某 风温上郁。目赤。脉左弦。当用辛以散之。（风温）
桑叶 夏枯草 连翘 草决明 赤芍
某（二三） 失血后。复受燥热。左目赤痛。当以辛凉清之。（燥热）
鲜菊叶 冬桑叶 生甘草 赤苓皮 绿豆皮 豆皮
鲍（氏） 秋风化燥。上焦受邪。目赤珠痛。
连翘 薄荷 黄芩 山栀 夏枯草 青菊叶 苦丁茶 桑皮
席 用淡渗渐安。是暑入气阻。热蒸湿郁。勿取大辛大苦之开泄。仿清邪中上治法。（暑湿郁蒸）
冬桑叶 谷精草 望月砂 苡仁 川通草 绿豆皮 茯苓
顾（五四） 头额闷胀。目赤。（木火上郁）
羚羊角 夏枯草 草决明 山栀皮 连翘 生香附
潘 戒饮。浊减十四。略可加谷。近日竟夕无寐。目珠赤痛。阳升不交于阴。暂停妙香散。
桑叶 丹皮 夏枯草 黑山栀 川贝 苡仁
陆（妪） 郁勃气火。翳遮目睛。高年苦辛难进。
夏枯草 谷精草 草决明 望月砂 生香附 连翘 山栀皮 丹皮
某 头面风肿。目起星。是气中热。
羚羊角 夏枯草 薄荷梗 谷精草 生香附 小生地 丹皮 望月砂 连翘 山栀
汪 脉左弦。左目赤痛。泪多。
桑叶 丹皮 草决明 小胡麻 夏枯草 谷精草 绿豆皮 黑 豆皮
汪 目痛偏左。翳膜红丝。诊脉左弦涩。由肝胆气热所致。
草决明 冬桑叶 夏枯草 小胡麻 丹皮 谷精草
某（十一） 肝火上郁。目眶红肿。
连翘 赤芍 菊花叶 黑栀皮 苦丁茶 夏枯草
江 脉数右大。郁久热生目。障心痛。
夏枯草花 小生香附 金石斛 半夏曲 茯苓 橘红
某（八岁） 目胞浮肿。不饥不运。（脾肺蕴湿）
桑皮（八分） 茯苓皮（三钱） 大腹皮（一钱） 广皮（一钱） 姜皮（五分） 苡仁（一钱半）
通草（一钱）
王（妪） 高年目暗已久。血络空虚。气热乘其空隙。攻触脉络。液尽而痛。当夜而甚。乃热气由阴而
上。想外科用酒调末药。必系温散攻坚。因此而痛。虚症可知。（血络虚热）
羚羊角 连翘心 夏枯草 青菊叶 全当归 川桂枝 丹皮
叶 微寒。汗大出。下有痔漏。左眼眶疼痛。此阴伤火郁。不可作时邪泛治。（阴虚火郁） 六味去萸加
芍蔓荆子丹皮重用
某（三六） 右目多泪。 胀心嘈杂。阳明空虚。肝阳上扰使然。当调补肝胃。（胃虚肝风）
嫩黄 （三钱） 当归（一钱半） 白芍（一钱半） 茯神（三钱） 煨姜（一钱） 南枣（一枚）
祝（四八） 当夏形懒。不耐大气发泄。入冬两目无光。精气无收藏。凡五脏精华。皆聚于目。失藏失聚。
内乏生真。不独一脏之损。当用养营汤。（营阴虚）
某（三六） 脉涩细。左目痛。泪热翳膜。此肝阴内亏。厥阳上越所致。（肝阴虚）
冬桑叶（一钱） 炒枸杞（一钱半） 小胡麻（一钱半） 望月砂（三钱） 制首乌（三钱） 石决明（一具）
黄菊花（一钱） 豆皮（三钱）
某（三六） 目痛无光。（肝肾虚）
制首乌（六两） 枸杞子（二两） 柏子仁（一两） 细生地（二两） 石决明（四两） 小胡麻（三两）
望月砂（三两） 刺蒺藜（二两） 冬桑叶（一两半） 黄菊花（一两）
用 豆皮八两。谷精珠二两。煎浓汁泛丸。每服五钱。开水送。
某 胀目昏。心中嘈杂。当治肝肾。
熟地（六两） 枸杞子（三两） 桑椹子（二两） 沙苑（二两） 石决明（二两） 茯神（二两）
女贞子（一两半） 青盐（一两） 黄菊花（一两） 川斛（四两）
加蜜丸。早上开水送四钱。
某（三六） 脉涩。 痛。右目当风泪多。当治肝肾。
制首乌 枸杞子 炒归身 桑椹子 沙苑子 茯神
某（二五） 遗止。心嘈目泪。仍是阳气过动。当填阴和阳。
熟地 杞子 天冬 萸肉 五味 生地 茯苓 菊花 山药 蜜丸
某 瞳神散大。左偏头痛。先损左目。是焦烦郁勃。阳升化风。劫伤血液使然。法当兼补肝肾。
熟地 枸杞子 山萸肉 五味 茯神 菊花 生神曲 谷精草 山药
眼科一症。古有五轮八廓。七十二问之辨。傅氏又分为一百零八症。因名目太多。徒滋惑
乱。至于见症。杨仁斋已备论。具载景岳。但阴阳虚实寒热标本施治。不可紊乱。经云。五脏
六腑之精华。皆上注于目。又云。目者肝之窍也。肝与胆为表里。肝液胆汁充足。目乃能远
视。故无论外感与内症。皆与肝胆有关系焉。夫六淫之邪。惟风火燥居多。兼寒兼湿者。亦
间有。内起之症。肝胆心肾为多。他脏亦间有之。若夫论治。则外感之症。必有头痛寒热鼻
塞。筋骨酸疼。脉见紧数。或浮洪。一切表症。方可清散。至于内因之症。有虚实之殊。实者肝
胆之风热盛也。凡暴赤肿痛。胀闷难开。翳膜眵泪。酸涩作痒。斑疮入睛。皆实症也。当除风
散热。虚者。肾经之水火衰也。凡久痛昏暗。青盲雀目。内障昏蒙。五色花翳。迎风泪出。皆虚
候也。治宜壮水益火。若阴血虽亏。而风热未尽。则当审其缓急。相参而治。若久服寒凉。虚
阳转盛。则当补以甘温。从乎反佐。至于红色浅淡而紫者为虚热。鲜泽而赤者为实热。瞳
神内涌白睛带赤者。为热症。瞳神青绿白睛枯槁者。为寒症。肿胀红赤。眼珠刺痛。夜则尤
甚。目不能开。而视物犹见者。为邪火炽盛。若白翳遮睛。珠不甚痛。或全不痛。目仍能开。而
视物不见者。为真火不足。当细察其形症色脉。因症而用药。此内治之大法也。若日久失
调。致气血凝滞。火热壅结。而为赤肿腐烂。翳膜遮蔽。致成外障。譬之镜受污垢。必当濯磨。
须用点药。若但服药。必不能愈。至于内障之症。但宜服药。倘用点药。徒伤其气血。必无益
而有损。更当知目 白珠属阳。故昼痛。点苦寒药则可效。瞳子黑睛属阴。故夜痛。点苦寒
药则反剧。是外治之法。亦当以阴阳区别也。若夫偏正头风。属气虚痛者。朝重暮轻。血虚
痛者。朝轻暮重。亦有外感内因之别。此症当以补养正气为主。略兼治表。倘概以风热而
论。专于表散。最易损目。更有肝阴亏耗。木火上炎。头痛恶心。眉棱骨痛。不欲饮食。眼胞红
肿。睛珠刺痛。眵泪如脓。白睛如 。目珠上窜不下。不得寤寐。甚则巅顶脑后。如破如裂。此
内发之风也。夫肝属木。木主风。热盛化风。其体必本阴亏。男子或有遗精白浊。肠风痔漏
下血等疾。女子或犯淋带崩漏诸症。此系阴伤阳升。内风沸起。大忌发散。宜用育阴熄风。
柔肝滋肾等法。或可救十中之四五。凡羌活防风川芎细辛 本升麻等药。皆不可用。倘
或失治。必致膏伤低陷。青黄牒出。致成痼疾而不可救。专是科者。不可不留意焉。叶先生
虽非眼目专科。观其案内诸法。真补前贤之未备。较之惯用苦寒升散。及概用点药者。不
啻如霄壤之殊矣。学人当细心而参玩之。（丁圣彦）
徐评 眼科自有专家。其现症各有主治之方。案中虽未必切中。然清淡和平。无苦寒温补等
弊。反胜于近日之名为眼科者。医理苟明。则无不通矣。若欲深求。则有专门之书在。
某患者，风温之邪上郁于头目。出现眼睛发红，脉象左侧呈弦象。治疗应当使用辛散之法以疏散风热。（病机：风温）
处方：桑叶、夏枯草、连翘、草决明、赤芍。
某患者（年龄二十三岁），在失血之后，又感受燥热之邪。左眼红肿疼痛。治疗应当用辛凉之法以清解燥热。（病机：燥热）
处方：鲜菊叶、冬桑叶、生甘草、赤苓皮、绿豆皮、豆皮。
鲍姓患者，秋季风气化为燥邪，上焦受到邪气侵袭。眼睛红赤，眼球疼痛。
处方：连翘、薄荷、黄芩、山栀、夏枯草、青菊叶、苦丁茶、桑皮。
席姓患者，使用淡渗利湿的药物后症状逐渐缓解。这是暑邪侵入气分导致阻滞，热气蒸腾湿气郁结。不可使用大辛大苦的药物进行开泄发散。仿照清解上部邪气的治法。（病机：暑湿郁蒸）
处方：冬桑叶、谷精草、望月砂、苡仁、川通草、绿豆皮、茯苓。
顾姓患者（年龄五十四岁），头额部感到闷胀，眼睛发红。（病机：木火上郁）
处方：羚羊角、夏枯草、草决明、山栀皮、连翘、生香附。
潘姓患者，戒除饮酒后，体内浊气减少十四分之四，稍微能够进食。近日整夜无法入睡，眼球红赤疼痛。阳气上升而不能与阴气相交。暂停使用妙香散。
处方：桑叶、丹皮、夏枯草、黑山栀、川贝、苡仁。
陆姓老年女性，气火郁勃，翳膜遮蔽眼睛。年事已高，难以承受过于辛苦的药物。
处方：夏枯草、谷精草、草决明、望月砂、生香附、连翘、山栀皮、丹皮。
某患者，头面部出现风肿，眼睛生出星状翳膜。这是气分中有热所致。
处方：羚羊角、夏枯草、薄荷梗、谷精草、生香附、小生地、丹皮、望月砂、连翘、山栀。
汪姓患者，脉象左侧呈弦象，左眼红赤疼痛，流泪多。
处方：桑叶、丹皮、草决明、小胡麻、夏枯草、谷精草、绿豆皮、黑豆皮。
汪姓患者，眼睛疼痛偏向左侧，有翳膜和红丝。诊察脉象左侧弦涩。这是由于肝胆气热所致。
处方：草决明、冬桑叶、夏枯草、小胡麻、丹皮、谷精草。
某患者（十一岁），肝火上郁，眼眶红肿。
处方：连翘、赤芍、菊花叶、黑栀皮、苦丁茶、夏枯草。
江姓患者，脉数且右侧脉大，郁久化热导致眼睛生障，心痛。
处方：夏枯草花、小生香附、金石斛、半夏曲、茯苓、橘红。
某患者（八岁），眼睑浮肿，没有饥饿感，运化功能停滞。（病机：脾肺蕴湿）
处方：桑皮（八分）、茯苓皮（三钱）、大腹皮（一钱）、广皮（一钱）、姜皮（五分）、苡仁（一钱半）、通草（一钱）。
王姓老年女性，年老眼花已久，血络空虚。气热乘其空隙，攻触脉络，津液耗尽而疼痛，夜间加重。这是因为热气由阴分而上行。推测外科使用的酒调末药，必定是温散攻坚的药物，因此导致疼痛。可知此为虚证。（病机：血络虚热）
处方：羚羊角、连翘心、夏枯草、青菊叶、全当归、川桂枝、丹皮。
叶姓患者，微恶寒，大汗出，下部有痔漏，左眼眶疼痛。这是阴伤火郁，不可当作时行邪气泛泛治疗。（病机：阴虚火郁）
处方：六味地黄丸去掉山茱萸，加入芍药、蔓荆子、丹皮，并重用丹皮。
某患者（三十六岁），右眼多泪，心中胀满嘈杂。这是阳明胃气空虚，肝阳上扰所致。应当调理补益肝胃。（病机：胃虚肝风）
处方：嫩黄芪（三钱）、当归（一钱半）、白芍（一钱半）、茯神（三钱）、煨姜（一钱）、南枣（一枚）。
祝姓患者（四十八岁），夏季身体倦怠懒动，不耐受大气发泄。入冬后两眼无光，精气不能收藏。凡五脏的精华，都汇聚于眼睛。失去收藏和汇聚，内部缺乏生机真气，不仅仅是某一脏器的损伤。应当使用养营汤。（病机：营阴虚）
某患者（三十六岁），脉象涩细，左眼疼痛，流泪热且有翳膜。这是肝阴内亏，厥阳上越所致。（病机：肝阴虚）
处方：冬桑叶（一钱）、炒枸杞（一钱半）、小胡麻（一钱半）、望月砂（三钱）、制首乌（三钱）、石决明（一具）、黄菊花（一钱）、豆皮（三钱）。
某患者（三十六岁），眼睛疼痛且视力模糊。（病机：肝肾虚）
处方：制首乌（六两）、枸杞子（二两）、柏子仁（一两）、细生地（二两）、石决明（四两）、小胡麻（三两）、望月砂（三两）、刺蒺藜（二两）、冬桑叶（一两半）、黄菊花（一两）。
用法：用豆皮八两、谷精珠二两，煎煮浓汁泛丸。每次服用五钱，开水送服。
某患者，眼睛胀痛昏花，心中嘈杂。应当治疗肝肾。
处方：熟地（六两）、枸杞子（三两）、桑椹子（二两）、沙苑（二两）、石决明（二两）、茯神（二两）、女贞子（一两半）、青盐（一两）、黄菊花（一两）、川斛（四两）。
用法：加蜜制成丸剂。早上用开水送服四钱。
某患者（三十六岁），脉象涩，眼睛疼痛。右眼遇风流泪多。应当治疗肝肾。
处方：制首乌、枸杞子、炒归身、桑椹子、沙苑子、茯神。
某患者（二十五岁），遗精止住后，心中嘈杂，眼睛流泪。仍然是阳气过动所致。应当填补阴精以调和阳气。
处方：熟地、杞子、天冬、萸肉、五味、生地、茯苓、菊花、山药，制成蜜丸。
某患者，瞳神散大，左侧偏头痛。先损伤左眼，这是焦躁烦闷、气火郁勃，阳气上升化风，劫伤血液所致。治法应当兼补肝肾。
处方：熟地、枸杞子、山萸肉、五味、茯神、菊花、生神曲、谷精草、山药。
眼科这一病症，古代有五轮八廓、七十二问的辨证。傅氏又将其分为一百零八种病症。因为名称太多，徒然造成困惑混乱。至于所见症状，杨仁斋已经详细论述，记载在景岳全书中。但是阴阳虚实寒热标本的治疗，不可紊乱。经书说：五脏六腑的精华，都上注于眼睛。又说：眼睛是肝的窍道。肝与胆互为表里，肝液胆汁充足，眼睛才能远视。所以无论外感还是内症，都与肝胆有关系。六淫邪气中，只有风火燥居多，兼有寒湿的，也有偶尔出现的。内起之症，多见于肝胆心肾，其他脏器也有偶尔涉及的。如果论治，外感之症，必须有头痛寒热鼻塞、筋骨酸疼、脉象见紧数或浮洪等一切表症，才可以清散。至于内因之症，有虚实之分。实者，是肝胆的风热盛。凡是突然红赤肿痛，胀闷难开，翳膜眵泪，酸涩作痒，斑疮入睛，都是实症。应当除风散热。虚者，是肾经的水火衰。凡是久痛昏暗，青盲雀目，内障昏蒙，五色花翳，迎风泪出，都是虚候。治疗宜壮水益火。如果阴血虽然亏损，而风热未尽，则应当审察其缓急，参合而治。如果久服寒凉药物，虚阳反而旺盛，则应当用甘温药物补益，从乎反佐。至于红色浅淡而紫的是虚热，鲜泽而赤的是实热。瞳神内涌、白睛带赤的是热症，瞳神青绿、白睛枯槁的是寒症。肿胀红赤，眼珠刺痛，夜间尤其严重，眼睛不能睁开，但还能看见东西的，是邪火炽盛。如果白翳遮睛，眼珠不甚痛，或者完全不痛，眼睛仍能睁开，但看不见东西的，是真火不足。应当仔细察辨其形症色脉，因病用药。这是内治的大法。如果日久失调，导致气血凝滞，火热壅结，而成赤肿腐烂，翳膜遮蔽，成为外障。譬如镜子受到污垢，必须洗涤磨擦。必须使用点药。如果只服药，一定不能痊愈。至于内障之症，只宜服药。如果使用点药，徒然损伤气血，必无益而有损。更应当知道，眼的白珠属阳，所以白天痛，点苦寒药可以见效。瞳子和黑睛属阴，所以晚上痛，点苦寒药反而加剧。这是外治的方法，也应当以阴阳来区别。如果是偏正头风，属于气虚痛的，早晨重傍晚轻；属于血虚痛的，早晨轻傍晚重。也有外感和内因的区别。此症应当以补养正气为主，略微兼治表邪。如果一概按风热而论，专门用于表散，最容易损伤眼睛。更有肝阴亏耗，木火上炎，头痛恶心，眉棱骨痛，不欲饮食，眼睑红肿，眼珠刺痛，眵泪如脓，白睛如冰（此处原文可能有误，意指浑浊或特定状态），眼珠上窜不下，不得睡眠，甚至头顶脑后，如破如裂，这是内发之风。肝属木，木主风，热盛化风，其体质必定本于阴亏。男子或有遗精白浊、肠风痔漏下血等疾病，女子或犯淋带崩漏诸症。这是阴伤阳升，内风沸起，大忌发散。宜用育阴熄风、柔肝滋肾等方法，或许可以救十中之四五。凡是羌活、防风、川芎、细辛、藁本、升麻等药，都不可用。如果失治，必定导致膏脂损伤低陷，青黄分泌物流出，成为痼疾而不可救。专门从事眼科的人，不可以不留意这一点。叶先生虽然不是眼科专科医生，观察他医案中的各种方法，真正弥补了前贤的未备之处，比起惯用苦寒升散及一概使用点药的人，简直如同霄壤之别。学习者应当细心参悟玩味。（丁圣彦评）
徐评：眼科自有专家，其现症各有主治之方。医案中虽然未必完全切中病情，但药性清淡和平，没有苦寒温补等弊端，反而胜于近日那些名为眼科医生的人。医理如果明白，就没有不通达的了。如果想要深求，则有专门的书籍存在。
Patient A, wind-warmth pathogen stagnates upward in the head and eyes. Eyes are red, pulse is wiry on the left side. Treatment should employ acrid dispersing methods to scatter wind-heat. (Pathogenesis: Wind-Warmth)
Prescription: Sangye (Folium Mori), Xiakucao (Herba Prunellae), Lianqiao (Fructus Forsythiae), Caojueming (Semen Cassiae), Chishao (Radix Paeoniae Rubra).
Patient B (age 23), after losing blood, contracted dryness-heat again. Left eye is red, swollen, and painful. Treatment should employ acrid-cool methods to clear dryness-heat. (Pathogenesis: Dryness-Heat)
Prescription: Xianjuye (Folium Chrysanthemi Indici), Dong Sangye (Folium Mori), Sheng Gancao (Radix Glycyrrhizae Preparata), Chi Lingpi (Pericarpium Arecae Catechu), Lv Dou Pi (Testa Phaseoli Sojae), Dou Pi (Pericarpium Phaseoli Sojae).
Patient Bao, autumn wind transforms into dryness pathogen, upper jiao is invaded by pathogen. Eyes are red, eyeballs are painful.
Prescription: Lianqiao (Fructus Forsythiae), Bohe (Herba Menthae), Huang Qin (Radix Scutellariae), Shan Zhi (Fructus Gardeniae), Xiakucao (Herba Prunellae), Qing Juye (Folium Chrysanthemi Indici), Ku Ding Cha (Folium Ilicis Kudingcha), Sang Pi (Cortex Mori Radicis).
Patient Xi, symptoms gradually improved using light diaphoretic/damp-draining methods. This indicates summer-heat entered the qi level causing obstruction, heat steams and dampness stagnates. Do not use large acrid or large bitter drugs for opening and draining. Follow the treatment method of clearing pathogens affecting the upper jiao. (Pathogenesis: Summer-Dampness Stagnation and Steaming)
Prescription: Dong Sangye (Folium Mori), Gujingcao (Cornea Gypsi), Wangyuesha (Faeces Leporis), Yiren (Semen Coicis), Chuan Tongcao (Medulla Tetrapanacis), Lv Dou Pi (Testa Phaseoli Sojae), Fuling (Poria).
Patient Gu (age 54), forehead feels stuffy and distended, eyes are red. (Pathogenesis: Wood-Fire Stagnating Upward)
Prescription: Lingyangjiao (Cornu Saigae Tataricae), Xiakucao (Herba Prunellae), Caojueming (Semen Cassiae), Shan Zhi Pi (Pericarpium Gardeniae), Lianqiao (Fructus Forsythiae), Sheng Xiangfu (Rhizoma Cyperi Rotundi).
Patient Pan, after quitting drinking, turbidity decreased significantly, slightly able to eat. Recently unable to sleep all night, eyeballs are red and painful. Yang rises but fails to interact with Yin. Temporarily suspend Miaoxiang San.
Prescription: Sangye (Folium Mori), Danpi (Cortex Moutan), Xiakucao (Herba Prunellae), Hei Shan Zhi (Fructus Gardeniae Carbonized), Chuan Bei (Bulbus Fritillariae Cirrhosae), Yiren (Semen Coicis).
Patient Lu (elderly woman), Qi and Fire stagnate vigorously, nebula covers the eyes. Advanced age makes it difficult to tolerate harsh medicines.
Prescription: Xiakucao (Herba Prunellae), Gujingcao (Cornea Gypsi), Caojueming (Semen Cassiae), Wangyuesha (Faeces Leporis), Sheng Xiangfu (Rhizoma Cyperi Rotundi), Lianqiao (Fructus Forsythiae), Shan Zhi Pi (Pericarpium Gardeniae), Danpi (Cortex Moutan).
Patient C, wind-swelling on head and face, stars appear in the eyes. This is caused by heat in the Qi level.
Prescription: Lingyangjiao (Cornu Saigae Tataricae), Xiakucao (Herba Prunellae), Bohe Geng (Caulis Menthae), Gujingcao (Cornea Gypsi), Sheng Xiangfu (Rhizoma Cyperi Rotundi), Xiao Shengdi (Radix Rehmanniae Preparata), Danpi (Cortex Moutan), Wangyuesha (Faeces Leporis), Lianqiao (Fructus Forsythiae), Shan Zhi.
Patient Wang, pulse is wiry on the left, left eye is red and painful, excessive tearing.
Prescription: Sangye (Folium Mori), Danpi (Cortex Moutan), Caojueming (Semen Cassiae), Xiao Huma (Semen Sesami Nigrum), Xiakucao (Herba Prunellae), Gujingcao (Cornea Gypsi), Lv Dou Pi (Testa Phaseoli Sojae), Hei Dou Pi (Testa Phaseoli Sojae Nigra).
Patient Wang, eye pain偏向 left, nebula and red filaments. Pulse on the left is wiry and choppy. Caused by Qi-Heat in Liver and Gallbladder.
Prescription: Caojueming (Semen Cassiae), Dong Sangye (Folium Mori), Xiakucao (Herba Prunellae), Xiao Huma (Semen Sesami Nigrum), Danpi (Cortex Moutan), Gujingcao (Cornea Gypsi).
Patient D (age 11), Liver-Fire stagnates upward, eye sockets are red and swollen.
Prescription: Lianqiao (Fructus Forsythiae), Chishao (Radix Paeoniae Rubra), Juhua Ye (Folium Chrysanthemi Indici), Hei Zhi Pi (Pericarpium Gardeniae Carbonized), Ku Ding Cha (Folium Ilicis Kudingcha), Xiakucao (Herba Prunellae).
Patient Jiang, pulse is rapid and large on the right, long-term stagnation generates heat causing eye opacity, heart pain.
Prescription: Xiakucao Hua (Flos Prunellae), Xiao Sheng Xiangfu (Rhizoma Cyperi Rotundi), Jin Shi Hu (Herba Dendrobii), Banxia Qu (Massa Medicata Fermentata Chinensis), Fuling (Poria), Ju Hong (Pericarpium Citri Reticulatae).
Patient E (age 8), eyelids are swollen, no hunger sensation, digestion stalled. (Pathogenesis: Dampness Accumulation in Spleen and Lung)
Prescription: Sang Pi (Cortex Mori Radicis, 0.8 qian), Fuling Pi (Pericarpium Arecae Catechu, 3 qian), Dafupi (Pericarpium Arecae Catechu, 1 qian), Guangpi (Pericarpium Citri Reticulatae, 1 qian), Jiangpi (Cortex Zingiberis Recensis, 0.5 qian), Yiren (Semen Coicis, 1.5 qian), Tongcao (Medulla Tetrapanacis, 1 qian).
Patient Wang (elderly woman), elderly with long-standing dim vision, blood collaterals are empty. Qi-Heat exploits the void, attacking collaterals, fluids exhausted causing pain, worse at night. Heat rises from Yin. Presumably external medicine used wine-mixed powder, likely warm-dispersing and hard-breaking drugs, thus causing pain. This indicates a deficiency syndrome. (Pathogenesis: Blood Collateral Deficiency Heat)
Prescription: Lingyangjiao (Cornu Saigae Tataricae), Lianqiao Xin (Stamen Nelumbinis), Xiakucao (Herba Prunellae), Qing Juye (Folium Chrysanthemi Indici), Quan Danggui (Radix Angelicae Sinensis), Chuan Guizhi (Ramulus Cinnamomi), Danpi (Cortex Moutan).
Patient Ye, slight aversion to cold, profuse sweating, hemorrhoids/fistula below, left eye socket painful. This is Yin injury with Fire stagnation, cannot be treated as common seasonal epidemic. (Pathogenesis: Yin Deficiency Fire Stagnation)
Prescription: Liuwei Dihuang Wan minus Cornus, add Shaoyao, Manjingzi, Danpi, heavily increase Danpi dosage.
Patient F (age 36), right eye tears excessively, chest distension and acid regurgitation. Yangming stomach Qi is deficient, Liver-Yang disturbs upward. Should tonify and regulate Liver and Stomach. (Pathogenesis: Stomach Deficiency Liver-Wind)
Prescription: Nen Huangqi (Radix Astragali Membranacei, 3 qian), Danggui (Radix Angelicae Sinensis, 1.5 qian), Baishao (Radix Paeoniae Alba, 1.5 qian), Fushen (Poria cum Radix Pini, 3 qian), Wei Jiang (Rhizoma Zingiberis Recensis Prepared, 1 qian), Nanzao (Fructus Jujubae, 1 piece).
Patient Zhu (age 48), lethargic in summer, intolerant to atmospheric ventilation. In winter, eyes lack luster, essence and Qi fail to store. Essence of five zang organs gathers in the eyes. Loss of storage and gathering leads to internal lack of vital Qi, not just damage to one organ. Should use Yangying Tang. (Pathogenesis: Ying-Nutrient Yin Deficiency)
Patient G (age 36), pulse is choppy and fine, left eye painful, hot tears and nebula. This is internal deficiency of Liver-Yin, Jue-Yang floats upward. (Pathogenesis: Liver-Yin Deficiency)
Prescription: Dong Sangye (Folium Mori, 1 qian), Chao Gouqi (Fructus Lycii, 1.5 qian), Xiao Huma (Semen Sesami Nigrum, 1.5 qian), Wangyuesha (Faeces Leporis, 3 qian), Zhi Shouwu (Radix Polygoni Multiflori Preparata, 3 qian), Shijueming (Concha Meretricis et Arca, 1 unit), Huang Juhua (Flos Chrysanthemi Indici, 1 qian), Dou Pi (Pericarpium Phaseoli Sojae, 3 qian).
Patient H (age 36), eye pain and blurred vision. (Pathogenesis: Liver-Kidney Deficiency)
Prescription: Zhi Shouwu (Radix Polygoni Multiflori Preparata, 6 liang), Gouqi Zi (Fructus Lycii, 2 liang), Baizi Ren (Semen Platycladi, 1 liang), Xi Shengdi (Radix Rehmanniae Preparata, 2 liang), Shijueming (Concha Meretricis et Arca, 4 liang), Xiao Huma (Semen Sesami Nigrum, 3 liang), Wangyuesha (Faeces Leporis, 3 liang), Cili Li (Fructus Tribuli, 2 liang), Dong Sangye (Folium Mori, 1.5 liang), Huang Juhua (Flos Chrysanthemi Indici, 1 liang).
Usage: Lv Dou Pi (8 liang), Gujing Zhu (2 liang), decoct thick liquid to make pills. Take 5 qian each time, wash down with boiled water.
Patient I, eye distension and dimness, heart acid regurgitation. Should treat Liver and Kidney.
Prescription: Shudi (Radix Rehmanniae Preparata, 6 liang), Gouqi Zi (Fructus Lycii, 3 liang), Sangshenz (Fructus Morii, 2 liang), Shayuan (Semen Astragali Complanati, 2 liang), Shijueming (Concha Meretricis et Arca, 2 liang), Fushen (Poria cum Radix Pini, 2 liang), Nvzhenzi (Fructus Ligustri Lucidi, 1.5 liang), Qingyan (Sal, 1 liang), Huang Juhua (Flos Chrysanthemi Indici, 1 liang), Chuan Hu (Herba Dendrobii, 4 liang).
Usage: Add honey to make pills. Take 4 qian in the morning washed down with boiled water.
Patient J (age 36), pulse is choppy, eye pain. Right eye tears excessively when exposed to wind. Should treat Liver and Kidney.
Prescription: Zhi Shouwu (Radix Polygoni Multiflori Preparata), Gouqi Zi (Fructus Lycii), Chao Guishen (Radix Angelicae Sinensis Prepared), Sangshenz (Fructus Morii), Shayuanzi (Semen Astragali Complanati), Fushen (Poria cum Radix Pini).
Patient K (age 25), after emission stops, heart acid regurgitation and eye tearing. Still due to excessive movement of Yang. Should fill Yin to harmonize Yang.
Prescription: Shudi (Radix Rehmanniae Preparata), Qizi (Fructus Lycii), Tiandong (Herba Asparagi), Yurou (Fructus Corni), Wuwei (Fructus Schisandrae), Shengdi (Radix Rehmanniae Recens), Fuling (Poria), Juhua (Flos Chrysanthemi Indici), Shanyao (Rhizoma Dioscoreae), honey pills.
Patient L, pupil dilated, left-sided headache. Left eye damaged first, due to anxiety, frustration, Qi-Fire stagnation, Yang rising transforming into Wind, consuming Blood. Treatment should simultaneously tonify Liver and Kidney.
Prescription: Shudi (Radix Rehmanniae Preparata), Gouqi Zi (Fructus Lycii), Shanyuzhou (Fructus Corni), Wuwei (Fructus Schisandrae), Fushen (Poria cum Radix Pini), Juhua (Flos Chrysanthemi Indici), Shenshenqu (Massa Medicata Fermentata Chinensis), Gujingcao (Cornea Gypsi), Shanyao (Rhizoma Dioscoreae).
Ophthalmology conditions were historically differentiated by Five Wheels, Eight Corridors, and Seventy-Two Questions. Fu divided them into 108 types. Too many names cause confusion. Symptoms were detailed by Yang Renzhai and recorded in Jingyue Quanshu. However, treatment based on Yin/Yang, Deficiency/Excess, Cold/Heat, Root/Branch must not be chaotic. Classics state: Essence of five zang and six fu organs ascends to the eyes. Also: Eyes are the aperture of the Liver. Liver and Gallbladder are interior-exterior partners. Sufficient liver fluid and gallbladder bile allow distant vision. Thus, both exterior and interior conditions relate to Liver and Gallbladder. Among Six Evils, Wind, Fire, and Dryness are most common; Cold and Dampness occur occasionally. Interior conditions mostly involve Liver, Gallbladder, Heart, Kidney; other organs occasionally involved. For treatment: Exterior conditions must present with headache, chills/fever, nasal congestion, bone/joint soreness, pulse tight/rapid or floating/surging—only then can clearing and dispersing be used. Interior conditions differ in Deficiency/Excess. Excess: Liver-Gallbladder Wind-Heat flourishing. Sudden redness, swelling, pain, inability to open, nebula, discharge, itching, sores entering eye—all excess. Remove Wind, clear Heat. Deficiency: Kidney Water/Fire decline. Long-term pain, dimness, congenital blindness, cataracts, colored nebulae, wind-induced tearing—all deficiency. Strengthen Water, benefit Fire. If Yin-Blood deficient but Wind-Heat remains, assess urgency and combine treatments. Long-term use of cold/bitter drugs may cause deficient Yang to surge; use sweet/warm tonics with counter-assistance. Pale-red-purple indicates deficient heat; bright-red indicates excess heat. Pupil protrusion with red sclera indicates heat; green/cyan pupil with withered sclera indicates cold. Swelling, redness, stabbing pain, worse at night, eyes closed but seeing objects indicates blazing evil fire. White nebula covering eye, little/no pain, eyes open but blind indicates true fire insufficiency. Carefully observe form, symptoms, color, pulse, and medicate accordingly. This is the major principle of internal treatment. If neglected long-term, Qi/Blood stagnate, Fire/Heat accumulate, causing redness, swelling, rotting, nebula—becoming external cataract. Like a dirty mirror, must be cleaned. Must use eye drops. Oral meds alone will not cure. Internal cataracts require oral meds only; eye drops harm Qi/Blood without benefit. Note: White sclera is Yang, day pain responds to bitter-cold drops. Pupil/black cornea is Yin, night pain worsens with bitter-cold drops. External treatment also distinguishes Yin/Yang. Headaches: Qi-deficiency type heavy morning/light evening; Blood-deficiency type light morning/heavy evening. Differentiate exterior/interior. Tonify Zheng-Qi primarily, slightly address exterior. Generalizing as Wind-Heat and dispersing easily damages eyes. Liver-Yin depletion, Wood-Fire flaming up causes headache, nausea, brow bone pain, anorexia, eyelid swelling, stabbing eye pain, purulent discharge, scleral cloudiness, eye protrusion, insomnia, even splitting pain at vertex/back of head—this is internally generated Wind. Liver belongs to Wood, Wood governs Wind. Heat generating Wind implies underlying Yin deficiency. Men may have spermatorrhea, white turbidity, intestinal wind, hemorrhoids bleeding. Women may have leukorrhea, metrorrhagia. This is Yin injury, Yang rising, internal Wind boiling. Strictly avoid dispersing. Use nourishing Yin extinguishing Wind, softening Liver nourishing Kidney methods. May save 40-50%. Avoid Qianghuo, Fangfeng, Chuanxiong, Xixin, Gaoben, Shengma etc. Mismanagement leads to essence depletion, prolapse, discharge, incurable chronic disease. Ophthalmologists must note this. Mr. Ye, though not an ophthalmology specialist, his case methods truly supplement predecessors' omissions, vastly superior to those habitually using bitter-cold dispersing or indiscriminate eye drops. Students should study carefully. (Comment by Ding Shengyan)
Xu's Comment: Ophthalmology has its own experts with specific formulas for presenting symptoms. Cases may not always hit the mark precisely, but prescriptions are light, clear, and peaceful, avoiding pitfalls of bitter-cold or warm-tonifying, surpassing modern self-proclaimed ophthalmologists. If medical principles are understood, nothing is inaccessible. For deep study, specialized books exist.