凡赤脉翳初从上而下者,属太阳,以太阳主表,其病必连眉棱骨痛,或脑顶痛,或半边
头肿痛是也,治宜温之散之;赤脉翳从下而上者,或从内 出外者,皆属阳明,以阳明主里
其症多热,或便实是也,治以下之寒之;赤脉翳初从外 入内者,为少阳主半表半里,治
宜和解之,翳膜者风热重则有之,或斑入眼,此肝气盛而发在表,翳膜乃生在表,明矣,宜
发散而去之也。若反疏利,则邪气内搐,为翳益深。邪气未定,谓之热翳而浮;邪气已定,
谓之水翳而沉;邪气牢而深者,谓之陷翳,当以 发之物,使其邪气再动,翳膜乃浮,
佐之以退翳之药,而能自去也。病久者不能速效,宜以岁月渐除之,新翳所生表散方东垣羌
活除翳汤,有热者退云丸之类, 发陷翳保命集羚羊角散之类治之,在人消息,若阴虚
有热者,兼服神仙退云丸。
黄膜上冲病最真,风云膏内起黄云,白际黑云深处里,直从坎位灌瞳神,只因大便结,
最恶是头疼,经络多壅滞,火燥涩炎蒸,错认涌波翳,空令目不明。
此症于风轮下际,坎位之间,神膏内初起而色黄者,如人指甲根白岩相似,若凝脂之症
但凝脂,翳从轮外生,点药可去,此在膏内,点药所不能及者。若漫及瞳神,其珠必破,
不可误认为涌波治之,此是经络塞极,三焦关格,火土诸邪之盛实者,故大便秘而小便塞,
则膏火蒸作脓,若上冲失治,凸HT 之患必矣。宜服∶
通脾泻胃汤 是症最逆,非一方可疗,当究脉之虚实,当随所因,置方施治可也。
麦门冬(去心) 茺蔚子(各一钱半) 知母 玄参 车前子 软石膏( ) 防风(各一钱)
黄芩 天门冬 熟大黄(各七分)
上锉剂。白水二钟,煎至八分,食远服。热甚者,加玄明粉一钱。
立应散 治内外障翳,昏涩多泪,及暴赤眼,一切目疾,并皆治之,三次搐鼻。
鹅不食草(洗净,晒干) 香白芷(洗) 当归(去须洗) 羊踯躅花(减半) 川附子(炮,去
皮脐) 雄黄(另研后入,各等分)
上为细末,入麝香少许,和匀。含水 鼻内,去尽浊涕,泪出为度。
凡是赤脉(眼内红血丝)和翳(角膜混浊)初起时从上向下发展的,属于太阳经病变。因为太阳经主表,其病症必然牵连眉棱骨疼痛,或者头顶疼痛,或者半边头部肿痛,治疗应当采用温散的方法;赤脉翳从下向上发展的,或者从内部向外部扩散的,都属于阳明经病变。因为阳明经主里,其症状多表现为热证,或者大便干结,治疗应当采用寒下法;赤脉翳初起时从外部向内部侵入的,为少阳经所主的半表半里证,治疗应当采用和解法。
翳膜这种病,风热邪气重的时候会出现,或者是斑疹侵入眼睛,这是肝气旺盛而病发在体表,翳膜生在体表,这是很明显的,适宜用发散的方法祛除它。如果反而使用疏利攻下的方法,那么邪气就会向内收缩,导致翳膜更加深重。邪气尚未稳固的,称为“热翳”,位置浮浅;邪气已经稳固的,称为“水翳”,位置深沉;邪气牢固且深的,称为“陷翳”,应当使用发散的药物,使邪气再次活动,翳膜才会浮起,再辅以退翳的药物,翳膜自然能去除。病程久的不能求速效,宜以年月逐渐消除。新产生的翳膜,表散方剂可用东垣羌活除翳汤;有热证的,可用退云丸之类;发散陷翳的,可用《保命集》中的羚羊角散之类来治疗,具体运用需根据情况斟酌。如果是阴虚有热的,兼服神仙退云丸。
黄膜上冲的病是最真实的。风云膏内治起的黄云,位于白睛与黑睛交界处深处,直接从坎位(肾/瞳孔对应部位)灌注至瞳神(瞳孔及晶状体等)。只因为大便秘结,最可怕的是头疼,经络大多壅滞,火燥涩炎蒸腾。错把涌波翳当作此病,只会让眼睛不明亮。
此症发生在风轮(黑睛)下际、坎位之间,神膏(晶状体或玻璃体等内部组织)内初起且颜色黄的,像人指甲根部的白岩一样。如果是凝脂翳,只是凝脂,翳从轮外生出,点药可以去除;此症在膏内,点药无法触及。如果漫延到瞳神,眼球必然破裂,不可误认为涌波翳来治疗。这是经络极度闭塞,三焦关格(上下不通),火土诸邪盛实所致,所以大便秘结而小便堵塞,导致膏中火热蒸腾化作脓液。如果上冲失治,必然出现凸睛(眼球突出)的祸患。适宜服用:
通脾泻胃汤:此症最为凶险,不是一方可以治愈的,应当探究脉象的虚实,应当根据病因,制定方剂进行治疗。
药材:麦门冬(去心)、茺蔚子(各一钱半)、知母、玄参、车前子、软石膏、防风(各一钱)、黄芩、天门冬、熟大黄(各七分)。
以上切碎成剂。用白水两钟,煎至八分,饭后服用。热势严重的,加玄明粉一钱。
立应散:治疗内外障翳,昏涩多泪,以及暴发性赤眼,一切眼疾,都加以治疗,三次搐鼻给药。
药材:鹅不食草(洗净,晒干)、香白芷(洗)、当归(去须洗)、羊踯躅花(减半)、川附子(炮制,去皮脐)、雄黄(另研后加入,各等分)。
以上研为细末,加入少许麝香,混合均匀。含水含于口中,滴入鼻内,直到排尽浊涕,眼泪流出为止。
Wherever the red vessels (hyperemia of conjunctival blood vessels) and nebulae (corneal opacity) initially develop from top to bottom, it belongs to the Taiyang (Greater Yang) channel. Since the Taiyang channel governs the exterior, the pathology must involve pain in the supraorbital ridge, or pain at the vertex of the head, or swelling and pain on one side of the head. The treatment should employ warming and dispersing methods. Wherever the red vessel nebula develops from bottom to top, or spreads from the interior to the exterior, it all belongs to the Yangming (Yang Brightness) channel. Since the Yangming channel governs the interior, the symptoms often present as heat syndromes or solidified stool (constipation). The treatment should employ purgative and cooling methods. Wherever the red vessel nebula initially invades from the exterior to the interior, it is governed by Shaoyang (Lesser Yang), which controls the half-exterior and half-interior. The treatment should employ harmonizing methods. Nebulae occur when wind-heat pathogenic factors are severe, or when macules enter the eye; this indicates that Liver Qi is exuberant and the disease manifests on the exterior. Since the nebula forms on the exterior, it is clear that dispersing and eliminating methods should be used. If one instead uses draining and purging methods, the pathogenic factor will retract inward, causing the nebula to become deeper. When the pathogenic factor is unsettled, it is called "Heat Nebula" and is superficial; when the pathogenic factor has settled, it is called "Water Nebula" and is deep; when the pathogenic factor is firm and deep, it is called "Sunken Nebula." One should use dispersing agents to agitate the pathogenic factor again so that the nebula floats up, then assist with anti-nebula drugs to allow it to disappear naturally. For chronic conditions, rapid effects cannot be expected; gradual elimination over months and years is appropriate. For newly formed nebulae, Dongyuan's Qianghuo Chuyi Decoction (Notopterygium and Rhizoma Ligustici Decoction for Removing Nebulae) can be used for exterior dispersal; for heat syndromes, Tuī Yún Wán (Cloud-Dispersing Pill) and similar formulas may be used; for dispersing sunken nebulae, Lingyangjiao San (Antelope Horn Powder) from *Baoming Ji* (Collection Preserving Life) can be used. Application depends on careful consideration. For those with Yin deficiency and heat, Shenxian Tuī Yún Wán (Immortal Cloud-Dispersing Pill) should be taken concurrently.
The condition of Yellow Membrane Rushing Upward is most authentic. Within Fengyun Gao (Wind-Cloud Ointment), yellow clouds arise. Located deep within the boundary between the white sclera and black cornea, they directly flood the pupil from the Kan position (associated with the Kidney/pupil). This is due to constipation, and headache is the worst symptom. Meridians are often obstructed, with fire, dryness, astringency, and inflammation steaming upward. Mistaking Yongbo Yi (Wave Ripple Opacity) for this condition will only result in blurred vision.
This syndrome occurs at the lower margin of the Wind Wheel (black cornea), between the Kan positions, initially appearing yellow within the Shen Gao (internal ocular fluids/tissues), resembling the white rock at the root of a human fingernail. In cases of Nourzhi Yi (Congealed Fat Opacity), the congealed fat originates outside the wheel, and topical medication can remove it. However, this condition lies within the internal tissues, where topical medication cannot reach. If it spreads to the pupil, the eyeball will inevitably rupture. It must not be mistaken for Yongbo Yi for treatment. This is caused by extreme obstruction of meridians, Guan Ge (blockage of upper and lower passages) of the San Jiao (Triple Burner), and excess of Fire and Earth pathogenic factors. Consequently, there is constipation and urinary retention, leading to the steaming of internal fire into pus. If the upward rush is untreated, complications such as protruding eyes (exophthalmos) will certainly occur. The following formula is suitable:
Tongpi Xiewei Tang (Splea-Clearing and Stomach-Purging Decoction): This syndrome is extremely adverse and cannot be cured by a single formula alone. One must investigate the deficiency or excess indicated by the pulse and prescribe formulas according to the specific etiology.
Ingredients: Maidong (Ophiopogonis Radix, heart removed), Chongweizi (Ecliptae Fructus) (each 1.5 qian); Zhimu (Anemarrhenae Rhizoma), Xuanshen (Scrophulariae Radix), Cheqianzi (Plantaginis Semen), Shigao (Gypsum Fibrosum), Fangfeng (Saposhnikoviae Radix) (each 1 qian); Huangqin (Scutellariae Radix), Tiandong (Asparagi Radix), Dahuang (Rhei Radix et Rhizoma, prepared) (each 0.7 qian).
Process: Cut into pieces. Decoct in two zhong of plain water until reduced to eight fen. Take after meals. For severe heat, add Xuanmingfen (Mirabilite) 1 qian.
Liying San (Instant-Efficacy Powder): Treats internal and external nebulae, blurriness and astringency with excessive tearing, acute red eye, and all types of eye diseases. Administer via nasal insufflation three times.
Ingredients: Euphorbiae Hirtae Herba (cleaned, dried), Baizhi (Angelicae Dahuricae Radix, washed), Danggui (Angelicae Sinensis Radix, whiskers removed, washed), Yangzhizhu Hua (Rhododendri Mollis Flos, halved), Chuan Fuzi (Aconiti Lateralis Radix Praeparata, processed, skin and umbilicus removed), Xionghuang (Realgar) (separately ground and added later) (equal parts).
Process: Grind into a fine powder. Add a small amount of Shexiang (Moschus) and mix evenly. Hold water in the mouth, instill into the nose, until turbid discharge and tears are completely expelled.