1. What is the cause of the upward flow of yellow pus and how should it be treated?

2. What are the treatment principles for this disease?

1. Upward rushing of yellow fluid refers to the accumulation of yellow pus between the cornea and the iris. This is often due to pathogenic toxic heat and fire burning, which damage the iris. Fluids become scorched, which subsequently transforms the fluid into pus that accumulates internally. Excess heat in the fu organs is a common clinical co-pattern; because the pus flows upward, the yangming channel is often affected. The treatment principle should focus on clearing and descending yangming toxic heat.

The iris belongs to liver, and the liver and gallbladder have an interior-exterior relationship. In cases such as these, it is common to see the pattern of intense liver and gallbladder fire. The treatment principle therefore, should also focus on clearing the liver and sedating fire. Pus often results from the liquidation of excessive heat and the erosion of bloody flesh. It is stated in the Life-Saving Manual of Diagnosis and Treatmentof External Diseases ( Wài Kē Zhèng Zhì Quán Shēng Jí, 外科证治全生集) that “Pus is transformed from qi and blood, which is caused by internal heat.” Hence, the main treatment principle for upward-rushing yellow pus is always to clear heat and sedate fire.

2. In the early and mid stages, the main therapeutic principles are first to treat the excessive patterns and eliminate the pathogens. In the early stage, focus the treatment on eliminating wind and clearing heat. In the mid stage, focus on clearing the liver and sedating fire, or sedating fire and resolving toxins. In the late stage, a combined manifestation of deficient and excessive patterns often occurs. Treatment should concurrently focus on tonifying deficiency, sedating excess, supporting the upright qi, eliminating pathogens, abating the nebula and brightening the eyes. Since this disease is often caused by pathogenic toxic fire heat, which damages the qi and yin. Based on the severity of qi or yin damage, treatment should focus on benefiting qi, nourishing yin or tonifying both qi and yin.