癸巳仲夏,吴比部凤麓父母,以次君弦台先生眼目红痛,恐学道按临,速于取效,乃听
眼科
罄寒凉而治,两越月无验。又眼科视之曰,目疾不宜多用寒凉,恐冰其血。以人参五钱,枸
杞子一两,悉温补之剂。凡用人参、枸杞子五六斤矣。目肿如桃,绝不能开。又专科语之
曰∶红肿而痛,明是热症,误服温补,反助其热,宁不益肿。顾其势,即百寒凉亦不易瘳,
快捷方式无如用下,此釜底抽薪法也。弦台惟其速效,一听下之,用大黄、芒硝、枳壳作大剂,
下五六次,而饮食日减,恶心、畏风,则不能出房门矣。又专门谓前剂欠当,大泻之后,正
合补也,又听补之。一补而目肿如旧。又有眼师云∶目疾热症多,寒症少,只当滋补肾水,
水升则火自降,火降而目疾斯愈矣。用是以滋阴降火之剂为恃,才数服而精滑不禁,一夜梦
遗一二次,神气大脱。投补则目肿痛,用降则精元滑脱,屡试屡如是。诸医无策,悉谢而退
。乃修书命使自淮阴之海阳,恳祝令君介绍,征予为治。予始以远为惧,祝再四为渠言,予
亦素为渠重义,不得以远为辞,乃解行李向往。至即诊之,左寸脉甚短,右寸大而无力,左
关弦弱,右滑,两尺亦滑。予见其坐在幔中,略不敢见风。问其日食几何?答曰三次,计二
碗许,荤腥绝不能用。予曰∶夜卧安否?答曰∶迩来甚苦于睡,才合目即梦魇可畏,或被虎
蛇交咬,或有鬼来勾摄,或落桥坠井,或与人争门而负。猛然惊悟,冷汗淋淋,四肢瘫软
,不能动惮,少顷乃定。今幸公不远千里而临,足征素雅。予曰∶足下始无大恙,只缘大推
大搬,以致野狼狈若是。彼专科者,不足恃也。经谓五脏精华皆上注于目。今专科局局然守其
死法,安知五脏盈虚,阴阳消长,随时出入哉。以愚管见,但平平治之易与耳。据足下之脉
,心神脾志互相不足,肝胆之火郁而不散,致生目痹。今为补养心脾,壮其神志,则饮食日
加,寝卧安稳,而精元有守,神水盈溢,何目痹之不愈哉!弦台曰∶善,惟先生命剂。乃以
归脾汤减去黄 、木香,加丹参而补心脾,以大安丸专助脾胃,而磨谷食,俾新痰不生,则
气血可继日而旺矣。后五日而饮食加;十日而梦魇少,寻能出户,不畏风日;半月而肌肉生
,目可观奕,津津然而有万全之兆。不虞专门张氏子复至,以白眼药日频点之,一日凡七八
次,后此复不能开,脸肉风粟生满。适予有南都之往,卒为所误。后幸有李少塘,打去风粟
,眼始能开。李虽手法精熟,然于轩岐阃奥,尚亦未窥藩篱。予后自南都至,见左目虽愈,
右目终成内障。予故曰∶彼专科者,不足恃也,岂虚语哉!
In the mid-summer of the Guisi year, the parents of Wu Bilu (a member of the Ministry of Justice), concerned that their second son, Mr. Xiantai, was suffering from red and painful eyes, and fearing an inspection by the Education Commissioner, sought rapid results. They followed the advice of eye specialists, using exclusively cold-natured herbs to treat the condition. After two months, there was no improvement.
Another eye specialist examined him and stated that eye diseases should not be treated with excessive cold-natured herbs, as this might cause the blood to congeal like ice. Consequently, warm-tonic formulas were used, consisting of Ren Shen (Ginseng Radix) 5 qian and Gou Qi Zi (Lycium Fruit) 1 liang. A total of five to six jin of Ren Shen and Gou Qi Zi were consumed. The result was severe eyelid swelling resembling a peach, making it impossible to open the eyes.
A further specialist remarked: "Redness, swelling, and pain clearly indicate a Heat syndrome. Misusing warm tonics has exacerbated the Heat, inevitably worsening the swelling. Given the current severity, even a hundred doses of cold herbs would hardly cure it. The most expedient method is purgation; this is the technique of 'removing firewood from under the cauldron'." Seeking quick relief, Mr. Xiantai agreed to purgation. Large doses of Da Huang (Rhei Radix et Rhizoma), Mang Xiao (Natrii Sulfas), and Zhi Qiao (Aurantii Fructus) were administered, resulting in five or six bowel movements. This led to decreased appetite, nausea, and aversion to wind, rendering him unable to leave his room.
Another specialist deemed the previous treatment inappropriate, arguing that after severe purgation, tonification was necessary. Upon resuming tonification, the eye swelling returned to its previous state.
Yet another eye practitioner claimed: "Eye diseases are mostly Heat syndromes and rarely Cold syndromes. One should nourish Kidney Water; when Water ascends, Fire descends naturally, and the eye disease will heal." Relying on Yin-nourishing and Fire-descending formulas, he suffered from seminal emission without control after just a few doses, experiencing nocturnal emissions one or twice a night, leading to significant depletion of Shen (Spirit) and Qi. Tonification aggravated the eye swelling and pain, while Fire-descending methods caused leakage of Jing (Essence). Repeated attempts yielded the same results. All physicians were at a loss and withdrew.
A letter was sent via envoy from Huaiyin to Haiyang, requesting the local magistrate's introduction to invite me for treatment. Initially, I feared the long distance. However, after repeated entreaties from Mr. Zhu, who emphasized my reputation for valuing righteousness, I could not decline due to distance. Thus, I packed my bags and traveled there.
Upon arrival, I took his pulse: the Cun position on the left was very short; the Cun position on the right was large but forceless; the Guan position on the left was wiry and weak; the Guan position on the right was slippery; and both Chi positions were slippery. I observed him sitting within a curtain, afraid to expose himself to even slight wind. I asked about his daily food intake. He replied: "Three times a day, approximately two bowls; I cannot consume any meat or fish." I asked: "Is your sleep peaceful?" He answered: "Recently, sleep has been very distressing. As soon as I close my eyes, I have terrifying nightmares—being bitten by tigers or snakes, having ghosts come to capture my soul, falling off bridges or into wells, or losing arguments over doors. I wake up suddenly in a cold sweat, with limbs paralyzed and unable to move, calming down only after a while. It is fortunate that you have traveled a thousand miles here; it demonstrates your noble character." I said: "You originally had no major illness. Your wretched state is solely due to excessive purgation and excessive tonification. Those specialists are unreliable. The Classics state that the essence of the Five Zang organs flows upward to the eyes. These specialists rigidly adhere to fixed methods, unaware of the fullness or emptiness of the Five Zang, the waxing and waning of Yin and Yang, and the dynamic changes. In my humble opinion, simple regulation will suffice. Based on your pulse, the Heart Shen and Spleen Zhi are mutually deficient, and Liver-Gallbladder Fire is stagnant and undispersed, causing Bi obstruction in the eyes. By nourishing the Heart and Spleen and strengthening Shen and Zhi, your diet will increase, sleep will stabilize, Jing will be retained, and Shen Shui (ocular fluid) will be abundant. How could the eye Bi not heal?"
Mr. Xiantai said: "Very well. Please prescribe." I prescribed Gui Pi Tang (Restore the Spleen Decoction), removing Huang Qi (Astragali Radix) and Mu Xiang (Aucklandiae Radix), and adding Dan Shen (Salviae Miltiorrhizae Radix) to tonify the Heart and Spleen. I also prescribed Da An Wan (Great Peace Pill) specifically to assist the Spleen and Stomach in digesting grains, preventing the formation of new Phlegm, thereby allowing Qi and Blood to flourish daily.
After five days, his appetite increased. After ten days, nightmares decreased, and he could go outside without fear of wind or sun. After half a month, muscle mass improved, and his eyes could see chess games, showing signs of complete recovery.
Unexpectedly, the son of the specialist Zhang arrived again, applying white eye drops frequently, seven or eight times a day. Consequently, his eyes became unable to open again, and his eyelids were covered with wind-corns (small bumps). Fortunately, I was traveling to Nanjing at the time, which ultimately led to mismanagement. Later, thanks to Li Shaotang, who removed the wind-corns, his eyes could finally open. Although Li was skilled in manual techniques, he had not yet penetrated the profound mysteries of Xuanti (referring to Yellow Emperor and Qibo, symbols of TCM classics). When I returned from Nanjing, I saw that although the left eye had healed, the right eye had eventually developed Nei Zhang (internal cataract-like opacity). Therefore, I say: "Specialists are unreliable." Is this merely empty talk?