给事张禹功,目赤不明,服祛风散热药,反畏明重听,脉大而虚,此因劳心过度,饮食失节,
以补中益气加茯神、枣仁、山药、山茱、五味顿愈。又劳役复甚,用十全大补兼以前药渐愈
,却用补中益气加前药而痊。
东垣云∶诸经脉络,皆走于面而行空窍,其清气散于目而为精
,走于耳而为听,若心烦事冗,饮食失节,脾胃亏损,心火太盛,百脉沸腾,邪害孔窍而失
明矣。况脾为诸阴之首,目为血脉之宗,脾虚则五脏之精气皆为失所,若不理脾胃,不养神
血,乃治标而不治本也。
少宰李蒲汀,耳如蝉鸣,服四物汤,耳鸣益甚,此元气亏损之症,五更服六味地黄丸,食前服
补中益气汤顿愈。此症若血虚而有火,用八珍加山栀、柴胡。气虚而有火,四君加山栀、柴
胡。若因怒就聋或鸣,实,用小柴胡加芎、归、山栀,虚,用补中益气加山栀。午前甚,用四物加
白术、茯苓,久,须用补中益气,午后甚,用地黄丸。
少司马黎仰之,南银台时,因怒耳鸣,吐痰,作呕,不食,寒热,胁痛,用小柴胡合四物加山栀、茯
神、陈皮而瘥。
尚宝刘毅斋,怒则太阳作痛,用小柴胡加茯苓、山栀以清肝火,更用六味丸以生肾水,后
不再发。
一儒者,日晡两目紧涩,不能瞻视,此元气下陷,用补中益气倍加参、 ,数剂痊愈。
一男子,亦患前症,服黄柏、知母之类,更加便血,此脾虚不能统血,肝虚不能藏血也,用补
中益气、六味地黄而愈。
一儒者,两目作痛,服降火祛风之药,两目如绯,热倦殊甚,余用十全大补汤数剂,诸症悉退
,服补中益气兼六味丸而愈。复因劳役,午后目涩、体倦,服十全大补而痊。
一男子,房劳兼怒,风府胀闷,两胁胀痛,余作色欲损肾,怒气伤肝,用六味地黄丸料加柴胡
、当归,一剂而安。
一儒者,酒色过度,头脑两胁作痛,余以为肾虚而肝病,亦用前药顿安。
一男子,面白鼻流清涕,不闻馨秽,三年矣,用补中益气加麦门、山栀而愈。
一男子,年二十,素嗜酒色,两目赤痛,或作或止,两尺洪大,按之微弱。余谓少年得此,目当
失明。翌早索途而行,不辨天日,众皆惊异。余与六味地黄料加麦门、五味,一剂顿明。
妇人症,见《女科撮要》。
给事中张禹功,眼睛发红且视力模糊,服用祛风散热的药物后,反而更加畏光并出现听力下降的症状,脉象大而虚弱。这是因为用心过度、饮食不规律,导致脾胃受损所致。使用补中益气汤加入茯神、酸枣仁、山药、山茱萸、五味子,服后立即痊愈。后来因劳累过度复发,改用十全大补汤配合之前的药物,逐渐好转,最后仅用补中益气汤加上之前的药物而彻底康复。
李东垣说:各条经络的脉络,都上行至面部并通达各个孔窍。其中的清气散布于眼睛则形成视觉的精微物质,上行于耳朵则形成听觉。如果心烦意乱、事务繁杂,加上饮食不节制,导致脾胃亏损、心火过盛,百脉沸腾,邪气侵害孔窍,就会导致失明。况且脾为诸阴之首,目为血脉之宗,脾虚则五脏的精气都会失去依托。如果不调理脾胃、不滋养神血,就是治标不治本。
少宰李蒲汀,耳朵像蝉鸣一样响,服用四物汤后,耳鸣症状反而加重。这是元气亏损的病症,在五更天服用六味地黄丸,饭前服用补中益气汤,立即痊愈。这种病症如果是血虚而有火,用八珍汤加山栀、柴胡;气虚而有火,用四君子汤加山栀、柴胡。如果是因愤怒导致耳聋或耳鸣,实证用小柴胡汤加川芎、当归、山栀,虚证用补中益气汤加山栀。如果在午前症状加重,用四物汤加白术、茯苓;病程久者,须用补中益气汤;午后症状加重,用地黄丸。
少司马黎仰之,在南银台任职时,因愤怒导致耳鸣,伴有吐痰、作呕、食欲不振、寒热往来、胁痛等症状,用小柴胡汤合四物汤加山栀、茯神、陈皮而治愈。
尚宝刘毅斋,发怒时太阳穴部位疼痛,用小柴胡汤加茯苓、山栀以清肝火,随后用六味地黄丸以滋补肾水,之后不再发作。
一位儒生,傍晚时分两眼紧绷干涩,无法视物,这是元气下陷所致,使用补中益气汤加倍人参、黄芪,服用数剂后痊愈。
一名男子,也患有上述症状,服用黄柏、知母等药物后,更加严重并出现便血,这是脾虚不能统摄血液、肝虚不能贮藏血液所致,使用补中益气汤、六味地黄丸而痊愈。
一位儒生,双眼疼痛,服用降火祛风的药物后,双眼变得通红,极度疲乏倦怠,我用十全大补汤服用数剂,所有症状全部消退,随后服用补中益气汤兼六味地黄丸而痊愈。后来因劳累,午后眼睛干涩、身体疲倦,服用十全大补汤而康复。
一名男子,因房事劳损兼有愤怒,导致风府穴处胀闷,两胁胀痛。我认为是色欲损伤肾脏,怒气伤害肝脏,使用六味地黄丸药料加柴胡、当归,服用一剂后安定。
一位儒生,因饮酒和房事过度,导致头脑和两胁疼痛,我认为这是肾虚兼肝病,也使用前面的药物(指六味地黄丸加柴胡、当归)立即安宁。
一名男子,面色苍白,鼻子流出清涕,闻不到气味,已经三年了,使用补中益气汤加麦门冬、山栀而痊愈。
一名二十岁的男子,平时嗜好酒色,双眼赤痛,时好时坏,两尺脉洪大但重按微弱。我谓少年得此症,眼睛应当失明。第二天早上他摸索着走路,分不清白天黑夜,众人都感到惊异。我给他六味地黄丸药料加麦门冬、五味子,服用一剂后视力立刻恢复。
妇女的相关病症,见《女科撮要》。
Zhang Yugong, a Censor (Jishi), suffered from red eyes and blurred vision. After taking wind-dispelling and heat-clearing herbs, his photophobia worsened, accompanied by hearing loss. His pulse was large and deficient. This condition resulted from excessive mental exertion and irregular diet. He was cured rapidly with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fushen (Poria with Hostwood), Suanzaoren (Ziziphus Seed), Shanyao (Dioscorea Rhizome), Shanzhuyu (Cornus Fruit), and Wuweizi (Schisandra Berry). Later, due to severe physical overexertion, the symptoms recurred. He improved gradually using Shiquan Dabu Tang (Perfect Ten Tonifying Decoction) combined with the previous prescription, and finally recovered completely using Buzhong Yiqi Tang with the added herbs.
Li Dongyuan stated: The meridians and collaterals all ascend to the face and open into the orifices. The clear qi scatters into the eyes to form visual essence, and ascends to the ears to form hearing. If one is troubled by worry and busy with affairs, coupled with dietary irregularities, it leads to spleen-stomach deficiency and excessive heart fire. The hundred vessels boil, evil pathogens harm the orifices, resulting in blindness. Moreover, the spleen is the head of all yin organs, and the eyes are the congregation of blood vessels. When the spleen is deficient, the essential qi of the five zang organs loses its support. If the spleen and stomach are not regulated, and spirit and blood are not nourished, this treats the branch but not the root.
Li Puting, a Vice Minister, experienced tinnitus sounding like cicadas. After taking Siwu Tang (Four Substances Decoction), his tinnitus worsened. This was a syndrome of yuanqi (primordial qi) deficiency. He took Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) at dawn (wugeng) and Buzhong Yiqi Tang before meals, resulting in rapid recovery. For this syndrome, if there is blood deficiency with fire, use Bazhen Tang (Eight Treasures Decoction) added with Zhizi (Gardenia Fruit) and Chaihu (Bupleurum Root). If there is qi deficiency with fire, use Sijunzi Tang (Four Gentlemen Decoction) added with Zhizi and Chaihu. If deafness or tinnitus arises from anger, for excess patterns, use Xiaochaihu Tang (Minor Bupleurum Decoction) added with Xiong (Ligusticum Rhizome), Gui (Angelica Sinensis), and Zhizi; for deficiency patterns, use Buzhong Yiqi Tang added with Zhizi. If symptoms are worse in the morning, use Siwu Tang added with Baizhu (Atractylodes Macrocephala Rhizome) and Fuling (Poria); for chronic cases, Buzhong Yiqi Tang is required; if symptoms are worse in the afternoon, use Dihuang Wan (Rehmannia Pill).
Li Yangzhi, a Vice Minister of Military Affairs, while serving as a Grand Secretary in Nanjing, suffered from tinnitus due to anger, accompanied by expectoration, vomiting, anorexia, alternating chills and fever, and hypochondriac pain. He was cured using Xiaochaihu Tang combined with Siwu Tang, added with Zhizi, Fushen, and Chenpi (Tangerine Peel).
Liu Yizhai, a Director of Imperial Jewels, experienced pain in the Taiyang region upon anger. He was treated with Xiaochaihu Tang added with Fuling and Zhizi to clear liver fire, followed by Liuwei Dihuang Wan to generate kidney water, after which the condition did not recur.
A scholar suffered from tightness and dryness in both eyes in the late afternoon, unable to see clearly. This was caused by sinking of yuanqi. He was cured after several doses of Buzhong Yiqi Tang with doubled amounts of Renshen (Ginseng Root) and Huangqi (Astragalus Root).
A man suffered from similar symptoms. After taking herbs such as Huangbai (Phellodendron Bark) and Zhimu (Anemarrhena Rhizome), he developed hematochezia. This indicated that spleen deficiency failed to control blood, and liver deficiency failed to store blood. He was cured using Buzhong Yiqi Tang and Liuwei Dihuang Wan.
A scholar suffered from eye pain. After taking fire-descending and wind-dispelling herbs, his eyes became crimson red, and he felt extreme fatigue and lassitude. I administered Shiquan Dabu Tang for several doses, after which all symptoms subsided. He then recovered completely by taking Buzhong Yiqi Tang combined with Liuwei Dihuang Wan. Later, due to physical overexertion, he experienced eye dryness and body fatigue in the afternoon, and recovered after taking Shiquan Dabu Tang.
A man, suffering from sexual exhaustion compounded by anger, experienced distension and stuffiness at Fengfu (GV16) and distending pain in both hypochondria. I diagnosed this as kidney damage from excessive sex and liver injury from anger. He was prescribed Liuwei Dihuang Wan formula added with Chaihu and Danggui (Angelica Sinensis), and felt relieved after one dose.
A scholar, due to excessive alcohol and sexual indulgence, suffered from headache and hypochondriac pain. I diagnosed this as kidney deficiency complicated by liver disease, and treated him with the aforementioned prescription, resulting in immediate relief.
A man with a pale complexion had clear nasal discharge and anosmia for three years. He was cured using Buzhong Yiqi Tang added with Maidong (Ophiopogon Tuber) and Zhizi.
A twenty-year-old man, accustomed to indulging in alcohol and sex, suffered from red and painful eyes that came and went. His chi pulses were surging but weak upon deep pressure. I predicted that a young man with this condition would lose his sight. The next morning, he walked feeling his way, unable to distinguish day from night, astonishing everyone. I gave him Liuwei Dihuang Wan formula added with Maidong and Wuweizi, and his vision restored immediately after one dose.
For women's syndromes, please refer to *Nuke Cuoyao* (Essentials of Gynecology).