚬肉没有区别，因此被称为“鸡冠蚬肉”。
古人将此症分为两种，但究其根本，都是由于人体真元之气虚弱，加之食用过多炙烤爆炒及浓烈滋腻的食物导致消化不良，致使血分有热、体内燥火旺盛。再感受阴阳乖戾不正之气，从而引发高热。热盛则生风，风动则促使血行加速，气血向上逼迫头面空窍，酝酿而成此病。这种病症是眼科疾病中常见的，但也令许多医生感到畏惧。
为什么此症早晨生成傍晚就生长迅速，开始柔软后来变硬？治疗时应当先用白虎汤加入黄连、木通、麦冬、竹叶，大量服用一剂以清热泻火，然后沿着根部将赘肉彻底割除，不可残留丝毫。之后再服用几剂防风散结汤，观察刀口是否平整。如果伤口不平整且出血不止，赘肉像韭菜一样，剪去后又会蓬勃生长，此时必须紧急使用烙法以遏制其势头。烙治之后，煎服黄连解毒汤，静坐半天，病情应当会清静安宁。
倘若患者畏惧手术，家属半信半疑，认为这只是像鸡、蚬那样的恶物，那么赘肉必定会逐渐长大，危害到白睛（巩膜/气轮），甚至完全遮盖黑睛（青睛）。严重时变得坚硬骇人，想割都割不动，即便能割也毫无益处了。
同乡朱家有个女孩，刚六岁，左眼内眼睑在伤寒病后突然长出一片参差不齐的红肉，突出于眼外。我说：“这是鸡冠症，应当割除，否则长大后会布满黑睛而导致失明。”朱家人怀疑恐惧，犹豫不定。第二天，她的眼睛变成了菌状毒物，高约一寸，大如茶盏，颜色红而软，后来逐渐长到三寸高才停止，形状类似新鲜的牛斗角。没过多久，又在耳畔长出一个疣，几天时间长得像碗一样大，比石头还硬。有人按血溢治疗，有人按火郁治疗，结果日夜痛苦不堪，奄奄一息，再次请我去诊治。我主张用托里消毒法，辅以三黄汤、滋肾剂等，疼痛稍止。不久疣体溃破，眼部的赘肉也随之萎缩，但患者的形体和精神都不如从前那样丰润健康。一天傍晚午睡时，全家人都认为应该让她安静休息，不敢惊动她醒来。等到点灯查看时，发现她已经死去很久了。这是一个奇特的病症，也是一件奇特的事。有人说，病症和事件固然奇特，但你作为医生的处置并非尽善尽美，这大概是金石般确凿无疑的话。因此保存这个医案，以此记录我的过失，并以此拓宽见闻。
Clam meat and rooster combs are generally similar in appearance. They often grow on the margins of the eyelids and subsequently spread to the region of the black pupil (cornea). This is a disaster caused by the mutual interaction of Fire pathogen and Earth dampness, where both Yin and Yang disorders act as villains. If one does not master the knife-cautery method, one should not treat such patients.
This condition initially presents with high fever, redness, swelling, and pain in the eyes. Within twenty-four hours, purple stasis flesh grows between the inner aspects of the upper eyelids, hanging like leaves outside the eyelid margin; even when the eyes are closed, it does not retract. Its shape is indistinguishable from a fighting rooster's comb or clam meat, hence the name "Rooster Comb and Clam Meat."
Ancients divided this into two conditions, but ultimately, all stem from deficiency of the True Yuan Qi (vital energy). Excessive consumption of roasted, fried, and rich/flavorful foods leads to indigestion, causing blood heat and internal dryness/fire. Combined with the contraction of abnormal Yin-Yang pathogenic qi, it triggers high fever. Excessive heat generates Wind; Wind movement accelerates blood circulation, forcing Qi and Blood upward into the orifices, where they ferment and form this lesion. This is a common ophthalmic disease that many physicians fear. Why does it appear in the morning and grow rapidly by evening, starting soft but becoming hard? The initial treatment must involve administering a large dose of Baihu Tang (White Tiger Decoction) added with Huanglian (Coptis Rhizome), Mutong (Akebia Caulis), Maidong (Ophiopogon Tuber), and Zhuye (Bamboo Leaf). Afterward, cut away the growth completely along its root, leaving not a hair's breadth. Then, administer Fangfeng Sanjie Tang (Saposhnikovia Detumescence-Decoction) for several doses to check if the incision is flat. If the wound remains uneven and bleeding persists, and the flesh resembles chives—regrowing vigorously after being cut—emergency cauterization is required to suppress its momentum. After cauterization, decoct Huanglian Jiedu Tang (Coptis Detoxification Decoction) and sit quietly for half a day; clarity and peace should ensue.
If the patient fears the procedure and the family is skeptical, regarding it merely as an ugly growth like chicken or clam meat, the growth will inevitably expand, affecting the Qi Wheel (sclera/conjunctiva) and eventually covering the Qing Jing (black pupil/cornea). It may become solid and terrifying, making excision impossible, or if excised, it yields no benefit.
The daughter of Mr. Zhu from my neighborhood, aged six, suddenly developed a patch of irregular red flesh protruding from the outer aspect of her left inner eyelid following a Shanghan (Cold Damage) illness. I stated, "This is the Rooster Comb syndrome; it must be excised, otherwise it will fill the cornea and cause blindness." The Zhu family was doubtful and fearful. The next day, her eye transformed into a mushroom-like toxic growth, about one cun high and the size of a tea bowl, red and soft. It gradually grew up to three cun before stopping, resembling fresh ox horns. Shortly after, a wart appeared near her ear, growing to the size of a bowl within days, harder than stone. Some treated it as blood extravasation, others as constrained fire. Her pain intensified day and night, leaving her weak and near death. She sought me again. I prescribed Tuoli Xiaodu (Supporting Interior and Eliminating Toxin) methods, assisted by Sanhuang (Three Yellows) and Zishen (Nourishing Kidney) formulas. Pain subsided slightly. Soon the wart ulcerated, and the ocular flesh atrophied accordingly, though her physique and spirit were never as robust and lustrous as before. One evening during a nap, the whole family believed she needed rest and dared not wake her. When lights were lit to check on her, it was found she had been dead for some time. A strange case, a strange event. Some say, while the case and event are indeed strange, your management as a physician was not perfect. This is likely an indisputable truth. Therefore, I preserve this medical record to acknowledge my fault and broaden knowledge.