强者盛而有力也。实者坚而内充也。故有力者强而欲抟。内充者实而自收。是以阴阳无两强。亦无两实。
惟强与实。以偏则病。内抟于身。上见于虚窍也。足少阴肾为水。肾之精上为神水。手厥阴心包络为相火。
火强抟水。水实而自收。其病神水紧小。渐小而又小。积渐之至瞳仁竟如菜子许。又有神水外围。相类虫
蚀者。然皆能睹而不昏。但微觉 羞涩耳。是皆阳气强盛而抟阴。阴气坚实而有御。虽受所抟。终止于
边鄙皮肤也。内无所伤动。治法当抑阳缓阴则愈。以其强耶。故可抑。以其实耶。惟可缓。而不宜助。助之则
反胜。抑阳酒连散主之。大抵强者则不易入。故以酒为之导引。欲其气味投合。入则可展其长。此反治也。
还阴救苦汤主之。疗相火药也。亦宜用 鼻碧云散。然此病世亦罕见。医者要当识之。
抑阳酒连散(治神水紧小。渐如菜子大许。神水外围相类虫蚀者。然皆能睹物不昏。微有 涩之症。)
独活 生地黄(各四钱) 黄柏 汉防己 知母(各三钱) 蔓荆子 前胡
川羌活 白芷 生甘草(各四钱) 防风(各四钱) 山栀(炒) 黄芩(酒制) 寒水石 黄连(酒制各五钱)
共为末。每服三钱。白水二钟。煎至一钟。去滓。大热服。
上方抑阳缓阴之药也。以生地黄补肾水真阴为君。独活、黄柏、知母俱益肾水为臣。蔓荆子、羌活、防风、
白芷。群队升阳之药为佐者。谓既抑之令其分。而更不相犯也。生甘草、黄芩、栀子、寒水石、防己、黄连。寒
而不走之药为使者。惟欲抑之。不欲祛除也。凡用酒制者。为之引导耳。
强壮,是指脉气旺盛且有力。充实,是指体内精气坚满而充盈。因此,脉气有力的表现为强劲且欲聚结;体内精气的表现为充实而自然收敛。所以,阴阳二者不能同时处于过强或过实的状态。
只有当“强”与“实”出现偏颇时才会致病,这种病理状态会在体内聚结,并在头面部的空窍(如眼目)上表现出来。足少阴肾属水,肾的精气上行化为神水(指瞳仁内的清澈液体,中医认为与视力密切相关)。手厥阴心包络属相火。
若相火过强而搏结于肾水,肾水因充实而自行收敛,其病症表现为神水紧缩变小,逐渐越来越小,最终瞳孔缩小至如菜籽大小。此外,神水外围可能出现类似被虫蛀蚀的形态。然而,患者虽然瞳孔缩小,仍能视物而不昏花,只是略微感到眼部干涩不适。这些都是阳气过盛而搏结阴液,阴气坚实而有抵御能力所致。虽然受到阳气的搏结,但病邪仅停留在边缘的皮肤层面,内部脏腑并未受到损伤。治疗方法应当抑制阳气、缓和阴气,即可痊愈。因为阳气过强,所以可以抑制;因为阴气充实,所以只能缓和,而不宜助长。若助长阴气,反而会导致阴胜阳衰。主方使用抑阳酒连散。
大抵而言,药性刚强者不易直接进入病所,因此用酒作为引导,使药味与病情相契合,进入体内后便能发挥其特长,这属于“反治法”。另外可用还阴救苦汤,这是治疗相火的方剂。也适宜使用鼻碧云散。然而此病在世间极为罕见,医生应当知晓。
抑阳酒连散(主治神水紧缩变小,逐渐如菜籽大小,神水外围类似虫蚀之状,然皆能视物不昏花,微有干涩症状。)
药材组成:独活、生地黄(各四钱)、黄柏、汉防己、知母(各三钱)、蔓荆子、前胡、川羌活、白芷、生甘草(各四钱)、防风(各四钱)、山栀(炒制)、黄芩(酒制)、寒水石、黄连(酒制,各五钱)。
制作与服用方法:将上述药物共研为细末。每次服用三钱,加水二钟,煎煮至一钟,去渣滓,趁大热服用。
上方为抑阳缓阴的药物组合。以生地黄补肾水真阴作为君药;独活、黄柏、知母均辅助益肾水作为臣药;蔓荆子、羌活、防风、白芷,这些升提阳气的药物群作为佐药,意思是既抑制了亢盛的阳气使其分散,从而不再相互侵犯;生甘草、黄芩、栀子、寒水石、防己、黄连,这些寒凉但不走窜的药物作为使药,目的在于抑制亢阳,而非祛除病邪。凡是使用酒制的药物,是为了起到引导作用。
Strength (Qiang) refers to the pulse being vigorous and forceful. Solidity (Shi) refers to the interior being firm and filled with essence. Therefore, what is forceful manifests as strong and prone to coalescing; what is filled manifests as solid and naturally contracting. Thus, Yin and Yang cannot both be excessively strong or excessively solid.
Only when "strength" and "solidity" become unbalanced does disease arise. This pathological state coalesces within the body and manifests externally in the hollow orifices (such as the eyes). The Foot-Shaoyin Kidney channel belongs to Water; the essence of the Kidney ascends to form Shen Shui (divine water, referring to the clear fluid within the pupil associated with vision). The Hand-Jueyin Pericardium channel belongs to Ministerial Fire.
If Ministerial Fire becomes excessive and coalesces upon Kidney Water, and Kidney Water becomes solid and contracts naturally, the pathology presents as Shen Shui tightening and shrinking, gradually becoming smaller until the pupil is reduced to the size of a vegetable seed. Additionally, the periphery of Shen Shui may resemble lesions caused by insect erosion. However, despite this, the patient can still see without blurring, experiencing only slight dryness and astringency in the eyes. These conditions result from Excessive Yang coalescing with Yin, while Yin Qi is solid and capable of defense. Although affected by the coalescence, the pathogen remains confined to the peripheral skin, causing no internal damage to the organs. The treatment method should suppress Yang and moderate Yin, leading to recovery. Because Yang is excessive, it can be suppressed; because Yin is solid, it can only be moderated, not assisted. Assisting it would lead to Yin overcoming Yang. The primary formula is Yiyang Jiulian San (Suppress Yang Wine-Processed Coptis Powder).
Generally speaking, potent medicinal properties do not easily penetrate the disease site; therefore, wine is used as a guide to ensure the medicinal flavors align with the condition, allowing them to exert their full effect once inside. This constitutes a "contrary treatment" (Fan Zhi). Alternatively, Huanyin Jiuku Tang (Restore Yin Rescue Suffering Decoction) may be used, which is a formula for treating Ministerial Fire. Biyun San (Nasal Jade Cloud Powder) is also suitable. However, this disease is extremely rare in the world, and physicians must be aware of it.
Yiyang Jiulian San (Indicated for Shen Shui tightening and shrinking to the size of a vegetable seed, with the periphery resembling insect erosion, yet vision remains clear without blurring, accompanied by slight dryness/astringency.)
Ingredients: Duhuo (Angelicae Pubescentis Radix), Sheng Dihuang (Rehmanniae Radix Recens) (each 4 qian); Huangbai (Phellodendri Cortex), Han Fangji (Stephaniae Tetrandrae Rhizoma), Zhimu (Anemarrhenae Rhizoma) (each 3 qian); Manjingzi (Vittariae Fructus), Qianhu (Peucedani Radix); Chuan Qianghuo (Notopterygii Rhizoma et Radix), Baizhi (Angelicae Dahuricae Radix), Sheng Gancao (Glycyrrhizae Radix et Rhizoma Recens) (each 4 qian); Fangfeng (Saposhnikoviae Radix) (4 qian); Shanzhi (Gardeniae Fructus, stir-fried), Huangqin (Scutellariae Radix, wine-processed), Hanshuishi (Calcitum), Huanglian (Coptidis Rhizoma, wine-processed) (each 5 qian).
Preparation and Administration: Grind all ingredients into a fine powder. Take 3 qian per dose, add 2 zhong of plain water, decoct until 1 zhong remains, remove the dregs, and consume while very hot.
The above formula consists of herbs that suppress Yang and moderate Yin. Sheng Dihuang (Rehmanniae Radix Recens) tonifies the true Yin of Kidney Water and serves as the Sovereign (Jun) herb. Duhuo, Huangbai, and Zhimu assist in benefiting Kidney Water and serve as Ministers (Chen). Manjingzi, Qianghuo, Fangfeng, and Baizhi are a group of herbs that raise Yang, serving as Assistants (Zuo); their function is to suppress the excess so that it disperses and no longer invades one another. Sheng Gancao, Huangqin, Zhizi, Hanshuishi, Fangji, and Huanglian are cold herbs that do not disperse rapidly, serving as Envoys (Shi); their purpose is solely to suppress, not to expel. Any herbs processed with wine are included merely for guidance/leading purposes.