小儿疳热,上攻于眼,故发时痒涩赤烂,眼胞肿疼,白睛生翳,渐渐遮满,不时流泪,闭目羞明诸病状,
古法主先用泻肝汤疏解之(如生地黄、当归、赤芍、川芎、连翘、生栀子、龙胆草、大黄、羌活、生甘草、防风,
引用灯芯)。
次用清热退翳汤消其翳(如微炒栀子、胡黄连、木贼草、生地、羚羊角、龙胆草、银柴胡、蝉壳、赤芍、
生甘草、菊花、蒺藜,引用灯芯)。
若日久不愈,法宜改用调补,古法主逍遥散(如茯苓、白术、当归、炒白芍、柴胡、薄荷、炙甘草、丹皮、
栀子,引用姜、枣)。
古法又主羊肝散〔如青羊肝(一具),去筋膜,切韭菜薄片。人参、羌活、土炒白术、蛤粉各等分,共为细
末,调匀,将药末置荷叶上,如钱浓一层,铺肝一层、包固,外以新青布包裹蒸熟,令儿食之,如不食者,及夏
月恐腐坏,则宜晒干为末),早晚白汤调服,服完再合,以好为度。
此散如系肝热,则减去人参不用。
〔真按〕眼疾失治,便成废人,泻肝散内之当归、羌活、防风等味,究不易用,但以龙胆草钱半,谷精草
二钱,净蝉蜕十个,赤芍药钱半,胡黄连五分,滁菊花二钱,霜桑叶钱半,潼蒺藜钱半,生甘草五分,鲜生地二
钱,引用羚羊片五分,先煎,后入各药再煎服。
外以真熊胆少许,用净水略润开,尽去筋膜尘土,入冰脑一二片,如泪痒则加生姜粉些少,以新牙箸点眼,
能退翳障,神效。
小儿疳积发热,热气上攻于眼部,因此发病时出现眼睛痒、涩痛、红肿溃烂,眼睑肿胀疼痛,白眼球表面生成翳膜,逐渐遮蔽瞳孔,不时流泪,畏光喜闭等病症表现。
古代医法主张首先使用泻肝汤进行疏解(方药包括:生地黄、当归、赤芍、川芎、连翘、生栀子、龙胆草、大黄、羌活、生甘草、防风,煎药时加入灯芯草作为引经药)。
其次使用清热退翳汤以消除翳膜(方药包括:微炒的栀子、胡黄连、木贼草、生地、羚羊角、龙胆草、银柴胡、蝉蜕、赤芍、生甘草、菊花、蒺藜,煎药时加入灯芯草作为引经药)。
如果病程日久不愈,治疗法则应当改为调理补益,古代医法主张使用逍遥散(方药包括:茯苓、白术、当归、炒白芍、柴胡、薄荷、炙甘草、丹皮、栀子,煎药时加入生姜和大枣作为引经药)。
古代医法又主张使用羊肝散(方药组成如:青羊肝一副,去除筋膜,切成韭菜大小的薄片。人参、羌活、土炒白术、蛤粉各取等量,共同研磨成细末,调匀。将药末铺在荷叶上,厚度如铜钱般厚一层,再铺一层羊肝,如此层层包裹固定,外层用新的青色布包裹蒸熟,让患儿食用。如果患儿不吃,或者夏季担心药物腐坏,则可以将药材晒干研末),早晚用温开水调服,服完后再重新制作,以痊愈为度。
【陈守真按语】眼疾如果延误治疗,会导致失明成为废人。原泻肝散中的当归、羌活、防风等药物,在实际应用中终究不容易把握使用,建议改用以下方药:龙胆草一钱半,谷精草二钱,净蝉蜕十个,赤芍药一钱半,胡黄连五分,滁菊花二钱,霜桑叶一钱半,潼蒺藜一钱半,生甘草五分,鲜生地二钱,引用羚羊片五分先煎,然后加入其他药物再煎服。
外用少许真熊胆,用清水略微润开,彻底去除筋膜和尘土,加入冰片一二片。如果眼泪多且痒,则加少量生姜粉,用新牙签蘸取点入眼中,能够消退翳障,效果神奇。
Infantile malnutrition with heat, where the pathogenic heat attacks upward to the eyes, thus causing symptoms upon onset such as itching, astringency, redness, and ulceration of the eyes; swelling and pain of the eyelids; formation of nebulae (opacities) on the sclera that gradually cover the pupil; frequent tearing; photophobia (aversion to light); and a preference for keeping the eyes closed.
Ancient methods primarily advocate using Xie Gan Tang (Liver-Draining Decoction) to disperse and resolve the condition first (ingredients include: Sheng Di Huang [Rehmanniae Radix], Dang Gui [Angelicae Sinensis Radix], Chi Shao [Paeoniae Radix Rubra], Chuan Xiong [Ligustici Chuanxiong Rhizoma], Lian Qiao [Forsythiae Fructum], Sheng Zhi Zi [Gardeniae Fructum], Long Dan Cao [Gentianae Radix et Rhizoma], Da Huang [Rhei Radix et Rhizoma], Qiang Huo [Notopterygii Rhizoma et Radix], Sheng Gan Cao [Glycyrrhizae Radix et Rhizoma], Fang Feng [Saposhnikoviae Radix], with Deng Xin Cao [Junci Medulla] used as an guiding herb).
Subsequently, use Qing Re Tui Yi Tang (Heat-Clearing and Nebula-Dispelling Decoction) to eliminate the nebulae (ingredients include: Wei Chao Zhi Zi [Gardeniae Fructum, lightly stir-fried], Hu Huang Lian [Coptidis Rhizoma substitute: Picrorhizae Rhizoma], Mu Zei Cao [Equiseti Herba], Sheng Di [Rehmanniae Radix], Ling Yang Jiao [Saiga Tataricae Cornu], Long Dan Cao [Gentianae Radix et Rhizoma], Yin Chai Hu [Stellariae Radix], Chan Ke [Cicadae Periostracum], Chi Shao [Paeoniae Radix Rubra], Sheng Gan Cao [Glycyrrhizae Radix et Rhizoma], Ju Hua [Chrysanthemi Flos], Ji Li [Tribuli Fructus], with Deng Xin Cao [Junci Medulla] used as an guiding herb).
If the condition persists for a long time without healing, the therapeutic method should be changed to regulation and tonification. Ancient methods primarily advocate using Xiao Yao San (Free and Easy Wanderer Powder) (ingredients include: Fu Ling [Poria], Bai Zhu [Atractylodis Macrocephalae Rhizoma], Dang Gui [Angelicae Sinensis Radix], Chao Bai Shao [Paeoniae Radix Alba, stir-fried], Chai Hu [Bupleuri Radix], Bo He [Menthae Haplocalycis Herba], Zhi Gan Cao [Glycyrrhizae Radix et Rhizoma, honey-fried], Dan Pi [Moutan Cortex], Zhi Zi [Gardeniae Fructum], with Sheng Jiang [Zingiberis Rhizoma Recens] and Da Zao [Jujubae Fructus] used as guiding herbs).
Ancient methods also advocate using Yang Gan San (Sheep Liver Powder) (ingredients such as: Qing Yang Gan [Caprae Hircae Hepatis, one whole liver], remove fascia and cut into thin slices similar to leek slices. Ren Shen [Ginseng Radix et Rhizoma], Qiang Huo [Notopterygii Rhizoma et Radix], Tu Chao Bai Zhu [Atractylodis Macrocephalae Rhizoma, stir-fried in earth powder], Ge Fen [Concha Meretricis et Cyprinis] each in equal parts, grind together into fine powder, mix evenly. Place the medicinal powder on a lotus leaf in a layer as thick as a coin, then lay a layer of liver, wrap securely, and further wrap in new blue cloth. Steam until cooked, and let the child eat it. If the child refuses to eat, or if there is fear of spoilage in summer, dry the ingredients and grind into powder instead). Take orally mixed with warm water morning and evening. After finishing one batch, prepare another, continuing until recovery.
If this powder is indicated for Liver Heat, Ren Shen [Ginseng Radix et Rhizoma] should be omitted.
[Author's Note] Eye diseases left untreated can lead to blindness and disability. The Dang Gui [Angelicae Sinensis Radix], Qiang Huo [Notopterygii Rhizoma et Radix], and Fang Feng [Saposhnikoviae Radix] in the original Xie Gan San are ultimately difficult to apply precisely. Instead, I recommend the following prescription: Long Dan Cao [Gentianae Radix et Rhizoma] 1.5 qian, Gu Jing Cao [Junci Effusi Spica] 2 qian, Jing Chan Tui [Cicadae Periostracum] 10 pieces, Chi Shao Yao [Paeoniae Radix Rubra] 1.5 qian, Hu Huang Lian [Picrorhizae Rhizoma] 5 fen, Chu Ju Hua [Chrysanthemi Flos] 2 qian, Shuang Sang Ye [Mori Folium, frosted] 1.5 qian, Tong Ji Li [Tribuli Fructus] 1.5 qian, Sheng Gan Cao [Glycyrrhizae Radix et Rhizoma] 5 fen, Xian Sheng Di [Rehmanniae Radix Recens] 2 qian, with Ling Yang Pian [Saiga Tataricae Cornu slice] 5 fen used as a guiding herb, decocted first, followed by the addition of other herbs for further decoction.
Externally, use a small amount of real Xiong Dan [Ursi Fel], moisten slightly with clean water, thoroughly remove all fascia and dust, add Bing Nao [Borneolum Syntheticum] 1-2 pieces. If there is excessive tearing and itching, add a little Sheng Jiang Fen [Zingiberis Rhizoma Pulvis]. Apply to the eye using a new toothpick. This can dispel nebulae and opacities with miraculous efficacy.