治舒舌弄舌。
防风 黄芩 天花粉 浓朴（姜炙） 石膏 枳壳 黄连 陈皮 甘草 水煎服。
治鹅口重舌，及舌疮。
青黛 朴硝（各一钱） 龙脑（一字） 为末，鹅翎少许，敷上。
治舌口一切诸疮。
升麻 射干（各三两） 柏叶（一升） 苦竹叶 地黄汁（各五合） 大青（二两）
生玄参汁（三合） 蔷薇根白皮 生芦根（各五两） 赤蜜（八合） 水四升，先将药煎至
一升，去滓，入玄参汁，再煎，下地黄汁，各煎两沸，下蜜煎浓，安舌上细咽。
一方
治小儿心有客热，满口生疮。用天南星末，醋调贴脚心。又有用吴茱萸末，米醋调涂，俱妙。
用乱头发， 存性，为极细末，猪脂调敷。
《经》曰∶夫心者，五脏之专精也。（五脏各有其精而心专之。）目者，其窍也。（目
为肝窍，然能辨别事物，故又为心窍。）华色者，其荣也。是以人之有德也。则气和于目，水
之精为志，火之精为神，水火相成，神志俱悲，是以目之水生也。谚曰∶心悲名曰志
悲，志与心精，共凑于目也。泣涕者，脑也。脑者，阴也。髓者，胃之充也。故脑渗为涕，志者，
骨之主也。是以水流而涕从之者，其行类也。（脑为髓海与肾流通，）神不守精，精神
去，目涕泪出也。由是观之，哭而无泪者，肾气脑髓枯槁也。目之红肿赤痛者，水精不足也。
目之青目内障者，火精不足也。
泣涕久而目盲者何？《灵枢》曰；心者，五脏六腑之主也。目者，宗脉之所聚也，上
液之道也。口鼻者，气之门户也。故悲哀愁忧而心动，心动则五脏六腑皆摇，摇则宗脉
感，液道开，故泣涕出焉。液者，所以灌精濡空窍者也。泣不止则液竭，液竭则精不灌
目无所见矣，故命曰夺精。《经》曰∶瞳子黑眼法于阴，白眼亦脉法于阳，故阴阳合传
于精，明此则眼具阴阳也。又云∶五脏六腑之精气，皆上注于目而为之精。然肾脏主藏
精，故治目者，以肾为主。虽为肝窍，子母相生，肾肝同一治也。其精之窠为眼，骨之
精为瞳子，筋之精为黑眼，血之精为络，其窠气之精为白眼，肌肉之精为约束裹撷，筋
骨气血之精，而与脉并为系，上属于脑，后出于项中，此眼具五腑六腑也。后世以大
赤者属心，君火为实火，小 赤者属心包，相火为虚火。上下两胞属脾，白眼属肺，黑
眼属肝，瞳人属肾，谓之五轮，本诸此也。
又有八廊之说，无义无据，不可宗也。
目者，五脏六腑之精也，故精散则视歧。又营卫魂魄之所常营也，神气之所生
也。故劳神则魂魄散，志意乱，且目者，心使也。心者，神之舍也。故精神乱而不转，
卒然见非常处也。且人之有两眼，犹天之有日月也。视万物察纤毫，日月有时晦者，风
云雷雨之所致也。目有时失明者，四气七情之所害也。凡在腑为表，当除风散热；在脏
为里，当养血安神。如暴赤肿痛，昏涩翳膜眵泪，斑疮入眼，皆表也。风热也，宜表散
以去之。如昏弱不欲视物，内障见黑花，瞳神散大，皆里也。由血少神劳肾虚也。宜养
血补水，安肾以调之。久则有瘀，当以破血生新之味兼用。白珠属阳，白珠痛者，则昼
甚；黑珠属阴，黑珠痛者，则夜甚。或有体肥气盛，风热上行，目昏涩者，此由胸中浊
气上行也。重则或为痰厥，亦能损目，若常使胸中气清，自无此病。若瘦人眼痛，多是
血少血热也。有病眼逢春夏便发者，此肝肾虚，而且多郁火也。又因有服目疾凉药过
多，阳气因损者，久之眼渐昏弱，乍明乍暗，不能视物也。有视物不明，见黑花者，
肾气弱也。有暴失明者，眼居诸阳交会之所，而阴反闭之，阳亡已极，而阴邪内满，
当有不测之患焉。
目闭不开者，足太阳之脉，为目上纲，足阳明之脉，为目下纲，平则约束，热则筋
纵，故目不能为之开也。海藏曰∶目瞑者，肝气不治也。
眼赤肿痛，古方用药，内外不同，在内汤散，则用苦寒辛凉之药以泻火，兼利小便
以导肝经风热；在外点洗，则用辛热辛凉之药，以散其邪，故点药莫要于冰片，而冰片
大辛热，故借以拔出火邪。古方用烧酒洗眼，或用干姜末，生姜汁点眼者，皆此意
也。盖赤眼是邪火内炎，上攻于目，故内治用苦寒之药，是治其本。然火邪既客于目，
从内出外。若外用寒凉，以阻逆之，则郁火内攻，得不散矣。故点药用辛热，洗眼用热
汤，是火郁则发之从治法也。世人不知冰片为劫药，而误认为寒，常用点眼，遂致积热
入目，而香窜走泄清光，则昏暗障翳，故云，眼不点不瞎者此也。又不知外治忌寒
凉，而妄将冷水冷药挹洗，尝致昏瞎者有之。
眼疾所因，不过实虚二者而已。虚者，眼目昏花，肾经真水之微也。实者，眼目肿
痛，肝经风热之甚也。热焉则散其风热，虚焉则滋其真阴，虚热相仍，则散风热，滋真
阴兼之，此内治之法也。至于久而失调热壅血凝，而为攀睛瘀肉、翳膜赤烂之类，不假
点洗，外法之法，则何由则愈？盖病情有标本，治法有内外，又尝论之。气有余便是
火，故散火在于抑气，古方多用枳壳、柴胡者是也。血不足则阴虚，而补阴在于滋水，
故古方必用归芍地黄者是也。常使血能配气，水能制火，则眼疾胡为则作也。
肝开窍于目，胆汁减则目暗，目者，肝之外候，胆之精华也。故诸胆皆治目疾，点
服说云∶病有内外，治各不同，内疾既发，非服不除；外疾既成，非点不退。内疾始
盛，浚流不如塞源，伐枝不如去根，不服药而除者，未之见也。外障既成，如物污须
濯，镜垢须磨，不点而去，未之有也。若内障不服，而外点反激其火，动其血气，无益
反损。若外障已成，虽服药不发不长，而所结不除，必内外夹攻，方尽其妙。然目 白
珠属阳，故昼痛，点苦寒药则效。黑珠属阴，故夜痛，点苦寒药则反剧，则点药外治
之法，亦当以阴阳区别矣。
倒睫拳毛者，其毛入眼中央是也。由伏热内攻，阴气外行，而目急皮缩之故，当去
其内热火邪，使眼皮缓，则眼毛立出矣。故眼楞紧急缩小者，即倒睫拳毛之渐也。盖阳
主散，阳虚则眼楞紧急，而为倒睫拳毛。阴主敛，阴虚则瞳子散大，而为目昏眼花。故
东垣治眼楞紧，用参 补气为君，佐以辛味
疏散，而忌芍药五味之酸收。治瞳子散大。用地黄补血为君。佐以五味子酸味收敛，而
忌茺蔚子、青箱子之辛散，一开一阖，大有径庭矣。
华元化云∶目形类丸，瞳神居中，而煎如日月之丽，东南而晦西北也。有神膏神水
神光，真气真血五精，此滋目之源液也。神膏者，目内包涵膏液，此膏由胆中渗润精
汁，积而成者，能涵养瞳神，衰则有损神水者，由三焦而发源，先天真一之气所化，目
上润泽之水是也。水衰，则有火胜燥暴之患，水竭，则有目轮大小之疾，耗涩，则有
昏眇之危，亏则多盈者少，是以世无全精之目，神光者，原于命门，通于胆，发于心，
是火之用也。火衰则有昏瞑之患。瞑者，目闭不开，是肝气不足也。火炎则有焚烁之
殃，虽有两心而无正轮。心，君主也，通于大 ，故大 赤者，实火也。包络为小心，
小心相火也，代君行令，通于小 ，故小 赤者，虚火也。若君主拱默，则相火自然清
宁矣。真血者，即肝中升运滋目注络之血也。此血非肌肉间易行之血，从天一所生之
水，故肝肾同源也。真气者，即目之经络中往来生用之气，乃先天真一发生之元阳也。
真精者，乃先天元气所化，精汁起于肾，施于胆，而后及瞳神也。凡此数者，一有损，
目则病矣。大概目圆而长，外有坚壳数重，中有清脆肉包，黑稠神膏一函，外则曰稠神
水，神水以滋神膏，水外则皆血，血以滋神水，膏中一点黑莹，是肾胆所聚之精华，惟
此一点烛熙，鉴视空阔无穷者，是曰水轮，内应于肾，北方壬癸亥子水也。五轮之中，
惟瞳神乃照，或曰∶瞳神。水耶、气耶、血耶、膏耶？曰∶非气、非血、非水、非膏，
乃先天之气所生，后天之气所成，阴阳之妙蕴水火之精华。血养水，水养膏，膏护瞳
神，气为运用，神即维持，喻以日月，理实同之，男子右目不如左目精华，女子左目不
如右目光彩，此皆各得其阴阳气分之正也。人之邪正寿夭贵贱，皆可验目而得之，岂非
入身之至宝乎。
《经》曰∶目流KT KT 无所见者，阴内夺。又曰∶脱阴者，则精丧而目盲，此房劳目昏
也。右肾阴虚，益阴地黄丸，如六味地黄丸。右肾阳虚，补肾丸，或八味地黄丸。若
能远视，不能近视者，阳气有余，阴气不足也。海藏云∶目能远视，责其有火，不能近
视，责其无水。《秘要》云∶阴精不足，阳光有余，病于水者，故光发见散乱而能收敛
近视，治之在心肾，心肾平则水火调，而阴阳和。夫水之所化为血，在身为津液，在目
为膏汁。若贪淫恣欲，饿饱失节，形脉劳甚，过于悲泣，皆能断耗阴精，阴精亏则阳
水盛，火性炎而发见，阴精不能制伏挽回，故越于外而远照，不能近之而反视也。治之
当如何？壮水之主，以镇阳光。若能近视不能远视，阳气不足，阴气有余也。海藏云∶
目能近视，责其有水，不能远视，责其无火。《秘要》云，此证非谓禀成近窥之病，
乃平昔无病。素能远视，而忽然不能者也。盖阳不足，阴有余，病于火者，故光华不能
发越于外，而偎敛近视耳，治之在胆肾，胆肾足则水火通明，神气宣畅，而精光远达
矣。夫火之所用为气，在身为威仪，在目为神光，若从恣色欲，丧其元阳，元阳既备，
则云霾阴翳，肾中之阴水，仅足以回光自照，焉能健运精汁，以滋于胆，而使水中之
火，速布于空中耶。《灵枢》曰∶精脱者，耳聋，气脱者，目不明，治之当何如？益火
之源以消阴翳。又有阳虚不能抗阴者，因饮食失节，劳役过度，脾胃虚弱，下陷于肾
肝，浊阴不能下降，清阳不能上升，天明则日月不明，邪害空窍，令人耳目不明。夫五
脏六腑之精，皆禀受于脾土，而上贯于目，此精字乃饮食所化之精，非天一之元精也。
脾者，诸阴之首也。目者，血气之宗也。故
脾虚则五脏之精气皆失所司，不能归明于目矣。况胃气下陷于肾肝，名曰重强，相火挟
心火而妄行，百脉沸腾，血脉逆上，而目病矣。若两目暗昏，四肢不怠者，用益气聪明
汤。若两目紧小，羞明畏日者，或视物无力，肢体倦怠，或手足麻木，乃脾肺气虚，
不能上行也，用神效黄 汤。若病后，或日晡，或灯下，不能视者，阳虚下陷也，决明
夜光丸，或升麻镇阴汤。如不知此，而徒以滋阴清凉为事，则苦寒伤胃，中气愈虚，饮
食少而运化迟，气血不生，精华俱耗，诸阴之首有亏，而欲眼目光明者，鲜矣。
张子和云∶目不因火则不病，白轮病赤，火乘肺也。囟轮赤肿，火乘脾也。黑水
神光被翳，火乘肝与脾也。赤脉贯目，火自甚也。能治火者，一句可了。但子和一味寒
凉治火，不若独补水以配火，亦一句可了。况目病而有火者，则为浮翳外障，虽肿痛难
忍，无害于目也。若病目而无火者，便为冰翳，内障虽无，所苦必致于丧明矣，治目
者，岂可专以去火为事耶！譬诸灯烛而无火，则不能济其光明之用矣。
五轮虽分五脏，实肝肾致病居多，非肝荣不足，暴赤肿疼，即肾水有亏，昏花内
障，气虚则目无精光，血虚则黑睛散大，除初病风热，应用疏散外，其余俱宜肝肾二
家，滋荣补水为主，久患而阳光不足者，补水之中更兼补阳，阳光一壮，精明乃能昭
着。若过用寒凉之药，浮翳为冰翳，外障成内障矣。
治疗伸舌、弄舌。
防风、黄芩、天花粉、厚朴（姜炙）、石膏、枳壳、黄连、陈皮、甘草，水煎服。
治疗鹅口疮、重舌以及舌疮。
青黛、朴硝（各一钱）、龙脑（一字），研为细末，用鹅毛蘸取少许，敷在患处。
治疗舌头和口腔的一切各种疮疡。
升麻、射干（各三两）、柏叶（一升）、苦竹叶、地黄汁（各五合）、大青（二两）、生玄参汁（三合）、蔷薇根白皮、生芦根（各五两）、赤蜜（八合）。用水四升，先将药物煎煮至一升，滤去药渣，加入玄参汁，再次煎煮，然后加入地黄汁，各煮沸两次，最后加入蜂蜜煎至浓稠，含于舌下细细咽下。
另一方法：
治疗小儿心经有客热，满口生疮。用天南星粉末，醋调匀后贴敷脚心。又有用吴茱萸粉末，米醋调涂，效果都很好。
用乱头发，存性（煅烧保留药性），研为极细末，用猪油调匀后敷贴。
《内经》说：心，是五脏精气汇聚专主的地方。（五脏各有其精，而心专门统摄它们。）眼睛，是心的外窍。（眼睛虽然是肝的外窍，但能辨别事物，所以又是心的外窍。）面色光泽，是心的荣华表现。因此人如果有德行，那么气和顺地表现在眼睛上。水的精华称为志，火的精华称为神，水火相互成就，神与志都悲伤，所以眼中会生出泪水。谚语说：心悲叫做志悲，志与心的精气，共同汇聚于眼睛。涕泪，源于脑。脑，属阴。髓，由胃气充养。所以脑液渗漏成为鼻涕，志，是骨的主宰。所以像水流一样，鼻涕也随之而出，它们的运行规律是相似的。（脑为髓海，与肾相通，）神不能守持精气，精神离去，眼泪就会流出。由此看来，哭泣而没有眼泪的，是肾气和脑髓枯槁的表现。眼睛红肿赤痛的，是水精不足的表现。眼睛出现青盲内障的，是火精不足的表现。
为什么流泪久了会导致失明呢？《灵枢》说：心，是五脏六腑的主宰。眼睛，是众多经脉汇聚的地方，也是津液上行的通道。口鼻，是气息的门户。所以悲哀愁忧会使心动，心动则五脏六腑都摇动，摇动则众多经脉感应，津液通道打开，所以眼泪鼻涕流出。津液，是用来灌注精髓、濡润空窍的。如果眼泪不止，津液就会枯竭，津液枯竭则精髓得不到灌注，眼睛就无法视物了，所以称之为“夺精”。《内经》说：黑眼瞳仁效法于阴，白眼珠也效法于阳，所以阴阳结合传递于精髓，明白这一点，就知道眼睛具备阴阳属性。又说：五脏六腑的精气，都向上注于眼睛而形成视觉。既然肾脏主管藏精，所以治疗眼病，以肾为主。虽然眼睛是肝的外窍，但肝肾母子相生，肾肝的治疗原则是一致的。精髓的巢穴就是眼睛，骨的精髓表现为瞳仁，筋的精髓表现为黑眼珠，血的精髓表现为血络，气的精髓表现为白眼珠，肌肉的精髓表现为眼睑约束包裹的部分，筋骨气血的精髓，与脉一起构成目系，向上连接大脑，向后出于项中，这样眼睛就具备了五脏六腑的特征。后世认为大片的红属于心，君火为实火；小片的红属于心包，相火为虚火。上下眼睑属于脾，白眼珠属于肺，黑眼珠属于肝，瞳仁属于肾，这被称为“五轮”，本于此理。
又有“八廓”的说法，没有意义和依据，不可遵从。
眼睛，是五脏六腑精气的汇聚，所以精气涣散就会导致视物成双。眼睛也是营卫魂魄经常营守的地方，是神气产生的地方。所以劳神过度则魂魄涣散，意志混乱，而且眼睛是心的使者。心，是神的居所。所以精神混乱而不回转，突然看到不寻常的事物。况且人有两只眼睛，就像天上有太阳和月亮。观察万物，洞察毫厘，日月有时昏暗，是因为风云雷雨造成的。眼睛有时失明，是因为四时气候和七情所害。凡是在腑的为表证，应当祛风散热；在脏的为里证，应当养血安神。如突然红肿疼痛，昏涩有翳膜眵泪，斑疮入眼，都属于表证。这是风热所致，宜用解表发散的方法去除它。如昏弱不想看东西，内障见黑花，瞳神散大，都属于里证。这是由于血少、神劳、肾虚所致。宜用养血补水、安肾的方法来调理。时间久了会有瘀血，应当兼用破血生新的药物。白眼珠属阳，白眼珠痛，则白天加重；黑眼珠属阴，黑眼珠痛，则夜间加重。或者有身体肥胖气盛，风热上行，眼睛昏涩的，这是由于胸中浊气上行所致。严重的甚至发生痰厥，也能损害眼睛，如果常使胸中气机清朗，自然没有这种病。如果是瘦人眼痛，多是血少血热所致。有病人在春夏季节眼睛发作的，这是肝肾虚弱，而且多有郁火。又因为服用治眼病的凉药过多，阳气受损，久而久之眼睛逐渐昏弱，忽明忽暗，不能视物。有视物不明，看见黑花的，是肾气虚弱。有突然失明的，眼睛位于诸阳经交会之处，而阴邪反而闭塞它，阳气亡失已极，而阴邪内满，应当有不测的危险。
眼睛闭合不能睁开，足太阳膀胱经的经脉，是上眼睑；足阳明胃经的经脉，是下眼睑。正常时约束眼球，受热则筋脉弛纵，所以眼睛不能睁开。海藏说：眼睛闭合，是肝气失调所致。
眼睛红肿疼痛，古方用药，内外不同。在内服用汤剂散剂，则用苦寒辛凉的药物治疗以泻火，兼利小便以引导肝经风热；在外点洗，则用辛热辛凉的药物治疗以疏散邪气，所以点眼药最重要的是冰片，而冰片大辛大热，所以借它来拔出火邪。古方用烧酒洗眼，或用干姜末、生姜汁点眼的，都是这个意思。大概赤眼是邪火内炎，上攻于眼睛，所以内治用苦寒的药物，是治其根本。然而火邪既然客居于眼睛，从内出到外。如果外用寒凉药物，来阻逆它，则郁火内攻，怎么能不散呢？所以点药用辛热，洗眼用热汤，这是火郁则发之的从治法。世人不知道冰片是劫药，而误认为是寒性，常用它点眼，导致积热入眼，香气窜走泄失清光，则昏暗障翳，所以说，眼睛不点药就不会瞎的是因为这个原因。又不知道外治忌讳寒凉，而妄用冷水冷药洗涤，曾经导致失明的情况也有。
眼疾的原因，不过是虚实两种而已。虚证，是眼睛昏花，是肾经真水微弱。实证，是眼睛肿痛，是肝经风热严重。热则散其风热，虚则滋其真阴，虚热相兼，则散风热、滋真阴兼用，这是内治的方法。至于时间久了失调，热壅血凝，形成攀睛瘀肉、翳膜赤烂之类，如果不借助点洗等外治方法，怎么能痊愈呢？大概病情有标本，治法有内外，我又曾论述过。气有余便是火，所以散火在于抑制气，古方多用枳壳、柴胡就是这个道理。血不足则阴虚，而补阴在于滋水，所以古方必用归芍地黄丸就是这个道理。常使血能配气，水能制火，那么眼疾怎么会发作呢？
肝开窍于目，胆汁减少则眼睛昏暗，眼睛，是肝之外候，胆之精华。所以各种胆经药物都治疗眼疾，点服的说法说：病有内外，治疗各不相同。内疾既已发作，不服药不能消除；外疾既已形成，不点药不能退除。内疾刚开始旺盛，疏通源头不如堵塞根源，砍伐树枝不如去掉树根，不服药就能消除的情况，从未见过。外障既已形成，如同物体污染必须洗涤，镜子污垢必须磨擦，不点药就能去除的情况，从未有过。如果是内障不服药，而外点药反而激发其火，扰动其血气，无益反而有害。如果是外障已形成，虽然服药不发不长，但结聚不去除，必须内外夹攻，才能尽其妙用。然而白眼珠属阳，所以白天痛，点苦寒药有效。黑眼珠属阴，所以夜间痛，点苦寒药反而加剧，那么点药外治的方法，也应当以阴阳来区别。
倒睫拳毛，是指睫毛进入眼睛中央。这是由于伏热内攻，阴气外行，导致眼部肌肉紧急皮肤收缩的缘故，应当去除内部热火邪气，使眼皮松弛，那么眼毛自然立出了。所以眼裂紧急缩小的，就是倒睫拳毛的先兆。大概阳主散，阳虚则眼裂紧急，而为倒睫拳毛。阴主敛，阴虚则瞳仁散大，而为目昏眼花。所以东垣治疗眼裂紧，用人参补气为君药，佐以辛味疏散，而忌用芍药、五味子的酸收。治疗瞳仁散大，用地黄补血为君药，佐以五味子酸味收敛，而忌用茺蔚子、青葙子的辛散，一开一阖，差别很大。
华元化说：眼睛形状像丸子，瞳神居中，煎灼如日月的照耀，东南晦暗西北明亮。有神膏、神水、神光，真气、真血、五精，这些是滋润眼睛的源液。神膏，是眼睛内部包含的膏液，这种膏由胆中渗润精汁，积聚而成，能涵养瞳神，衰败则有损神水者，由三焦发源，先天真一之气所化，是眼睛上润泽的水。水衰，则有火胜燥暴的祸患，水竭，则有眼睛大小轮的疾病，耗涩，则有昏眇的危险，亏损则盈者少，所以世上没有完全精良的眼睛。神光，源于命门，通于胆，发于心，是火的作用。火衰则有昏瞑的祸患。瞑，是眼睛闭合不开，是肝气不足。火炎则有焚烁的灾殃，虽有两心而无正轮。心，是君主，通于大络，所以大络红，是实火。包络为小心，小心是相火，代君行使命令，通于小络，所以小络红，是虚火。如果君主拱手沉默，则相火自然清宁了。真血，即肝中升运滋润眼睛注入脉络的血。这种血不是肌肉间容易运行的血，从天一所生的水而来，所以肝肾同源。真气，即眼睛经络中往来生用的气，乃先天真一发生之元阳。真精，乃先天元气所化，精汁起于肾，施于胆，而后及于瞳神。凡是这几样，有一样受损，眼睛就病了。大概眼睛圆而长，外面有坚壳数层，里面有清脆肉包，黑稠神膏一函，外面叫稠神水，神水以滋养神膏，水外面都是血，血以滋养神水，膏中一点黑莹，是肾胆所聚的精华，只有这一点烛照熙暖，鉴视空阔无穷的，叫做水轮，内应于肾，北方壬癸亥子水。五轮之中，只有瞳神能照，有人说：瞳神是水吗、气吗、血吗、膏吗？回答说：不是气、不是血、不是水、不是膏，乃先天之气所生，后天之气所成，阴阳的妙蕴，水火的精华。血养水，水养膏，膏护瞳神，气为运用，神即维持，比喻为日月，道理其实相同，男子右眼不如左眼精华，女子左眼不如右眼光彩，这都是各自得到阴阳气分的正气。人的邪正寿夭贵贱，都可以验之于眼睛而得知，难道不是人身上的至宝吗。
《内经》说：眼睛流泪看不清东西的，是阴气内夺。又说：脱阴的人，则精髓丧失而失明，这是房劳导致的目昏。右肾阴虚，用益阴地黄丸，如六味地黄丸。右肾阳虚，用补肾丸，或八味地黄丸。如果能远视，不能近视的，是阳气有余，阴气不足。海藏说：眼睛能远视，责在有火，不能近视，责在没有水。《秘要》说：阴精不足，阳光有余，病在水，所以光芒发散散乱而不能收敛近视，治疗在心肾，心肾平和则水火调，而阴阳和。水所化为血，在身为津液，在目为膏汁。如果贪淫恣欲，饿饱失节，形体脉象劳甚，过于悲泣，都能断耗阴精，阴精亏则阳水盛，火性炎上而发见，阴精不能制伏挽回，所以越于外而远照，不能近之而反视。治疗应当如何？壮水之主，以镇阳光。如果能近视不能远视，是阳气不足，阴气有余。海藏说：眼睛能近视，责在有水，不能远视，责在没有火。《秘要》说，此证不是说禀赋造成近窥的病，而是平素无病，素能远视，而忽然不能的。大概阳不足，阴有余，病在火，所以光华不能发越于外，而偎敛近视耳，治疗在胆肾，胆肾充足则水火通明，神气宣畅，而精光远达了。火的作用为气，在身为威仪，在目为神光，如果放纵色欲，丧其元阳，元阳既备，则云霾阴翳，肾中的阴水，仅足以回光自照，怎么能健运精汁，以滋于胆，而使水中的火，速布于空中呢？《灵枢》说：精脱者，耳聋，气脱者，目不明，治疗应当如何？益火之源以消阴翳。又有阳虚不能抗阴的，因饮食失节，劳役过度，脾胃虚弱，下陷于肝肾，浊阴不能下降，清阳不能上升，天明则日月不明，邪害空窍，令人耳目不明。五脏六腑的精气，都禀受于脾土，而上贯于目，这个“精”字乃是饮食所化的精，非天一之元精。脾，是诸阴之首。眼睛，是血气之宗。所以脾虚则五脏的精气都失去主宰，不能归明于眼睛了。何况胃气下陷于肝肾，名叫重强，相火挟心火而妄行，百脉沸腾，血脉逆上，而眼睛病了。如果两眼暗昏，四肢不怠的，用益气聪明汤。如果两眼紧小，羞明畏日的，或者视物无力，肢体倦怠，或者手足麻木，是脾肺气虚，不能上行，用神效黄芪汤。如果病后，或者傍晚，或者灯下，不能视物的，是阳虚下陷，用决明夜光丸，或升麻镇阴汤。如果不知道这些，而徒然以滋阴清凉为事，则苦寒伤胃，中气愈虚，饮食少而运化迟，气血不生，精华俱耗，诸阴之首有亏，而想要眼睛光明的，很少了。
张子和说：眼睛不因火则不病，白轮病赤，是火乘肺。囟轮赤肿，是火乘脾。黑水神光被翳，是火乘肝与脾。赤脉贯目，是火自甚。能治火，一句可了。但子和一味寒凉治火，不如独补水以配火，也是一句可了。况且眼病而有火的，则为浮翳外障，虽然肿痛难忍，无害于眼睛。如果病眼而无火的，便为冰翳，内障虽然没有，所苦必定导致失明，治眼的人，岂可专以去火为事耶！譬如灯烛而无火，则不能济其光明之用矣。
五轮虽然分属五脏，实际上是肝肾致病居多，不是肝荣不足，暴赤肿疼，就是肾水有亏，昏花内障，气虚则目无精光，血虚则黑睛散大，除了初病风热，应用疏散外，其余都适宜肝肾两家，滋荣补水为主，久患而阳光不足的，补水之中更兼补阳，阳光一壮，精明乃能昭着。如果过用寒凉的药物，浮翳为冰翳，外障成内障了。
Treats protruding tongue (Shetong) and playing with the tongue (Nongshe).
Fangfeng (Saposhnikovia Root), Huangqin (Scutellaria Root), Tianhuafen (Trichosanthes Root), Houpo (Magnolia Bark, processed with ginger), Shigao (Gypsum Fibrosum), Zhike (Aurantium Fructus), Huanglian (Coptis Rhizome), Chenpi (Citrus Reticulatae Pericarpium), Gancao (Licorice Root). Decoct in water and take orally.
Treats goose-mouth sores (E'kou), double tongue (Chongshe), and tongue ulcers.
Qingdai (Indigo Naturalis), Puxiao (Natrii Sulfas, each 1 qian), Longnao (Borneolum Syntheticum, 1 zi). Grind into fine powder. Dip a small amount onto a goose feather and apply to the affected area.
Treats all kinds of sores on the tongue and mouth.
Shengma (Cimicifugae Rhizoma), Shegan (Belamcandae Rhizoma, each 3 liang), Baiye (Platycladi Cacumen, 1 sheng), Ku Zhuye (Bitter Bamboo Leaf), Dihuang Zhi (Rehmanniae Juice, each 5 he), Daqing (Isatidis Folium, 2 liang), Sheng Xuanshen Zhi (Scrophulariae Juice, 3 he), Qiangwei Gen Baipi (Rosa Rugosae Radix Cortex), Sheng Lugen (Phragmitis Rhizoma, each 5 liang), Chi Mi (Red Honey, 8 he). Use 4 sheng of water. First decoct the herbs until reduced to 1 sheng. Strain and remove dregs. Add Xuanshen Zhi and decoct again. Then add Dihuang Zhi and boil twice. Finally add honey and decoct until thick. Place under the tongue and swallow slowly.
Another prescription:
Treats children with guest-heat in the Heart causing sores all over the mouth. Use Tannanxing (Arisaematis Rhizoma) powder mixed with vinegar applied to the sole of the foot. Another method uses Wuzhuyu (Evodiae Fructus) powder mixed with rice vinegar applied topically; both are excellent.
Use tangled hair, preserved by calcination (Cunxing), ground into an extremely fine powder, mixed with pig fat (Zhuzhi) and applied.
The *Classic* states: The Heart is the essence and specialization of the five zang organs. (Each zang organ has its own essence, but the Heart governs them specifically.) The eyes are its orifice. (Although the eyes are the orifice of the Liver, they distinguish objects, thus they are also the orifice of the Heart.) Luster and color are its flourishing manifestation. Therefore, when a person possesses virtue, qi harmonizes in the eyes. The essence of water is called Zhi (Will), and the essence of fire is called Shen (Spirit). Water and fire complement each other; when Shen and Zhi are both sorrowful, tears arise from the eyes. The proverb says: Heart sorrow is called Zhi sorrow. Zhi and the Heart's essence gather together at the eyes. Nasal discharge and tears originate from the brain. The brain is Yin. Marrow is nourished by Stomach qi. Thus, brain fluid seeps out as nasal mucus. Zhi is the master of bones. Therefore, just as water flows, nasal mucus follows; their movement patterns are similar. (The brain is the sea of marrow and communicates with the Kidney.) When Shen does not guard the essence, and spirit departs, tears flow from the eyes. From this, we see that crying without tears indicates exhaustion of Kidney qi and brain marrow. Redness, swelling, and pain of the eyes indicate insufficiency of water essence. Green blindness and internal cataracts indicate insufficiency of fire essence.
Why does prolonged tearing lead to blindness? The *Ling Shu* states: The Heart is the master of the five zang and six fu organs. The eyes are the gathering place of the major meridians and the upper pathway for fluids. The mouth and nose are the portals of qi. Therefore, sorrow and worry cause the Heart to move; when the Heart moves, the five zang and six fu organs tremble. Trembling causes the major meridians to be stimulated, the fluid pathways open, and tears and nasal discharge flow out. Fluids are used to irrigate essence and moisten the orifices. If tears do not stop, fluids are exhausted. When fluids are exhausted, essence is not irrigated, and the eyes lose vision. This is called "Robbing Essence." The *Classic* states: The pupil and black eye imitate Yin, while the white sclera imitates Yang. Thus, Yin and Yang combine to transmit to the essence. Understanding this reveals that the eye possesses both Yin and Yang. It is also said: The essence of the five zang and six fu organs all ascend to the eyes to form vision. Since the Kidney governs storing essence, treating eye diseases focuses primarily on the Kidney. Although the eyes are the orifice of the Liver, due to the mother-son relationship between Liver and Kidney, their treatment principles are unified. The nest of essence is the eye. The essence of bone manifests as the pupil. The essence of sinew manifests as the black eye (iris/cornea). The essence of blood manifests as the blood vessels. The essence of qi manifests as the white sclera. The essence of muscle manifests as the eyelid constraints. The essence of sinew, bone, qi, and blood, combined with the meridians, forms the optic nerve, connecting upward to the brain and exiting posteriorly at the neck. Thus, the eye embodies the five zang and six fu organs. Later generations associate extensive redness with the Heart, where Minister Fire represents Excess Fire. Minor redness is associated with the Pericardium, where Minister Fire represents Deficient Fire. The upper and lower eyelids belong to the Spleen. The white sclera belongs to the Lung. The black eye belongs to the Liver. The pupil belongs to the Kidney. This is called the "Five Wheels," originating from this theory.
There is also a theory of the "Eight Palaces," which lacks meaning and evidence and should not be followed.
The eyes are the essence of the five zang and six fu organs. Therefore, if essence scatters, vision becomes double. The eyes are also where Ying and Wei, Hun and Po commonly circulate, and where Shen Qi arises. Therefore, mental labor causes Hun and Po to scatter and will to become chaotic. Moreover, the eyes are the emissary of the Heart. The Heart is the residence of Shen. Therefore, when spirit and mind are chaotic and unresponsive, one suddenly sees extraordinary things. Furthermore, humans have two eyes, just as heaven has the sun and moon. Observing all things and detecting minute details: the sun and moon sometimes darken due to wind, clouds, rain, and thunder. Eyes sometimes lose sight due to harm from the four climatic factors and seven emotions. Pathologies in the fu organs are exterior; treat by dispelling wind and clearing heat. Pathologies in the zang organs are interior; treat by nourishing blood and calming the spirit. Sudden redness, swelling, pain, turbidity, dryness, membranes, discharge, and sores entering the eye are all exterior conditions caused by wind-heat. Disperse them via the exterior. Dimness, weakness, aversion to viewing objects, internal cataracts, seeing black flowers, and dilated pupils are all interior conditions caused by blood deficiency, mental fatigue, and Kidney deficiency. Nourish blood, tonify water, and calm the Kidney to regulate. Prolonged cases may involve blood stasis; use blood-breaking and blood-generating herbs. The white sclera is Yang; pain here worsens during the day. The black eye is Yin; pain here worsens at night. Obese individuals with abundant qi and ascending wind-heat experience dim, dry eyes due to turbid qi ascending from the chest. Severe cases may result in phlegm-jue, damaging the eyes. Keeping the chest qi clear prevents this. Thin individuals with eye pain often suffer from blood deficiency and blood-heat. Eye disease flaring in spring and summer indicates Liver-Kidney deficiency with much stagnant fire. Overuse of cooling medicines for eye disease damages Yang qi, leading to gradual dimness, fluctuating vision, and inability to see clearly. Unclear vision with black flowers indicates weak Kidney qi. Sudden blindness occurs because the eyes are at the convergence of all Yang meridians, yet Yin pathogen closes them off. Extreme Yang depletion with full Yin pathogen inside portends unpredictable danger.
Eyes closed and unable to open: The Foot-Taiyang meridian governs the upper eyelid; the Foot-Yangming meridian governs the lower eyelid. Normally, they constrain the eye. Heat causes sinew laxity, preventing opening. Haizang stated: Closed eyes indicate disordered Liver qi.
For red, swollen, and painful eyes, ancient prescriptions differ internally and externally. Internally, decoctions and powders use bitter-cold and acrid-cool herbs to drain fire and promote urination to guide Liver wind-heat outward. Externally, drops and washes use acrid-hot and acrid-cool herbs to disperse pathogens. The most important drop herb is Bingpian (Borneolum), which is acrid-hot, used to extract fire pathogen. Ancient methods used hot wine to wash eyes or dry ginger powder/ginger juice to drop, following this logic. Red eyes are caused by internal flaming fire attacking the eyes. Internal treatment with bitter-cold herbs addresses the root. However, once fire pathogen resides in the eye and moves outward, using cold external agents blocks it, causing stagnant fire to attack inward. Thus, acrid-hot drops and hot water washes follow the principle of "releasing stagnant fire." People mistakenly believe Bingpian is cold and use it frequently, causing accumulated heat to enter the eye, dispersing clarity, leading to dimness and opacity. Hence, "eyes do not go blind unless dropped [with wrong meds]." Ignoring the contraindication of cold for external treatment, people wrongly use cold water/herbs to wash, causing blindness.
Eye disease causes are merely excess or deficiency. Deficiency presents as dim vision due to weak Kidney true water. Excess presents as swelling and pain due to severe Liver wind-heat. For heat, disperse wind-heat. For deficiency, nourish true yin. For deficient heat, do both. This is internal treatment. For long-term imbalance with heat stagnation and blood coagulation causing pterygium, fleshy growths, membranes, and red rot, external drops/washes are necessary. Disease has root and branch; treatment has internal and external. Excess qi becomes fire; dispersing fire requires suppressing qi (ancient formulas use Zhike, Chaihu). Blood deficiency leads to yin deficiency; tonifying yin requires nourishing water (ancient formulas use Guishao Dihuang Wan). If blood harmonizes with qi and water controls fire, eye disease will not arise.
The Liver opens into the eyes. Bile reduction causes dim vision. The eyes are the external manifestation of the Liver and the essence of the Gallbladder. Thus, Gallbladder herbs treat eye diseases. Drop administration theory states: Diseases have internal and external aspects; treatments differ. Internal diseases require oral medication to resolve; external diseases require topical application to retreat. Early-stage internal disease: blocking the source is better than dredging the stream; removing the root is better than cutting branches. Never seen a case cured without medicine. Formed external obstruction: like cleaning dirt or polishing mirrors, never cured without drops. Treating internal obstruction without oral meds, while using external drops, may provoke fire and disturb blood/qi, causing harm. If external obstruction is formed, oral meds may prevent progression but won't remove the knot; internal and external attack together is optimal. White sclera is Yang, so daytime pain responds to bitter-cold drops. Black eye is Yin, so nighttime pain worsens with bitter-cold drops. Thus, external drop therapy must distinguish Yin/Yang.
Trichiasis (Daojie) and rolled lashes occur when lashes enter the center of the eye. This is due to latent heat attacking internally and Yin qi moving externally, causing eye muscles to tighten and skin to shrink. Remove internal fire-heat pathogen to relax eyelids, allowing lashes to emerge. Tight, shrinking eye fissures are precursors to trichiasis. Yang governs dispersion; Yang deficiency causes tight fissures and trichiasis. Yin governs consolidation; Yin deficiency causes dilated pupils and dim vision. Dongyuan treated tight fissures using Renshen (Ginseng Root) as sovereign to tonify qi, assisted by acrid herbs to disperse, avoiding Sour-astringent Shaoyao and Wuweizi. He treated dilated pupils using Dihuang (Rehmannia Root) as sovereign to nourish blood, assisted by Wuweizi for astringency, avoiding Xiongwei Zi and Qingxiang Zi for their acrid-dispersing nature. Opening and closing differ greatly.
Hua Yuanhua stated: The eye shape resembles a sphere, with the pupil centered, shining like the sun and moon. There are Shen Gao (Divine Paste), Shen Shui (Divine Water), Shen Guang (Divine Light), Zhen Qi (True Qi), Zhen Xue (True Blood), and Five Essences, which are the source fluids nourishing the eye. Shen Gao is the paste contained within the eye, formed by accumulating essence fluid seeping from the Gallbladder, nurturing the pupil. Decline damages Shen Shui, which originates from the Sanjiao and transforms from Pre-heaven True One Qi, providing moisture. Water decline leads to fire dominance and dryness; water exhaustion leads to eye wheel disorders; consumption leads to dimness/blindness risk. Loss means less abundance, so no perfect eyes exist in the world. Shen Guang originates from Mingmen, connects to the Gallbladder, issues from the Heart, and is the function of Fire. Fire decline causes dimness. Dimness is closed eyes, indicating Liver qi deficiency. Fire flaming causes burning disaster, resulting in two hearts without proper wheels. The Heart is the Monarch, connecting to large collaterals; redness in large collaterals indicates Excess Fire. The Pericardium is the Small Heart, representing Minister Fire acting for the Monarch, connecting to small collaterals; redness in small collaterals indicates Deficient Fire. If the Monarch remains still, Minister Fire is naturally peaceful. True Blood is the blood rising from the Liver to nourish the eye collaterals. This is not easily flowing muscle blood but comes from Water generated by Heaven One, hence Liver and Kidney share the same source. True Qi is the qi circulating in eye meridians, the Primordial Yang of Pre-heaven generation. True Essence is transformed from Pre-heaven Original Qi; essence fluid starts in the Kidney, applies to the Gallbladder, then reaches the pupil. Damage to any of these causes eye disease. Generally, eyes are round and long, surrounded by hard shells, containing clear meat packages, dense black Shen Gao, and dense Shen Shui outside. Shen Shui nourishes Shen Gao; outside Shen Shui is blood, nourishing Shen Shui. A dark, bright point in the paste is the gathered essence of Kidney and Gallbladder. This single light illuminates infinite space, called the Water Wheel, corresponding to the Kidney, North Ren-Gui Hai-Zi Water. Among the Five Wheels, only the pupil shines. Some ask: Is the pupil water, qi, blood, or paste? Answer: Neither qi, nor blood, nor water, nor paste. It is born from Pre-heaven qi, formed by Post-heaven qi, containing the wonder of Yin/Yang and the essence of Water/Fire. Blood nourishes water, water nourishes paste, paste protects the pupil, qi operates, spirit maintains. Like sun and moon, the principle is the same. Men's right eyes lack the left's essence; women's left eyes lack the right's brilliance. This is obtaining correct Yin/Yang qi distribution. Human righteousness, longevity, death, nobility, and baseness can all be verified by the eyes. Are they not the greatest treasure of the body?
The *Classic* states: Eyes tearing and unable to see indicate internal loss of Yin. Also: Loss of Yin leads to essence loss and blindness, caused by sexual exhaustion. Right Kidney Yin deficiency: Yiyin Dihuang Wan, such as Liuwei Dihuang Wan. Right Kidney Yang deficiency: Bushen Wan, or Bawei Dihuang Wan. Ability to see far but not near indicates Excess Yang and Insufficient Yin. Haizang stated: Seeing far blames Fire; seeing near blames Water absence. *Mi Yao* states: Insufficient Yin essence, excessive Yang sunlight, pathology in Water causes scattered light unable to converge for near vision. Treat Heart and Kidney; balance makes Water/Fire harmonious and Yin/Yang balanced. Water transforms into blood, becomes Jin-Ye in the body, and becomes paste/juice in the eyes. Indulgence in lust, irregular eating/drinking, extreme physical/mental labor, and excessive weeping all consume Yin essence. Yin deficiency allows Yang water to flourish; Fire flares up. Yin cannot control it, so it escapes outward, shining far but unable to focus near. Treatment: Strengthen the Master of Water to suppress Yang sunlight. Ability to see near but not far indicates Insufficient Yang and Excess Yin. Haizang stated: Seeing near blames Water; seeing far blames Fire absence. *Mi Yao* states: This is not congenital near-sightedness, but sudden inability after previously seeing far. Yang insufficient, Yin excessive, pathology in Fire causes light unable to project outward, converging for near vision. Treat Gallbladder and Kidney; sufficient Gallbladder/Kidney makes Water/Fire bright, Shen Qi smooth, and essence light reach far. Fire's function is Qi, manifested as demeanor in the body and Shen Guang in the eyes. Indulgence in lust loses Yuan Yang. With Yuan Yang prepared, cloud/haze obscures. Kidney Yin water barely reflects light inward; how can it transport essence to nourish the Gallbladder and distribute Fire in Water into the air? *Ling Shu* states: Essence depletion causes deafness; Qi depletion causes unclear vision. Treatment: Tonify the Source of Fire to dissipate Yin haze. Yang deficiency failing to resist Yin, due to irregular diet, overwork, weak Spleen/Stomach sinking into Liver/Kidney, turbid Yin failing to descend, clear Yang failing to ascend, results in obscured vision like darkened sun/moon. Pathogen harms orifices, blinding ears and eyes. Essence of five zang/six fu derives from Spleen Earth and ascends to the eyes. This "essence" is food-derived, not Pre-heaven Yuan Jing. Spleen is head of all Yin. Eyes are chief of blood/qi. Spleen deficiency causes five zang essence to lose control, failing to clarify vision. Stomach qi sinking into Liver/Kidney is called "Heavy Strength." Minister Fire carries Heart Fire to wander wildly, boiling hundred vessels, reversing blood flow, causing eye disease. Dark/dim eyes with non-fatigued limbs: Use Yiqi Congming Tang. Tight/small eyes, photophobia, weak vision, limb fatigue, numbness: Spleen/Lung Qi deficiency failing to ascend. Use Shenxiao Huangqi Tang. Post-illness, dusk, or lamp-light vision failure: Yang deficiency sinking. Use Jueming Yeguang Wan or Shengma Zhenyin Tang. Without this knowledge, merely using Yin-nourishing/cooling herbs damages Stomach with bitter-cold, worsening Middle Qi. Poor appetite, slow digestion, no blood/qi generation, essence consumed. Defect in Head of Yin makes bright vision rare.
Zhang Zihe stated: Eye disease arises from Fire. Redness in the White Wheel indicates Fire invading Lung. Redness/swelling in the Xin Wheel indicates Fire invading Spleen. Obscured Black Water/Shen Guang indicates Fire invading Liver and Spleen. Red vessels crossing the eye indicates Fire self-excess. Controlling Fire resolves it in one sentence. But Zhang Zihe used only cold/cool herbs to treat Fire; better to solely tonify Water to match Fire, also one sentence. Eye disease with Fire causes floating opacity/external obstruction; though painful, harmless to vision. Eye disease without Fire causes ice opacity/internal obstruction; though no pain, inevitably leads to blindness. Treating eyes cannot focus solely on removing Fire! Like a candle without fire, it cannot provide light.
Although Five Wheels divide among five zang, Liver/Kidney pathology is most common. Either Liver blood deficiency causing sudden red/swollen/painful eyes, or Kidney water deficiency causing dimness/internal cataracts. Qi deficiency causes lack of luster; Blood deficiency causes dilated cornea. Except early wind-heat requiring dispersion, rest should focus on Liver/Kidney nourishment and water supplementation. Long-term cases with insufficient Yang should supplement Yang within water supplementation. Once Yang strengthens, clarity appears. Overusing cold/cool herbs turns floating opacity into ice opacity, external obstruction into internal obstruction.