陈无择云∶病者喜怒不节,忧思兼并,致脏气不平,郁而生涎,随气上厥,逢脑之虚,
侵淫眼系,荫注于目,轻则昏涩,重则障翳,眵泪 肉,白膜瞒睛,皆内所因。或数冒风寒
,不避暑湿,邪中于项,乘虚循系,以入于脑,故生外翳,医论中所谓青风、绿风、紫风、
黑风、赤风、白风、白翳、黄翳等,随八风所中,变生诸症,皆外所因。或嗜欲不节,饮食
无时,生食五辛,热啖炙 ,驰骋田猎,冒涉烟尘,劳动外情,丧明之本,皆不内外因
治之。
按∶论中所言致证之因,至为详悉。惜乎其方多本于风热,及水脏阳虚处治而未备,学
者当自为通变矣。
巢氏曰∶凡眼内 头忽结成 ,三五日间,便生脓汁,世呼为偷针。此由热气客在 间
,热抟于津液所成。但其势轻者,小小结聚,汁溃热歇乃瘥。
谨按∶世传眼 初生小 ,视其背上,即有细红点如疮,以针刺破,眼时即瘥,故名偷
针,实解太阳经结热也。人每试之有验。然巢氏但具所因,而不更分经络,其诸名实,所过
者多矣。
东垣云∶戊申六月,徐总管患眼疾,上眼皮下出黑白翳二点,隐涩难开,两目紧缩而不
痛,两寸脉细紧,按之洪大而无力,乃足太阳膀胱为命门相火煎熬,逆行作寒水翳,及寒膜
遮睛,呵欠,善悲健忘,嚏喷眵泪,时泪下,面赤而白,能食,大便难,小便数而欠,气上
而喘,以拨云汤治之。
论瞳子散大并方论 戊戌冬初,李叔和至西京,朋友待之以猪肉煎饼,同蒜醋食之,后
复饮酒太醉,卧于暖坑。翌日病眼,两瞳子散大于黄睛,视物无的,以小为大,以短为长,
卒然见非常之处,行步踏空,多求医疗,而莫之愈。至己亥春,求治于先师,曰∶《内经》
有云∶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。又云∶筋骨气血
之精而为脉,并为系,上属于脑。又瞳子黑眼法于阴。今瞳子散大者,由食辛热之物过多故
也。所谓辛主散,热则助火,上乘于脑中,其精故散。精散则视物亦散大也。夫精明者,所
以视万物者也。今视物不真,则精衰矣。盖火之与气,势不两立。故经云∶壮火食气,壮火
散气。手少阴足厥阴所主风热,连目系,邪之中人,各从其类,故循此道而来攻。头目肿闷
而瞳子散大,皆血虚阴弱故也。当除风热,凉血益血,以收耗散之气,则愈矣,滋阴地黄丸
。《内经》云∶热淫所胜,平以咸寒,佐以苦甘,酸收之。以黄连、黄芩大苦寒,除邪气之
盛为君;当归身辛温,生熟地黄苦甘寒,养血凉血为臣;五味子酸寒,体轻浮上,收瞳子之
散大,人参、甘草、地骨皮、天门冬、枳壳苦甘寒,泻热补气为佐;柴胡引用为使也。忌食
辛辣物而助火邪,及食寒冷物损胃气,药不能上行也。
〔丹溪〕∶一壮年人早起,忽视物不见,就睡片时,略见而不明,食减倦甚,脉缓大,重按
则散而无力,意其受湿所致。询之,果卧湿地半月。遂以白术为君,黄 、茯苓、陈皮为臣
,附子为使,十余帖而愈。
〔丹溪〕∶一老人忽盲,他无所苦,予以大虚治之,急煎人参膏二斤。服二日,一医与磁石
药,予曰∶今夜死矣。果然。
〔丹溪〕∶一人形实,好饮热酒,忽目盲脉涩,此热酒所伤,胃气污浊之血,死其内而然。
以苏木作汤,调人参末,服二日,鼻及两掌皆紫黑。予曰∶滞血行矣。以四物加苏木、桃仁
、红花、陈皮煎,调人参末服,数日而愈。(以上治验三条见《丹溪纂要》)
谦甫云∶郎中张子敬,年六十七岁,病眼目昏暗,微黑色,皮肤不泽,六脉弦细而无力
。一日出视治眼二方,问予曰∶可服否?予曰∶此二方以黄连大苦之药为君,诸风药为使,
且人年五十,胆汁减而目不明。《内经》云∶土位之主,其泻以苦,诸风药亦能泻土。人年
七十,脾胃虚而皮肉枯,重泻其土,使脾胃虚而不能营运荣卫之气,滋养元气,胃气不能
上行,隔气吐食诸病生矣。又况年高衰弱,此药不服可也。只宜慎言语,节饮食,惩忿窒欲
,此不治之治也。子敬以明年春,除关西路按察使,三年致仕回还,精神清胜,脉遂平和,
此不可妄服寒凉之剂也。《内经》云∶征伐无过,是谓太惑,解之可也。
海藏妻侄女形肥,笄年时得目疾,每月或二月一发,发则红肿难开,如此者三年,服除
风散热等剂,左目反有顽翳,从锐 遮瞳人,右目亦有翳,从下而上。经云∶从内走外者,
少阳病;从下上者,阳明病。予谓此少阳阳明二经有积滞也。脉短滑而实,晨则似短。洁古
云∶短为有积滞遏抑脏腑,宜下之。遂用温白丸,减川芎、附子三之二,多加龙胆草、黄连
,如东垣五积法,从二丸加起,每日加一丸;如至大利,然后减丸;又从二丸加起,忽一日
,于利中下黑血块若干,如黑豆大而硬坚,从此渐痊,而翳尽去。(见《医学纲目》)
楼全善先生曰∶夏枯草治目珠疼,至夜则疼甚者神效;或用苦寒药点之反疼者,亦神效
。盖目珠者,连目本,又各系属厥阴之经也。夜甚及用苦寒药点之反甚者,夜与寒亦阴故也
。丹溪云∶夏枯草有补养厥阴血脉之功,其草三四月开花,遇夏至阴生则枯。盖禀纯阳之气
也。至哉斯言。故治厥阴目疼如神者,以阳治阴也。予男至夜目珠及连眉棱骨作疼,头半边
肿痛,用黄连膏点之,反大痛,百药不效;灸厥阴少阳,疼随止,半日又作;又灸又止,月
余;遂以夏枯草二两,香附末二两,甘草四钱,同为细末,每服一钱半,用清茶调服,下咽
则疼减大半,至四五日良愈。
一男子六十余岁,所患与前证皆同,但黑睛有白翳二点,诸药不效,亦以此药与东垣选
奇汤,加四物汤,及黄连煎,间服,并灸厥阴少阳而安。
陈无择说:患者情绪喜怒没有节制,忧愁与思虑交织,导致脏腑之气不平和,气机郁结而生出痰涎,随着气机上逆,遇到脑部虚弱之处,侵入并浸渍眼系,投射于眼睛,轻则感到昏花干涩,重则形成翳障、眵泪增多、息肉生长、白膜遮盖瞳孔,这些都是内因所致。或者多次遭受风寒侵袭,不注意避暑湿,邪气中伤项部,乘虚沿着眼系进入脑部,所以产生外翳,医书中所说的青风、绿风、紫风、黑风、赤风、白风、白翳、黄翳等,随着八种风向的邪气所中,变化产生各种症状,这些都是外因所致。或者嗜好欲望没有节制,饮食没有定时,生吃五种辛辣食物,热食烧烤肉类,骑马驰骋打猎,冒犯涉入烟尘之中,劳累耗损外在的情志,这是导致失明的根本原因,都属于不内外因。对此进行治疗。
按语:论述中所说的致病原因,非常详细完备。可惜其中的方剂大多基于风热,以及针对水脏(肾)阳虚的情况进行诊治而不够全面,学习者应当自行融会贯通、灵活变通。
巢元方说:凡是眼睛内部突然结成小硬结,三到五天内,就生出脓汁,世人称之为偷针眼。这是由于热气客居在眼睑之间,热邪搏结津液所形成。但病情较轻的,只是小小结聚,脓汁溃破、热邪消退后就会痊愈。
谨按:世间流传的说法是,眼疾初生时出现小硬结,观察其背部,就有像疮一样的细小红点,用针刺破,眼疾随即痊愈,所以名叫偷针,这实际上是解除了太阳经的结热。人们每次尝试都有疗效。然而巢元方只说明了病因,而没有进一步区分经络,其中许多名称和实际对应关系,经过的地方太多了。
李东垣说:戊申年六月,徐总管患眼疾,上眼皮下出现黑白两种翳障两点,隐涩难受难以睁开,双眼紧缩但不疼痛,两手寸脉细紧,重按则洪大而无力的感觉,这是足太阳膀胱经被命门相火煎熬,逆行化作寒水之翳,以及寒膜遮蔽瞳孔,伴有呵欠、容易悲伤健忘、打喷嚏流涕流泪、时常流泪、面色红白相间、能进食、大便困难、小便频数且伴有气短,气上逆而喘息,用拨云汤治疗。
论瞳孔散大及方剂论述:戊戌年初冬,李叔和来到西京,朋友用猪肉煎饼招待他,同蒜醋一起食用,后来又饮酒大醉,睡在温暖的炕上。第二天发病,两眼瞳孔散大超过黑眼球部分,视物模糊不清,把小的看成大的,把短的看成长的,突然看到不存在的地方,走路踏空,多方求医治疗,但没有治愈。到了己亥年春季,来拜求我的老师治疗,老师说:《内经》中说:五脏六腑的精气,都注入眼睛从而形成视觉精华。精华的汇聚处为眼,骨的精华表现为瞳孔。又说:筋骨气血的精华形成血脉,汇集成眼系,向上连接于脑。又说:瞳孔和黑眼的形态效法于阴。现在瞳孔散大,是因为吃了过多的辛热食物所致。所谓辛味主发散,热性助长火气,上乘于脑中,因此精华涣散。精华涣散则视物也显得散大。那精明的功能,是用来观察万物的。现在视物不真切,说明精气衰败了。大概火与气,势力不能并存。所以经书说:壮火消耗正气,壮火涣散正气。手少阴心经和足厥阴肝经所主的风热,连着目系,邪气中人,各从同类而来,所以循着这条道路来攻击。头目肿胀闷痛且瞳孔散大,都是血虚阴弱的缘故。应当祛除风热,凉血养血,以收敛耗散的气,就能痊愈,用滋阴地黄丸。《内经》说:热邪过盛,用咸寒之品平抑它,辅以苦甘之品,用酸味收敛它。用黄连、黄芩大苦大寒之药,清除旺盛的邪气作为君药;当归身辛温,生地黄和熟地黄苦甘寒,养血凉血作为臣药;五味子酸寒,质地轻浮上行,收敛瞳孔的散大,人参、甘草、地骨皮、天门冬、枳壳苦甘寒,泻热补气作为佐药;柴胡作为引经使药。忌食辛辣食物以免助长火邪,以及忌食寒冷食物以免损伤胃气,否则药物不能上行发挥作用。
〔朱丹溪〕:一个壮年人早起,看东西看不见,躺睡片刻,稍微看见但不清晰,食欲减退疲倦严重,脉象缓大,重按则散漫无力,推测是受湿邪所致。询问得知,果然睡了半个月的地铺。于是用白术作为君药,黄芪、茯苓、陈皮作为臣药,附子作为使药,服用十余帖而痊愈。
〔朱丹溪〕:一个老人突然失明,没有其他痛苦,我认为是大虚证,急忙煎制人参膏两斤。服用两天后,一位医生给他服用磁石类药物,我说:今晚就会死了。果然如此。
〔朱丹溪〕:一个人形体壮实,喜欢喝热酒,突然双目失明,脉象涩滞,这是热酒所伤,导致胃气污浊之血,死血在内所致。用苏木煎汤,调服人参末,服用两天,鼻子和双手掌都变成紫黑色。我说:瘀血已经行散了。用四物汤加入苏木、桃仁、红花、陈皮煎煮,调服人参末,几天后痊愈。(以上三条治验见于《丹溪纂要》)
谦甫说:郎中张子敬,六十七岁,患眼目昏暗,微带黑色,皮肤不润泽,六脉弦细而无力。有一天出来查看治疗眼疾的两个方子,问我:可以服用吗?我说:这两个方子以黄连这种大苦的药物为君药,各种风药为使药,况且人年过五十,胆汁减少而视力不明。《内经》说:土位的主病,用苦味来泻,各种风药也能泻土。人年过七十,脾胃虚弱而皮肉枯槁,再重泻其土,使得脾胃更加虚弱而不能营运荣卫之气,滋养元气,胃气不能上行,隔气、呕吐食物等各种疾病就会产生。何况年老体弱,这些药不服用也可以。只应该谨慎言语,节制饮食,克制愤怒,抑制欲望,这就是不治之治的方法。子敬第二年春天,被任命为关西路按察使,三年后退休回家,精神清爽胜过以前,脉象随之平和,这说明不可妄服寒凉药剂。《内经》说:征伐(攻伐)没有过错,被称为太惑(过于迷惑),解释一下就可以明白了。
海藏妻子的侄女形体肥胖,成年时得了眼疾,每月或两个月发作一次,发作时红肿难以睁开,这样持续了三年,服用除风散热等药剂后,左眼反而长出顽固翳障,从眼角内侧遮住瞳孔,右眼也有翳障,从下方往上长。经书说:从内向外走的,是少阳病;从下往上的,是阳明病。我认为这是少阳、阳明二经有积滞。脉象短滑而实,早晨看起来像短脉。洁古说:短脉是有积滞遏抑脏腑,应当用下法。于是用温白丸,减去川芎、附子的三分之二,多加龙胆草、黄连,按照东垣的五积法,从两丸开始加量,每天加一丸;如果导致严重腹泻,然后减少丸数;又从两丸开始加量,忽然有一天,在腹泻中排出若干黑血块,像黑豆一样大而坚硬,从此逐渐痊愈,翳障全部去除。(见《医学纲目》)
楼全善先生说:夏枯草治疗眼珠疼痛,到晚上疼痛加剧的,效果神奇;或者用苦寒药物点眼反而疼痛加剧的,也效果神奇。因为眼珠连着目本,又各自隶属于厥阴经。夜间加重及使用苦寒药点后反而加重,是因为夜与寒都属于阴的缘故。丹溪说:夏枯草有补养厥阴血脉的功效,它的草在三四月开花,遇到夏至阴气生发则枯萎。大概是禀受了纯阳之气。说得真好。所以治疗厥阴经引起的眼疼如神效的,是用阳来治阴。我的儿子每到晚上眼珠及连带的眉棱骨疼痛,半边头肿痛,用黄连膏点眼,反而剧痛,百药无效;灸厥阴、少阳经穴,疼痛随即停止,半天后又发作;又灸又止,持续一个多月;于是用夏枯草二两,香附末二两,甘草四钱,共同研为细末,每次服用一钱半,用清茶调服,咽下后疼痛减轻大半,到四五日完全痊愈。
一个六十多岁的男子,所患与前证相同,但黑眼球上有两个白翳,各种药物无效,也用此药配合东垣的选奇汤,加上四物汤,以及黄连煎煮,交替服用,并灸厥阴、少阳经穴而安定。
Chen Wuyue stated: When patients lack moderation in their emotions of joy and anger, and when sorrow and overthinking intertwine, it leads to an imbalance of the Qi within the Zang organs. The stagnation generates phlegm-fluids (Tan Yin), which ascend with the Qi and, encountering deficiency in the brain, invade and infiltrate the eye system, projecting into the eyes. Mild cases result in blurred vision and dryness; severe cases lead to visual obstructions (Yi Yi), excessive discharge and tearing, flesh growths, and white membranes covering the pupil. These are all caused by internal factors. Alternatively, repeated exposure to wind and cold, failure to avoid summer heat and dampness, allows pathogenic factors to strike the neck, entering the brain via the eye system due to deficiency. This produces external visual obstructions. Conditions described in medical texts such as Green Wind, Green Wind, Purple Wind, Black Wind, Red Wind, White Wind, White Obstruction, and Yellow Obstruction arise from the influence of the Eight Winds, generating various symptoms; these are all caused by external factors. Or, if desires and lusts are unregulated, eating is irregular, raw pungent foods are consumed, roasted meats are eaten while hot, one engages in horse riding and hunting, or exposes oneself to smoke and dust, laboring the external aspects of emotion, this constitutes the root cause of blindness and falls under the category of neither internal nor external factors. Treatment should be applied accordingly.
Commentary: The causes of disease discussed here are extremely detailed and comprehensive. It is a pity that the formulas often rely on clearing wind-heat and treating kidney Yang deficiency without being fully exhaustive. Students must learn to adapt and vary these principles flexibly.
Chao Yuanfang stated: Whenever a small hard nodule suddenly forms inside the eyelid, producing pus within three to five days, the world calls this "Stealing Needle" (Tou Zhen). This occurs because heat pathogens lodge between the eyelids, and heat condenses body fluids to form the lesion. In mild cases, where there is only minor aggregation, once the pus breaks and the heat subsides, recovery ensues.
Respectfully noted: Folk tradition holds that when an eye ailment first presents with a small nodule, observing the patient's back reveals fine red spots resembling sores. Pricking these spots with a needle cures the eye condition instantly, hence the name "Stealing Needle." This actually resolves the constrained heat in the Taiyang Meridian. Empirical tests confirm its efficacy. However, Chao Yuanfang only identified the etiology without further distinguishing the meridians involved, and many of the names and actual correspondences have been subject to extensive interpretation.
Li Dongyuan stated: In the sixth month of the Wushen year, Commander Xu suffered from an eye disease. Two black-and-white visual obstructions appeared beneath the upper eyelids, causing a hidden sensation of roughness and difficulty opening the eyes. Both eyes were constricted but painless. The Cun position of both wrists presented a thin and tight pulse, which felt surging yet powerless upon deep pressure. This indicated that the Foot-Taiyang Bladder Meridian was being scorched by the Ministerial Fire of the Gate of Life, reversing its flow to create a cold-water obstruction and a cold membrane obscuring the pupil. Symptoms included yawning, propensity for sadness and forgetfulness, sneezing with discharge and tears, frequent spontaneous tearing, a complexion alternating between red and pale, good appetite, difficult defecation, frequent urination accompanied by sighing, upward rushing of Qi leading to wheezing, and was treated with Bo Yun Tang.
Discussion on Pupil Dilation and Formulas: In early winter of the Wuxu year, Li Shuhe arrived at the Western Capital. Friends entertained him with pork pancakes eaten with garlic and vinegar. He subsequently drank excessively until drunk and slept on a warm kang. The next day, he fell ill with eye problems: both pupils dilated beyond the iris, vision became blurry, perceiving small objects as large and short distances as long, seeing non-existent things, stumbling while walking. Despite seeking various medical treatments, none cured him. By spring of the Jihai year, he sought treatment from my teacher, who said: The *Neijing* states: "The essence of the Five Zang and Six Fu organs all pours into the eyes to form visual clarity. The gathering place of essence is the eye; the essence of bone manifests as the pupil." It also says: "The essence of tendons, bones, Qi, and blood forms the vessels, converging into the eye system, connecting upwards to the brain." Furthermore, "The pupil and dark part of the eye follow the principle of Yin." Currently, the dilation of the pupil is due to excessive consumption of pungent and hot foods. Pungency promotes dispersion, and heat aids fire, which ascends to the brain, causing the essence to scatter. Scattered essence results in dispersed vision. Clarity is what allows us to perceive all things. Since perception is not true, the essence has declined. Fire and Qi cannot coexist in dominance. Thus, the classics state: "Excessive fire consumes Qi; excessive fire scatters Qi." The wind-heat governed by the Hand-Shaoyin Heart Meridian and Foot-Jueyin Liver Meridian connects to the eye system. Pathogens attacking humans follow their own kind, thus attacking via this pathway. Head and eye swelling, stuffiness, and pupil dilation are all due to Blood deficiency and Yin weakness. One should dispel wind-heat, cool the blood and nourish Blood, to gather the scattered Qi, and recovery will occur. Use Ziyin Dihuang Wan. The *Neijing* states: "When heat dominates, soothe it with salty-cold substances, assist with bitter-sweet ones, and astringe with sour ones." Use Coptidis Rhizoma (Huanglian) and Scutellariae Radix (Huangqin), both greatly bitter and cold, to eliminate rampant pathogenic factors as Sovereign drugs; Angelicae Sinensis Radix (Danggui Shen), acrid-warm, along with Rehmanniae Radix Preparata (Shu Dihuang) and Rehmanniae Radix (Sheng Dihuang), bitter-sweet and cold, to nourish and cool Blood as Ministers; Schisandrae Fructus (Wuweizi), sour-cold, light and floating upward, to astringe the dilated pupil; Ginseng Radix (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao), Lycii Cortex (Digupi), Asparagi Radix (Tianmendong), and Aurantii Fructus (Zhike), all bitter-sweet and cold, to drain heat and tonify Qi as Assistants; Bupleuri Radix (Chaihu) as the Guide drug. Avoid spicy foods that aid fire pathogens, and avoid cold foods that damage Stomach Qi, otherwise the medicine cannot ascend.
[Zhu Danxi]: A young man woke up unable to see objects. After lying down for a moment, he could see slightly but unclearly. His appetite decreased, and he was extremely fatigued. His pulse was slow and large, scattering and powerless upon deep pressure. I suspected dampness. Upon inquiry, he confirmed sleeping on a damp floor for half a month. I used Atractylodis Macrocephalae Rhizoma (Baizhu) as Sovereign, Astragali Radix (Huangqi), Poria (Fuling), and Citri Reticulatae Pericarpium (Chenpi) as Ministers, and Aconiti Lateralis Radix Praeparata (Fuzi) as Assistant. After more than ten doses, he recovered.
[Zhu Danxi]: An elderly man suddenly went blind with no other complaints. I diagnosed extreme deficiency and urgently decocted two jin of Ren Shen Gao (Ginseng Paste). After two days of ingestion, another physician administered Magnetitum (Cishi) medicine. I said, "He will die tonight." Indeed, he did.
[Zhu Danxi]: A robust man who enjoyed drinking hot wine suddenly went blind with a choppy pulse. This injury was caused by hot wine, resulting in turbid blood in the Stomach Qi and stagnant dead blood internally. I used Sappan Lignum (Sumu) decoction, mixed with Ginseng powder. After two days, his nose and palms turned purple-black. I said, "The stagnant blood is moving." I prescribed Si Wu Tang added with Sumu, Persicari Herba (Taoren), Carthami Flos (Honghua), and Chenpi, decocted and mixed with Ginseng powder. He recovered after several days. (The above three case records are from *Danxi Zuanyao*).
Qianfu stated: Director Zhang Zijian, aged 67, suffered from dim vision, slight blackening of the eyes, and lusterless skin. His six pulses were wiry, thin, and powerless. One day, he showed me two prescriptions for eye treatment and asked, "Can I take these?" I replied, "These two formulas use Huanglian, a greatly bitter herb, as the Sovereign, and various wind-dispelling herbs as Assistants. Moreover, after age fifty, Gallbladder juice diminishes, leading to poor vision. The *Neijing* states: 'For disorders of the Earth element, purge with bitterness; wind herbs can also purge Earth.' After age seventy, the Spleen and Stomach are deficient, and flesh is withered. Purging Earth heavily renders the Spleen and Stomach too weak to circulate Ying and Wei Qi, failing to nourish Yuan Qi. If Stomach Qi cannot ascend, diseases like chest oppression, vomiting, and food regurgitation will arise. Given his advanced age and frailty, it is better not to take these medicines. He should speak cautiously, regulate his diet, restrain anger, and curb desires. This is the method of curing without direct treatment." The following spring, Zhang was appointed Inspector General of Guanxi Road. Three years later, upon retirement, his spirit was clearer than before, and his pulse became peaceful. This demonstrates that one should not recklessly administer cold-cooling agents. The *Neijing* states: "Punitive measures without excess are called great confusion," which explains the situation.
Hai Zang's wife's niece was obese. She developed eye disease upon reaching marriageable age, recurring monthly or every two months. Attacks involved severe redness and swelling making eyes hard to open. This persisted for three years. After taking wind-dispelling and heat-clearing formulas, her left eye developed stubborn opacity spreading from the inner canthus to cover the pupil, and her right eye developed opacity rising from below. The classics state: "Spreading from inside out indicates Shaoyang disease; rising from below indicates Yangming disease." I believed there was accumulation in the Shaoyang and Yangming meridians. Her pulse was short, slippery, and solid, appearing short in the morning. Jiegu stated: "A short pulse indicates accumulation obstructing the Zang-Fu; purgation is indicated." I used Wen Bai Wan, reducing Chuanxiong Rhizoma (Chuanxiong) and Fuzi by two-thirds, adding significantly Gentianae Radix (Longdancao) and Huanglian. Following Dongyuan's method for five accumulations, starting with two pills, increasing by one pill daily. If severe diarrhea occurred, reduce the dose; then restart from two pills. Suddenly, on one day, she passed several black blood clots in her stool, hard and bean-sized. From then on, she gradually recovered, and the opacities completely disappeared. (See *Yixue Gangmu*).
Lou Quanshan stated: Xia Ku Cao (Prunella Vulgaris) is miraculously effective for eyeball pain that worsens at night. It is also miraculous for cases where using cold-bitter eye drops exacerbates the pain. The eyeball connects to the root of the eye and belongs to the Jueyin Meridian. Pain worsening at night or with cold-bitter applications occurs because night and cold belong to Yin. Danxi said: "Xia Ku Cao has the function of nourishing the Jueyin Blood vessels. It flowers in the third and fourth lunar months and withers when Yin arises at the Summer Solstice. It possesses pure Yang Qi." This is profound. Therefore, treating Jueyin eye pain effectively involves using Yang to treat Yin. My son suffered from nightly pain in the eyeballs extending to the supraorbital ridge, with unilateral head swelling and pain. Using Huanglian Gao (Coptis Ointment) exacerbated the pain severely, and hundreds of remedies failed. Moxibustion on Jueyin and Shaoyang points stopped the pain temporarily, but it returned after half a day. This cycle continued for over a month. Finally, I used two liang of Xia Ku Cao, two liang of Cyperi Rhizoma (Xiangfu) powder, and four qian of Gancao, ground into fine powder. Each dose was one and a half qian, taken with clear tea. The pain reduced by more than half upon swallowing, and full recovery occurred within four to five days.
A man in his sixties suffered identically to the previous case, except for two white opacities on the cornea. Various medicines failed. He was given the same formula combined with Dongyuan's Xuanqi Tang, Si Wu Tang, and Huanglian decoction, administered alternately, along with moxibustion on Jueyin and Shaoyang meridians, leading to stabilization.