五脏无偏胜。虚阳无补法。六腑有调候。弱阴有强理。心肝脾肺肾。各有所滋生。一脏或有余。四脏俱不足。
此五脏无偏胜也。或浮或为散。是曰阳无根。益之欲令实。翻致不能禁。此虚阳无补法也。膀胱大小肠。三
焦胆包络。俾之各有主。平秘永不危。此六腑有调候也。衰弱不能济。遂使阳无御。反而欲匹之。要以方术
盛。此弱阴有强理也。解精微论曰。心者五脏之专精。目者其窍也。又为肝之窍。肾生骨。骨之精为神水。故
肝木不平。内挟心火。为势妄行。火炎不制。神水受伤。上为内障。此五脏病也。劳役过多。心不行事。相火代
之。五脏生成论曰。诸脉皆属于目。相火者。心包络也。主百脉。上荣于目。火盛则百脉沸腾。上为内障。此虚
阳病也。膀胱小肠三焦胆脉。俱循于目。其精气亦皆上注而为目之精。精之窠为眼。四腑一衰。则精气尽
败。邪火乘之。上为内障。些六腑病也。神水黑珠。皆法于阴。白眼赤脉。皆法于阳。阴齐阳侔。故能为视。阴微
不立。阳盛即淫。阴阳应象大论曰。壮火食气。壮火散气。上为内障。此弱阴病也。其病初起时。视觉微昏。常
见空中有黑花。神水淡绿色。次则视歧。睹一成二。神水淡白色。可为冲和养胃汤主之。益气聪明汤主之。
千金磁朱丸主之。石斛夜光丸主之。有热者泻热黄连汤主之。久则不睹。神水纯白色。永为废疾也。然废
疾亦有治法。先令病者以冷水洗眼如冰。气血不得流行为度。用左手大指次指。按定眼珠。不令转动。次
用右手持鼠尾针。去黑睛如米许。针之令入。白睛翳浓。欲入甚难。必要手准力完。重针则破。然后斜回针
首。以针刀刮之。障落则明。有落而复起者。起则重刮。刮之有至再三者。皆为洗不甚冷。气血不凝故也。障
落之后。以绵裹黑豆数粒。令如杏核样。使病目重闭。覆眼皮上。用软帛缠之。睛珠不得动移为度。如是五
七日。才许开视。视勿劳也。亦须服上药。庶几无失。此法治者五六。不治者亦四五。五脏之病。虚阳之病。六
腑之病。弱阴之病。四者皆为阴弱不能配阳之故。噫。学人慎之。
冲和养胃汤(治成内证。兼治内障初起。视觉微昏。空中有黑花。神水变淡绿色。次则视物成二。
神水变淡白色。久则不睹。神水变纯白色。)
白茯苓(四分) 柴胡(七分) 人参 甘草(炙) 当归身(酒制) 白术(土炒) 升麻
葛根(各一钱) 白芍药(六分) 羌活(一钱二分) 黄 (蜜制钱半) 防风(各五分) 五味子(三分)
上锉剂。水三钟。煎至二钟。生姜一片。入黄芩黄连二钱。再煎至一钟。去滓。稍热食后服。
上方因肝木不平。内挟心火。故以柴胡平肝。人参开心。黄连泻心火为君。酒制当归荣百脉。五味敛百
脉之沸。心包络主血。白芍药顺血脉散恶血为臣。白茯苓泻膀胱之湿。羌活清利小肠之湿。甘草补三
焦。防风升胆之降为佐。阴阳皆总于脾胃。黄 补脾胃。白术健脾胃。升麻、葛根行脾胃之经。黄芩退壮
火。干生姜入壮火。为导为使。此方逆攻从顺。反异正宜俱备。
东垣泻热黄连汤(治眼暴发。赤肿疼痛。)
黄连(酒制) 黄芩(酒制) 草龙胆 生地黄(各钱半) 升麻 柴胡(各五分)
上锉剂。水二钟。煎至一钟。去滓。午时食前热服。午后服之。则阳逆不行。临睡休服。为反助阴也。
上方治主治客之剂也。治主者。升麻主脾胃。柴胡行肝经为君。生地黄凉血为臣。为阳明太阴厥阴多
血故也。治客者。黄连、黄芩皆疗湿热为佐。龙胆草专除眼中诸疾为使。为诸湿热。俱从外来。为客也。
益气聪明汤(治证同上。并治耳聋耳鸣。)
蔓荆子(钱半) 黄 人参(各五分) 黄柏(酒炒) 白芍药(各一钱) 甘草(炙四分) 升麻
葛根(各三分)
共为一剂。水二钟。煎至一钟。去滓。临睡热服。五更再煎服。
上方以黄 人参之甘温治虚劳为君。甘草之甘平。承接和协。升麻之苦平微寒。行手阳明足阳明足
太阴之经为臣。葛根之甘平。蔓荆子之辛温。皆能升发为佐。芍药之酸微寒。补中焦。顺血脉。黄柏之苦
寒。治肾水膀胱之不足为使。酒制又炒者。因热用也。或有热。可渐加黄柏。春夏加之。盛暑倍加之。脾胃
虚者去之。热倍此者。泻热黄连汤主之。
五脏之间没有偏盛的情况。对于虚阳,没有直接补益的方法。六腑可以通过调理寒热来平衡。对于衰弱的阴液,有增强调理的道理。心、肝、脾、肺、肾,各自有其滋生的规律。如果某一脏有余(过盛),其他四脏就会都显得不足。
这就是所谓的“五脏无偏胜”。脉象或浮或散,这叫做“阳无根”(阳气没有根基)。想要通过补益使其充实,反而会导致身体无法承受。这就是“虚阳无补法”的道理。膀胱、大小肠、三焦、胆、心包络,使它们各有其主导功能,保持平和秘固就永远不会危险。这就是“六腑有调候”的道理。阴气衰弱不能济助阳气,致使阳气失去抵御能力。反过来想要匹敌阳气,必须依靠方术的力量来强盛它。这就是“弱阴有强理”的道理。《解精微论》说:心是五脏精气的神聚所在,眼睛是心的外窍。同时眼睛也是肝的外窍。肾生成骨骼,骨骼的精气转化为神水(指眼内晶莹透明的液体)。所以,如果肝木之气不平顺,内部挟带心火,火势妄行。火炎上而得不到制约,损伤了神水,向上导致内障(眼内疾病)。这是五脏引起的病变。过度劳累,心气不能正常行使职能,相火(寄居于肝肾的命门之火)代替行使职能。《五脏生成论》说:所有的脉络都归属于眼睛。相火就是心包络,主管全身血脉,向上荣养眼睛。火气旺盛则百脉沸腾,向上导致内障。这是虚阳引起的病变。膀胱、小肠、三焦、胆的经脉,都循行于眼睛,它们的精气也都向上注入成为眼睛的精气。眼的结构称为“精之窠”,如果这四个腑的功能衰退,精气就会全部败坏,邪火趁机侵袭,向上导致内障。这是六腑引起的病变。神水和黑珠(黑睛)都效法于阴,白眼和赤脉都效法于阳。阴与阳齐平相当,所以能够视物。如果阴微弱不能确立,阳过盛就会淫溢泛滥。《阴阳应象大论》说:壮火会消耗元气,壮火会散失元气,向上导致内障。这是弱阴引起的病变。这种病初起时,视力轻微昏花,经常看到空中有黑花飞舞,神水呈淡绿色;随后出现视一为二(复视),神水呈淡白色。可以用冲和养胃汤主治,或者益气聪明汤主治,或者千金磁朱丸主治,或者石斛夜光丸主治。如果有热证,用泻热黄连汤主治。时间久了则完全看不见,神水变成纯白色,永远成为废疾。然而废疾也有治疗方法。先让病人用冷水洗眼,直到感觉像冰一样冷,气血流动停滞的程度。用左手的大拇指和食指,按住定眼球,不让其转动。然后用右手拿着鼠尾针,距离黑睛(角膜)约米粒大小的地方,针刺入,使针进入白睛翳膜浓密处,想要进入非常困难,必须手法准确、力量完备。重刺则会刺破眼球。然后斜着回退针头,用针刀刮除障膜,障膜脱落视力就恢复了。如果有脱落后又长起来的,长起来就再次刮除。刮除两三次以上的,都是因为水洗得不夠冷,气血没有凝固的缘故。障膜脱落后,用棉絮包裹几粒黑豆,使其形状像杏核大小,让患病的眼睛紧紧闭合,覆盖在眼皮上,用软布缠绕固定,以眼球不得移动为标准。这样五到七天后,才允许睁开视物,但不要劳累。也必须服用上述药物,这样才能不失误。这种方法治疗好的占五六成,治不好的也占四五成。五脏的病、虚阳的病、六腑的病、弱阴的病,这四者都是由于阴弱不能配阳的缘故。唉,学习中医的人要谨慎啊。
冲和养胃汤(治疗成内证,兼治内障初起,视力轻微昏花,空中有黑花,神水变淡绿色,随后视物成双,神水变淡白色,时间久了看不见,神水变纯白色。)
白茯苓(四分) 柴胡(七分) 人参 甘草(炙) 当归身(酒制) 白术(土炒) 升麻 葛根(各一钱) 白芍药(六分) 羌活(一钱二分) 黄芪(蜜制钱半) 防风(各五分) 五味子(三分)
以上药材切碎成剂,用水三钟,煎煮至二钟,加入生姜一片,再加入黄芩、黄连各二钱,继续煎煮至一钟,去渣滓,稍热后饭后服用。
上方因为肝木之气不平顺,内部挟带心火,所以用柴胡平抑肝气,用人参开心气,用黄连清泻心火作为君药。酒制的当归滋养百脉,五味子收敛百脉的沸腾之气。心包络主血,白芍药理顺血脉并消散恶血作为臣药。白茯苓泻除膀胱的湿气,羌活清利小肠的湿气,甘草补益三焦,防风提升胆气的下降作为佐药。阴阳都总归于脾胃,黄芪补益脾胃,白术健运脾胃,升麻、葛根运行脾胃的经络,黄芩退除壮火,干生姜引导进入壮火,作为导引和使药。此方逆攻从顺,反异正宜俱备。
东垣泻热黄连汤(治疗眼病突发,红肿疼痛。)
黄连(酒制) 黄芩(酒制) 草龙胆 生地黄(各钱半) 升麻 柴胡(各五分)
以上药材切碎成剂,用水二钟,煎煮至一钟,去渣滓,午时饭前热服。午后服用,则阳气逆行不通。临睡前不要服用,因为这会反助阴气。
上方是治疗客邪的药剂。治疗主气的,升麻主脾胃,柴胡行肝经作为君药。生地黄凉血作为臣药,因为阳明、太阴、厥阴多血的原因。治疗客邪的,黄连、黄芩都治疗湿热作为佐药,龙胆草专门清除眼中各种疾病作为使药,因为各种湿热都从外来,属于客邪。
益气聪明汤(症状同上,并治疗耳聋耳鸣。)
蔓荆子(钱半) 黄芪 人参(各五分) 黄柏(酒炒) 白芍药(各一钱) 甘草(炙四分) 升麻 葛根(各三分)
共为一剂,用水二钟,煎煮至一钟,去渣滓,临睡前热服。五更天再煎服一次。
上方以黄芪、人参的甘温性质治疗虚劳作为君药,甘草的甘平性质承接和协。升麻的苦平微寒性质,运行手阳明、足阳明、足太阴的经络作为臣药。葛根的甘平性质,蔓荆子的辛温性质,都能升发作为佐药。芍药的酸微寒性质,补益中焦,理顺血脉。黄柏的苦寒性质,治疗肾水和膀胱的不足作为使药。酒制又炒制,是因为有热证使用。如果有热,可以逐渐增加黄柏的量,春夏季节增加,盛夏加倍增加。脾胃虚弱者去掉黄柏。热证加倍于此者,用泻热黄连汤主治。
There is no excessive dominance among the Five Zang organs. There is no direct tonification method for Deficient Yang (Xu Yang, deficient yang qi). The Six Fu organs can be balanced by regulating their thermal states. For weak Yin fluids, there are methods to strengthen and regulate them. The Heart, Liver, Spleen, Lung, and Kidney each have their own laws of generation. If one Zang organ is in excess, the other four will all appear deficient.
This refers to "no excessive dominance among the Five Zang organs." The pulse may be floating or scattered; this is called "Yang without root" (Yang Qi lacking a foundation). Attempting to tonify it to make it solid may instead cause the body to be unable to withstand it. This explains why there is no direct tonification method for Deficient Yang. The Bladder, Large Intestine, Small Intestine, Sanjiao (Triple Burner), Gallbladder, and Pericardium should each have their primary functions, maintaining balance and stability ensures they never become critical. This illustrates that the Six Fu organs can be balanced by regulating their thermal states. When Yin Qi is too weak to assist Yang Qi, Yang Qi loses its defensive capacity. To counteract Yang, one must rely on medical formulas to strengthen it. This demonstrates the principles of strengthening weak Yin. The *Jie Jing Wei Lun* states: "The Heart is the concentration of the essence of the Five Zang organs, and the eyes are its orifice. The eyes are also the orifice of the Liver. The Kidneys generate bones, and the essence of bones transforms into Shen Shui (the clear fluid within the eye)." Therefore, if Liver Wood Qi is imbalanced, it internally carries Heart Fire, causing the fire to act recklessly. Uncontrolled flaming fire damages the Shen Shui, leading upward to internal cataracts (internal eye diseases). This is a disease caused by the Five Zang organs. Excessive labor causes the Heart Qi to fail in its duties, and Ministerial Fire (Ministerial Fire, the life gate fire residing in the Liver and Kidneys) acts in its place. The *Wu Zang Sheng Cheng Lun* states: "All meridians connect to the eyes." Ministerial Fire is the Pericardium, which governs all vessels and nourishes the eyes upward. When fire is excessive, all vessels boil, leading upward to internal cataracts. This is a disease caused by Deficient Yang. The meridians of the Bladder, Small Intestine, Sanjiao, and Gallbladder all traverse the eyes, and their essence fluids all ascend to become the essence of the eyes. The structure of the eye is called the "nest of essence." If these four Fu organs decline, their essence fluids deteriorate completely, allowing pathogenic fire to invade, leading upward to internal cataracts. This is a disease caused by the Six Fu organs. The Shen Shui and the black pupil both follow Yin, while the white sclera and red vessels both follow Yang. When Yin and Yang are equal and balanced, vision is possible. If Yin is weak and cannot establish itself, and Yang is excessive and overflows, as stated in the *Yin Yang Ying Xiang Da Lun*: "Excessive Fire consumes Qi, and Excessive Fire scatters Qi," leading upward to internal cataracts. This is a disease caused by Weak Yin. At the onset of this disease, vision is slightly blurred, with frequent floaters (black flowers) seen in the air, and the Shen Shui appears pale green. Subsequently, diplopia (seeing one object as two) occurs, and the Shen Shui becomes pale white. These conditions can be primarily treated with Chonghe Yangwei Tang (Harmonizing and Stomach-Nourishing Decoction), Yiqi Congming Tang (Qi-Boosting and Acuity-Enhancing Decoction), Qianjin Cizhu Wan (Thousand Gold Magnetite Pill), or Shihu Yeguang Wan (Dendrobium Night-Light Pill). If there is heat, Xiere Huanglian Tang (Heat-Draining Coptis Decoction) should be used. If left untreated for a long time, vision is lost completely, the Shen Shui turns pure white, resulting in permanent disability. However, even disabled eyes can be treated. First, let the patient wash their eyes with cold water until they feel icy, stopping when blood and qi circulation stagnates. Use the thumb and index finger of the left hand to hold the eyeball steady, preventing rotation. Then, using the right hand, take a mouse-tail needle and insert it into the white sclera at a distance of about a grain of rice from the cornea (Hei Jing). Inserting the needle into the dense opacity of the sclera is very difficult and requires precise technique and sufficient force; excessive force will rupture the eyeball. Then, tilt the needle head back and scrape away the opacity with the needle knife. If the opacity falls off, vision clears. If it grows back after falling, scrape it again. Repeated scraping two or three times indicates that the water was not cold enough, and the blood and qi did not coagulate properly. After the opacity is removed, wrap several black beans in cotton to the size of an apricot kernel, place them on the closed eyelids of the affected eye, and bind securely with soft cloth, ensuring the eyeball does not move. After five to seven days, the patient may open their eyes, but must avoid strain. They must also take the aforementioned medicines to ensure success. With this treatment method, five or six out of ten cases recover, while four or five do not. Diseases of the Five Zang, Deficient Yang, Six Fu, and Weak Yin are all due to the inability of weak Yin to match Yang. Alas, students of medicine must be cautious.
Chonghe Yangwei Tang (Treats internal disorders, and initially treats internal cataracts with slight blurring, floaters, pale green Shen Shui, progressing to diplopia, pale white Shen Shui, and eventually blindness with pure white Shen Shui.)
Poria cocos (4 fen) Bupleurum root (7 fen) Ginseng Radix Glycyrrhiza preparata (Honey-fried) Angelica sinensis radix (wine-processed) Atractylodes macrocephala rhizome (soil-fried) Cimicifugae Rhizoma Puerariae Radix (each 1 qian) White Peony Root (6 fen) Notopterygii Rhizoma et Radix (1.2 qian) Astragalus membranaceus (Honey-fried, 1.5 qian) Saposhnikoviae Radix (each 5 fen) Schisandrae Fructus (3 fen)
Crush the herbs into pieces. Add three zhong of water, decoct until two zhong remain. Add one slice of fresh ginger, then add Scutellariae Radix and Coptidis Rhizoma (each 2 qian), continue decocting until one zhong remains. Strain and drink warm after meals.
In this formula, because Liver Wood Qi is imbalanced and internally carries Heart Fire, Bupleurum root is used to soothe the Liver, Ginseng Radix to benefit the Heart, and Coptidis Rhizoma to drain Heart Fire as the Sovereign drug. Wine-processed Angelica sinensis radix nourishes all vessels, and Schisandrae Fructus收敛 (astringes) the boiling of all vessels. The Pericardium governs blood, and White Peony Root smooths the blood vessels and disperses bad blood as the Minister drug. Poria cocos drains dampness from the Bladder, Notopterygii Rhizoma et Radix clears dampness from the Small Intestine, Glycyrrhiza preparata tonifies the Sanjiao, and Saposhnikoviae Radix promotes the descending action of the Gallbladder as the Assistant drug. Yin and Yang are generally governed by the Spleen and Stomach. Astragalus membranaceus tonifies the Spleen and Stomach, Atractylodes macrocephala rhizome strengthens the Spleen and Stomach, Cimicifugae Rhizoma and Puerariae Radix promote the circulation of the Spleen and Stomach meridians, Scutellariae Radix reduces excessive fire, and dried ginger guides the action into the excessive fire, serving as the Guide and Envoy drugs. This formula combines opposing and conforming actions, preparing for both reversal and normality.
Dongyuan Xiere Huanglian Tang (Treats sudden onset of eye inflammation, redness, swelling, and pain.)
Coptidis Rhizoma (wine-processed) Scutellariae Radix (wine-processed) Gentiana scabra root (each 1.5 qian) Rehmanniae Radix (1.5 qian) Cimicifugae Rhizoma Bupleurum root (each 5 fen)
Crush the herbs into pieces. Add two zhong of water, decoct until one zhong remains. Strain and drink hot before noon meal. Do not take in the afternoon, as it causes Yang Qi to reverse and stagnate. Do not take before sleep, as it would inadvertently assist Yin.
This formula is a remedy for external pathogens. To treat the internal host, Cimicifugae Rhizoma governs the Spleen and Stomach, and Bupleurum root circulates through the Liver meridian as the Sovereign drug. Rehmanniae Radix cools the blood as the Minister drug, because the Yangming, Taiyin, and Jueyin meridians contain much blood. To treat the external guest, Coptidis Rhizoma and Scutellariae Radix both treat damp-heat as Assistant drugs, and Gentiana scabra root specifically eliminates various eye diseases as the Envoy drug, because all damp-heat comes from outside and is considered a guest pathogen.
Yiqi Congming Tang (Indications same as above, also treats deafness and tinnitus.)
Vitex fruit (1.5 qian) Astragalus membranaceus Ginseng Radix (each 5 fen) Phellodendri Cortex (wine-fried) White Peony Root (each 1 qian) Glycyrrhiza preparata (4 fen) Cimicifugae Rhizoma Puerariae Radix (each 3 fen)
Combine as one dose. Add two zhong of water, decoct until one zhong remains. Strain and drink hot before sleep. Decoct again at the third watch (5-7 AM) and drink.
In this formula, the sweet-warm nature of Astragalus membranaceus and Ginseng Radix treats deficiency fatigue as the Sovereign drug. The sweet-neutral nature of Glycyrrhiza preparata receives and harmonizes. The bitter-pale-slightly-cold nature of Cimicifugae Rhizoma circulates through the Hand-Yangming, Foot-Yangming, and Foot-Taiyin meridians as the Minister drug. The sweet-neutral nature of Puerariae Radix and the pungent-warm nature of Vitex fruit both promote ascending and emerging as Assistant drugs. The sour-slightly-cold nature of White Peony Root tonifies the Middle Jiao and smooths the blood vessels. The bitter-cold nature of Phellodendri Cortex treats insufficiency of Kidney Water and Bladder as the Envoy drug. Wine-processing and frying are done because of the presence of heat. If there is heat, the amount of Phellodendri Cortex can be gradually increased; increase in spring and summer, double in midsummer. Remove it if the Spleen and Stomach are deficient. If heat is doubled compared to this standard, use Xiere Huanglian Tang (Heat-Draining Coptis Decoction) as the primary treatment.