膏粱之变,滋味过也;气血之盛,禀受浓也;元阳上炎,阴不济也;邪入经络,内无御也;
因生而化,因化而热。热为火,火性上炎。足厥阴肝为木,木生火,母妊子,子以淫胜,火发
反克。而肝开窍于目,故肝受克,而目亦受病也。其病眵多 紧涩,赤脉贯睛。脏腑秘结者
为重,重者芍药清肝散主之,通气利中丸主之。眵多 臊紧涩,赤脉贯睛,脏腑不秘结者为轻,
轻者减去硝黄,芍药清肝散主之,黄连天花粉丸主之,火盛,服通气利中丸。目眶烂者,内服上
药,外以黄连炉甘石散收其烂处,兼以点眼春雪膏、龙脑黄连膏、 鼻
碧云散攻其淫热,此治淫热反克之法也。非膏粱之变,非气血之盛,非亢阳上炎,非邪入经络,
毋用此也。用此则寒凉伤胃,生意不上升,反为所害,病岂不治而已也?噫!审诸。
风动物而生于热,譬如烈火焰而必吹,此物类感召而不能违间者也。因热而召,是为外来;
久热不散,感而自生,是为内发。内外为邪,惟病则一。淫热之祸,条已如前,益以风邪,为害
岂纤乎?风加头痛,风加鼻塞,风加肿胀,风加涕泪,风加脑巅沉重,风加眉骨酸疼,有一
于此,羌活胜风汤主之。风加痒,则以杏仁、
龙胆草泡散洗之。病者有此数证,或不服药,或误服药,翳必随之而生。翳如云雾,翳如丝缕,
翳如秤星。翳如秤星者,或一点,或三四点,而至数十点。翳如螺盖者,为病久不去,治不
如法,至极而至也。为服寒凉药过多,脾胃受伤,生意不能上升,渐而至也。然必要明经络,
庶能应手。翳凡自内 而出,为手太阳、足太阳受邪,治在小肠膀胱经,加蔓荆子、苍术,羌
活胜风汤主之。自锐 客主人而入者,为足少阳、手少阳、手太阳受邪,治在胆与三焦小肠经,
加龙胆草、 本,少加人参,羌活胜风汤主之。自目系而下者,为足厥阴手少阴受邪,治在肝
经心经,加黄连,倍加柴胡,羌活胜风汤主之。自抵过而上者,为手太阳受邪,治在小肠经,
加木通、五味子,羌活胜风汤主之。热甚者,兼用治淫热之药, 鼻碧云散俱治已上之证,大抵
如开锅盖法, 之随效,然力少而锐,宜不时用之以聚其力。虽然,早者易而久者难,渐而复渐,
复而又复可也。急于复者即不治。今世医用磨翳药者有之,用手法揭翳者有之。噫!翳犹疮也,
奚斯愈乎?庸者用此,非徒无益,增害尤甚。愚者受此,欣然而不悟,可叹也哉!故置风热不
制之病治法。
膏粱厚味引发的病变,是因为滋味过于浓厚;气血旺盛,是由于先天禀赋充足;元阳之火向上炎升,是因为阴液不足无法制约;邪气侵入经络,是因为体内缺乏抵御能力;
这些因素导致病情产生变化,因变化而产生热象。热即是火,火的性质是向上炎升。足厥阴肝经属木,木能生火,母(肝)滋养子(心/火),若子脏过盛反侮母脏,导致火势爆发并反向克制肝脏。
而肝开窍于目,所以肝脏受到克制,眼睛也会随之患病。其症状表现为眼屎多且干涩紧缩,红血丝贯穿眼球。如果伴有脏腑便秘结滞的属于重症,重症用芍药清肝散主治,或用通气利中丸主治。如果眼屎多且有臊味、干涩紧缩,红血丝贯穿眼球,但脏腑没有便秘结滞的属于轻症,轻者去掉方中的芒硝、大黄,用芍药清肝散主治,或用黄连天花粉丸主治;若火热极盛,服用通气利中丸。眼眶溃烂的,内服上述药物,外用黄连炉甘石散涂抹溃烂处,同时配合点眼春雪膏、龙脑黄连膏,以及吹鼻碧云散来攻逐淫热,这是治疗淫热反克的方法。如果不是因为膏粱厚味的变异,不是气血过盛,不是亢盛的阳气上炎,也不是邪气侵入经络,不要使用这些方法。使用了就会因寒凉药物损伤胃气,生机不能上升,反而受到伤害,疾病难道能只治不愈吗?唉!务必审慎考察。
风是动态的,由热而生,譬如烈火焰必然被风吹动,这是物类相互感召而不能违背的自然规律。因外热而招致风邪,称为外来;久热不散,感应而自生风邪,称为内发。无论是内邪还是外邪,致病原理是一致的。淫热的祸害,前面已经阐述清楚,再加上风邪,危害难道轻微吗?风邪加上头痛,风邪加上鼻塞,风邪加上肿胀,风邪加上涕泪,风邪加上头脑沉重,风邪加上眉骨酸痛,只要出现其中一种症状,就用羌活胜风汤主治。风邪加上瘙痒,就用杏仁、龙胆草泡制的散剂清洗患处。患者如果有这些证候,或者不服药,或者误服药,翳膜必定随之产生。翳膜像云雾一样,翳膜像丝缕一样,翳膜像秤星一样。翳膜像秤星的,或有一点,或三四点,甚至多达数十点。翳膜像螺盖一样的,是因为病程长久未去,治疗不得法,发展到极致所致。这是因为服用过多寒凉药物,脾胃受伤,生机不能上升,逐渐发展而成的。然而必须明确经络辨证,才能手到病除。翳膜凡是自内向外出的,为手太阳、足太阳经受邪,治疗在小肠、膀胱经,加蔓荆子、苍术,用羌活胜风汤主治。自锐眦客主人穴而入的,为足少阳、手少阳、手太阳经受邪,治疗在胆、三焦、小肠经,加龙胆草、藁本,少加人参,用羌活胜风汤主治。自目系向下生的,为足厥阴、手少阴经受邪,治疗在肝、心经,加黄连,加倍柴胡,用羌活胜风汤主治。自抵过穴向上生的,为手太阳经受邪,治疗在小肠经,加木通、五味子,用羌活胜风汤主治。热势严重的,兼用治疗淫热的药物,吹鼻碧云散均能治疗以上证候,大体上如同揭开锅盖的方法,药效随即显现,但药力较小而作用尖锐,适宜不时使用以聚集药力。虽然如此,早期的容易治愈,久病的难治,逐渐恢复,反复调理是可以的。急于求成复原则无法治愈。当今世医中有使用磨翳药的,有用手法揭翳的。唉!翳膜就像疮疡一样,怎么能迅速痊愈呢?庸医使用这种方法,不仅无益,增加的危害尤其严重。愚笨的患者接受这种治疗,欣然不觉悟,真是可叹啊!因此,将风热不受控制疾病的治法记录于此。
Pathological changes caused by rich and greasy food (Gao Liang) result from excessive richness of flavors; vigorous Qi and Blood stem from robust congenital endowment; the flaming upward of Primordial Yang occurs due to Yin failing to balance it; pathogenic factors entering the meridians happen because there is no internal defense;
these factors generate transformation, and through transformation, heat arises. Heat is Fire, and the nature of Fire is to flare upward. The Foot Jueyin Liver belongs to Wood, and Wood generates Fire; as the Mother nourishes the Child, if the Child becomes excessive, it may counter-attack, causing Fire to erupt and reverse-clash with the Liver.
Since the Liver opens into the eyes, when the Liver is counter-attacked, the eyes also become diseased. Symptoms include excessive eye discharge (Shi) with tightness and dryness, and red vessels traversing the eyeball. If accompanied by constipation and stagnation of the Zang-Fu organs, it is a severe case, primarily treated with Shaoyao Qinggan San (Peony Decoction to Clear the Liver), or Tongqi Lizhong Wan (Pill to Unblock Qi and Benefit the Middle). If there is excessive eye discharge with a fishy odor, tightness and dryness, and red vessels traversing the eyeball, but without constipation of the Zang-Fu organs, it is a mild case. For mild cases, remove Rhubarb (Dahuang) and Mirabilite (Mangxiao) from the formula; treat primarily with Shaoyao Qinggan San, or Huanglian Tianhuafen Wan (Coptis and Trichosanthes Root Pill); if Fire is extremely abundant, administer Tongqi Lizhong Wan. For ulcerated eye orbits, take the aforementioned medicines internally, and externally apply Huanglian Luguanshi San (Coptis and Calamine Powder) to the ulcerated areas, combined with applying Chunxue Gao (Spring Snow Ointment) and Longnao Huanglian Gao (Borneol and Coptis Ointment) to the eyes, and blowing Biyun San (Blue Cloud Powder) into the nose to attack the excessive heat. This is the method for treating excessive heat counter-attacking. Do not use these methods unless there are pathological changes from rich food, excessive Qi and Blood, flaming upward of hyperactive Yang, or pathogenic invasion of meridians. Using them otherwise will damage the Stomach with cold-cooling herbs, prevent the rise of vital energy, cause harm, and the disease will not be cured. Alas! Exercise caution.
Wind is dynamic and generated by heat, just as a fierce flame must be blown by wind; this is the mutual induction between things that cannot be violated. Attracted by external heat, it is termed exogenous; lingering heat not dissipating induces self-generation, termed endogenous. Whether exogenous or endogenous pathogens, the pathology is one. The disaster of excessive heat has been described above; adding Wind pathogen, how could the harm be slight? If Wind adds headache, use Qianghuo Shengfeng Tang (Notopterygium Decoction to Overcome Wind). If Wind adds nasal congestion, swelling, runny nose and tears, heaviness in the head, or soreness in the brow bone, and any of these occur, Qianghuo Shengfeng Tang is the primary treatment. If Wind adds itching, wash with an infusion of Xingren (Apricot Seed) and Longdancao (Gentian Root). If patients have these syndromes, or refuse medication, or take incorrect medication, nebulae (Yi) will inevitably follow. Nebulae may appear like clouds and mist, like silk threads, or like star scales. Nebulae like star scales may be single, three or four dots, up to dozens. Nebulae like snail covers indicate long-standing disease, improper treatment, reaching the extreme. This results from taking too many cold-cooling medicines, injuring the Spleen and Stomach, preventing the rise of vital energy, developing gradually. However, one must clearly understand the meridians to achieve effective treatment. Nebulae emerging from inside out indicate pathogenic invasion of the Hand Taiyang and Foot Taiyang meridians; treatment focuses on the Small Intestine and Bladder meridians, add Manjingzi (Vitex Fruit) and Cangzhu (Atractylodes Rhizome), treat with Qianghuo Shengfeng Tang. Entering from the canthus via Keren acupoint indicates pathogenic invasion of the Foot Shaoyang, Hand Shaoyang, and Hand Taiyang meridians; treatment focuses on the Gallbladder, Sanjiao, and Small Intestine meridians, add Longdancao and Gaoben (Ligusticum Sinense), add a small amount of Renshen (Ginseng), treat with Qianghuo Shengfeng Tang. Descending from the eye system indicates pathogenic invasion of the Foot Jueyin and Hand Shaoyin meridians; treatment focuses on the Liver and Heart meridians, add Huanglian (Coptis Rhizome), double the dose of Chaihu (Bupleurum Root), treat with Qianghuo Shengfeng Tang. Ascending from Diguo acupoint indicates pathogenic invasion of the Hand Taiyang meridian; treatment focuses on the Small Intestine meridian, add Mutong (Akebia Caulis) and Wuzi (Schisandra Berry), treat with Qianghuo Shengfeng Tang. In cases of severe heat, combine with medicines for excessive heat; Biyun San treats all the above conditions. Generally, this is like opening a pot lid; efficacy follows immediately, but the force is weak yet sharp, suitable for intermittent use to concentrate its power. Although so, early cases are easy to cure, late cases are difficult; gradual recovery, repeated attempts are acceptable. Rushing for immediate recovery leads to untreatable conditions. Nowadays, some physicians use grinding nebulae medicines, others use manual techniques to peel off nebulae. Alas! Nebulae are like ulcers; how can they heal quickly? Quacks using this method gain nothing but increase harm. Foolish patients accept this happily without realizing, truly lamentable! Therefore, record the treatment methods for diseases where Wind-Heat is uncontrolled.