论曰。眼之为病。在腑则为表。当除风散热。在脏则为里。宜养血安神。暴发者为表而易治。久病者在里
而难愈。除风散热者。泻青丸主之。养血安神者。定志丸。妇人熟干地黄丸是也。或有体肥气盛。风热上行。
目昏涩者。槐子散主之。此由胸中气浊上行也。重则为痰厥。亦能损目。常使胸中气清。无此病也。又有因目
疾服药多而损气者。久之眼渐昏弱。乍明乍暗。不欲视物。此目少血之验也。熟干地黄丸。消风散。定志丸。
相须而养之。或有视物不明。见黑花者。此谓之肾气弱也。宜补肾水。驻景丸是也。或有暴失明者。谓眼居诸
阳交之会也。而阴反闭之。此风邪内满。当有不测之疾也。翳膜者。风热重而有之。或斑入眼。此肝气盛而发
在表也。翳膜已生在表明矣。当发散而去之。反疏利则邪气内搐。为翳则深也。邪气未定。谓之热翳而浮。邪
气已定。谓之冰翳而沉。邪气牢而深者。谓之陷翳。当以 发之物。使其邪气再动。翳膜乃浮。辅之退翳之药。
则能自去也。病久者。不能速效。当以岁月除之。
治眼赤暴发肿。散热饮子。
防风 羌活 黄芩 黄连(各一两)
上 。每服半两。水二盏。煎至一盏。食后温服。如大便秘涩。加大黄一两。如痛甚者。加当归地黄。如
烦躁不能眠睡。加栀子一两。
川芎散 治风热上冲。头目眩热肿。及胸中不利。
川芎 槐子(各一两)
上细末三钱。如胸中气滞不利。生姜汤调。目疾茶调。风热上攻。 咀一两。水煎食后服。
治眼久病昏涩。因发而久不愈。地黄汤。
防风 羌活 黄芩 黄连 地黄 当归 人参 茯神(各等分)
上为粗末。每服五七钱。水一盏半。煎至一盏。去滓温服食后。
槐子散
槐子 黄芩 木贼 苍术(各等分)
上细末。茶清调下。食后。
治眼生翳膜。及斑入眼。 赤已过者。泻青丸主之。当半减大黄。如大便秘。 气未定。根据方服之。
治冰翳久不去者。羚羊角散主之。
羚羊角 升麻 细辛(各等分) 甘草(半之)
上为细末。一半为散。一半蜜为丸。如桐子大。每服五七十丸。以羚羊角散下之。食后临卧。米泔水煎服。
治太阳经。卫虚血贯肿人脸重。头中湿淫肤脉。睛痛肝风盛。眼黑肾虚。桔梗丸。
桔梗(一斤) 牵牛(头末三两)
上二味为末。炼蜜为丸。如桐子大。每服四五十丸。加至百丸。食前温水下。日二服。
金丝膏 点眼药。
生姜(四两取汁) 白沙蜜(一斤炼去滓) 猪胆汁(三钱) 黄连(四两槌用水一斗浸煎取五升)
上先煎黄连水。后入姜汁。次入蜜。同煎去沫净。次入下项药末。
脑子(四钱) 麝香(三钱) 砂(四钱) 硼砂(三钱) 轻粉(五钱) 熊胆(四钱) 青盐(三钱)
上极细搅匀。熬令稀膏。点用。
治眼暴赤发嗔痛不可忍者。救苦丸。
黄连(一两) 当归(二钱) 甘草(一钱)
上同 细。新水半碗。浸一宿。以慢火熬。约至一半。以绵滤去滓。以净为妙。用火再熬。作稠膏子为度。
摊在碗上倒合。以物盖之。用熟艾一大弹子许。底下燃之。用艾熏膏子。艾尽为度。再入下项药。
朱砂(一钱飞) 脑子(半钱) 乳香 没药(等分)
上同研极细。入黄连膏内。搜和丸如米大。每用二丸。点眼大角内。仰面卧。药化则起。
治眼发赤肿。毒瓦斯侵睛胀痛。宣毒散。
盆硝 雄黄 乳香 没药(各等分)
上为极细末。以少许。鼻内 之。
治眼风毒发肿。鼻中欲嚏。嚏多大损而生疮。宣风散。
川芎 甘菊(各二钱) 乳香 没药(各一钱)
上和匀。再研极细。少许鼻内 之。
能远视不能近视。局方中定志丸。
白茯苓(去皮) 人参(去芦头各三两) 远志(去苗及心) 菖蒲(各二两)
目能近视不能远视。万寿地芝丸。
生姜(四两焙) 天门冬(四两去心) 枳壳(三两去穣炒) 甘菊(二两)
上为细末。炼蜜丸如桐子大。茶清或温酒下一百丸。食后。此药能愈大风热。
洗眼药
诃子(二两) 黄丹(四两) 蜜(八两) 柳枝(四十寸)
上以河水二碗。熬至半碗。用一钱热水化洗之。石器内熬。
治眼赤瞎。以青 蛆。不以多少。淘净晒干末之。令害眼人仰卧合目。用药一钱散在眼上。须臾药行。待
少时去药。赤瞎亦无。
治倒睫 无名异末之。掺在纸中。卷作捻子。点着到药处
吹杀。以烟熏目。睫自起。
论述说:眼睛发生的疾病,如果病位在腑,则属于表证,应当采用祛风散热的治法;如果病位在脏,则属于里证,适宜采用养血安神的治法。突然发作的病症属于表证,容易治疗;病程长久的病症属于里证,难以痊愈。采用祛风散热治法的,以泻青丸为主方;采用养血安神治法的,以定志丸、妇人熟干地黄丸为主方。有的人身体肥胖、气机壅盛,导致风热之邪上行,出现眼睛昏花、干涩的症状,以槐子散为主方。这是由于胸中浊气上逆所致。病情严重的会发展为痰厥,也会损伤眼睛。只要常使胸中清气通畅,就不会得这种病。又有因为眼疾服药过多而损伤正气的人,久而久之眼睛逐渐昏弱,视力时好时坏,不想看东西,这是眼睛阴血不足的验证。此时可用熟干地黄丸、消风散、定志丸配合服用以滋养眼睛。有的人视物不清,眼前出现黑花飞舞的现象,这称为肾气虚弱。适宜补肾水,使用驻景丸。有的人突然失明的,这是因为眼睛位于诸阳经交汇之处,而阴气反而闭塞了它,这是风邪内盛的表现,预示着可能会有不可预测的疾病发生。翳膜(角膜混浊),是由于风热较重而产生的。或者斑痕进入眼中,这是肝气旺盛且病发在表的表现。翳膜已经生成,说明病位已在表面,应当发散邪气将其去除。如果反而使用疏利攻下的方法,会导致邪气内陷收缩,形成深部的翳膜。邪气尚未稳固的,称为热翳,位置浮浅;邪气已经稳固的,称为冰翳,位置深沉;邪气牢固且深的,称为陷翳。应当使用发散的药物,使邪气再次活动,让翳膜浮起,再辅助使用退翳的药物,翳膜就能自行脱落。病程久的,不能追求速效,应当以年岁为单位慢慢消除。
治疗眼睛突然发红、肿胀的,用散热饮子。
药物组成:防风、羌活、黄芩、黄连(各一两)。
制法用法:将上述药物捣碎成粗末。每次服用半两,加水二盏,煎煮至一盏,饭后温服。如果大便秘结不通,加大黄一两;如果疼痛剧烈,加当归、地黄;如果烦躁不能入睡,加栀子一两。
川芎散,治疗风热上冲引起的头目眩晕、发热、肿胀,以及胸中气机不畅。
药物组成:川芎、槐子(各一两)。
制法用法:将上述药物研成细末,每次取三钱。如果胸中气滞不畅,用生姜汤调服;如果是眼疾,用茶调服;如果是风热上攻,将药材切碎一两,加水煎煮,饭后服用。
治疗眼睛久病昏涩,因发作而长久不愈的,用地黄汤。
药物组成:防风、羌活、黄芩、黄连、地黄、当归、人参、茯神(各等分)。
制法用法:将上述药物制成粗末。每次服用五到七钱,加水一盏半,煎煮至一盏,去渣后饭后温服。
槐子散
药物组成:槐子、黄芩、木贼、苍术(各等分)。
制法用法:将上述药物研成细末,用清茶调服,饭后服用。
治疗眼睛生翳膜,以及斑痕入眼,且红肿已经消退的,以泻青丸为主方。应当减半大黄用量。如果大便秘结,且邪气未定,按照原方服用。
治疗冰翳长久不去的,以羚羊角散为主方。
药物组成:羚羊角、升麻、细辛(各等分),甘草(减半)。
制法用法:将上述药物研成细末,一半做成散剂,一半用蜂蜜做成丸剂,如梧桐子大小。每次服用五七十丸,用羚羊角散送服,饭后临睡前服用,米泔水煎服。
治疗太阳经卫气虚弱、血液充盈导致的脸部浮肿沉重,头部湿气浸淫皮肤脉络,眼球疼痛、肝风旺盛,眼睛发黑、肾虚等症状,用桔梗丸。
药物组成:桔梗(一斤),牵牛子(头末三两)。
制法用法:将这两味药研成末,炼蜜为丸,如梧桐子大小。每次服用四五十丸,可加至一百丸,饭前温水送服,每日两次。
金丝膏,点眼药。
药物组成:生姜(四两取汁),白沙蜜(一斤炼去渣滓),猪胆汁(三钱),黄连(四两捶碎用水一斗浸泡煎煮取五升)。
制法用法:先煎煮黄连水,然后加入姜汁,接着加入蜂蜜,共同煎煮并撇去浮沫,使其洁净。然后加入以下药末:脑子(冰片,四钱)、麝香(三钱)、砂(硇砂,四钱)、硼砂(三钱)、轻粉(五钱)、熊胆(四钱)、青盐(三钱)。将所有药物极细搅拌混合均匀,熬制成稀膏状,用于点眼。
治疗眼睛突然发红、愤怒肿痛不可忍受的,用救苦丸。
药物组成:黄连(一两),当归(二钱),甘草(一钱)。
制法用法:将上述药物一同捣碎变细,用新水半碗浸泡一夜,用慢火熬煮,约剩下一半时,用绵布过滤去渣,以纯净为好。再用火熬煮,制成稠膏状。摊在碗上倒扣覆盖,用物体盖住,用一大团熟艾在底下燃烧,用艾烟熏烤膏体,直到艾燃尽为止。再加入以下药物:朱砂(一钱飞过的),脑子(半钱),乳香、没药(等分)。将上述药物一同研成极细末,放入黄连膏内,揉和制成如米粒大小的丸剂。每次用两丸,点在眼角内侧,仰面躺卧,药化开后起身。
治疗眼睛发红肿胀,毒气侵袭睛球胀痛,用宣毒散。
药物组成:盆硝(朴硝),雄黄,乳香,没药(各等分)。
制法用法:将上述药物研成极细末,取少许纳入鼻中搐吸。
治疗眼睛风毒发作肿胀,鼻子想打喷嚏,打太多喷嚏会严重损伤并生疮,用宣风散。
药物组成:川芎、甘菊(各二钱),乳香、没药(各一钱)。
制法用法:混合均匀,再研磨成极细末,取少许纳入鼻中搐吸。
能看清远处但不能看清近处的,用局方中的定志丸。
药物组成:白茯苓(去皮),人参(去芦头,各三两),远志(去苗及心),石菖蒲(各二两)。
能看清近处但不能看清远处的,用万寿地芝丸。
药物组成:生姜(四两焙干),天门冬(四两去心),枳壳(三两去瓤炒),甘菊(二两)。
制法用法:将上述药物研成细末,炼蜜为丸,如梧桐子大小。饭后用清茶或温酒送服一百丸。此药能治愈大风热症。
洗眼药
药物组成:诃子(二两),黄丹(四两),蜜(八两),柳枝(四十寸)。
制法用法:用河水二碗,熬煮至半碗,取一钱用药液热水化开清洗眼睛。需在石器内熬煮。
治疗眼睛红盲,用青蚯蚓,数量不限,淘洗干净晒干后研成末。让患眼者仰卧闭眼,取药末一钱撒在眼睛上,须臾间药力运行,待稍候去掉药末,红盲症状即可消除。
Discourse states: Diseases of the eyes, if located in the Fu organs (Hollow organs), belong to exterior syndromes and should be treated by dispelling wind and clearing heat. If located in the Zang organs (Solid organs), they belong to interior syndromes and should be treated by nourishing blood and calming the spirit. Sudden onset indicates an exterior syndrome that is easy to treat; chronic illness indicates an interior syndrome that is difficult to cure. For dispelling wind and clearing heat, Xie Qing Wan (Drain the Green Pill) is the primary formula. For nourishing blood and calming the spirit, Ding Zhi Wan (Stabilize the Will Pill) and Furen Shu Gan Di Huang Wan (Women's Prepared Rehmannia Pill) are used. Some individuals with obesity and excessive Qi experience upward movement of wind-heat, resulting in blurred vision and dryness/astringency of the eyes; Huai Zi San (Sophora Seed Powder) is indicated. This arises from turbid Qi ascending from the chest. In severe cases, it may develop into Phlegm-Jue (Phlegm obstruction leading to loss of consciousness or function), which also damages the eyes. Keeping the Qi in the chest clear prevents this disease. Others who have taken excessive medication for eye diseases may damage their Zheng Qi (Upright Qi); over time, their vision gradually becomes dim and weak, fluctuating between clarity and darkness, with a reluctance to look at objects. This is evidence of insufficient Blood in the eyes. In such cases, Shu Gan Di Huang Wan (Prepared Rehmannia Pill), Xiao Feng San (Eliminate Wind Powder), and Ding Zhi Wan (Stabilize the Will Pill) should be used together to nourish the eyes. Some patients suffer from unclear vision and see black spots dancing before their eyes; this is termed Kidney Qi deficiency. It is appropriate to tonify Kidney Water using Zhu Jing Wan (Reside in the Scenery Pill). Those who suddenly lose sight do so because the eyes are the meeting point of all Yang meridians, yet Yin pathogenic factors obstruct them. This indicates an excess of wind pathogens internally and portends unpredictable disease. Membranes (Pterygium/Corneal opacity) arise from severe wind-heat. Or, if macules enter the eye, this indicates Liver Qi excess manifesting in the exterior. Once membranes have formed, the pathology is superficial; one should disperse and eliminate the pathogen. Conversely, using purgative methods causes the pathogen to retract inward, forming deep-seated membranes. When the pathogen is unsettled, it is called Re Yi (Heat Membrane) and floats superficially; when settled, it is called Bing Yi (Ice Membrane) and sinks deeply; when firm and deep, it is called Xian Yi (Sunken Membrane). One should use dispersing agents to agitate the pathogen again, causing the membrane to float, then assist with anti-membrane drugs to allow it to detach naturally. Chronic conditions cannot be cured quickly; treatment must span years.
To treat sudden redness and swelling of the eyes, use Re San Yin Zi (Heat-Dispersing Decoction).
Ingredients: Fang Feng (Saposhnikovia Root), Qiang Huo (Notopterygium Rhizome), Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome) (each 1 liang).
Preparation and Administration: Coarsely crush the ingredients. Take 0.5 liang per dose, add 2 cups of water, decoct to 1 cup, and take warm after meals. If constipation is present, add Da Huang (Rhubarb Root) 1 liang. If pain is severe, add Dang Gui (Angelica Sinensis Root) and Di Huang (Rehmannia Root). If irritability and insomnia occur, add Zhi Zi (Gardenia Fruit) 1 liang.
Chuan Xiong San (Ligusticum Chuanxiong Powder) treats wind-heat rushing upward, causing dizziness, heat, and swelling of the head and eyes, as well as stagnation in the chest.
Ingredients: Chuan Xiong (Ligusticum Chuanxiong Rhizome), Huai Zi (Sophora Fruit) (each 1 liang).
Preparation and Administration: Grind into fine powder. Take 3 qian per dose. If there is chest Qi stagnation, mix with Ginger Decoction. For eye diseases, mix with tea water. For wind-heat attacking upward, chop 1 liang of herbs, decoct in water, and take after meals.
For chronic eye disease with blurriness and astringency that persists despite treatment, use Di Huang Tang (Rehmannia Decoction).
Ingredients: Fang Feng (Saposhnikovia Root), Qiang Huo (Notopterygium Rhizome), Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), Di Huang (Rehmannia Root), Dang Gui (Angelica Sinensis Root), Ren Shen (Ginseng Root), Fu Shen (Poria with Hostwood) (equal parts).
Preparation and Administration: Make into coarse powder. Take 5-7 qian per dose, add 1.5 cups of water, decoct to 1 cup, strain, and take warm after meals.
Huai Zi San (Sophora Seed Powder)
Ingredients: Huai Zi (Sophora Fruit), Huang Qin (Scutellaria Root), Mu Zei (Equisetum Hiemale), Cang Zhu (Atractylodes Rhizome) (equal parts).
Preparation and Administration: Grind into fine powder. Mix with clear tea water and take after meals.
For eye membranes and macules entering the eye, where redness has subsided, use Xie Qing Wan (Drain the Green Pill). Reduce the dosage of Da Huang (Rhubarb Root) by half. If constipated and the pathogen is unsettled, follow the standard prescription.
For persistent Bing Yi (Ice Membrane), use Ling Yang Jiao San (Antelope Horn Powder).
Ingredients: Ling Yang Jiao (Antelope Horn), Sheng Ma (Cimicifuga Rhizome), Xi Xin (Asarum Root) (equal parts), Gan Cao (Licorice Root) (half amount).
Preparation and Administration: Grind into fine powder. Half is used as a powder, half is made into pills with honey, sized like sophora seeds. Take 50-70 pills per dose, washed down with Ling Yang Jiao San. Take after meals and before bed, with rice wash decoction.
For Tai Yang Meridian disorders involving Wei Qi deficiency, blood congestion causing facial heaviness, dampness invading skin and vessels, eye pain, excess Liver Wind, darkening of vision, and Kidney deficiency, use Jie Geng Wan (Platycodon Pill).
Ingredients: Jie Geng (Platycodon Root) (1 jin), Qian Niu (Morning Glory Seed) (head powder 3 liang).
Preparation and Administration: Grind these two ingredients into powder, make pills with refined honey, sized like sophora seeds. Take 40-50 pills per dose, increasing up to 100 pills. Take before meals with warm water, twice daily.
Jin Si Gao (Golden Thread Ointment) for eye application.
Ingredients: Sheng Jiang (Fresh Ginger) (4 liang, juice extracted), Bai Sha Mi (White Bee Honey) (1 jin, refined and strained), Zhu Dan (Pig Bile) (3 qian), Huang Lian (Coptis Rhizome) (4 liang, crushed and soaked in 1 dou of water, decocted to obtain 5 sheng).
Preparation and Administration: First decoct the Huang Lian water, then add ginger juice, followed by honey. Simmer together, skim off foam until clean. Then add the following powders: Nao Zi (Borneol) (4 qian), She Xiang (Musk) (3 qian), Sha (Ammonium Chloride/Nuo Sha) (4 qian), Peng Sha (Borax) (3 qian), Qing Fen (Calomel) (5 qian), Xiong Dan (Bear Gallbladder) (4 qian), Qing Yan (Green Salt) (3 qian). Mix extremely finely, simmer into a thin paste, and use for eye application.
For sudden redness, anger-induced swelling, and unbearable pain of the eyes, use Jiu Ku Wan (Save from Suffering Pill).
Ingredients: Huang Lian (Coptis Rhizome) (1 liang), Dang Gui (Angelica Sinensis Root) (2 qian), Gan Cao (Licorice Root) (1 qian).
Preparation and Administration: Crush finely. Soak in half a bowl of fresh water overnight. Simmer slowly until reduced by half. Filter through cotton cloth to remove dregs, ensuring purity. Re-boil to form a thick paste. Spread on a bowl, invert cover, seal with material. Burn a large ball of prepared Mugwort (Ai Ye) underneath to smoke the paste until the mugwort is consumed. Then add: Zhu Sha (Cinnabar) (1 qian, washed), Nao Zi (Borneol) (0.5 qian), Ru Xiang (Frankincense), Mo Yao (Myrrh) (equal parts). Grind extremely finely, mix into the Huang Lian paste, and roll into rice-grain-sized pills. Use 2 pills per application, placed in the inner canthus. Lie supine; rise after the pill melts.
For redness, swelling, toxic invasion of the eyeball, and distending pain, use Xuan Du San (Disperse Toxicity Powder).
Ingredients: Pen Xiao (Mirabilite/Pu Xiao), Xiong Huang (Realgar), Ru Xiang (Frankincense), Mo Yao (Myrrh) (equal parts).
Preparation and Administration: Grind into extremely fine powder. Insert a small amount into the nose to sneeze.
For wind-toxin causing eye swelling and urge to sneeze (excessive sneezing damages and causes sores), use Xuan Feng San (Disperse Wind Powder).
Ingredients: Chuan Xiong (Ligusticum Chuanxiong Rhizome), Gan Ju (Chrysanthemum Flower) (each 2 qian), Ru Xiang (Frankincense), Mo Yao (Myrrh) (each 1 qian).
Preparation and Administration: Mix evenly, grind extremely finely. Insert a small amount into the nose to sneeze.
For presbyopia (can see far but not near), use Ding Zhi Wan (Stabilize the Will Pill) from the Bureau Formulary.
Ingredients: Bai Fu Ling (Poria) (peeled), Ren Shen (Ginseng Root) (de-rooted, each 3 liang), Yuan Zhi (Polygala Root) (de-seeded and de-heart), Shi Chang Pu (Acorus Rhizome) (each 2 liang).
For inability to see far but ability to see near, use Wan Shou Di Zhi Wan (Ten-Thousand-Year Earth Essence Pill).
Ingredients: Sheng Jiang (Fresh Ginger) (roasted 4 liang), Tian Men Dong (Asparagus Tuber) (de-hearted 4 liang), Zhi Ke (Aurantium Fruit) (de-pithed and stir-fried 3 liang), Gan Ju (Chrysanthemum Flower) (2 liang).
Preparation and Administration: Grind into fine powder, make pills with honey sized like sophora seeds. Take 100 pills after meals with clear tea or warm wine. This medicine cures severe wind-heat.
Eye Wash Medicine
Ingredients: He Zi (Chebula Fruit) (2 liang), Huang Dan (Red Lead) (4 liang), Mi (Honey) (8 liang), Liu Zhi (Willow Branch) (40 cun).
Preparation and Administration: Decoct in 2 bowls of river water until reduced to half a bowl. Dissolve 1 qian in hot water to wash the eyes. Decoct in stone vessels.
To treat red blindness, use Qing Qu (Green Earthworms), quantity unspecified. Wash clean, dry, and grind into powder. Have the patient lie supine with eyes closed. Scatter 1 qian of powder on the eyes. Wait briefly for the medicine to act, then remove. Red blindness will disappear.
For trichiasis (inverted eyelashes), grind Wu Ming Yi (Illud/Opus Siliceum) into powder, place in paper, roll into a taper, ignite, and smoke the affected area. The smoke will熏 (fumigate) the eyes, causing the lashes to stand upright.