徽州方奉安令郎，十二岁。孩时乳母无乳，且喜酒，恐其父知无乳，私以果米食喂之，
乳哺三年后，便眼弦红烂，此受母湿热故也，渐至眼不得开。延予治之，六脉俱洪。予曰∶此肾
水不足之疾，当益水以滋肝木，以六味汤加柴胡、山栀，数十帖而愈，时方秋候，余复言宜
多服前剂，预培肾水，以助来春生发之气。彼怠缓不果，至春遂如予言。他医治以芩、连凉
心之剂，进至五日，眼不开，且发热不思食，作泻，咳嗽，此过伤苦寒，收降太过，致阳气
受亏，胃气不升发也。（凡过服苦寒，在血实之人，胃络凝痹，当见一块结急而疼痛，且
愈觉内热。血虚之人，胃血辟易，胃体寒僵，肚中一片全不柔和，溏泄作坠而微痛，若不速
救，至舌淡无苔，是血络全闭，胃气不能上荣也。此案是湿热酒毒，久伏血肉之中，治宜活
血解毒，使遍身发疮自瘳。苦寒逆折，固在所忌，甘温补脾，亦非邪盛时所宜，能增湿热助
毒瓦斯。）复请视之，六脉俱八、九至，按至骨则细无神，左心肝洪大于右，按之无力，此气
血大虚，元气大惫之症。幸童子真元未散，尚可救药，亦须服药半年，方可见效，治以四君
加黄 、山药、门冬、五味。三月，发热、咳嗽稍可，作泻犹未止，教以服补剂参苓白术丸
，间以前药，至半年，脉退六七，眼亦开矣，第赤烂上下粘腻未除，或时可，或时粘，此正
气未全复，邪火未全退也，还当扶元气，而邪火自息。彼吝于参费，复用别医，以补血当归
、生地之类，一两月，前症复作，眼复赤烂不开，反增恶寒发热，作泻、咳嗽如旧，事已告
急，复求予诊，六脉俱细数，比前更甚，余许以八帖之后，恶寒不减，便不可回。服保元加
白术、门冬、五味。四剂后，恶寒顿退，惟发热不已。余曰∶盖恶寒者，阳气虚也，服四剂
而祛之，阳尚强，尚可救疗，后以保元、四君加山药、门冬出入服之。至冬，眼弦赤烂已去
，数脉俱退，止五六至，按之无力，眼中不时两 有红 入睛，此阳虚上越之故也。以补中
汤去升麻，入熟附一二分，七八剂 退，数脉亦退，仍眼前剂而全愈。
左光禄丞，年及四十。两目俱瘀肉满珠，他医与以祛风散热之剂，不效。余谓∶脾主肌
肉，此脾胃肉滞也。以桃仁泥二钱，枳实一钱半，连翘一钱半，元明粉二分，白芷二分，山楂肉
一钱半，晚上日服一帖，至十帖而全愈。余以此方治数百人患此者，俱未尝不效。第先曾服
多苦寒之剂，已伤脾胃，不思饮食者，禁不可与，如勉用之，则眼必坏，且致虚损。如患此
症，服过寒凉，已伤中气，且宜静养守之，亦得渐退，不可造次，至于失明。盖此症医者罕
识，阳明多血多气之经，而经云∶血实宜决之，此方决之之意也。如患者脾胃素虚，必欲服
之，或间日一帖，或间二日一帖可也，急服则损目伤脾也。（此方从桃仁承气套出，而丁宁
告戒者，过服寒凉，胃血辟易，再用苦咸寒泄，即血不复能上荣。）
邱豫章，患瘀 满眼，医以大黄行之，祛风散热之剂服之，俱不退，以前方三、四剂而
一女人，年五十余。素眼疾，因服祛风散热之剂，忽口干，且发热，多眵，开合不得，
红筋薄翳满目，六脉洪数五六至，浮沉俱无力，此气有余而血不足症也。四物加黑柏二分、
刘夫人，年五十余，忽眼疾，医以祛风散热养血之剂治之，不效。已五、六日矣，眼珠
痛，声撼邻。予诊之，左关洪喘且大，此肝血不足，肝自生风也。细观之，左瞳神散大，痛不可
忍，无红筋，加味逍遥一帖，服之痛止，一二时复作，此药力尽也，日服二剂，将六七帖，
痛减十六，十二三帖全愈，后教以服六味地黄以生肝木。
杨宅使女，年八岁。两目眵泪不干，眼眶赤烂，此脾胃湿热，以胃苓加酒炒黄芩、连翘
一朱友，年三十外，患左目自上而下，红瘀兼翳，俗曰垂帘。其势自上而下，象垂帘之
状，故云。用加味逍遥去白术，加川芎，少白芍。十数帖，去其十六，再十帖而全愈。复令服地
一唐友，年二十外，症亦如前，亦用逍遥加减如上，服十五六帖而愈。
徽州方奉安县令的儿子，十二岁。小时候乳母没有乳汁，且喜欢喝酒，恐怕被父亲知道没奶，私自用果子和米汤喂养他。哺乳三年后，便出现眼睑边缘红肿溃烂，这是受到母亲体内湿热的影响，逐渐发展到眼睛无法睁开。请我诊治时，六脉都呈现洪大之象。我说：这是肾水不足的病证，应当滋补肾水以滋养肝木，使用六味地黄汤加入柴胡、山栀，服用几十帖后痊愈。当时正值秋季，我又建议多服用前面的方剂，预先培补肾水，以助来年春季的生发之气。但他懈怠拖延没有照做，到了春天果然如我所言发病。其他医生用黄芩、黄连等凉心药物给他治疗，服用了五天，眼睛更加无法睁开，并且发热、不想吃东西、腹泻、咳嗽，这是因为过度损伤了苦寒药物，收敛下降太过，导致阳气受损，胃气不能升发。（凡是过度服用苦寒药物，对于血实的人，胃络会凝滞痹阻，应当见到一块结急而疼痛，且更觉得内热。对于血虚的人，胃血会被排斥移位，胃体变得寒冷僵硬，肚中一片完全不再柔和，大便溏泄且有下坠感并微痛，如果不迅速救治，等到舌淡无苔，就是血络完全闭塞，胃气不能上荣于面。这个案例是湿热酒毒，长久潜伏在血肉之中，治疗应当活血解毒，使全身发出疮疡自然痊愈。苦寒逆折，固然在所禁忌，甘温补脾，也不是邪气盛时所适宜，会增加湿热帮助毒瓦斯。）再次请我诊治，六脉都达到八、九至，按到骨头则细弱无神，左心肝脉比右脉洪大，但按之无力，这是气血大虚、元气极度疲惫的症状。幸好童子真元尚未散失，还可以救治，但也需要服药半年，才能见效，治疗使用四君子汤加入黄芪、山药、麦冬、五味子。三个月后，发热、咳嗽稍有好转，但腹泻仍未停止，教导他服用补剂参苓白术丸，间断服用前面的药方，到了半年，脉象退去六七成，眼睛也能睁开了，只是上下眼睑赤烂粘腻未除，有时好一些，有时又粘腻，这是正气未完全恢复，邪火未完全消退的缘故，还应当扶助元气，邪火自然会平息。他吝啬人参的费用，又找别的医生，用补血当归、生地之类的药物，一两个月后，前面的症状复发，眼睛再次赤烂无法睁开，反而增加了恶寒发热、腹泻、咳嗽如旧，事情已经危急，再次请求我诊脉，六脉都细数，比以前更严重，我许诺八帖之后，如果恶寒不减轻，就不可挽救了。服用保元汤加白术、麦冬、五味子。四剂后，恶寒顿时减退，只有发热不止。我说：大概恶寒是因为阳气虚，服用四剂后祛除了它，阳气尚强，还可以救疗，后来用保元汤、四君子汤加入山药、麦冬交替服用。到了冬天，眼睑赤烂已去除，数脉全部退去，只剩五六至，按之无力，眼中不时有红丝进入睛珠，这是阳虚上浮的缘故。使用补中益气汤去掉升麻，加入熟附子一二分，七八剂后红丝退去，数脉也退去，仍然服用前面的方剂而完全痊愈。
左光禄丞，年龄接近四十。双眼都有瘀肉长满眼球，其他医生给予祛风散热的药剂，无效。我说：脾主肌肉，这是脾胃肌肉滞涩。使用桃仁泥二钱，枳实一钱半，连翘一钱半，元明粉二分，白芷二分，山楂肉一钱半，晚上每日一帖，服用十帖后完全痊愈。我用这个方子治疗数百人患此病者，都没有不有效的。只是先前曾服用过多苦寒药物，已经损伤脾胃，不思饮食的人，禁止不可使用，如果勉强使用，那么眼睛必定毁坏，并且导致虚损。如果患此症，服用过寒凉药物，已经损伤中气，且宜静养守之，也能逐渐消退，不可急躁，以至于失明。大概此症医者很少认识，阳明是多血多气的经络，而经云：血实宜决之，这个方子就是决之的意思。如果患者脾胃素来虚弱，一定要服用，或者隔日一帖，或者隔两日一帖也可以，急服则会损害眼睛伤害脾胃。（这个方子从桃仁承气汤套出，而丁宁告诫的是，过度服用寒凉，胃血被排斥移位，再用苦咸寒泄，即血液不能再上荣。）
邱豫章，患有瘀肉满眼，医生用大黄行气，祛风散热的药剂服用，都不退，以前方三、四剂而愈。
刘夫人，年五十余。素来眼疾，因服用祛风散热药剂，忽然口干，且发热，多眵（眼屎），开合不得，红筋薄翳满目，六脉洪数五六至，浮沉俱无力，这是气有余而血不足症也。
杨宅使女，年八岁。两目眵泪不干，眼眶赤烂，这是脾胃湿热，以胃苓汤加酒炒黄芩、连翘治疗。
朱友，年三十外，患左目自上而下，红瘀兼翳，俗曰垂帘。其势自上而下，象垂帘之状，故云。用加味逍遥散去掉白术，加入川芎，少用白芍。十数帖，去其十六，再十帖而全愈。复令服地黄丸。
唐友，年二十外，症亦如前，亦用逍遥散加减如上，服十五六帖而愈。
The son of Fang Feng'an, Magistrate of Huizhou, was twelve years old. In his infancy, the wet nurse had no milk and enjoyed drinking alcohol. Fearing her master would discover she lacked milk, she privately fed him fruit and rice gruel. After three years of nursing, he developed redness and ulceration of the eyelid margins; this was due to receiving damp-heat from the mother, gradually progressing until the eyes could not open. When I treated him, all six pulses were surging (Hong). I said: This is a disease of insufficient Kidney Water (Shen Shui); one should tonify Water to nourish Liver Wood (Gan Mu), using Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction) added with Chaihu (Bupleuri Radix) and Shanzhi (Gardeniae Fructus). After dozens of doses, he recovered. At that time, it was autumn. I further advised taking more of the previous formula to pre-nourish Kidney Water, aiding the rising energy of the coming spring. He was negligent and did not follow through. By spring, as predicted, he fell ill. Other physicians treated him with cooling agents like Huangqin (Scutellariae Radix) and Lianzi (Coptidis Rhizoma) to cool the Heart. After five days, his eyes remained closed, accompanied by fever, anorexia, diarrhea, and cough. This resulted from excessive damage by bitter-cold herbs, causing too much contraction and descent, leading to deficiency of Yang Qi and failure of Stomach Qi to ascend. (Generally, excessive use of bitter-cold herbs in persons with Blood Excess causes stagnation and bi-syndrome in the stomach collaterals, presenting as a painful, tight knot and increased internal heat. In persons with Blood Deficiency, stomach blood is displaced, the stomach body becomes cold and stiff, the abdomen feels completely unyielding, with loose stools, bearing-down sensation, and slight pain. If not rescued promptly, leading to a pale tongue without coating, it indicates complete closure of blood collaterals and inability of Stomach Qi to nourish upwards. This case involves damp-heat and alcohol toxins lurking long-term in flesh and blood; treatment should focus on invigorating blood and resolving toxicity, allowing sores to erupt over the body for natural healing. Bitter-cold reversal is strictly contraindicated; sweet-warm spleen tonification is also unsuitable when pathogenic factors are abundant, as it increases damp-heat and aids toxin qi.) Upon re-examination, all six pulses were rapid (8-9 beats per breath), becoming thin and spiritless when pressed to the bone. The Left Heart and Liver pulses were larger than the Right but powerless upon pressure. This indicated severe deficiency of Qi and Blood, and extreme exhaustion of Yuan Qi. Fortunately, the boy's True Yuan had not dispersed, so he was still salvageable, though medication would be needed for half a year before effects appeared. Treatment used Sijunzi Tang (Four Gentlemen Decoction) added with Huangqi (Astragali Radix), Shanyao (Dioscoreae Rhizoma), Maidong (Ophiopogonis Radix), and Wuweizi (Schisandrae Fructus). After three months, fever and cough improved slightly, but diarrhea persisted. I instructed him to take Shenling Baizhu Wan (Ginseng, Poria, and Atractylodes Macrocephala Pill) as a tonic, interspersed with the previous prescription. By six months, the pulse slowed by 60-70%, and the eyes opened. However, redness and ulceration with sticky discharge at the upper and lower lids remained, fluctuating between improvement and stickiness. This signified incomplete recovery of Zheng Qi (Upright Qi) and incomplete clearance of Xie Huo (Evil Fire); thus, supporting Yuan Qi was necessary, after which Evil Fire would subside naturally. Stingy about the cost of Renshen (Ginseng Radix et Rhizoma), he consulted another physician who prescribed blood-tonifying herbs like Danggui (Angelicae Sinensis Radix) and Shengdi (Rehmanniae Radix). Within one to two months, previous symptoms recurred: eyes became red, ulcerated, and unable to open, accompanied by aversion to cold, fever, diarrhea, and cough. The situation became critical, and he sought my diagnosis again. All six pulses were fine and rapid, worse than before. I promised that if aversion to cold did not diminish after eight doses, recovery would be impossible. He took Baoyuan Tang (Preserve the Origin Decoction) added with Baizhu (Atractylodis Macrocephalae Rhizoma), Maidong, and Wuweizi. After four doses, aversion to cold suddenly subsided, leaving only persistent fever. I said: Aversion to cold stems from Yang Qi deficiency. Having dispelled it in four doses, Yang remains strong enough for salvage. Subsequently, Baoyuan Tang and Sijunzi Tang were alternated with additions of Shanyao and Maidong. By winter, eyelid redness and ulceration resolved, and rapid pulses decreased to 5-6 beats per breath, feeling powerless on pressure. Red filaments occasionally entered the eyeballs, caused by deficient Yang floating upward. Buyang Zhongyi Tang (Tonify the Middle and Augment the Qi Decoction) was used without Shengma (Cimicifugae Rhizoma), adding 1-2 fen of Shu Fuzi (Prepared Aconiti Lateralis Radix). After 7-8 doses, red filaments receded, rapid pulses normalized, and full recovery was achieved with continued dosage.
Zuo Guanglu Cheng, aged nearly forty, had fleshy growths (Pterygium) filling both eyeballs. Other physicians prescribed wind-dispelling and heat-clearing agents without effect. I stated: The Spleen governs muscles; this is stagnation of Spleen and Stomach muscle tissue. I prescribed Taoren Ni (Peach Kernel Paste) 2 qian, Zhishi (Aurantii Fructus Immaturus) 1.5 qian, Lianqiao (Forsythiae Fructus) 1.5 qian, Yuanming Fen (Mirabilite) 2 fen, Baizhi (Angelicae Dahuricae Radix) 2 fen, and Shanzha Rou (Crataegi Fructus Flesh) 1.5 qian, taken once nightly. After ten doses, he fully recovered. I have used this formula to treat hundreds of such cases with consistent efficacy. However, it is contraindicated for those who have previously taken many bitter-cold herbs, damaging the Spleen and Stomach, resulting in anorexia. Forcible use will ruin the eyes and cause deficiency consumptive diseases. If this condition arises after taking cold-cooling herbs that damaged Middle Qi, quiet rest and preservation are advisable; gradual regression can occur without haste, avoiding blindness. Few physicians recognize this syndrome. The Yangming channel is rich in blood and Qi. As the Classics state: "When Blood is excess, it should be drained." This formula embodies the principle of draining. If the patient has inherent Spleen-Stomach deficiency, it may be taken every other day or every two days; urgent administration damages the eyes and harms the Spleen. (This formula derives from Tao Ren Cheng Qi Tang, with strict warnings against excessive cold usage displacing stomach blood; subsequent bitter-salty-cold purgatives prevent blood from nourishing upwards.)
Qiu Yuzhang suffered from pterygium filling the eyes. Physicians used Dahuang (Rhei Radix et Rhizoma) for purgation and wind-dispelling/heat-clearing agents without success. Using the aforementioned formula for 3-4 doses cured him.
Madam Liu, over fifty years old. She had chronic eye disease. After taking wind-dispelling and heat-clearing agents, she suddenly experienced dry mouth, fever, excessive ocular discharge, inability to open/close eyes, and red vessels with thin membranes covering the eyes. All six pulses were surging and rapid (5-6 beats per breath), powerless at both superficial and deep levels. This indicated excess Qi and insufficient Blood. Treatment involved Siwu Tang (Four Substances Decoction) added with Heibai (Scorzonerae Radix? Note: Text says Heibai, likely referring to specific processed herb or typo for Ku Bai Pi/Huangbai contextually, but literal translation kept) 2 fen. *Correction based on standard TCM*: Likely refers to Ku Bai Pi (Phellodendri Cortex) or similar bitter cold herb, but text says "Heibai". I will translate literally as Heibai. Actually, looking at context "Siwu plus...", it might be a typo for Huangbai or Ku Bai. Given WHO standards, I will use the literal term provided in source if ambiguous, or standard equivalent if clear. "Heibai" is not standard. It might be "Huangbai" (Phellodendri Cortex) or "Ku Bai Pi". Let's assume it's a specific local name or typo. I will translate as "Heibai (likely Phellodendri Cortex)". Wait, looking at the next case, "Liu Furen" is mentioned separately? No, "Liu Furen" is the subject. "Yi ren... si wu jia hei bai...". Let's stick to literal.
Miss Yang, servant girl in the Yang household, eight years old. Her eyes had constant discharge and tears, with red and ulcerated eye sockets. This was Spleen-Stomach damp-heat. Treatment used Weiling Tang (Ping Wei San combined with Wu Ling San) added with Jiuhuang Qin (Wine-fried Scutellariae Radix) and Lianqiao.
Zhu You, over thirty years old, suffered from left eye pathology descending from top to bottom, with redness, stasis, and membrane, commonly called "drooping curtain". The trend descended, resembling a curtain. Treatment used Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) without Baizhu, added with Chuanxiong (Chuanxiong Rhizoma), and reduced Shaoyao (Paeoniae Radix Alba). After ten-plus doses, symptoms reduced significantly; after another ten doses, full recovery. He was then instructed to take Dihuang Wan (Rehmannia Pill).
Tang You, over twenty years old, presented similarly. Used modified Xiao Yao San as above, recovering after 15-16 doses.