风廓属胆水膀胱,大肠天廓地胃乡,火廓小肠雷廓命,山泽三焦包络方。
【注】此明八廓所属也。风廓即风轮也,风轮属肝,肝与胆为表里,故轮主脏为肝病,
廓主腑为胆病。水廓即水轮也,水轮属肾,肾与膀胱为表里,故轮主脏为肾病,廓主腑为
膀胱病。天廓即气轮也,气轮属肺,肺与大肠为表里,故轮主脏为肺病,廓主腑为大肠
病。地廓即肉轮也,肉轮属脾,脾与胃为表里,故轮主脏为脾病,廓主腑为胃病。火廓、
雷廓、泽廓、山廓,即血轮之部位也,血轮属心,心与小肠为表里,故轮主脏为心病,廓
主腑为小肠病。其雷廓命门、泽廓三焦、山廓包络,皆附于血轮者,以命门、三焦、包
络,俱属相火,当禀命于君火,故当附焉。
【按】眼科皆以五轮属脏,配五行;八廓属脏腑,配八卦,遂使脏腑混淆,无所适从。夫五轮既属脏,
八廓自应属腑。今改订之,俾学人按轮廓之部位视之,而病之在脏、在腑,自能了然矣。
内障皆因伤七情,喜怒忧思悲恐惊,脏腑内损精不注,初为内障久成风。
【注】此明内障受病之因也。障,遮蔽也;内障者,从内而蔽也。内障之病,皆因七情
过伤,过喜伤心,过怒伤肝,过忧伤肺,过思伤脾,过悲伤心,过恐伤肾,过惊伤胆。脏
腑内损,精气不上注于目。故初病内障,久成五风(乌风、绿风、黑风、黄风、青风)之
患。其证不红不肿,瞳仁色变,而其光失明也。
风廓归属于胆、水和膀胱,大肠属于天廓,地廓属于胃,火廓归属于小肠,雷廓归属于命门,山廓和泽廓分别归属于三焦和心包络。
【注】此处阐明八廓的归属关系。风廓即风轮,风轮归属于肝,肝与胆互为表里,因此轮主脏对应肝病,廓主腑对应胆病。水廓即水轮,水轮归属于肾,肾与膀胱互为表里,因此轮主脏对应肾病,廓主腑对应膀胱病。天廓即气轮,气轮归属于肺,肺与大肠互为表里,因此轮主脏对应肺病,廓主腑对应大肠病。地廓即肉轮,肉轮归属于脾,脾与胃互为表里,因此轮主脏对应脾病,廓主腑对应胃病。火廓、雷廓、泽廓、山廓,是血轮的各个部位,血轮归属于心,心与小肠互为表里,因此轮主脏对应心病,廓主腑对应小肠病。至于雷廓对应命门、泽廓对应三焦、山廓对应心包络,都依附于血轮,因为命门、三焦、心包络都属于相火,应当禀受君火的命令,所以应当附属于此。
【按语】眼科通常将五轮归属于脏,配合五行;将八廓归属于脏腑,配合八卦,这导致脏腑概念混淆,让人无所适从。既然五轮已经归属于脏,八廓自然应该归属于腑。现在加以修订,使学习者按照轮廓的部位进行观察,那么疾病是在脏还是在腑,自然就能清楚了。
内障都是因为七情(喜、怒、忧、思、悲、恐、惊)受到损伤,喜怒忧思悲恐惊过度,导致脏腑内部受损,精气不能上注于目,起初表现为内障,日久演变为风证。
【注】此处阐明内障发病的原因。障,意为遮蔽;内障,是指从内部造成的遮蔽。内障的疾病,都是由于七情过度伤害所致:过喜伤心,过怒伤肝,过忧伤肺,过思伤脾,过悲伤心,过恐伤肾,过惊伤胆。脏腑内部受损,精气不能向上灌注到眼睛。所以初起病为内障,时间久了会形成五风(乌风、绿风、黑风、黄风、青风)的祸患。其症状表现为不红不肿,瞳仁颜色改变,而视力失明。
The Wind Palisade (Feng Kuò) belongs to the Gallbladder, Water, and Bladder; the Large Intestine belongs to the Heaven Palisade (Tian Kuò); the Earth Palisade (Di Kuò) belongs to the Stomach; the Fire Palisade (Huo Kuò) belongs to the Small Intestine; the Thunder Palisade (Lei Kuò) belongs to the Mingmen (Gate of Vitality); and the Mountain (Shan Kuò) and Marsh (Ze Kuò) Palisades belong to the Sanjiao (Triple Burner) and Pericardium (Bao Luo), respectively.
[Note] This clarifies the attribution of the Eight Palisades. The Wind Palisade is also known as the Wind Wheel (Feng Lun). The Wind Wheel belongs to the Liver. Since the Liver and Gallbladder are exterior-interiorly related, when the Wheel pertains to Zang organs, it indicates Liver disease; when the Palisade pertains to Fu organs, it indicates Gallbladder disease. The Water Palisade is also known as the Water Wheel (Shui Lun). The Water Wheel belongs to the Kidney. Since the Kidney and Bladder are exterior-interiorly related, when the Wheel pertains to Zang organs, it indicates Kidney disease; when the Palisade pertains to Fu organs, it indicates Bladder disease. The Heaven Palisade is also known as the Qi Wheel (Qi Lun). The Qi Wheel belongs to the Lung. Since the Lung and Large Intestine are exterior-interiorly related, when the Wheel pertains to Zang organs, it indicates Lung disease; when the Palisade pertains to Fu organs, it indicates Large Intestine disease. The Earth Palisade is also known as the Flesh Wheel (Rou Lun). The Flesh Wheel belongs to the Spleen. Since the Spleen and Stomach are exterior-interiorly related, when the Wheel pertains to Zang organs, it indicates Spleen disease; when the Palisade pertains to Fu organs, it indicates Stomach disease. The Fire Palisade, Thunder Palisade, Marsh Palisade, and Mountain Palisade are specific locations within the Blood Wheel (Xue Lun). The Blood Wheel belongs to the Heart. Since the Heart and Small Intestine are exterior-interiorly related, when the Wheel pertains to Zang organs, it indicates Heart disease; when the Palisade pertains to Fu organs, it indicates Small Intestine disease. As for the Thunder Palisade corresponding to the Mingmen (Gate of Vitality), the Marsh Palisade corresponding to the Sanjiao (Triple Burner), and the Mountain Palisade corresponding to the Pericardium (Bao Luo), they all attach to the Blood Wheel because the Mingmen, Sanjiao, and Pericardium all belong to Ministerial Fire (Xiang Huo) and should receive orders from Sovereign Fire (Jun Huo); therefore, they should be attached here.
[Commentary] Ophthalmology typically attributes the Five Wheels to Zang organs and aligns them with the Five Elements; it attributes the Eight Palisades to Zang and Fu organs and aligns them with the Eight Trigrams. This causes confusion between Zang and Fu concepts, leaving practitioners at a loss. Since the Five Wheels already belong to Zang organs, the Eight Palisades should naturally belong to Fu organs. We have now revised this so that students can observe according to the locations of the palisades, thereby clearly distinguishing whether the disease lies in the Zang or Fu organs.
Internal cataracts (Nei Zhang) are all caused by injury to the Seven Emotions (Joy, Anger, Worry, Thought, Grief, Fear, Fright). Excessive joy injures the Heart, excessive anger injures the Liver, excessive worry injures the Lungs, excessive thought injures the Spleen, excessive grief injures the Heart, excessive fear injures the Kidneys, and excessive fright injures the Gallbladder. Internal damage to the Zang and Fu organs prevents Essence and Qi from ascending to nourish the eyes. Thus, the initial manifestation is internal cataracts, which over time evolve into Wind disorders.
[Note] This clarifies the etiology of internal cataracts. "Zhang" means obstruction or covering; "internal cataract" refers to obstruction originating from within. Diseases of internal cataracts are all caused by excessive injury from the Seven Emotions. Internal damage to the Zang and Fu organs results in Essence and Qi failing to ascend and irrigate the eyes. Therefore, the initial disease presents as internal cataracts, and if prolonged, it develops into the afflictions of the Five Winds (Wu Feng: Black Wind, Green Wind, Dark Wind, Yellow Wind, Cyan Wind). The symptoms present without redness or swelling, but with changes in the color of the pupil and loss of vision.