Foxtail millet refers to the small granules that occur inside the eyelid. Due to their red color and hardness, resembling Pricklyash Peel, they are called prickly-ash-like sore (trachoma); if they are yellow and soft, resembling foxtail millet, they are called millet sore (conjunctival folliculitis). It is also known as "pepper sore" or "foxtail millet sore." This condition Yinhai Jingwei refers to as "eyelid wind foxtail millet." Zhengzhi Zhunsheng categorizes it into "prickly-ash-like sore (trachoma)" and "millet sore (conjunctival folliculitis)." Although there are certain distinctions in their forms, the disease causes are generally attributed to the combination of internal and external wind-dampness heat pathogens, leading to stagnation in the eyelid's meridians and disharmony of qi and blood, hence they are discussed together.

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1. Spleen Channel Wind-Heat︰In the initial stage [first stage], only mild eye discomfort and slight itching are felt, with symptoms such as bladder colic and pregnant dysuria. The eyelids may show a few small, red, and hard granules resembling Pricklyash Peel. As the condition progresses, the granules inside the eyelids increase, and the tendency of the disease worsens, leading to symptoms such as grittiness, photophobia, eye discharge, tearing, swollen and hardened eyelids, and clustered granules forming uneven patches. These granules may subtly rub against the eyeball, causing drooping pannus (trachomatous pannus), wind orbiculus, star-like nebula membrane, and other complications, gradually affecting vision. This condition arises from the invasion of wind heat toxin into the eyelids, with spleen and stomach heat attacking the eyes. The interaction of wind and heat obstructs the collaterals, leading to qi and blood stasis, resulting in the protrusion of small granules. Wind dominance causes itching, while heat excess causes redness. Severe qi and blood stasis may lead to swollen and hardened eyelids, with layers of granules forming clusters. The friction of Pricklyash Peel-like granules against the qi orbiculus and wind orbiculus causes symptoms such as grittiness and tearing. The key diagnostic feature is the presence of red, hard granules inside the eyelids resembling Pricklyash Peel. Treatment involves clearing the spleen and dispersing wind, with the Qingpi Cooling Blood Decoction recommended. For severe blood stasis, the approach is to cool blood and resolve stasis, using the Guishao Carthamus Powder.
2. Spleen Meridian Dampness-Heat︰In the early stages, there are often no obvious subjective symptoms, or only mild itching and discomfort. Upon turning the eyelid, granules can be seen growing inside, round in shape, yellow in color, and soft in texture, either sparse or dense, especially at the junction of the inner eyelid and the wind orbiculus, often first appearing on the lower eyelid. The patient's complexion is shallow yellow, the pulse is soggy and slow, and the tongue coating is thin and sticky with blackened swallowwort root. In severe cases, there is gritty discomfort, itching, pain, photophobia, and tearing, or even swelling of the eyelid, red eyes, and dense granules inside the eyelid that rub against the eyeball. This may complicate with trichiasis, nebula, and other conditions that affect vision, with a slippery and rapid pulse and a yellow, sticky tongue coating. Spleen deficiency with excessive dampness, accumulated heat in the stomach, and dampness-heat stagnating in the spleen and stomach can ascend to attack the eyelid, causing qi and blood obstruction. The combination of dampness-heat with blood and qi leads to the formation of granules inside the eyelid. If the condition persists without healing and the dampness-heat does not disperse, the granules increase, accompanied by eyelid swelling, a slippery and rapid pulse, and a yellow, sticky tongue coating. The key diagnostic feature is the presence of granules inside the eyelid, yellow in color, soft in texture, and round in shape, resembling foxtail millet. For mild cases, treatment focuses on strengthening the spleen and eliminating dampness, using the prescription White Atractylodes Rhizome Decoction. For severe cases, the treatment involves clearing heat and dispelling dampness, combined with dispersing, using the prescription Wind-Dispelling Spleen-Clearing Decoction.

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1. Yinhai Jingwei．"Foxtail Millet on the Eyelid": "Foxtail millet on the eyelid refers to the accumulation of blood in the eyelid over a long period, leading to the growth of foxtail millet, similar to canthus disease. Eye discharge is sticky without foxtail millet, hence it is considered a separate condition. The upper eyelid is called 'bao', and the lower eyelid is called 'jian'. This condition is caused by excessive heat in the spleen and stomach, leading to the gradual growth of foxtail millet-like grains between the eyelids, which can even resemble the bark of the Chinese wax myrtle. These grains rub against the pupil, causing nebula in the black of the eye. Treatment involves turning the foxtail millet and using a sharp needle to densely prick it three to five times, and cauterization is even more effective. For eyes with nebula, use the Yin San Yang Wu medicine to blow and apply, once every two or three nights, and avoid foods that stir wind and blood."
2. Shenshi Yaohan．"Prickly-ash-like Sore (Trachoma)": "This condition occurs inside the spleen, appearing red and hard, causing difficulty in opening the eyes, excessive tearing, and pain. Many mistake it for millet sore (conjunctival folliculitis). However, millet sore also occurs in the spleen but is yellow, soft, and easily dispersible, whereas this condition is hard and difficult to disperse. Common folk treatments involve using dragon whiskers and lamp wicks to draw blood for effect, but they fail to realize that the eyes rely on blood for nourishment, and blood loss can lead to a decline in brightness. Mild cases should be treated gently. For severe cases with continuous patches, uneven bumps, and blood stasis, it is necessary to guide the treatment, stopping once the condition is controlled, and avoiding excess."