脾番症乃眼胞番转如舌抵唇之状。由胃经气滞血壅。皮急丝吊所致。宜泻脾胃之积热。
漏睛为睛内有孔。时流脓汁也。其名不一。如正漏生于风轮。初出白膏如痰。尚可治。久则出青黑膏。损
及瞳人者不治。偏漏生于气轮者轻。流白水。重则成脓。久而膏枯者不治。内漏生于目窍之傍。外漏生
于肉轮之外。此由积热痰火熏蒸所致。阴漏则昼轻夜重。宜养血清肝。阳漏则夜轻昼重。宜清金补气。
又。在大 属心经君火。宜补北泻南。小 属心胞相火。宜于北方中补而抑之也。总之。目者肝之窍。肾
者肝之主。治宜补肾宣肝为要。
白薇丸 治漏睛出脓。
白薇(一两) 防风 白蒺藜 羌活(各三钱) 石榴皮(三钱)
共为末。米糊丸。梧子大。每服一钱。白汤送下。
解毒丸 治漏睛出脓。
杏仁(去皮尖二两另研) 栀子(十两) 大黄(五两)
为末。炼石蜜一斤为丸。梧子大。每服二三钱。茶汤送下。
眼 出脓者。大肠热也。用桔梗、芩、连、木通、槟榔、茱萸之类。眼 出血者。小肠热也。用归尾、赤芍、
黄连、桃仁、甘草之类。
经络 耳者心肾之窍。肝胆之经。宗脉之所聚也。心肾主内。如精血不足。或聋 。或虚鸣。禀赋弱也。六
味地黄丸加桑螵蛸。或滋阴地黄丸。肝胆主外。如风热有余。或胀痛。或脓痒。邪气客也。柴胡清肝散。因
血燥者。柴胡栀子汤。如未应。佐以六味丸。间服九味芦荟丸。因食积内热者。四味肥儿丸之类。
柴胡清肝散 治疮毒生于耳前耳后。自身外侧至足股内侧至足。或胸乳小腹下等处。皆肝胆三焦
经风热。
柴胡 黄芩(炒) 人参(各一钱) 栀子(炒) 川芎(各一钱五分) 连翘 桔梗(各一钱二分)
甘草(五分)
水煎。食远服。
滋阴地黄丸(见耳疳门) 柴胡栀子汤(见小儿胎毒疮疡) 九味芦荟丸(见疳疮门) 四味肥儿丸
脾番症是指眼睑翻转,形状如同舌头抵住嘴唇的样子。这是由于胃经气机阻滞、血液壅塞,导致皮肤紧绷、脉络牵拉所致。治疗应当清泻脾胃的积热。
漏睛症是指眼内(泪窍)有孔洞,时常流出脓液。它的名称不一:如果“正漏”生在黑睛(风轮),初起时流出白色膏状物如痰涎,还可以治疗;时间久了则流出青黑色膏状物,损伤到瞳孔的,属于不治之症。“偏漏”生在白睛(气轮)的病情较轻,流出清水,严重时化为脓液,时间久了膏液枯竭的,也不治。“内漏”生在目窍旁边,“外漏”生在胞睑(肉轮)之外。这些症状都是由积热和痰火熏蒸所致。阴漏表现为白天轻晚上重,治疗宜养血疏肝;阳漏表现为晚上轻白天重,治疗宜清肺补气。另外,大眦(内眼角)属心经君火,治疗宜补肾水以制约心火(补北泻南);小眦(外眼角)属心包相火,治疗应在滋肾水中加以抑制。总之,眼睛是肝的窍道,肾脏是肝脏的根本,治疗应以补肾疏肝为关键。
白薇丸:治疗漏睛出脓。
白薇(一两)、防风、白蒺藜、羌活(各三钱)、石榴皮(三钱)。
共研为细末,用米糊制作成梧桐子大小的药丸。每次服用一钱,用温开水送服。
解毒丸:治疗漏睛出脓。
杏仁(去皮尖,二两,单独研磨)、栀子(十两)、大黄(五两)。
研为细末,用炼制的蜂蜜一斤制成梧桐子大小的药丸。每次服用二三钱,用茶水送服。
大眦出脓,是大肠有热。使用桔梗、黄芩、黄连、木通、槟榔、吴茱萸等药物。小眦出血,是小肠有热。使用当归尾、赤芍、黄连、桃仁、甘草等药物。
经络:耳朵是心和肾的窍道,也是肝胆经脉循行之处,更是宗脉汇聚的地方。心和肾主管内部,如果精血不足,就会出现耳聋或虚性耳鸣,这是禀赋虚弱所致。可用六味地黄丸加桑螵蛸,或者滋阴地黄丸。肝胆主管外部,如果风热有余,会出现胀痛或脓痒,这是邪气客居所致。可用柴胡清肝散。如果是因血燥引起的,用柴胡栀子汤。如果效果不明显,配合服用六味地黄丸,间服九味芦荟丸。如果是因食积导致内热的,可用四味肥儿丸之类。
柴胡清肝散:治疗疮毒生于耳前、耳后,以及身体外侧至足股内侧直至足部,或胸部、乳房、小腹下等处。这些都是肝胆和三焦经的风热所致。
柴胡、黄芩(炒制)、人参(各一钱)、栀子(炒制)、川芎(各一钱五分)、连翘、桔梗(各一钱二分)、甘草(五分)。
加水煎煮,饭后服用。
Pi Fan Syndrome (Spleen Eversion) refers to the condition where the eyelids are everted, resembling a tongue protruding against the lips. This is caused by Qi stagnation and blood congestion in the Stomach Meridian, leading to tight skin and tethered meridians. Treatment should focus on purging accumulated heat from the Spleen and Stomach.
Lou Jing Syndrome (Leaking Pupil) is characterized by a hole within the eye corner that intermittently discharges pus. Its names vary: If "Zheng Lou" (Central Leakage) occurs at the Wind Wheel (cornea), initially discharging white paste-like phlegm, it is treatable; if prolonged and discharging dark green or black paste damaging the pupil, it is incurable. If "Pian Lou" (Lateral Leakage) occurs at the Qi Wheel (sclera), the condition is mild with clear fluid discharge; if severe with pus formation and eventual depletion of fluids, it is incurable. "Nei Lou" (Internal Leakage) occurs beside the lacrimal punctum, while "Wai Lou" (External Leakage) occurs outside the Flesh Wheel (eyelids). These are caused by steaming from accumulated heat and phlegm-fire. Yin Lou presents with symptoms lighter during the day and heavier at night; treatment requires nourishing blood and soothing the Liver. Yang Lou presents with symptoms lighter at night and heavier during day; treatment requires clearing Metal (Lung) and tonifying Qi. Furthermore, the inner canthus belongs to the Heart Meridian's Minister Fire; treatment involves tonifying Water (Kidney) and purging South (Heart). The outer canthus belongs to the Pericardium's Minister Fire; treatment involves tonifying within the North (Kidney) while suppressing it. In summary, the eyes are the orifices of the Liver, and the Kidneys are the masters of the Liver; thus, treatment must prioritize tonifying the Kidneys and promoting the free flow of the Liver.
Bai Wei Wan (White Violet Pill): Treats Lou Jing with pus discharge.
Ingredients: Bai Wei (Radix Cynanchi Atrati, 1 liang), Fang Feng (Radix Saposhnikoviae, 3 qian), Bai Ji Li (Fructus Tribuli, 3 qian), Qiang Huo (Rhizoma Notopterygii, 3 qian), Shi Liu Pi (Pericarpium Granati, 3 qian).
Preparation: Grind into fine powder, mix with rice paste to form pills the size of wutong seeds. Dosage: 1 qian per dose, taken with warm water.
Jie Du Wan (Detoxification Pill): Treats Lou Jing with pus discharge.
Ingredients: Xing Ren (Semen Armeniacae Amarum, peeled and tipped, 2 liang, ground separately), Zhi Zi (Fructus Gardeniae, 10 liang), Da Huang (Radix et Rhizoma Rhei, 5 liang).
Preparation: Grind into fine powder, bind with refined honey (1 jin) to form pills the size of wutong seeds. Dosage: 2-3 qian per dose, taken with tea water.
Discharge of pus from the inner canthus indicates Heat in the Large Intestine. Use Jie Geng (Radix Platycodonis), Qin (Radix Scutellariae), Lian (Radix Coptidis), Mu Tong (Caulis Akebiae), Bing Lang (Semen Arecae), and Yu Zhu (Fructus Corni) etc. Bleeding from the outer canthus indicates Heat in the Small Intestine. Use Gui Wei (Radix Angelicae Sinensis caudex), Chi Shao (Radix Paeoniae Rubra), Huang Lian (Rhizoma Coptidis), Tao Ren (Semen Persicae), and Gan Cao (Radix Glycyrrhizae) etc.
Meridians: The ear is the orifice of the Heart and Kidney, the pathway of the Liver and Gallbladder meridians, and the gathering place of the Zong Mai (Convergent Vessels). The Heart and Kidney govern the interior; insufficiency of essence and blood leads to deafness or tinnitus (empty ringing), indicating weak congenital constitution. Use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) plus Sang Piao Xiao (Ootheca Mantidis), or Zi Yin Di Huang Wan (Nourishing Yin Earth-Huang Pill). The Liver and Gallbladder govern the exterior; excess wind-heat leads to distending pain or itching with pus, indicating pathogenic invasion. Use Chai Hu Qing Gan San (Bupleurum Liver-Clearing Powder). For blood dryness, use Chai Hu Zhi Zi Tang (Bupleurum Gardenia Decoction). If ineffective, supplement with Liu Wei Wan, and intermittently take Jiu Wei Lu Hui Wan (Nine-Ingredient Aloe Vera Pill). For internal heat due to food stagnation, use Si Wei Fei Er Wan (Four-Ingredient Fat-Nourishing Pill) etc.
Chai Hu Qing Gan San: Treats sores/toxins arising around the anterior and posterior ears, extending along the lateral body to the medial thigh and foot, or to the chest, breasts, and lower abdomen. These are attributed to Wind-Heat in the Liver, Gallbladder, and San Jiao meridians.
Ingredients: Chai Hu (Radix Bupleuri), Huang Qin (Radix Scutellariae, stir-fried), Ren Shen (Radix Ginseng) (each 1 qian); Zhi Zi (Fructus Gardeniae, stir-fried), Chuan Xiong (Rhizoma Chuanxiong) (each 1.5 qian); Lian Qiao (Fructus Forsythiae), Jie Geng (Radix Platycodonis) (each 1.2 qian); Gan Cao (Radix Glycyrrhizae) (0.5 qian).
Preparation: Decoct in water, take well after meals.
Zi Yin Di Huang Wan (see Ear Fungal Disease Section), Chai Hu Zhi Zi Tang (see Pediatric Congenital Toxin Sores Section), Jiu Wei Lu Hui Wan (see Malnutrition Sores Section), Si Wei Fei Er Wan.