治神水宽大渐散, 昏如雾露, 空中有黑花, 及睹物成二, 神水淡绿,
淡白色者.
天门冬二两 菟丝子七钱 人参二两 茯苓二两 甘菊花七钱 干山
药七钱 麦冬一两 熟地一两 肉苁蓉五钱 青葙子五钱 生地一两
枸杞七钱 羚羊角 ( 镑 ) 五钱 草决明八钱 石斛七钱 杏仁七
钱 蒺藜五钱 川芎五钱 甘草 ( 炙 ) 五钱 黄连五钱 防风五
钱 枳壳五钱 乌犀 ( 镑 ) 五钱 牛膝七钱五分, 右为细末, 炼蜜
丸,桐子大, 每服三, 五十丸, 温服盐汤下.
【集注】罗谦甫曰: 此方为阳衰阴弱, 不能升精于目而设, 故目科与
千金磁朱丸并重, 治证亦同. 然磁朱为镇坠药, 此为羡补药. 『针经
』曰: 五脏六腑精气, 皆上于目而为之精. 故夫目之精明者, 阴阳合
传而为精明者也. 若肾肝虚, 则阴弱不能敛精, 以升养神水于内. 脾
肺虚, 则阳衰不能摄阴, 而浮散神光于外, 以致神水宽大, 睹物成二
.此其治法, 其营在肝, 其主在肾, 其合在脾, 能合肾脾之阴而使肝
达之, 则必能归精于两眸, 而继明如昼夜矣. 是方先补肾肝, 以二冬
,二地, 菟丝, 枸杞, 五味, 牛膝, 苁蓉群队滋阴之品, 以之强阴填
精,敛气安神养血, 此壮水之主, 亦所以生水也. 复以人参, 炙草 ,
茯苓, 山药培补中宫, 使调合阴阳也. 佐之以蒺藜, 甘菊, 川芎, 枳
壳,防风行肝达气, 青葙, 决明子解结散滞, 黄连, 乌犀, 羚角清火
泻热. 然必取石斛之妙合脾肾者, 清而行之, 要使升精归明之用, 脏
腑合德专精致一耳. 其以为丸者, 补上治下, 利以缓, 利以久, 不利
以速也.
治疗神水(瞳孔及眼内液体)逐渐散大,视物昏蒙如雾露笼罩,眼前出现黑花飞舞,以及视物重影,神水颜色呈淡绿色或淡白色的病症。
天门冬二两,菟丝子七钱,人参二两,茯苓二两,甘菊花七钱,干山药七钱,麦冬一两,熟地黄一两,肉苁蓉五钱,青葙子五钱,生地黄一两,枸杞子七钱,羚羊角(镑成细粉)五钱,草决明八钱,石斛七钱,杏仁七钱,蒺藜五钱,川芎五钱,甘草(炙)五钱,黄连五钱,防风五钱,枳壳五钱,乌犀角(镑成细粉)五钱,牛膝七钱五分。以上药物研为细末,用炼蜜制成丸剂,大小如梧桐子,每次服用三十至五十丸,温盐汤送服。
【集注】罗谦甫说:此方是针对阳气衰弱、阴精虚弱,导致精气不能上注于目而设立的,因此眼科中常与《千金方》中的磁朱丸并重使用,治疗的证候也相同。然而磁朱丸属于镇坠类药物,此方则属于滋补类药物。《针经》说:五脏六腑的精气,都上注于目而形成视觉的精华。所以眼睛之所以能精明视物,是阴阳和谐交融的结果。如果肝肾虚弱,则阴精不足而不能收敛精气,无法在内部滋养神水;如果脾肺虚弱,则阳气衰弱而不能固摄阴精,导致神光浮散于外,致使神水散大,视物重影。这种病的治疗法则,关键在于肝的营血,肾的主宰,以及脾的合和。若能结合肾脾之阴,使肝气得以疏达,就一定能将精气归聚于双眼,从而使视力恢复清明,如同昼夜般清晰。此方首先补益肝肾,使用天冬、麦冬、生地、熟地、菟丝子、枸杞子、五味子、牛膝、肉苁蓉等滋阴药物群队,来强壮阴精、填补精髓、收敛气机、安神养血,这是壮水之主以制阳光,也是滋生水液的方法。接着用人参、炙甘草、茯苓、山药培补脾胃(中宫),以调和阴阳。辅以蒺藜、甘菊、川芎、枳壳、防风疏肝行气,青葙子、草决明解结散滞,黄连、乌犀角、羚羊角清热泻火。然而必须取石斛妙合脾肾的特性,清利而行,要使精气上升、目光明亮的功效,达到脏腑和谐、专精一致的目的。将其制成丸剂,是因为补上焦治下焦,宜缓不宜急,宜久服不宜速效。
Treats conditions where the Shen Shui (aqueous humor/pupil and intraocular fluid) gradually dilates, vision is dim and obscured like fog or dew, black spots float in the visual field, double vision occurs, and the Shen Shui appears pale green or pale white.
Asparagus cochinchinensis Radix (Tianmendong), 2 liang; Cuscutae Semen (Tusizi), 7 qian; Ginseng Radix et Rhizoma (Renshen), 2 liang; Poria (Fuling), 2 liang; Chrysanthemi Flos (Gan Juhua), 7 qian; Dioscoreae Rhizoma (Ganshanyao), 7 qian; Ophiopogonis Radix (Maidong), 1 liang; Rehmanniae Radix Praeparata (Shudihuang), 1 liang; Cistanches Herba (Roucongrong), 5 qian; Celosiae Semen (Qingxiangzi), 5 qian; Rehmanniae Radix (Shengdihuang), 1 liang; Lycii Fructus (Gouqi), 7 qian; Antelopis Cornu (Lingyangjiao), powdered, 5 qian; Cassiae Semen (Caojue ming), 8 qian; Dendrobii Caulis (Shihu), 7 qian; Armeniacae Semen Amarum (Xingren), 7 qian; Tribuli Fructus (Jili), 5 qian; Chuanxiong Rhizoma (Chuanxiong), 5 qian; Glycyrrhizae Radix et Rhizoma (Gancao), roasted, 5 qian; Coptidis Rhizoma (Huanglian), 5 qian; Saposhnikoviae Radix (Fangfeng), 5 qian; Aurantii Fructus (Zhike), 5 qian; Rhinocerotis Cornu (Wuxi), powdered, 5 qian; Achyranthis Bidentatae Radix (Niuxi), 7.5 qian. The above herbs are ground into a fine powder, mixed with refined honey to make pills, sized like tung tree seeds. Take 30-50 pills per dose, administered warm with salt water.
[Collected Annotations] Luo Qianfu stated: This formula is designed for cases of Yang deficiency and Yin weakness, where essence cannot ascend to nourish the eyes. Therefore, in ophthalmology, it is often used alongside the Ci Zhu Wan (Magnetite and Magnetized Iron Pill) from *Qianjin Fang*, treating similar syndromes. However, while Ci Zhu Wan belongs to sedating and anchoring herbs, this formula belongs to tonifying herbs. The *Zhen Jing* (Needle Classic) states: The essence and qi of the five zang and six fu organs all ascend to the eyes to form visual acuity. Thus, the clarity of vision results from the harmonious integration of Yin and Yang. If the Liver and Kidney are deficient, Yin essence is insufficient to consolidate essence and fails to nourish the Shen Shui internally. If the Spleen and Lung are deficient, Yang Qi is too weak to secure Yin, causing the Shen Guang (visual spirit/light) to scatter externally, resulting in dilated Shen Shui and diplopia. The therapeutic principle for this condition focuses on the Ying (Nutritive) aspect in the Liver, the Master role of the Kidney, and the Harmonizing function of the Spleen. By combining the Yin of the Kidney and Spleen to allow the Liver Qi to diffuse freely, essence can be returned to both eyes, restoring clear vision as distinct as day and night. This formula first tonifies the Liver and Kidney using a group of Yin-nourishing herbs including Tian Dong, Mai Dong, Di Huang (both raw and prepared), Tusizi, Gouqi, Wuweizi, Niuxi, and Roucongrong, to strengthen Yin, fill essence, consolidate Qi, calm the Spirit, and nourish Blood. This strengthens the source of Water (Kidney Yin) to generate fluids. Subsequently, Renshen, Zhi Gancao, Fuling, and Shanyao are used to cultivate the Middle Jiao (Spleen/Stomach) to harmonize Yin and Yang. Auxiliaries include Jili, Ganju, Chuanxiong, Zhike, and Fangfeng to soothe the Liver and promote Qi movement; Qingxiangzi and Caocuoming to resolve stagnation and disperse accumulation; Huanglian, Wuxi, and Lingyangjiao to clear fire and drain heat. However, the unique efficacy of Shihu lies in its ability to harmonize the Spleen and Kidney, clearing and guiding the action, ensuring that the function of ascending essence and brightening the eyes achieves unity among the viscera. The reason for making pills is that tonifying the upper and treating the lower requires a slow, sustained effect rather than a rapid one.