经曰∶诸脉者,皆属于目。又曰∶东方青色入于肝,开窍于目。陈飞霞曰∶夫目虽为肝窍,而五脏俱备,
神之所化。故白珠属肺,黑珠属肝,瞳仁属肾,两角属心,上下眼胞属脾。五脏五色,各有所司,心主赤,赤甚者,
心实热也;赤微者,心虚热也。肝主青,青甚者,肝热也;淡青者,肝虚也。脾主黄,黄甚者,脾热也;淡黄
者,脾虚也。目无睛光,及白睛多而黑睛少者,肝肾俱不足也。
目内赤色,心经积热上攻。宜泻丙火,从小便而出,导赤散加黄连防风。
目内黄者,脾热也,宜泻黄散。上下眼胞肿者,脾经风热,亦同上治。
目连眨者,肝有风也。凡病或新或久,肝风入目,上下左右
因风吹,儿不能任,故连眨也,泻青丸。目直视者,肝有热也。热气入目,障其筋脉,目之两角俱紧,不能转运,
故直视也,泻青丸。
小儿初生目闭,此胎热也。内服地黄汤,外用胆草煎汤洗目上,一日七次,恐延缠则损目。
小儿生下,眼泡赤烂者,由产时拭洗不净,以致秽恶浸溃两目角。故两泡赤烂,至长不瘥,真金散。
小儿久嗽,其目两眶肿黑,如物伤损,白珠红赤如血,谓之血眼。内服泻白散,外用贴法。
小儿生下数月内,夜不见物,谓之雀目,由肝虚也。六味地黄汤丸,常以猪肝煮熟压之。
小儿热病,其目羞明喜暗者,风热也。宜疏散风热,清阳散火汤。
导赤散(见前夜啼方内)
《集成》泻黄散 治脾经积热,白珠生黄。
藿香梗(一钱二分) 黑栀仁(一钱) 熟石膏(一钱) 防风(一钱) 炙甘草(六分)
净水煎,半饥服。
泻青丸 (见前颈项方内)
生地黄汤 治小儿胎热,初生眼闭不开用。
生地(一钱) 赤芍药(一钱) 川芎(五分) 当归(一钱) 天花粉(一钱) 炙甘草(一钱) 灯心
(十茎) 长流水煎服。
《集成》真金散 治小儿眼泡赤烂用。
川雅连(一钱) 黄柏(一钱) 当归(一钱) 赤芍药(一钱) 杏仁(一钱去皮尖)
上锉碎,以乳汁浸一宿,饭上蒸过,取浓汁点眼内。
泻白散 治小儿久嗽,两眶黑肿,白珠如血用。
炙甘草(一钱) 桔梗(一钱) 陈皮(一钱) 桑白皮(一钱) 地骨皮(一钱)
又贴药用。
生地(一两) 黑豆(一两)
上二味用水同浸一宿,取起捣为膏,贴眼皮上,其血自散,血泪既出,肿黑自消。
六味地黄丸(见前喘哮方内)
清阳散火汤 治小儿风热眼疾,羞明喜暗用。
荆芥穗(一钱) 条芩(一钱) 川芎(五分) 防风(一钱) 连翘(一钱) 黑栀仁(一钱) 当归
(一钱) 熟石膏(一钱) 羌活(五分) 炙甘草(一钱) 灯心(十茎)
水煎食后服。
涂蔚生曰∶眼科另是一种专门学问,自有方书可查。小儿除风火食热等症外,内外障疾颇少,故本书不多赘
及。但其所谓之两眼角属心,当有心肾之分,未可混合。大眼角之红筋属心,红而胀大者,心实热也。小眼角则
属于肾,红甚固属火甚,淡红则属相火虚也。粟黍之辨,似过于迂。诚恐差以毫厘,谬以千里耳。
古籍记载说:所有的经脉,都汇聚于眼睛。又说:东方青色入通于肝,肝开窍于目。陈飞霞说:眼睛虽然作为肝的窍道,但五脏的功能在眼中都有体现,是神气所化生的结果。因此,眼白(巩膜)属于肺,黑珠(虹膜及瞳孔部分)属于肝,瞳仁属于肾,内外眼角属于心,上下眼睑属于脾。五脏对应五色,各有其主管范围:心主红色,红色严重的,是心经实热;红色轻微的,是心经虚热。肝主青色,青色严重的,是肝热;颜色淡青的,是肝虚。脾主黄色,黄色严重的,是脾热;颜色淡黄的,是脾虚。如果眼睛没有神采光泽,以及眼白多而黑珠少的情况,是肝肾两脏都不足的表现。
眼睛内部发红,是心经积热上攻所致。应当清泻心火(丙火),使热邪从小便排出,可用导赤散加黄连、防风。
眼睛内部发黄,是脾热所致,适宜用泻黄散。上下眼睑肿胀的,是脾经风热所致,治疗方法同上。
眼睛频繁眨动的,是肝有风邪所致。无论疾病是新发还是久病,若肝风侵入眼部,加上外界风吹刺激,小儿无法忍受,所以会频繁眨眼,治疗用泻青丸。眼睛直视不转的,是肝有热邪所致。热气侵入眼部,阻滞筋脉,导致两眼角拘紧,不能转动,所以出现直视症状,治疗用泻青丸。
新生儿出生时眼睛紧闭,这是胎热所致。内服地黄汤,外用龙胆草煎汤清洗眼部,每天七次,恐怕拖延会导致病情缠绵从而损害视力。
小儿出生后,眼睑红肿溃烂的,是因为分娩时擦拭清洗不干净,导致污秽之物浸渍腐蚀两眼眼角。所以眼睑红肿溃烂,长期不愈,使用真金散。
小儿久咳,眼眶周围肿胀发黑,如同受到外伤损伤,眼白发红如血,称为“血眼”。内服泻白散,外用贴敷疗法。
小儿出生后数月内,夜间看不见东西,称为“雀目”(夜盲症),这是由于肝虚所致。服用六味地黄丸,经常将煮熟的猪肝敷压在眼部。
小儿患热病,眼睛怕光喜暗的,是风热所致。适宜疏散风热,使用清阳散火汤。
导赤散(见前文夜啼方剂中)
《集成》泻黄散 治疗脾经积热,眼白发黄。
藿香梗(一钱二分) 黑栀仁(一钱) 熟石膏(一钱) 防风(一钱) 炙甘草(六分)
用清水煎煮,在半饥半饱时服用。
泻青丸 (见前文颈项方剂中)
生地黄汤 治疗小儿胎热,初生眼闭不开时使用。
生地(一钱) 赤芍药(一钱) 川芎(五分) 当归(一钱) 天花粉(一钱) 炙甘草(一钱) 灯心(十茎)
用长流水煎服。
《集成》真金散 治疗小儿眼睑红肿溃烂使用。
川雅连(一钱) 黄柏(一钱) 当归(一钱) 赤芍药(一钱) 杏仁(一钱,去皮尖)
以上药材切碎,用乳汁浸泡一夜,放在饭上蒸过,取浓汁点入眼内。
泻白散 治疗小儿久咳,眼眶黑肿,眼白如血使用。
炙甘草(一钱) 桔梗(一钱) 陈皮(一钱) 桑白皮(一钱) 地骨皮(一钱)
另外用于贴敷的药方:
生地(一两) 黑豆(一两)
以上两味药用水共同浸泡一夜,取出捣碎成膏,贴在眼皮上,瘀血自然消散,血泪流出后,肿胀黑色自然消退。
六味地黄丸(见前文喘哮方剂中)
清阳散火汤 治疗小儿风热眼疾,怕光喜暗使用。
荆芥穗(一钱) 条芩(一钱) 川芎(五分) 防风(一钱) 连翘(一钱) 黑栀仁(一钱) 当归(一钱) 熟石膏(一钱) 羌活(五分) 炙甘草(一钱) 灯心(十茎)
水煎,饭后服用。
涂蔚生说:眼科是一种专门的学问,自有方书可以查阅。小儿除了风、火、食、热等病症外,内障和外障疾病很少,所以本书不再过多赘述。但是其中所说的两眼眼角属心,应当区分心和肾,不可混淆。大眼角(内侧)的红筋属于心,红且胀大的,是心经实热。小眼角(外侧)则属于肾,红得厉害固然属于火盛,淡红则属于相火虚。对于粟黍之辨(指对细微症状的过度辨析),似乎过于迂腐。诚恐差之毫厘,谬以千里。
The classics state: All meridians converge upon the eyes. It is also stated: The green color of the East enters the Liver (Gan), which opens into the eyes. Chen Feixia said: Although the eyes serve as the orifice of the Liver, the functions of all five Zang organs are present within them, transformed from Shen (Spirit). Therefore, the white part of the eye (sclera) belongs to the Lung (Fei), the black pupil/iris belongs to the Liver, the pupil belongs to the Kidney (Shen), the inner and outer canthi belong to the Heart (Xin), and the upper and lower eyelids belong to the Spleen (Pi). The five Zang organs correspond to five colors, each having its specific domain: The Heart governs red; severe redness indicates Heart Excess-Heat (Xin Shi Re); slight redness indicates Heart Deficiency-Heat (Xin Xu Re). The Liver governs green; severe greenness indicates Liver Heat (Gan Re); pale green indicates Liver Deficiency (Gan Xu). The Spleen governs yellow; severe yellowness indicates Spleen Heat (Pi Re); pale yellow indicates Spleen Deficiency (Pi Xu). If the eyes lack luster and vitality, or if the sclera is excessive while the iris/pupil is diminished, this indicates insufficiency of both the Liver and Kidney.
Redness inside the eye is caused by accumulated heat in the Heart meridian attacking upwards. One should clear and drain Heart Fire (Bing Huo), allowing the pathogenic heat to exit via urination. Use Dao Chi San (Coptis Decoction for Expelling Emptiness) added with Huang Lian (Rhizoma Coptidis) and Fang Feng (Saposhnikoviae Radix).
Yellowness inside the eye indicates Spleen Heat; Xie Huang San (Decoction to Drain the Spleen) is appropriate. Swelling of the upper and lower eyelids is due to Wind-Heat in the Spleen meridian, treated similarly.
Frequent blinking of the eyes indicates Wind in the Liver. Whether the illness is new or chronic, if Liver Wind enters the eyes, combined with external wind stimulation, the child cannot tolerate it, resulting in frequent blinking. Treat with Xie Qing Wan (Pill to Drain the Green/Liver). Fixed staring gaze indicates Heat in the Liver. Heat qi enters the eye, obstructing the sinews and vessels, causing tension at both corners of the eyes and inability to rotate, resulting in fixed staring. Treat with Xie Qing Wan.
Newborns with closed eyes at birth suffer from Fetal Heat (Tai Re). Internally administer Di Huang Tang (Rehmannia Decoction); externally wash the eyes with a decoction of Long Dan Cao (Gentianae Radix) seven times daily, lest delay leads to lingering pathology damaging vision.
Infants born with red and ulcerated eyelids result from incomplete cleaning during delivery, allowing filth to soak and corrode the eye canthi. Thus, the eyelids remain red and ulcerated without healing for a long time. Use Zhen Jin San (True Gold Powder).
Children with chronic cough who develop swollen and darkened orbital areas, resembling trauma, with sclera red as blood, are diagnosed with "Blood Eye" (Xue Yan). Internally administer Xie Bai San (Decoction to Drain the White/Lung); externally apply topical paste.
Infants within months of birth who cannot see at night suffer from "Sparrow Eye" (Que Mu, i.e., Night Blindness), caused by Liver Deficiency. Administer Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia), and frequently press cooked liver against the eyes.
Children with febrile diseases who show photophobia and preference for darkness suffer from Wind-Heat. Disperse Wind-Heat using Qing Yang San Huo Tang (Clear Yang Decoction to Dispel Fire).
Dao Chi San (See Night Crying formula above).
Ji Cheng Xie Huang San: Treats Spleen meridian accumulated heat, presenting with yellow sclera.
Huo Xiang Geng (Aromatic Rice Stem, 1.2 qian), Hei Zhi Ren (Black Gardenia Seed, 1 qian), Shu Shi Gao (Prepared Gypsum Fibrosum, 1 qian), Fang Feng (Saposhnikoviae Radix, 1 qian), Zhi Gan Cao (Honey-fried Licorice Root, 0.6 qian).
Decoct in clean water; take when half-hungry.
Xie Qing Wan (See Neck Formula above).
Sheng Di Huang Tang: Treats pediatric fetal heat, used for newborns with closed eyes.
Sheng Di (Raw Rehmannia Root, 1 qian), Chi Shao Yao (Red Peony Root, 1 qian), Chuan Xiong (Ligusticum Rhizome, 0.5 qian), Dang Gui (Angelica Sinensis, 1 qian), Tian Hua Fen (Trichosanthes Root, 1 qian), Zhi Gan Cao (Honey-fried Licorice Root, 1 qian), Deng Xin (Juncus Medullary, 10 stalks).
Decoct in running water and take orally.
Ji Cheng Zhen Jin San: Treats pediatric red and ulcerated eyelids.
Chuan Ya Lian (Chuanlian/Coptis, 1 qian), Huang Bo (Phellodendron Bark, 1 qian), Dang Gui (Angelica Sinensis, 1 qian), Chi Shao Yao (Red Peony Root, 1 qian), Xing Ren (Apricot Seed, peeled and removed of tips, 1 qian).
Crush the herbs, soak in milk overnight, steam over rice, extract thick juice, and instill into the eyes.
Xie Bai San: Treats pediatric chronic cough with dark swollen orbits and bloody sclera.
Zhi Gan Cao (Honey-fried Licorice Root, 1 qian), Jie Geng (Platycodon Root, 1 qian), Chen Pi (Aged Tangerine Peel, 1 qian), Sang Bai Pi (Mulberry Root Bark, 1 qian), Di Gu Pi (Lycium Bark, 1 qian).
Additionally, for topical application:
Sheng Di (Raw Rehmannia Root, 1 liang), Hei Dou (Black Soybean, 1 liang).
Soak these two ingredients in water overnight, remove, pound into a paste, and apply to the eyelids. The blood stasis will dissipate naturally; after blood tears cease, swelling and darkness will resolve.
Liu Wei Di Huang Wan (See Asthma/Wheezing formula above).
Qing Yang San Huo Tang: Treats pediatric Wind-Heat eye disease with photophobia and preference for darkness.
Jing Jie Sui (Schizonepeta Flower Spike, 1 qian), Tiao Qin (Scutellaria Root, 1 qian), Chuan Xiong (Ligusticum Rhizome, 0.5 qian), Fang Feng (Saposhnikoviae Radix, 1 qian), Lian Qiao (Forsythia Fruit, 1 qian), Hei Zhi Ren (Black Gardenia Seed, 1 qian), Dang Gui (Angelica Sinensis, 1 qian), Shu Shi Gao (Prepared Gypsum Fibrosum, 1 qian), Qiang Huo (Notopterygium Rhizome, 0.5 qian), Zhi Gan Cao (Honey-fried Licorice Root, 1 qian), Deng Xin (Juncus Medullary, 10 stalks).
Decoct in water; take after meals.
Tu Weisheng remarked: Ophthalmology is a specialized discipline with its own medical texts for reference. Aside from conditions like Wind, Fire, Food Stagnation, and Heat, children rarely suffer from internal or external cataracts/opacities; thus, this book does not elaborate extensively on them. However, regarding the assertion that both eye canthi belong to the Heart, one must distinguish between the Heart and Kidney, avoiding conflation. The medial canthus (inner corner) red veins belong to the Heart; redness with swelling indicates Heart Excess-Heat. The lateral canthus (outer corner) belongs to the Kidney; intense redness indicates excessive Fire, while pale red indicates Deficient Ministerial Fire (Xiang Huo Xu). The distinction regarding millet-sized grains seems overly pedantic. Indeed, a slight error may lead to a great deviation.