〔薛〕目者,肝之窍也,肝胆属风木,二经兼为相火,肝藏血,血不足则风火内
生,故目睛为之 动,经曰∶曲直动摇。风之象也。宜用四物益其血,柴胡、山栀、
清其肝,阴血内荣,则虚风自息矣。若因肝经血燥而自病者,用六味丸以滋其源。
因肺金克肝木者,用泻白散以平金邪。若眼眶 动者,肝木乘脾土也,用抱龙丸。
若愈后惊悸不寐,或寐中发搐切牙,目睛 动者,血虚不能荣筋脉也,用补中益气
汤或归脾汤加茯苓、五味。盖有余者,邪气实也,不足者,真气虚也,凡病气有余,
当认为不足,此证兼属肝脾,多为慢惊之渐。
〔薛〕唇为脾之华,口乃脾之窍。又阳明之脉,环唇口而交人中,阳明胃也,是
以脾胃虚者,多有此证,不独病后而已。夫脾主涎,脾虚则不能收摄,多兼流涎,
或误认为痰,而用祛逐之药,则津液益枯,不能滋养筋脉,遂致四肢抽搐,病势愈
甚,原其治法,与慢脾风相同,当用大补脾胃之药加升麻、柴胡,切勿用青皮、龙
胆草之类。兼察其色,黄者脾弱也,青者肝胜也,青黄不泽,木来克土也,青赤相
兼,木火风热也,黑为寒水反来侮土,白为气虚亡阳,凡此,宜用六君子汤加小柴
胡汤。若四肢微搐,或潮热往来,或泄泻呕吐,面色痿黄,皆脾胃有伤也,宜用白
木、黄 、川芎、当归、人参、陈皮、肉豆蔻、神曲、干葛、白芍药、黄连、炙甘
草、白茯苓以补胃气。若脾胃虚弱者用五味异功散,虚寒,加木香、炮姜。若脾气
下陷者用补中益气汤以升其阳。作渴者用七味白术散以生津液。若肝木侮脾者用补
中益气汤加茯苓、半夏、芍药,以制肝补脾。
〔薛己〕眼睛是肝的外窍,肝胆归属于风木,这两条经络兼有相火。肝主藏血,如果血液不足,就会在内产生风火,因此眼球会随之转动。经书说:“曲直动摇”,这是风的征象。适宜使用四物汤来补益血液,用柴胡、山栀来清泻肝火,阴血在体内得到滋养,虚风自然平息。如果是由于肝经血燥而自发的病症,使用六味丸来滋补肾水之源。如果是因肺金克制肝木导致的,使用泻白散来平抑肺金之邪气。如果是眼眶跳动,这是肝木乘袭脾土的表现,使用抱龙丸。如果在病愈后出现惊悸失眠,或者睡眠中发生抽搐咬牙、眼球转动,这是血虚不能荣养筋脉所致,使用补中益气汤或归脾汤加入茯苓、五味子。大凡有余的病症,是邪气实盛;不足的病症,是真气虚弱。凡是遇到气有余的病证,应当将其认定为不足,此证兼属肝脾两脏,多为慢惊风的先兆。
〔薛己〕嘴唇是脾的外华,口是脾的外窍。另外,阳明经脉环绕唇口并交于人中穴,阳明经属于胃,因此脾胃虚弱的人,多有此类症状,不仅仅是在病后才会出现。脾主司涎液,脾虚则不能收摄控制,多伴有流口水,有时被误认为是痰,而使用祛痰逐饮的药物,这样津液会更加枯竭,不能滋养筋脉,于是导致四肢抽搐,病情更加严重。推究其治疗方法,与慢脾风相同,应当使用大补脾胃的药物,加入升麻、柴胡,切勿使用青皮、龙胆草之类的药物。同时观察面色:面色黄是脾弱,面色青是肝胜,面色青黄无光泽,是木来克土,面色青赤相间,是木火风热,黑色是寒水反来侮土,白色是气虚亡阳。凡是这些情况,适宜使用六君子汤合小柴胡汤。如果出现四肢轻微抽搐,或者潮热往来,或者泄泻呕吐,面色萎黄,都是脾胃受损的表现,适宜使用白术、黄芪、川芎、当归、人参、陈皮、肉豆蔻、神曲、干葛、白芍药、黄连、炙甘草、白茯苓来补益胃气。如果脾胃虚弱,使用五味异功散;如果是虚寒证,加入木香、炮姜。如果是脾气下陷,使用补中益气汤来提升阳气。如果有口渴症状,使用七味白术散来生津液。如果是肝木侮脾,使用补中益气汤加入茯苓、半夏、芍药,以制约肝气、补益脾气。
[Xue] The eyes are the orifices of the Liver. The Liver and Gallbladder belong to Wind-Wood, and these two meridians also harbor Ministerial Fire (Xiang Huo). The Liver stores Blood; when Blood is insufficient, internal Wind and Fire arise spontaneously, causing the eyeballs to move. The Classics state: "Bending and straightening, shaking and moving," which are manifestations of Wind. It is appropriate to use Siwu Tang (Four Substance Decoction) to nourish the Blood, and Chaihu (Bupleuri Radix), Shanzhi (Gardeniae Fructus) to clear the Liver. When Yin-Blood is internally nourished, deficient Wind will naturally subside. If the condition arises from dryness of Blood in the Liver Meridian, Liuwei Wan (Six-Ingredient Pill with Rehmannia) should be used to nourish its source. If caused by Lung Metal overcoming Liver Wood, Xiebai San (White Powder to Drain the Lungs) should be used to pacify the pathogenic factor of Metal. If the eye sockets twitch, it indicates Liver Wood overacting on Spleen Earth; Baolong Wan (Embracing Dragon Pill) should be used. If after recovery there are palpitations and insomnia, or convulsions, teeth grinding, and eye movement during sleep, this is due to Blood deficiency failing to nourish the sinews and vessels; Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) or Guipi Tang (Restore the Spleen Decoction) added with Fuling (Poria) and Wuweizi (Schisandrae Fructus) should be used. Generally, excess refers to the fullness of pathogenic factors, while deficiency refers to the weakness of true Qi. In cases where Qi appears excessive, one must recognize it as deficiency. This syndrome involves both the Liver and Spleen and often serves as a precursor to Slow Convulsion (Man Jing).
[Xue] The lips are the flourishing aspect of the Spleen, and the mouth is the orifice of the Spleen. Furthermore, the Yangming Meridian encircles the lips and mouth and intersects at the Renzhong point; the Yangming belongs to the Stomach. Therefore, individuals with Spleen-Stomach deficiency often present with such symptoms, not only after illness. The Spleen governs saliva; when the Spleen is deficient, it fails to retain fluids, often accompanied by drooling. If mistakenly diagnosed as Phlegm and treated with phlegm-resolving drugs, body fluids will become further depleted, failing to nourish the sinews, leading to convulsions of the four limbs and worsening of the disease. Its treatment method is identical to that of Slow Spleen Wind (Man Pi Feng); one should use herbs that strongly tonify the Spleen and Stomach, adding Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix). One must strictly avoid using Qingpi (Aurantii Fructus Pericarpium) and Longdancao (Gentianae Radix). Simultaneously observe the complexion: yellow indicates weak Spleen; green indicates dominant Liver; dull green and yellow indicate Wood overcoming Earth; green mixed with red indicates Wood-Fire Wind-Heat; black indicates Cold Water counter-attacking and insulting Earth; white indicates Qi deficiency and collapse of Yang. For all these conditions, Liujunzi Tang (Six Gentlemen Decoction) combined with Xiaochaihu Tang (Minor Bupleurum Decoction) is appropriate. If there are slight convulsions of the four limbs, alternating tidal fever, diarrhea, vomiting, and a sallow complexion, these indicate damage to the Spleen and Stomach. It is appropriate to use Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqi (Astragali Radix), Chuanxiong (Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Renshen (Ginseng Radix), Chenpi (Citri Reticulatae Pericarpium), Roudoukou (Myristicae Semen), Shenqu (Massa Medicata Fermentata), Genge (Puerariae Lobatae Radix), Baishao (Paeoniae Radix Alba), Huanglian (Coptidis Rhizoma), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), and Baifuling (Poria cum Paribus) to tonify Stomach Qi. For Spleen-Stomach weakness, Wuyi Yigong San (Five Agents for Extraordinary Effort Powder) should be used; for deficiency-cold, add Muxiang (Aucklandiae Radix) and Paojiang (Prepared Zingiberis Rhizoma). For sinking of Spleen Qi, Buzhong Yiqi Tang should be used to raise Yang. For thirst, Qiwei Bashu San (Seven Ingredients for White Atractylodes Powder) should be used to generate body fluids. For Liver Wood insulting the Spleen, Buzhong Yiqi Tang added with Fuling (Poria), Banxia (Pinelliae Rhizoma), and Shaoyao (Paeoniae Radix) should be used to restrain the Liver and tonify the Spleen.