按内经。运气泪出。皆从风热。经云。厥阴司天之政。三之气。天政布。风乃时举。民病泣出是也。
灵枢黄帝曰。人之哀而泣涕者。何气使然。岐伯曰。心者五脏六腑之主也。目者宗脉之所聚也。上液之
道也。口鼻者气之门户也。故悲哀愁忧则心动。心动则五脏六腑皆摇。摇则宗脉感。宗脉感则液道开。
液道开故涕泣出焉。液者所以灌精濡空窍者也。故上液之道开则泣。泣不止则液竭。液竭则精不灌。
精不灌则目无所见矣。故命曰夺精。补天柱经侠颈侠头中分也。又曰。五脏六腑。心为之主。耳为之
听。目为之视。肺为之相。肝为之荣。脾为之卫。肾为之主。故五脏六腑之津液。上渗于目。心悲气并则心
系急。心系急则肺举。肺举则津液上溢。夫心系与肺。不能常举。乍上乍下。故咳而泣出矣。素问解精
微论曰。厥则目无所见。夫人厥则阳气并于上。阴气并于下。阳并于上则火独光也。阴气并于下则足
寒。足寒则胀。夫一水不胜五火。故目昏盲。是以气冲风泣下而不止。夫风之中目也。阳气内守于精。是
火气燔目。故风见则泣下。有喻比之。夫火疾风生乃能雨。此之类也。东垣云。水附木势。上为眼涩为
眵为冷泪。此皆由肺金之虚。而肝木寡于长也。
迎风冷泪。水木俱虚。血液不足。寒药勿施。失治则重。宜早补之。
此症谓见风则冷泪流。若赤烂有障翳者非也。水木二经。血液不足。阴邪之患。久而失治。则有内障视
渺等症生焉。与无时冷泪不同。此为窍虚。因邪引邪之患。若无时冷泪则内虚。胆肾自伤之患也。此宜服。
河间当归汤(治风邪所伤。寒中目。泪自出。肌瘦汗不止。)
白术(炒) 白茯苓 干姜(炮) 细辛 川芎 白芍药 甘草(炙各五分) 官桂 陈皮(各一钱) 当归身(酒
制) 人参(各二钱)
上为剂。水二钟。姜一片。辉枣三枚。煎八分。去滓热服。不计时。并三服。
阿胶散(治目有冷泪。流而不结者。肝经受风冷故也。)
阿胶 马兜铃(各两半) 紫菀 款冬花 糯米(各一两) 白蒺藜(炒二钱半) 甘草(五钱)
上为细末。每服二钱。水一钟煎。不拘时服。
枸杞酒(治目视不明。迎风冷泪。)
枸杞子(拣肥者一斤杵烂右用绢袋盛贮须浸酒密封勿令泄气候三七日取饮) 陈无灰酒(十斤)
仍用猪肝煮熟切片。蘸花椒盐同食。每饮酒一二杯。勿宜过饮。若或过饮。反佐湿热。为害不浅矣。
按肝气通于目。肝和则能辨五色矣。今肝为劳伤。致目视不明。多出冷泪。经曰。味为阴。味浓为阴中之
阴。枸杞子味浓。故足以养厥阴之阴。煮以纯酒。取其浃洽气血而已。
根据《内经》记载,因五运六气失调导致的流泪,皆由风热引起。经文说:“厥阴司天之政,三之气时,天令布散,风气按时兴起,民众出现流泪的症状。”
《灵枢·口问》篇中黄帝问道:“人悲哀哭泣流涕,是什么气使然?”岐伯回答说:“心是五脏六腑的主宰,眼睛是宗脉汇聚之处,也是上焦津液运行的通道;口鼻是气息出入的门户。所以悲哀愁忧会使心动,心动则五脏六腑都受到震动,脏腑震动则宗脉感应,宗脉感应则津液通道开启,津液通道开启故涕泪流出。津液是用来滋润精气、濡养空窍的。所以上焦津液通道开启就会流泪,流泪不止则津液枯竭,津液枯竭则精气得不到滋润,精气得不到滋润则眼睛无法视物,这叫做‘夺精’。治疗应补益天柱经,取位于颈项两侧及头部正中的穴位。又说:五脏六腑中,心为主宰,耳为听觉器官,目为视觉器官,肺为相傅之官,肝为荣华之源,脾为卫外之职,肾为主蛰之本。因此五脏六腑的津液会上渗于目。若心中悲伤导致气机郁结,则心系拘急;心系拘急则牵引肺气上举;肺气上举则津液上溢。由于心系与肺不能经常处于上举状态,而是忽上忽下,所以会出现咳嗽并伴随流泪的现象。《素问·解精微论》说:发生厥逆时眼睛看不见东西。人发生厥逆时,阳气并聚于上部,阴气并聚于下部。阳气并聚于上部则火气独盛于上;阴气并聚于下部则足部寒冷,足寒则腹部胀满。因为一水(肾水)不能胜五火(五脏之火),所以眼睛昏花盲暗。因此气机上冲,迎风流泪不止。风邪侵入眼睛时,阳气内守于精,这是火气燔灼眼部,所以见到风就流泪。打个比方:火势猛烈风生起才能下雨,就是这个道理。李东垣说:水依附于木势,上行导致眼涩、有分泌物(眵)或冷泪。这都是由于肺金虚弱,而肝木缺乏生长之力所致。”
迎风冷泪证,是水木二脏俱虚,血液不足,不可使用寒凉药物,若误治病情会加重,宜尽早补益。
此症指见风则冷泪流下,如果是眼红溃烂或有翳障的则不属于此症。水(肾)木(肝)二经血液不足,属于阴邪为患,日久失治,会产生内障、视物渺茫等症状。这与无特定诱因的冷泪不同,此为孔窍空虚,因邪引邪的病患;若无时冷泪则是内脏虚损,胆肾自伤的病患。对此适宜服用以下方剂:
河间当归汤(治疗风邪所伤,寒气中于目,泪水自出,肌肉消瘦汗出不止。)
白术(炒)、白茯苓、干姜(炮制)、细辛、川芎、白芍药、甘草(炙,各五分)、官桂、陈皮(各一钱)、当归身(酒制)、人参(各二钱)。
以上药材制成剂型,用水两钟,生姜一片,大枣三枚,煎至八分,去渣后热服,不限时间,共服三次。
阿胶散(治疗眼睛有冷泪,流出而不凝结者,因肝经受风冷所致。)
阿胶、马兜铃(各一两半)、紫菀、款冬花、糯米(各一两)、白蒺藜(炒,二钱半)、甘草(五钱)。
以上研为细末,每次服用二钱,用水一钟煎煮,不拘时间服用。
枸杞酒(治疗视物不明,迎风冷泪。)
枸杞子(挑选肥大的,一斤捣烂,用绢袋盛装,需浸泡在酒中密封,勿令漏气,气候适宜时三七天后取饮)、陈年无灰酒(十斤)。
另外用猪肝煮熟切片,蘸花椒盐同食。每次饮酒一二杯,不宜过量饮酒。如果过量饮酒,反而助长湿热,危害不小。
按:肝气通于目,肝气调和则能辨别五色。如今肝因劳伤,导致视物不明,多流出冷泪。经书说:味道属阴,味浓者为阴中之阴。枸杞子味浓,故足以滋养厥阴之阴。用纯酒煮制,是为了取其通达气血的作用。
According to the *Neijing* (Inner Canon), tears caused by the imbalance of Five Movements and Six Qi are all due to Wind-Heat. The classic states: "When Jueyin governs the Heaven's mandate, during the third Qi period, the heavenly decree spreads, wind rises according to time, and the people suffer from tearing."
In the *Lingshu* (Spiritual Pivot) chapter *Kouwen*, Huangdi asked: "What qi causes a person to weep and shed tears when grieving?" Qibo replied: "The Heart is the master of the five zang organs and six fu organs. The eyes are the gathering place of the Zong Mai (Gathering Vessels) and the pathway for the fluids of the upper jiao; the mouth and nose are the portals of qi. Therefore, grief and sorrow move the Heart, moving the Heart causes the five zang organs and six fu organs to tremble. Trembling causes the Zong Mai to be stimulated; stimulation of the Zong Mai opens the fluid pathways. When the fluid pathways open, nasal discharge and tears flow. Fluids are used to nourish essence and moisten the orifices. Thus, when the upper fluid pathway opens, one cries. If crying does not stop, fluids are depleted. When fluids are depleted, essence is not nourished. When essence is not nourished, the eyes cannot see. This is called 'Loss of Essence'. Treatment should tonify the Tianzhu Meridian, selecting acupoints located on both sides of the neck and along the midline of the head. It is also said: Among the five zang organs and six fu organs, the Heart is the master, the ears provide hearing, the eyes provide vision, the Lung acts as the minister, the Liver provides brilliance, the Spleen provides defense, and the Kidney provides the foundation. Therefore, the fluids of the five zang organs and six fu organs seep upwards into the eyes. If sadness in the heart causes qi to merge, the Xin Mai (Heart Vessel) becomes tense. Tension in the Xin Mai causes the Lung to rise. Rising of the Lung causes fluids to overflow upwards. Since the Xin Mai and Lung cannot remain constantly elevated, but fluctuate up and down, coughing accompanied by tearing occurs. The *Suwen* chapter *Jie Jing Wei Lun* states: In cases of Jue (reversal cold/heat), the eyes cannot see. When a person experiences Jue, Yang Qi merges in the upper part, and Yin Qi merges in the lower part. Yang merging in the upper part means Fire shines alone; Yin merging in the lower part means the feet are cold. Cold feet cause distension. Because one Water (Kidney Water) cannot overcome five Fires (Fire of the five Zang organs), the eyes become dim and blind. Therefore, qi rushes upward, and wind causes continuous tearing. When Wind pathogen invades the eyes, Yang Qi remains internally preserved in the essence, which means Fire Qi blazes the eyes. Thus, seeing wind causes tearing. To use an analogy: intense fire generates wind, which then produces rain; this is similar. Li Dongyuan stated: Water follows the momentum of Wood, ascending to cause eye dryness, discharge (Chi), or cold tears. All these are due to the deficiency of Metal (Lung) and the lack of growth of Wood (Liver)."
Wind-facing cold tears syndrome involves deficiency of both Water (Kidney) and Wood (Liver), with insufficient blood. Cold-natured herbs should not be administered; if mismanaged, the condition will worsen, so early tonification is appropriate.
This syndrome refers to cold tears flowing upon exposure to wind. If there is redness, ulceration, or nebula, it is not this syndrome. Deficiency of blood in the Water (Kidney) and Wood (Liver) meridians constitutes a disorder of Yin pathogens. If left untreated for a long time, internal nebula and blurred vision may develop. This differs from spontaneous cold tears without specific triggers; this type is due to empty orifices, where pathogen attracts pathogen. Spontaneous cold tears, however, result from internal deficiency and self-injury of the Gallbladder and Kidney. The following formulas are suitable:
Hejian Danggui Tang (Treats damage by Wind pathogen, Cold invading the eyes, spontaneous tearing, emaciation, and incessant sweating.)
Bai Zhu (Atractylodis Rhizoma, stir-fried), Bai Fu Ling (Poria), Gan Jiang (Zingiberis Rhizoma, processed), Xi Xin (Asari Radix), Chuan Xiong (Chuanxiong Rhizome), Bai Shao Yao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 5 fen), Guan Gui (Cinnamomi Cortex), Chen Pi (Citri Reticulatae Pericarpium, each 1 qian), Dang Gui Shen (Angelicae Sinensis Radix, wine-processed), Ren Shen (Ginseng Radix, each 2 qian).
Process the above into a dosage form. Use two zhong of water, one slice of fresh ginger, and three dates. Decoct until eight parts remain, remove dregs, and take hot. Take at any time, total three doses.
Ejiao San (Treats cold tears in the eyes that flow without coagulating, caused by Wind-Cold invading the Liver Meridian.)
E Jiao (Colla Corii Asini), Ma Dou Ling (Aristolochiae Fructus, each 1.5 liang), Zi Wan (Asteris Radix), Kuan Dong Hua (Farflos Flos), Nu Mi (Oryza Sativa Glutinosa, each 1 liang), Bai Ji Li (Tribuli Fructus, stir-fried, 2.5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 5 qian).
Grind the above into fine powder. Take 2 qian per dose, decoct in one zhong of water, take at any time.
Gouqi Jiu (Treats blurred vision and wind-facing cold tears.)
Gou Qi Zi (Lycii Fructus, select plump ones, 1 jin, pounded thoroughly, stored in a silk bag, must be immersed in wine and sealed tightly to prevent leakage; after 37 days in suitable climate, take for drinking), Chen Wu Hui Jiu (Aged non-ashy rice wine, 10 jin).
Additionally, cook pork liver until done, slice it, and eat it dipped in Sichuan pepper salt. Drink one or two cups of wine each time. Do not drink excessively. Excessive drinking will instead promote Damp-Heat, causing significant harm.
Note: The Qi of the Liver connects to the eyes. When Liver Qi is harmonious, one can distinguish the five colors. Now, due to overstrain injuring the Liver, vision is unclear, often resulting in cold tears. The classics state: Taste belongs to Yin; strong taste is Yin within Yin. Gou Qi Zi has a strong taste, thus sufficient to nourish the Yin of Jueyin. Boiling with pure wine aims to facilitate the circulation of Qi and Blood.