Male, 65 years old. Gradual deterioration of the vision over four years. Symptoms included blurred vision, dry eyes, night sweats, insomnia with dreaming, a dry mouth with no desire to drink, irritability, hot and foul breath and constipation. Examination showed visual acuity of 0.4 in both eyes with no abnormality of the outside of the eyes. A grayish-white cloudiness was observed in both lenses with unclear refractive media, visible optical papilla in the fundus and vessels in the retina and no obvious changes in macula. The tongue body was red with a yellow, greasy coating and the pulse was thin and rapid.
The case uses Gān Lù Yĭn (Sweet Dew Beverage) to resolve a case of cataracts caused by yin deficiency with internal heat. The key to understanding the selection of this formula over another yin tonic formula, for instance, Zhī Băi Dì Huáng Wán (Anemarrhena, Phellodendron and Rehmannia Pill), is the patient’s symptoms of constipation and mouth sores. Gān Lù Yĭn nourishes the yin, clears heat, disseminates the lung qi and resolves dampness. The root of the pattern for this case is unresolved heat in the yangming that injures fluids. The residual heat combines with dampness, which causes the symptoms of mouth sores, bad breath, constipation and gum inflammation. Zhī Băi Dì Huáng Wán, clear empty fire and nourishes the kidney yin, while Gān Lù Yĭn clears heat from the stomach and lung channels. The stomach channel commences below the eye and the muscle wheel of the eye belongs to the stomach and spleen. This channel relationship also suggests that Gān Lù Yĭn would also be useful when treating blepharitis.