经云∶五脏六腑之精华,皆上注于目。目者肝之窍也,肝与胆为表里,肝液胆汁充足,
目乃能远视,故无论外感内症,皆与肝胆有关。六淫之邪,风火与燥气居多,内起之症,肝胆与心肾为多。
白睛属肺曰气轮,乌球属肝曰风轮。大小 心曰火轮,上下胞脾曰肉轮。瞳神属肾曰水
轮,五脏五轮多肝经。目得血养视乃明,肝有风热目病生。
风温上郁目赤(左脉弦)
桑叶 夏枯草 连翘 草决明 菊叶 青菊花 苦丁茶 桑皮 料豆衣
燥热目赤且痛
鲜荷叶 山栀 赤芍 绿豆皮 夏枯草 生草 菊叶 苦丁茶 料豆衣 薄荷 桑白皮 连翘
暑热郁蒸目红
桑叶 谷精珠 通草 绿豆衣 米仁 望月砂 茯苓
木火上郁目赤疼肿
羚羊片 夏枯草 桑叶 谷精草 石决明 丹皮 绿豆皮 米仁 连翘 炒山栀 生地 菊叶
血络虚热,眼痛,白上红丝
羚羊片 连翘 川桂枝 青菊叶 丹皮 秦当归
脾肺蕴热(目胞浮肿,不饥不运)
桑皮 大腹皮 苡米仁 通草 茯苓 广陈皮 生姜皮
阴虚火郁(微寒汗出,下有痔漏,左眼疼)
六味丸去萸肉,加白芍,蔓荆子。
胃虚肝风(右眼多泪,心嘈杂)
嫩黄 归身 煨姜 大白芍 茯神 大枣
肝阴虚(左目痛热泪,翳膜)
桑叶 望月砂 黄甘菊 石决明 杞子 料豆衣 赤首乌 小胡麻(即黑芝麻)
肝肾虚目痛(治法同前)
熟地 归身 茯神 白蒺藜 萸肉 五味 菊花 柏子仁 生地 山药 桑椹子
大天冬 杞子 谷精草
陈参曰∶治法外感者必有寒热,头痛鼻塞,骨疼,脉见紧数浮洪方可清散。内固者如
肝胆之风热盛,当散热除风,如肾经之水。火衰,当壮水益火。若阴血虽亏,而风热未尽,则
当审其缓急,相参而治。
古籍记载:五脏六腑的精微物质,都向上灌注于眼睛。眼睛是肝的窍道,肝与胆互为表里,肝液和胆汁充足,眼睛才能看清远处的事物,所以无论是外感病还是内伤病,都与肝胆有关。六淫邪气中,风、火和燥气居多;体内产生的病症,多与肝胆和心肾有关。
白睛属于肺,称为气轮;黑眼球(乌球)属于肝,称为风轮;内外眼角的心部区域称为火轮;上下眼睑属于脾,称为肉轮;瞳孔属于肾,称为水轮。五脏对应的五轮大多与肝经有关。眼睛得到血液的滋养视力才清明,肝有风热则眼病发生。
风温上郁导致目赤(左脉弦):
桑叶、夏枯草、连翘、草决明、菊叶、青菊花、苦丁茶、桑皮、料豆衣。
燥热导致目赤且痛:
鲜荷叶、山栀、赤芍、绿豆皮、夏枯草、生甘草、菊叶、苦丁茶、料豆衣、薄荷、桑白皮、连翘。
暑热郁蒸导致目红:
桑叶、谷精珠、通草、绿豆衣、米仁(薏苡仁)、望月砂、茯苓。
木火上郁导致目赤疼肿:
羚羊片、夏枯草、桑叶、谷精草、石决明、丹皮、绿豆皮、米仁、连翘、炒山栀、生地、菊叶。
血络虚热,眼痛,白睛上有红丝:
羚羊片、连翘、川桂枝、青菊叶、丹皮、秦当归。
脾肺蕴热(眼睑浮肿,食欲不振,运化无力):
桑皮、大腹皮、薏苡仁、通草、茯苓、广陈皮、生姜皮。
阴虚火郁(轻微恶寒出汗,下部有痔漏,左眼疼痛):
六味丸去掉山茱萸,加入白芍、蔓荆子。
胃虚肝风(右眼多泪,心中嘈杂):
嫩黄芪、当归身、煨姜、大白芍、茯神、大枣。
肝阴虚(左眼疼痛热泪,有翳膜):
桑叶、望月砂、黄甘菊、石决明、枸杞子、料豆衣、赤首乌、小胡麻(即黑芝麻)。
肝肾虚导致目痛(治法同前):
熟地黄、当归身、茯神、白蒺藜、山茱萸、五味子、菊花、柏子仁、生地黄、山药、桑椹子、天冬、枸杞子、谷精草。
陈参说:治疗外感引起的眼病,必须有恶寒发热、头痛鼻塞、骨节疼痛、脉象紧数浮洪的表现,才可以采用清散的方法。内在固结的病症,如肝胆风热盛,应当散热除风;如果是肾经水亏火衰,应当壮水益火。如果阴血虽然亏损,但风热未尽,则应当审察病情的缓急,综合参酌进行治疗。
The ancient texts state: The essence of the five zang organs and six fu organs all ascend to nourish the eyes. The eyes are the orifice of the Liver (Gan). The Liver and Gallbladder (Dan) have an exterior-interior relationship. When the liver fluid and bile juice are sufficient, the eyes can see distant objects clearly. Therefore, whether it is an external contraction disease or an internal syndrome, it is related to the Liver and Gallbladder. Among the pathogenic factors of the Six Excesses (Liu Yin), wind, fire, and dryness are predominant; among internally generated syndromes, they are mostly related to the Liver, Gallbladder, Heart, and Kidney.
The white part of the eye belongs to the Lung (Fei) and is called the Qi Wheel (Qi Lun); the black pupil (Wu Qiu) belongs to the Liver and is called the Wind Wheel (Feng Lun); the inner and outer canthi belong to the Heart (Xin) and are called the Fire Wheel (Huo Lun); the upper and lower eyelids belong to the Spleen (Pi) and are called the Flesh Wheel (Rou Lun); the pupil belongs to the Kidney (Shen) and is called the Water Wheel (Shui Lun). The Five Wheels corresponding to the five zang organs are mostly related to the Liver Meridian. The eyes need blood nourishment for clear vision; if there is wind-heat in the Liver, eye diseases arise.
Wind-Warmth (Feng Wen) stagnating upward causing red eyes (Left pulse is wiry/Xian):
Sang Ye (Folium Mori), Xia Ku Cao (Spica Prunellae), Lian Qiao (Fructus Forsythiae), Cao Jue Ming (Semen Cassiae), Ju Ye (Folium Chrysanthemi), Qing Ju Hua (Flos Chrysanthemi Indici), Ku Ding Cha (Folium Ilicis Kudingcha), Sang Pi (Cortex Mori), Liao Dou Yi (Testa Phaseoli Sojae).
Dryness-Heat (Zao Re) causing red eyes with pain:
Xian He Ye (Folium Nelumbinis), Shan Zhi (Fructus Gardeniae), Chi Shao (Radix Paeoniae Rubra), Lv Dou Pi (Testa Phaseoli Sojae Viridis), Xia Ku Cao, Sheng Gan Cao (Radix Glycyrrhizae uralensis), Ju Ye, Ku Ding Cha, Liao Dou Yi, Bo He (Herba Menthae haplocalycis), Sang Bai Pi (Cortex Mori), Lian Qiao.
Summer-Heat (Shu Re) steaming and stagnating causing red eyes:
Sang Ye, Gu Jing Zhu (Corpus Sparganii), Tong Cao (Medulla Tetrapanacis), Lv Dou Yi, Mi Ren (Semen Coicis), Wang Yue Sha (Faeces Leporis), Fu Ling (Poria).
Wood-Fire (Mu Huo) stagnating upward causing red eyes, pain, and swelling:
Ling Yang Pian (Cornu Saigae Tataricae), Xia Ku Cao, Sang Ye, Gu Jing Cao (Herba Sparganii), Shi Jue Ming (Concha Haliotidis), Dan Pi (Cortex Moutan), Lv Dou Pi, Mi Ren, Lian Qiao, Chao Shan Zhi (Fructus Gardeniae Praeparatus), Sheng Di (Radix Rehmanniae Preparata), Ju Ye.
Deficient heat in blood collaterals, eye pain, red threads on the sclera:
Ling Yang Pian, Lian Qiao, Chuan Gui Zhi (Ramulus Cinnamomi), Qing Ju Ye (Folium Chrysanthemi Indici), Dan Pi, Qin Dang Gui (Radix Angelicae Sinensis).
Spleen-Lung accumulated heat (Eyelid edema, lack of appetite, poor digestion):
Sang Pi, Da Fu Pi (Pericarpium Arecae), Yi Mi Ren (Semen Coicis), Tong Cao, Fu Ling, Guang Chen Pi (Pericium Citri Reticulatae), Sheng Jiang Pi (Pericium Zingiberis Recens).
Yin deficiency with fire stagnation (Mild aversion to cold with sweating, hemorrhoids/fistula below, left eye pain):
Liu Wei Wan (Six-Ingredient Pill with Rehmannia) without Yu Rou (Fructus Corni), added with Bai Shao (Radix Paeoniae Alba), Man Jing Zi (Fructus Viticis).
Stomach deficiency with Liver wind (Right eye tearing excessively, heart palpitations/restlessness):
Nen Huang Qi (Radix Astragali), Gui Shen (Radix Angelicae Sinensis), Wei Jiang (Rhizoma Zingiberis Recens Praeparatum), Da Bai Shao, Fu Shen (Sclerotium Poria cum Radice), Da Zao (Fructus Jujubae).
Liver Yin deficiency (Left eye pain with hot tears, nebula/membrane):
Sang Ye, Wang Yue Sha, Huang Gan Ju (Flos Chrysanthemi Indici), Shi Jue Ming, Qi Zi (Semen Lycii), Liao Dou Yi, Chi Shou Wu (Radix Polygoni Multiflori Preparata), Xiao Hu Ma (Semen Sesami Nigrum, i.e., Black Sesame).
Kidney-Liver deficiency causing eye pain (Treatment method same as above):
Shu Di (Radix Rehmanniae Preparata), Gui Shen, Fu Shen, Bai Ji Li (Fructus Tribuli), Yu Rou, Wu Wei (Fructus Schisandrae), Ju Hua (Flos Chrysanthemi), Bai Zi Ren (Semen Platycladi), Sheng Di, Shan Yao (Rhizoma Dioscoreae), Sang Shen Zi (Fructus Mori), Da Tian Dong (Radix Asparagi), Qi Zi, Gu Jing Cao.
Chen Can stated: For treating external contractions, there must be symptoms of chills and fever, headache, nasal congestion, bone pain, and a pulse that is tight, rapid, floating, or surging before clearing and dispersing methods can be used. For internal consolidation, such as excess wind-heat in the Liver and Gallbladder, one should dissipate heat and remove wind; if it is water deficiency and fire decline in the Kidney meridian, one should strengthen water and benefit fire. If yin-blood is deficient but wind-heat is not yet exhausted, one must examine the urgency of the condition and treat comprehensively by combining approaches.