一、两目赤色。火症也。必兼舌燥口渴。六脉洪大有力。宜犀角、连翘等清透之。阳毒三黄石膏汤。
表里兼解之。若目赤颧红。六脉沉细。手足指冷者。此少阴虚火上冒。假热真寒也。六脉洪大。
按之无力者。亦是。
一、两目黄色。此湿热内盛。欲发黄也。必兼小便不利。腹满口渴。脉沉数。轻则茵陈五苓散。
重则茵陈大黄汤。若目黄小便自利。大便黑。小腹硬满而痛。属蓄血。桃仁承气汤下之。若目黄身冷。
口不渴。脉沉细。属阴黄。茵陈理中汤。
邵评∶热瘀下焦。与蓄血下焦。其辨在小便不利为热瘀。小便自利是蓄血。
一、病患目眵多结者。肝胆火盛也。宜清之。
一、病患目睛微定。临时转动者。痰也。宜加味导痰汤。痰去。目珠自然流动矣。
一、病患眼胞上下黑者。痰也。
一、病患目色清白宁静者。多非火症。不可妄用寒凉。
一、病患目不识人。阳明实症可治。少阴虚症难治。
一、凡目昏不知人。或戴眼上视。或目瞪直视。或眼胞陷下。皆属死症。
按伤寒断无日传一经之理。仲景既无明文。其说始于误解经义。素问热论篇云。伤寒一日。巨阳受
之。故头项痛。腰背强。二日阳明受之。故身热目痛。鼻干不得眠。三日少阳受之。故胸胁痛而耳聋。此言三
阳受邪发病之期。有浅深先后之次序。非谓传经之日期也。故下文云。七日巨阳病衰。头痛少愈。八日
阳明病衰。身热少愈。九日少阳病衰。耳聋微闻。此言病之向愈。大约以七日为期。以七日始行尽本经也。故太阳病至
七日始衰。而头痛少愈。则六日内只在本经。非传至厥阴明矣。
注疏者。以六日为传经已尽。以七日巨阳病衰为再传经释之。致后人皆以日传一经为常例。不知六气之伤人无常。
或入于阳。或入于阴。灵枢云。中于面。则下阳明。中于项。则下太阳。中于颊。则下少阳。以此可知三阳
各自受邪。非必从太阳传入也。则太阳受病一日发。阳明受病二日发。其义显然。故伤寒非必始太阳而终
厥阴。亦非一经止病一日。亦非一经独病相传。大抵今之伤寒。无不兼经而病。即古人所称合病并病之症。
后学不解此旨。而欲拘拘于六经传次。印证今病。宜无一症合其式矣。兹将六经古法述于前。新法续于后。
其各经兼并之症。列于六经正病之下。庶临症者得其把握焉。
1. Redness of both eyes. This is a manifestation of Fire syndrome (Huǒ zhèng, Heat/Fire pathogenic factor). It must be accompanied by a dry tongue and thirst, with the six pulses being surging (Hóng,洪) and forceful. It is appropriate to use Rhinoceros Horn (Xījiǎo, 犀角 - *Note: Substitute with Water Buffalo Horn in modern practice*) and Forsythia (Liánqiáo, 连翘) etc., for clearing heat and venting it out. If it is Yang Toxicity (Yáng dú, 阳毒), Sanhuang Shigao Tang (Coptis, Rhubarb and Gypsum Decoction) should be used to resolve both the exterior and interior simultaneously. If the eyes are red and the malar regions are flushed, yet the six pulses are deep (Chén, 沉) and fine (Xì, 细), and the fingertips are cold, this indicates Deficient Fire floating upward due to Shaoyin deficiency (Shàoyīn xū huǒ shàng mào, 少阴虚火上冒), which is False Heat and True Cold (Jiǎ rè zhēn hán, 假热真寒). If the six pulses are surging but weak upon deep pressure, it is also this condition.
2. Yellowing of both eyes. This indicates excessive Damp-Heat (Shī Rè, 湿热) internally, leading to impending Jaundice (Huáng Dàn, 黄疸). It must be accompanied by difficult urination, abdominal fullness, thirst, and a deep (Chén, 沉) and rapid (Shuò, 数) pulse. For mild cases, Yinchen Wuling San (Artemisiae Scopariae Five-Ingredient Powder) is used; for severe cases, Yinchen Dahuang Tang (Artemisiae Scopariae and Rhubarb Decoction) is used. If the eyes are yellow, urination is free, stool is black, and the lower abdomen is hard, full, and painful, this belongs to Blood Stasis accumulation (Xù Xuè, 蓄血); Taoren Chengqi Tang (Peach Kernel and Magnolia Bark Decoction) should be used to purge it. If the eyes are yellow, the body is cold, there is no thirst, and the pulse is deep and fine, this belongs to Yin Jaundice (Yīn Huáng, 阴黄); Yinchen Lizhong Tang (Artemisiae Scopariae and Gastrodia Decoction) is indicated.
Commentary by Shao: The differentiation between Heat-Stasis in the Lower Jiao and Blood Stasis in the Lower Jiao lies in the urination: difficulty in urination indicates Heat-Stasis, while free urination indicates Blood Stasis.
3. Excessive and sticky eye discharge in patients indicates Excess Fire in the Liver and Gallbladder (Gān Dǎng Huǒ Shèng, 肝胆火盛). Clearing heat is appropriate.
4. Slightly fixed eyeballs that occasionally move indicate Phlegm (Tán, 痰). Jiawei Daotan Tang (Modified Phlegm-Resolving Decoction) is appropriate. Once the phlegm is resolved, the eyeballs will naturally become mobile.
5. Dark coloration on the upper and lower eyelids indicates Phlegm (Tán, 痰).
6. Eyes with clear white sclera and a calm demeanor mostly do not indicate Fire syndrome. Cold-Cooling (Hán Liáng, 寒凉) drugs should not be used recklessly.
7. Patients who cannot recognize people: if it is Yangming Excess Syndrome (Yángmíng Shí Zhèng, 阳明实证), it is treatable; if it is Shaoyin Deficiency Syndrome (Shàoyīn Xū Zhèng, 少阴虚证), it is difficult to treat.
8. Any case of blurred vision with inability to recognize people, or eyes rolling upward (Dài Yǎn, 戴眼), or staring straight ahead without movement, or sunken eyelids, all belong to fatal syndromes.
Annotation: There is absolutely no principle in Shanghan (Cold Damage) disease of transmitting one meridian per day. Zhang Zhongjing did not provide explicit text for this theory; such interpretations originated from misunderstandings of the classic texts. The *Suwen* chapter "Re Lun" states: "On the first day of Shanghan, the Juyang (Taiyang) meridian receives the pathogen, hence headache, stiff neck, and back rigidity. On the second day, the Yangming meridian receives the pathogen, hence fever, eye pain, dry nose, and insomnia. On the third day, the Shaoyang meridian receives the pathogen, hence hypochondriac pain and deafness." This describes the sequence and depth of onset when the three Yang meridians receive pathogens, not the specific days of transmission. Therefore, the following text states: "On the seventh day, the Taiyang disease declines, and the headache slightly improves. On the eighth day, the Yangming disease declines, and the fever slightly improves. On the ninth day, the Shaoyang disease declines, and deafness slightly improves." This describes the recovery process, generally taking seven days as a cycle, as it takes seven days to complete the circulation within the original meridian. Thus, Taiyang disease begins to decline only on the seventh day, with slight improvement in headache; within the previous six days, the pathogen remained only in its own meridian and had not transmitted to the Jueyin meridian.
Annotators assumed that six days constituted the completion of transmission and interpreted the decline of Taiyang disease on the seventh day as a subsequent transmission, causing later generations to regard "transmitting one meridian per day" as a standard rule. They failed to realize that the Six Qi (Liù Qì, 六气) pathogens attack humans without fixed patterns, sometimes entering Yang meridians and sometimes Yin meridians. The *Ling Shu* states: "If struck on the face, it enters the Yangming meridian; if struck on the nape, it enters the Taiyang meridian; if struck on the cheek, it enters the Shaoyang meridian." From this, we know that the three Yang meridians can each receive pathogens independently, not necessarily transmitting from Taiyang. Therefore, Taiyang disease manifests on the first day, and Yangming disease manifests on the second day; the logic is clear. Thus, Shanghan does not necessarily begin in Taiyang and end in Jueyin, nor does one meridian's disease last only one day, nor does one meridian transmit exclusively to another. Generally, contemporary Shanghan involves multiple meridians simultaneously, corresponding to what ancients called He Bing (Combined Syndromes, 合病) and Bing Bing (Concurrent Syndromes, 并病). Later scholars who fail to understand this principle and insist on rigidly applying the sequence of Six Meridian transmission to verify current diseases will find no symptoms matching their models. Here, the ancient methods of the Six Meridians are presented first, followed by new methods. Symptoms involving concurrent meridians are listed under the primary diseases of each of the Six Meridians, so that clinicians may have a firm grasp during practice.