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.

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.