心热眼红者,血热则可用黄连、当归尾、苏木、红花、赤芍药之类;虚者痒痛本方;若虚此数味除之,加人参、细
辛、没药、归尾、熟地、茯苓之类。
肺热火旺者,则可用山栀、桑白皮、地骨皮、黄芩、防风、天
麦二门冬之类;虚则可加人参、沉香、黄 、磁石、五味子之类;实者用葶苈子、连翘。
肝气盛火旺者,则可用柴胡、羌活、青葙子、白芍药、羚羊角;虚则除之,加熟地黄、当归、川芎、楮实子、枸杞
子之类;脾胃实者,则可用石膏、朴硝、黄芩、黄柏;虚则除之,可加白术、苍术、枳壳、陈皮、半夏、人参之类。
肾热相火旺者,则可用黄柏、知母、车前子、木通、滑石、瞿麦、 蓄、大黄、朴硝之类;虚则大忌之,可加肉苁
蓉、五味子、磁石、菟丝子、乳香、川椒、青盐、枸杞子之类。
夫审瞳仁之法,瞳仁开大者,忌辛辣之药;瞳仁焦小者,宜寒凉辛辣则可也。开大者,以酸药收之;焦小者,以辛
药散之。久注不开者,宜发之,久积宜行气血为主。
养肝血还睛丸亦可用之。未成症主方秘要,服表里不退,疼痛愈甚,用细辛汤。
明目细辛汤 治眼赤痛、眉攒肿闷、鼻塞涕 稠粘、大便秘结、羞明怕日、隐涩难开、睫成 多眵粘。
助阳和血汤 治阴阳不升降,作痛不时,隐涩有泪,眵蠹红泪糊;或时发赤眼,凉药不退者用。
当苦汤 眼暴发热,火旺苦痛不住,服利药未效,有热火退可用。
当归龙胆汤 治眼中黄仁生黄白翳,从下而上。此候多是火旺也,人若患此,此药能泻火退热,又且能退翳消
红肿。
桑螵蛸酒调散 治风热里病双解散,实热里病。此药治伤风头疼及眼珠肿痛,或偏正,此是伤风寒,眼肿虽
甚,其眼皮带浮而软,人多鼻塞声重,眼羞明怕日,白仁虽虚壅而不蠹红。如此状者,用前二散表里之,肿消痛止,用
生地黄散、拨云汤。变用又变,前方不可久服。
郁金酒 里热无表症,治一切实热,其眼肿起如桃,有不近人手之怕,羞明怕日,或内壅突起,蠹红泪出如汤,
鼻涕溏流内生淡赤虚翳。如此状者,其翳不能为害,热去退翳即消。此药通解之,痛止后用救苦汤,当归龙胆收功。
酒调洗肝散 经验洗肝散 治一切热眼,及赤肿难开,眼珠痛,白仁赤而痛,不虚可用止痛。生地黄散后用,
功亦同。
当归活血汤 治一切羞明怕日者,头痛虽甚,内不蠹红,此样眼多虚,或眼上珠生白陷翳者。此方可与蝉花散、
密蒙花散相间服之效。
密蒙花散 治一应体虚之人,无疼有羞明者,服凉药不得,其眼羞明而内痛,白仁内隐红,常流清涕泪,视物
蒙蒙,此药可用。日进二三服。决明子散、蝉花散此三方功亦同效。
省风汤 治一切肝气有余,瞳仁锁紧,或成干缺,视物不能明,撩乱白仁淡红,瞳仁焦小黄色,夜见五色烽光
者。此方能除肝胆极热。
久仙饮 治年老之人,眼赤不退,带紫红白色。若有蠹红者,以暴发客热类推之。
洗肝散 治眼肝气有余,风轮变色,焦枯或疼痛,外生赤翳。此方能除火退肝热。
紫金丸 治外障生云膜血翳,服凉药不退,而不多痛者可用。
夜光柳红丸 治风毒上攻眼,虚肿,颇有紫红或痒或痛,生翳年久,服诸药不效可用。
修肝散 治暴发眼,及发不时,疼痛甚者,热服肝气上升,泪出汪汪,内有鲜红可用。至如痛止血散不用。
补肝重明丸 治诸眼服凉药表里愈后失神光者,其眼无羞明,用之能补养肝血。还睛丸亦可用之。
当归龙胆汤 治眼中黄仁生白翳,从下而上。此候多是火旺也,人有此患,此药泻热退火,用能退翳消红肿。
心经有热导致眼睛发红,属于血热证,可以使用黄连、当归尾、苏木、红花、赤芍药等药物;若属虚证且伴有痒痛,使用上述基础方剂;若为虚证,则去除上述几味清热活血药,加入人参、细辛、没药、当归尾、熟地黄、茯苓等药物。
肺经火热旺盛,可以使用山栀(栀子)、桑白皮、地骨皮、黄芩、防风、天冬和麦冬等药物;若属虚证,可加入人参、沉香、黄柏、磁石、五味子等药物;若属实证,使用葶苈子、连翘。
肝气盛且火旺,可以使用柴胡、羌活、青葙子、白芍药、羚羊角;若属虚证,则去除上述药物,加入熟地黄、当归、川芎、楮实子、枸杞子等药物;脾胃实证,可以使用石膏、朴硝、黄芩、黄柏;若属虚证,则去除上述药物,可加入白术、苍术、枳壳、陈皮、半夏、人参等药物。
肾热且相火旺盛,可以使用黄柏、知母、车前子、木通、滑石、瞿麦、萹蓄、大黄、朴硝等药物;若属虚证,则大忌用上述寒凉攻下药,可加入肉苁蓉、五味子、磁石、菟丝子、乳香、川椒、青盐、枸杞子等药物。
审视瞳孔的方法:瞳孔散大的,忌用辛辣药物;瞳孔缩小且干枯的,适宜使用寒凉兼辛辣的药物。瞳孔散大的,用酸味药物收敛;瞳孔缩小的,用辛味药物发散。病程长久且瞳孔不能正常开合的,宜用发散法;病程长久且有积滞的,以调理气血为主。
养肝血还睛丸也可以使用。对于尚未形成固定症结的主方秘要,如果服用解表清里药物后症状不退,疼痛加剧,使用细辛汤。
明目细辛汤:治疗眼睛红肿疼痛、眉头肿胀闷痛、鼻塞流稠粘鼻涕、大便秘结、畏光怕日、眼内隐涩难睁、睫毛间分泌物多且粘稠。
助阳和血汤:治疗阴阳之气升降失常,疼痛发作无定时,眼内隐涩流泪,眼屎多、红泪模糊;或偶尔发作赤眼,使用寒凉药物无效者适用。
当苦汤:眼睛突然发热,火势旺盛痛苦不止,服用泻下利水药物未见效,待火热消退后可使用。
当归龙胆汤:治疗眼中虹膜(黄仁)生出黄白色翳障,从下方长至上方。这种病候多是火旺所致,人若患此病,此药能泻火退热,又能退翳消除红肿。
桑螵蛸酒调散:治疗风热在里的病症,以及双解散所治的实热在里的病症。此药治疗伤风引起的头痛及眼球肿痛,无论偏头痛还是正头痛,这是因伤风寒所致,眼睑肿胀虽然严重,但眼皮带浮肿柔软,人多伴有鼻塞声重,畏光怕日,白睛(巩膜)虽有虚性壅滞但不充血发红。出现此类症状,使用前两种散剂解表清里,待肿消痛止后,使用生地黄散、拨云汤。病情变化则用药随之变化,前方不可久服。
郁金酒:治疗里有热而无表证的病症,治疗一切实热证,其眼部肿胀如桃状,令人不敢靠近,畏光怕日,或内部壅塞突起,充血发红流泪如汤,鼻涕稀薄内生淡红色虚翳。出现此类症状,其翳障不会造成危害,热去后翳障自消。此药通解郁热,痛止后使用救苦汤,最后用当归龙胆汤收功。
酒调洗肝散(又名经验洗肝散):治疗一切热性眼病,以及红肿难睁、眼球疼痛、白睛发红疼痛,非虚证可用此止痛。在生地黄散之后使用,功效相同。
当归活血汤:治疗一切畏光怕日者,即使头痛严重,内部也不充血发红,这类眼病多属虚证,或者眼睑上长出白色凹陷翳障者。此方可与蝉花散、密蒙花散交替服用,效果显著。
密蒙花散:治疗所有体质虚弱之人,不疼痛但有畏光症状,服用寒凉药物无效,其眼畏光且内部疼痛,白睛内隐约发红,常流清涕样泪水,视物模糊,此药可用。每日进服二三次。决明子散、蝉花散这三个方剂功效相同。
省风汤:治疗一切肝气有余,瞳孔紧缩,或形成干缺,视物不清,撩乱白睛呈淡红色,瞳孔缩小干枯发黄,夜间看见五色火光的人。此方能清除肝胆极热。
久仙饮:治疗老年人眼睛发红不退,带有紫红或白色。若有充血发红者,参照暴发客热的情况类推治疗。
洗肝散:治疗眼肝气有余,黑睛(风轮)变色,干枯或疼痛,外部长出赤色翳障。此方能除火退肝热。
紫金丸:治疗外障疾病生成云膜、血翳,服用寒凉药物无效,且疼痛不剧烈者可用。
夜光柳红丸:治疗风毒上攻眼睛,虚肿,颇有紫红色,或痒或痛,生翳日久,服用其他药物无效者可用。
修肝散:治疗突发眼病,以及不时发作,疼痛严重者,热服可治肝气上升,泪出汪汪,内有鲜红者可用。至于疼痛停止后止血散则不使用。
补肝重明丸:治疗各种眼病服用寒凉药物解表清里后,失去神光者,其眼无畏光症状,使用此药能补养肝血。还睛丸也可使用。
当归龙胆汤:治疗眼中虹膜生出白色翳障,从下方长至上方。这种病候多是火旺所致,人有此患,此药泻热退火,使用能退翳消除红肿。
When the Heart channel has heat causing red eyes, indicating Blood Heat, one may use herbs such as Huanglian (Coptidis Rhizoma), Dangguiwei (Angelicae Sinensis Radix caudex), Sumu (Sappan Lignum), Honghua (Carthami Flos), and Chishao (Paeoniae Radix Rubra); if it is a Deficiency pattern with itching and pain, use the aforementioned base formula; if it is a Deficiency pattern, remove the aforementioned heat-clearing and blood-invigorating herbs, and add Renshen (Ginseng Radix et Rhizoma), Xixin (Asari Radix et Rhizoma), Moyao (Myrrha Resina), Dangguiwei (Angelicae Sinensis Radix caudex), Shudi (Rehmanniae Radix Preparata), and Fuling (Poria).
When the Lung channel has excessive fire, one may use Zhizi (Gardeniae Fructus), Sangbaipi (Mori Cortex), Digupi (Lycii Cortex), Huangqin (Scutellariae Radix), Fangfeng (Saposhnikoviae Radix), and Tiandong & Maidong (Asparagi Radix & Ophiopogonis Radix); if it is a Deficiency pattern, one may add Renshen (Ginseng Radix et Rhizoma), Chenxiang (Aquilaria Lignum), Huangbai (Phellodendri Cortex), Cishi (Magnetitum), and Wuweizi (Schisandrae Fructus); if it is an Excess pattern, use Tinglizi (Descurainiae Semen) and Lianqiao (Forsythiae Fructus).
When Liver Qi is abundant and Fire is blazing, one may use Chaihu (Bupleuri Radix), Qianghuo (Notopterygii Rhizoma et Radix), Qingxiangzi (Celosiae Semen), Baishao (Paeoniae Radix Alba), and Lingyangjiao (Saigae Tataricae Cornu); if it is a Deficiency pattern, remove the aforementioned herbs, and add Shudi (Rehmanniae Radix Preparata), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chushizi (Celastrus Semen), and Gouqi (Lycii Fructus); for Spleen and Stomach Excess patterns, one may use Shigao (Gypsum Fibrosum), Poxiao (Natrii Sulfas), Huangqin (Scutellariae Radix), and Huangbai (Phellodendri Cortex); if it is a Deficiency pattern, remove the aforementioned herbs, and may add Baizhu (Atractylodis Macrocephalae Rhizoma), Cangzhu (Atractylodis Rhizoma), Zhiqiao (Aurantii Fructus Immaturus), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma Preparatum), and Renshen (Ginseng Radix et Rhizoma).
When Kidney Heat and Ministerial Fire are abundant, one may use Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Cheqianzi (Plantaginis Semen), Mutong (Akebiae Caulis), Huashi (Talcum), Qumai (Dianthi Herba), Pianxu (Polygoni Avicularis Herba), Dahuang (Rhei Radix et Rhizoma), and Poxiao (Natrii Sulfas); if it is a Deficiency pattern, these cold-purging herbs are strictly contraindicated; instead, one may add Rongcongrou (Cynomorchii Herba), Wuweizi (Schisandrae Fructus), Cishi (Magnetitum), Tusizi (Cuscutae Semen), Rushi (Olibanum), Chuanjiao (Zanthoxyli Pericarpium), Qingyan (Sal Nigrum), and Gouqi (Lycii Fructus).
Regarding the method of examining the pupil: if the pupil is dilated, spicy herbs are contraindicated; if the pupil is constricted and dry, cool herbs combined with spicy herbs are appropriate. For dilation, use sour herbs to astringe; for constriction, use pungent herbs to disperse. If the condition persists for a long time with inability to open/close normally, dispersing methods should be used; if there is long-standing accumulation, regulating Qi and Blood is primary.
Yangganxue Huanjing Wan (Liver-Nourishing Blood Restoring Vision Pill) may also be used. For the secret main formula for conditions not yet formed into fixed masses, if symptoms do not resolve after taking exterior-resolving and interior-clearing drugs and pain increases, use Xixin Tang (Asari Decoction).
Mingmu Xixin Tang (Brightening Eyes Asari Decoction): Treats red and painful eyes, swelling and oppression at the brow, nasal congestion with thick sticky discharge, constipation, photophobia, gritty sensation difficult to open, and excessive sticky secretion around eyelashes.
Zhuyang Hexue Tang (Yang-Assisting and Blood-Harmonizing Decoction): Treats dysfunction of ascending and descending of Yin and Yang, irregular pain, gritty sensation with tears, excessive discharge, red tears blurring vision; or intermittent red eye episodes unresponsive to cooling medicines.
Dangku Tang (Bitter-Shoulder Decoction): Treats sudden onset of eye heat, unbearable burning due to excessive fire, when purgative/diuretic medicines have failed; usable after the fire-heat subsides.
Danggui Longdan Tang (Angelica Gentian Root Decoction): Treats yellow-white nebula forming on the Iris (Huangren) growing from bottom to top. This condition is mostly due to excessive Fire; this medicine can purge Fire, reduce heat, clear nebula, and eliminate redness and swelling.
Sangpiaoxiao Jiutiao San (Mantis Egg-case Wine-Adjusted Powder): Treats interior Wind-Heat and interior Excess Heat (also indicated by Shuangjie San). This powder treats headache caused by wind-cold and swollen/painful eyeballs, whether lateral or frontal. It addresses injury by wind-cold where eyelids are severely swollen but soft and puffy, often accompanied by nasal congestion and heavy voice, photophobia, while the sclera shows deficiency-type stagnation without hyperemia. For such presentations, use the aforementioned two powders to resolve exterior and interior; once swelling subsides and pain stops, use Shengdihuang San (Rehmannia Powder) and Boyun Tang (Cloud-Pushing Decoction). If the condition changes, adjust the prescription accordingly; the former formulas should not be taken for long.
Yujin Jiu (Curcuma Wine): Treats interior Heat without exterior syndrome, addressing all Excess Heat patterns. Symptoms include eyes swelling like peaches, aversion to touch, photophobia, internal obstruction/protrusion, hyperemia with tearing like broth, thin runny nose, and pale red deficiency nebula inside. In such cases, the nebula poses no harm; once heat clears, the nebula dissipates. This medicine resolves stagnation; after pain stops, use Jiuku Tang (Save Suffering Decoction), concluding with Danggui Longdan Tang.
Jiutiao Xi Gan San / Jingyan Xi Gan San (Wine-Adjusted Liver-Washing Powder / Experienced Liver-Washing Powder): Treats all heat-type eye diseases, severe redness and swelling making opening difficult, eyeball pain, red and painful sclera. Suitable for non-deficiency patterns to stop pain. Used after Shengdihuang San, with similar efficacy.
Danggui Huoxue Tang (Angelica Invigorating Blood Decoction): Treats all cases of photophobia. Even if headache is severe, there is no internal hyperemia; such eye conditions are mostly deficiency, or involve white depressed nebula on the upper eyelid. This formula can be alternately administered with Chan Hua San (Cicada Flower Powder) and Mimenghua San (Mimosa Powder) for effective results.
Mimenghua San (Mimosa Powder): Treats all constitutionally deficient individuals who have photophobia without pain, unresponsive to cooling medicines. Symptoms include photophobia with internal pain, faint redness within the sclera, frequent clear watery tears, and blurred vision. This medicine is applicable. Take 2-3 doses daily. Jimingzi San (Cassia Seed Powder) and Chan Hua San (Cicada Flower Powder) share similar efficacy.
Shengfeng Tang (Wind-Prohibiting Decoction): Treats all cases of Liver Qi excess, locked/constricted pupils, or dry defects, unclear vision, disturbed pale red sclera, constricted dry yellow pupils, and seeing colored halos at night. This formula eliminates extreme Heat in the Liver and Gallbladder.
Juxian Yin (Longevity Immortal Drink): Treats elderly patients with persistent eye redness, presenting with purple-red or white tones. If hyperemia is present, infer treatment based on acute external heat patterns.
Xi Gan San (Liver-Washing Powder): Treats Liver Qi excess, discoloration of the Cornea (Fenglun), dryness/withering or pain, and external growth of red nebula. This formula clears Fire and reduces Liver Heat.
Zijin Wan (Purple Gold Pill): Treats exogenous obstructions forming cloud membranes or blood nebula, unresponsive to cooling medicines, and with mild pain.
Yeguang Liuhong Wan (Night-Light Willow-Red Pill): Treats Wind-Toxin attacking the eyes, causing puffiness, purple-red hue, itching or pain, long-standing nebula unresponsive to other medicines.
Xiu Gan San (Repair Liver Powder): Treats sudden onset eye disease or intermittent attacks with severe pain. Taken hot to treat rising Liver Qi, profuse tearing, and internal fresh redness. Do not use Zhi Xue San (Stop Bleeding Powder) once pain stops.
Bugan Chongming Wan (Tonify Liver Double-Brightness Pill): Treats various eye conditions where Shen Guang (Spirit Light) is lost after using cooling medicines to resolve exterior and interior. The eyes show no photophobia; this medicine tonifies Liver Blood. Huanjing Wan may also be used.
Danggui Longdan Tang (Angelica Gentian Root Decoction): Treats white nebula forming on the Iris (Huangren) growing from bottom to top. This condition is mostly due to excessive Fire; this medicine purges Heat and reduces Fire, effectively clearing nebula and eliminating redness and swelling.