Pigmentary Degeneration of Retina

retina
The article is extracted  from English-Chinese Concise, Traditional Chinese Medicine, Publishing House of Shanghai College of T.C.M. (1993)

Identification and Treatment

1)  Decline of the Fire from the Life Gate

Main Manifestations: Night blindness but with normal vision in the day time, slight contraction of visual field, lustreless eyes, pale complexion, aversion to cold and cold limbs. Pale tongue with white coating, deep and thready pulse.

Therapeutic Method: Warm and recuperate the life gate.

Decoction: Prepared rehmannia root 30g, dogwood fruit 12g, (Chinese yam 12g, Chinese angelica root 12g, wolfberry fruit 12g, eucommia bark 12g, antler glue 12g, cinnamon bark 6g, prepared aconite root 6g, and dodder seed 18g.

Patent Medicine: Kidney Yang-Tonifying Pill (You Gui Wan). Take 9g each time, twice a day.

2) Deficiency of Both Liver and Kidney

Main Manifestations: Night blindness, contraction of visual field, diminution of central vision, dryness and discomfort of the eyes, dizziness and tinnitus, insomnia and dreamfulness. Red tongue with scanty coating, thready and rapid pulse.

Therapeutic Method: Nourish the liver and kidney.

Decoction: Dried rehmannia root 18g, prepared rehmannia root 18g, red sage root 18g, dogwood fruit 12g, wolfberry fruit 12g, chrysanthemum flower 12g, Chinese yam 9g, Oriental Water plantain rhizome 9g, poria with hostwood 9g, moutan bark 9g, bupleurum root 9g, Chinese angelica root 9g, and schisandra fruit 9g.

Patent Medicine: Kidney Yin-Tonifying Pill (Zuo Gui Wan). Take 9g each time, twice a day.

Acupuncture and Moxibustion

Main Points: Jingming (Ub 1) and Qiuhou (Ex 7).

Complementary Pints: Taiyang (Ex 2), Hegu (Li 4), Zusanli (St 36) and Sanyinjiao (Sp 6).

Method: Select 1 main point and 1 or 2 complementary points for each treatment. Puncture the points with moderate stimulation and retain the needles for 20 minutes. Give one treatment a day, 10 treatments as a course.

Medicated Diet

  1. Boil fresh tender sweet potato leaf 100g and sheep liver 90g together (do not cook them too long). Take it once a day, 5 – 7 days successively.
  2. Make decoction with 15g of bat’s feces. Remove the dregs from it and cook the smashed pig liver 90 – 120g in the boiling decoction. Drink the decoction and eat the liver. Take a dose a day and 2 or 3 doses successively.
  3. Make decoction with 500g of spinach, 1 piece of sheep liver and 15g of pipewort. Eat the liver and drink the decoction. Take a dose a day, 3 or 4 doses successively.
  4. Decoct 1 piece of chicken liver, 15g mulberry leaf and 15g of silkworm excrement together in water. Take the decoction a dose a day and several doses successively.
  5. Cook 1 piece of fish liver (rid of the gallbladder), 2 eggs and 15g of fermented soya bean together in water for eating.
  6. Have 1 set of grass carp intestines washed clean and cut into short sections. Add 2 eggs and mix them thoroughly with a right amount of water, and then stew them until done for eating.
  7. Decoct 60g of sheep liver, 10g of pipewort and 10g of white chrysanthemum flower in water for eating.
  8. Make cakes or snacks for eating with walnut kernel, chestnut, Chinese yam, dried longan pulp and wolfberry fruit in a right amount respectively.
  9. Decoct 100g of celosia seed in water. Take out the extract every 20 minutes, and then add water to decoct it again. Put together the extract obtained at 3 times. Boil 500g of black Chinese date in the extract until they are thoroughly done. When the remaining extract is thickened, add 500g of honey and mix them thoroughly. Put the mixture in bottle for later use. Take 15g each time, once a day.
  10. Soak rutabaga seed 1000g in spirits for a night and take it out, and then steam it over the boiling water for 20 minutes. Dry it under the sunlight and grind it into fine powder. Make pills as big as soybeans by mixing the powder with honey. Take 6g each time, twice a day.
  11. Have carrot washed clean, cut into slices and steamed. Take as much as one pleases.

Blepharitis Ciliaris

eye
By Shandong Science And Technology Press (1985)

Blepharitis ciliaris is a very common subacute or chronic inflammation of the lid margin. Its pathogenesis is general weakness, infection of bacteria or stimulation by discharge due to chronic conjunctivitis.Symptoms and Signs

It occurs in the following three types:

  1. Ulcerative blepharitis: congestion, swelling and scales at the base of lashes. Ulcers may be presented when scales removed. Lashes may be glued together and easily lost but they are not replaced. Painful sensation, photophobia and lacrimation often associated.
  2. Scaly blepharitis: congestion of lid margin. There are whitish scales in the bases of the lashes, which are easily lost but not replaced.
  3. Canthal blepharitis: the inflammatory reaction usually occurs in the canthal margin of the lid, marked local congestion, ulceration and itching sensation present.

Blepharitis usually caused by diplococci of Morax-Axenfeld.

Treatment

A Points: Ermen and Hegu are the primary points. In the case of upper lid, Yuyao, Zanzhu, Sizhukong are associated. Yingxiang is associated for blepharitis of lower lid. Tongziliao is associated for lateral canthal blepharitis and Jingming for medical canthal blepharitis.

B Procedure: Ermen, perpendicular penetration performed 0.5 ~ 1 inch in deep with scraping the needle. Hegu, penetrated toward the Laogong. For all above points, retain the needle 5 ~ 10 minutes and manipulate once every 5 ~ 10 minutes. All associated points, except Jingming, are stirred up with three-edged needle till bleeding. Those are given once every other day.

Method of puncturing Jingming seen for acute conjunctivitis.

C Case example

Patient Guo, female, 63 years old, a peasant.

Blepharitis of lower lids and right medial canthus for more than 10 years. The severity was various with times and recurred though frequent remedies given.

Patient worked tiredly in recent days and sleep was not enough, symptoms thus became severe. Redness of lid margin, photophobia, lacrimation and increase of discharge. There were many small ulcers on the base of lashes.

The diagnosis was ulcerative blepharitis, and the treatment given was puncturing Ermen and Hegu given once daily, retained the needle 30 minutes, manipulated the needle once every 10 minutes. Stirred up Yingxiang till bleeding, once every other day. Redness of lid margin and discharge fluid diminished after three punctures. Swelling of lids lost after 6 punctures, discharge much reduced but slight congestion of lid margin remained. Symptoms all lost after further 3 remedies given. Patient had attacks twice in following days and cured with same treatments as above. The therapeutic effect was well in after 3 years.

Remarks

Blepharitis is like “Jian Xuan Chi Lan” , “Lan Yan Bian” or “Hong Yan Bian”. It was described in ancient Chinese medical book: “Over fatigue may cause redness and ulceration due to fire. Alcoholism may cause those symptoms to become severe. Too much crying may cause suffering of fire and wind-heat appears”.

Author treated 7 cases of blepharitis with above prescription. The results were 3 cases symptoms lost and no recurrence in after 1 year. 2 cases markedly improved, with partial symptoms lost; 1 case slightly improved; treatment discontinued in 1 case against advice.

Retinopathy

Eye
By Shandong Science And Technology Press (1985)

Retinopathy is common fundus disease in clinic, which is difficult to treat. It includes central retinitis, centro-retino-choroiditis, retinal central vein occlusion, retinal arterial occlusion, retinal hemorrhage and retinal arteriosclerosis.

Symptoms and Signs:

Those diseases occur more in adult males. Patient may suffer from a varying degree of decreasing visual acuity and metamorphopsia.In case of retinal arterial occlusion, the patient may suddenly lose his visual acuity completely or partially. If it is not treated in time, vision may be severely impaired.

Treatment

Remedy 1

A Points: there are two groups of points used:
Group 1. Jingming, Yiming, Yangbai Guangming;
Group 2. Qiuhou, Taiyang, Fengchi, Xingjian.

B Procedure: two groups of points used alternately in courses of treatment. Manipulations for Jingming, same as in acute conjunctivitis, and those for Yiming penetrate perpendicularly 0.5 ~ 1 inch with twirling. In Yangbai needle is directed toward the Yuyao with twirling and scraping the needle. Penetrate Guangming toward the contraside with 1 ~ 1.5 inch deep and twirling the needle.

During puncturing Qiuhou, let patient look forward, the physician takes the needle as holding a writing brush and penetrates along the lower border of the orbit perpendicularly with 1 ~ 1.5 inch.

It should be noticed that if insertion of the needle must be slow after the needle has passed subcutaneous tissue, then lifting and scraping the needle slowly. In puncture of Taiyang, the needle is at a 450 angle and toward the Xiaguan with depth of 1 ~ 1.2 inch and then thrusting, lifting and scraping the needle. The method used for Fengchi is the same as in acute conjunctivitis.

Xiangjian is penetrated perpendicularly 0.3 ~ 0.6 inch and twirling method is used.

Retaining of needles in above points are 15 ~ 30 minutes. Once manipulation is given for every 5 ~ 10 minutes. Remedy is given once every day. Seven treatments are therapeutic course and are given with interval of 2 ~ 3 days between the course.

The treatment described above is indicative for central retinitis.

C Case Examples:

Case 1. Wang, male 34 years old, Jun 13, 1975 O.P.D. patient.

Vision much impaired suddenly for 3 days, headache and vertigo associated. Ophthalmologic examination performed in other hospital the results are: Swelling of macular region of fundus ++, severe cloudiness, no reflex seen in the disc. Visual acuity O.S. 0.3, O.D. 1.5. Diagnosis was central retinitis. Patient was treated with both modern and Chinese traditional medicines but no improvement obtained. Acupuncture therapy thus acquired.
In author’s O.P.D. patient was treated with remedy 1 with retaining of needle 30 minutes. Puncture is given once daily. Patient’s visual acuity markedly improved after 3 times of acupuncture, O.S. increased to 0.6, vertigo and headache much diminished also.

Group 2 points were used in the second therapeutic course with acupuncture once daily. On Jun 29, patient’s vision increased to 1.2, swelling of macula region all lost. Central macula reflex presented but the color discrimination still not quite definite.

Therapeutic effect still presents in after half year.

Case 2. Oct. 10, 1977, O.P.D. patient Liu, male, 37 years age, a worker.

Metamorphosis, micropsie and diminution in acuteness of vision occurred rapidly since recent 8 months. Diagnosis given in other hospitals is central retinitis. Patient was hospitalized for more than 6 months there, various treatments received, but the visual acuity still diminished progressively and had decreased to 0.04 O.U.

Visual acuity just before acupuncture was 0.1. Acupuncture was given as above, two groups of points were adapted alternately for each therapeutic course.

The interval between treatment courses was 3 days. Vision acuity increased to 0.5 after 3 punctures and increased to 0.7 after one course of treatment. Flashing lights sensation diminished, central dark spot in the fundus reduced.

Vision acuity increased to 0.8, metamorphosia lost after second treatment. Vision acuity remained 0.8 in third course of therapy, and the treatment discontinued since then.

Acuteness of vision remained 0.8 in after one year.

Remedy 2

A Points: Jingming, Hegu

B Procedure: At first, puncture left Jingming slowly with depth about 1 inch. Scraping the needle, patient may feel numbness sensation in fundus of eye and lateral canthus during acupuncture. Lacrimation may also present.

The next step is to puncture right Jingming with same method as in left side.

Puncture Hegu and twirl the needle.

Retaining of needles for above point are 15 ~ 30 minutes in duration.

Puncture given once daily with manipulation once every 15 ~ 30 minutes.

This method of treatment is prevalent on central retinal arterial occlusion.

C Case example:

Sept. 20, 1970, O.P.D. patient Yin, female, 28 years of age, a staff.

Vision O.S. lost suddenly 3 days ago. Ophthatmological examination performed in a hospital: Vision acuity O.D. 0.8, light sensation O.S. Dilation of right pupil with dullness to direct light reflex. Macula appears cherry red. Retinal artery became narrow as a thread. Optic disc whitish with indefinite border.

Diagnosis: Central retinal arterial occlusion

Patient was treated as above with retaining needle 30 minutes. Manipulated the needle once every 10 minutes. Remedy was given once every day. Patient’s vision was improved to 0.5 after treatment, and 3 remedies were given totally. Then the patient’s vision acuity increased to 1.0 after the treatments.

Remedy 3

A Points: Fengchi, Luxi, Jiaosun, Dazhui, Ganshu, Shenshu, Jingming, Taiyang, Yangbai, Yuyao, Zanzhu, Gaohuang

B Procedure: for making brain to be clear and eyes to be good in vision and relieving the blood stasis, Fengchi, Luxi, Jiaosun, Dazhui, Ganshu and Shenshu are adapted with manipulation for inducing heat sensation.

In the point of Jingming, insertion of needle should be gentle.

For Taiyang, Yangbai, Yuyao, and Zanzhu, ordinary methods are adapted.

In order to regulate the function of liver and tranquilization, invigorate the kidney to strengthen the body, Gaohuang, Ganshu, Shenshu are adapted for inducing heat sensation but not retaining the needle.

For other symptoms, associated points may be selected (Zheng Yulin: J. Chinese Traditional Med. 1957. 6).

Remedy used for 41 cases by author, the results were 12 cases radically cured; 6 cases markedly improved; 19 cases slightly improved; 4 cases no effect.

Remarks:

Retinopathy belongs to “Nei Zhang” in Chinese traditional medicine, which is very similar to eye diseases such as “Shi Zhan Hun Miao”, “Bao Mang” or “Shi Huo” etc. The pathogenesis is very complicated. Over fatigue, depression of liver-energy, dryness of fire and wind, deficiency of kidney function, congenital deficiency, acquired malnutrition etc. may cause this disease.

It was considered that “Nei Zhang” usually belongs to Xu in nature, the treatment of this disease according to the deficiency of blood and asthenia of kidney and liver is not very reasonable. Points in acupuncture therapy should be selected symptomatically.

The points in local area for treating retinopathy are Jingming, Qiuhou, Yangbai, Taiyang.

Point Qiuhou locates near the ciliary ganglion and ciliary nerve, which supplies the eyes. Puncture of Qiuhou is very effective in treating retinopathy directly.

“Exploration to Formations of Internal Organs” described: “Channels all belong to the eyes”. So, eye diseases are the reaction of pathological change of internal organs. Therefore, in treating eye diseases not only select the local points near the eye, such as Yiming and Fengchi, but also the points away from the eyes, such as Hegu, Guangming, Xingjian. Thus balance of various portions of whole body may be resulted and the cure of fundus diseases may also be successful.

Duration of treating retinopathy is usually long. The manipulation of needle is still under discussion. Author suggested that method of manipulation in acupuncture may be various in different patients. Physician Yang Ji Zhou said: “ The methods of treating disease are various with persons but do not depend upon the number of treatments given. Variations of treating methods depend upon the kind of disease but not the remedy used.”

It has been proved that acupuncture is very effective to fundus diseases, improvement of visual acuity usually obtained by first treatment and get better progressively after each remedy. There was a case, patient Xu suffered from retinochoroiditis with loss of vision for 8 years, improvement was gotten after first acupuncture and even better after 7 times of treatment.

Pathological Changes of Optic Nerve

Eyeball
By Shandong Science And Technology Press (1985)

The common pathological changes of optic nerve are atrophy of optic nerve and optic neuritis, which includes papillitis, and retrobular optic neuritis.Those above diseases may be infected from the foci such as tonsillitis, parasinusitis, caries teeth, virus, or tuberculosis. They may also be spread from retinitis, choroiditis etc.

Atrophy of optic nerve may be either primary or secondary in nature. The primary optic atrophy caused usually by surgical trauma, bony fracture, intracraninal compression, or intoxication due to methyl alcohol, quinine or lead. The secondary optic atrophy is commonly seen in case of papilitis, papilar edema or in the late stage of glaucoma.

Symptoms and Signs:

1 Retrobulbar optic neuritis: impairment of vision, pain of eyeball (may be excited with movements of the eyeball), central scotoma, and contraction of visual field.

2 Papillitis: usually unilateral in nature, vision markedly reduced at the beginning of disease, contraction of visual field, and central scotoma and frequently associated.

3 Optic atrophy: the primary symptoms are diminution of visual acuity, even blind, contraction of visual field and color blindness.

Treatment:

Remedy 1

A Points:  Three groups of points may be adapted.
Group 1: Jingming, Qimai, Yangbai, Yiming, Ganshu, and Gukong.
Group 2: Qiuhou, Taiyang, Fengchi, Shenshu, and Guangming.
Group 3: Chengqi, Geshu, Sizhukong, and Xingjian

B Procedure: Jingming, Yangbai, Yiming, Qiuhou, Taiyang, Fengchi, Guangming, Xingjian same as for acute conjunctivitis and pathological changes of retina.

Qi Mai is penetrated along the skin surface 0.3 ~ 0.6 inch and scrap the needle.

Ganshu and Geshu are penetrated with needle in 300 angle and obliquely downward 0.8 ~ 1.2 inch. Twirl the needle at the same time.

In puncturing Shenshu, needle is inserted in 300 angle with the manipulation of twirling.

For Sizhukong, needle is inserted upward and along the border of orbit with depth of 0.3 ~ 0.5 inch.

Moxibustion performed on Gukong with putting the cone on a piece of ginger (0.1 ~ 0.17 inch in thick). Three to five cones for one therapy will be enough.

To the point Chengqi, penetrate perpendicularly and slowly with depth of 0.5 ~ 1.5 inch and acrape the needle. For preventing intraorbital bleeding due to trauma of blood vessel, twirling and twisting are contra indicated and if it appears, compress the eyeball with cotton sponge 3 ~ 5 minutes.

It is a rule, puncture Shu points in dorsal aspect of the trunk first, and the retaining of needle is usually short. Other points are penetrated afterward with retaining of the needle 30 ~ 60 minutes and manipulate the needle once every 10 ~ 20 minutes.

Treatment is given once daily. Every 5 treatments are a course of therapy. The interval between courses is 1 ~ 2 days.

Following Chinese medicinal herb and pills should be given at the same time:

  • A Herb broth:
  • Rhizoma Rehmanniae Praeparatae
  • Fructus Lycii
  • Radix Polygoni Multiflori
  • Fructus Ligustri Lucidi
  • Radix Salriae Miltiorrhizae
  • Radix Angelicae Sinesis
  • Radix Bupleuri
  • Semen Cassiae
  • Concha Haliotidis
  • Rhizoma Atractylodis Macrocephalae
  • Herba Dendrobii
  • Radix Ledebouriellae

In treating the pathological change of optic nerve with herb, to nourish Yin and to supplement kidney is the primary principal. Other drugs may be used for dispersing the depressed liver-energy and depressive syndrome, eliminating the phlegm and clearing away the wind-heat.

Given by decoction in water for oral dose Q.D.

B Pills: Sheep liver pills (according to prescription given in “Golden Mirror for Original Medicine”

C Case example:

April 27, 1965, O.P.D. patient Zhu, female, 60 years old, a farmer. Diminution of vision occurred for 2 years suggesting hyperopia. Symptom increased in recent 5 months, only light perception still present.

Patient was examined in a hospital and represented that external occurs normal, margin of papillae became blurring and pale, central fovea diminished, narrowing of retinal artery. The diagnosis was optic atrophy.

Physical examination in author’s O.P.D. revealed pale fur, pulse sinking and weak in its proximal portion.

Thirst, pain of back and insomnia are complained.

Patient was treated in author’s O.P.D. with acupuncture and Chinese traditional medicine. Among which, Chinese traditional medicines are used for nourishing Yin and kidney, relaxing the liver and improving the blood circulation.

Sheep liver pills were also given.

Above groups of points adapted alternately for each course of therapy. Patient was treated for 3 months as above.

Seventy herb broth taken totally, after treatments described above, patient’s visual acuity recovered to 0.3 O.S.; 0.2 O.D. Since then, patient can take care of herself and attend to homework.

Remedy 2

(A) Points: There are seven groups of points to be selected.
Group 1: Fengfu, Fengchi, and Taiyang
Group 2: Shangxing, Muchuang, and Yingxiang
Group 3: Binao, Hegu, and Guangming
Group 4: Zhaohai, Hegu, and Zanzhu
Group 5: Yuyao, Sibai, and Shenmai
Group 6: Jingming, Tongziliao, and Head-Linqi
Group 7: Mingmen and Ganshu

(B) Procedure: One group of points adapted alternately by 1 day.

Each therapeutic course consisted of 7 days. Twirl and scrape the needle in case of Ganshu and Mingmen quickly.

In other points besides Ganshu and Mingmen, manipulate the needle once every 5 ~ 10 minutes and retain the needle 15 ~ 30 minutes.

Fengchi is penetrated perpendicularly with slow insertion and 0.3 ~ 0.5 inch deep, scraping the needle gently. In order to avoid injury of medulla, deep penetration is contraindicated.

In point of Muchuang, push the needle forward horizontally 0.3 ~ 0.5 inch and manipulate the needle by twirling and scraping.

Needle penetrating Binao is directed upward 450 angle and 0.8 ~ 1 inch and that puncturing Zhaohai is directed perpendicularly with 0.3 ~ 0.5 inch in deep. The needles penetrating above two points are manipulated with twirling.

Zanzhu is penetrated toward Yuyao and Shenmai is punctured perpendicularly 0.3 ~ 0.5 inch.

Head-Linqi is penetrated forward horizontally with 0.3 ~ 0.5 inch deep.

Manipulate the needle with scraping and twirling for Head-Linqi, Shenmai and Zanzhu.

There were 21 cases of retrabulbar optic neuritis treated with the method mentioned above in Congqing hospital of TCM, among them, 7 cases were cured.

Remarks:

Pathological changes of optic nerve belong to the class of “Qing Bao” and “Shi Zhan Hun Miao” in Chinese traditional medicine. In the ancient medical book “Comprehensive collection on Medicine” considered: “Patients lose their visual acuity without any abnormality in the appearance of the eye.”

The cause of this disease usually suggests as the deficit of liver and loses of seven modes of emotions. Kidney is the water storage and is also the congenital essential substance. If the kidney loses its function congenitally, the wood could not be nourished.

The eye is the orifice to live. Once wood is malnourished, the liver blood becomes deficient and can not flow upward to the eye. Ancient Chinese medical book “The Canon of Internal medicine” described: “Visual acuity only presents when blood is gotten and blindness occurs when blood is lost”.

Therefore, in treating eye disease, strengthening Yin and restoring kidney are the essential principle. Because kidney is essential to liver, the liver may be nourished after kidney restored and visual acuity recovered spontaneously after liver wood has been nourished.

However, the disease is not so simple. The deficiency of kidney may be in some time associated with wind-heat, wetness-phlegm, and depression of liver-energy. Therefore, selection of point in acupuncture and prescription in medication would be nimble with adaptability.

Experiences about acupuncture therapy for eye diseases have been reported. There are three aspects in selecting points:

1 Select the points in local region or near the eye, e.g. Jingming, Qiuhou, Chengqi, Sizhukong, Yangbai, Taiyang etc.

2 Points along the channels, e.g. Shenmai, Guangming, Fengchi, Qimai etc.

3 Points various with symptoms, e.g. Zhaohai, Shenshu, Ganshu, and Geshu.

Thus, the eye disease is treated both locally and generally. If the primary cause and secondary cause are treated at the same time, good effect will be obtained therefore.

The pathological changes of the eye are a kind of degenerative disease, it is necessary to treat for long time. Groups of points may be adapted alternately, for elevating its sensitivity and the therapeutic effect.

Cataract II

eye
By Shandong Science And Technology Press (1985)

Cataract is a condition of any opacity of lens and is a common eye diseases.There is neither nerve nor blood vessel in the lens. The nutrition of lens depends upon aqueous humor, which nourishes the lens through its capsule, thus the metabolism of lens is retained. Any condition disturbing the lens metabolism (e.g. inflammation, trauma etc) may cause opacity of lens.

Cataract may be present in any year of age but more in senile.

Symptoms and Signs:

According to the time of attack, cataract may be divided into two types – congenital and acquired. Acquired cataract mostly occurs in senile age. Cataract may also be caused by trauma. Adolescent cataract and cataract due to other disease may be also present.

The opacity of lens may look like flower of date or as oil floating on the water. The margin of opacity is usually clear. The range of disturbance in vision is various with location opacity.

Treatment:

A Points:
Group 1: Jingming, Yangbai, Fengchi, and Hegu
Group 2: Qiuhou, Taiyang, Yiming, and Binao

B Procedure:

Adapt two group points alternately for each seven days, which are recorded as a therapeutic course. The internal between courses is 2 ~ 3 days. Remedy is given once daily. The manipulation of needles is same as in pathological changes of optic nerve, retinopathy and acute conjunctivitis. All manipulation should be quick.

C Case Examples:

Case 1.

Oct 3, 1964, O.P.D. patient Ke, male 37 years old, a cadre.

There was a piece of white opacity on the right upper on the right lens, sized as a date flower with clear margin. Vision much disturbed when looked to the right. Patient received treatments in past half year in a hospital but did not cure and he was advised to treat with acupuncture therapy in author’s O.P.D. Jingming, Yangbai, Fengchi, Hegu were penetrated once daily with quick manipulation. Lens opacity disappeared after 5 treatments given. No recurrence in 10 years.

Case 2.

Nov 7, 1965, O.P.D. patient Li, male, 11 years old, a student.

There was a small area of lens opacity in the medical lower portion of left lens, looking as a new moon, the color was whitish with clear margin. Patient’s visual acuity was much disturbed.

Treatments were given as above. Two groups of points adapted alternately, one group for each course with the internal of 3 days. Remedy was given once daily. Lens opacity much diminished after 5 courses of treatment.

Remarks:

Cataract is a modern medical term, which is much like “Yun Wu Yi Jing” in its initial stage and “Yin Nei Zhang” or “Yuan Yi Nei Zhang” in the mature stage, in Chinese traditional medicine. “A Precious Bood of Opathalmology” described: “The diseased (cataract) area is white in color, various in size and thickness. Patient feels there is some moving substance in his visual field.” The pathogenesis has also been described in same book, which is much similar to the description in modern medicine.

Since there is no blood vessel, nerve and active cells in the lens, some medical books consider that there is no metabolic activity in the lens and its pathological change is passive in nature and this treatment is therefore very difficult, only extraction may be performed.

In contrast with above, there has been much more understanding about cataracts and much experience has been obtained in treating this disease in the field of Chinese traditional medicine.

A report of acupuncture treatment for cataract presented by Zhong Shan Medical College has represented that the therapeutic efficiency in 43 cases (80 eyes) was 73.7% (59 eyes). The results of Guangxi Worker’s Hospital in 24 cases (32 eyes) were: 8 eyes cured, markedly improved 11 eyes, mildly improved 9 eyes and no effect in 4 eyes.

Reports described above indicated that acupuncture therapy to treating cataract is very appreciable.

Chinese traditional physicians thought that aqueous humor is the vital liquid in the eye, which is resulted from the accumulation of Qi which is the functional activity of organs and metabolism is also included there.

In fact, vitreous body is a part of the body and has its own metabolism but much lower than the others.

Acupuncture therapy may excite the function of the various part of the eye, disperses the channels around the eye and promote the local metabolism. Treatments given above are beneficial to the absorption of cloudy substances in case of cataract.

Trachoma

Eyes
By Shandong Science And Technology Press (1985)

It is a chronic infectious disease caused by the virus. It is a very important infection on account of its disastrous complications and squaclae, which are responsible for many cases of partial or total blindness.

Symptoms and Signs

In mild cases, there is slight foreign body sensation in the eyes and the discharge is usually small in amount. Those of severe cases are feeling of stimulation sensation and much discharge associated with photophobia, lacrimation, inversion of lids and eyelashes. Corneal ulcer may also complicate.

Treatment

A Points: penetrate Sizhukong toward Yuyao, or Zanzhu toward Yuyao; puncture Sibai toward Jingming. Fengchi and Hegu penetration also required.

B Procedure: pinch up the skin around the point with the thumb and index finger of left hand, then insert the needle rapidly toward the other point. Twirl or scrape the needle.

Twirling the needles for the points of Fengchi and Hegu only.

Acupuncture is given once daily till cure.

For all points mentioned above needles should be retained in short duration.

C Case example:

Patient Song, a female, 65 years of age, a housewife.

Patient suffered from trachoma for 10 years. The symptoms were various with time and became more severe in recent days. Photophobia, lacrimation and itching of eyes were associated.

Examinations revealed trachoma II O.S. III O.D., inversion of eye lashes, much discharge was present. Patient’s symptoms were diminished after acupuncture given twice and almost after 5 remedies.

Remark

Trachoma belongs to the class of “Jiao Chuang” or “Su Chuang” in Chinese traditional medicine, which also reported its pathogenesis, symptology and treatment.

Ancient medical book “Essentials of Ophthalmology” considered: “Congestion of lids for years causes growth of Feng Su on the lips … heating of the stomach and the spleen causes growth of Feng Su, then gradually becomes a size of rice even a shape of red bay berry. Those granular substances rub the pupil of eyes.” The treatments for it are puncturing the granules with needle … iron it if possible, better result will be presented. Much symptoms and signs had been in old medical books as follows in this disease, there are granules (as chestnut) on the lids which are caused by evil in the lungs, heat in the large intestine and wind in the liver.

From the review above, it is known that the pathogenesis is related to the following factors: evil heat in Yangming, evil accumulated in lungs, liver-heat stirring inside, gall-bladder fire moving upward and obstructing the channels, blood stasis etc. The principles of treatment therefore are clearing the heat, detoxification, promoting the blood circulation and eliminating phlegm.

Puncture of Zanzhu, Sizhukong, Sibai and Jingming may expel the local channels and eliminate phlegm.

Puncture of Fengchi may clear the wind-heat of the head region. Hegu is a primary point of large intestine channel. Lungs and large intestine are superficial and internal to each other. Puncture of Hegu can purge Yangming evil heat and detoxicate the evil in the lungs. Therefore, prescription given above is useful to treating trachoma.

Night Blindness

night street
By Shandong Science And Technology Press (1985)

Night blindness occurs usually in children with deficiency of vitamin A. It is frequently induced with starvation, indigestion, diarrhea or high fever.

Symptoms and Signs:

The sight is good by day or with good illumination, but deficient at night or with reduced illumination. The external appearance and fundus of the eye are normal.

Treatment

A Points: the primary points are Ganshu, Jingming, Zusanli, Sifeng and Zhongwan may be associated for the case with diarrhea; Dazhui and Hegu are adapted for the cases with high fever.

B Procedure: scrape the needle in Jingming, Zhongwan, and Tianshu after insertion, Puncture Sifeng with three-edged needle. In puncturing Dazhui, lifting and thrusting are used in manipulating needle. For other points, twisting and twirling are provided. The retaining of the needle for all above points must be very quick. Acupuncture is given once daily till cure.

C Case example:

Patient Zhang, male 8 years of age.

General weakness, loss appetite, desquamation and dryness of skin, loss of brightness of hair, bulging of abdomen, night sweating, diminishment of visual acuity in the evening since 3 days before visiting O.P.D. Patient’s sight is good by day.

Malnutrition and night blindness were diagnosed. Then once acupuncture given daily in the following points: Jingming, Ganshu, Zusanli, Sifeng, and Zhongwan with manipulation described above. Patient was encouraged to take more sheep’s liver and was cured after 5 acupuncture.

Remarks

Night blindness was called “Que Mu Zheng” or “Ji Mang Yan”.

The old medical classic “Golden Mirror for Original Medicine” explains that Que Mu Zheng is a disease, blind in the night and bright in the daytime, which is similar to a bird in the evening. Patient can easily look downward but difficult upward. Liver-wind and fire-evil make the disturbances of both pupils.

The pathogenesis suggested in “Essentials of Ophthalmology”, Liver-asthenia once injured by evil heat, channel stasis appears. Yin and Yang become unbalanced and incommunicable between Rong and Wei presented. Thus, visual acuity is disturbed in the night.

The method for treating night blindness was devolved in ancient medical paper “Compendium of Acupuncture and Moxibustion”, patient of infantile Que Mu can not see anything in the night. Moxibustion may be given 1 inch proximal to the thumb nail, point Neiling and transverse hairline on the skull respectively with one moxa-cone each.

Modern experiences also prove that acupuncture is very useful in treating night blindness. The principles for selecting points are reinforcing liver, promoting circulation, expelling channels and regulating spleen and stomach functions.

Jingming is a local point of the eye, which is used to expel the channels surrounding eyes, thus circulation may be promoted and phlegm is eliminated.

Puncturing the Zusanli may invigorate the function of spleen and stomach, and also increase the appetite. Those are the radical remedies.
Puncture of Ganshu may invigorate the liver function and blood circulation.

Since the blood is stored in the liver, deficiency of blood in liver may thus cause blindness. Penetration of Dazhui, Hegu etc. may expel the wind-heat, which is useful for treating night blindness.