bubble_chart Concept

Phlegm nodule in the eyelid refers to a hard, nodular mass that forms between the skin and flesh of the eyelid, progressing slowly and prone to recurrence. Since it occurs more frequently on the upper eyelid and less on the lower eyelid, it is also called "phlegm nodule of the spleen."

This condition was first mentioned in Yuanji Qiwei as "a disease where blood and qi are not separated, mixing and thus forming a knot." Zhengzhi Zhunsheng , Shenshi Yaohan , Zhangshi Yitong , and Yizong Jinjian all referred to it as "phlegm nodule of the spleen." The "Yinhai Zhinan" and Mujing Dacheng called it "phlegm nodule." The "Ophthalmology Essence Record" referred to it as "phlegm node in eyelid (chalazion)." Additionally, it has been given various other names such as "tumor in ophthalmology," "eyelid nodule," and "eye wart."

bubble_chart Pattern Analysis

1. Damp Phlegm︰It grows within the eyelid, between the skin and flesh, forming a raised nucleus as small as a grain of rice or a soybean, or even as large as a silkworm bean. It is neither painful nor itchy, with no redness on the surface skin, and the skin and nucleus do not adhere to each other. It moves when pushed and feels relatively hard to the touch. Upon flipping the eyelid, a purplish-red or grayish-red raised area can be seen inside. Larger nodules may cause a sense of swelling, heaviness, and a grade I foreign body sensation, with no obvious systemic symptoms. It is often caused by excessive consumption of spicy, rich, or sweet foods, which impairs the spleen and stomach functions, disrupts transportation and transformation, leading to the accumulation of body fluids that congeal into phlegm. Phlegm-dampness obstructs the meridians and accumulates in the eyelid, gradually forming a nodule. The subcutaneous nodule blocks the meridians, hindering the flow of qi and blood. When qi and blood stasis occur, a purplish-red raised nodule appears inside the eyelid. Yuanji Qiwei said: "Blood serves as nourishment, qi as defense. Nourishment flows within the vessels, defense circulates outside the vessels. Thus, blood and qi aspects do not mix and flow without obstruction... If they mix, obstruction occurs; obstruction leads to congealment, and congealment has nowhere to go, hence it rises hidden beneath the skin, forming wart disease." Treatment involves resolving phlegm and softening hardness, with the prescription of Two Old Ingredients Decoction.
2. Phlegm-fire Stagnation and Binding︰Symptoms include swelling, nodules, pain, and itching of the eyelid, with reddened surface skin. In severe cases, there may be dry mouth and throat, a red tongue, and a rapid pulse. The cause of the disease is the binding of phlegm-dampness, which stagnates and transforms into fire, leading to the mutual contention of phlegm and fire. Additionally, it is caused by the external invasion of wind-toxicity combined with the binding of phlegm-dampness. The key points of pattern identification are pain and itching of the phlegm node in the eyelid (chalazion), with reddened surface skin. Shenshi Yaohan states: "When fire is more severe than phlegm, the color is red-purple, as phlegm stagnates and binds due to fire." It also says: "This is caused by accumulated heat in the Yangming channel, usually due to excessive alcohol consumption and a preference for spicy, roasted, or fried foods." The treatment should focus on clearing away heat to dissipate mass, and the recommended prescription is Stomach-Clearing Decoction.

This condition is caused by phlegm-dampness obstructing the meridians, accumulating in the eyelid, and gradually forming a swelling. Early-stage medication can resolve it, but if it persists for a long time and medication becomes ineffective, surgical treatment may be necessary.

bubble_chart Documentation

1. Yizong Jinjian-Yanke Xinfa Yaojue: "The condition of phlegm nodule in the canthus is formed by the accumulation of phlegm-fire, occurring outside the eyelid and inside the skin, shaped like a bean, hard and painless. It is advisable to use Saposhnikovia Powder decoction to resolve phlegm and disperse the nodule. If left untreated for a long time, it may gradually grow into a goiter, and if it ruptures, it becomes a fistula disease, which is difficult to treat."
2. Zhang Jiechun's Ophthalmology Diagnosis and Treatment-Flesh Orbiculus Disorders: "This disease is also known as eye wart... mostly caused by spleen dampness and stomach heat, with dampness-heat combining to produce phlegm, which obstructs the meridians and accumulates in the eyelid."