bubble_chart Concept

Upward rushing of yellow fluid (hypopyon) refers to the symptom where yellow pus forms and accumulates between the black of the eye and the iris, gradually rising to cover the pupil.

This condition is referred to as "upward rushing of yellow fluid (hypopyon) external ophthalmopathy" in Michuan Yanke Longmu Lun. The Qing dynasty text Mujing Dacheng states: "In reality, it is not a membrane but a fluid," hence it was renamed "upward rushing of yellow fluid (hypopyon)." The "Ophthalmology Simplified Secret Manuscript" directly calls it "upward rushing of yellow pus (hypopyon)."

Another condition, "surging wave nebula," originates from the lower edge outside the black of the eye and grows upward, which should be distinguished from "upward rushing of yellow fluid (hypopyon)" that rises from within the black of the eye and is more acute and severe. As stated in Zhengzhi Zhunsheng, Chapter on the Seven Orifices: "The obstruction grows from the outer rim of the eye, rising from below, hence it is called a surging wave. It is not comparable to the acute upward rushing of yellow fluid (hypopyon) that arises from within."

bubble_chart Common Symptoms and Signs

1. Spleen-stomach excess heat upward rushing of yellow fluid (hypopyon): Sudden onset, severe pain, photophobia, inability to open the eyes, tears like hot water, but no eye discharge. The white of the eye is mixed with red or purple-red, and pus gradually forms below the black of the eye and iris, rising to form a fluid level, resembling the white crescent at the base of a fingernail, and may even cover the pupil. Accompanied by bitter taste, dry throat, chest tightness, poor appetite, scanty dark urine, dry stools, red tongue with yellow, greasy, and dry coating, and a slippery, rapid pulse.
2. Deficiency-cold of spleen and stomach upward rushing of yellow fluid (hypopyon): Slow onset, mild or no pain, no photophobia, no eye discharge or tears, only a faint red ring around the black of the eye. A small amount of pale yellow pus forms below the iris, forming a horizontal level. Accompanied by dull complexion, vomiting, diarrhea, abdominal distension, poor appetite, pale tongue with white coating, and a deep, thin, or slow pulse.

1. Spleen-stomach excess heat upward rushing of yellow fluid (hypopyon): Often caused by improper diet, excessive consumption of spicy, fried, or rich foods, leading to heat accumulation in the spleen and stomach. Pathogenic heat attacks the eyes, causing pus to form internally. The onset is usually sudden, with symptoms such as pain, photophobia, and yellow pus rising to cover the pupil. Spleen-stomach heat dries up body fluids, leading to bitter taste and dry throat. Internal heat stagnation disrupts qi movement, causing chest tightness, poor appetite, dark urine, constipation, yellow, greasy, and dry tongue coating, and a slippery, rapid pulse. Treatment should focus on clearing excess heat from the Yangming to preserve body fluids. The Decoction for Clearing Heat from Spleen and Stomach is recommended, with raw gypsum and raw rhubarb replacing the processed forms. Add Mirabilite for severe heat. If accompanied by liver-gallbladder fire excess, treat by clearing and purging liver-gallbladder fire, using the Modified Four-Ingredient Cooling Decoction.
2. Deficiency-cold of spleen and stomach upward rushing of yellow fluid (hypopyon): Often caused by improper diet, excessive consumption of cold and raw foods, damaging the spleen and stomach. Cold-dampness obstructs internally, cold congeals in the middle energizer, and spleen yang is weakened, leading to poor transportation and transformation. This results in insufficient nourishment to the eyeball, causing cold to congeal in the meridians and produce yellow pus. The onset is usually slow, with mild or no pain, no photophobia, and a small amount of pale yellow pus. Cold obstructs the middle, causing stomach qi to ascend counterflow, leading to vomiting. Spleen-stomach weakness results in poor digestion, abdominal distension, poor appetite, diarrhea, pale tongue with white coating, and a deep, thin, or slow pulse. Treatment should focus on warming the middle and dissipating cold, tonifying the spleen and stomach, using Middle-Regulating Decoction with added Cyperus and Dried Tangerine Peel.
3. Spleen and stomach excess heat upward rushing of yellow fluid (hypopyon) and deficiency-cold of spleen and stomach upward rushing of yellow fluid (hypopyon): Both are pathological changes of the spleen and stomach. However, one is due to excess heat, so the onset is sudden, with pain and photophobia, and the yellow fluid is thick and viscous, the tendency of the disease is severe, the treatment is deficient, and there is a risk of damage to the eye and sinking of the eyeball. The other is due to deficiency-cold, so the onset is slow, the pain is mild and without photophobia, and the yellow fluid is clear and thin, the tendency of the disease is relatively mild, but it often lingers and does not heal.

1. Michuan Yanke Longmu Lun．Eye upward rushing of yellow fluid (hypopyon) external ophthalmopathy》："At the initial onset of this eye condition, there is intermittent pain. During episodes, there is redness, astringency, and tearing, gradually leading to the formation of a yellow membrane. This membrane directly covers the black of the eye, making it difficult to distinguish objects. It is all due to wind-cold in the kidneys and extreme heat in the gastrointestinal system."