邮电局职工，尤其是长途电话工人，常患-一一种耳聋耳鸣证，数十年来求治者甚多，而见效者甚少。及查色脉，大多虚弦而滑，面色较白，长期失眠，或时见烦躁易怒。思之，乃心气之不足，痰火内阻者，予十味温胆汤治之多效。曾治患者耿××，女，38岁。长途电话工人。近5年来听力日渐下降，近半年来几乎听不见电话传来的声音而不能坚持工作，失眠心烦、口干口苦，烦躁。审其面色较白，舌苔薄白，脉虚弦滑。为拟十味温胆汤加减：黄芪15克，当归10克，麦冬10克，党参10克，五味子10克，竹茹10克，枳实10克，半夏10克，陈皮10克，茯苓10克，甘草6克，菖蒲10克，远志10克。服药6剂，耳鸣耳聋好转，继服30剂诸证消失而愈。
卡他性中耳炎之耳聋，其病多猝然而发。猝起者，多因外邪所致，因此疏散风邪尤为医者所重视。然徒散其风，不予补正，则虚火上扰而难速治。正如朱丹溪所说：“耳者，宗脉之所附，宗脉虚而风邪乘之，使经气否而不宣，是为风聋，内必作痒，或兼头痛。”曾治患者伍××，女，30岁。两个多月来两耳发堵，听力减退。某院诊为卡他性中耳炎。住院20多天，予西药及中药通窍耳聋丸治之不效。审其脉证，除耳聋外，并见从两耳窍中流水，下肢沉重。证脉合参，诊为湿邪蒙蔽，耳窍闭塞。为拟祛湿散风清热。羌活胜湿汤加减：羌活4克，独活4克，川芎1．5克，甘草2克，防风1．5克，蔓荆子1克，防己6克，藁本1．5克。服药3剂，证减七八，继服5剂，诸证消失而愈。患者云：余曾自用此方治之不效，老师用之却其效如神何也?答曰：湿邪者，重浊粘滞难化之邪，其在上者当发散之，但散之必用辛温之风药，过之则但祛风而不胜湿，即仲景所谓但风气祛，湿气在之象，所以前用量大而无效，吾用小量而取效。
暴发性耳聋，与卡他性中耳炎之病机近似，故散其少阴、肝胆之邪尤为诸法之首要。如患者郭××，男，50岁。半年前(春节期间)突然发现耳呜，听力下降。急至重庆、成都等地医院住院治疗，诊为暴发性耳聋。前后住院5个多月，耳呜不但加重，而且两耳已基本全部失去听觉。不得已，又至太原某院住院治疗。住院2个月后，听力已完全丧失，耳鸣如击鼓，烦躁。不得已，又出院求治。审其两耳听力完全丧失，虽近在10厘米之内大声讲话也听不见一点声音，舌苔白，脉浮紧。综合脉证，诊为风寒闭郁于少阴、少阳之经耳。为拟疏风散寒，平肝泻火：夏枯草15克，蝉衣10克，细辛3克，龙胆草10克，全虫6克，防风10克，酒军4克，川芎10克，当归10克，羌活10克。服药3剂，耳呜大减；继服4剂，耳呜消失七八，耳聋微闻，一般讲话已听清80％左右，继服6剂，耳聋消失而愈。患者云：前用西药不效，后用中药平肝泻火之剂亦无效，而你却1剂效，10剂愈，其故何也?答曰：外邪闭郁者，非散之不除，此用泻火不除之故也。又曰：实如师言，前医每每以泻火而病剧。
青风障症
曾治患者何××，女，17岁。突然两眼疼痛，头痛恶心，视力下降，瞳孔散大20多天，某院诊为急性青光眼。先用西约其证不减，审其证，除上述诸证外，并见舌苔薄白，脉弦。证脉合参，诊为肝火内郁，风邪外袭，为拟平肝泻火散风：草决明15克，龙胆草10克，黄芩10克，夏枯草15克，菊花10克，防风6克，车前子10克(布包)，柴胡6克，薄荷6克。蝉衣9克。服药4剂，头痛、眼痛消失，继服20剂愈。患者问：前用羚羊角等无效，你用此方有效者何也?答曰：羚羊角乃眼科圣药，然羚羊角、石决明等均偏平降，而散之力不足，此病猝然而起，肝火内郁，风邪外袭所致也，但泻其火，不散其风则郁火反增，故散风始效也。正如张石顽所说：“瞳视散大者，风热所为也，火邪散，挟风益炽，神光怯弱不能支，亦随而散漫，犹风起而水波也。”因此散风之法不可缺也。
眼珠疼痛
曾治患者刘××，女，42岁。产后不久，连续写材料1个多月后，发现眼珠疼痛，不能看任何东西，经某院反复检查无阳性发现，前后住院5次，共计约两年多，但未见效果。3个月前因急性胃炎用阿托品等治疗后，突然失明，休息十几天‘后，视力才逐渐恢复，但眼珠却整天疼痛不止，眼眶、两太阳穴亦沉重疼痛不敢睁眼，烦躁易怒，朝轻暮重。近几月来，月经又淋漓不断，舌质红、苔薄白，脉弦细。思之，病起于产后，又加久视伤血，《素问·五脏生成篇》说：“肝受血而能视”。此眼之疼痛者，血失所养耳。拟养血益肝明目：当归12克，山药15克，生地30克，白芍15克，女贞子30克，柴胡6克，决明子15克，珍珠母30克，车前子(布包)9克。服药4剂，眼痛果减，但头痛、眼眶疼痛同前；加枸杞子12克、白术9克，继服10剂，眼痛、头痛消失七八，并能看一般东西，但不能长时间的读书，继服20剂诸证消失而愈。
青盲
曾治患者高××，女，5岁。流行性乙型脑炎高热昏迷抽搐，经治已经痊愈。但两眼完全失明。某院诊断为皮质盲。先用西药治疗2个月无效，继予明目地黄丸、石斛夜光丸等治疗1个月仍不效。审其两眼外无异常，舌质红少苔，脉虚稍数。予补精填髓，明目：龟甲、鳖甲、首乌、生地、白芍、覆盆子、五味子、牡蛎等加减1个月，视力稍复，继服1个月而愈
复视
明·傅仁宇认为本病的原因是“胆肾真一之精不足”和“火壅于络”，制补肝散治“肝风内障，不痛不痒，眼见花发黄白黑赤，或一物二形难辨；”冲和养胃汤治“内障初起，视觉微昏，空中有黑花，神水变绿色，次则视物成二，神水变淡白色，久则不睹，神水变纯白色。”而未论及跌打损伤。再察部分眼科专书和医案，亦未睹外伤所致者。曾治邢××，男，成。3个月前右前额外伤后，右眼视力明显下降，视一为二，右眼球向上、向下和内收的运动丧失。某医院诊为动眼神经麻痹。先用中、西药物、针灸治疗无效。邀余诊视。察其证见右眼睑下垂，外斜视，瞳孔散大，对光反射和调节反射消失，眼球向上、向下和向内的运动丧失，舌苔白，脉右虚大而弦，左弦涩不调。审其前用诸方，多为活血之品。思之，跌打损伤应予活血通络，然其右脉虚大而弦，大为虚，正如东垣所说：“气口脉大而虚者，为内伤于气。”当益气以培本，活血通络以治标。处以补阳还五汤：黄芪30克，当归12克，赤芍12克，川芎10克，地龙10克，桃仁10克，红花10克。药进3剂视力骤增，运动好转，再进10剂，眼球运动基本恢复，视力正常，瞳孔等大，乃继进10剂而善其后。
胬肉攀睛
胬肉攀睛，傅仁宇认为：“多起气轮，有胀如肉，或如黄油，至后渐渐厚而长积，赤瘀胬起如肉，故曰胬肉。”沈金鳌认为：“必眼先赤烂多年，时痒时痛，两眦头努出筋膜。”其发病原因，《银海精微》认为：“脾胃热毒，脾受肝邪，多是七情郁结之人，或夜思寻，家筵无歇，或饮乐欲，致使三焦壅热，或肥壮之人，血滞于大眦。”沈金鳌认为：“心气不宁，忧虑不已……用力作劳……或由风热冲肝而成。”傅仁宇认为：“凡性躁暴悸，恣嗜辛热之人，患此者多。”其治疗方法，《银海精微》认为：“实者小钩为钩，钩起剪断些宽，三五日剪痕收满，方可点阴二阳四药，吹点，余翳渐清，避风忌口斋戒可也，若乍发不宜钩剪，宜服药，点以淡丹可也。三焦心火俱炎，亦能生此疾，治之须钩割后，宜服泻脾除热饮。”傅仁宇认为：“治宜峻伐，久则自愈……及珠尚露，皆不必用钩割之治，宜服点还睛散，吹霞散。”《中医眼科学》认为：“多因心脾二经风热壅盛，经络瘀滞，或恣嗜五辛酒浆，脾胃湿热蕴蒸，血滞于眦部所致。亦有由于过劳恣欲，暗耗肾阴，水火不济，以致心火上炎而发”；“若胬肉渐长，红筋渐布，多眵多泪，羞明刺痛，属心肺风热壅盛，当祛风清热，方用金花丸，或栀子胜奇散。若眵多干结，涩痒交作，口渴，右寸脉较胜，偏于肺经风热者，宜清肺泄热，可用清肺饮，或清肺丸。如便秘溺赤，属于脾胃湿热蕴结者，宜泄热通腑，可用泻脾除热饮。若胬肉出现红筋，乍起乍退，涩痒间作，伴有心中烦热，口舌干燥，小便黄赤等证，属于阴虚火炎，宜滋阴降火，可用知柏八味丸，兼用甘露饮治之。”“若胬肉厚大头尖而赤，伸展较速，侵入黑睛，有掩及瞳神趋势者，须进行割治。若胬肉齐头，薄白色白，伸展迟缓，或仅侵及风轮边缘，而无赤痛及进行趋势者，则不必割治。但胬肉终是顽固的赘生物，不论在何阶段，割治之后，应服药内治，以防复发。”然验之临床，用于初起红涩痒痛而属实者，多效；用于病程较久者，则多服药无功，即如钩割之后者，亦多复发。因思亡兄健在时曾云：“诊眼病目赤时应注意三点：一视其眼鲜红者为实火．二视其眼深红而暗者为瘀血，三视其嫩红者为气阴两虚或阴虚。”胬肉攀睛色赤深红而暗，为瘀血；而时发时止则为肝肾阴伤，故治者当活血滋阴：例如：韩××，女，35岁。两眼胬肉2年多，近1年多来加重。先请某院西医治之不效，后又请中医治之仍不效。审视其证，左眼胬肉约2毫米×4毫米，右眼约l毫米×3毫米，涩痒而痛，色深红，舌中心无苔，脉弦细。综合脉证，诊为胃阴不足，血络瘀滞。为拟养阴活血。桃仁承气汤加减。处方：石斛12克，麦冬12克，当归9克，赤芍9克，桂枝9克，桃仁9克，元参30克，煅龙骨12克，煅牡蛎12克，蝉蜕6克。服药2剂，涩痒疼痛大见好转，胬肉缩小，继服8剂，涩痒疼痛消失，胬肉缩小3／4，又继服20剂而愈。其后，见此类患者，为加强其活血之力，加全虫3克，其效更著。某医见此方效著，改为丸、散内服，进行系统观察获得了较好效果。但久而久之，见效者虽多，不效者亦不少，细审其因，多为辨证有误。例如：耿××，男，成。翳状胬肉5个多月。某院先以西医力。法治之不效，后以中药清热泻火，活血养阴之法治之仍无功?审其脉证，除以上症状外，脉见虚大，右大于左。综合脉证，诊为气阴俱虚，治以补气养阴，补中益气汤加味。处方：黄芪15克，白术10克，党参10克，当归10克，升麻10克，柴胡10克，陈皮10克，甘草10克，知母12克，元参15克，麦冬12克。服药8剂，霍然痊愈。
暴盲
曾治患者任××，男，成。1个多月前，突因小石头击伤右前额、眼眶而失明。某院眼科诊为黄斑区损伤。先以亚硝酸异戊脂吸入，妥拉苏林球后注射，烟酸内服等治疗无效，后又配合中药养阴明目仍无效。审视其证，两眼外观无异常，不红小痛，食欲、睡眠正常，舌苔薄黄，脉右弦大，左弦。综合脉证，诊为气血俱虚，络脉瘀滞，为拟补阳还五汤加减。处方：黄芪50克，当归10克，赤芍10克，川芎10克，地龙10克，桃仁10克，红花10克。服药20剂，视力明显好转，由完全失明转为能看一般书报，但看20分钟后，视力很快下降，或昏花不清，或视直笔为弯曲之笔，或发生颜色改变。舌脉同前，为加强明目之效，加菟丝子3克，继服30剂而愈。
视神经炎
曾治患者梁×x，女，30岁。产后数天即发现关节疼痛。医诊风湿性关节炎。予中药祛风除湿，温经散寒之剂治之，身痛未减，而却汗出乏力更甚，并进而发现目视昏花，虽人或物在l米之内亦看不清楚。某院眼科诊为视神经炎。先予中药明目养阴之剂不效，继予西药视力稍有增加，但视力增至能在2米内看清人或物时，不再继续提高。审视其证，两眼外观无异常，但经常感到疲乏无力，自汗盗汗，关节疼痛，腰酸，口苦而干，舌苔白，脉虚大。综合脉证，诊为气阴两虚。为拟补气养阴。芪脉地黄汤加减：黄芪15克，当归10克，麦冬10克，党参10克，五味子10克，生地18克，苍术10克，茯苓10克，石斛10克，泽泻10克，丹皮10克。服药30剂后，视力增加，身痛大减，继服30剂，视力恢复，其他诸证亦大减。某医云：余前予石斛夜光丸及养阴明目之剂不效者何也?答曰：脉大者，气血俱虚或气阴俱虚。气血俱虚或气阴俱虚者当补气养血或补气养阴同施。前方养阴所以无效者，在于未补其气耳。
虹膜睫状体炎
曾治患者宋××，男，50岁。3个多月前生气后两眼困痛，视力逐渐下降，现仅能看1米左右的人或物。某院眼科诊为虹膜睫状体炎。先用西药治疗微有效果，但见效非常缓慢，加服中药明目地黄丸后，效果仍然不太显著。审视其证，除两眼视力明显下降外(在30厘米左右内能基本分清手指)，并见眼微赤，困痛，头痛，心烦易怒，胸胁苦满，舌苔白，脉弦。综合脉证，诊为肝阴不足为本，肝郁化火为标。治以滋水清肝饮加减。处方：柴胡10克，当归10克，白芍15克，丹皮10克，栀子10克，生地15克，元参60克，薄荷2克，茺蔚子10克。服药7剂后，诸证好转，视力明显增加，继服20剂而视力恢复正常，其他诸证亦大见好转。
慢性咽炎
邮电局职工，尤其是长途电话工人，常患一种耳聋耳鸣证，数十年来求治者甚多，而见效者甚少。及查色脉，大多虚弦而滑，面色较白，长期失眠，或时见烦躁易怒。思之，乃心气之不足，痰火内阻者，予十味温胆汤（Shiwei Wendan Tang, Ten-Ingredient Cinnamon Twig and Pinellia Decoction）治之多效。曾治患者耿××，女，38岁。长途电话工人。近5年来听力日渐下降，近半年来几乎听不见电话传来的声音而不能坚持工作，失眠心烦、口干口苦，烦躁。审其面色较白，舌苔薄白，脉虚弦滑。为拟十味温胆汤加减：黄芪（Astragali Radix, Huangqi）15克，当归（Angelicae Sinensis Radix, Danggui）10克，麦冬（Ophiopogonis Radix, Maidong），党参（Codonopsis Radix, Dangshen），五味子（Schisandrae Fructus, Wuweizi），竹茹（Bambusae Caulis in Taeniam, Zhuru），枳实（Aurantii Fructus Immaturus, Zhishi），半夏（Pinelliae Rhizoma Preparatum, Banxia），陈皮（Citri Reticulatae Pericarpium, Chenpi），茯苓（Poria, Fuling），甘草（Glycyrrhizae Radix et Rhizoma, Gancao），石菖蒲（Acori Tatarinowii Rhizoma, Changpu），远志（Polygalae Radix, Yuanzhi）。服药6剂，耳鸣耳聋好转，继服30剂诸证消失而愈。
卡他性中耳炎（Catarrhal Otitis Media）之耳聋，其病多猝然而发。猝起者，多因外邪所致，因此疏散风邪尤为医者所重视。然徒散其风，不予补正，则虚火上扰而难速治。正如朱丹溪所说：“耳者，宗脉之所附，宗脉虚而风邪乘之，使经气否而不宣，是为风聋，内必作痒，或兼头痛。”曾治患者伍××，女，30岁。两个多月来两耳发堵，听力减退。某院诊为卡他性中耳炎。住院20多天，予西药及中药通窍耳聋丸（Tongqiao Erlong Wan, Unblocking Orifice and Ear-Deafness Pill）治之不效。审其脉证，除耳聋外，并见从两耳窍中流水，下肢沉重。证脉合参，诊为湿邪蒙蔽，耳窍闭塞。为拟祛湿散风清热。羌活胜湿汤（Qianghuo Shengshi Tang, Notopterygium Decoction for Overcoming Dampness）加减：羌活（Notopterygii Rhizoma et Radix, Qianghuo），独活（Angelicae Pubescentis Radix, Duhuo），川芎（Ligustici Chuanxiong Rhizoma, Chuanxiong），甘草（Glycyrrhizae Radix et Rhizoma, Gancao），防风（Saposhnikoviae Radix, Fangfeng），蔓荆子（Viticis Fructus, Manjingzi），防己（Stephaniae Tetrandrae Radix, Fangji），藁本（Ligustici Jizhi Rhizoma, Gaoben）。服药3剂，证减七八，继服5剂，诸证消失而愈。患者云：余曾自用此方治之不效，老师用之却其效如神何也?答曰：湿邪者，重浊粘滞难化之邪，其在上者当发散之，但散之必用辛温之风药，过之则但祛风而不胜湿，即仲景所谓但风气祛，湿气在之象，所以前用量大而无效，吾用小量而取效。
暴发性耳聋（Sudden Deafness），与卡他性中耳炎之病机近似，故散其少阴、肝胆之邪尤为诸法之首要。如患者郭××，男，50岁。半年前(春节期间)突然发现耳呜，听力下降。急至重庆、成都等地医院住院治疗，诊为暴发性耳聋。前后住院5个多月，耳呜不但加重，而且两耳已基本全部失去听觉。不得已，又至太原某院住院治疗。住院2个月后，听力已完全丧失，耳鸣如击鼓，烦躁。不得已，又出院求治。审其两耳听力完全丧失，虽近在10厘米之内大声讲话也听不见一点声音，舌苔白，脉浮紧。综合脉证，诊为风寒闭郁于少阴、少阳之经耳。为拟疏风散寒，平肝泻火：夏枯草（Prunellae Spica, Xiakucao），蝉衣（Cicadae Periostracum, Chan Yi），细辛（Asari Radix et Rhizoma, Xixin），龙胆草（Gentianae Radix, Longdancao），全虫（Scorpio, Quan Chong），防风（Saposhnikoviae Radix, Fangfeng），酒军（Rhei Radix et Rhizoma Vin-processed, Jiujun），川芎（Ligustici Chuanxiong Rhizoma, Chuanxiong），当归（Angelicae Sinensis Radix, Danggui），羌活（Notopterygii Rhizoma et Radix, Qianghuo）。服药3剂，耳呜大减；继服4剂，耳呜消失七八，耳聋微闻，一般讲话已听清80％左右，继服6剂，耳聋消失而愈。患者云：前用西药不效，后用中药平肝泻火之剂亦无效，而你却1剂效，10剂愈，其故何也?答曰：外邪闭郁者，非散之不除，此用泻火不除之故也。又曰：实如师言，前医每每以泻火而病剧。
青风障症（Green Cataract Syndrome）
曾治患者何××，女，17岁。突然两眼疼痛，头痛恶心，视力下降，瞳孔散大20多天，某院诊为急性青光眼（Acute Glaucoma）。先用西约其证不减，审其证，除上述诸证外，并见舌苔薄白，脉弦。证脉合参，诊为肝火内郁，风邪外袭，为拟平肝泻火散风：草决明（Cassiae Semen, Caojueming），龙胆草（Gentianae Radix, Longdancao），黄芩（Scutellariae Radix, Huangqin），夏枯草（Prunellae Spica, Xiakucao），菊花（Chrysanthemi Flos, Juhua），防风（Saposhnikoviae Radix, Fangfeng），车前子（Plantaginis Semen, Cheqianzi，布包），柴胡（Bupleuri Radix, Chaihu），薄荷（Menthae Haplocalycis Herba, Bohe），蝉衣（Cicadae Periostracum, Chan Yi）。服药4剂，头痛、眼痛消失，继服20剂愈。患者问：前用羚羊角等无效，你用此方有效者何也?答曰：羚羊角（Saiga Tataricae Cornu, Lingyangjiao）乃眼科圣药，然羚羊角、石决明（Haliotidis Concha, Shijueming）等均偏平降，而散之力不足，此病猝然而起，肝火内郁，风邪外袭所致也，但泻其火，不散其风则郁火反增，故散风始效也。正如张石顽所说：“瞳视散大者，风热所为也，火邪散，挟风益炽，神光怯弱不能支，亦随而散漫，犹风起而水波也。”因此散风之法不可缺也。
眼珠疼痛
曾治患者刘××，女，42岁。产后不久，连续写材料1个多月后，发现眼珠疼痛，不能看任何东西，经某院反复检查无阳性发现，前后住院5次，共计约两年多，但未见效果。3个月前因急性胃炎（Acute Gastritis）用阿托品（Atropine）等治疗后，突然失明，休息十几天‘后，视力才逐渐恢复，但眼珠却整天疼痛不止，眼眶、两太阳穴亦沉重疼痛不敢睁眼，烦躁易怒，朝轻暮重。近几月来，月经又淋漓不断，舌质红、苔薄白，脉弦细。思之，病起于产后，又加久视伤血，《素问·五脏生成篇》说：“肝受血而能视”。此眼之疼痛者，血失所养耳。拟养血益肝明目：当归（Angelicae Sinensis Radix, Danggui），山药（Dioscoreae Rhizoma, Shanyao），生地（Rehmanniae Radix, Shengdi），白芍（Paeoniae Radix Alba, Baishao），女贞子（Ligustri Lucidi Fructus, Nvzhenzi），柴胡（Bupleuri Radix, Chaihu），决明子（Cassiae Semen, Juemingzi），珍珠母（Margaritifera Concha, Zhenzhumu），车前子（Plantaginis Semen, Cheqianzi，布包）。服药4剂，眼痛果减，但头痛、眼眶疼痛同前；加枸杞子（Lycii Fructus, Gouqizi）12克、白术（Atractylodis Macrocephalae Rhizoma, Baizhu）9克，继服10剂，眼痛、头痛消失七八，并能看一般东西，但不能长时间的读书，继服20剂诸证消失而愈。
青盲（Blue Cataract / Optic Atrophy）
曾治患者高××，女，5岁。流行性乙型脑炎（Japanese Encephalitis B）高热昏迷抽搐，经治已经痊愈。但两眼完全失明。某院诊断为皮质盲（Cortical Blindness）。先用西药治疗2个月无效，继予明目地黄丸（Mingmu Dihuang Wan, Bright-Eye Rehmannia Pill）、石斛夜光丸（Shihu Yeguang Wan, Dendrobium Night-Light Pill）等治疗1个月仍不效。审其两眼外无异常，舌质红少苔，脉虚稍数。予补精填髓，明目：龟甲（Testudinis Carapax et Plastrum, Guijia），鳖甲（Trionycis Carapax, Biejia），首乌（Polygoni Multiflori Radix, Shouwu），生地（Rehmanniae Radix, Shengdi），白芍（Paeoniae Radix Alba, Baishao），覆盆子（Rubiae Fructus, Fupenzi），五味子（Schisandrae Fructus, Wuweizi），牡蛎（Ostrea Concha, Muli）等加减1个月，视力稍复，继服1个月而愈
复视（Diplopia）
明·傅仁宇认为本病的原因是“胆肾真一之精不足”和“火壅于络”，制补肝散（Bugan San, Liver-Nourishing Powder）治“肝风内障，不痛不痒，眼见花发黄白黑赤，或一物二形难辨；”冲和养胃汤（Chonghe Yangwei Tang, Harmonizing Stomach-Nourishing Decoction）治“内障初起，视觉微昏，空中有黑花，神水变绿色，次则视物成二，神水变淡白色，久则不睹，神水变纯白色。”而未论及跌打损伤。再察部分眼科专书和医案，亦未睹外伤所致者。曾治邢××，男，成。3个月前右前额外伤后，右眼视力明显下降，视一为二，右眼球向上、向下和内收的运动丧失。某医院诊为动眼神经麻痹（Oculomotor Nerve Palsy）。先用中、西药物、针灸（Acupuncture and Moxibustion）治疗无效。邀余诊视。察其证见右眼睑下垂，外斜视，瞳孔散大，对光反射和调节反射消失，眼球向上、向下和向内的运动丧失，舌苔白，脉右虚大而弦，左弦涩不调。审其前用诸方，多为活血之品。思之，跌打损伤应予活血通络，然其右脉虚大而弦，大为虚，正如东垣所说：“气口脉大而虚者，为内伤于气。”当益气以培本，活血通络以治标。处以补阳还五汤（Buyang Huanwu Tang, Tonifying Yang and Restoring Five Decoction）：黄芪（Astragali Radix, Huangqi）30克，当归（Angelicae Sinensis Radix, Danggui）12克，赤芍（Paeoniae Radix Rubra, Chishao），川芎（Ligustici Chuanxiong Rhizoma, Chuanxiong），地龙（Pheretima, Dilong），桃仁（Persicae Semen, Taoren），红花（Carthami Flos, Honghua）。药进3剂视力骤增，运动好转，再进10剂，眼球运动基本恢复，视力正常，瞳孔等大，乃继进10剂而善其后。
胬肉攀睛（Pterygium）
胬肉攀睛，傅仁宇认为：“多起气轮，有胀如肉，或如黄油，至后渐渐厚而长积，赤瘀胬起如肉，故曰胬肉。”沈金鳌认为：“必眼先赤烂多年，时痒时痛，两眦头努出筋膜。”其发病原因，《银海精微》认为：“脾胃热毒，脾受肝邪，多是七情郁结之人，或夜思寻，家筵无歇，或饮乐欲，致使三焦壅热，或肥壮之人，血滞于大眦。”沈金鳌认为：“心气不宁，忧虑不已……用力作劳……或由风热冲肝而成。”傅仁宇认为：“凡性躁暴悸，恣嗜辛热之人，患此者多。”其治疗方法，《银海精微》认为：“实者小钩为钩，钩起剪断些宽，三五日剪痕收满，方可点阴二阳四药，吹点，余翳渐清，避风忌口斋戒可也，若乍发不宜钩剪，宜服药，点以淡丹可也。三焦心火俱炎，亦能生此疾，治之须钩割后，宜服泻脾除热饮（Xiepi Chure Yin, Splea-Clearing Heat-Removing Drink）。”傅仁宇认为：“治宜峻伐，久则自愈……及珠尚露，皆不必用钩割之治，宜服点还睛散（Huanning San, Eye-Recovering Powder），吹霞散（Chuixia San, Blowing-Mist Powder）。”《中医眼科学》认为：“多因心脾二经风热壅盛，经络瘀滞，或恣嗜五辛酒浆，脾胃湿热蕴蒸，血滞于眦部所致。亦有由于过劳恣欲，暗耗肾阴，水火不济，以致心火上炎而发”；“若胬肉渐长，红筋渐布，多眵多泪，羞明刺痛，属心肺风热壅盛，当祛风清热，方用金花丸（Jinhua Wan, Golden Flower Pill），或栀子胜奇散（Zhizi Shengqi San, Gardenia Victory Marvel Powder）。若眵多干结，涩痒交作，口渴，右寸脉较胜，偏于肺经风热者，宜清肺泄热，可用清肺饮（Qingfei Yin, Lung-Clearing Drink），或清肺丸（Qingfei Wan, Lung-Clearing Pill）。如便秘溺赤，属于脾胃湿热蕴结者，宜泄热通腑，可用泻脾除热饮。若胬肉出现红筋，乍起乍退，涩痒间作，伴有心中烦热，口舌干燥，小便黄赤等证，属于阴虚火炎，宜滋阴降火，可用知柏八味丸（Zhibai Bawei Wan, Anemarrhena, Phellodendron and Eight-Ingredient Pill），兼用甘露饮（Ganlu Yin, Sweet Dew Drink）治之。”“若胬肉厚大头尖而赤，伸展较速，侵入黑睛，有掩及瞳神趋势者，须进行割治。若胬肉齐头，薄白色白，伸展迟缓，或仅侵及风轮边缘，而无赤痛及进行趋势者，则不必割治。但胬肉终是顽固的赘生物，不论在何阶段，割治之后，应服药内治，以防复发。”然验之临床，用于初起红涩痒痛而属实者，多效；用于病程较久者，则多服药无功，即如钩割之后者，亦多复发。因思亡兄健在时曾云：“诊眼病目赤时应注意三点：一视其眼鲜红者为实火．二视其眼深红而暗者为瘀血，三视其嫩红者为气阴两虚或阴虚。”胬肉攀睛色赤深红而暗，为瘀血；而时发时止则为肝肾阴伤，故治者当活血滋阴：例如：韩××，女，35岁。两眼胬肉2年多，近1年多来加重。先请某院西医治之不效，后又请中医治之仍不效。审视其证，左眼胬肉约2毫米×4毫米，右眼约l毫米×3毫米，涩痒而痛，色深红，舌中心无苔，脉弦细。综合脉证，诊为胃阴不足，血络瘀滞。为拟养阴活血。桃仁承气汤（Taoren Chengqi Tang, Peach Kernel and Rheum Decoction）加减。处方：石斛（Dendrobii Caulis, Shihu），麦冬（Ophiopogonis Radix, Maidong），当归（Angelicae Sinensis Radix, Danggui），赤芍（Paeoniae Radix Rubra, Chishao），桂枝（Cinnamomi Ramulus, Guizhi），桃仁（Persicae Semen, Taoren），元参（Scrophulariae Radix, Yuanshen），煅龙骨（Fossilia Ossis Maxillariae Calcined, Duangulonggu），煅牡蛎（Ostrea Concha Calcined, Duangunli），蝉蜕（Cicadae Periostracum, Chantui）。服药2剂，涩痒疼痛大见好转，胬肉缩小，继服8剂，涩痒疼痛消失，胬肉缩小3／4，又继服20剂而愈。其后，见此类患者，为加强其活血之力，加全虫（Scorpio, Quan Chong）3克，其效更著。某医见此方效著，改为丸、散内服，进行系统观察获得了较好效果。但久而久之，见效者虽多，不效者亦不少，细审其因，多为辨证有误。例如：耿××，男，成。翳状胬肉（Pterygium-like Growth）5个多月。某院先以西医力。法治之不效，后以中药清热泻火，活血养阴之法治之仍无功?审其脉证，除以上症状外，脉见虚大，右大于左。综合脉证，诊为气阴俱虚，治以补气养阴，补中益气汤（Buzhong Yiqi Tang, Tonify the Middle and Augment Qi Decoction）加味。处方：黄芪（Astragali Radix, Huangqi）15克，白术（Atractylodis Macrocephalae Rhizoma, Baizhu）10克，党参（Codonopsis Radix, Dangshen）10克，当归（Angelicae Sinensis Radix, Danggui）10克，升麻（Cimicifugae Rhizoma, Shengma）10克，柴胡（Bupleuri Radix, Chaihu）10克，陈皮（Citri Reticulatae Pericarpium, Chenpi）10克，甘草（Glycyrrhizae Radix et Rhizoma, Gancao）10克，知母（Anemarrhenae Rhizoma, Zhimu）12克，元参（Scrophulariae Radix, Yuanshen）15克，麦冬（Ophiopogonis Radix, Maidong）12克。服药8剂，霍然痊愈。
暴盲（Sudden Blindness）
曾治患者任××，男，成。1个多月前，突因小石头击伤右前额、眼眶而失明。某院眼科诊为黄斑区损伤（Macular Area Injury）。先以亚硝酸异戊脂吸入，妥拉苏林球后注射，烟酸内服等治疗无效，后又配合中药养阴明目仍无效。审视其证，两眼外观无异常，不红小痛，食欲、睡眠正常，舌苔薄黄，脉右弦大，左弦。综合脉证，诊为气血俱虚，络脉瘀滞，为拟补阳还五汤加减。处方：黄芪（Astragali Radix, Huangqi）50克，当归（Angelicae Sinensis Radix, Danggui）10克，赤芍（Paeoniae Radix Rubra, Chishao）10克，川芎（Ligustici Chuanxiong Rhizoma, Chuanxiong）10克，地龙（Pheretima, Dilong）10克，桃仁（Persicae Semen, Taoren）10克，红花（Carthami Flos, Honghua）10克。服药20剂，视力明显好转，由完全失明转为能看一般书报，但看20分钟后，视力很快下降，或昏花不清，或视直笔为弯曲之笔，或发生颜色改变。舌脉同前，为加强明目之效，加菟丝子（Cuscutae Semen, Tusizi）3克，继服30剂而愈。
视神经炎（Optic Neuritis）
曾治患者梁×x，女，30岁。产后数天即发现关节疼痛。医诊风湿性关节炎（Rheumatoid Arthritis）。予中药祛风除湿，温经散寒之剂治之，身痛未减，而却汗出乏力更甚，并进而发现目视昏花，虽人或物在l米之内亦看不清楚。某院眼科诊为视神经炎。先予中药明目养阴之剂不效，继予西药视力稍有增加，但视力增至能在2米内看清人或物时，不再继续提高。审视其证，两眼外观无异常，但经常感到疲乏无力，自汗盗汗，关节疼痛，腰酸，口苦而干，舌苔白，脉虚大。综合脉证，诊为气阴两虚。为拟补气养阴。芪脉地黄汤（Qimai Dihuang Tang, Astragalus and Pulse Rehmannia Decoction）加减：黄芪（Astragali Radix, Huangqi）15克，当归（Angelicae Sinensis Radix, Danggui）10克，麦冬（Ophiopogonis Radix, Maidong）10克，党参（Codonopsis Radix, Dangshen）10克，五味子（Schisandrae Fructus, Wuweizi）10克，生地（Rehmanniae Radix, Shengdi）18克，苍术（Atractylodis Rhizoma, Cangzhu）10克，茯苓（Poria, Fuling）10克，石斛（Dendrobii Caulis, Shihu）10克，泽泻（Alismatis Rhizoma, Zexie）10克，丹皮（Moutan Cortex, Danpi）10克。服药30剂后，视力增加，身痛大减，继服30剂，视力恢复，其他诸证亦大减。某医云：余前予石斛夜光丸及养阴明目之剂不效者何也?答曰：脉大者，气血俱虚或气阴俱虚。气血俱虚或气阴俱虚者当补气养血或补气养阴同施。前方养阴所以无效者，在于未补其气耳。
虹膜睫状体炎（Iridocyclitis）
曾治患者宋××，男，50岁。3个多月前生气后两眼困痛，视力逐渐下降，现仅能看1米左右的人或物。某院眼科诊为虹膜睫状体炎。先用西药治疗微有效果，但见效非常缓慢，加服中药明目地黄丸后，效果仍然不太显著。审视其证，除两眼视力明显下降外(在30厘米左右内能基本分清手指)，并见眼微赤，困痛，头痛，心烦易怒，胸胁苦满，舌苔白，脉弦。综合脉证，诊为肝阴不足为本，肝郁化火为标。治以滋水清肝饮（Zishui Qinggan Yin, Nourishing Water and Clearing Liver Drink）加减。处方：柴胡（Bupleuri Radix, Chaihu）10克，当归（Angelicae Sinensis Radix, Danggui）10克，白芍（Paeoniae Radix Alba, Baishao）15克，丹皮（Moutan Cortex, Danpi）10克，栀子（Gardeniae Fructus, Zhizi）10克，生地（Rehmanniae Radix, Shengdi）15克，元参（Scrophulariae Radix, Yuanshen）60克，薄荷（Menthae Haplocalycis Herba, Bohe）2克，茺蔚子（Leonuri Fructus, Chongweizi）。服药7剂后，诸证好转，视力明显增加，继服20剂而视力恢复正常，其他诸证亦大见好转。
慢性咽炎（Chronic Pharyngitis）
Employees of the postal and telecommunications bureau, especially long-distance telephone workers, often suffer from a syndrome of deafness and tinnitus. For decades, many have sought treatment, but few have achieved effective results. Upon examination of complexion and pulse, most present with a deficient, wiry, and slippery pulse; their complexion is relatively pale; they suffer from chronic insomnia or occasional irritability and anger. Reflecting on this, it is determined to be due to insufficiency of Heart Qi and internal obstruction by phlegm-fire. Treatment with Shiwei Wendan Tang (Ten-Ingredient Cinnamon Twig and Pinellia Decoction) proved highly effective.
Case 1: Patient Geng XX, female, 38 years old, a long-distance telephone worker. For the past five years, her hearing has gradually declined. For the past six months, she could hardly hear the phone ringing and was unable to continue working. She suffered from insomnia, mental restlessness, dry mouth, bitter taste, and irritability. Examination revealed a relatively pale complexion, thin white tongue coating, and a deficient, wiry, and slippery pulse. A modified prescription of Shiwei Wendan Tang was formulated: Huangqi (Astragali Radix) 15g, Danggui (Angelicae Sinensis Radix) 10g, Maidong (Ophiopogonis Radix) 10g, Dangshen (Codonopsis Radix) 10g, Wuweizi (Schisandrae Fructus) 10g, Zhuru (Bambusae Caulis in Taeniam) 10g, Zhishi (Aurantii Fructus Immaturus) 10g, Banxia (Pinelliae Rhizoma Preparatum) 10g, Chenpi (Citri Reticulatae Pericarpium) 10g, Fuling (Poria) 10g, Gancao (Glycyrrhizae Radix et Rhizoma) 6g, Changpu (Acori Tatarinowii Rhizoma) 10g, Yuanzhi (Polygalae Radix) 10g. After taking 6 doses, her tinnitus and deafness improved. After continuing for 30 doses, all symptoms disappeared, and she recovered.
Deafness associated with Catarrhal Otitis Media often arises suddenly. Sudden onset is mostly caused by external pathogenic factors; therefore, dispersing wind pathogens is particularly emphasized by physicians. However, merely dispersing wind without tonifying righteousness allows deficient fire to harass upward, making rapid cure difficult. As Zhu Danxi stated: "The ear is where the master vessels attach. When the master vessels are deficient, wind pathogens take advantage, causing meridian qi to become obstructed and not disseminated. This is called wind deafness. Internally, there must be itching, or accompanied by headache."
Case 2: Patient Wu XX, female, 30 years old. For over two months, she experienced blockage in both ears and reduced hearing. A certain hospital diagnosed Catarrhal Otitis Media. After more than 20 days of hospitalization, treatment with Western medicine and Tongqiao Erlong Wan (Unblocking Orifice and Ear-Deafness Pill) yielded no effect. Examination of pulse and symptoms revealed, besides deafness, fluid discharge from both ear canals and heaviness in the lower limbs. Integrating signs and pulse, the diagnosis was dampness obscuring and blocking the ear orifices. The treatment principle was to dispel dampness, disperse wind, and clear heat. A modified prescription of Qianghuo Shengshi Tang (Notopterygium Decoction for Overcoming Dampness) was used: Qianghuo (Notopterygii Rhizoma et Radix) 4g, Duhuo (Angelicae Pubescentis Radix) 4g, Chuanxiong (Ligustici Chuanxiong Rhizoma) 1.5g, Gancao (Glycyrrhizae Radix et Rhizoma) 2g, Fangfeng (Saposhnikoviae Radix) 1.5g, Manjingzi (Viticis Fructus) 1g, Fangji (Stephaniae Tetrandrae Radix) 6g, Gaoben (Ligustici Jizhi Rhizoma) 1.5g. After 3 doses, symptoms decreased by 70-80%. After continuing for 5 doses, all symptoms disappeared, and she recovered. The patient asked: "I used this formula myself without effect, why did your use yield miraculous results?" I replied: "Dampness is a heavy, turbid, sticky, and difficult-to-resolve pathogen. Those located above should be dispersed, but dispersion must use acrid-warm wind-dispersing herbs. Excessive use only dispels wind but fails to overcome dampness, which is what Zhang Zhongjing referred to as 'wind is dispelled, but dampness remains.' Hence, the previous large dosage was ineffective, while my small dosage achieved success."
Sudden Deafness has a pathogenesis similar to Catarrhal Otitis Media; thus, dispersing pathogens in the Shaoyin and Liver/Gallbladder meridians is paramount.
Case 3: Patient Guo XX, male, 50 years old. Half a year ago (during the Spring Festival), he suddenly developed tinnitus and hearing loss. He urgently sought hospitalization in Chongqing and Chengdu, where he was diagnosed with Sudden Deafness. After more than 5 months of hospitalization, his tinnitus worsened, and he had almost completely lost hearing in both ears. Reluctantly, he sought further treatment at a hospital in Taiyuan. After 2 months of hospitalization there, his hearing was completely lost, tinnitus sounded like drumming, and he was irritable. Forced to leave the hospital to seek other treatments, examination revealed complete hearing loss in both ears; even loud speech within 10 cm was inaudible. The tongue coating was white, and the pulse was floating and tight. Integrating signs and pulse, the diagnosis was closure and stagnation of wind-cold in the Shaoyin and Shaoyang meridians. The treatment principle was to disperse wind, scatter cold, calm the liver, and drain fire. The prescription included: Xiakucao (Prunellae Spica) 15g, Chan Yi (Cicadae Periostracum) 10g, Xixin (Asari Radix et Rhizoma) 3g, Longdancao (Gentianae Radix) 10g, Quan Chong (Scorpio) 6g, Fangfeng (Saposhnikoviae Radix) 10g, Jiujun (Rhei Radix et Rhizoma Vin-processed) 4g, Chuanxiong (Ligustici Chuanxiong Rhizoma) 10g, Danggui (Angelicae Sinensis Radix) 10g, Qianghuo (Notopterygii Rhizoma et Radix) 10g. After 3 doses, tinnitus greatly decreased. After 4 more doses, tinnitus disappeared by 70-80%, slight hearing returned, and about 80% of normal conversation was understood. After 6 more doses, deafness disappeared, and he recovered. The patient asked: "Previous Western medicine was ineffective, and subsequent Chinese medicine for calming the liver and draining fire was also ineffective. Why did you achieve results with 1 dose and recovery with 10?" I replied: "For external pathogens causing closure and stagnation, dispersion is necessary for removal. The failure of previous treatments was due to using only fire-draining methods without dispersion." He added: "Indeed, as the teacher said, previous doctors often exacerbated the condition by solely draining fire."
Green Cataract Syndrome (Qing Feng Zhang)
Case 4: Patient He XX, female, 17 years old. Suddenly developed eye pain, headache, nausea, decreased vision, and dilated pupils for over 20 days. A certain hospital diagnosed Acute Glaucoma. Initial Western medicine treatment did not reduce symptoms. Examination revealed, besides the above symptoms, a thin white tongue coating and a wiry pulse. Integrating signs and pulse, the diagnosis was internal depression of Liver Fire and external invasion of Wind Pathogens. The treatment principle was to calm the liver, drain fire, and disperse wind. The prescription included: Caojueming (Cassiae Semen) 15g, Longdancao (Gentianae Radix) 10g, Huangqin (Scutellariae Radix) 10g, Xiakucao (Prunellae Spica) 15g, Juhua (Chrysanthemi Flos) 10g, Fangfeng (Saposhnikoviae Radix) 6g, Cheqianzi (Plantaginis Semen, wrapped) 10g, Chaihu (Bupleuri Radix) 6g, Bohe (Menthae Haplocalycis Herba) 6g, Chan Yi (Cicadae Periostracum) 9g. After 4 doses, headache and eye pain disappeared. After 20 more doses, she recovered. The patient asked: "Why were Lingyangjiao (Saiga Tataricae Cornu) etc. ineffective previously, but this formula effective?" I replied: "Lingyangjiao is a sacred herb for ophthalmology, but Lingyangjiao, Shijueming (Haliotidis Concha), etc., tend to descend and lack dispersing power. This disease arose suddenly due to internal depression of Liver Fire and external invasion of Wind. Merely draining fire without dispersing wind causes depressed fire to increase. Thus, dispersing wind is the key to efficacy." As Zhang Shiwan stated: "Dilated pupils are caused by wind-heat. When fire pathogens disperse, they carry wind, intensifying it. The spirit light becomes weak and cannot support itself, scattering along with it, like water waves rising with the wind." Therefore, the method of dispersing wind is indispensable.
Eye Pain
Case 5: Patient Liu XX, female, 42 years old. Shortly after childbirth, after continuously writing materials for over a month, she discovered eye pain and inability to see anything. Repeated examinations at a certain hospital showed no positive findings. She was hospitalized 5 times over approximately two years with no effect. Three months ago, after treatment with Atropine etc. for Acute Gastritis, she suddenly went blind. After resting for ten days, vision gradually recovered, but eye pain persisted throughout the day. The eye sockets and bilateral temporal regions felt heavy and painful, making opening eyes difficult. She was irritable and prone to anger, with symptoms lighter in the morning and heavier in the evening. In recent months, menstruation had been dripping continuously. The tongue body was red with a thin white coating, and the pulse was wiry and fine. Reflecting on this, the disease originated postpartum, compounded by prolonged visual strain damaging blood. The *Suwen: Chapter on Generation of the Five Viscera* states: "The Liver receives blood and enables vision." The pain in this eye is due to blood failing to nourish. The treatment principle was to nourish blood, benefit the liver, and brighten the eyes. The prescription included: Danggui (Angelicae Sinensis Radix) 12g, Shanyao (Dioscoreae Rhizoma) 15g, Shengdi (Rehmanniae Radix) 30g, Baishao (Paeoniae Radix Alba) 15g, Nvzhenzi (Ligustri Lucidi Fructus) 30g, Chaihu (Bupleuri Radix) 6g, Juemingzi (Cassiae Semen) 15g, Zhenzhumu (Margaritifera Concha) 30g, Cheqianzi (Plantaginis Semen, wrapped) 9g. After 4 doses, eye pain indeed decreased, but headache and orbital pain remained unchanged. Gouqizi (Lycii Fructus) 12g and Baizhu (Atractylodis Macrocephalae Rhizoma) 9g were added. After 10 more doses, eye pain and headache disappeared by 70-80%, and she could see general objects, though not read for long periods. After 20 more doses, all symptoms disappeared, and she recovered.
Blue Cataract (Qing Mang)
Case 6: Patient Gao XX, female, 5 years old. She suffered high fever, coma, and convulsions due to Japanese Encephalitis B, which was cured after treatment. However, she became completely blind in both eyes. A certain hospital diagnosed Cortical Blindness. Two months of Western medicine treatment were ineffective. One month of treatment with Mingmu Dihuang Wan (Bright-Eye Rehmannia Pill) and Shihu Yeguang Wan (Dendrobium Night-Light Pill) was also ineffective. Examination showed no abnormalities externally in the eyes, a red tongue with little coating, and a slightly rapid, deficient pulse. The treatment principle was to tonify essence, fill marrow, and brighten the eyes. A modified prescription included: Guijia (Testudinis Carapax et Plastrum), Biejia (Trionycis Carapax), Shouwu (Polygoni Multiflori Radix), Shengdi (Rehmanniae Radix), Baishao (Paeoniae Radix Alba), Fupenzi (Rubiae Fructus), Wuweizi (Schisandrae Fructus), Muli (Ostrea Concha), etc. After one month, vision slightly recovered. After continuing for another month, she recovered.
Diplopia (Fu Shi)
Fu Renyu of the Ming Dynasty believed the cause of this disease was "insufficiency of the true essence of Gallbladder and Kidney" and "fire obstructing the collaterals." He formulated Bugan San (Liver-Nourishing Powder) to treat "internal cataracts due to Liver Wind, without pain or itching, seeing flowers yellow, white, black, or red, or one object appearing as two forms difficult to distinguish"; and Chonghe Yangwei Tang (Harmonizing Stomach-Nourishing Decoction) to treat "early-stage internal cataracts, slight visual dimness, black flowers in the air, aqueous humor turning green, then diplopia, aqueous humor turning pale white, eventually blindness, aqueous humor turning pure white." He did not discuss traumatic injuries. Further inspection of some ophthalmology monographs and medical cases also failed to find cases caused by trauma.
Case 7: Patient Xing XX, male, adult. Three months ago, after trauma to the right forehead, right eye vision significantly decreased, diplopia occurred, and movement of the right eyeball up, down, and inward was lost. A certain hospital diagnosed Oculomotor Nerve Palsy. Initial treatment with Chinese/Western medicines and Acupuncture and Moxibustion was ineffective. Upon consultation, signs included right ptosis, exotropia, dilated pupil, loss of pupillary light reflex and accommodation reflex, and loss of upward, downward, and inward eye movements. The tongue coating was white, the right pulse was deficient, large, and wiry, and the left pulse was wiry, choppy, and irregular. Reviewing previous prescriptions, they mostly contained blood-invigorating agents. Reflecting on this, traumatic injury requires invigorating blood and unblocking collaterals. However, the right pulse being deficient, large, and wiry indicates deficiency in the "large" aspect. As Dongyuan stated: "A large and deficient pulse at the Qi Kou indicates internal injury to Qi." The treatment principle should be to tonify Qi to root the foundation and invigorate blood/unblock collaterals to treat the branch. A prescription of Buyang Huanwu Tang (Tonifying Yang and Restoring Five Decoction) was given: Huangqi (Astragali Radix) 30g, Danggui (Angelicae Sinensis Radix) 12g, Chishao (Paeoniae Radix Rubra) 12g, Chuanxiong (Ligustici Chuanxiong Rhizoma) 10g, Dilong (Pheretima) 10g, Taoren (Persicae Semen) 10g, Honghua (Carthami Flos) 10g. After 3 doses, vision increased sharply, and movement improved. After 10 more doses, eye movement basically recovered, vision normalized, and pupils were equal. Another 10 doses were taken to consolidate the result.
Pterygium (Nu Rou Pan Jing)
Regarding Pterygium, Fu Renyu stated: "It mostly originates in the Qi Wheel, swelling like flesh or like yellow butter, gradually becoming thick and accumulating, with red stasis rising like flesh, hence called Nu Rou." Shen Jin'ao stated: "The eye must have been red and ulcerated for many years, with intermittent itching and pain, with fascia protruding from the corners of the eyes." Regarding its etiology, *Yin Hai Jing Wei* stated: "Heat-toxin in Spleen and Stomach, Spleen affected by Liver pathogens, mostly people with stagnant seven emotions, or night-time worrying, endless family banquets, or indulgence in drinking and pleasure, causing Triple Burner heat congestion, or obese people with blood stagnation at the outer canthus." Shen Jin'ao stated: "Heart Qi unrest, endless worry... strenuous labor... or caused by wind-heat rushing to the Liver." Fu Renyu stated: "People with irritable and violent temper who indulge in acrid and hot foods mostly suffer from this." Regarding treatment methods, *Yin Hai Jing Wei* stated: "For excess patterns, use a small hook to lift, cut wider, wait 3-5 days for the cut mark to heal, then apply Yin-Er Yang-Si medicine, blow powder, residual opacity will gradually clear, avoid wind, dietary restrictions, and fasting are acceptable. If newly erupted, hooking/cutting is unsuitable; medication is preferred, applying Dan medicine. Triple Burner and Heart fire inflammation can also cause this disease; treatment requires hooking/cutting followed by Xiepi Chure Yin (Splea-Clearing Heat-Removing Drink)." Fu Renyu stated: "Treatment should involve severe attack; it will heal itself over time... if the globe is still exposed, hooking/cutting is unnecessary; Huanning San (Eye-Recovering Powder) and Chuixia San (Blowing-Mist Powder) should be taken." *TCM Ophthalmology* stated: "Mostly caused by wind-heat congestion in Heart and Spleen meridians, meridian/collateral stasis, or indulgence in five pungents and alcohol, causing Spleen/Stomach damp-heat steaming and blood stagnation at the canthus. Also caused by overwork and excessive desire, secretly consuming Kidney Yin, failing to balance Water and Fire, leading to Heart Fire flaring up." "If Nu Rou grows gradually, red veins spread, with much discharge and tearing, photophobia and stabbing pain, belonging to Lung/Heart wind-heat congestion, dispel wind and clear heat, using Jinhua Wan (Golden Flower Pill) or Zhizi Shengqi San (Gardenia Victory Marvel Powder). If discharge is dry and clotted, alternating astringency and itching, thirst, and the right Cun pulse is stronger, leaning towards Lung meridian wind-heat, clear Lung and drain heat, using Qingfei Yin (Lung-Clearing Drink) or Qingfei Wan (Lung-Clearing Pill). If constipation and dark urine belong to Spleen/Stomach damp-heat accumulation, drain heat and purge bowels, using Xiepi Chure Yin. If Nu Rou shows red veins, appearing and disappearing intermittently, alternating astringency and itching, accompanied by mental restlessness, dry mouth/tongue, yellow-red urine, belonging to Yin deficiency with fire flaming, nourish Yin and descend fire, using Zhibai Bawei Wan (Anemarrhena, Phellodendron and Eight-Ingredient Pill), combined with Ganlu Yin (Sweet Dew Drink)." "If Nu Rou is thick with a pointed head and red, expanding rapidly, invading the black cornea, with a trend of covering the pupil, surgical cutting is required. If Nu Rou is flat-headed, thin and white, expanding slowly, or only invading the edge of the Wind Wheel, without red pain and progressive trend, cutting is unnecessary. But Nu Rou is ultimately a stubborn growth; regardless of stage, after cutting, internal medication should be taken to prevent recurrence." However, clinical verification shows that for early-stage red, astringent, itchy, painful excess patterns, it is mostly effective; for long-course diseases, medication is often ineffective, and even after hooking/cutting, recurrence is common. Recalling my late brother's words when alive: "When diagnosing eye diseases with red eyes, pay attention to three points: 1. Bright red indicates excess fire. 2. Deep red and dark indicates blood stasis. 3. Tender red indicates dual deficiency of Qi and Yin or Yin deficiency." Nu Rou Pan Jing with deep red and dark color indicates blood stasis; intermittent occurrence indicates Liver/Kidney Yin damage. Therefore, treatment should invigorate blood and nourish Yin.
Case 8: Patient Han XX, female, 35 years old. Bilateral Nu Rou for over 2 years, worsening for over 1 year. Western medicine treatment at a certain hospital was ineffective. Subsequent Chinese medicine treatment was also ineffective. Examination revealed left eye Nu Rou approx. 2mm x 4mm, right eye approx. 1mm x 3mm, with astringency, itching, and pain, deep red color, no coating in the center of the tongue, and wiry-fine pulse. Integrating signs and pulse, the diagnosis was Stomach Yin insufficiency and blood collateral stasis. The treatment principle was to nourish Yin and invigorate blood. A modified prescription of Taoren Chengqi Tang (Peach Kernel and Rheum Decoction) was used: Shihu (Dendrobii Caulis) 12g, Maidong (Ophiopogonis Radix) 12g, Danggui (Angelicae Sinensis Radix) 9g, Chishao (Paeoniae Radix Rubra) 9g, Guizhi (Cinnamomi Ramulus) 9g, Taoren (Persicae Semen) 9g, Yuanshen (Scrophulariae Radix) 30g, Duangulonggu (Fossilia Ossis Maxillariae Calcined) 12g, Duangunli (Ostrea Concha Calcined) 12g, Chantui (Cicadae Periostracum) 6g. After 2 doses, astringency, itching, and pain greatly improved, and Nu Rou shrank. After 8 more doses, astringency, itching, and pain disappeared, and Nu Rou shrank by 3/4. After 20 more doses, she recovered. Later, for such patients, adding Quan Chong (Scorpio) 3g to enhance blood-invigorating power yielded better results. A certain physician saw the significant effect of this formula, changed it into pills and powders for internal use, and obtained good results through systematic observation. However, over time, although many responded, many did not. Careful review of the cause indicated mostly incorrect pattern differentiation.
Case 9: Patient Geng XX, male, adult. Pterygium-like growth for over 5 months. Initially treated with Western medicine at a certain hospital without effect. Subsequently treated with Chinese medicine for clearing heat, draining fire, invigorating blood, and nourishing Yin, still without effect. Examination of pulse and symptoms, besides the above, revealed a deficient-large pulse, larger on the right than the left. Integrating signs and pulse, the diagnosis was dual deficiency of Qi and Yin. The treatment principle was to tonify Qi and nourish Yin. A modified prescription of Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) was used: Huangqi (Astragali Radix) 15g, Baizhu (Atractylodis Macrocephalae Rhizoma) 10g, Dangshen (Codonopsis Radix) 10g, Danggui (Angelicae Sinensis Radix) 10g, Shengma (Cimicifugae Rhizoma) 10g, Chaihu (Bupleuri Radix) 10g, Chenpi (Citri Reticulatae Pericarpium) 10g, Gancao (Glycyrrhizae Radix et Rhizoma) 10g, Zhimu (Anemarrhenae Rhizoma) 12g, Yuanshen (Scrophulariae Radix) 15g, Maidong (Ophiopogonis Radix) 12g. After 8 doses, she recovered abruptly.
Sudden Blindness (Bao Mang)
Case 10: Patient Ren XX, male, adult. Over a month ago, he suddenly went blind due to a small stone striking his right forehead and orbit. The ophthalmology department of a certain hospital diagnosed Macular Area Injury. Initial treatment with inhalation of amyl nitrite, retrobulbar injection of tolazoline, and oral niacin was ineffective. Subsequent combination with Chinese medicine for nourishing Yin and brightening eyes was also ineffective. Examination revealed no abnormalities in the appearance of both eyes, no redness or slight pain, normal appetite and sleep, thin yellow tongue coating, right pulse wiry-large, left pulse wiry. Integrating signs and pulse, the diagnosis was dual deficiency of Qi and Blood, and collateral stasis. A modified prescription of Buyang Huanwu Tang (Tonifying Yang and Restoring Five Decoction) was used: Huangqi (Astragali Radix) 50g, Danggui (Angelicae Sinensis Radix) 10g, Chishao (Paeoniae Radix Rubra) 10g, Chuanxiong (Ligustici Chuanxiong Rhizoma) 10g, Dilong (Pheretima) 10g, Taoren (Persicae Semen) 10g, Honghua (Carthami Flos) 10g. After 20 doses, vision significantly improved, transitioning from total blindness to being able to read general books/newspapers. However, after reading for 20 minutes, vision dropped quickly, becoming blurry, or straight lines appeared curved, or color changes occurred. Tongue and pulse remained the same. To enhance the eye-brightening effect, Tusizi (Cuscutae Semen) 3g was added. After 30 more doses, she recovered.
Optic Neuritis (Shi Shen Jing Yan)
Case 11: Patient Liang XX, female, 30 years old. Several days postpartum, joint pain was discovered. Diagnosed with Rheumatoid Arthritis. Treatment with Chinese medicine for dispelling wind, removing dampness, warming meridians, and scattering cold did not reduce body pain; instead, sweating and fatigue worsened. Subsequently, blurred vision was discovered; even people or objects within 1 meter were unclear. The ophthalmology department of a certain hospital diagnosed Optic Neuritis. Initial treatment with Chinese medicine for brightening eyes and nourishing Yin was ineffective. Subsequent Western medicine slightly increased vision, but once vision improved enough to see people/objects within 2 meters, it no longer continued to improve. Examination revealed no abnormalities in the appearance of both eyes, but frequent feelings of fatigue and weakness, spontaneous sweating, night sweats, joint pain, sore waist, bitter and dry mouth, white tongue coating, and large, deficient pulse. Integrating signs and pulse, the diagnosis was dual deficiency of Qi and Yin. The treatment principle was to tonify Qi and nourish Yin. A modified prescription of Qimai Dihuang Tang (Astragalus and Pulse Rehmannia Decoction) was used: Huangqi (Astragali Radix) 15g, Danggui (Angelicae Sinensis Radix) 10g, Maidong (Ophiopogonis Radix) 10g, Dangshen (Codonopsis Radix) 10g, Wuweizi (Schisandrae Fructus) 10g, Shengdi (Rehmanniae Radix) 18g, Cangzhu (Atractylodis Rhizoma) 10g, Fuling (Poria) 10g, Shihu (Dendrobii Caulis) 10g, Zexie (Alismatis Rhizoma) 10g, Danpi (Moutan Cortex) 10g. After 30 doses, vision increased, and body pain greatly decreased. After 30 more doses, vision recovered, and other symptoms greatly diminished. A certain physician asked: "Why were Shihu Yeguang Wan and Yin-nourishing eye-brightening formulas ineffective previously?" I replied: "A large pulse indicates dual deficiency of Qi and Blood or dual deficiency of Qi and Yin. For dual deficiency of Qi and Blood or Qi and Yin, tonifying Qi and Blood or tonifying Qi and Yin should be applied simultaneously. The previous Yin-nourishing formula was ineffective because it failed to tonify Qi."
Iridocyclitis (Hong Mu Jie Zhuang Ti Yan)
Case 12: Patient Song XX, male, 50 years old. Over 3 months ago, after getting angry, he experienced tiredness and pain in both eyes, with gradual vision decline. Currently, he can only see people/objects at about 1 meter. The ophthalmology department of a certain hospital diagnosed Iridocyclitis. Initial Western medicine treatment had slight effect but was very slow. Adding Mingmu Dihuang Wan (Bright-Eye Rehmannia Pill) did not significantly improve results. Examination revealed, besides significant vision decline in both eyes (able to roughly distinguish fingers within ~30cm), slight redness, tiredness/pain, headache, mental restlessness, irritability, chest/hypochondriac fullness, white tongue coating, and wiry pulse. Integrating signs and pulse, the diagnosis was Liver Yin insufficiency as the root, and Liver depression transforming into fire as the branch. The treatment principle was Zishui Qinggan Yin (Nourishing Water and Clearing Liver Drink). A modified prescription was used: Chaihu (Bupleuri Radix) 10g, Danggui (Angelicae Sinensis Radix) 10g, Baishao (Paeoniae Radix Alba) 15g, Danpi (Moutan Cortex) 10g, Zhizi (Gardeniae Fructus) 10g, Shengdi (Rehmanniae Radix) 15g, Yuanshen (Scrophulariae Radix) 60g, Bohe (Menthae Haplocalycis Herba) 2g, Chongweizi (Leonuri Fructus) 10g. After 7 doses, all symptoms improved, and vision significantly increased. After 20 more doses, vision returned to normal, and other symptoms greatly improved.
Chronic Pharyngitis (Man Xing Yan Yan)