风沿眼系。上膈有积热。自饮食中挟怒气而成。顽痰痞塞。浊气不降。清气不升。由是火益
炽而水益降。积而久也。眼沿因脓积而肿。于中生细小虫丝。遂年久不愈。而多痒者是也。服柴
胡饮子。点蕤仁膏。
迎风赤烂证 目不论何风。见之则赤烂。无风则痞。盖赤者木中火证。烂者土之湿证。此专
言见风赤烂之患。与后
见风泪出诸证不同。川芎茶调散。
赤烂证 谓目烂惟 有之。目无别病也。赤胜烂者多火。乃劳心忧郁忿悖。无形之火所伤。
烂胜赤者湿多。乃恣燥嗜酒。风热熏蒸。有形之湿所伤。病属心络。甚则火盛水不清。而生疮于
边也。洗肝散加麻黄、蒺藜、川连。并用赤芍、防风、五倍子、川连煎汤。入盐、轻粉少许洗
之。点用炉甘石散。及晚蚕砂香油浸月余。重绵滤过点之。
经云。风气与阳明入胃。循脉而上至目内 。其人肥则风气不得外泄。则为热中而目黄。人
瘦。则外泄而寒。则为寒中而泣出。其目黄属热。泪出属寒也明矣。
东垣云。水乘木势。上为眼涩为眵为冷泪。此皆由肺金之虚。而肝木寡于畏也。凡目见西北
二风。则涩痛泪出。乃肝虚受克之病。止泪补肝散。并灸睛明二穴。见东南二风。则涩痛泪出。
乃肝自病。菊花散。若不论何风。见则流冷泪者。乃肝肾经中有伏饮。血液不足。窍虚风入。因
邪引邪之患。夜光椒红丸。或四物换赤芍、生地。加防风、肉桂、羌活、木贼。又不论何风。见
则流热泪。乃肝肾经中有伏火。虚窍不密。因风引出其泪。川芎茶调散、菊花散选用。庞安常云。
头风冷泪。用菊花、决明、白术、白芷、细辛、羌活、荆芥煎服并洗。若目不赤不痛。别无病苦。
不因见风。亦时常流出冷泪。甚则视而昏眇。乃肝胆气弱。肾水不足。八味丸用椒制地黄加芎、
归。产后悲泣太过者。十全大补加川椒、细辛。若热泪不时常流。乃内火激动其水。因肝肾精血
耗竭。阳火易动而伤其液也。六味丸加川椒、制熟地。倍丹
皮哭泣太伤者。八珍汤加川椒、五味。又肺脏久冷。不时冷泪积于泪堂。此泪通于肺。难治。久
流令人目昏。又有睥内如痰。白稠腻甚。拭之即有者。是痰火上壅。脾肺湿热所致。故好酒嗜燥
悖郁者。每患此疾。逍遥散去柴胡、陈皮。加羌、防、菊花。若觉睥肿及有丝脉虬赤者。必滞入
血分。防瘀血灌睛等变。
风沿眼系。上膈有积热。自饮食中挟怒气而成。顽痰痞塞。浊气不降。清气不升。由是火益炽而水益降。积而久也。眼沿因脓积而肿。于中生细小虫丝。遂年久不愈。而多痒者是也。服柴胡饮子。点蕤仁膏。
风沿（眼睑边缘溃烂）病位在眼系（眼部经络组织）。上焦膈膜处有积聚之热，这种热邪源于饮食不当并夹杂怒气而形成。顽固的痰湿阻滞气机，导致浊气不能下降，清气不能上升。因此，火势更加炽盛，而肾水（阴液）更加下行受损。日积月累之后，眼睑边缘因脓液积聚而肿胀，其中生出细小的虫丝状物，于是长年不愈且伴有剧烈瘙痒，这就是风沿病的表现。治疗应服用柴胡饮子，并用蕤仁膏滴眼。
迎风赤烂证 目不论何风。见之则赤烂。无风则痞。盖赤者木中火证。烂者土之湿证。此专言见风赤烂之患。与后见风泪出诸证不同。川芎茶调散。
迎风赤烂证：眼睛无论遇到哪种风邪，见到风就会发红溃烂；没有风时则感觉痞闷不适。因为红色属于肝木中的火证，溃烂属于脾土的湿证。这里专门论述的是遇风即发红溃烂的病症，与后面提到的遇风流泪等证候不同。治疗可用川芎茶调散。
赤烂证 谓目烂惟有之。目无别病也。赤胜烂者多火。乃劳心忧郁忿悖。无形之火所伤。烂胜赤者湿多。乃恣燥嗜酒。风热熏蒸。有形之湿所伤。病属心络。甚则火盛水不清。而生疮于边也。洗肝散加麻黄、蒺藜、川连。并用赤芍、防风、五倍子、川连煎汤。入盐、轻粉少许洗之。点用炉甘石散。及晚蚕砂香油浸月余。重绵滤过点之。
赤烂证：指眼睛仅有溃烂，没有其他病变。如果红赤症状重于溃烂，多为火邪所致，这是由于过度劳累、心神忧思、愤怒抑郁，被无形的火邪所伤；如果溃烂症状重于红赤，多为湿邪所致，这是由于贪吃燥热食物、嗜好饮酒，受风热熏蒸，被有形的湿邪所伤。此病归属于心经脉络。严重时火盛而肾水不清，导致眼睑边缘生疮。治疗可用洗肝散加入麻黄、蒺藜、黄连。同时用赤芍、防风、五倍子、黄连煎汤，加入少量盐和轻粉清洗患处。外用炉甘石散点眼。另外，将晚蚕砂用香油浸泡一个多月，用多层细棉布过滤后滴眼。
经云。风气与阳明入胃。循脉而上至目内 。其人肥则风气不得外泄。则为热中而目黄。人瘦。则外泄而寒。则为寒中而泣出。其目黄属热。泪出属寒也明矣。
《内经》说：风邪与阳明经之气进入胃中，沿着经脉上行到达目内眦（眼角）。如果人体肥胖，风邪就不能向外宣泄，就会形成热中（体内蕴热）而导致眼睛发黄；如果人体消瘦，风邪容易向外宣泄而伴随寒气，就会形成寒中（体内虚寒）而导致流泪。由此可见，眼睛发黄属于热证，流泪属于寒证，这是很明确的。
东垣云。水乘木势。上为眼涩为眵为冷泪。此皆由肺金之虚。而肝木寡于畏也。凡目见西北二风。则涩痛泪出。乃肝虚受克之病。止泪补肝散。并灸睛明二穴。见东南二风。则涩痛泪出。乃肝自病。菊花散。若不论何风。见则流冷泪者。乃肝肾经中有伏饮。血液不足。窍虚风入。因邪引邪之患。夜光椒红丸。或四物换赤芍、生地。加防风、肉桂、羌活、木贼。又不论何风。见则流热泪。乃肝肾经中有伏火。虚窍不密。因风引出其泪。川芎茶调散、菊花散选用。庞安常云。头风冷泪。用菊花、决明、白术、白芷、细辛、羌活、荆芥煎服并洗。若目不赤不痛。别无病苦。不因见风。亦时常流出冷泪。甚则视而昏眇。乃肝胆气弱。肾水不足。八味丸用椒制地黄加芎、归。产后悲泣太过者。十全大补加川椒、细辛。若热泪不时常流。乃内火激动其水。因肝肾精血耗竭。阳火易动而伤其液也。六味丸加川椒、制熟地。倍丹皮哭泣太伤者。八珍汤加川椒、五味。又肺脏久冷。不时冷泪积于泪堂。此泪通于肺。难治。久流令人目昏。又有睥内如痰。白稠腻甚。拭之即有者。是痰火上壅。脾肺湿热所致。故好酒嗜燥悖郁者。每患此疾。逍遥散去柴胡、陈皮。加羌、防、菊花。若觉睥肿及有丝脉虬赤者。必滞入血分。防瘀血灌睛等变。
李东垣说：肾水乘袭肝木之势，向上表现为眼睛干涩、分泌物增多（眵）和冷泪。这都是由于肺金虚弱，导致肝木缺乏制约（寡于畏，指五行中金克木，金虚则木亢）的缘故。凡是眼睛遇到西北方向的风，就出现干涩疼痛并流泪，这是肝虚受到克制（金克木，西北属金）的病证。治疗用止泪补肝散，并艾灸睛明穴双侧。遇到东南方向的风，出现干涩疼痛并流泪，这是肝脏自身的病证（东南属木，同气相求）。治疗用菊花散。如果不论遇到什么风，一见风就流出冷泪，这是肝肾经络中有潜伏的水饮（伏饮），血液不足，眼窍空虚，风邪侵入，因邪气引发邪气的病变。治疗用夜光椒红丸，或者用四物汤将赤芍换成生地黄，再加入防风、肉桂、羌活、木贼。如果不论遇到什么风，一见风就流出热泪，这是肝肾经络中有潜伏的火邪，眼窍虚而不固，因风邪引出泪水。可选用川芎茶调散或菊花散。庞安常说：治疗头风引起的冷泪，用菊花、决明子、白术、白芷、细辛、羌活、荆芥煎服并用来清洗。如果眼睛不红不痛，没有其他病痛，不是因为见风，也经常流出冷泪，甚至视力模糊昏暗，这是肝胆气弱，肾水不足。治疗用八味丸，用花椒炮制的熟地黄，加入川芎、当归。产后悲伤哭泣过多的，用十全大补汤加入川椒、细辛。如果热泪不时常流，这是内火扰动肾水，因为肝肾精血耗竭，阳气之火容易妄动而损伤津液。治疗用六味丸，加入川椒、制熟地黄，加倍使用牡丹皮。如果是因过度哭泣损伤的，用八珍汤加入川椒、五味子。另外，如果肺脏长期寒冷，不时有冷泪积聚在泪堂（泪囊部位），这泪水与肺相通，难以治愈，长期流泪会导致眼睛昏花。还有眼睑内部像有痰一样，白色粘稠腻厚，擦拭后即有的，这是痰火上壅，由脾肺湿热所致。所以喜好饮酒、贪吃燥热食物、性格暴躁抑郁的人，常常患此疾病。治疗用逍遥散去柴胡、陈皮，加入羌活、防风、菊花。如果觉得眼睑肿胀以及有血丝脉络扭曲红赤，说明病邪必然滞留进入血分，要防止瘀血灌睛等变证发生。
Fengyan (Marginal Blepharitis) involves the eye meridians. There is accumulated heat in the upper jiao (upper burner/diaphragm), formed by dietary indiscretion combined with anger. Stubborn phlegm causes obstruction, turbid qi fails to descend, and clear qi fails to ascend. Consequently, fire becomes more intense while kidney water (yin fluids) descends excessively. Over time, the eyelid margins swell due to pus accumulation, and fine worm-like filaments grow within, leading to chronic non-healing conditions characterized by severe itching. This is Fengyan. Treatment involves taking Chaihu Yinzi (Bupleurum Decoction) and applying Ruiren Gao (Buckthorn Fruit Ointment) as eye drops.
Zhengfeng Chilan Syndrome (Wind-Induced Red and Ulcerated Eyelids): Regardless of which wind pathogen is encountered, exposure causes redness and ulceration; without wind, there is a sensation of stagnation or fullness. Redness indicates a fire syndrome within Wood (Liver); ulceration indicates a dampness syndrome within Earth (Spleen). This specifically discusses the pathology of redness and ulceration upon wind exposure, which differs from subsequent syndromes involving tearing upon wind exposure. Treatment uses Chuanxiong Chatiao San (Ligusticum Tea-Pingling Powder).
Chilan Syndrome (Red and Ulcerated Eyes): Refers to eyes that are only ulcerated without other distinct diseases. If redness predominates over ulceration, it is mostly due to fire, caused by mental exhaustion, worry, depression, and anger, injuring the body with formless fire. If ulceration predominates over redness, it is mostly due to dampness, caused by indulging in dry foods and alcohol, steamed by wind-heat, injuring the body with tangible dampness. The disease belongs to the Heart collaterals. In severe cases, excessive fire clouds the water (kidney yin), leading to sores on the margins. Treatment uses Xigan San (Liver-Washing Powder) added with Mahuang (Ephedrae Herba), Jili (Tribuli Fructus), and Chuanlian (Coptidis Rhizoma). Additionally, decoct Chishao (Paeoniae Radix Rubra), Fangfeng (Saposhnikoviae Radix), Wubeizi (Galla Chinensis), and Chuanlian in water. Add a small amount of salt and Qingfen (Calomelas) to wash the area. Apply Luganshi San (Calamine Powder) for eye application. Also, soak Wancangsha (Mulberry Silkworm Feces) in Sesame Oil for over a month, filter through heavy silk cloth, and apply as eye drops.
The Classics state: Wind qi enters the stomach along with the Yangming meridian, circulating up the vessels to the inner canthus. In obese individuals, wind qi cannot escape outward, resulting in "Heat in the Middle" (Re Zhong) and yellow eyes. In thin individuals, wind escapes outward accompanied by cold, resulting in "Cold in the Middle" (Han Zhong) and tearing. Thus, yellow eyes belong to heat, and tearing belongs to cold, which is clear.
Li Dongyuan stated: Water overcoming Wood leads upward to eye dryness, discharge (Chi), and cold tears. All these result from deficiency of Lung Metal, causing Liver Wood to lack restraint. Whenever the eyes encounter winds from the Northwest, dryness, pain, and tearing occur; this is a disease of Liver deficiency being overcome (Metal overcomes Wood). Treatment uses Zhilei Bugan San (Tear-Stopping Liver-Nourishing Powder) and moxa is applied to both Jingming (BL1) acupoints. Encountering winds from the Southeast causes dryness, pain, and tearing; this is a primary Liver disorder (Wood matches Wood). Treatment uses Juhua San (Chrysanthemum Powder). If regardless of the wind, cold tears flow upon exposure, this is latent fluid retention (Fu Yin) in the Liver and Kidney meridians, insufficient blood, empty orifices allowing wind entry, and evil triggering evil. Treatment uses Yeguang Jiaohong Wan (Night-Shining Pepper-Red Pill), or modify Siwu Tang by replacing Chishao with Shengdi, adding Fangfeng, Rougui, Qianghuo, and Muzei. If regardless of the wind, hot tears flow upon exposure, this is latent fire in the Liver and Kidney meridians, loose orifices, and wind drawing out the tears. Selectively use Chuanxiong Chatiao San or Juhua San. Pang Anchang stated: For head wind with cold tears, decoct and wash with Juhua (Chrysanthemi Flos), Juemingzi (Cassiae Semen), Baizhu (Atractylodis Macrocephalae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Xixin (Asari Radix et Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), and Jingjie (Schizonepetae Spica). If the eyes are not red or painful, with no other distress, and cold tears flow frequently even without wind exposure, potentially leading to blurred vision, this is weak Qi of Liver and Gallbladder and insufficient Kidney water. Use Bawei Wan (Eight-Ingredient Pill) using Sichuan pepper-processed Dihuang, added with Chuanxiong and Danggui. For postpartum cases of excessive weeping, use Shiquan Dabu Tang added with Chuanjiao and Xixin. If hot tears flow intermittently, this is internal fire agitating water, due to depletion of essence and blood in Liver and Kidney, where yang fire easily moves and damages fluids. Use Liuyun Wan (Six-Ingredient Pill) added with Chuanjiao and Zhi Shudi, doubling Danpi. For injury from excessive crying, use Bazhen Tang added with Chuanjiao and Wuweizi. Furthermore, if the Lung organ has long-standing cold, cold tears accumulate in the lacrimal sac at times; since these tears connect to the Lung, they are difficult to treat, and prolonged flow causes visual dimness. Another condition involves phlegm-like substance inside the eyelids, white, thick, and greasy, appearing upon wiping; this is phlegm-fire obstructing upwards, caused by Spleen and Lung damp-heat. Thus, those who enjoy alcohol, crave dry foods, and are prone to irritability and depression often suffer from this. Modify Xiaoyao San by removing Chaihu and Chenpi, adding Qianghuo, Fangfeng, and Juhua. If eyelid swelling and twisted, red vascular patterns are felt, the pathogen must have stagnated in the Blood level, guarding against complications such as Yu Xue Guan Jing (Blood Stasis Irrigating the Eye).