《六节藏象论》曰∶肝受血而能视。《宣明五气篇》曰∶久视伤血。《气厥论》曰∶胆
移热于脑则辛 鼻渊,传为衄蔑瞑目。《缪刺论》曰∶冬刺经脉,血气皆脱,令人目不
明。由此推之,目之为血所养者明矣。手少阴心主血,血荣于目;足厥阴肝,开窍于目,肝
亦多血,故血亡目病。男子衄血便血,妇人产后崩漏亡之过多者,皆能病焉。其为病睛珠痛
,珠痛不能视,差明瘾涩,眼睫无力,眉骨太阳,因为酸疼,当作芎归补血汤主之,当归养
荣汤主之,除风益损汤主之,滋阴地黄丸主之。诸有热者,加黄芩;妇人产漏者,加阿胶;
脾胃不佳,恶心不进食者,加生姜。复其血,使其所养则愈。然要忌咸物。《宣明五气篇》
又曰∶咸走血,血病无多食咸。是忌。
东垣李明之曰∶诸斑疹皆从寒水逆流而作也。子之初生也,在母腹中,母呼亦呼。母吸
亦吸。呼吸者,阳也,而动作生焉。饥食母血,渴饮母血。饮食者,阴也,而形质生焉。阴
具阳足,十月而降,口中恶血,因啼即下,却归男子生精之所,女子结胎之处,命宗所谓玄
牝玄关者也。此血僻伏而不时发,或因乳食内伤,或因湿热下溜,营气不从,逆于肉理,所
僻伏者,乃为所发。初则膀胱壬水夹脊逆流而克小肠丙火,故颈项以上先见也;次则胃经癸
水,又克心火,故胸腹以上次见也;终则二火炽盛,反制寒水,故胸腹以下后见也。至此则
五脏六腑皆病也。七日齐,七日盛,七日谢,三七二十一日而愈者,七为火数故也。愈后或
有病疽病疮者,是皆余毒尚在不去者,今其病目者亦然。所害者,与风热不制之病稍同而异
,总以羚羊角散主之。便不硬者,减硝黄。未满二十一日而病作者,消毒化斑汤主之。此
药功非独能于目,盖专于斑者之药也。不问初起已着,服之便令消化,稀者则不复出,方随
四时加减。
《素问·六节藏象论》说:肝得到血液的滋养就能看见。《素问·宣明五气篇》说:长时间用眼会耗伤血液。《素问·气厥论》说:胆的热邪转移至脑部,就会引起鼻窍辛辣、流浊涕的鼻渊病,进而发展为鼻出血、视物模糊或失明。《素问·缪刺论》说:冬季针刺经脉,导致血气大量脱失,使人眼睛看不清楚。由此推断,眼睛之所以明亮,是因为得到了血液的滋养,这是很明显的道理。手少阴心经主司血液,血液使眼睛获得荣润;足厥阴肝经开窍于目,肝脏也富含血液,所以血液亡失过多会导致眼部疾病。男子出现鼻出血、大便下血,妇女产后崩漏(非经期大量阴道出血)失血过多的,都会引发此类眼病。其症状表现为眼球内部疼痛,因疼痛无法视物,视力时好时坏且伴有干涩感,眼睑无力,眉骨及太阳穴部位酸疼,治疗应当以芎归补血汤为主方,或者用当归养荣汤、除风益损汤、滋阴地黄丸主治。如果有热象的,加入黄芩;如果是妇女产后漏下的,加入阿胶;如果脾胃功能不好,恶心不想进食的,加入生姜。通过补充血液,使其重新滋养眼部,疾病即可痊愈。然而必须忌食咸味食物。《素问·宣明五气篇》又说:咸味入走血分,患有血病的人不宜多吃咸味食物。这就是需要忌讳的原因。
李东垣(名杲,字明之)说:所有的斑疹都是由于寒水之气逆流而上而形成的。人刚出生时,在母腹中,母亲呼气他也呼气,母亲吸气他也吸气。呼吸属于阳气,动作由此产生。饥饿时吃母亲的血液,口渴时喝母亲的血液。饮食属于阴气,形体和质料由此生成。阴气具备、阳气充足,经过十个月孕育后降生,口中含有恶血,因为啼哭就排出了,这口血又回归到男子生成精气的地方、女子结胎的部位,也就是命门学说中所说的“玄牝”、“玄关”。这段潜伏的血气如果不按时发散,可能因为乳食内伤,也可能因为湿热下注,导致营气运行不畅,逆乱于肌肉纹理之间,那些潜伏的血气就被激发出来。起初是膀胱壬水夹着脊柱逆流克制小肠丙火,所以颈部以上先出现斑疹;接着是胃经癸水,又克制心火,所以胸腹部以上随后出现;最后是两火炽盛,反过来制约寒水,所以胸腹部以下最后出现。到了这个阶段,五脏六腑都受到影响了。发病后第七天整齐划一,第十四天达到鼎盛,第二十天开始消退,经过三个七天共二十一天痊愈,这是因为七是火的成数。痊愈后如果出现痈疽疮疡等病症,都是因为余毒尚未清除干净,现在这种因病导致的目疾也是如此。所伤害的病机,与风热不能制约的病症稍有相同但又有不同,总体上都以羚羊角散为主方。如果大便不硬的,减少芒硝和大黄的用量。如果在未满二十一天时就发病的,以消毒化斑汤主治。这个药的功效不仅仅在于治眼,更是专门针对斑疹的药物。无论病情是初起还是已经显现,服用后就能使其消散,皮疹稀少的就不再发出,方剂可根据四季变化进行加减。
The *Suwen: Liujie Zangxiang Lun* (Six Sections on the Viscera and Manifestations) states: "When the Liver receives blood, it can see." The *Suwen: Xuanming Wuqi Pian* (Chapter on the Five Qi in Manifestation) states: "Prolonged viewing injures the Blood." The *Suwen: Qijue Lun* (Chapter on Qi Reversal) states: "When Gallbladder heat transfers to the Brain, it causes a pungent sensation in the nose and rhinorrhea (Bi Yuan), which transmits into epistaxis (Xu Mie) and blindness or dim vision." The *Suwen: Miao Ci Lun* (Chapter on Miraculous Acupuncture) states: "If meridians are needled in winter, causing the depletion of Blood and Qi, it renders the person unable to see clearly." From this, we can deduce that the clarity of the eyes is undoubtedly due to nourishment by Blood. The Hand-Shaoyin Heart meridian governs Blood, and Blood provides nourishment to the eyes; the Foot-Jueyin Liver meridian opens into the eyes, and the Liver also contains abundant Blood; therefore, excessive loss of Blood leads to eye diseases. Men suffering from epistaxis or hematochezia, and women suffering from metrorrhagia (Beng Lou) with excessive blood loss after childbirth, are all prone to these conditions. The symptoms include pain within the eyeball, inability to see due to pain, fluctuating vision accompanied by dryness and grittiness, weakness of the eyelids, and soreness in the supraorbital ridge and temporal region. Treatment should primarily employ Xiong Gui Bu Xue Tang (Ligusticum and Angelica Decoction for Nourishing Blood), or alternatively Dang Gui Yang Rong Tang (Angelica Decoction for Nourishing Ying), Chu Feng Yi Sun Tang (Decoction for Removing Wind and Benefiting Injury), or Zi Yin Di Huang Wan (Yin-Nourishing Rehmannia Pill). For cases with Heat signs, add Huang Qin (Scutellariae Radix); for women with postpartum leakage, add E Jiao (Donkey-hide Gelatin); for those with poor Spleen and Stomach function, nausea, and anorexia, add Sheng Jiang (Zingiberis Rhizoma Recens). By replenishing the Blood so that it may nourish the eyes again, the disease will heal. However, one must strictly avoid salty foods. The *Suwen: Xuanming Wuqi Pian* further states: "Salty flavor travels to the Blood; those with Blood disorders should not consume much salt." This is the prohibition.
Li Dongyuan (courtesy name Mingzhi) stated: "All macules and rashes arise from the retrograde flow of Cold Water." When a child is first born, while in the mother's womb, when the mother exhales, the infant exhales; when the mother inhales, the infant inhales. Respiration belongs to Yang, and movement arises from it. Hunger is satisfied by consuming the mother's blood, and thirst is quenched by drinking the mother's blood. Diet belongs to Yin, and form and substance arise from it. With Yin fully formed and Yang sufficient, after ten months of gestation, the child descends. The foul blood in the mouth is expelled upon crying, returning to the place where men generate essence and where women conceive the fetus—what the School of Life Gate refers to as the "Mysterious Female" (Xuan Pin) and the "Mysterious Pass" (Xuan Guan). This latent blood, if not discharged at the proper time, may be triggered by internal injury from milk and food, or by damp-heat flowing downward. When Ying Qi does not flow smoothly and reverses within the muscle tissue, the latent blood is activated. Initially, Bladder Ren Water flows retrogradely along the spine to overcome Small Intestine Bing Fire, so macules appear first above the neck and head; subsequently, Stomacy Gui Water overcomes Heart Fire, so they appear next above the chest and abdomen; finally, the two Fires become blazing and counter-restrict Cold Water, so they appear last below the chest and abdomen. At this stage, all five Zang and six Fu organs are diseased. On the seventh day, the rash becomes uniform; on the fourteenth day, it reaches its peak; on the twentieth day, it begins to recede. Healing occurs after three sevens (21 days) because seven is the number associated with Fire. After healing, if carbuncles or sores appear, it is because residual toxins remain unexpelled. The current eye disease caused by such residual toxins is similar in nature but distinct from diseases caused by unconstrained Wind-Heat. Generally, Ling Yang Jiao San (Antelope Horn Powder) is used as the primary formula. If the stool is not hard, reduce the dosage of Xiao Shi (Natrii Sulfas) and Da Huang (Rhei Radix et Rhizoma). If the disease manifests before twenty-one days have passed, use Xiao Du Hua Ban Tang (Detoxifying and Macule-Resolving Decoction). This medicine’s efficacy is not limited to treating the eyes; it is specifically a remedy for macules and rashes. Whether the condition is in its initial stage or has fully developed, administration will cause it to dissipate; if the rash is sparse, it will not reappear. The prescription should be modified according to the four seasons.