bubble_chart Concept

Baolun Red refers to the hyperemia of the ocular conjunctiva around the black of the eye, forming a red ring like a belt, hence the name.

This condition was seen in the Yuan Dynasty's Yuanji Qiwei , but it was already recorded in the Song Dynasty's "Zhizhi Fang" as "fire gan (scleritis)."

bubble_chart Pattern Analysis

1. Excessive Liver and Gallbladder Fire︰The white of the eye around the black of the eye appears red like a ring, with contracted pupil (iridocyclitis), tenderness and resistance to pressure, photophobia, tearing, aversion to heat and preference for coolness, varying degrees of vision decline, dizziness, bitter taste in the mouth, dry throat, dysphoria, and irritability. The tongue coating is yellow, the tongue body is red, and the pulse is wiry and rapid. This is mostly caused by liver-gallbladder fire flaming upward to invade the lung. Therefore, the clinical manifestations include ciliary hyperemia of the white of the eye, a red ring-like band, and in severe cases, swelling of the white of the eye. Heat blockage causes blood stagnation between the black and white parts, leading to pain and resistance to pressure. Interior heat is intense, hence the accompanying aversion to heat, preference for coolness, bitter taste in the mouth, dry throat, dysphoria, and irritability. The tongue coating is yellow, the tongue body is red, and the pulse is wiry and rapid. The *Zhizhi Fang* states: "Fire gan (scleritis), stabbing pain with floating swelling, is due to liver heat." Treatment should focus on dispersing wind and clearing heat, assisted by dissipating stasis, using Dong Yuan's Jiuku Tang.
2. Spleen-Stomach Excess Heat︰Black of the eye with ciliary hyperemia, to be decocted later, yellow pus surging upward. Pain, tearing, photophobia, aversion to heat, preference for coolness, tenderness, dry mouth with desire to drink, dry stool. Yellow and greasy tongue coating, slippery and rapid pulse. Often caused by excessive consumption of spicy and fried foods, leading to accumulated heat in the spleen and stomach rushing upward. Thus, clinically manifested as hyperemia between the black and white of the eye, aversion to heat, preference for coolness, pain, and tenderness. Pathogenic heat scorches the iris, aqueous humor, and vitreous humor, with pus spreading upward from the lower edge of the black of the eye, even covering the pupil. Accompanied by symptoms such as dry mouth with desire to drink and dry stool. Treatment should focus on draining heat and moistening dryness, using the Decoction for Clearing Heat from the Spleen and Stomach.
3. Qi Deficiency Wind Predominance︰There is a faint redness around the black of the eye, with slight photophobia and mild pain. The condition has persisted for a long time, fluctuating in severity. The eyelashes lack strength and often droop or close. The tongue coating is white, the tongue body is pale, and the pulse is weak and thin. This is often caused by physical exhaustion, the seven emotions (especially worry and overthinking), excessive sexual activity, or the depletion of original qi. Alternatively, it may result from overuse of cold medicine for eye diseases, which suppresses yang qi, combined with exposure to wind pathogens. Therefore, the clinical presentation includes faint redness around the black of the eye, which differs from the intense red ring seen in cases of excess heat. The eyeball feels sore and slightly painful, unlike the severe tenderness and aversion to touch seen in excess heat. Due to qi deficiency, clear yang fails to rise, leading to weak eyelashes and drooping eyelids. Treatment should focus on tonifying qi, supporting the body's vital energy, dispelling wind, and uplifting yang. The recommended formula is the Yang-Supporting and Blood-Harmonizing Decoction. If wind transforms into heat, it can be combined with Coptis RhizomeGoats Liver Pill.

The condition of "embracing the wheel red" can be divided into deficiency and excess types. The excess type is mostly caused by heat, characterized by ciliary hyperemia, and in severe cases, the entire white of the eye turns red, with symptoms such as photophobia, unbearable pain, a preference for cold and aversion to pressure, and heat tearing. If it is due to excessive liver and gallbladder fire, symptoms such as a bitter taste in the mouth, dry throat, dysphoria, irritability, dizziness, and blurred vision will be present. If it is caused by spleen and stomach excess heat, it is often accompanied by dry mouth and thirst, dry stool, and upward rushing of yellow fluid (hypopyon). The deficiency pattern is often due to inherent qi deficiency combined with wind evil, resulting in a faint red color around the wheel, slight soreness and pain in the eyeball, without signs of excess heat, and a fine and weak pulse. These should be differentiated accordingly.

bubble_chart Documentation

1. Yuanji Qiwei: "The disease of heart fire attacking metal and water deficiency counteracting it: ... There is a slight bluish color in the white of the eye, a slight whitish tint in the black of the eye, and a red ring like a belt between the white and black, which is called 'encircling redness'. This is the pathogenic fire attacking metal. It is a disease where water deficiency counteracts it. This disease may be caused by long-standing eye problems, depression, or excessive consumption of cold and cooling medicines mistakenly taken for eye diseases. It may also be caused by excessive sexual activity during eye diseases. All of these can damage the original qi internally. Once the original qi is deficient, the exuberance of heart fire causes fire to overcome metal. Metal corresponds to the hand Taiyin lung, and the white of the eye belongs to the lung. Water corresponds to the foot Shaoyin kidney, and the black essence belongs to the kidney. Water naturally overcomes fire, but when water is deficient, it cannot overcome fire and is instead controlled by fire, leading to blurred vision, as if in a fog. Or the eyeball may be uneven, its color lifeless, and lacking luster, with metal gan (phlyctenular conjunctivitis) appearing red. ... Calming the heart fire, nourishing the kidney water, and enriching the original qi will naturally lead to recovery."