陈紫山曰∶古方有十种论症,然脉浮为风虚,沉伏为水病,沉则脉络虚,伏则小便难,即为正水,脾脉虚大,
多作脾肿,因循不治,乃成水肿。盖脾属土,喜燥而恶湿,土败不能制水,则停蓄不行,留滞皮肤,故作浮肿。初
得病时,是眼胞早晨浮突,
至午后稍消。然此症夏与秋冬治之颇易,惟春不然。盖四时之水,无如春水泛滥,兼肝木旺而脾土受克,不能制
水,所以难疗。进退不常,徐徐调理取效。大凡小儿浮肿,先用发散,然后以泄法。
治法∶推三关,推脾土,黄蜂出洞,运五经纹,二扇门,掐威灵,天门入虎口,斗时。春夏用水,秋冬用葱、
姜,真麻油调之,再用酒一盏,飞盐少许,皂角一片为末,黄土一钟,同炒,布包,倒合掌心,掐大指节即消。
涂蔚生曰∶肿以四肢言,胀以心腹言。虽同是脾胃主病,而其中寒热虚实,亦无不参杂其间。挟外感而发生
肿胀者,亦不过十分中之一二耳。治之者必须审定此种肿胀,是否有寒有热,有虚有实,而为一种寒热虚实之对
待法。方不至为病所误,而为紫山之先用发散,后以泻法所瞒也。
陈紫山曰∶小儿双目忽然红,盖因肝脏热兼风,散风清火斯为妙,痘后须知宜别攻。火眼之症治,宜补肾水,
推天河,六腑,分阴阳,运八卦,推脾土,水底捞明月,合骨,曲池,肩井。
风眼之症治,宜推三关,揉肾,掐五指节,分阴阳,运八卦,推天河,六腑,水底捞明月,合谷,曲池,肩井。
涂蔚生曰∶紫山只云风眼火眼之症,而未云风眼究系何如,火眼究系何若,未免叫人难辨。实则火眼色极赤而
干燥,风眼色鲜红而多泪也。然火甚可以生风,而风甚亦多含火也。
陈紫山说:古代医方中有十种论述病症的方法,然而脉象浮取表示风邪或虚证,沉取伏匿表示水湿病证;脉象沉表示脉络空虚,脉象伏表示小便困难,这被称为正水(指水气内停的重症水肿);脾脏的脉象虚大,多表现为脾肿大。如果拖延不治疗,就会演变成全身性水肿。因为脾脏属土,喜欢干燥而厌恶潮湿,如果脾气衰败不能制约水湿,就会导致水液停滞不行,滞留于皮肤之间,从而形成浮肿。在疾病初起时,早晨眼睑会突然浮肿,到了午后症状会稍微减轻。然而这种病症在夏季和秋冬季节治疗比较容易,唯独春季不同。因为四季中的水气,没有像春天那样泛滥的,加上春季肝木旺盛克制脾土,导致脾土不能制约水湿,所以难以治疗。病情变化无常,需要慢慢调理才能见效。大凡小儿出现浮肿,先用发散风邪的方法,然后再用泄法。
治疗方法:推三关穴,推脾土穴,黄蜂出洞手法,运五经纹,二扇门穴,掐威灵穴,天门入虎口手法,斗时手法。春夏季节用水调药,秋冬季节用葱、姜调药,用纯芝麻油调和,再用酒一杯,少许飞盐,一片皂角研成粉末,一钟黄土,一起炒热,用布包裹,倒扣在掌心,掐按大拇指节即可消退。
涂蔚生说:肿主要指四肢的症状,胀主要指心腹部的症状。虽然都主要是脾胃主管的疾病,但其中的寒热虚实夹杂情况,也没有不包含在内的。由外感引发的肿胀,也不过是其中的十分之一二罢了。治疗者必须仔细审定这种肿胀,是否有寒有热,有虚有实,从而采取相应的寒热虚实对治方法。这样才不会误诊,也不会被陈紫山提出的“先用发散,后用泻法”的观点所误导。
陈紫山说:小儿双眼突然发红,是因为肝脏有热兼受风邪,疏散风邪、清除火热才是妙法,痘疹后遗症需知应当另行攻治。火眼病症的治疗,宜补肾水,推天河穴,六腑穴,分阴阳手法,运八卦手法,推脾土穴,水底捞明月手法,合骨穴,曲池穴,肩井穴。
风眼病症的治疗,宜推三关穴,揉肾穴,掐五指节,分阴阳手法,运八卦手法,推天河穴,六腑穴,水底捞明月手法,合谷穴,曲池穴,肩井穴。
涂蔚生说:陈紫山只说了风眼和火眼的病症,却没有说明风眼究竟是什么样的,火眼究竟是什么样的,未免让人难以辨别。实际上,火眼的颜色极红且干燥,风眼的颜色鲜红且多泪。然而火势盛可以生风,风势盛也往往含有火邪。
Chen Zishan said: Ancient prescriptions include ten types of syndrome discussions. However, a floating pulse indicates wind or deficiency, while a deep and hidden pulse indicates water-dampness disease; a deep pulse suggests empty meridians, and a hidden pulse suggests difficulty in urination, which is termed Zheng Shui (True Water edema); a deficient and large spleen pulse often indicates splenic swelling. If left untreated over time, it develops into generalized edema. Since the spleen belongs to Earth, it prefers dryness and dislikes dampness. When Earth fails to control Water, fluid accumulation stagnates and remains in the skin, causing swelling. At the onset of the disease, the eyelids swell suddenly in the morning and subside slightly by afternoon. This condition is relatively easy to treat in summer, autumn, and winter, but difficult in spring. Among the four seasons, no water qi is as rampant as in spring; combined with the flourishing Liver Wood overcoming Spleen Earth, preventing Earth from controlling Water, treatment becomes challenging. The condition fluctuates irregularly, requiring gradual regulation for efficacy. Generally, for pediatric edema, one should first use dispersing methods, followed by draining methods.
Treatment methods: Push San Guan (Three Gates), push Pi Tu (Spleen Earth), Huang Feng Chu Dong (Yellow Bee Exits Cave), move Wu Jing Wen (Five Meridian Lines), Er Feng Men (Two Gate Doors), pinch Wei Ling, Tian Men Ru Hu Kou (Heaven's Door Enters Tiger's Mouth), Dou Shi (Fight Time). In spring and summer, use water for mixing; in autumn and winter, use scallion and ginger. Mix with pure Sesame Oil (Sesamum indicum), add one cup of wine, a little refined salt, one piece of Gleditsia sinensis (Zao Jiao) powder, and one bell full of yellow soil. Stir-fry together, wrap in cloth, invert onto the palm, and pinch the thumb joint to reduce swelling.
Tu Weisheng said: "Swelling" refers to symptoms in the four limbs, while "distension" refers to symptoms in the heart and abdomen. Although both are primarily diseases governed by the Spleen and Stomach, cold, heat, deficiency, and excess are invariably mixed within them. Swelling caused by external pathogens accounts for only one or two out of ten cases. Practitioners must carefully determine whether the swelling involves cold, heat, deficiency, or excess, and apply corresponding treatments based on these patterns. Only then can one avoid being misled by Chen Zishan’s assertion of using dispersing methods first and draining methods later.
Chen Zishan said: Sudden redness in children's eyes is due to Liver heat combined with wind. Dispersing wind and clearing fire is the best approach; for sequelae after smallpox/variolous eruptions, different attacking methods are required. For Huo Yan (Fire Eye), treatment should tonify Kidney Water, push Tian He Shui (River of Heaven), Liu Fu (Six Fathoms), Fen Yin Yang (Separate Yin and Yang), move Ba Gua (Eight Trigrams), push Pi Tu (Spleen Earth), perform Shui Di Lao Ming Yue (Fishing the Bright Moon from the Bottom of the Water), and stimulate He Gu (Hegu, LI4), Qu Chi (Quchi, LI11), and Jian Jing (Jianjing, GB21).
For Feng Yan (Wind Eye), treatment should push San Guan (Three Gates), knead the Kidney, pinch Wu Zhi Jie (Five Finger Joints), separate Yin and Yang, move Ba Gua (Eight Trigrams), push Tian He Shui (River of Heaven), Liu Fu (Six Fathoms), perform Shui Di Lao Ming Yue (Fishing the Bright Moon from the Bottom of the Water), and stimulate He Gu (Hegu, LI4), Qu Chi (Quchi, LI11), and Jian Jing (Jianjing, GB21).
Tu Weisheng said: Zishan mentioned Wind Eye and Fire Eye syndromes but failed to describe their specific characteristics, making them hard to distinguish. In reality, Fire Eye presents with extreme redness and dryness, whereas Wind Eye presents with bright redness and excessive tearing. However, intense fire can generate wind, and strong wind often contains fire elements.