伤寒病愈后。或有目复大病者。以其清阳之气不升。而余邪上走空窍也。其病瘾涩赤胀。生翳羞明。头脑
骨痛。宜作群队升发之剂饵之。数服斯愈。伤寒论曰。冬时严寒。万类深藏。君子固密。不伤于寒。触冒之者。
乃名伤寒。其伤于四时之气者。皆能为病。又生气通天论曰。四时之气。更伤五脏。五脏六腑一病。则浊阴
之气不得下。清阳之气不得上。今伤寒时病虽愈。浊阴清阳之气。犹未来复。浊阴清阳之气未复。故余邪
尚炽不休。故其走上而为目之害也。是以一日而愈者。余邪在太阳。二日而愈者。余邪在阳明。三日而愈
者。余邪在少阳。四日而愈者。余邪在太阴。五日而愈者。余邪在少阴。六日而愈者。余邪在厥阴。七日而复。
是皆清阳不能出上窍。而复受其所害也。当为助清阳上出则治。人参补胃汤主之。羌活胜风汤主之。加
减地黄丸主之。 鼻碧云散亦宜用也。忌大黄芒硝苦寒通利之剂。用之必不治。
人参补胃汤(治伤寒愈后。余邪不散。上走空窍。其病瘾涩赤胀。生翳障。羞明。头脑骨皆痛。)
羌活 独活(各六分) 白芍药 生地黄 泽泻(各三分) 人参 白茯苓
炙甘草 白术 黄 熟地黄(酒洗) 当归身(各四分) 柴胡 防风(各五分)
上锉剂。白水二钟。煎至一钟。去滓热服。
上方分利阴阳。升降上下之药也。羌活、独活为君者。导阳之升也。茯苓、泽泻为臣者。导阴之降也。人参、
白术大补脾胃。内盛则邪自不容。黄 、防风大实皮毛。外密则邪自不入。为之佐也。当归、熟地黄俱生
血。谓目得血而能视。生地黄补肾水。谓神水属肾。白芍药理气。柴胡行经。甘草和百药。为使。
伤寒病痊愈后,有的人眼睛再次发生严重疾病。这是因为清阳之气不能上升,而残留的病邪向上侵犯头面空窍所致。其病症表现为眼睑涩痛、红肿充血、生翳膜、畏光,以及头脑和骨骼疼痛。适宜使用具有升发作用的复方药剂服用,服几剂后即可痊愈。《伤寒论》说:冬季严寒,万物深藏,君子(指养生有道的人)注意固密防护,就不受寒邪伤害;如果触犯冒犯寒气,才称为伤寒。凡是受到四时气候异常影响的,都能导致疾病。《生气通天论》又说:四时的气候交替伤害五脏,五脏六腑中只要有一个脏腑发病,就会导致浊阴之气不能下降,清阳之气不能上升。如今伤寒等时行疾病虽然已经痊愈,但浊阴与清阳之气尚未恢复平衡。由于浊阴和清阳之气未复,所以残留的病邪依然炽盛不止,因此向上侵犯而导致眼睛受害。所以,一天就痊愈的,残留病邪在太阳经;两天痊愈的,残留病邪在阳明经;三天痊愈的,残留病邪在少阳经;四天痊愈的,残留病邪在太阴经;五天痊愈的,残留病邪在少阴经;六天痊愈的,残留病邪在厥阴经;七天则正气来复。这些都是因为清阳之气不能出于上窍,反而受到病邪侵害的缘故。应当采用帮助清阳之气上升的方法治疗。主用人参补胃汤、羌活胜风汤、加减地黄丸。鼻科用的碧云散也适宜使用。忌用大黄、芒硝等苦寒通利的药物,如果使用这些药物,必定治不好。
人参补胃汤(治疗伤寒痊愈后,残留病邪不散,向上侵犯空窍。其病症为眼睑涩痛、红肿、生翳障、畏光,头脑和骨骼均疼痛。)
药材组成:羌活、独活(各六分),白芍药、生地黄、泽泻(各三分),人参、白茯苓、炙甘草、白术、黄芪、熟地黄(酒洗)、当归身(各四分),柴胡、防风(各五分)。
煎服法:将上述药材切碎,用水两钟,煎煮至一钟,滤去药渣,趁热服用。
上方是分别利导阴阳、升降上下气机的药物组合。羌活、独活作为君药,作用是引导阳气上升;茯苓、泽泻作为臣药,作用是引导阴气下降;人参、白术大补脾胃,体内正气充足则邪气自然无法容留;黄芪、防风大实皮毛,体表固密则邪气自然无法侵入,这三组作为佐药;当归、熟地黄共同生成血液,因为眼睛得到血液滋养才能视物;生地黄补肾水,因为神水(眼内液体)归属于肾;白芍药调理气机,柴胡疏通经络,甘草调和诸药,这三者作为使药。
After the recovery from Shanghan disease (Cold Damage), some individuals may suffer from severe eye diseases again. This is because the clear yang qi (vital energy that ascends and warms) fails to rise, while residual pathogenic factors ascend to invade the orifices of the head and face. The symptoms include eyelid astringency, redness, swelling, formation of corneal opacities (nebulae/pannus), photophobia, as well as pain in the head and bones. It is appropriate to administer compound decoctions with ascending and dispersing properties; after taking several doses, the condition will heal. The *Shanghan Lun* (Treatise on Cold Damage) states: "In winter, when the cold is severe, all things are deeply hidden. The wise person maintains solidity and protection, thus avoiding injury by cold. Those who are exposed to it are named as having Shanghan." Any illness caused by abnormal climate changes during the four seasons can result in disease. Furthermore, the *Shengqi Tongtian Lun* (Treatise on the Connection Between Life and Heaven) states: "The qi of the four seasons alternately injures the five zang organs. If any one of the five zang or six fu organs becomes diseased, turbid yin qi cannot descend, and clear yang qi cannot ascend." Although the Shanghan or seasonal epidemic disease has now healed, the balance between turbid yin and clear yang qi has not yet been restored. Because this balance is unrestored, residual pathogenic factors remain vigorous and ceaseless, thereby ascending to cause harm to the eyes. Therefore, if healing occurs in one day, the residual pathogen is in the Taiyang channel; if in two days, it is in the Yangming channel; if in three days, it is in the Shaoyang channel; if in four days, it is in the Taiyin channel; if in five days, it is in the Shaoyin channel; if in six days, it is in the Jueyin channel; and by the seventh day, recovery occurs. In all these cases, it is because clear yang qi cannot emerge through the upper orifices and is instead harmed by pathogens. Treatment should focus on assisting the ascent of clear yang qi. The primary formulas are Renshen Buwei Tang (Ginseng Decoction for Tonifying the Stomach), Qianghuo Shengfeng Tang (Notopterygium Decoction for Overcoming Wind), and Jiadi Dihuang Wan (Modified Rehmannia Pill). Biyun San (Green Cloud Powder) for nasal conditions is also suitable. One must avoid using bitter-cold purgatives such as Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas); using them will certainly fail to cure the disease.
Renshen Buwei Tang (Treats residual pathogens lingering after Shanghan recovery, ascending to invade orifices. Symptoms include eyelid astringency, redness, swelling, corneal opacities, photophobia, and pain in the head and bones.)
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Duohuo (Angelicae Pubescentis Radix) (each 6 fen); Baishao Yao (Paeoniae Radix Alba), Shengdihuang (Rehmanniae Radix), Zexie (Alismatis Rhizoma) (each 3 fen); Renshen (Ginseng Radix), Bai Fuling (Poria), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqi (Astragali Radix), Shudihuang (Rehmanniae Radix Praeparata washed with wine), Danggui Shen (Radix Angelicae Sinensis, the root body) (each 4 fen); Chaihu (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix) (each 5 fen).
Preparation and Administration: Coarsely crush the ingredients. Add two zhong of plain water, boil until reduced to one zhong, strain, and take hot.
The above formula consists of herbs that separate and guide yin and yang, and regulate the ascending and descending of qi. Qianghuo and Duohuo serve as the sovereign drugs (Jun), guiding the ascent of yang; Fuling and Zexie serve as the minister drugs (Chen), guiding the descent of yin; Renshen and Baizhu greatly tonify the spleen and stomach; when internal vitality is abundant, pathogens naturally cannot reside; Huangqi and Fangfeng strongly consolidate the exterior (skin and hair); when the exterior is secure, pathogens naturally cannot enter; these three groups act as assistant drugs (Zuo); Danggui and Shudihuang jointly generate blood, based on the principle that the eyes can see only when nourished by blood; Shudihuang tonifies kidney water, based on the principle that the divine fluid (eye humors) belongs to the kidney; Baishao regulates qi mechanism, Chaihu circulates through the channels, and Gancao harmonizes all herbs; these three act as envoy drugs (Shi).