(目黄 出火 见鬼 昏花 目珠红)
眼为肝窍。又阳明脉络所绕。故其为病。皆肝胃两经之咎。
眼珠黄者。在胃经属湿热。甚则通身皆黄。小便必然不利。宜五苓散。加茵陈栀子秦皮黄柏知母治之。在
肝经是瘀热。仲景云。衄家目黄者。衄未止。是血中有热故也。凡是血热者。其目多黄。四物汤。加柴胡黄芩
丹皮苏木茵陈红花治之。目珠红亦是瘀血。治与上同。
目中出火者。一是胃火亢甚。必兼口渴身热等证。犀角地黄汤。加石膏天花粉金银花枳壳治之。一是肝
火外越。必兼口苦耳鸣等证。当归芦荟丸治之。目中见鬼者。一是胃有燥屎。目神昏花。三一承气汤治之。
一是肝经血室。蓄有瘀热。夜则谵语。大柴胡汤。加桃仁牡丹皮治之。
目运者。肝之风火也。观羊角风可悟。宜小柴胡汤。加当归白芍防风菊花治之。眼花者。肾之阴虚。瞳神属
肾。客热犯之。时见黑花。或成五色。宜地黄汤。加枸杞朱砂磁石肉苁蓉石决明元参知母细辛治之。
又有阳虚。血大吐后。目光散大。不能见者。必小便多也。宜肾气丸。
以上所举。皆血家间有之病。其余目疾。非血家兼有者。不赘。
陈修园曰。肾开窍于耳。而肾脉却不上头。肾与心交。假道于心腑小肠之脉。以入耳中。名曰听宫。为司听
之神所居。其形如珠。皮膜包裹真水。若真水破。而耳立聋。有为大声所震而聋者。皮膜破也。或聋或不聋
者。心肾不交也。宜磁朱丸。以交心肾。有先耳鸣而后聋者。肾虚不能闭藏阴气。窒塞于阳窍也。宜六味丸
去丹皮。加磁石五味龟板。令阴气自盛于本宫。不触于阳窍而愈。若外感暴聋。总不外少阳一经。足少阳
胆脉绕耳叶。手少阳三焦脉入于耳。邪气壅塞。听宫为其所掩。宜逍遥散。去白术。加黄芩半夏生姜竹黄
羚羊角玉竹治之。风火交煽。宜防风通圣散。肝火炽甚。宜当归芦荟丸。尺脉弱者。宜桂附地黄丸。尺脉数
者。宜大补阴丸。俱加磁石菖蒲肉苁蓉。神而明之。存乎其人。非笔楮所能尽。
按上陈修园说最明。但又有久病之人。以及产妇。中宫大虚。不能堵塞肝肾之气。以致虚火上冲。而发耳
鸣者。虽系胆与肾中之火。却要填补脾胃。以堵塞之。归脾汤。加柴胡山栀子鱼鳔莲子五味治之。四君子
汤。加莲米芡实薏苡仁黄精白芍淮山药。亦治之。
眼睛是肝的窍道。同时,阳明经的脉络环绕着眼部。因此,眼部疾病的发生,都是肝经和胃经的问题。
眼球发黄,在胃经属于湿热证,严重时全身都会发黄,小便必然不通畅。适宜用五苓散,加入茵陈、栀子、秦皮、黄柏、知母来治疗。在肝经则属于瘀热证,《伤寒论》作者张仲景说:经常流鼻血的人如果眼球发黄,是因为鼻衄未止,这是血液中有热的缘故。凡是血热的情况,眼睛大多发黄。适宜用四物汤,加入柴胡、黄芩、丹皮、苏木、茵陈、红花来治疗。眼球发红也是瘀血所致,治疗方法与上述相同。
眼中仿佛有火冒出,一是因为胃火亢盛,必定兼有口渴、身体发热等症状。适宜用犀角地黄汤,加入石膏、天花粉、金银花、枳壳来治疗。二是肝火外越,必定兼有口苦、耳鸣等症状。适宜用当归芦荟丸治疗。
眼中看见鬼怪,一是因为胃中有燥屎积滞,导致眼神昏花。适宜用三一承气汤治疗。二是肝经血室蓄积了瘀热,夜间出现胡言乱语。适宜用大柴胡汤,加入桃仁、牡丹皮来治疗。
眼睛眩晕,是肝的风火所致。观察羊角风(癫痫)可以领悟此理。适宜用小柴胡汤,加入当归、白芍、防风、菊花来治疗。眼花,是肾的阴虚所致。瞳神归属于肾,客热侵犯它,时常看见黑花,或者呈现五色。适宜用地黄汤,加入枸杞、朱砂、磁石、肉苁蓉、石决明、玄参、知母、细辛来治疗。
又有阳气虚弱者,在大出血之后,目光散大,不能视物,必定伴有小便频多。适宜用肾气丸治疗。
以上列举的,都是失血患者间或出现的病症。其余的眼疾,如果不是失血患者兼有的,就不再赘述。
陈修园说:肾开窍于耳,但肾的经脉并不直接上达头部。肾与心相交,借道于心腑和小肠的经脉,进入耳中,这个部位名为听宫,是掌管听觉的神灵所居住的地方。其形状像珠子,由皮膜包裹着真水(肾精)。如果真水破裂,耳朵立刻就会聋。有的因大声震动而耳聋,是因为皮膜破裂。有的聋、有的不聋,是因为心肾不交。适宜用磁朱丸,以交通心肾。有的先耳鸣而后耳聋,是肾虚不能闭藏阴气,阴气窒塞于阳窍(耳)所致。适宜用六味地黄丸去掉丹皮,加入磁石、五味子、龟板,使阴气在本宫自然旺盛,不触犯阳窍而痊愈。如果是外感引起的突发耳聋,总离不开少阳一经。足少阳胆脉环绕耳廓,手少阳三焦脉进入耳中,邪气壅塞,听宫被邪气掩盖。适宜用逍遥散,去掉白术,加入黄芩、半夏、生姜、竹黄、羚羊角、玉竹来治疗。如果是风火交织煽动,适宜用防风通圣散。肝火炽盛,适宜用当归芦荟丸。尺脉虚弱者,适宜用桂附地黄丸。尺脉数者,适宜用大补阴丸。这些方剂都要加入磁石、石菖蒲、肉苁蓉。其中的奥妙,在于人的灵活运用,不是笔墨所能完全尽述的。
按:以上陈修园的说法最为明白。但是又有久病之人,以及产妇,中焦脾胃极度虚弱,不能堵塞肝肾之气,导致虚火上冲,从而引发耳鸣。虽然涉及胆和肾中的火,却需要填补脾胃,以堵塞虚火的上冲。适宜用归脾汤,加入柴胡、山栀子、鱼鳔、莲子、五味子来治疗。或者用四君子汤,加入莲米、芡实、薏苡仁、黄精、白芍、淮山药,也能治疗。
(Eye Jaundice, Fire from Eyes, Hallucinations of Ghosts, Blurred Vision, Redness of the Eye Globe)
The eyes are the orifice of the Liver (Gan). Furthermore, the meridians of the Yangming channel wind around them. Therefore, diseases of the eyes are attributable to both the Liver and Stomach channels.
Jaundice of the eye globe, in the Stomach channel, belongs to Damp-Heat (Shi Re). In severe cases, the whole body becomes yellow, and urination is inevitably obstructed. It is suitable to use Wu Ling San (Five-Ingredient Powder with Poria) added with Yin Chen Hao (Artemisiae Scopariae Herba), Zhi Zi (Gardeniae Fructus), Qin Pi (Fraxini Cortex), Huang Bo (Phellodendri Cortex), and Zhi Mu (Anemarrhenae Rhizoma) for treatment. In the Liver channel, it is due to Blood-Stasis and Heat (Yu Re). Zhang Zhongjing stated: "In persons prone to epistaxis who develop jaundice of the eyes, if the bleeding has not stopped, it is because there is heat in the blood." Generally, in cases of Blood-Heat (Xue Re), the eyes tend to be yellow. It is suitable to use Si Wu Tang (Four-Substance Decoction) added with Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Dan Pi (Moutan Cortex), Su Mu (Sappan Lignum), Yin Chen Hao, and Hong Hua (Carthami Flos) for treatment. Redness of the eye globe is also caused by Blood-Stasis; the treatment is the same as above.
The sensation of fire emerging from the eyes: One cause is excessive Stomach-Fire (Wei Huo), which must be accompanied by symptoms such as thirst and fever. It is suitable to use Xi Jiao Di Huang Tang (Rhino Horn and Rehmannia Decoction) added with Shi Gao (Gypsum Fibrosum), Tian Hua Fen (Trichosanthis Radix), Jin Yin Hua (Lonicerae Japonicae Flos), and Zhi Qiao (Aurantii Fructus) for treatment. The other cause is Liver-Fire (Gan Huo) escaping outward, which must be accompanied by bitter taste in the mouth and tinnitus. It is suitable to use Dang Gui Lu Hui Wan (Angelica and Aloe Pill) for treatment.
Seeing ghosts in the eyes: One cause is dry stool retained in the Stomach, leading to blurred vision and confusion of the spirit. It is suitable to use San Yi Cheng Qi Tang (Three-One Purging Decoction) for treatment. The other cause is accumulation of Blood-Stasis and Heat in the Blood Chamber of the Liver channel, accompanied by delirium at night. It is suitable to use Da Chai Hu Tang (Major Bupleurum Decoction) added with Tao Ren (Persicae Semen) and Mu Dan Pi (Moutan Cortex) for treatment.
Vertigo of the eyes is due to Wind-Fire of the Liver. This can be understood by observing Epilepsy (Yang Jiao Feng). It is suitable to use Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Fang Feng (Saposhnikoviae Radix), and Ju Hua (Chrysanthemi Flos) for treatment. Blurred vision is due to Kidney-Yin Deficiency (Shen Yin Xu). The pupil belongs to the Kidney. When pathogenic heat invades it, one may intermittently see black spots or colors of five hues. It is suitable to use Di Huang Tang (Rehmannia Decoction) added with Gou Qi Zi (Lycii Fructus), Zhu Sha (Cinnabar), Ci Shi (Magnetitum), Rou Cong Rong (Cistanches Herba), Shi Jue Ming (Haliotidis Concha), Yuan Shen (Scrophulariae Radix), Zhi Mu, and Xi Xin (Asari Radix et Rhizoma) for treatment.
There are also cases of Yang Deficiency (Yang Xu), where after massive hemorrhage, the gaze becomes scattered and vision is lost, accompanied by polyuria. It is suitable to use Shen Qi Wan (Kidney Qi Pill) for treatment.
The above mentioned conditions are those occasionally seen in patients with blood disorders. Other eye diseases that are not concurrent with blood disorders will not be elaborated upon.
Chen Xiuyuan said: The Kidney opens into the ears, yet the Kidney meridian does not ascend directly to the head. The Kidney communicates with the Heart, borrowing the pathway through the meridians of the Heart Fu and Small Intestine to enter the ear. This area is named Ting Gong (Auditory Palace), the residence of the deity governing hearing. Its shape is like a pearl, wrapped in skin and membrane containing True Water (Kidney Essence). If the True Water ruptures, deafness occurs immediately. Deafness caused by loud noises results from rupture of the skin and membrane. Cases where some are deaf and others are not are due to non-interaction between the Heart and Kidney. It is suitable to use Ci Zhu Wan (Magnetite and Cinnabar Pill) to facilitate the interaction between the Heart and Kidney. Cases starting with tinnitus and progressing to deafness are due to Kidney Deficiency failing to secure Yin Qi, causing obstruction in the Yang orifice (ear). It is suitable to use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) with Dan Pi removed, adding Ci Shi, Wu Wei Zi (Schisandrae Fructus), and Gui Ban (Testudinis Carapax et Plastrum), so that Yin Qi naturally flourishes in its origin and does not disturb the Yang orifice, leading to recovery. Sudden deafness due to external contraction generally involves only the Shaoyang channel. The Foot-Shaoyang Gallbladder meridian winds around the ear, and the Hand-Shaoyang Sanjiao meridian enters the ear. Pathogenic qi causes congestion, covering the Ting Gong. It is suitable to use Xiao Yao San (Free and Easy Wanderer Powder) with Bai Zhu (Atractylodis Macrocephalae Rhizoma) removed, adding Huang Qin, Ban Xia (Pinelliae Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens), Zhu Huang (Bambusae Caulis in Taenia), Ling Yang Jiao (Capricornis Cornu), and Yu Zhu (Polygonati Odorati Rhizoma) for treatment. If Wind and Fire interact and flare up, it is suitable to use Fang Feng Tong Sheng San (Saposhnikovia and Gardenia Powder for Unblocking the Interior). If Liver-Fire is blazing, it is suitable to use Dang Gui Lu Hui Wan. If the Chi pulse is weak, it is suitable to use Gui Fu Di Huang Wan (Cinnamon and Aconite Rehmannia Pill). If the Chi pulse is rapid, it is suitable to use Da Bu Yin Wan (Great Yin-Nourishing Pill). All these formulas should be added with Ci Shi, Shi Chang Pu (Acori Tatarinowii Rhizoma), and Rou Cong Rong. The subtlety lies in the practitioner's discretion, which cannot be fully expressed in writing.
Note: The explanation by Chen Xiuyuan above is the clearest. However, there are also cases in chronically ill patients and postpartum women, where the Middle Jiao (Spleen/Stomach) is severely deficient, unable to block the Qi of the Liver and Kidney, leading to defluxion of Deficient-Fire upward, causing tinnitus. Although this involves Fire in the Gallbladder and Kidney, it is necessary to tonify the Spleen and Stomach to block this defluxion. It is suitable to use Gui Pi Tang (Restore the Spleen Decoction) added with Chai Hu, Shan Zhi Zi (Gardeniae Fructus), Yu Biao (Hydrophis Mollis), Lian Zi (Nelumbinis Semen), and Wu Wei Zi for treatment. Alternatively, Si Jun Zi Tang (Four Gentlemen Decoction) added with Lian Mi (Nelumbinis Semen), Qian Shi (Euryales Semen), Yi Yi Ren (Coicis Semen), Huang Jing (Polygonati Rhizoma), Bai Shao, and Huai Shan Yao (Dioscoreae Hypoglaucae Rhizoma) can also be used for treatment.