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Sunday, 1 December 2013

Muscae Volitantes (Floater) - Treatments In Traditional Chinese medicine perspective

Muscae volitantes or Floater is defined as a condition of pathol moving black specks or threads seen before the eyes, as results of opaque fragments floating in the vitreous humour or a lens defect due to degeneration of the vitreous humour.  Floater as it suspends in the vitreous humour, it tends to drift  and follows the rapid motions of the eye as a result of damage of the eye that causes material to enter the vitreous humour.
C. In traditional Chinese medicine perspective(35)
According tothe article of  FLOATERS AND THEIR TREATMENT WITH CHINESE HERBS in theEnglish-Chinese Encyclopedia of Practical Traditional Chinese Medicine (2), there is a short section on diseases of the vitreous. The clinical manifestations are said to range from mild cases with black shadows floating up and down like flying flies (but no other change in vision) to severe cases, where the eyes seem to be covered by a membrane. There are three categories of causation listed: 
1.  Accumulation and steaming up of damp-heat and attack of turbid qi a. This corresponds to the disorder of the gallbladder described above.  b. A recommended formula is modified San ren Tang (Three Seed Decoction), which have a function to clear damp-heat. Ingredients includes b.1. Xing Ren (Apricot Seed or Kernel) b.2. Bai Dou Kou (Round Cardamom Fruit) b.3. Hou Po (Magnolia Bark) b.4. Ban Xia (Pinellia Rhizome) b.5. Yi Yi Ren (Seeds of Job's Tears) b.6. Tong Cao (Rice Paper Pith, Tetrapanax) b.7. Dan Zhu Ye (Lophatherum Stem and Leaves) b.8.Hua Shi (Talcum)
2. Stagnation of liver qi, resulting in blood stasis and extravasation of blood
a. This corresponds to the leakage of blood into the vitreous cavity, perhaps as a result of retinitis.  b. A recommended formula is modified Jiawei Xiaoyao San (Bupleurum and Peony Formula. b.1.Radix Bupleuri Chinensis (Chai hu) b.2. Radix Angelicae Sinensis (Dang gui) b.3. Radix Paeoniae Lactiflorae (Bai shao) b.4. Rhizoma Atractylodis Macrocephalae  (Bai zhu) b.5. Sclerotium Poriae Cocos  (Fu ling) b.6. Radix Glycyrrhizae Uralensis (Gan cao) b.7. Cortex Moutan Radicis (Paeonia Suffruticosa) (Mu dan pi) b.8. Fructus Gardeniae Jasminoidis (Zhi zi) b.9. Herba Menthae Haplocalycis (Bo he)   

3. Deficiency of kidney and liver, resulting in flaring up of deficiency fire
a. This corresponds to the weakness of the kidney water, and associated heat that causes drying of the vitreous.  b.  The recommended formula is a modified Zhibai Dihuang Tang (Anemarrhena, Phellodendron, and Rehmannia Formula),. Ingredients include b.1. Radix Rehmanniae Preparata  (Shu Di Huang) b.2. Fructus Corni Officinalis (Shan Zhu Yu) b.3. Cortex Moutan Radicis (Paeonia Suffruticosa) (Mu Dan Pi) b.4. Rhizoma Dioscoreae Oppositae  (Shan Yao) b.5. Sclerotium Poriae Cocos (Fu Ling) b.6. Rhizoma Alismatis Orientalis (Ze Xie) b.7. Rhizoma Anemarrhenae Asphodeloidis (Zhi Mu) b.8. Cortex Phellodendri Chinensis  (Huang Bo)