气阳也。类天之云雾。性本动。聚其体也。聚为阴。是阳中之阴。乃离中有水之象。阳外阴内。故聚也。纯阳。故
不聚也。不聚则散。散则经络不收。经曰。足阳明胃之脉。常多气多血。又曰。足阳明胃之脉。常生气生血。七
情内伤。脾胃先病。怒。七情之一也。胃病脾病。气亦病焉。阴阳应象大论曰。足厥阴肝主木。在志为怒。怒甚
伤肝。伤脾胃则气不聚。伤肝则神水散。何则。神水亦气聚也。其病无眵泪痛痒羞明紧涩之证。初但昏如
雾露中行。渐空中有黑花。又渐睹物成二体。久则光不收。遂为废疾。盖其神水渐散。而又散。终而尽散故
也。初渐之次。宜以千金磁朱丸主之。镇坠药也。石斛夜光丸主之。补益药也。益阴肾气丸主之。壮水药也。
有热者滋阴地黄丸主之。此病最难治。饵服上药。必要积以岁月。必要无饥饱劳役。必要驱七情五贼。必
要德性纯粹。庶几易效。不然必废。废则终不复治。久病光不收者。亦不复治。一证因为暴怒。神水随散。光
遂无收。都无初渐之次。此一得永不复治之证也。又一证为物所击。神水散如暴怒之证。亦不复治。俗名
为青盲者是也。世病者多不为审。概曰目昏无伤。始不经意。目病已成。世医亦不识。只曰热之所致。竟以
凉药投治之。殊不知凉药又伤胃。况不知凉为秋为金。肝为春为木。凉药又伤肝。往往致废然后已。病者
犹不以药为非。而委之曰命也。医者犹不自悟其药。而赘之曰病拙。吁。二者若此。罪将谁归。予屡见也。故
兼陈凉药之误。
千金磁朱丸(治神水宽大渐散。昏如云雾中行。渐睹空中有黑花。渐睹物成二体。久则光不
收。及内障神水淡绿色淡白色者。)
磁石(吸针者佳) 辰砂 神曲
先以磁石置巨火中 。醋淬七次。晒干。另研极细二两。辰砂另研极细一两。生神曲末二两。与前药和
匀。更以神曲末一两。水和作饼。煮浮为度。搜入前药。炼蜜为丸。如桐子大。每服十丸。加至三十丸。空心饮汤下。
上方以磁石辛咸寒。镇坠肾经为君。令神水不外移也。辰砂微甘寒。镇坠心经为臣。肝其母。此子能令
母实也。肝实则目明。神曲辛温甘。化脾胃中宿食为佐。生用者发其生气。熟用者敛其暴气也。服药后。
俯视不见。仰视渐睹星月者。此其效也。亦治心火乘金。水衰反制之病。久病屡发者服之。则永不更作。
空心服之。午前更以石斛夜光丸主之。
滋阴地黄丸(治少血神劳肾虚。眼目昏暗。神水淡绿色淡白色。内障者。眵多 者。并治。)
当归身(酒制) 黄芩 熟地黄(各半两) 枳壳(炒三钱半) 天门冬(去心焙) 柴胡 五味子
甘草(各三钱) 生地黄(酒制两半) 黄连(一两) 地骨皮 人参(各二钱)
上为细末。炼蜜为丸。如桐子大。每服百丸。食后茶汤送下。日进三服。
上方治主以缓。缓则治其本也。以黄连、黄芩苦寒。除邪气之盛为君。当归身辛温。生熟地黄苦甘寒。养
血凉血为臣。五味子酸寒。体轻浮。收神水之散大。人参、甘草、地骨皮、天门冬、枳壳苦甘寒。泻热补气为
佐。柴胡引用为使也。亡血过多之病。有热者。兼服当归养荣汤。
石斛夜光丸(治内障初起。视觉微昏。空中有黑花。神水变淡绿色。次则睹物成二。神水变淡白色。
久则不睹。神水变纯白色。及有眵泪 等证。)
天门冬(去心) 麦门冬(去心) 人参 茯苓 熟地黄 生地黄(各一两) 牛膝(酒浸)
杏仁(去皮尖) 枸杞子(各七钱半) 草决明(八钱) 川芎 犀角(锉细末) 白蒺藜 羚羊角(锉细末)
枳壳(麸炒) 石斛 五味子(炒) 青葙子 甘草 防风 肉苁蓉 川黄连(各五钱) 菊花 山药 菟丝子(酒煮
各七钱)
上为细末。炼蜜为丸。如桐子大。每服三五十丸。温酒盐汤任下。
上方补益药也。补上治下。利以缓。利以久。不利以速也。故君以天门冬、人参、菟丝子之通肾安神。强阴
填精也。臣以五味子、麦冬、杏仁、茯苓、枸杞子、牛膝、生熟地黄。敛气除湿。凉血补血也。佐以甘菊花、蒺藜、
石斛、苁蓉、川芎、甘草、枳壳、山药、青葙子。疗风治虚。益气祛毒也。使以防风、黄连、草决明、羚羊角、犀角。
散滞泻热。解结明目也。阴弱不能配阳之病。并宜服之。此从则顺治之法也。
益阴肾气丸
白茯苓(乳蒸八钱) 泽泻(四钱) 当归尾(酒制) 丹皮 五味子 山药 山茱萸(去核酒制)
柴胡(各五钱) 熟地黄(酒蒸三两) 生地(酒炒四两)
上为细末。炼蜜为丸。如桐子大。外水飞辰砂为衣。每服五六十丸。空心淡盐汤送下。
上方壮水之主。以镇阳光。气为怒伤。散而不聚也。气病血亦病也。肝得血而能视。又目为心之窍。心主
血。故以熟地黄补血衰。当归尾行血。牡丹皮治积血为君。茯苓利中益真气。泽泻除湿泻邪气。生地黄
补肾水真阴为臣。五味子补五脏。干山药平气和胃为佐。山茱萸强阴益精通九窍。柴胡引入厥阴经
为使。蜜丸者。欲泥膈难下也。辰砂为衣者。为通于心也。
气属于阳。其形态类似于天上的云雾。本性是运动的。聚集起来形成形体,聚集的状态属于阴,这是阳中的阴,也就是离卦中蕴含水的意象。外阳内阴,所以能够聚集。如果是纯阳之气,就无法聚集。无法聚集就会消散,消散后经络就无法收敛固摄。《内经》说:足阳明胃经,通常多气多血。又说:足阳明胃经,常能化生气血。七情(喜、怒、忧、思、悲、恐、惊)内伤,脾胃首先患病。怒,是七情之一。胃病和脾病,气也会随之生病。《素问·阴阳应象大论》说:足厥阴肝主木,在情志上对应怒。大怒会损伤肝脏。损伤脾胃则气不能聚拢,损伤肝脏则神水(指眼内维持视力的精微物质)散失。为什么呢?因为神水也是气聚集而成的。这种病没有眼屎、流泪、疼痛、瘙痒、畏光、眼睑紧涩等症状。起初只是视力模糊,如同在雾露中行走,逐渐出现眼前有黑花飞舞,又逐渐看物体变成两个影像,时间久了光线无法收敛,最终成为废疾。这是因为神水逐渐散失,且不断散失,最终完全散尽的缘故。在病情初起渐变的阶段,适宜用千金磁朱丸主治。这是镇坠药。也可以用石斛夜光丸主治,这是补益药。还可以用益阴肾气丸主治,这是壮水药。如果有热象的,用滋阴地黄丸主治。这个病最难治疗,服用上述药物,必须积累岁月才能见效,必须避免饥饱不均和过度劳役,必须驱除七情和五贼(指嗜欲),必须保持德性纯粹,这样才容易见效。否则必然导致失明,一旦失明就最终无法再治。久病导致光线无法收敛的,也不再治疗。有一种证候是因为暴怒,神水随即散失,光线立刻无法收敛,完全没有初起渐变的阶段,这是一种一旦发作就永不复治的证候。另一种证候是被外力击打,神水散失如同暴怒之证,也不复治疗。俗称为青盲的就是这类病。世间的患者大多不仔细审视,一概认为目昏无碍,开始不在意。等到眼病已经形成,世俗医生也不认识,只说是热邪所致,竟然用凉药投治。殊不知凉药又会损伤胃气,况且不知道凉性对应秋季和金,肝对应春季和木,凉药又会损伤肝脏,往往导致失明才停止。患者还不认为药不对症,而推脱说是命运不好。医生也不自我醒悟用药错误,反而推诿说是医术拙劣。唉,两者都如此,罪责归谁呢?我屡次见到这种情况,所以一并陈述使用凉药的错误。
千金磁朱丸(治疗神水宽大逐渐散失,视力模糊如行于云雾中,逐渐看到空中有黑花,逐渐看物体成双影,时间久了光线不收,以及内障见神水呈淡绿色或淡白色者。)
磁石(以能吸针的为佳) 辰砂 神曲
先将磁石放在大火中烧红,用醋淬炼七次,晒干,另外研磨成极细粉二两。辰砂另外研磨成极细粉一两。生神曲末二两,与前药混合均匀。再用神曲末一两,用水调和做成饼,煮至浮起为度,揉入前药,用炼蜜制成丸,如梧桐子大。每次服用十丸,加量至三十丸,空腹时饮汤送下。
上方以磁石的辛咸寒之性,镇坠肾经为君药,使神水不外移。辰砂微甘寒,镇坠心经为臣药,肝为心之母,此为“子能令母实”。肝实则目明。神曲辛温甘,化解脾胃中宿食为佐药。生用可发其生气,熟用可敛其暴气。服药后,俯视看不见,仰视逐渐看到星月,这是药效的表现。也治疗心火乘金、水衰反制之病。久病屡发者服用,则永不复发。空腹服用。午前再以石斛夜光丸主治。
滋阴地黄丸(治疗少血神劳肾虚,眼目昏暗,神水淡绿色淡白色,内障者,眼屎多者,一并治疗。)
当归身(酒制) 黄芩 熟地黄(各半两) 枳壳(炒三钱半) 天门冬(去心焙干) 柴胡 五味子 甘草(各三钱) 生地黄(酒制一两半) 黄连(一两) 地骨皮 人参(各二钱)
以上研为细末,炼蜜制成丸,如梧桐子大。每次服用一百丸,饭后用茶汤送下,每日进服三次。
上方治疗原则以缓为主,缓则治其本。以黄连、黄芩苦寒之性,清除盛盛的邪气为君药。当归身辛温,生地黄、熟地黄苦甘寒,养血凉血为臣药。五味子酸寒,质地轻浮,收敛散大的神水。人参、甘草、地骨皮、天门冬、枳壳苦甘寒,泻热补气为佐药。柴胡作为引经药为使药。亡血过多的病,有热象的,兼服当归养荣汤。
石斛夜光丸(治疗内障初起,视觉轻微昏花,空中有黑花,神水变淡绿色,随后看物体成双影,神水变淡白色,时间久了看不见,神水变纯白色,以及有眼屎流泪等证候。)
天门冬(去心) 麦门冬(去心) 人参 茯苓 熟地黄 生地黄(各一两) 牛膝(酒浸) 杏仁(去皮尖) 枸杞子(各七钱半) 草决明(八钱) 川芎 犀角(锉成细末) 白蒺藜 羚羊角(锉成细末) 枳壳(麸炒) 石斛 五味子(炒) 青葙子 甘草 防风 肉苁蓉 川黄连(各五钱) 菊花 山药 菟丝子(酒煮各七钱)
以上研为细末,炼蜜制成丸,如梧桐子大。每次服用三五十丸,温酒或盐汤任便送下。
上方是补益药。补上治下,利以缓,利以久,不利以速。所以以天门冬、人参、菟丝子的通肾安神、强阴填精为君药。以五味子、麦冬、杏仁、茯苓、枸杞子、牛膝、生熟地黄敛气除湿、凉血补血为臣药。以甘菊花、蒺藜、石斛、苁蓉、川芎、甘草、枳壳、山药、青葙子疗风治虚、益气祛毒为佐药。以防风、黄连、草决明、羚羊角、犀角散滞泻热、解结明目为使药。阴弱不能配阳的病,都适宜服用。这是顺从病机治疗的法则。
益阴肾气丸
白茯苓(乳蒸八钱) 泽泻(四钱) 当归尾(酒制) 丹皮 五味子 山药 山茱萸(去核酒制) 柴胡(各五钱) 熟地黄(酒蒸三两) 生地(酒炒四两)
以上研为细末,炼蜜制成丸,如梧桐子大,外用飞过的辰砂为衣。每次服用五六十丸,空腹时用淡盐汤送下。
上方壮水之主,以镇阳光。气被怒所伤,散而不聚。气病则血亦病。肝得血才能视物,又眼睛是心的窍,心主血,所以以熟地黄补血衰,当归尾行血,牡丹皮治积血为君药。茯苓利中益真气,泽泻除湿泻邪气,生地黄补肾水真阴为臣药。五味子补五脏,干山药平气和胃为佐药。山茱萸强阴益精通九窍,柴胡引入厥阴经为使药。蜜丸是为了让药力停留难下(缓慢释放)。辰砂为衣是为了通达于心。
Qi belongs to Yang. Its form is similar to the clouds and mist in the sky. Its nature is dynamic. When gathered, it forms a body; the state of gathering belongs to Yin, which is the Yin within Yang, representing the image of water contained within the Li trigram (☲). Outer Yang and inner Yin allow for gathering. If it is pure Yang, it cannot gather. If it cannot gather, it scatters. Scattering causes the meridians to fail to restrain and consolidate. The Classics state: The Foot-Yangming Stomach Meridian usually has abundant Qi and Blood. It also states: The Foot-Yangming Stomach Meridian constantly generates Qi and Blood. Internal injury by the Seven Emotions (Joy, Anger, Worry, Overthinking, Sadness, Fear, Fright) first damages the Spleen and Stomach. Anger is one of the Seven Emotions. Disease of the Stomach and Spleen leads to disease of Qi. The Treatise on the Correspondence of Yin and Yang (Yin-Yang Ying-Xiang Da-Lun) states: The Foot-Jueyin Liver governs Wood and corresponds to Anger in emotions. Severe anger injures the Liver. Injury to the Spleen and Stomach prevents Qi from gathering; injury to the Liver causes the Shen Water (refined essence maintaining vision) to scatter. Why? Because Shen Water is also formed by the gathering of Qi. This disease presents without symptoms such as eye discharge, tearing, pain, itching, photophobia, or tightness and dryness of the eyelids. Initially, vision is merely blurred, as if walking in fog or dew. Gradually, black spots appear in the visual field. Then, objects are seen as double images. After a long time, light fails to converge, eventually resulting in disability. This is because the Shen Water gradually scatters and continues to scatter until it is completely exhausted. In the initial gradual stage, Qianjin Cizhu Wan (Thousand Gold Magnetite and Cinnabar Pill) should be used as the main treatment. This is a sedating and anchoring formula. Shihu Yeguang Wan (Dendrobium Night-Glowing Pill) can also be used as the main treatment; this is a tonifying formula. Yiyin Shenqi Wan (Nourish-Yin Kidney-Energy Pill) can also be used as the main treatment; this is a formula to strengthen Water. If there is heat, Ziyin Dihuang Wan (Nourish-Yin Rehmannia Pill) should be used. This disease is difficult to treat. Taking the above medicines requires accumulation over years to show effect. One must avoid irregular eating and excessive labor. One must dispel the Seven Emotions and the Five Thieves (desires). One must maintain pure virtue. Only then will recovery be likely. Otherwise, blindness will inevitably occur. Once blind, it cannot be treated again. For chronic cases where light fails to converge, treatment is no longer attempted. One syndrome occurs due to sudden rage, causing Shen Water to scatter immediately and light to fail to converge instantly, with no initial gradual stage. This is a syndrome that never recovers once it occurs. Another syndrome results from external trauma, where Shen Water scatters similarly to sudden rage, and also does not recover. This is commonly known as Qingmang (Green Blindness). Most patients do not examine carefully, generally believing that blurred vision is harmless and ignoring it initially. By the time eye disease is established, common physicians do not recognize it, attributing it solely to Heat, and administering cooling medicines. They do not realize that cooling medicines further damage Stomach Qi. Moreover, they fail to understand that cooling properties correspond to Autumn and Metal, while the Liver corresponds to Spring and Wood; thus, cooling medicines also injure the Liver, often leading to blindness before stopping. Patients still do not consider the medicine inappropriate, blaming fate instead. Physicians do not reflect on their erroneous prescriptions, blaming poor skill instead. Alas, both parties are like this; who bears the blame? I have witnessed this repeatedly, so I hereby state the errors of using cooling medicines.
Qianjin Cizhu Wan (Treats Shen Water widening and gradual scattering, blurred vision as if walking in clouds/mist, gradual appearance of black spots in the air, gradual diplopia, long-term failure of light convergence, and internal cataracts showing pale green or pale white Shen Water.)
Cishi (Magnetitum, preferably that attracts needles) Zhensha (Cinnabaris) Shenqu (Massa Medicata Fermentata)
First, place Magnetitum in a fierce fire until red-hot, quench in vinegar seven times, dry, and grind separately into an extremely fine powder (2 liang). Grind Cinnabaris separately into an extremely fine powder (1 liang). Use Massa Medicata Fermentata powder (2 liang), mix evenly with the previous powders. Take another 1 liang of Massa Medicata Fermentata powder, mix with water to make cakes, boil until they float, knead into the previous mixture, and form pills with refined honey, sized like paulownia seeds. Take 10 pills per dose, increasing to 30 pills, taken with warm water on an empty stomach.
In the above formula, Magnetitum, with its acrid, salty, and cold nature, anchors the Kidney Meridian as the Sovereign herb, preventing Shen Water from shifting outward. Cinnabaris, slightly sweet and cold, anchors the Heart Meridian as the Minister herb. The Liver is the Mother of the Heart; this follows the principle that "the Son can make the Mother solid." When the Liver is solid, vision is clear. Massa Medicata Fermentata, acrid, warm, and sweet, resolves retained food in the Spleen and Stomach as the Assistant herb. Raw use promotes its generating Qi; cooked use restrains violent Qi. After taking the medicine, if looking down reveals nothing but looking up gradually reveals stars and moon, this indicates efficacy. It also treats diseases where Heart Fire attacks Metal and Water deficiency allows counter-restriction. Taken by those with chronic, recurrent conditions, it prevents recurrence. Take on an empty stomach. In the forenoon, follow with Shihu Yeguang Wan.
Ziyin Dihuang Wan (Treats blood deficiency, mental fatigue, Kidney deficiency, dim vision, pale green or pale white Shen Water, internal cataracts, and excessive eye discharge.)
Dangguishen (Radix Angelicae Sinensis, stem) prepared with wine Huangqin (Radix Scutellariae) Shudihuang (Radix Rehmanniae Praeparata) (each half liang) Zhike (Fructus Aurantii, stir-fried) (3.5 qian) Tianmendong (Herba Asparagi, heart removed, roasted) Chaihu (Radix Bupleuri) Wuweizi (Fructus Schisandrae) Gancao (Radix Glycyrrhizae) (each 3 qian) Shengdihuang (Radix Rehmanniae, prepared with wine) (1.5 liang) Huanglian (Rhizoma Coptidis) (1 liang) Digupi (Cortex Lycii) Renshen (Radix Ginseng) (each 2 qian)
Grind all into fine powder. Form pills with refined honey, sized like paulownia seeds. Take 100 pills per dose, washed down with tea water after meals. Administer three times daily.
The treatment principle above emphasizes slowness; slowness treats the root. Huanglian and Huangqin, bitter and cold, eliminate excess pathogenic factors as the Sovereign herbs. Dangguishen, acrid and warm, along with Shengdihuang and Shudihuang, bitter, sweet, and cold, nourish and cool blood as the Minister herbs. Wuweizi, sour and cold, with a light floating nature, gathers scattered Shen Water. Renshen, Gancao, Digupi, Tianmendong, and Zhike, bitter, sweet, and cold, drain heat and tonify Qi as the Assistant herbs. Chaihu serves as the Guide herb. For diseases involving excessive blood loss with heat signs, combine with Danggui Yangrong Tang.
Shihu Yeguang Wan (Treats early-stage internal cataracts, slight visual blurring, black spots in the air, Shen Water turning pale green, followed by diplopia, Shen Water turning pale white, eventual blindness, Shen Water turning pure white, and symptoms such as eye discharge and tearing.)
Tianmendong (Herba Asparagi, heart removed) Maimendong (Herba Ophiopogonis, heart removed) Renshen (Radix Ginseng) Fuling (Sclerotium Poriae) Shudihuang (Radix Rehmanniae Praeparata) Shengdihuang (Radix Rehmanniae) (each 1 liang) Niuxi (Radix Achyranthis Bidentatae, soaked in wine) Xingren (Semen Pruni Armeniacae, skin and tip removed) Gouqizi (Fructus Lycii) (each 7.5 qian) Caojueming (Semen Cassiae) (8 qian) Chuanxiong (Rhizoma Chuanxiong) Xijiao (Cornu Rhinocerotis, ground to fine powder) Baijili (Fructus Tribuli) Lingyangjiao (Cornu Saigae Tataricae, ground to fine powder) Zhike (Fructus Aurantii, bran-fried) Shihu (Caulis Dendrobii) Wuweizi (Fructus Schisandrae, stir-fried) Qingxiangzi (Semen Celosiae) Gancao (Radix Glycyrrhizae) Fangfeng (Radix Saposhnikoviae) Rongzhu (Caulis Cistanches) Chuanhuilian (Rhizoma Coptidis) (each 5 qian) Juhua (Flos Chrysanthemi) Shanyao (Rhizoma Dioscoreae) Tusizi (Semen Cuscutae, boiled in wine) (each 7 qian)
Grind all into fine powder. Form pills with refined honey, sized like paulownia seeds. Take 30-50 pills per dose, washed down with warm wine or salt water at discretion.
The above formula is a tonifying preparation. Tonifies the upper, treats the lower; benefits through slowness, benefits through duration, not through speed. Therefore, Tianmendong, Renshen, and Tusizi, which unblock the Kidney, calm the Spirit, strengthen Yin, and fill Essence, are the Sovereign herbs. Wuweizi, Maimendong, Xingren, Fuling, Gouqizi, Niuxi, Shengdihuang, and Shudihuang, which gather Qi, remove dampness, cool blood, and nourish blood, are the Minister herbs. Juhua, Jili, Shihu, Rongzhu, Chuanxiong, Gancao, Zhike, Shanyao, and Qingxiangzi, which treat wind and deficiency, tonify Qi, and dispel toxins, are the Assistant herbs. Fangfeng, Huanglian, Caojueming, Lingyangjiao, and Xijiao, which disperse stagnation, drain heat, resolve knots, and brighten the eyes, are the Guide herbs. Diseases where Yin weakness fails to coordinate with Yang are suitable for this formula. This is the method of treating according to the顺应 (compliance) principle.
Yiyin Shenqi Wan
Baifuling (Poria, steamed with milk) (8 qian) Zexie (Radix Alismatis) (4 qian) Dangguwei (Radix Angelicae Sinensis, tail) prepared with wine Danpi (Cortex Moutan) Wuweizi (Fructus Schisandrae) Shanyao (Rhizoma Dioscoreae) Shanzhuyu (Fructus Corni, pitted, prepared with wine) Chaihu (Radix Bupleuri) (each 5 qian) Shudihuang (Radix Rehmanniae Praeparata, steamed with wine) (3 liang) Shengdi (Radix Rehmanniae, stir-fried with wine) (4 liang)
Grind all into fine powder. Form pills with refined honey, sized like paulownia seeds. Coat externally with Feichen Sha (water-triturated Cinnabar). Take 50-60 pills per dose, washed down with light salt water on an empty stomach.
The above formula strengthens the Master of Water to suppress Yang brilliance. Qi injured by anger scatters and fails to gather. Qi disease implies Blood disease. The Liver requires Blood to see. The eyes are the orifice of the Heart, and the Heart governs Blood. Therefore, Shudihuang tonifies Blood deficiency, Dangguwei moves Blood, and Mudanpi treats accumulated Blood as the Sovereign herbs. Fuling benefits the middle and augments True Qi, Zexie removes dampness and drains pathogenic factors, and Shengdihuang tonifies the True Yin of Kidney Water as the Minister herbs. Wuweizi tonifies the Five Zang organs, dried Shanyao harmonizes Qi and regulates the Stomach as the Assistant herbs. Shanzhuyu strengthens Yin, benefits Essence, and opens the nine orifices. Chaihu guides the formula into the Jueyin Meridian as the Guide herb. Honey pills are used to delay dissolution and absorption. Cinnabar coating is used to connect with the Heart.