论曰眼者肝之候也,五脏六腑精气,皆上注于目。小儿体本挟热,将养过温,致腑脏积
蓄邪热,熏渍肝经,上冲于目,始则赤痛,若不即治,蕴结变生障翳,热气轻者生白翳。如
黍米,大者如麻豆,重者乃生两三翳,又甚则翳生白障,侵遮瞳人,满目悉白,遂致失明。
然障亦有轻者,黑睛边微有白膜来侵,黑睛渐染散漫,当急治之,即免侵遮黑睛,有瞽蒙之
患。
治小儿热毒瓦斯盛,翳膜侵睛,兼赤眼疼痛。蕤仁丸方
蕤仁(汤浸去皮别捣一两半) 兔肝(炙一具) 栀子仁 黄芩(去黑心) 黄连(去
须各半
两) 升麻 决明子(各三分) 细辛(去苗叶一分)
上八味,捣罗为末,炼蜜丸如绿豆大,每服三丸至五丸,温水下,早晨日晚各一服,更
随儿大小加减。
治小儿风翳散漫侵瞳人,及风疳眼。恶实散方
恶实(炒) 木通(锉) 蒺藜子(炒去角各一两)
上三味,捣罗为散 每服半钱匕。以水捣羊子肝汁调下,早晨日晚各一服,更量儿大小
加减。
治小儿眼赤,或生翳膜,或眼常合不开。决明子散方
决明子 车前子 栀子仁 防风(去叉) 黄连(去须各一两半)
上五味,捣罗为散,每服一字至半钱匕。捣生猪肝,投热汤,取汁调下,早晨日晚各一
服,更量儿大小加减。
治小儿肝受病,目昏渐生翳膜,散漫侵睛,因此失明,须内外治之。龙胆饮方
龙胆 钩藤 土瓜根 茯神(去木各半两) 甘草(炙) 桑根白皮(炙) 防风(去
叉各一
分)
上七味,粗捣筛,每服一钱匕,水一盏,入枣半枚去核。同煎至六分,去滓分作二服,
量儿大小加减,早晚服。
治小儿肝热,眼生翳膜,或生血轮肿胀,切宜急治。车前子汤方
车前子 防风(去叉) 甘菊花 甘草(炙锉) 人参 菥 子 青葙子(各三分) 栀
子
仁黄连(去须各半两)
上九味,粗捣筛,每服一钱匕。水一盏,入淡竹叶七片,煎至五分,去滓温服日三,量
儿大小加减。
治小儿疳眼,翳膜沙涩。煮肝散方
黄连(去须) 沙参 玄精石 决明子
上四味等分,捣罗为散,每服半钱匕,用羊子肝一片,竹篦子切作缝子,掺末在内,线
系。入沙罐子内垂挂,勿令到底,以米泔煮熟,淡食羊肝,每一片分作两服,或三服,量儿
大小与食。
治小儿五岁以下,肝脏热毒,目生丁翳。黄芩汤方
黄芩(去黑心) 升麻 甘草(炙锉各半两) 葳蕤 玄参 犀角(镑各一分)
上六味,粗捣筛,每服一钱匕,水七分,煎至四分,去滓分温二服,量儿大小加减,日
三四服。
治小儿肝脏壅热,眼生疮翳。车前子丸方
车前子 甘菊花 芎 黄连(去须) 当归(切焙各一分) 大黄(湿纸裹煨) 黄
芩(去
黑心各半分)
上七味,捣罗为末,炼蜜丸如绿豆大,每服五七丸,量儿大小加减,煎桑枝汤下。
治小儿风热疳气,攻眼赤痛障翳。拨云膏方
桃仁 杏仁(各四枚并去皮尖双仁) 蕤仁 郁李仁(各五枚并去皮)
上四味同生研细,滤入蜜龙脑麝香腻粉各少许,再研极匀,点之。
治小儿因泻痢日久,眼生翳膜,并疳眼,退翳。如圣散方
蛇蜕(两条用纸烛烧灰研) 谷精草(一两) 蝉蜕(去土一分) 附子(生去皮脐二
钱) 石
决明(刷净一分) 胡粉(研四钱)
上六味,捣研为散,每服一字半,羊子肝一片批破掺末。用麻皮线缠,米泔煮熟,先熏
眼,后与食,量大小加减,如未能食,研汁灌之。
治小儿眼有障翳,七八岁瞳子未坚,不宜点药,用蚀翳。珊瑚散方
珊瑚(半两)
上一味,细研如粉,每点时,取如黍米大,纳翳上,日再点。
治小儿目睛有膜。白矾膏方
白矾(熬令汁尽一分)
上一味,以清水四合,置熟铜器中,煎取半合,去滓入少许白蜜。以绵滤过,每日三度。
点如黍米大。
论述说:眼睛是肝脏的外候,五脏六腑的精气,都向上灌注于眼睛。小儿体质本来挟带热邪,如果养育时保暖过度,导致脏腑积聚了邪热,熏蒸浸渍肝经,热气上冲至眼睛,起初出现红肿疼痛,如果不立即治疗,热邪蕴结变异产生障翳(角膜混浊),热气轻的生成如黍米大小的白翳,大的如麻豆大小,严重的甚至生成两三个翳膜,更严重的则生成白色障膜,侵入遮盖瞳孔,满眼皆白,于是导致失明。然而障翳也有较轻的情况,黑睛边缘微有白膜来侵犯,黑睛逐渐被染成散漫状,应当紧急治疗,以免侵入遮盖黑睛,造成盲视的祸患。
治疗小儿热毒旺盛,翳膜侵犯眼球,兼有红眼疼痛的方剂:蕤仁丸方。
蕤仁(用汤浸泡去皮后单独捣碎一两半) 兔肝(炙烤一具) 栀子仁 黄芩(去除黑色中心部分) 黄连(去除须根,各半两) 升麻 决明子(各三分) 细辛(去除苗叶一分)。
以上八味药,捣碎过筛成为粉末,炼制蜂蜜制成如绿豆大小的丸药,每次服用三丸至五丸,温水送服,早晨和晚上各服一次,并根据患儿年龄大小酌情增减剂量。
治疗小儿风翳散漫侵犯瞳孔,以及风疳眼的方剂:恶实散方。
恶实(炒制) 木通(锉碎) 蒺藜子(炒制去刺角,各一两)。
以上三味药,捣碎过筛成为散剂,每次服用半钱匕的量。用水调和羊子肝汁送服,早晨和晚上各服一次,并依据患儿年龄大小酌情增减剂量。
治疗小儿眼睛发红,或者生成翳膜,或者眼睛经常闭合不睁开的方剂:决明子散方。
决明子 车前子 栀子仁 防风(去除叉枝) 黄连(去除须根,各一两半)。
以上五味药,捣碎过筛成为散剂,每次服用一字至半钱匕的量。捣碎生猪肝,投入热水中,取汁液调服散剂,早晨和晚上各服一次,并依据患儿年龄大小酌情增减剂量。
治疗小儿肝脏受病,视力昏花逐渐生成翳膜,散漫侵犯眼球,因此导致失明,必须内外兼治的方剂:龙胆饮方。
龙胆 钩藤 土瓜根 茯神(去除木质心,各半两) 甘草(炙烤) 桑根白皮(炙烤) 防风(去除叉枝,各一分)。
以上七味药,粗捣过筛,每次服用一钱匕的量,用水一盏,加入半个去核的大枣。共同煎煮至六分满,滤去药渣,分作两次服用,依据患儿年龄大小酌情增减,早晚服用。
治疗小儿肝热,眼睛生成翳膜,或者血轮(眼睑边缘血管)肿胀,切宜紧急治疗的方剂:车前子汤方。
车前子 防风(去除叉枝) 甘菊花 甘草(炙烤锉碎) 人参 菥蓂子 青葙子(各三分) 栀子仁 黄连(去除须根,各半两)。
以上九味药,粗捣过筛,每次服用一钱匕的量。用水一盏,加入淡竹叶七片,煎煮至五分满,滤去药渣温服,每日三次,依据患儿年龄大小酌情增减剂量。
治疗小儿疳眼,翳膜伴有沙涩感的方剂:煮肝散方。
黄连(去除须根) 沙参 玄精石 决明子。
以上四味药等量分配,捣碎过筛成为散剂,每次服用半钱匕的量,用一片羊子肝,用竹篦子切成缝隙,将药末掺入其中,用线系住。放入沙罐内悬挂起来,不要让药肝接触到底部,用淘米水煮熟,空腹吃羊肝,每一片分为两服或三服,依据患儿年龄大小给予食用。
治疗五岁以下小儿,肝脏热毒,眼睛生成丁翳(一种形状如钉的翳膜)的方剂:黄芩汤方。
黄芩(去除黑色中心部分) 升麻 甘草(炙烤锉碎,各半两) 葳蕤 玄参 犀角(镑成片,各一分)。
以上六味药,粗捣过筛,每次服用一钱匕的量,用水七分,煎煮至四分,滤去药渣分两次温服,依据患儿年龄大小酌情增减,每日三四次服用。
治疗小儿肝脏壅滞发热,眼睛生成疮翳的方剂:车前子丸方。
车前子 甘菊花 川芎 黄连(去除须根) 当归(切片焙干,各一分) 大黄(用湿纸包裹煨制) 黄芩(去除黑色中心部分,各半分)。
以上七味药,捣碎过筛成为粉末,炼制蜂蜜制成如绿豆大小的丸药,每次服用五至七丸,依据患儿年龄大小酌情增减,用桑枝汤煎服送下。
治疗小儿风热疳气,攻冲眼睛导致红痛障翳的方剂:拨云膏方。
桃仁 杏仁(各四枚,均去皮尖及双仁) 蕤仁 郁李仁(各五枚,均去皮)。
以上四味药一同生研细,过滤后加入少许蜂蜜、龙脑(冰片)、麝香、腻粉(轻粉),再次研磨极均匀,点涂患处。
治疗小儿因腹泻痢疾日久,眼睛生成翳膜,以及疳眼,退除翳膜的方剂:如圣散方。
蛇蜕(两条用纸烛烧成灰后研细) 谷精草(一两) 蝉蜕(去除泥土一分) 附子(生用,去皮脐二钱) 石决明(刷洗干净一分) 胡粉(研细四钱)。
以上六味药,捣碎研细成为散剂,每次服用一字半的量,取一片羊子肝剖开掺入药末。用麻皮线缠绕,用淘米水煮熟,先熏眼睛,然后给患儿吃,依据年龄大小酌情增减,如果患儿不能进食,将药汁研碎灌服。
治疗小儿眼睛有障翳,七八岁儿童瞳子尚未坚固,不宜点涂药物,采用蚀翳法的方剂:珊瑚散方。
珊瑚(半两)。
以上一味药,细研如粉状,每次点药时,取如黍米大小的量,放置在翳膜上,每日点两次。
治疗小儿目睛有膜的方剂:白矾膏方。
白矾(熬制至汁液尽,一分)。
以上一味药,用清水四合,置于熟铜器中,煎取半合,滤去药渣加入少许白蜜。用绵布过滤,每日三次,点涂如黍米大小的量。
Commentary states: The eyes are the external manifestation of the Liver (Gan). The essence and qi of the five zang organs and six fu organs all ascend and pour into the eyes. Children's constitutions inherently carry heat pathogens. If nurtured with excessive warmth, it leads to the accumulation of pathogenic heat in the fu organs, which steams and soaks the Liver Meridian (Gan Jing), rushing upward to the eyes. Initially, there is redness and pain; if not treated immediately, the heat accumulates and transforms into opacities (Yi Yi - corneal clouding). With mild heat, white opacities form like millet grains; larger ones resemble hemp or bean seeds; severe cases may develop two or three opacities. Even more severely, white membranes grow, invading and covering the pupil, turning the entire eye white, ultimately leading to blindness. However, some opacities are milder, where a slight white membrane invades from the edge of the black cornea (Hei Jing), causing the cornea to gradually become diffuse. Urgent treatment is required to prevent invasion and coverage of the cornea, avoiding the risk of blindness.
Formula for treating children with abundant heat-toxin vapor, opacities invading the eyeball, accompanied by red eyes and pain: Ruren Wan (Prunus Persica Kernel Pill).
Ruren (Prunus Persica Seed, soaked in decoction, skin removed, pounded separately, 1 liang 5 qian)
Tugan (Rabbit Liver, roasted, one whole)
Zhizi Ren (Gardenia Fruit Kernel)
Huangqin (Scutellaria Root, remove black heart)
Huanglian (Coptis Rhizome, remove mustache, each 0.5 liang)
Shengma (Cimicifuga Rhizome)
Juemingzi (Cassiae Semen, each 3 fen)
Xixin (Asarum Root, remove seedlings and leaves, 1 fen)
The above eight herbs are pounded and sieved into powder. Honey is refined to make pills the size of mung beans. Take 3 to 5 pills per dose, swallowed with warm water, once in the morning and once in the evening. Dosage should be adjusted according to the child's age and size.
Formula for treating children with wind-opacities diffusing and invading the pupil, as well as wind-gan eye disease: Eshi San (Arctium Powder).
Eshi (Arctii Fructus, stir-fried)
Mutong (Akebia Caulis, chopped)
Jilizi (Tribuli Fructus, stir-fried, thorns removed, each 1 liang)
The above three herbs are pounded and sieved into powder. Take half a qianbi (a small measuring spoon) per dose. Mix with juice extracted from lamb liver using water, swallow. Once in the morning and once in the evening. Dosage should be adjusted according to the child's age and size.
Formula for treating children with red eyes, generation of opacities, or eyes that remain closed: Juemingzi San (Cassiae Semen Powder).
Juemingzi (Cassiae Semen)
Cheqianzi (Plantaginis Semen)
Zhizi Ren (Gardenia Fruit Kernel)
Fangfeng (Saposhnikoviae Radix, remove forks)
Huanglian (Coptis Rhizome, remove mustache, each 1.5 liang)
The above five herbs are pounded and sieved into powder. Take one zi (a very small measure) to half a qianbi per dose. Pound fresh pig liver, immerse in hot water, take the juice to mix with the powder for swallowing. Once in the morning and once in the evening. Dosage should be adjusted according to the child's age and size.
Formula for treating children whose liver is diseased, vision dimming with gradual formation of opacities diffusing to invade the eyeball, leading to blindness due to this condition; internal and external treatment is necessary: Longdan Yin (Gentiana Decoction).
Longdan (Gentiana Radix)
Gouteng (Uncariae Ramulus cum Uncis)
Tugua Gen (Trichosanthes Radix)
Fushen (Poria with Hostwood, remove wood core, each 0.5 liang)
Gancao (Licorice Root, roasted)
Sanggen Bapi (Mori Cortex, roasted)
Fangfeng (Saposhnikoviae Radix, remove forks, each 1 fen)
The above seven herbs are coarsely pounded and sieved. Take one qianbi per dose, with one cup of water and half a pitted jujube. Decoct together until reduced to 60%. Strain and divide into two doses. Adjust dosage according to the child's age and size, taken in the morning and evening.
Formula for treating children with liver heat, generation of eye opacities, or swelling of the blood wheel (limbus/ciliary body area); urgent treatment is essential: Cheqianzi Tang (Plantaginis Decoction).
Cheqianzi (Plantaginis Semen)
Fangfeng (Saposhnikoviae Radix, remove forks)
Gan Juhua (Chrysanthemi Flos)
Gancao (Licorice Root, roasted and chopped)
Renshen (Ginseng Radix)
Xingzi (Thlasidis Semen)
Qiangxiangzi (Celosiae Semen)
Zhizi Ren (Gardenia Fruit Kernel)
Huanglian (Coptis Rhizome, remove mustache, each 0.5 liang)
The above nine herbs are coarsely pounded and sieved. Take one qianbi per dose, with one cup of water and seven slices of Dan Zhu Ye (Lophatheri Herba). Decoct until reduced to 50%. Strain and take warm, three times daily. Adjust dosage according to the child's age and size.
Formula for treating children with gan-eye disease, opacities with a gritty sensation: Zhu Gan San (Boiled Liver Powder).
Huanglian (Coptis Rhizome, remove mustache)
Shashen (Adenophorae Radix)
Xuanjing Shi (Natrii Sulfas)
Juemingzi (Cassiae Semen)
The above four herbs are mixed in equal parts, pounded and sieved into powder. Take half a qianbi per dose. Take one slice of lamb liver, cut slits with a bamboo comb, insert the powder inside, and tie with thread. Hang inside a clay pot, ensuring it does not touch the bottom. Cook thoroughly in rice washing water. Eat the lamb liver on an empty stomach. Divide each slice into two or three doses, administered according to the child's age and size.
Formula for treating children under five years old with liver heat-toxin, generating Ding Yi (nail-shaped opacity): Huangqin Tang (Scutellaria Decoction).
Huangqin (Scutellaria Root, remove black heart)
Shengma (Cimicifuga Rhizome)
Gancao (Licorice Root, roasted and chopped, each 0.5 liang)
Weirui (Polygonati Rhizoma)
Xuanshen (Scrophulariae Radix)
Xijiao (Rhino Horn, shaved, each 1 fen)
The above six herbs are coarsely pounded and sieved. Take one qianbi per dose, with 0.7 cups of water. Decoct until reduced to 0.4 cups. Strain and divide into two warm doses. Adjust dosage according to the child's age and size, taken three to four times daily.
Formula for treating children with liver stagnation-heat, generating sores and opacities in the eyes: Cheqianzi Wan (Plantaginis Pill).
Cheqianzi (Plantaginis Semen)
Gan Juhua (Chrysanthemi Flos)
Xiong (Ligustici Chuanxiong Rhizoma)
Huanglian (Coptis Rhizome, remove mustache)
Danggui (Angelicae Sinensis Radix, sliced and baked, each 1 fen)
Dahuang (Rhei Radix et Rhizoma, wrapped in wet paper and baked)
Huangqin (Scutellaria Root, remove black heart, each 0.5 fen)
The above seven herbs are pounded and sieved into powder. Honey is refined to make pills the size of mung beans. Take 5 to 7 pills per dose. Adjust dosage according to the child's age and size. Swallow with a decoction of mulberry branches.
Formula for treating children with wind-heat gan-qi attacking the eyes, causing redness, pain, and opacities: Boyun Gao (Cloud-Piercing Ointment).
Taoren (Persicae Semen, 4 pieces, skin and tips removed, including double kernels)
Xingren (Armeniacae Semen Amarum, 4 pieces, skin and tips removed, including double kernels)
Ruren (Prunus Persica Seed)
Yuliren (Pruni Semen, 5 pieces, skin removed)
The above four herbs are ground raw into a fine paste. Filter and add a small amount of honey, Long Nao (Borneolum Syntheticum), Shexiang (Moschus), and Nin Fen (Calomelas). Grind extremely uniformly. Apply topically.
Formula for treating children with opacities generated after prolonged diarrhea/dysentery, as well as gan-eye disease, to eliminate opacities: Rusheng San (Like-Sage Powder).
Shetui (Ophichthidis Cutis Coriacea, two strips burned to ash with paper candle and ground)
Gu Jing Cao (Eriocauli Flos, 1 liang)
Chantui (Cicadae Periostracum, free of dirt, 1 fen)
Fuzi (Aconiti Lateralis Radix Preparata, raw, skin and navel removed, 2 qian)
Shijueming (Concha Arcae, brushed clean, 1 fen)
Hufen (Plumbi Carbonas, ground, 4 qian)
The above six herbs are pounded and ground into powder. Take 1.5 zi per dose. Take one slice of lamb liver, split it, and sprinkle the powder inside. Wrap with hemp fiber thread. Cook thoroughly in rice washing water. First fumigate the eyes, then feed the child. Adjust dosage according to age and size. If the child cannot eat, grind into juice and administer orally.
Formula for treating children with eye opacities, aged 7-8 years where the pupil is not yet firm, unsuitable for topical drops; use cauterization method: Shanhu San (Coral Powder).
Shanhu (Corallium Rubrum, 0.5 liang)
The above single herb is finely ground into powder. When applying, take an amount the size of a millet grain, place it on the opacity. Apply twice daily.
Formula for treating children with membrane on the eyeball: Bai Fan Gao (Alum Ointment).
Baifan (Alumen, boiled until juice is exhausted, 1 fen)
The above single herb is placed in four he of clear water in a cooked copper vessel. Decoct until reduced to half a he. Strain and add a small amount of white honey. Filter through cotton cloth. Apply three times daily, an amount the size of a millet grain.