〔《灵》〕帝曰∶余尝上清泠之台,中阶而顾,匐匍而前则惑。余私异之,窃内怪之,独瞑独视,安心定气,
久而不解。独搏独眩,被发长跪,俯而视之,后久之不已也。卒然自上,何气使然?岐伯曰∶五脏六腑之精气,
皆注于目,而为之精。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,裹撷筋骨血气之精而与脉并为系,上属于脑,后出于项中。故邪中于项,因逢其身之虚,其入深,
则随眼系以入于脑,入于脑则脑转,脑转则目系急,目系急则目眩以转矣。邪中其精,其精所中,不相比也,
则精散,精散则视歧,故见两物。(大惑论)
〔《本》〕荀牧仲顷年尝谓予曰∶有人视一物为两,医作肝气盛,故见一为二,服泻肝药皆不验,此何疾也?
予曰∶孙真人曰∶《灵枢》有云,目之系上属于脑,后出于项中云云,则视歧故见两物也。令服驱风入脑药得
愈。
〔《灵》〕目者,五脏六腑之精也,荣卫魂魄之所常营也,神气之所生也。故神劳则魂魄散,志意乱,是
故瞳子黑眼法于阴,白眼赤脉法于阳也。故阴阳合转而睛明也。目者,心之使也。心者,神之舍也。故神精
乱而不转,卒然见非常处,精神魂魄散不相得,故曰惑也。帝曰∶余疑其然。余每之东苑,未曾不惑,去之则
复,余唯独为东苑劳神乎?何其异也?岐伯曰∶不然也。心有所喜,神有所恶,卒然相感,则精气乱,视误故
惑,神移乃复,是故间者为迷,甚者为惑。(大惑篇)
〔《素》〕夫精明者,所以视万物,别白黑,审长短。以长为短,以白为黑,如是则精衰矣。
右目乱见,治法东垣益气聪明之类是也。
【《灵枢》】黄帝说:我曾经登上清泠之台,走到台阶中间回头张望,趴着向前爬行就会感到迷惑。我私下对此感到奇怪,内心暗自惊异,即使独自闭眼或睁眼,安心定气,长时间也无法消除这种错觉。独自拍打头部或感到眩晕,披散头发长跪不起,俯身注视地面,过了很久症状仍不消失。这种症状突然从上方袭来,是什么气导致的呢?岐伯回答说:五脏六腑的精气,都汇聚于眼睛,从而形成眼的精气。精气的聚集处称为眼,骨的精气表现为瞳仁,筋的精气表现为黑眼球(虹膜),血的精气表现为血络。气聚的窠臼中,气的精气表现为白眼(巩膜),肌肉的精气表现为眼睑(约束)。这些精气包裹并汲取筋骨血气的精华,与经脉合并成为目系,向上连接于脑,向后出于项部。所以邪气侵袭项部,恰逢身体虚弱,邪气深入,便随着目系进入脑部。进入脑部则导致脑转(头晕),脑转则导致目系紧张,目系紧张则引起目眩和旋转感。邪气侵入其精气所在之处,若精气被邪气所伤而不能协调一致,则精气涣散,精气涣散则出现视物歧义(复视),所以看到两个物体。(出自《大惑论》)
【《本草》/注引】荀牧仲近年来曾对我说:有人看一个物体却看成两个,医生诊断为肝气盛,因此将一物看作两物,服用泻肝药物均无效,这是什么病呢?我说:孙真人曾说:《灵枢》中有云,目系向上连接于脑,向后出于项中等等,那么视歧导致看见两个物体就是这个原因。令其服用驱风入脑的药物得以痊愈。
【《灵枢》】眼睛,是五脏六腑精气的汇聚处,也是营卫、魂魄经常营运的地方,神气产生的地方。所以精神劳倦则魂魄涣散,意志混乱,因此瞳仁和黑眼球效法阴,白眼和赤色血脉效法阳。阴阳协调运转则目光明亮。眼睛,是心的使者。心,是神的居所。所以如果精神紊乱不能正常转动,突然看到不寻常的景象,精神、魂魄分散而不相协调,这就叫做“惑”。黄帝说:我怀疑确实如此。我每次去东苑,没有不感到迷惑的,离开那里就恢复了,难道只有我去东苑才劳神吗?为什么这么奇怪呢?岐伯说:不是这样的。心中有所喜好,神有所厌恶,突然相互感应,导致精气紊乱,视觉错误所以感到迷惑,神志转移后才会恢复,所以轻微的是“迷”,严重的是“惑”。(出自《大惑篇》)
【《素问》】精明(视力),是用来观察万物,辨别黑白,审视长短的。如果把长的看成短的,把白的看成黑的,这说明精气已经衰败了。
上述关于目乱见的病症,治疗方法参考李东垣的益气聪明汤之类的方剂。
[Ling Shu] The Yellow Emperor said: "I once ascended the Qingling Terrace. When I looked back from the middle of the stairs, or crawled forward on my hands and knees, I felt confused. I privately found this strange and secretly marveled at it internally. Even when closing one eye or opening one eye, calming my mind and regulating my breath, for a long time I could not resolve it. Whether beating my head alone or feeling dizzy, with hair disheveled, kneeling for a long time, or looking down at the ground, even after a long while, it did not cease. This sudden onset from above, what Qi causes it?" Qibo replied: "The essence of the Five Zang and Six Fu organs all pours into the eyes, forming the Jing (essence) of the eyes. The nest of Jing is the Eye itself; the Jing of Bone manifests as the Pupil (Tongzi); the Jing of Sinew manifests as the Black Eye (iris/cornea area); the Jing of Blood manifests as the Collaterals (blood vessels). Within the nest, the Jing of Qi manifests as the White Eye (sclera); the Jing of Muscle manifests as the Constraints (eyelids). These wrap and gather the Jing of sinews, bones, blood, and Qi, merging with the meridians to form the Eye System (Muxi), which connects upward to the Brain and exits posteriorly through the Neck. Therefore, if pathogenic factors strike the neck, coinciding with deficiency in the body, and enter deeply, they follow the Eye System into the Brain. Once in the Brain, it causes 'Brain Rotation' (vertigo/dizziness); Brain Rotation leads to tension in the Eye System; tension in the Eye System leads to dizziness and visual rotation. If pathogenic factors strike the Jing, and the affected Jing cannot coordinate harmoniously, then the Jing scatters. When Jing scatters, vision becomes bifurcated (diplopia), thus seeing two objects." (From *Da Huo Lun*)
[Ben Cao / Annotation] Xun Muzhong recently told me: "Someone saw one object as two. Physicians diagnosed it as Excess Liver Qi, causing the perception of one as two, but administering formulas to drain the Liver yielded no effect. What disease is this?" I said: "Sun Simiao stated: *Ling Shu* says, 'The Eye System connects upward to the Brain and exits posteriorly through the Neck,' etc. Thus, diplopia resulting in seeing double is due to this mechanism. Instruct him to take Wind-dispelling formulas that enter the Brain, and he will be cured."
[Ling Shu] The Eyes are the gathering place of the essence of the Five Zang and Six Fu organs, the constant site of operation for Ying (Nutritive) and Wei (Defensive) Qi, Hun, and Po, and the birthplace of Shen (Spirit). Therefore, mental labor causes Hun and Po to scatter and Zhi (Will) to become chaotic. Hence, the Pupil and Black Eye correspond to Yin, while the White Eye and Red Collaterals correspond to Yang. When Yin and Yang combine and rotate harmoniously, the eyes become bright. The Eyes are the messengers of the Heart. The Heart is the residence of Shen. Therefore, if Shen and Jing become chaotic and fail to rotate normally, and one suddenly sees unusual sights, causing Spirit, Jing, Hun, and Po to scatter and lose coordination, this is called 'Huo' (Confusion/Delusion). The Yellow Emperor said: "I suspect this is true. Every time I go to Dongyuan, I am invariably confused; leaving there restores clarity. Am I the only one whose Shen is labored by Dongyuan? Why is it so peculiar?" Qibo said: "Not so. If the Heart has preferences and Shen has aversions, sudden mutual stimulation causes Chaos of Essence and Qi, leading to erroneous vision and confusion. Only when Shen shifts does recovery occur. Thus, mild cases are 'Mi' (Blurry/Muddled), severe cases are 'Huo' (Deluded)." (From *Da Huo Pian*)
[Su Wen] Jing Ming (Clear Vision) is used to perceive all things, distinguish black from white, and assess length and shortness. To perceive long as short, or white as black, indicates that Jing (Essence) has declined.
Regarding the aforementioned disorder of vision (Mu Luan Jian), the treatment method refers to Li Dongyuan's Yi Qi Cong Ming Tang (Qi-Boosting and Brightening Decoction) and similar formulas.