按真人《总理眼科秘诀》一书,专治少年中年时发时歇红丝云翳遮蔽瞳人等症。至于时症,只服冲和
汤、开明汤二方愈矣。
若年久生云红丝翳者,开手先用∶
白术(五分,土炒) 枳壳(麸炒) 川芎 防风 白芷 羌活 桔梗 前胡 独活 荆芥 薄荷(各四分) 柴
胡(七分) 黄芩(酒炒,五分) 炙甘草(三分)
清水二钟,煎一钟,早饭后大热服。渣即煎服。
凡红丝自上眼皮而出,倍加柴胡,加黄连(酒炒)五分;自下眼皮而出,加木通五分,五味子二分。自大
眼而出,加蔓荆子(炒打碎、)苍术各五分;自小眼 而出,加 本、龙胆草各五分,人参三分。
内服此药,外点开疆扫雾丹。
点法∶临卧用骨簪蘸凉水,拈药小米许,点大眼角内,药力尽再点。轻者点三次,重者点五、六次,
俱三更前点完。明早,点落翳膜粘住眼皮,用骨簪蘸温水拨净,避风。
点时宜静,病者并旁人不许说话,恐真气散而药力不行也。
胜风汤服至十数剂,眼中云膜虚浮者点去,坚固者点不下来,接服大决明散,仍点扫雾丹。点几日,
歇几日,不宜常点,看光景点歇。服决明散后,老翳浓膜贴在眼珠上不退,即服揭障丹。揭障丹服五、七
日,口中有痰涎,咽喉不清利,吐去唾沫一、二尺不断,闻口内气腥秽熏人,是肝肺上障开矣,即用十
大将军吹冲法。吹冲三、五日,眼内红丝翳膜虚浮,吹冲十日后,红丝翳膜与眼珠离开,以簪拨红丝云翳
活动,即用赛宝丹点。点法如《秘诀》,点七日歇七日云云。
大约云翳薄者,扫雾丹可以点去,浓者非赛宝丹不能去,或宜点扫雾丹,或宜点赛宝丹,在临时看眼
之变动何如耳。释熏法则在口授,秋冬在屋内。早饭后,服揭障丹一次,午饭后服一次,日夕用吹法∶
用杌子一个,置天井无风处,朝日,将吹药煎滚,倒大碗内,放杌子上;却令病者坐小板凳,在杌
子东边向西,头上蒙绵被一床,将头与身上半截并杌子,药套在内,不令药气出;口含苇子筒一个,如
笔管长,上头含口内,下头入碗药水内,口内用力吹药,令药气起,攻冲头目,出汗,毛孔开而风火出;
吹半炷香,觉口内涎粘稠糊如黑脂油,由口中入筒,碗内流出之物,如《秘诀》所载豆腐油等云云。
其肝肺虚浮者,自然流出,坚实成块,必咳嗽顿吐方出。此时若气力不足,独参汤吃三、四口,再吹,
药水冷即止。病者仍蒙绵单睡,汗解方出。药再煎滚,又吹一次,一日二次,吹完,吃大米粥或以养之。
根据孙真人《总理眼科秘诀》一书,该书专门治疗少年和中年时期时发时止的红丝云翳遮蔽瞳孔等症状。对于时令病症,只需服用冲和汤、开明汤两个方剂即可痊愈。
如果是病程长久形成的云红丝翳,开始治疗时先用以下方剂:
白术(五分,土炒) 枳壳(麸炒) 川芎 防风 白芷 羌活 桔梗 前胡 独活 荆芥 薄荷(各四分) 柴胡(七分) 黄芩(酒炒,五分) 炙甘草(三分)
用两碗清水,煎至一碗,早饭后趁大热服用。药渣再次煎煮后服用。
凡是红丝从上眼皮长出的,加倍使用柴胡,加黄连(酒炒)五分;从下眼皮长出的,加木通五分,五味子二分。从大眼角(内眦)长出的,加蔓荆子(炒后捣碎)、苍术各五分;从小眼角(外眦)长出的,加藁本、龙胆草各五分,人参三分。
内服此药的同时,外用“点疆扫雾丹”滴眼。
点药方法:临睡前用骨簪蘸取凉水,挑取少许如小米大小的药粉,点在眼角内侧,待药力完全吸收后再点一次。病情轻的点三次,病情重的点五到六次,都在三更天前点完。第二天早上,如果翳膜脱落粘在眼皮上,用骨簪蘸温水将其拨净,注意避风。
点药时应当保持安静,患者及旁人都不许说话,恐怕真气散失导致药力无法发挥。
服用胜风汤十几剂后,眼中虚浮的云膜可以用药点去,坚固的则点不下来,接着服用大决明散,同时继续点扫雾丹。点几天,停几天,不宜经常点,根据光点的变化来决定是否暂停。服用决明散后,如果老翳浓膜贴在眼珠上不退,就服用揭障丹。服用揭障丹五到七日后,口中出现痰涎,咽喉不清利,吐唾沫长达一、二尺不断,闻到口内气息腥秽熏人,这是肝肺上的障蔽已开的征兆,此时立即使用十大将军吹冲法。吹冲三到五日,眼内红丝翳膜变得虚浮,吹冲十日后,红丝翳膜与眼珠分离,用骨簪拨动红丝云翳使其活动,随即使用赛宝丹点眼。点药方法如同《秘诀》所述,点七天停七天等。
大致来说,云翳薄的,扫雾丹可以点去;厚的非赛宝丹不能去除。是宜点扫雾丹还是赛宝丹,需根据当时眼睛的变化情况而定。熏法的原理在于口头传授,秋冬季节在屋内进行。早饭后,服用一次揭障丹,午饭后服用一次,早晚使用吹法:准备一个凳子,放在天井无风且朝阳的地方,将吹药煎滚,倒入大碗中,放在凳子上;让病人坐在小板凳上,位于凳子东侧面向西,头上蒙一条绵被,将头、上半身以及凳子一起罩在药气中,不让药气逸出;口中含一根苇子筒,长度如笔管,上端含在口中,下端插入碗中药水里,用力向管内吹气,使药气升起,攻冲头目,促使出汗,毛孔张开从而排出风火;吹约半炷香时间,感觉口中唾液粘稠糊状如黑脂油,由口中进入筒内,碗中流出的物质,如同《秘诀》所载的豆腐油等。
如果是肝肺虚浮的障蔽,自然会流出;如果是坚实成块的,必须通过咳嗽剧烈呕吐才能排出。此时如果气力不足,喝三四口独参汤,然后再吹,药水冷了即停止。病人仍蒙着单被睡觉,待汗解之后才出来。药水再煎滚,再吹一次,一天两次,吹完后,吃大米粥来调养身体。
According to Sun Taizhen's "Zongli Yanke Mijue" (Secrets of Ophthalmology), this book specifically treats conditions such as red threads, cloud-like nebulas, and pterygium obscuring the pupil that occur intermittently in youths and middle-aged individuals. For seasonal ailments, recovery can be achieved by taking only two formulas: Chonghe Tang (Harmonizing Decoction) and Kaiming Tang (Illuminating Decoction).
If the condition has persisted for a long time resulting in cloud-like red thread nebulas, treatment should begin with the following prescription:
Baizhu (Atractylodis Rhizoma, 5 fen, stir-fried with soil) Zhike (Aurantii Fructus, bran-stir-fried) Chuanxiong (Ligustici Chuanxiong Rhizoma) Fangfeng (Saposhnikoviae Radix) Baizhi (Angelicae Dahuricae Radix) Qianghuo (Notopterygii Rhizoma et Radix) Jiegeng (Platycodonis Radix) Qianhu (Peucedani Radix) Duhuo (Angelicae Pubescentis Radix) Jingjie (Schizonepetae Spica) Bohe (Menthae Haplocalycis Herba) [each 4 fen] Chaihu (Bupleuri Radix, 7 fen) Huangqin (Scutellariae Radix, wine-stir-fried, 5 fen) Zhigancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 3 fen)
Decoct two bowls of clear water until one bowl remains. Take it while very hot after breakfast. The dregs should be decocted again and taken.
If the red threads emerge from the upper eyelid, double the dosage of Chaihu (Bupleuri Radix) and add Huanglian (Coptidis Rhizoma, wine-stir-fried, 5 fen); if they emerge from the lower eyelid, add Mutong (Akebiae Caulis, 5 fen) and Wuweizi (Schisandrae Chinensis Fructus, 2 fen). If they emerge from the inner canthus (medial canthus), add Manjingzi (Viticis Semen, stir-fried and crushed) and Cangzhu (Atractylodis Rhizoma, each 5 fen); if they emerge from the outer canthus (lateral canthus), add Gaoben (Ligustici Wallichii Rhizoma et Radix) and Longdancao (Gentianae Radix, each 5 fen), and Renshen (Ginseng Radix et Rhizoma, 3 fen).
While taking this internal medicine, apply external eye drops using "Dian Jiangsaowu Dan" (Cloud-Dispelling Pill for Eye Instillation).
Method of instillation: Before going to bed, dip a bone hairpin into cool water, pick up a small amount of medicine roughly the size of a millet seed, and place it in the inner corner of the eye. Repeat once the medicinal effect has fully absorbed. For mild cases, instill three times; for severe cases, five or six times. All instillations must be completed before the third watch of the night (midnight to 2 AM). The next morning, if the nebula membrane falls off and sticks to the eyelid, use a bone hairpin dipped in warm water to gently remove it, and avoid wind.
Instillation should be done in silence. Neither the patient nor bystanders are allowed to speak, lest the True Qi scatter and the medicinal power fail to act.
After taking Shengfeng Tang (Wind-Overcoming Decoction) for more than ten doses, if the cloud membranes in the eyes are loose and floating, they can be removed by instillation. If they are firm, they cannot be removed by instillation alone; instead, take Dajueming San (Great Cassia Powder) and continue instilling Saowu Dan. Instill for a few days, then pause for a few days. Do not instill continuously; observe changes in light perception to decide when to pause. After taking Jueming San, if old, thick nebulas adhere firmly to the eyeball and do not recede, take Jiezhang Dan (Barrier-Removing Pill). After taking Jiezhang Dan for five to seven days, phlegm and saliva will appear in the mouth, the throat will feel unclear, and spitting may produce streams of saliva lasting one to two chi. A foul, fishy odor will emanate from the mouth. This indicates that the barriers in the Liver and Lung have opened. At this point, immediately employ the "Ten Great Generals Blowing and Rushing Method" (Shi Da Jiangjun Chuichong Fa). After blowing and rushing for three to five days, the red thread nebulas in the eyes will become loose and floating. After ten days of this method, the red thread nebulas will separate from the eyeball. Use a hairpin to manipulate the active red thread nebulas, then immediately apply Saibao Dan (Precious Treasure Pill) for instillation. The instillation method is as described in the "Mijue": instill for seven days, then pause for seven days, and so on.
Generally speaking, thin nebulas can be removed by Saowu Dan; thick ones require Saibao Dan. Whether to use Saowu Dan or Saibao Dan depends on the specific changes in the eye at that moment. The principle of fumigation is explained orally. In autumn and winter, perform this indoors. After breakfast, take one dose of Jiezhang Dan; after lunch, take another dose. In the morning and evening, use the blowing method: Place a stool in a windless, sunlit courtyard. Boil the blowing medicine and pour it into a large bowl, placing the bowl on the stool. Have the patient sit on a small stool to the east of the stool, facing west. Cover the patient's head with a cotton quilt, enclosing the head, upper body, and the stool within the blanket to prevent the medicinal vapor from escaping. Hold a reed tube (length like a pen) in the mouth; the upper end stays in the mouth, and the lower end is inserted into the medicinal liquid in the bowl. Blow forcefully into the tube to generate medicinal vapor that rises to attack the head and eyes, inducing sweating and opening pores to expel Wind and Fire. Blow for about half an incense stick's duration. When the saliva in the mouth becomes viscous and paste-like, resembling black grease oil, flowing from the mouth into the tube, and the substance flowing out of the bowl resembles tofu oil as described in the "Mijue," the process is complete.
If the Liver and Lung barriers are loose and floating, they will naturally flow out. If they are solid and formed into masses, they must be expelled through violent coughing and vomiting. If the patient lacks strength at this time, drink three or four mouthfuls of Dushen Tang (Single Ginseng Decoction), then resume blowing. Stop if the medicinal liquid cools down. The patient should sleep covered with a single quilt until the sweat resolves, then come out. Boil the medicinal liquid again and blow one more time. Perform this twice a day. After completing the blowing sessions, nourish the body with rice porridge.