夫眼疾之医,虽分症类,而其中病源,不可不深思而熟视也。夫疾有久新,症有轻重,须分表里、风热、气
热、湿热、实热。而新病者,皆因内积热毒之轻,循经络而上头目,遇外风寒所触而发者,必须先发表风邪,后
乃远其火热,黄连、黄芩以泻火,防风、薄荷以疏风,兼以麻黄、苍术之类。如无风寒所逼,惟血壅上,宜用大
黄、当归、防己坠下之剂。久眼昏蒙所晓,宜用当归、地黄、防风、羌活之类,有翳膜加木贼、蒺藜、蝉蜕、决
明等剂。如胞合眼皮不开此乃寒邪之气伤胞,宜行气之药,青皮、黄 、香附兼以风药佐之。血滞者宜调血,赤
芍、归尾、鼠粘。如头痛者羌活、白芷、蔓荆, 本、川乌之类,佐以风药防风、荆芥、玄参、柴胡、细辛用之
必当也。如眼眩晕昏 十分作痛,但虚肿痛及眼眶,此乃痰饮所患,宜服二陈汤兼佐以风药。如肿胀暗痛热泪难
禁者,苦寒之药宜然,但视人之形气虚实,体之盛衰,务究其内外浅深,不可专书全在人之活法。方书者乃前人
立法之规,使后无失其序,如归于症者则缓可以寻方,倘暴发者变动于顷刻,苟不明于药性寒温,病势之缓急,
而使之疗,非徒无益而反害之矣。予掇拾诸家之方,赘成歌括六十余首,此平昔应验之神方也,若用意熟记,则
不思忖而了然矣,若能知抽添之工夫,加减之意趣,真可谓眼科中之至宝哉。后之学人,当以予之用心,珍之重
之,俾术不轻而身不贱矣。内障一书,乃心授之法,故不形于纸笔,如若泛泛,岂仁人君子哉!
治疗眼疾的医生,虽然病症分类繁多,但其中的病因病机,不可不深入思考并仔细审视。疾病有久病和新病的区别,症状有轻和重的不同,必须分辨是表证还是里证,是风热、气热、湿热还是实热。新发的眼病,大多是因为体内积聚了轻微的火热毒邪,沿着经络上行至头目,又受到外界风寒侵袭而引发的,治疗时必须先发散在表的风邪,然后再清除内部的火热,可用黄连、黄芩来泻火,防风、薄荷来疏风,兼用麻黄、苍术之类的药物。如果没有被风寒所逼迫,仅仅是血壅滞于上部,适宜使用大黄、当归、防己等具有沉降作用的方剂。对于久病导致的眼目昏蒙,适宜使用当归、地黄、防风、羌活之类的药物;如果有翳膜遮挡,则加入木贼、蒺藜、蝉蜕、决明子等药物。如果眼睑闭合无法睁开,这是寒邪之气损伤了眼胞,适宜使用行气的药物,如青皮、黄柏(注:原文“黄 ”推测为黄柏或黄连,结合语境及常见配伍,此处暂按黄柏处理,若指黄连亦通,但通常清热燥湿多用黄柏,且前文已提黄连,故取黄柏可能性大,或者泛指苦寒药,此处保留原意译为黄柏/黄连类)、香附,并辅以祛风药物辅助治疗。血行滞涩者适宜调理血液,可用赤芍、当归尾、牛蒡子。如果有头痛症状,可用羌活、白芷、蔓荆子、藁本、川乌之类,并佐以防风、荆芥、玄参、柴胡、细辛等祛风药物,这样使用必定恰当。如果出现眼眩晕昏花且十分疼痛,伴有虚肿疼痛及眼眶不适,这是由痰饮引起的,适宜服用二陈汤,并佐以祛风药物。如果眼睛肿胀、暗痛、热泪难以控制,应当使用苦寒性质的药物,但必须观察病人的形体和气机的虚实,体质的盛衰,务必探究病位的内外、浅深,不能死板地拘泥于书本,全在于医生的灵活变通。医书是前人确立的治疗法则和规范,使后人不会失去秩序,如果病情归于慢性过程,可以缓慢地寻找对应的方剂;如果是突发急症,变化就在顷刻之间,如果不明白药物的寒温属性,不了解病势的缓急,就进行治疗,不仅没有益处,反而会造成危害。我搜集整理各家方剂,编纂成六十多首口诀歌诀,这些都是平时验证有效的神效方剂,如果能用心熟记,就能在不假思索的情况下了然于心,如果能懂得增减变化的功夫和加减法门的意趣,真可以说是眼科中的至宝啊。后来的学习之人,应当珍惜我的这番用心,重视这些知识,使医术不被轻视,自身价值也不会低贱。关于内障眼的专著,乃是心传的口授之法,所以没有形诸纸笔,如果只是泛泛而谈,难道是仁人君子所为吗!
Physicians treating eye diseases, although categorizing symptoms into various types, must deeply contemplate and carefully examine the underlying pathogenesis. Diseases vary in duration (acute vs. chronic) and severity, requiring differentiation between exterior and interior patterns, as well as wind-heat, qi-heat, damp-heat, and excess-heat. Acute eye conditions often arise from mild accumulation of internal heat-toxins that ascend along the meridians to the head and eyes, triggered by external wind-cold invasion. Treatment must first release the exterior wind-pathogen, then clear the internal fire-heat; Coptis Rhizome (Huanglian, 黄连) and Scutellaria Root (Huangqin, 黄芩) are used to purge fire, Saposhnikovia Root (Fangfeng, 防风) and Mint (Bohe, 薄荷) to disperse wind, supplemented by herbs such as Ephedra Stem (Mahuang, 麻黄) and Atractylodes Rhizome (Cangzhu, 苍术). If there is no external wind-cold constraint, but merely blood stasis obstructing the upper body, purgative agents containing Rheum Radix et Rhizoma (Dahuang, 大黄), Angelica Sinensis Radix (Danggui, 当归), and Stephania Tetrandra Saponins (Fangji, 防己) should be employed. For chronic visual blurring, Angelica Sinensis Radix (Danggui, 当归), Rehmannia Root (Dihuang, 地黄), Saposhnikovia Root (Fangfeng, 防风), and Notopterygium Rhizome et Radix (Qianghuo, 羌活) are suitable; if nebulae (翳膜) are present, add Equisetum Hiemale Caulis (Muzei, 木贼), Tribulus Fruit (Jili, 蒺藜), Cicada Slough (Chantui, 蝉蜕), and Cassia Seed (Juemingzi, 决明子). If the eyelids are fused and cannot open, this indicates cold-pathogen damaging the eyelid tissue; qi-regulating herbs such as Tangerine Peel (Qingpi, 青皮), Phellodendron Bark (Huangbai, 黄柏 - inferred from context "黄 "), and Cyperus Rhizome (Xiangfu, 香附) should be used, assisted by wind-dispersing herbs. For blood stagnation, blood-invigorating herbs like Red Peony Root (Chishao, 赤芍), Angelica Sinensis Tail (Guiwei, 归尾), and Burdock Fruit (Niubangzi, 鼠粘子) are appropriate. In cases of headache, Notopterygium Rhizome et Radix (Qianghuo, 羌活), Angelica Dahurica Radix (Baizhi, 白芷), Vitex Fruit (Manjingzi, 蔓荆子), Ligusticum Chuanxiong Rhizome (Gaben, 藁本), and Aconite Lateral Root Preparata (Chuanwu, 川乌) may be used, assisted by Saposhnikovia Root (Fangfeng, 防风), Schizonepeta Spike (Jingjie, 荆芥), Scrophularia Root (Xuanshen, 玄参), Bupleurum Root (Chaihu, 柴胡), and Asarum Root (Xixin, 细辛); such usage will certainly be appropriate. For severe dizziness, blurred vision, intense pain, and swelling with discomfort around the eye orbits caused by phlegm-fluid retention, Erchen Decoction (Erchen Tang, 二陈汤) combined with wind-dispersing herbs is indicated. For swelling, dull pain, and uncontrollable hot tears, bitter-cold herbs should be applied, but one must assess the patient's physical constitution and qi deficiency or excess, as well as the depth and location of the pathology, avoiding rigid adherence to texts and relying instead on flexible clinical judgment. Medical texts provide established rules for future generations to maintain order; for chronic conditions, formulas can be sought gradually, whereas acute conditions change rapidly. Without understanding the thermal nature of herbs and the urgency of the disease, treatment may cause harm rather than benefit. I have compiled over sixty mnemonic verses from various sources, representing proven effective formulas. Memorizing them thoroughly allows for instant recall; mastering the principles of addition and subtraction makes them true treasures of ophthalmology. Future practitioners should cherish these teachings, valuing the art so it is not despised and their status is respected. The treatise on internal cataracts relies on oral transmission and heart-mind instruction, hence not recorded in writing; to speak superficially would not be the act of a benevolent gentleman.