足太阳经为目上纲。足阳明经为目下纲。热则筋纵目不开。宜服助阳活血汤。(见卷二。)又小儿初生
下眼不开者。由产母过食辛热等物。致成斯疾。治法当以熊胆少许蒸水洗眼上。一日七次。如三日不
开。用生地黄散服。凡小儿不洗净。则秽汁必致浸渍于目 中。使眼赤烂。至长不瘥。
人参汤(治风头眩。但觉地屋俱转。目闭不敢开。)
人参 麦门冬(去心) 当归(酒制) 白术 防风(各八分) 白芍药 独活 黄 (各一钱二分) 官桂(去
皮七分)
上锉剂。白水二钟。煎至八分。去滓。食远服。
生地黄散
干地黄 赤芍药 川芎 甘草 当归身 天花粉(各等分)
上为细末。量其大小。灯心汤调。搽入口内。
集成。直视者。视物而目睛不转动者是也。若目睛动者。非直视也。伤寒直视者。邪气壅盛。冒其正气。使
神气不慧。脏腑之气不上荣于目。则目为之直视。伤寒至于直视。为邪气已极。证候已逆。多难治。经曰。
衄家不可发汗。发汗则额上陷。脉紧急。直视不能 。不能眠。以肝受血而能视。亡血。肝家气已虚。目气
已弱。又发汗亡阳。则阴阳俱虚所致。此虽错逆。犹未甚也。逮狂言反目直视。又为肾绝。直视摇头。又为
心绝。皆脏腑气脱绝也。直视谵语喘满者死。厥逆者亦死。又剧者发狂则不识人。循衣摸床。惕而不安。
微喘直视脉弦涩者死。皆邪气盛而正气脱也。素问曰。少阳终者。其百节纵。目 绝系。王注曰。 谓
直视如惊貌。目系绝。故目不动而直视。
足太阳经是眼睛的上眼睑(目上纲)。足阳明经是眼睛的下眼睑(目下纲)。若受热邪影响,筋脉松弛,导致眼睛无法睁开。适宜服用助阳活血汤。(参见卷二。)另外,小儿刚出生时下眼睑不睁开,是因为产母在孕期过食辛辣温热之物,从而造成此病。治疗方法应当用少许熊胆蒸水清洗眼部,每日七次。如果三天后仍不睁开,则内服生地黄散。凡是小儿出生后未能清洁干净,污秽汁液必然浸渍眼中,导致眼睛红肿溃烂,直至长大也无法痊愈。
人参汤(治疗头风眩晕,只感觉天地房屋都在旋转,眼睛紧闭不敢睁开。)
人参、麦门冬(去心)、当归(酒制)、白术、防风(各八分)、白芍药、独活、黄芩(各一钱二分)、官桂(去皮七分)
以上药材切碎成剂,加水两钟,煎煮至八分,滤去药渣,在饭后服用。
生地黄散
干地黄、赤芍药、川芎、甘草、当归身、天花粉(各等分)
以上药材研为细末,根据患者年龄大小,用灯心草汤调匀,涂抹入口内。
集成:所谓“直视”,是指注视物体时眼珠不转动。如果眼珠能转动,就不是直视。伤寒病出现直视症状,是因为邪气壅盛,蒙蔽正气,使神气昏昧,脏腑之气不能上行荣养于目,从而导致眼睛直视。伤寒发展到直视阶段,说明邪气已至极点,证候已属逆证,大多难以治愈。《内经》说:经常鼻出血的人不可发汗,若误用发汗法,会导致额部凹陷,脉象紧急,眼睛直视不能闭目,不能安眠。因为肝受血滋养才能视物,失血过多则肝气已虚,目气已弱,再加上发汗导致亡阳,这是阴阳俱虚所致。这种情况虽然错乱逆乱,但还算不太严重。等到出现胡言乱语、反白眼直视,则是肾气绝的表现;直视且摇头,则是心气绝的表现,这都是脏腑之气脱绝的现象。出现直视、谵语、喘满的会死亡,四肢厥逆的也会死亡。病情更重的出现发狂不识人,抓摸衣被床沿,惊恐不安,微喘且直视,脉象弦涩的也会死亡,这都是邪气盛而正气脱绝的结果。《素问》说:少阳经气终绝时,全身关节松弛无力,目系断绝。王冰注解说:“”指直视如受惊的样子。目系断绝,所以眼睛不动而直视。
The Foot-Taiyang Meridian serves as the upper eyelid (Shanggang of the eye). The Foot-Yangming Meridian serves as the lower eyelid (Xiagang of the eye). When affected by Heat, the tendons become flaccid, resulting in the inability to open the eyes. It is appropriate to administer Zhuyang Huoxue Tang (Assisting Yang and Invigorating Blood Decoction) [see Volume 2]. Additionally, when an infant's lower eyelids do not open at birth, it is caused by the mother consuming excessive spicy and hot substances during pregnancy, leading to this condition. The treatment method should involve washing the eyes with water steamed with a small amount of Xiongdan (Bear Bile), seven times a day. If they remain closed after three days, Shengdihuang San (Rehmannia Root Powder) should be taken internally. If a newborn is not cleaned properly, foul fluids will inevitably soak into the eyes, causing redness and ulceration that may persist until adulthood without healing.
Renshen Tang (Ginseng Decoction) (Treats Toufeng Xuanxuan [Head Wind Dizziness], where one feels the ground and houses are spinning, and the eyes are tightly closed and dare not open.)
Renshen (Radix Ginseng), Maimendong (Ophiopogonis Radix, heart removed), Danggui (Radix Angelicae Sinensis, wine-processed), Baizhu (Atractylodis Macrocephalae Rhizoma), Fangfeng (Saposhnikoviae Radix) (each 8 fen), Baishaoyao (Paeoniae Radix Alba), Duhuo (Angelicae Pubescentis Radix), Huangqi (Astragali Radix) (each 1 qian 2 fen), Guigui (Cinnamomi Ramulus, bark removed, 7 fen).
Crush these ingredients into pieces. Add two zhong of clear water, decoct until eight fen remains, remove the dregs, and take after meals.
Shengdihuang San (Rehmannia Root Powder)
Shengdihuang (Rehmanniae Radix Preparata), Chishaoyao (Paeoniae Radix Rubra), Chuanxiong (Ligustici Chuanxiong Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Dangguishen (Radix Angelicae Sinensis, root body), Tianhuafen (Trichosanthis Radix) (each equal parts).
Grind these into a fine powder. According to the patient's age/size, mix with Dengxin Tang (Junci Medullae Decoction), and apply inside the mouth.
Chengji: "Zhishi" (Fixed Gaze) refers to staring at objects without the eyeballs moving. If the eyeballs move, it is not Zhishi. In Shanghan (Cold Damage Disease), Zhishi occurs because pathogenic factors are abundant and obstruct the healthy Qi, causing the Shen Qi (Spiritual Energy) to become dull. The Qi of the Zang-Fu organs fails to ascend to nourish the eyes, resulting in fixed gaze. When Shanghan progresses to Zhishi, it indicates that pathogenic factors have reached their extreme and the syndrome has become rebellious; it is mostly difficult to treat. The Classics state: Those who suffer from frequent epistaxis (Nujia) should not undergo sweating therapy. If sweating is induced erroneously, the forehead may sink, the pulse becomes tight and urgent, the eyes stare fixedly unable to close, and sleeplessness ensues. This is because the Liver receives blood to enable vision; loss of blood makes Liver Qi deficient and Eye Qi weak. Furthermore, sweating causes Yang depletion, leading to deficiency of both Yin and Yang. Although this disorder is rebellious, it is not yet severe. However, when delirious speech, reversed eyes, and fixed gaze appear, it signifies Kidney exhaustion; fixed gaze accompanied by head shaking signifies Heart exhaustion. These are all manifestations of Zang-Fu Qi exhaustion. Fixed gaze with delirium and fullness in the chest with panting leads to death; Jueni (Cold extremities) also leads to death. In more severe cases, mania with inability to recognize people, grasping at clothes and bedrails, fearfulness and restlessness, slight panting, fixed gaze, and a wiry and choppy pulse indicate death. These are all due to excess of pathogenic factors and exhaustion of healthy Qi. Suwen states: When Shaoyang Qi terminates, the joints become flaccid, and the Musi (Eye Ties/Meridian connections) sever. Wang Bing's commentary notes: "Mu" refers to the appearance of fixed gaze like shock. Since the Musi are severed, the eyes do not move but stare fixedly.