实热生疮症。疮生各有经。泪如汤样注。涩急且羞明。睥或弦多溃。胞中椒粟成。疮生于 上。心火炽盈盈。
睑外脾家燥。唇边亦土形。肺脑形于鼻。周身旺六经。耳热尤肾燥。满面六阳蒸。三焦炎项上。下部六阴乘。
失治应须变。援睛目欠明。
此症谓目病生疮之故。轻重不等。痛痒不同。重则有堆高浓。紫血脓烂而腥臭者。乃气血不和。火实
之邪。血分之热尤重。如瘀滞之症。膏混水浊。每每流于睥 成疮。瘀血散而疮自除。勤劳湿热之人。每
患睥 成疮。别无痛肿症者。亦轻而无妨。若火盛疮生。惟重滞肿痛者。又当急治。恐浊气沿于目内。而
病及于珠。若先目病后生疮。必是热沿他症。凡见疮生。当验部分。以别内因何源而来。因其轻重而治之。宜服∶
加减四物汤
生地黄 苦参 苏薄荷 川芎 黍粘子 连翘 天花粉
防风 赤芍药 当归 荆芥穗（各等分）
上锉剂。白水二钟。煎至八分。食后服。
芎归汤
川芎 当归 赤芍药 防风 羌活（各等分）
上锉剂。白水二钟。煎至八分。去滓频洗。则血活风亦去矣。
搽药方（治眼皮外满睑生疮。溃烂疼痛。）
血竭 乳香 没药 轻粉 陀僧（各等分）
上研为细末。厌之疮处。
又方（治眼胞上下或睑生疮。破流黄水荫开者。）
青黛（一钱二分） 黄柏末 潮脑 轻粉（各一钱） 松香（一钱半）
上为细末。用旧青布。卷药在内。麻油湿透。烧灰。俟油灰滴于茶钟内蘸搽。
实热生疮证。疮疡生成各有其所属的经络。泪水如热水般流淌，眼睑涩滞急迫且畏光。眼睑或弦部多溃烂，胞睑中形成如椒粟般的颗粒。疮生于目上（黑睛），是心火炽盛的表现。
眼睑外部属脾家燥热，唇边也对应土形（脾）。肺与脑的病变反映于鼻部，周身六经火热旺盛。耳部发热尤为肾燥所致，满面红赤为六阳经热气蒸腾。三焦之火炎于颈部，下部则为六阴经受邪。
若失治则病情必然变化，导致眼睛视力不明。
此症指眼病生疮的原因，轻重不等，痛痒不同。重的则有疮堆高、流浓、紫血脓烂且腥臭，这是气血不和、火实之邪，血分之热尤重，如同瘀滞之症，膏液混浊如水，常常流注于眼睑成疮。瘀血消散而疮自除。勤劳湿热之人，常患眼睑成疮，别无痛肿症状者，亦轻而无妨。若火盛疮生，唯有红肿疼痛严重者，又当急治，恐浊气沿入目内，而病及于黑珠（角膜）。若先有眼病后生疮，必是热邪沿他症而来。凡见疮生，应当查验部位，以辨别内因从何源而来。因其轻重而治疗。宜服用：
加减四物汤
生地黄、苦参、苏薄荷、川芎、黍粘子（牛蒡子）、连翘、天花粉、防风、赤芍药、当归、荆芥穗（各等分）
以上锉剂，用白水两钟，煎至八分，食后服。
芎归汤
川芎、当归、赤芍药、防风、羌活（各等分）
以上锉剂，用白水两钟，煎至八分，去渣滓频频清洗，则血活风亦去矣。
搽药方（治眼皮外满睑生疮，溃烂疼痛。）
血竭、乳香、没药、轻粉、陀僧（各等分）
以上研为细末，掺于疮处。
又方（治眼胞上下或睑生疮，破流黄水荫开者。）
青黛（一钱二分）、黄柏末、潮脑（冰片）、轻粉（各一钱）、松香（一钱半）
以上为细末，用旧青布，卷药在内，麻油湿透，烧灰。俟油灰滴于茶钟内蘸搽。
**Syndrome of Ulcers Caused by Excess Heat.** Ulcers arise in specific meridians. Tears flow like boiling water; the eyes feel gritty, urgent, and photophobic. The eyelids or canthi may become stringy and ulcerated, with pepper-like granules forming within the palpebral conjunctiva. Ulcers occurring on the upper part of the eye (cornea) indicate blazing Heart Fire. Dryness in the external eyelids belongs to Spleen heat; the lips also correspond to the Earth element (Spleen). Lung and brain pathologies manifest at the nose; excessive heat in the six meridians affects the whole body. Heat in the ears indicates Kidney dryness; a flushed face reflects steaming of the six Yang meridians. Sanjiao (Triple Burner) inflammation rises to the neck, while the lower part is affected by the six Yin meridians.
If untreated, complications will arise, leading to impaired vision.
This syndrome refers to the etiology of ocular ulcers, varying in severity and presenting with different degrees of pain and itching. Severe cases feature raised ulcers, purulent discharge, purple blood, putrefaction, and foul odor. This results from disharmony of Qi and Blood, with excess Fire pathogens causing severe heat in the Blood level, similar to stasis syndromes. Turbid fluid mixes with clear water, often flowing into the eyelids to form ulcers. Once blood stasis dissipates, the ulcers heal spontaneously. Individuals engaged in labor under damp-heat conditions often suffer from eyelid ulcers without other painful swelling symptoms; these are mild and harmless. However, if fire is excessive and ulcers present with significant redness, swelling, and pain, urgent treatment is required to prevent turbid pathogens from entering the eye interior and damaging the cornea (Pearl). If an ulcer appears after an existing eye disease, it implies that heat has followed another pathology. Upon observing an ulcer, one must examine its location to determine the internal origin. Treatment should be tailored to the severity. Recommended formula:
**Modified Siwu Decoction (Four Substance Decoction)**
* *Rehmanniae Radix Preparata* (Sheng Di Huang)
* *Sophorae Flavescentis Radix* (Ku Shen)
* *Menthae Haplocalycis Herba* (Su Bo He)
* *Chuanxiong Rhizoma* (Chuan Xiong)
* *Arctii Fructus* (Shu Nian Zi / Niu Bang Zi)
* *Forsythiae Fructum* (Lian Qiao)
* *Trichosanthis Radix* (Tian Hua Fen)
* *Saposhnikoviae Radix* (Fang Feng)
* *Paeoniae Radix Rubra* (Chi Shao Yao)
* *Angelicae Sinensis Radix* (Dang Gui)
* *Schizonepetae Spica* (Jing Jie Sui)
(All ingredients in equal proportions.)
Decoct the crude drugs in two cups of plain water until reduced to 80%. Take after meals.
**Xiongui Decoction**
* *Chuanxiong Rhizoma* (Chuan Xiong)
* *Angelicae Sinensis Radix* (Dang Gui)
* *Paeoniae Radix Rubra* (Chi Shao Yao)
* *Saposhnikoviae Radix* (Fang Feng)
* *Notopterygii Rhizoma et Radix* (Qiang Huo)
(All ingredients in equal proportions.)
Decoct the crude drugs in two cups of plain water until reduced to 80%. Strain and wash the eyes frequently with the decoction to activate blood circulation and dispel wind.
**External Application Formula** (For ulcers covering the entire outer eyelid, with ulceration and pain.)
* *Draco Sanguis* (Xue Jie)
* *Boswelliae Resina* (Ru Xiang)
* *Myrrha Resina* (Mo Yao)
* *Calomelas* (Qing Fen)
* *Cupri Carbonas* (Tuo Seng)
(All ingredients in equal proportions.)
Grind into a fine powder and apply directly to the ulcerated area.
**Another Formula** (For ulcers on the upper or lower eyelids, breaking and oozing yellow fluid.)
* *Atriplae Semen* (Qing Dai) - 1.2 qian
* *Phellodendri Cortex* (Huang Bai Mo)
* *Borneolum Syntheticum* (Chao Nao / Bing Pian)
* *Calomelas* (Qing Fen)
(Each 1 qian)
* *Pini Rosin* (Song Xiang) - 1.5 qian
Grind into a fine powder. Wrap the medicine in old blue cloth, soak thoroughly in sesame oil, and burn to ash. Allow the oily ash to drip into a teacup and dip/applicate as needed.