(竹叶煎汤合生石蜜调服)
连翘(四两) 大黄 芒硝 生甘草(各二两) 栀仁 黄芩 薄荷(各一两)
大热目赤肿,此方主之。
大热,脏腑实火。目赤肿,本科险症。须以连翘、竹叶、荷叶之轻芬,升散于上,大黄、芒硝之猛烈,推荡
于中。黄芩、栀仁上清下行。生草、生蜜和中泥膈,症不变矣。经曰∶热淫于内,治以咸寒,佐以苦甘,此方之
谓与。
诗曰∶甘草大黄苏薄翘,条芩栀子化风硝,七般为散名凉膈,竹叶汤搀石蜜调。
龙胆草 当归 防风 羌活 山栀仁 芎 大黄(各等分)
青者,东方木神,于人为肝。泻青者,盖木忌蔽密,必伐去枝叶,始通风而不生虫。肝属木,忌血旺与气郁。
血旺则善怒,气郁则筋脉不舒。风火相循而起,发为头痛,目赤肿,翳障,热泪,坐卧不宁,本经谓之木火自焚。
不图急治,安望其条达。故用大黄、草龙胆、山栀仁苦寒下行,直入厥阴而折之。羌活、防风、芎 ,气雄能走,
从其性而升之。用当归者,以辛温润其燥,就以辛温补其血,是亦泻青之一法也。虽然青乃春阳发荣之色,化物
之源也。世医皆执东方常实,有泻无补,目病属肝,肝常有余,肝无补法诸说,起手便是平肝。不知五行之中,
惟木怀仁向荣,非如前
症,而用前药,譬以板斧伐条,标虽速去,本则随枯,来春杳无所生矣。春无所生,则夏长、秋收、冬藏者何物
乎?故余每救败症,从养阴益阳者居多。否则议和议泻,然终以益补收效。此何以故?盖病多假实真虚,而药只
有泻无补,饥肠寒骨,强自支持,因衣以绨袍,食以豆粥,犹久旱得雨,严寒出日,有不解其郁闷者乎。必曰肝
无补法,此门外汉子。凭卿用卿法,我自用我法也。
诗曰∶泻青莫漫防龙胆,羌活大黄当检点,至乃芎 栀子仁,症非如上任煎啖。
(Administered by mixing with a decoction of Bambusae Folium and raw rock sugar.)
Forsythiae Fructus (Lianqiao, 连翘) [4 liang], Rheum Palmatum Radix et Rhizoma (Dahuang, 大黄), Natrii Sulfas (Mangxiao, 芒硝), Glycyrrhizae Radix et Rhizoma Raw (Sheng Gancao, 生甘草) [each 2 liang], Gardeniae Semen (Zhiren, 栀子仁), Scutellariae Radix (Huangqin, 黄芩), Menthae Haplocalycis Herba (Bohe, 薄荷) [each 1 liang].
This formula is indicated for severe heat in the eyes causing redness and swelling.
"Severe heat" refers to excess fire within the zang-fu organs. "Redness and swelling of the eyes" is a critical condition in ophthalmology. One must use light and aromatic herbs such as Forsythiae Fructus, Bambusae Folium, and Nelumbinis Folium to ascend and disperse upwards; combined with potent purgatives like Rheum Palmatum Radix et Rhizoma and Natrii Sulfas to push down stagnation in the middle jiao. Scutellariae Radix and Gardeniae Qing clear heat from above and guide it downward. Raw Glycyrrhizae Radix et Rhizoma and raw honey harmonize the spleen and stomach, preventing damage to the diaphragm, thus stabilizing the condition. The *Neijing* states: "When heat invades internally, treat with salty-cold substances, assisted by bitter-sweet ones." This describes this formula.
The poem reads: Glycyrrhiza, Rheum, Perilla, Forsythia, Scutellaria, Gardenia, wind-resolving agents, and Mirabilite; seven ingredients made into a powder named Liangge San, mixed with Bamboo Leaf Decoction and adjusted with rock sugar.
Gentianae Radix (Longdancao, 龙胆草), Angelicae Sinensis Radix (Danggui, 当归), Saposhnikoviae Radix (Fangfeng, 防风), Notopterygii Rhizoma et Radix (Qianghuo, 羌活), Gardeniae Semen (Zhiren, 栀子仁), Ligustici Chuanxiong Rhizoma (Chuanxiong, 川芎), Rheum Palmatum Radix et Rhizoma (Dahuang, 大黄) [equal parts].
The color green corresponds to the East, belongs to Wood in the Five Elements, and corresponds to the Liver in the human body. "Xieqing" (Draining Green) implies that trees dislike being overly dense and shaded; branches and leaves must be pruned so that wind can circulate and prevent pest infestation. The Liver belongs to Wood and dislikes excessive blood abundance and qi stagnation. Excessive blood leads to irritability; qi stagnation leads to unrelaxed sinews and vessels. Wind and fire circulate together, manifesting as headache, red and swollen eyes, visual obscurations (cataracts/pterygium), profuse tears, restlessness in sitting or lying down. In the classic texts, this is called "Wood and Fire self-immolating." If not treated urgently, how can one expect smooth flow? Therefore, bitter-cold herbs descending in action, such as Rheum Palmatum Radix et Rhizoma, Gentianae Radix, and Gardeniae Semen, are used to enter the Jueyin Liver channel directly to subdue the fire. Saposhnikoviae Radix, Angelicae Dahuricae Radix (Baizhi is implied by context but text says Qianghuo/Fangfeng/Xion which usually implies Chuanxiong here given 'Xiong' abbreviation), and Ligustici Chuanxiong Rhizoma have potent aromas and moving properties, ascending in accordance with the liver's nature. Angelicae Sinensis Radix is used because its acrid-warm nature moistens dryness and tonifies blood through its acrid-warm property; this is also a method of "Draining Green." Although green is the color of spring yang flourishing and the source of transformation, worldly physicians adhere to the theory that the East (Liver) is constantly full, having only draining methods without tonification; they believe eye diseases belong to the Liver, the Liver is often in excess, and there is no tonification method for the Liver, so they begin with calming the Liver. They do not know that among the Five Elements, only Wood possesses benevolence and flourishing vitality. Unlike the aforementioned excess conditions, using draining drugs here is like chopping branches with an axe; although the symptoms are quickly removed, the root withers, and nothing will grow in the coming spring. If spring has no growth, what will there be for summer's elongation, autumn's harvest, and winter's storage? Thus, when I rescue critical cases, I mostly nourish yin and tonify yang. Even if discussing harmonizing or draining methods, ultimately efficacy is achieved through tonification. Why is this? Because diseases often present as false excess and true deficiency. If medicines only drain without tonifying, the intestines become empty and bones cold, forcing the body to sustain itself. This is like dressing a hungry, cold person in thick robes and feeding them bean porridge, akin to rain after a long drought or sun emerging from severe cold; would their depression not be resolved? Those who insist "the Liver has no tonification method" are laymen outside the gate. Use your methods as you please; I will use mine.
The poem reads: Do not casually use Gentianae Radix for Draining Green; carefully consider Saposhnikoviae Radix and Rheum Palmatum Radix et Rhizoma. As for Ligustici Chuanxiong Rhizoma and Gardeniae Semen, do not brew and consume them indiscriminately as in the previous prescription.