The internal visual obstruction of the eye, characterized by a circular nebula resembling Mercury in the pupil and decreased vision, is a chronic eye disease. Although similar symptoms and signs were recorded in early medical texts, the name of this syndrome was first documented in Michuan Yanke Longmu Lun.
This syndrome is commonly seen in the elderly, due to the decline of the body with age, deficiency of the liver and kidney, insufficiency of essence and blood, weakness of qi and blood, which cannot nourish the eyes, or due to spleen and stomach deficiency, where the body fluids of the five zang-organs and six fu-organs cannot ascend to the eyes. The treatment mainly focuses on nourishing the liver and kidney, and tonifying the spleen and replenishing qi.
The treatment of this disease with acupuncture and moxibustion was recorded early in ancient Chinese texts, such as Zhenjiu Jiayi Jing. The Tang dynasty's Beiji Qianjin Yaofang and Qianjin Yifang also have records. Later, Michuan Zhen Yanke Longmu Lun introduced several effective acupoints for treating this disease. Especially in the Ming dynasty's Zhenjiu Dacheng‧Volume 9, the disease cause and mechanism were discussed, believing it to be due to "anger damaging the liver, blood not returning to its place, exhaustion of kidney water, dissipation of qi and blood, inability to restrain at the time of illness, indulgence in sexual activities, and excessive mental exertion, hence this syndrome." When proposing acupoint prescriptions, it was also objectively pointed out that "it is difficult to treat."
Modern Western medicine's senile internal visual obstruction is the same as this syndrome.
bubble_chart Pattern Identification(1) Liver-kidney depletion.
The affected eye has unclear vision, as if seeing flies or mosquitoes flying or through light smoke and thin fog, accompanied by dizziness, sore waist, tinnitus, deafness, thin and rapid pulse, red tongue with little moisture.
(2) Spleen-stomach deficiency.
The affected eye has unclear vision, fatigue, poor appetite, poor sleep, loose stools, weak and feeble pulse, pale tongue with thin coating.
bubble_chart Treatment
(1) Liver-kidney depletion.
1. Treatment principle: Tonify the liver and kidney, enrich yin and remove obstruction.
2. Prescription: Ganshu (BL18), Shenshu (BL23), Taixi (KI3), Taichong (LR3), Fengchi (GB20), Tongziliao (GB1), Sizhukong (TE23).
3. Explanation: Ganshu (BL18), Taichong (LR3), Shenshu (BL23), Taixi (KI3) are respectively paired with Beishu and yuan-source points to tonify the liver and kidney and nourish essence and blood; Fengchi (GB20), Tongziliao (GB1) belong to the shaoyang meridian, used together with Sizhukong (TE23) to dredge the meridian qi of the eyes, hence this prescription has the function of tonifying the liver and kidney, removing obstruction and improving vision.
4. Treatment method: Ganshu (BL18), Shenshu (BL23), Taixi (KI3), Taichong (LR3) are all treated with tonifying method, the remaining points with reducing method.
(2) Spleen-stomach weakness.
1. Treatment principle: Tonify the spleen and replenish qi, remove obstruction and improve vision.
2. Prescription: Pishu (BL20), Weishu (BL21), Baihui (GV20), Jingming (BL1), Zusanli (ST36), Guangming (GB37), Hegu (LI4).
3. Explanation: Pishu (BL20), Weishu (BL21) strengthen the spleen and stomach; Baihui (GV20), Zusanli (ST36) tonify qi and raise the clear; Hegu (LI4) dredges the yangming meridian qi; Guangming (GB37), Jingming (BL1) are key points for removing obstruction and improving vision.
4. Treatment method: All points are treated with tonifying method, Jingming (BL1) should be deeply punctured 1.5 cun with a 32-gauge filiform needle, applying small amplitude twirling tonifying method, without lifting and thrusting.bubble_chart Ancient Prescriptions Recorded
Zhenjiu Jiayi Jing‧Volume Twelve: White membrane covering the pupil, unable to see, Jiexi (ST41) governs it.
Beiji Qianjin Yaofang‧Volume 6: White nebula in the eye, Qiangu (SI2) governs it.
Qianjin Yifang‧Volume 27: Skin nebula white membrane covering the pupil,... needle Jingming (BL1), insert one and a half fen, retain for three breaths, drain for five breaths. For cold, first tonify then drain, then tonify again.
Michuan Yanke Longmu Lun‧Volume 8: Juliao (ST3);... white nebula covering the pupil, needle insertion three fen, obtaining qi and then drain, moxibustion is also good, can moxa seven cones.
Tongziliao (GB1):... white membrane nebula in the eye... or moxa three cones, needle insertion three fen.
Shaoze (SI1):... treats skin nebula covering the pupil, can moxa one cone, needle insertion one fen.
Zhenjiu Dacheng‧Volume 9: Internal visual obstruction in the eye: Tongziliao (GB1), Hegu (LI4), Linqi, Jingming (BL1).... Then needle the following points: Guangming (GB37), Tianfu (LU3), Fengchi (GB20).