\r大 赤脉传睛图\p05-c20a3.bmp\r
赤脉传睛之症,起于大 者心之实也,此心邪之侵肝也。心属火主血,肝属木主筋;筋
得血灌引渐至黑睛,蔓延瞳仁,甚则看物如同隔绢,是三焦相火炎上。或劳心事太过,或夜
观书史,或能饮酒,及好食五辛,煎炒热物。法宜泻火退热,老少不同治。日积月累,筋脉
大者,宜用小锋针挑断,毒血流出,赤脉断矣。若是乍发赤脉,不用针挑发,点以阴二阳四
药,服以四顺八正当归散凉肝之剂,其病无不苏矣。又有暴横之人,赤脉灌睛者,此生相也
,非比前症治之。
问曰∶人之患目大 赤脉传睛,大 常壅涩,看物不准者何也?答曰∶乃心经之实热;
况心或因思虑劳神,或饮食太过,致使三焦发热,心火愈炽,故目常赤也。治之虽攻少阴经
,心胞阳火廓,先服三黄丸泻其心火,次以洗心散去其病,肝连丸常镇三黄丸,点用清源散
,服用清心利小肠经,降火为主,用八正散。
八正散
大黄 瞿麦 木通 栀子 滑石 甘草 蓄 车前子
上各等分为末,每服五钱,水一钟煎,或入竹叶灯心葱头,食后服。
导赤散
木通 甘草 栀子 黄柏 生地黄 知母
上每服细末四五钱,水一钟,入竹叶灯心草同煎,食后服。
七宝洗心散
当归 赤芍 大黄(各一两) 麻黄(二两) 荆芥(五分) 黄连(一两) 栀子
上为末,每服三四钱,水煎食后服。
三黄丸
黄连 黄芩(各一两) 大黄(三两,酒浸过炒)
上为末,炼蜜为丸,如桐子大,每服三十丸,热水下。
肝连丸
白羊子肝一付,勿令下水,以线结定总筋,吊起高处,滤干血水,轻轻刮去外膜,
可将肝置于平木板上,以竹刀割下肝粉,筋膜不用,肝粉和为丸。每服五十丸,茶送下。
赤脉传睛这一病症,起源于目内眦(大眦),其病机在于心气实盛,这是心之邪气侵犯肝脏所致。心属火而主司血液,肝属木而主司筋脉;筋脉得到血液的灌注牵引,逐渐蔓延至黑睛,进而扩散到瞳仁,严重时看东西如同隔着绢布一样模糊不清,这是由于三焦相火上炎所致。或者因为用脑过度、思虑太多,或者夜间读书看史书,或者能饮酒,以及喜好食用五辛(葱、蒜、韭、薤、兴渠)、煎炸炒制的热性食物。治疗法则应当泻火退热,但老人与年轻人的治疗方法有所不同。如果病程日久,导致目内眦处的筋脉粗大,适宜用小锋针挑断,使毒血流出,赤脉即可阻断。如果是初次发作出现的赤脉,则不用针挑破,而是点用“阴二阳四”药,服用具有凉肝作用的“四顺八正当归散”,这样疾病没有不能痊愈的。又有那些性情暴躁横逆之人,出现赤脉灌注眼睛的情况,这是生相(凶兆/体质特征),不同于前一种病症的治疗方法。
问:人患眼睛大眦部赤脉传睛,且大眦常感壅滞涩痛,视物不准的原因是什么?答:这是因为心经有实热;况且心可能因为思虑劳神,或者饮食过量,致使三焦发热,心火更加炽盛,所以眼睛经常发红。治疗时虽然要攻治少阴经,清理心包络的阳火,先服用三黄丸以泻除心火,接着使用洗心散去除此病,再用肝连丸常服以制约三黄丸的药性,外用清源散滴眼,内服清心利小肠经的药物以降火为主,使用八正散。
八正散
大黄、瞿麦、木通、栀子、滑石、甘草、萹蓄、车前子
以上药材各等分研为末,每次服用五钱,用水一钟煎煮,也可以加入竹叶、灯心草、葱头,饭后服用。
导赤散
木通、甘草、栀子、黄柏、生地黄、知母
以上药材每次取细末四五钱,用水一钟,加入竹叶、灯心草同煎,饭后服用。
七宝洗心散
当归、赤芍、大黄(各一两)、麻黄(二两)、荆芥(五分)、黄连(一两)、栀子
以上药材研为末,每次服用三四钱,水煎后饭后服用。
三黄丸
黄连、黄芩(各一两)、大黄(三两,酒浸过后炒制)
以上药材研为末,用炼蜜制成丸剂,如梧桐子大小,每次服用三十丸,用热水送下。
肝连丸
白羊子肝一副,不要让下水,用线结扎固定总筋,悬挂在高处,沥干血水,轻轻刮去外膜,可将肝脏置于平整的木板上,用竹刀割下肝粉,筋膜不用,将肝粉和药末混合制成丸剂。每次服用五十丸,用茶送下。
Diagram of the Great Red Veins Transmitting to the Canthus
The syndrome of "Great Red Veins Transmitting to the Canthus" originates at the inner canthus (Da Zi). Its pathogenesis lies in excess Qi of the Heart; this is an invasion of the Liver by Heart pathogenic factors. The Heart belongs to Fire and governs Blood, while the Liver belongs to Wood and governs Sinews. When sinews receive irrigation and traction from Blood, they gradually extend to the cornea (Hei Jing) and spread to the pupil (Tong Ren). In severe cases, vision becomes blurred as if looking through silk gauze, which is caused by the flaming upward of the Ministerial Fire of the San Jiao (Triple Burner). This may result from excessive mental labor or overthinking, reading history books late at night, alcohol consumption, or a preference for consuming the "Five Pungent Spices" (scallion, garlic, leek, wild onion, chives) and fried, roasted, or heat-inducing foods. The treatment principle should be to purge fire and reduce heat, though methods differ between the young and the old. If the condition persists over time, causing the vessels at the inner canthus to become enlarged, it is appropriate to use a small sharp needle to puncture and sever them, allowing toxic blood to flow out, thereby interrupting the red veins. If the red veins appear suddenly upon initial onset, needle puncture is not required. Instead, apply "Yin Er Yang Si" medicine and ingest "Si Shun Ba Zheng Dang Gui San" (Four Smooth Eight Just Angelica Decoction), which has the effect of cooling the Liver. Such illnesses will invariably recover. There are also individuals with violent or unyielding temperaments who present with red veins infusing the eyes; this represents a constitutional sign (ominous physique) and differs from the treatment of the aforementioned syndrome.
Question: Why do patients suffering from red veins transmitting to the inner canthus often experience congestion and astringency at the canthus, along with inaccurate vision?
Answer: This is due to excess heat in the Heart Meridian. Furthermore, the Heart may suffer from mental fatigue due to overthinking or damage from excessive diet, causing heat in the San Jiao and intensifying Heart Fire, thus resulting in frequently red eyes. Although treatment involves attacking the Shaoyin Meridian and clearing Yang Fire from the Pericardium, one should first administer San Huang Wan (Three Yellow Pill) to purge Heart Fire. Subsequently, use Xi Xin San (Wash Heart Powder) to eliminate the pathology. Chang Zhen (regularly stabilize) the effects of San Huang Wan with Gan Lian Wan (Liver-Link Pill). Apply Qing Yuan San (Clear Source Powder) topically. Internally, ingest formulas that clear the Heart and promote urination via the Small Intestine Meridian, focusing on descending fire, such as Ba Zheng San (Eight Rectifications Decoction).
Ba Zheng San (Eight Rectifications Decoction)
Rhubarb Root (Dahuang), Knotweed Herb (Qumai), Akebia Stem (Mutong), Gardenia Fruit (Zhizi), Talcum (Huashi), Licorice Root (Gancao), Persicaria Herba (Bianxu), Plantago Seed (Cheqianzi)
Grind all ingredients into equal parts powder. Take 5 qian per dose, decoct with one zhong of water. Alternatively, add Bamboo Leaves (Zhuye), Juncus Effusus (Dengxincao), and Scallion White (Congtou). Take after meals.
Dao Chi San (Guide Out Redness Decoction)
Akebia Stem (Mutong), Licorice Root (Gancao), Gardenia Fruit (Zhizi), Phellodendron Bark (Huangbai), Rehmannia Root (Shengdihuang), Anemarrhena Rhizome (Zhimu)
Take 4-5 qian of fine powder per dose, decoct with one zhong of water, adding Bamboo Leaves (Zhuye) and Juncus Effusus (Dengxincaogen). Take after meals.
Qi Bao Xi Xin San (Seven Treasures Wash Heart Powder)
Angelica Sinensis Root (Danggui), Red Peony Root (Chishao), Rhubarb Root (Dahuang, 1 liang each), Ephedra Stem (Mahuang, 2 liang), Schizonepeta Spike (Jingjie, 5 fen), Coptis Rhizome (Huanglian, 1 liang), Gardenia Fruit (Zhizi)
Grind into powder. Take 3-4 qian per dose, decoct with water. Take after meals.
San Huang Wan (Three Yellow Pill)
Coptis Rhizome (Huanglian), Scutellaria Root (Huangqin, 1 liang each), Rhubarb Root (Dahuang, 3 liang, soaked in wine then stir-fried)
Grind into powder, mix with refined honey to form pills the size of paulownia seeds. Take 30 pills per dose with warm water.
Gan Lian Wan (Liver-Link Pill)
One lamb liver (Baiyangzi Gan). Do not wash with water. Tie the main tendon securely with thread, hang it high up, and filter off the blood water. Gently scrape off the outer membrane. Place the liver on a flat wooden board and cut the liver flesh into powder using a bamboo knife. Discard the fascia. Mix the liver powder with other ingredients to form pills. Take 50 pills per dose with tea.