论曰眼者、五脏之精华,若风邪热毒,内干脏腑,则随其经络,上冲于目,故令赤脉波
贯黑睛也,上下左右,各有部分,不可不察,其从大 侵睛而痒者,肺胃热也。其从小 起
者,手少阳脉动,虚热也,其自上而下者,足太阳脉动,邪热也,其自下冲上者。足阳明脉
动,邪热也,其源不同,当察其部分,根据经以治之。
治脾肺热,目 痒,生瘀肉翳晕。芦根汤方
芦根(锉) 木通(锉各一两半) 栀子仁 桔梗 黄芩(去黑心) 甘草(炙各一两)
上六味。粗捣筛,每服五钱匕,水二盏,煎至一盏,去滓入地黄汁少许,再煎沸温服,
不拘时候。
散三焦热,治小 偏赤,赤脉射黑睛。通明汤方
木通(锉) 葳蕤 甘草(炙各一两半) 黄芩(去黑心) 枳壳(去瓤麸炒各一两)
上五味。粗捣筛,每服五钱匕,水二盏,煎至一盏,去滓下芒硝地黄汁各少许,再煎沸
,温服食后。
治眼上下赤脉贯黑睛。黄 汤方
黄 (锉) 芍药 知母 升麻 犀角(屑各一两半) 苦竹叶(五十片)
上六味。粗捣筛,每服五钱匕,水二盏,煎至一盏,去滓下芒硝少许,再煎沸,温服不
拘时候。
治眼自下冲上赤脉,攻黑睛。羚羊角汤方
羚羊角(屑) 芦根(锉) 旋复花 桑根白皮(锉) 木通(锉各一两半) 黄连(去
须一两)
淡竹叶(五十片)
上七味。粗捣筛,每服五钱匕,水二盏,煎至一盏,去滓下芒硝一钱匕,再煎沸。空心
食后各一。
治肝实热,赤脉波睛。前胡汤方
前胡(去芦头) 升麻(各二两) 菊花(一两半) 细辛(去苗叶) 栀子仁 大黄
(锉碎炒
熟各一两) 秦皮(去粗皮) 决明子(微炒) 蕤仁(去皮研如膏各二两) 苦竹叶(洗)
芒硝
(汤成下)
上一十一味。除硝竹叶外,粗捣筛,每服五钱匕,水二盏,入竹叶七片,煎至一盏,去
滓入芒硝一钱匕,放温食后临卧服。
治风热目赤痛,赤脉贯黑睛生翳。黄芩汤方
黄芩(去黑心) 木通(锉) 枳壳(去瓤锉炒) 葳蕤 甘草(微炙锉) 山栀子仁 生
干地
黄(各一两) 芒硝(汤成下)
上八味。除芒硝外,粗捣筛,每服五钱匕,水二盏,煎取一盏,去滓入芒硝一钱匕。食
后温服,临卧再服。
治目小 赤脉,利心肺。芍药汤方
芍药 芎 黄芩(去黑心) 大黄(锉炒熟) 甘草(微炙锉各半两) 黄连(去须
一两)
上六味。粗捣筛,每服五钱匕,水二盏,煎至一盏,去滓食后临卧温服。
治肝肺壅热,眼生 肉,赤脉涩痛,及赤眼障翳,目睛痒痛羞明,及小儿风疳,烁阳
眼赤。羚羊角丸方
羚羊角(锉末) 昨叶荷草(纱绢内洗去土各一两) 生干地黄(洗焙) 郁金(炮地
上出火
毒各二两) 甘草(生锉) 何首乌(白者去皮各一两)
上六味细锉曝干,捣罗为末,炼蜜和丸,如梧桐子大。每服十五丸,浓煎淡竹叶黑豆
汤,放冷下,食后临卧服,小儿丸如绿豆大,每服七丸至十丸。
治风热,赤脉贯黑睛,及有花翳。点眼真珠散方
真珠末 琥珀(各一分) 龙脑 丹砂(各半分) 砂(两豆大)
上五味。同研细,每日三五次点之。
治风热冲目,赤脉 肉。摩项明目膏方
生麻油(二升) 真酥(五两) 车前叶 淡竹叶(洗锉各半两) 吴蓝 大青 黄连
(去须)
山栀子仁 黄芩(去黑心) 甘草(炙) 麦门冬(去心) 槐白皮 柳白皮 马牙苋实
(研)
生犀角(镑) 马牙硝(别研) 朴硝(别研各一分) 盐花(研半两)
上一十八味。除消盐油酥外、细锉,绵裹入通油瓷瓶中,绵罩口,重汤煮三复时,捩
去滓,更新绵滤过,置生铁器中,每日饭后,及卧时,开发滴顶心,以生铁熨斗子,摩顶一
二千下,兼去目中热毒。昏障痛涩。
论述说:眼睛是五脏精华的汇聚之处,如果风邪和热毒内侵脏腑,就会随着经络上行冲击眼睛,从而导致赤脉波动贯穿黑睛(角膜)。赤脉在眼部的上下左右各有分布区域,不可不仔细辨别。其中,从大眦(内眼角)侵入眼睛且伴有瘙痒的,是肺胃有热。从小眦(外眼角)起始的,是手少阳三焦经脉气妄动,属于虚热。从上向下延伸的,是足太阳膀胱经脉气妄动,属于邪热。从下向上冲逆的,是足阳明胃经脉气妄动,属于邪热。这些病因源头不同,应当根据赤脉所在的部位,依据经络理论进行治疗。
治疗脾肺热盛导致的眼部瘙痒、胬肉攀睛及云翳晕障的芦根汤方:
芦根(切碎)、木通(切碎,各一两半)、栀子仁、桔梗、黄芩(去除黑色中心部分)、甘草(炙烤,各一两)。
以上六味药。粗捣筛碎,每次服用五钱匕,加水两盏,煎煮至一盏,滤去药渣,加入少许地黄汁,再次煮沸后温服,不限定具体时间。
疏散三焦热邪,治疗小眦偏红、赤脉射入黑睛的通明汤方:
木通(切碎)、葳蕤、甘草(炙烤,各一两半)、黄芩(去除黑色中心部分)、枳壳(去除瓤麸炒,各一两)。
以上五味药。粗捣筛碎,每次服用五钱匕,加水两盏,煎煮至一盏,滤去药渣,加入少许芒硝和地黄汁,再次煮沸,饭后温服。
治疗眼睛上下赤脉贯穿黑睛的黄连汤方:
黄连(切碎)、芍药、知母、升麻、犀角(锉成屑,各一两半)、苦竹叶(五十片)。
以上六味药。粗捣筛碎,每次服用五钱匕,加水两盏,煎煮至一盏,滤去药渣,加入少许芒硝,再次煮沸,温服,不限定具体时间。
治疗眼睛自下向上冲逆的赤脉,攻犯黑睛的羚羊角汤方:
羚羊角(锉成屑)、芦根(切碎)、旋复花、桑根白皮(切碎)、木通(切碎,各一两半)、黄连(去除须根,一两)、淡竹叶(五十片)。
以上七味药。粗捣筛碎,每次服用五钱匕,加水两盏,煎煮至一盏,滤去药渣,加入一钱匕芒硝,再次煮沸。空腹时和饭后各服一次。
治疗肝实热证导致的赤脉波动于眼球的的前胡汤方:
前胡(去除芦头)、升麻(各二两)、菊花(一两半)、细辛(去除苗叶)、栀子仁、大黄(切碎炒熟,各一两)、秦皮(去除粗皮)、决明子(微炒)、蕤仁(去皮研如膏状,各二两)、苦竹叶(洗净)、芒硝(汤成后加入)。
以上十一味药。除芒硝和竹叶外,粗捣筛碎,每次服用五钱匕,加水两盏,放入七片竹叶,煎煮至一盏,滤去药渣,加入一钱匕芒硝,放温后,于饭后临睡前服用。
治疗风热导致的眼部红肿疼痛、赤脉贯穿黑睛并生翳障的黄芩汤方:
黄芩(去除黑色中心部分)、木通(切碎)、枳壳(去除瓤切碎炒制)、葳蕤、甘草(微炙烤切碎)、山栀子仁、生干地黄(各一两)、芒硝(汤成后加入)。
以上八味药。除芒硝外,粗捣筛碎,每次服用五钱匕,加水两盏,煎取一盏,滤去药渣,加入一钱匕芒硝。饭后温服,临睡前再服一次。
治疗小眦赤脉,清利心肺的芍药汤方:
芍药、川芎、黄芩(去除黑色中心部分)、大黄(切碎炒熟)、甘草(微炙烤切碎,各半两)、黄连(去除须根,一两)。
以上六味药。粗捣筛碎,每次服用五钱匕,加水两盏,煎煮至一盏,滤去药渣,饭后临睡前温服。
治疗肝肺壅滞热邪,眼部生长胬肉,赤脉涩痛,以及赤眼障翳、眼球瘙痒疼痛畏光,还有小儿风疳病、烁阳眼红的羚羊角丸方:
羚羊角(锉成粉末)、昨叶荷草(在纱绢内清洗去土,各一两)、生干地黄(洗净焙干)、郁金(在土地上炮制以出火毒,各二两)、甘草(生切碎)、何首乌(白色者去皮,各一两)。
以上六味药细切晒干,捣碎过筛成末,用炼蜜调和制成丸药,大小如梧桐子。每次服用十五丸,用浓煎的淡竹叶黑豆汤,放冷后送服,饭后临睡前服用。小儿丸药做成绿豆大小,每次服用七丸至十丸。
治疗风热,赤脉贯穿黑睛,以及有花翳障的点眼真珠散方:
珍珠末、琥珀(各一分)、龙脑、丹砂(各半分)、砒霜(两豆大小)。
以上五味药。共同研磨极细,每日点眼三到五次。
治疗风热冲击眼睛,赤脉伴胬肉的摩项明目膏方:
生麻油(二升)、真酥(五两)、车前叶、淡竹叶(洗净切碎,各半两)、吴蓝、大青、黄连(去除须根)、山栀子仁、黄芩(去除黑色中心部分)、甘草(炙烤)、麦门冬(去除心)、槐白皮、柳白皮、马牙苋实(研碎)、生犀角(镑成片)、马牙硝(单独研碎)、朴硝(单独研碎,各一分)、盐花(研碎,半两)。
以上十八味药。除消石、盐和油酥外,其余细切,用棉布包裹放入通畅的油瓷瓶中,用棉布罩住瓶口,隔水重汤煮三个时辰,拧去药渣,更换新棉布过滤,置于生铁器中。每日饭后及睡觉时,滴于头顶百会穴处,用生铁熨斗按摩顶部一二千下,兼能去除目中热毒,缓解昏障、疼痛和涩感。
Discussion states: The eyes are the gathering place of the essence of the five Zang organs. If wind pathogens and heat toxins invade the internal organs, they will ascend along the meridians to strike the eyes, causing red vessels (blood vessels) to undulate and penetrate the black pupil (cornea). The red vessels have specific distributions in the upper, lower, left, and right parts of the eye, which must not be neglected. Those invading from the inner canthus (Da Zi) into the eye accompanied by itching indicate heat in the Lung and Stomach. Those originating from the outer canthus (Xiao Zi) indicate hyperactivity of the Hand Shaoyang Sanjiao meridian qi, constituting deficiency heat. Those extending from top to bottom indicate hyperactivity of the Foot Taiyang Bladder meridian qi, constituting pathogenic heat. Those rushing upward from bottom to top indicate hyperactivity of the Foot Yangming Stomach meridian qi, constituting pathogenic heat. Since the sources differ, treatment should be based on the location of the red vessels and guided by meridian theory.
Lugen Tang (Reed Rhizome Decoction) for treating spleen and lung heat causing eye itching, pterygium (fleshy growth), and nebula (cloudy opacity):
Radix Phragmitis (Cutilled), Radix Akebiae (Cutilled, each 1.5 liang), Semen Gardeniae, Radix Platycodi, Cortex Scutellariae (Remove black heart), Radix Glycyrrhizae (Honey-fried, each 1 liang).
The above six herbs are coarsely pounded and sifted. Take 5 qian bi per dose, add 2 zhan of water, decoct until 1 zhan remains, remove dregs, add a small amount of juice from Radix Rehmanniae Preparata, boil again, and take warm at any time.
Tongming Tang (Clear Brightness Decoction) for dispersing Sanjiao heat, treating reddening of the outer canthus, and red vessels shooting into the cornea:
Radix Akebiae (Cutilled), Rhizoma Polygonati, Radix Glycyrrhizae (Honey-fried, each 1.5 liang), Cortex Scutellariae (Remove black heart), Fructus Aurantii (Remove pulp, bran-fried, each 1 liang).
The above five herbs are coarsely pounded and sifted. Take 5 qian bi per dose, add 2 zhan of water, decoct until 1 zhan remains, remove dregs, add a small amount of Natrii Sulfas and juice from Radix Rehmanniae Preparata, boil again, and take warm after meals.
Huanglian Tang (Coptis Decoction) for treating red vessels penetrating the cornea in both upper and lower eyes:
Rhizoma Coptidis (Cutilled), Radix Paeoniae Alba, Rhizoma Anemarrhenae, Radix Cimicifugae, Cornu Rhinocerotis (Shaved, each 1.5 liang), Folium Bambusae Amarae (50 leaves).
The above six herbs are coarsely pounded and sifted. Take 5 qian bi per dose, add 2 zhan of water, decoct until 1 zhan remains, remove dregs, add a small amount of Natrii Sulfas, boil again, and take warm at any time.
Lingyangjiao Tang (Antelope Horn Decoction) for treating red vessels rushing upward from below, attacking the cornea:
Cornu Saigae Tataricae (Shaved), Radix Phragmitis (Cutilled), Flos Inulae, Cortex Morus Radicis (Cutilled), Radix Akebiae (Cutilled, each 1.5 liang), Rhizoma Coptidis (Remove roots, 1 liang), Folium Bambusae Dilutum (50 leaves).
The above seven herbs are coarsely pounded and sifted. Take 5 qian bi per dose, add 2 zhan of water, decoct until 1 zhan remains, remove dregs, add 1 qian bi of Natrii Sulfas, boil again. Take once on an empty stomach and once after meals.
Qianhu Tang (Peucedanum Decoction) for treating Liver excess heat causing red vessels undulating in the eyeball:
Radix Peucedani (Remove rhizome), Radix Cimicifugae (each 2 liang), Flos Chrysanthemi (1.5 liang), Radix Asari (Remove seedlings and leaves), Semen Gardeniae, Radix et Rhizoma Rhei (Cutilled, stir-fried ripe, each 1 liang), Cortex Fraxini (Remove coarse bark), Fructus Cassiae (Lightly fried), Semen Pruni (Remove skin, grind into paste, each 2 liang), Folium Bambusae Amarae (Washed), Natrii Sulfas (Add when decoction is ready).
The above eleven herbs, excluding Natrii Sulfas and bamboo leaves, are coarsely pounded and sifted. Take 5 qian bi per dose, add 2 zhan of water, put in 7 bamboo leaves, decoct until 1 zhan remains, remove dregs, add 1 qian bi of Natrii Sulfas, let cool slightly, and take after meals before bedtime.
Huangqin Tang (Scutellaria Decoction) for treating wind-heat causing eye redness and pain, red vessels penetrating the cornea with nebula formation:
Cortex Scutellariae (Remove black heart), Radix Akebiae (Cutilled), Fructus Aurantii (Remove pulp, cutilled and fried), Rhizoma Polygonati, Radix Glycyrrhizae (Lightly fried and cutilled), Semen Gardeniae, Radix Rehmanniae Preparata (each 1 liang), Natrii Sulfas (Add when decoction is ready).
The above eight herbs, excluding Natrii Sulfas, are coarsely pounded and sifted. Take 5 qian bi per dose, add 2 zhan of water, decoct to obtain 1 zhan, remove dregs, add 1 qian bi of Natrii Sulfas. Take warm after meals, and take again before bedtime.
Shaoyao Tang (Peony Decoction) for treating red vessels in the outer canthus, benefiting the Heart and Lungs:
Radix Paeoniae Alba, Radix Chuanxiong, Cortex Scutellariae (Remove black heart), Radix et Rhizoma Rhei (Cutilled, stir-fried ripe), Radix Glycyrrhizae (Lightly fried and cutilled, each 0.5 liang), Rhizoma Coptidis (Remove roots, 1 liang).
The above six herbs are coarsely pounded and sifted. Take 5 qian bi per dose, add 2 zhan of water, decoct until 1 zhan remains, remove dregs, and take warm after meals before bedtime.
Lingyangjiao Wan (Antelope Horn Pill) for treating Liver and Lung congestion-heat, pterygium growth in eyes, red vessels with涩 (astringent/stagnant) pain, red eye nebula, eye itching and photophobia, as well as pediatric wind-gan disease and "burning yang" red eyes:
Cornu Saigae Tataricae (Grind to powder), Herba Plantaginis (Wash and remove soil within gauze, each 1 liang), Radix Rehmanniae Recens (Wash and dry-bake), Radix Curcumae (Roast on earth to remove fire toxicity, each 2 liang), Radix Glycyrrhizae (Freshly cutilled), Radix Polygoni Multiflori (White variety, remove skin, each 1 liang).
The above six herbs are finely cutilled, dried in the sun, pounded, and sieved into powder. Mix with refined honey to make pills the size of Sophora japonica seeds. Take 15 pills per dose, swallow with cold decoction of Folium Bambusae Dilutum and Semen Sojae Preparatum, after meals before bedtime. For children, make pills the size of mung beans, taking 7 to 10 pills per dose.
Zhenzhu San (Pearl Powder) for eye application, treating wind-heat, red vessels penetrating the cornea, and floral nebula:
Margarita Pulvis, Succinum (each 1 fen), Borax, Cinabrium (each 0.5 fen), Arsenicum Rubrum (Size of two bean grains).
The above five herbs are ground together extremely finely. Apply to the eyes 3 to 5 times daily.
Moxiang Mingmu Gao (Neck-Massaging Bright-Eye Ointment) for treating wind-heat striking the eyes, red vessels with pterygium:
Oleum Sesami (2 sheng), Verum Butter (5 liang), Folium Plantaginis, Folium Bambusae Dilutum (Washed and cutilled, each 0.5 liang), Folium Isatidis, Radix Bupleuri, Rhizoma Coptidis (Remove roots), Semen Gardeniae, Cortex Scutellariae (Remove black heart), Radix Glycyrrhizae (Fried), Radix Ophiopogonis (Remove heart), Cortex Morus Albae, Cortex Salicis Albae, Semen Amaranthi (Grind), Cornu Rhinocerotis Recens (Sliced), Natrii Sulfas Crystallisatus (Separately ground), Natrii Sulfas (Separately ground, each 1 fen), Halitum (Ground, 0.5 liang).
The above eighteen herbs, excluding Natrii Sulfas, Halitum, oil, and butter, are finely cutilled. Wrap in cotton cloth, insert into a clear oil porcelain bottle, cover mouth with cotton, and boil in double boiler for three shichen (6 hours). Wring out dregs, filter through fresh cotton, place in a cast iron vessel. After meals and before sleep, drip onto the Baihui point (top of head), and massage the top of the head 1000-2000 times with a cast iron ironing tool, simultaneously removing heat toxins from the eyes, relieving nebula, pain, and astringency.