bubble_chart Concept

The term "red bean on the wheel" refers to granular protrusions on the surface of the white of the eye or the black of the eye, which can be moved when pushed, and are surrounded or clustered by red veins, resembling red beans in color, hence the name. It often occurs in children with a weak constitution.

Zhengzhi Zhunsheng．The "Seven Orifices" chapter calls it "wind-orbiculus red bean (fascicular keratitis) syndrome." Modern medical texts also refer to it as "wind-orbiculus red bean (fascicular keratitis)." Another condition, "fire gan (scleritis)," also occurs in the white of the eye but is located in the deeper layer and cannot be moved when pushed, allowing for differentiation. As Zhengzhi Zhunsheng．The "Seven Orifices" chapter states: "If there are red granules on the white of the eye with swelling, urgency, and astringent pain, and the pain extends inward with deep roots connecting to the inner layer, it is fire gan (scleritis)."

bubble_chart Pattern Analysis

1. Lung Meridian Dryness-Heat︰There are grayish-red raised granules on the surface of the white of the eye, which can be moved when pushed, surrounded by red blood vessels. The small granules may resolve or ulcerate on their own. Accompanied by grade I photophobia or eye discharge. The tongue is red with little moisture, and the pulse is rapid. This is mostly caused by dryness-heat from the lung channel scorching the tissues. The white of the eye belongs to the lung, and when heat-dryness affects the upper regions, grayish-red granules appear on the outer layer of the white of the eye, resembling red beans. These granules can move with the white membrane when pushed and are painless when pressed, surrounded by red blood vessels, with grade I eye discharge. Treatment should focus on clearing lung heat and cooling blood to resolve stasis. The recommended formula is Mulberry Root Bark Decoction, supplemented with Moutan Bark, Red Peony Root, and Unprocessed Rehmannia Root.
2. Liver Depression and Lung Heat︰At the junction of the black and white of the eye, there is a pale red foxtail millet-like protrusion, surrounded by red vessels, accompanied by photophobia, tearing, burning pain, and discomfort. The tongue is red with slightly yellow coating, and the pulse is wiry and rapid. This condition is often caused by lung and liver disorders, with stagnant heat rising upward. The black of the eye belongs to the liver, hence the protrusions at the junction of the black and white parts resemble red beans. Red vessels encircle from the white of the eye side, with redness predominantly on the qi orbiculus side. Treatment should focus on clearing the liver and purging the lung, using Mulberry Root Bark Decoction with additions such as feather cockscomb seed, Prunella, and feather cockscomb seed.
3. Excess Fire of the Liver Channel︰The margin of the black of the eye becomes raised with granular protrusions, which, after ulceration, gradually spread toward the center of the black of the eye in a creeping manner, accompanied by bundled red vessels trailing behind, resembling a comet or entwined like red beans. There is severe photophobia, and the affected child often covers their eyes with their hands or seeks to hide in dark places, closing doors and windows. Pain and tearing are pronounced. The tongue is red, and the pulse is wiry and rapid. $Liver channel fire flaming with red beans on the wheel and yin deficiency fire flaming with red beans on the wheel! Both are caused by the steaming of "fire" pathogens, hence the shared feature of granular protrusions at the margin of the black of the eye, which ulcerate and then invade toward the center, accompanied by bundled red vessels trailing behind. As stated in Zhengzhi Zhunsheng·Seven Orifices: "When qi orbiculus has red vessels pouring into it, they directly descend to the wind orbiculus, where granular accumulations rise, red in color, initially resembling rice beans and later growing larger." However, the two differ in deficiency and excess. For liver channel excess fire, the pain is unbearable, photophobia is severe, and tearing is as hot as boiling water. The tongue is red, and the pulse is full and rapid. Treatment should focus on clearing and purging the liver and gallbladder, using Gentian Liver-Draining Decoction with additions such as Peach Kernel, Carthamus, Shiny Bugleweed, and Moutan Bark. For yin deficiency fire flaming, the condition persists for a long time or recurs repeatedly, with faintly visible red vessels, mild photophobia and tearing, slight pain, a red tongue with scant coating, and a thin, rapid pulse. Treatment should focus on nourishing yin and reducing fire, using Anemarrhena and Phellodendron Rehmannia Decoction or Enriching Yin and Clearing the Lung Decoction, removing Mint and adding Motherwort Fruit, Cicada Slough, and Buerger Pipewort Flower.
4. Yin Deficiency︰White of the eye or black of the eye with raised granules, mild pain and photophobia, prolonged unhealing or recurrent episodes, faintly visible red vessels, dry mouth and throat, red tongue with scant coating, and thin rapid pulse. $Liver channel fire flaming with red bean on the orbiculus and yin deficiency fire flaming with red bean on the orbiculus! Both are caused by the steaming of "fire" pathogen, hence the common features include raised granules at the margin of the black of the eye, which erode and spread toward the center after ulceration, accompanied by bundle-like red vessels following the progression. As stated in Zhengzhi Zhunsheng·Seven Orifices: "When qi orbiculus is infused with red vessels that descend directly to the wind orbiculus, granules accumulate on the wind orbiculus, appearing red, initially like rice beans and gradually enlarging." However, the two differ in deficiency and excess. For liver channel excess fire, there is unbearable pain, severe photophobia, hot tearing like boiling water, red tongue, and full rapid pulse. Treatment should focus on clearing and purging the liver and gallbladder, using Gentian Liver-Draining Decoction with additions such as Peach Kernel, Carthamus, Shiny Bugleweed, and Moutan Cortex. For yin deficiency fire flaming, the condition is prolonged or recurrent, with faintly visible red vessels, mild photophobia and tearing, slight pain, red tongue with scant coating, and thin rapid pulse. Treatment should focus on nourishing yin and reducing fire, using Anemarrhena and Phellodendron Rehmannia Decoction or Enriching Yin and Clearing the Lung Decoction, removing Mentha and adding Motherwort Fruit, cicada slough, and Buerger Pipewort Flower.
5. Qi Deficiencyliver Heat︰A raised granular protrusion on the white or black of the eye, recurring and healing intermittently, photophobia, aversion to heat, lack of vitality, fatigue, dysphoria, and restlessness. The tongue appears pale red, and the pulse is soggy and rapid. Heat stagnation in the liver leads to dysphoria and restlessness, as well as disturbed sleep at night. The treatment should focus on tonifying qi and harmonizing the middle, clearing the liver and draining fire. The prescription uses Extraordinary Efficacy Powder, supplemented with Peony Root, Prunella, Neopicrorhiza, and feather cockscomb seed.
6. Spleen Deficiency with Phlegm︰Granules on the white or black of the eye, recurring episodes, pale complexion, numerous subcutaneous nodules on the neck, tongue with moist white coating, soggy and slippery pulse. Dampness accumulates into phlegm, congealing and obstructing the collaterals, leading to subcutaneous nodules on the neck and under the jaw. Treatment should focus on invigorating the spleen and resolving phlegm, moving qi and harmonizing the nutrient system. The prescription used is Xiangbei Yangying Decoction.

The condition of "red beans on the wheel" is a common ailment in children, often occurring after measles or Rebing, when both qi and yin are damaged, making them most susceptible. It can occur on the white membrane of the qi orbiculus or on the black of the eye. The excess pattern is often related to stagnant heat in the liver and lung meridians; the deficiency pattern is usually caused by spleen deficiency and weak qi, or prolonged illness leading to damage to yin. If the disease is in the white of the eye, the pathogenic factor is shallow, and the symptoms are mild and slow; if it is in the black of the eye, the pathogenic factor is deep, and the symptoms are severe and intense. Mild cases are easy to treat and may resolve on their own or heal after ulceration without leaving any traces; severe cases have larger granules, redness, astringency, pain, photophobia, tearing, and ulceration like sores, often leaving a nebula membrane after healing.

bubble_chart Documentation

1. Zhangshi Yitong: "Wind-orbiculus red bean (fascicular keratitis) syndrome: There are red vessels infusing the qi orbiculus, and on the wind orbiculus, there are accumulations of red granules due to static blood. It is urgent to open the obstruction, and as the blood gradually flows, the granules will also gradually dissipate. However, by this stage, nine out of ten cases are already damaged. If there are only fresh blood granules on the white part of the eye, it is also due to stasis and stagnation. If there are no connecting vessels above or below, blowing and applying medication will naturally dissipate them. If there are connecting vessels, there must be blood flowing from the vessels. Look towards the source of the flow and, depending on the severity, guide it accordingly."