积者重叠不解之貌。热为阳。阳平为常。阳淫为邪。邪行则病易见。易见则易治。此则前篇淫热之病也。若
邪深则不行。不行则伏。因伏而又伏。故日渐月聚。势不得不为积也。积已久。久积必溃。溃则难治。难治者。
非不治也。为邪积久。久则必溃。溃犹败也。其病隐涩不自在。稍觉 。视物微昏。内 开窍如针。目痛按
之则沁沁脓出。有两目俱病者。有一目独病者。目属肝。内 属膀胱。此盖二经积邪之所致也。故曰热积
必溃之病。又曰漏睛眼者是也。竹叶泻经汤主之。大便不硬者。减大黄为用。蜜剂解毒丸主之。不然。药误
病久。终为枯害矣。
竹叶泻经汤（治眼目瘾涩。稍觉 。视物微昏。内 开窍如针。目痛。按之脓浸出。）
柴胡 栀子仁（炒） 川羌活 升麻 甘草（炙） 川黄连（各五分） 白茯苓
泽泻 赤芍 草决明 车前子（各四分） 黄芩 大黄（各六分） 青竹叶（十片）
上锉剂。水二钟。煎至一钟。食后温服。
上方逆攻者也。先以行足厥阴肝。足太阳膀胱之药为君。柴胡、羌活是也。二经生意。皆总于脾胃。以调
足太阴足阳明之药为臣。升麻、甘草是也。肝经多血。以通顺血脉。除肝邪之药。膀胱经多湿。以利小便。
除膀胱湿之药为佐。赤芍药、草决明、泽泻、茯苓、车前子是也。总破其积热者。必攻必开。必利必除之药
为使。栀子、黄芩、黄连、大黄、竹叶是也。
蜜剂解毒丸（治证同上）
山栀仁（炒末十两） 杏仁（泡去皮尖取霜二两） 锦纹大黄（末五两） 川石蜜（一斤炼熟）
上末和蜜为丸。如桐子大。每服三十丸。加至百丸。茶汤送下。
上方以杏仁甘润治燥为君。为燥为热之原也。山栀子微苦寒治烦为臣。为烦为热所致也。石蜜甘平
温。安五脏为佐。为其解毒除邪也。大黄苦寒。性走不守。泻诸实热为使。为攻其积。不令其重叠不解也。
积，是指病邪重叠郁结、难以解散的状态。热属于阳邪。阳气平和是常态，阳气过盛则为邪气。邪气运行则疾病容易显现，容易显现就容易治疗。这指的是前一篇中提到的因淫热导致的疾病。如果邪气深入，则不能正常运行；不能正常运行就会潜伏；因为潜伏而又再次潜伏，所以日积月累，势力增长，不得不形成“积”。积存在已久，久积必然溃破。溃破后则难以治疗。所谓难治，并非不可治，而是因为邪气积聚时间长久，久了必然溃破。“溃”如同腐败败坏。其病症表现为眼部隐涩不适、不自在，稍微感觉模糊，视物轻微昏暗，内眦开窍处如针刺般疼痛，按压眼睛则有脓液渗出。有的双眼都患病，有的仅一只眼患病。目（眼睛）归属于肝，内眦归属于膀胱。这大概是足厥阴肝经和足太阳膀胱经积聚邪气所致。所以说这是“热积必溃之病”，又称为“漏睛眼”。主要使用竹叶泻经汤治疗。如果大便不硬结的，减少大黄的使用量。或者使用蜜剂解毒丸治疗。否则，若用药错误或病情迁延日久，最终会导致眼部枯槁损害。
竹叶泻经汤（治疗眼目隐涩不适，稍觉模糊，视物轻微昏暗，内眦开窍处如针刺般疼痛，目痛，按压有脓液浸出。）
柴胡、栀子仁（炒）、川羌活、升麻、甘草（炙）、川黄连（各五分），白茯苓、泽泻、赤芍、草决明、车前子（各四分），黄芩、大黄（各六分），青竹叶（十片）。
以上药物切碎成剂，用水二钟，煎煮至一钟，饭后温服。
上方属于逆攻之法。先以通行足厥阴肝经、足太阳膀胱经的药物作为君药，即柴胡、羌活。这两条经脉的生发之气，都统摄于脾胃，因此以调理足太阴脾经、足阳明胃经的药物作为臣药，即升麻、甘草。肝经多血，用通顺血脉、祛除肝经邪气的药物作为佐药；膀胱经多湿，用利小便、祛除膀胱湿气的药物作为佐药，即赤芍药、草决明、泽泻、茯苓、车前子。总攻破除积热的药物，必须具有攻散、开通、通利、清除的作用，作为使药，即栀子、黄芩、黄连、大黄、竹叶。
蜜剂解毒丸（主治证候同上）
山栀仁（炒成末十两）、杏仁（泡去皮尖取霜二两）、锦纹大黄（末五两）、川石蜜（一斤炼熟）。
以上研为细末，和蜂蜜制成丸药，大小如梧桐子大。每次服用三十丸，加至一百丸，用茶汤送服。
上方以杏仁的甘润性质治疗燥邪作为君药，因为燥是热的根源。山栀子味微苦寒，治疗烦热作为臣药，因为烦是由热引起的。石蜜味甘平温，安养五脏作为佐药，因为它能解毒除邪。大黄味苦寒，性善走而不守，泻除各种实热作为使药，以攻逐积热，不让其重叠郁结不解。
Ji (Accumulation) refers to the appearance of pathogenic factors overlapping and failing to resolve. Heat belongs to Yang. When Yang is balanced, it is normal; when Yang is excessive, it becomes pathogenic. When pathogens circulate, diseases easily manifest; when they easily manifest, they are easy to treat. This refers to the disease caused by exuberant heat mentioned in the previous chapter. If pathogens penetrate deeply, they cannot circulate freely; if they cannot circulate, they become latent; due to being latent and then becoming more latent, day by day and month by month, they accumulate, inevitably forming an "accumulation." Once an accumulation has existed for a long time, long-standing accumulations must ulcerate. Once ulcerated, it is difficult to treat. "Difficult to treat" does not mean untreatable, but rather that because pathogens have accumulated for a long time, they will eventually ulcerate. "Ulceration" is like decay or corruption. The symptoms include a sensation of itching and dryness in the eyes with discomfort, slight blurriness, dim vision, a needle-like pain at the inner canthus opening, and pus oozing out upon pressing the eye. Some patients have both eyes affected, while others have only one eye affected. The eyes belong to the Liver, and the inner canthus belongs to the Bladder. This is likely caused by the accumulation of pathogens in the Foot-Jueyin Liver Meridian and the Foot-Taiyang Bladder Meridian. Therefore, it is called the disease of "heat accumulation leading to inevitable ulceration," also known as "leaking tear duct eye" (Lou Jing Yan). It is primarily treated with Zhuye Xiejing Tang (Bamboo Leaf Decoction for Draining the Eye Channel). If the stool is not hard, reduce the dosage of Dahuang (Rhubarb Root and Rhizome). Alternatively, use Miji Jiedu Wan (Honeyed Pill for Detoxification). Otherwise, if medication is incorrect or the disease persists for a long time, it will ultimately lead to withering and damage of the eye.
Zhuye Xiejing Tang (Treats itching and dryness in the eyes, slight blurriness, dim vision, needle-like pain at the inner canthus opening, eye pain, and pus oozing upon pressure.)
Chaihu (Bupleuri Radix), Zhizi Ren (Gardeniae Fructus, stir-fried), Chuan Qianghuo (Notopterygii Rhizoma et Radix), Shengma (Cimicifugae Rhizoma), Gancao (Liquorice Root and Rhizoma, honey-fried), Chuan Huanglian (Coptidis Rhizoma) (each 5 fen); Bai Fuling (Poria), Zexie (Alisma Rhizoma), Chi Shao (Red Peony Root), Caojueming (Cassiae Semen), Cheqianzi (Plantaginis Semen) (each 4 fen); Huangqin (Scutellariae Radix), Dahuang (Rhei Radix et Rhizoma) (each 6 fen); Qingzhuye (Fresh Bamboo Leaf) (10 slices).
The above ingredients are cut into pieces. Add two zhong of water, decoct until one zhong remains. Take warm after meals.
The above formula employs a counter-attacking method. First, herbs that unblock the Foot-Jueyin Liver Meridian and the Foot-Taiyang Bladder Meridian are used as Sovereign drugs: Chaihu (Bupleuri Radix) and Qianghuo (Notopterygii Rhizoma et Radix). The vital energy of these two meridians is governed by the Spleen and Stomach. Therefore, herbs that regulate the Foot-Taiyin Spleen Meridian and the Foot-Yangming Stomach Meridian are used as Minister drugs: Shengma (Cimicifugae Rhizoma) and Gancao (Liquorice Root and Rhizoma). The Liver Meridian is rich in blood; thus, herbs that promote smooth blood circulation and eliminate Liver pathogens are used as Assistant drugs. The Bladder Meridian is prone to dampness; thus, herbs that promote urination and eliminate Bladder dampness are used as Assistant drugs: Chishao (Red Peony Root), Caojueming (Cassiae Semen), Zexie (Alisma Rhizoma), Fuling (Poria), and Cheqianzi (Plantaginis Semen). To break down accumulated heat, herbs that attack, open, drain, and clear are used as Envoy drugs: Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Dahuang (Rhei Radix et Rhizoma), and Zhuye (Bamboo Leaf).
Miji Jiedu Wan (Treats the same conditions as above)
Shanzhi Ren (Gardeniae Fructus, stir-fried and powdered, 10 liang), Xingren (Apricot Seed, soaked, skin and tip removed, pressed into paste, 2 liang), Jinwen Dahuang (Rhei Radix et Rhizoma, high-quality variety, powdered, 5 liang), Chuan Shimì (Rock Sugar from Sichuan, refined, 1 jin).
Grind all into powder, mix with honey to form pills the size of tung tree seeds. Take 30 pills per dose, increasing up to 100 pills, taken with tea soup.
In the above formula, Xingren (Apricot Seed) with its sweet and moist nature treats dryness as the Sovereign drug, because dryness is the origin of heat. Shanzhizi (Gardeniae Fructus) with its slightly bitter and cold nature treats irritability as the Minister drug, because irritability is caused by heat. Shimì (Rock Sugar) with its sweet, neutral, and warm nature calms the Five Zang Organs as the Assistant drug, because it detoxifies and eliminates pathogens. Dahuang (Rhei Radix et Rhizoma) with its bitter and cold nature moves freely without staying put, purging various excess heats as the Envoy drug, to attack the accumulation and prevent it from overlapping and failing to resolve.