The following cases present variations of this condition. After familiarizing yourself with the possible common pattern presentations and appropriate formulas for treatment, use the following exercises to test your overall understanding of the condition.

1. A male patient, age 14, had recurrent and intense itching eyes with very sticky, stringy secretions for four years. His inner eyelid was covered with granular particles that formed a rough, textured area. He had dirty-red conjunctiva and there were jellylike prominence at the limbus. He had a red tongue with yellow, greasy coat, and a soggy, rapid pulse.

What is the preferred formula for this disease?

A. Xiāo Fēng Săn (Wind-Dispersing Powder)

B . Yín Qiào Săn (Lonicera and Forsythia Powder)

C. Chú Shī Tāng (Dampness-Eliminating Decoction)

D. Modifed Sì Wù Tāng (Four Substances Decoction)

E. Lóng Dăn Xiè Gān Tāng (Gentian Liver-Draining Decoction)

2. A male patient, age 8, had itching and burning eyes with very sticky, stringy secretions and dirty-red conjunctiva. His inner eyelid was covered with granular particles that formed a rough, textured area. He had a red tongue with a thin yellow coat, and a foating, rapid pulse.

What is the appropriate formula for this presentation?

A. Jīng Fáng Bài Dú Săn (Schizonepeta and Saposhnikovia Toxin-Resolving Powder)

B. Xiāo Fēng Săn (Wind-Dispersing Powder)

C. Sāng Jú Yĭn (Mulberry Leaf and Chrysanthemum Beverage)

D. Chú Shī Tāng (Dampness-Eliminating Decoction)

E. Modifed Sì Wù Tāng (Four Substances Decoction)

3. A female patient, age 16, had seasonally recurrent dry, itching eyes for six years. Her conjunctiva was dirty red. She had a sallow complexion and a thin body. She had a light red tongue with thin white coat and a wiry, weak pulse.

What is the appropriate formula for this presentation?

A. Xiāo Fēng Săn (Wind-Dispersing Powder)

B. Chú Shī Tāng (Dampness-Eliminating Decoction)

C. Modifed Sì Jūn Zĭ Tāng (Four Gentlemen Decoction)

D. Modifed Sì Wù Tāng (Four Substances Decoction)

E. Yăng Yīn Qīng Fèi Tāng (Yin-Nourishing and Lung-Clearing Decoction)

1. C

2. B

3. D

Of the three case scenarios, the first case warrants a discussion to explore an unfamiliar formula. As compared to the chief case in this chapter, where the patient had simultaneous signs of qi and blood defciency, this case history depicts a much more straightforward presentation of damp-heat. Here, the itching, the exudate from the eyes, along with the greasy tongue coating and the soggy pulse clinches the diagnosis.

The formula is modified Chú Shī Tāng (Dampness-Eliminating Decoction) from the Compilation of Ophthalmology ( Yăn Kē Zuăn Yào, 眼科纂要) writen by Qing Dynasty doctor Huang Yan.

Formula: Chú Shī Tāng (Dampness-Eliminating Decoction)

[除湿汤]

The actions of the formula are to clear heat and resolve dampness, dispel wind and arrest itching. It is indicated for the treatment of red ulceration of the palpebral margin, wind red sore and itching eyes. The formula can be used to treat disease such as herpes zoster of the eyelid.

There are several familiar groupings of medicinals within the formula: lián qiào,jīng jiè and fáng fēng form the core wind-dispelling trio. The group is featured in at least a dozen formulas to dispel wind and clear heat, including Jīng Jiè Lián Qiào Tāng (Schizonepeta and Forsythia Decoction).

What is especially interesting is that when this group is also used in concert with huáng lián and huáng qín in several formulas that clear heat, alleviate fre toxin as well as resolve interior-exterior excessive patterns. These include the popular prepared formulas Huáng Lián Shàng Qīng Wán (Coptis Upper-Body-Clearing Pill), Qīng ShàngFáng Fēng Tāng (Upper-Body-Clearing Saposhnikovia Decoction) and Niú HuángShàng Qīng Wán (Bovine Bezoar Upper-Body-Clearing Pill), demonstrating how well this group is coordinates.

Huá shí, chē qián zĭ and mù tōng clear heat and drain dampness. This trio is combined in the formula Bā Zhèng Săn (Eight Corrections Powder) from the Song Dynasty classic Beneficial Formulas from the Taiping Imperial Pharmacy ( Tài Píng Huì MínHé Jì Jú Fāng, 太平惠民和剂局方). Chén pí, fú líng and gān căo strengthen the spleen regulate the qi and harmonize the formula. Moreover, this group forms the core of the phlegm-damp formula Èr Chén Tāng (Two Matured Substances Decoction), also from the Tài Píng Huì Mín Hé Jì Jú Fāng.