久头痛病，略感风寒便发，寒月须重绵浓帕包裹者，此属郁热，本热而标寒。世人不识，率用辛温解
散之药，临时得效，误认为寒。殊不知因其本有郁热，毛窍常疏，故风寒易入，外寒束其内热，闭逆而为
痛。辛热之药，虽能开通闭逆，散其标之寒邪，以热济热，病本益深，恶寒愈甚矣。惟当泻火凉血为主，
而佐以辛温散表之剂以从法治之，则病可愈，而根可
除也。
愚按前症多主于痰，痛甚者乃风毒上攻。有血虚者，有诸经气滞者，有气虚者，有四气外伤，有劳
役所伤；有可吐者，有可下者，当分虚实寒热兼变而治之。若夫偏正头风，久而不愈，乃内挟痰涎，风火
郁遏经络，气血壅滞，甚则目昏紧小，二便秘涩。宜砭出其血，以开郁解表。余尝治尚宝刘毅斋，但怒则
两太阳作痛，先用小柴胡加茯苓、山栀，后用六味丸以生肾水，而不再发。
谭侍御，每头痛必吐清水，不拘冬夏，吃姜便止。余作中气虚寒，用六君、当归、黄 、木香、炮
姜而瘥。
商仪部，劳则头痛。余作阳虚不能上升，以补中益气加蔓荆子而痊。
眼赤肿痛，古方用药，内外不同。在内汤散，用苦寒辛凉之药以泻其火；在外点洗，则用辛热辛凉之
药以散其邪。故点药莫要于冰片，而冰片大辛热，以其性辛甚，故借以拔出火邪，而散其热气。古方用
烧酒洗眼，或用干姜末、生姜汁点眼者，皆此意也。盖赤眼是火邪内炎，上攻于目，故内治用苦寒之药，
是治其本，如锅底之去薪也。然火邪既客于目，从内
出外，若外用寒凉以阻逆之，则郁火内攻不得散矣。故点眼用辛热，而洗眼用热汤，是火郁则发，因而散
之，从治法也。世人不知冰片为劫药，而误认为寒，常用点眼，遂致积热入目，而昏暗障翳，故云眼
不点不瞎者此也。又不知外治忌寒凉，而妄将冷水冷物冷药挹洗，致昏瞎者有之。
愚按前症若体倦少食，视物昏花，或饮食劳倦益甚者，脾胃虚也，用补中益气汤；眵多紧涩，赤脉贯
睛，或脏腑秘结者，用芍药清肝丸；若赤翳布白，畏日羞明，或痛如刺者，上焦风热也，用黄连饮子；若
久视生花，畏日，远视如雾者，神气伤也，用神效黄 汤。大凡午前甚而作痛者，东垣助阳活血汤；午后
甚而作痛者，黄连天花粉丸；午后甚而不痛者，东垣益阴肾气丸。能近视不能远视，地芝丸；能远视不能
近视，定志丸。故东垣先生云∶五脏六腑之精气，皆禀受于脾，上贯于目。脾者，诸阴之首也；目者，
血脉之宗也。故脾虚则五脏之精气皆失所司，不能归明于目矣。心者，君火也，主人之神，宜静而
安，相火代行其令。相火者，包络也，主百脉，皆荣于目。既劳役运动，势乃妄行，又因邪气所并，而损
血脉，故诸病生焉。凡医者不理脾胃及养血安神，治标不治本，是不明正理也。若概用辛凉苦寒之剂，损
伤真气，促成内障之症矣。
给事张禹功，目赤不明，服祛风散热药，反畏明重听，脉大而虚。此因劳心过度，饮食失节。以补中
益气汤加茯神、酸枣、山药、山茱、五味，顿愈。又劳役复甚，用十全大补汤兼以前药，渐愈，却用补中
益气汤加前药而痊。
久治不愈的头痛病，稍微感受风寒就会发作，寒冷月份必须用厚重的棉絮和浓密的帕子包裹头部才能缓解，这属于郁热证，本质是内热而表象为寒。世人不懂此理，通常使用辛温解表的药物，虽然临时见效，却错误地认为是寒证。殊不知因为患者本有郁热，毛孔常处于疏松状态，所以风寒容易侵入，外部的寒邪束缚住内部的郁热，导致气机闭逆而引发疼痛。辛热性质的药物，虽然能够开通闭阻、驱散表层的寒邪，但以热助热，会使疾病的根本更加深重，恶寒的症状也会更加严重。只有以泻火凉血为主要治疗原则，同时辅以辛温解表的药剂来顺应病势进行治疗，疾病才可以痊愈，病根也可以去除。
我按察认为，前述症状多由痰湿引起，疼痛剧烈的则是风毒上攻所致。有的属于血虚，有的属于各条经络气机阻滞，有的属于气虚，有的因外界四时邪气侵袭，有的因过度劳累损伤；有的适合用吐法，有的适合用下法，应当根据虚实、寒热及兼夹变证分别施治。至于偏头痛或正头痛（头风），日久不愈，往往是内部夹杂痰涎，风火郁结阻塞经络，气血壅滞不通，严重时会出现视力模糊、眼睛紧缩变小、大小便干涩不通。适宜用砭石刺络放血，以开郁结、解表邪。我曾治疗尚宝监刘毅斋，他一生气两侧太阳穴就疼痛，我先用小柴胡汤加茯苓、山栀，后来用六味丸滋补肾水，此后不再复发。
谭侍御，每次头痛必定呕吐清水，无论冬夏，吃生姜就能止住。我将此症辨为中气虚寒，使用六君子汤加当归、黄芪、木香、炮姜，病情痊愈。
商仪部，一劳累就头痛。我将此症辨为阳虚不能上升，使用补中益气汤加蔓荆子，病情痊愈。
眼睛红赤肿痛，古方用药，内服和外用的方法不同。在内服用汤剂散剂，使用苦寒辛凉的药物以清泻火热；在外点洗，则使用辛热或辛凉的药物以驱散邪气。因此，点眼药没有比冰片更重要的了，而冰片性质大辛大热，因为它气味极辛，所以借其辛散之力拔出火邪，并散发热气。古方有用烧酒洗眼，或用干姜末、生姜汁点眼的，都是这个意思。大概红眼病是火邪内炎，向上攻冲于目，所以内治使用苦寒药物，这是治本，就像锅底去掉柴火一样。然而火邪既然客居在眼中，从内向外发散，如果外用寒凉药物去遏制它，那么郁结的火邪会在内部攻冲而无法散发。所以点眼使用辛热药物，洗眼使用热水，这是“火郁则发”，顺势疏散，属于从治法。世人不知道冰片是劫夺正气之药，而误认为它是寒性，常用它点眼，致使积热进入眼中，造成视力昏暗、障翳，所以说“眼睛不点药就不会瞎”指的就是这种情况。又有人不知道外治忌讳寒凉，而胡乱用冷水、冷物、冷药清洗，导致失明的也有。
我按察认为，前述症状如果身体疲倦、食欲不振、视物昏花，或者饮食劳倦后加重的，属于脾胃虚弱，使用补中益气汤；如果眼屎多、眼睛紧缩涩痛、红脉贯穿眼球，或者脏腑便秘的，使用芍药清肝丸；如果白睛布满赤翳、怕光羞明，或者疼痛如针刺的，属于上焦风热，使用黄连饮子；如果久视出现眼花、怕光、看远处像雾一样的，属于神气受损，使用神效黄芪汤。凡是上午加重且疼痛的，使用东垣助阳活血汤；下午加重且疼痛的，使用黄连天花粉丸；下午加重但不疼痛的，使用东垣益阴肾气丸。能看清近处但不能看清远处的，用地芝丸；能看清远处但不能看清近处的，用定志丸。所以李东垣先生说：五脏六腑的精气，都禀受于脾，向上贯通于目。脾是诸阴之首；目是血脉的宗汇。所以脾虚则五脏的精气都失去主宰，不能使目光清明。心是君火，主宰人的精神，宜静而安，相火代行其令。相火者，即心包络，主管全身血脉，都荣养于目。既然后天劳役运动，相火之势就会妄行，再加上邪气侵并，损伤血脉，各种疾病就产生了。凡是不调理脾胃及养血安神的医生，只治标不治本，是不明白正理。如果一概使用辛凉苦寒的药物，会损伤真气，促成内障眼病。
给事中张禹功，眼睛红赤不明亮，服用祛风散热药后，反而更怕光、听力沉重，脉象大而虚。这是因为用心过度、饮食不节制造成的。我用补中益气汤加茯神、酸枣仁、山药、山茱萸、五味子，立刻痊愈。后来又因劳役过度复发，使用十全大补汤兼以前面提到的药物，逐渐痊愈，最后改用补中益气汤加前面提到的药物而彻底康复。
Chronic headache that is triggered by slight exposure to wind-cold, requiring heavy cotton and thick scarves for head wrapping in cold months, belongs to the category of constrained heat (Yu Re), where the root is internal heat but the branch manifests as cold. People in the world do not understand this, and usually use acrid-warm exterior-releasing medicines. Although temporary relief is obtained, it is mistakenly considered a cold syndrome. Little do they know that because the patient originally has constrained heat, the pores are often loose, making it easy for wind-cold to enter. The external cold binds the internal heat, causing obstruction and rebellion, leading to pain. Acrid-hot medicines, although capable of opening obstructions and dissipating the branch cold pathogen, add heat to heat, deepening the root of the disease and worsening aversion to cold. Only by focusing on purging fire and cooling blood, while assisting with acrid-warm exterior-dispersing agents to treat according to the method of compliance (Cong Zhi), can the disease be cured and the root eradicated.
In my opinion, the aforementioned symptoms are mostly due to phlegm; severe pain is caused by wind-toxin attacking upwards. Some cases are due to blood deficiency, some to qi stagnation in various meridians, some to qi deficiency, some to external injury from the four climatic factors, and some to injury from overexertion. Some are suitable for emesis, some for purgation; treatment should be differentiated based on excess/deficiency, cold/heat, and complicated variations. As for lateral or frontal headaches (Tou Feng) that persist for a long time, it is often due to internal retention of phlegm-fluids, with wind-fire constrained and blocking the meridians, causing qi and blood stasis. In severe cases, vision becomes blurred, eyes feel tight and small, and urination and defecation become difficult. It is appropriate to use bian stone (stone lancet) to bleed, thereby opening constraints and releasing the exterior. I once treated Liu Yizhai, a Supervisor of the Directorate of Palace Attendants, who experienced pain in both temples whenever he was angry. I first used Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Fu Ling (Poria) and Shan Zhi (Gardeniae Fructus), followed by Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) to nourish kidney water, after which the condition did not recur.
Tan Shiyu, an Imperial Censor, always vomited clear fluid when suffering from headaches, regardless of winter or summer; eating ginger would stop it. I diagnosed this as middle-jiao qi deficiency and cold, using Liu Jun Zi Tang (Six-Gentlemen Decoction) added with Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Mu Xiang (Aucklandiae Radix), and Pao Jiang (Prepared Ginger), resulting in recovery.
Shang Yibu, a Department Director of Commerce, suffered from headaches upon exertion. I diagnosed this as yang deficiency failing to ascend, treating him with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Man Jing Zi (Viticis Fructus), resulting in recovery.
For red, swollen, and painful eyes, ancient formulas differed between internal and external treatments. Internally, decoctions and powders used bitter-cold and acrid-cool medicines to purge fire; externally, drops and washes used acrid-hot or acrid-cool medicines to disperse pathogens. Therefore, among eye drops, nothing is more important than Bing Pian (Borneolum Syntheticum). Bing Pian is greatly acrid and hot; due to its extreme acridity, it helps extract fire pathogens and disperse heat. Ancient formulas used rice wine to wash eyes, or applied Gan Jiang (Zingiberis Rhizoma) powder or Sheng Jiang (Zingiberis Rhizoma Recens) juice to the eyes, all following this principle. Generally, red eyes result from fire pathogens flaring internally and attacking upwards to the eyes. Thus, internal treatment uses bitter-cold medicines to address the root, akin to removing firewood from under a pot. However, since the fire pathogen resides in the eye and moves from inside out, if cold-cool medicines are used externally to obstruct it, the constrained fire will attack internally without dispersing. Therefore, eye drops use acrid-hot substances, and eye washes use hot water; this follows the principle "when fire is constrained, release it," dispersing it through compliance, which is the method of Cong Zhi. People in the world do not know that Bing Pian is a drug that劫夺 (seizes/depletes) healthy qi, mistakenly believing it to be cold. Frequent use leads to accumulated heat entering the eyes, causing dimness and nebulae (cataracts/opacities). Hence the saying "eyes do not go blind unless medicated" refers to this. Others do not know that external treatment contraindicates cold-cool substances; recklessly washing with cold water, cold objects, or cold medicines has led to blindness.
In my opinion, if the aforementioned symptoms involve fatigue, poor appetite, blurred vision, or worsening with diet and overexertion, it indicates spleen-stomach deficiency, treated with Bu Zhong Yi Qi Tang. If there is excessive ocular discharge, tightness and astringency, red vessels crossing the eyeball, or organ constipation, use Shao Yao Qing Gan Wan (Peony Liver-Clearing Pill). If white sclera is covered with red nebulae, photophobia, or stabbing pain, it indicates upper-jiao wind-heat, treated with Huang Lian Yin Zi (Coptis Infusion). If prolonged viewing causes visual hallucinations, photophobia, and blurry distance vision, it indicates damage to spirit and qi, treated with Shen Xiao Huang Qi Tang (Miraculous Efficacy Astragalus Decoction). Generally, pain worsening in the morning is treated with Dong Yuan's Zhu Yang Huo Xue Tang (Assist Yang and Invigorate Blood Decoction); pain worsening in the afternoon is treated with Huang Lian Tian Hua Fen Wan (Coptis and Trichosanthes Root Pill); afternoon worsening without pain is treated with Dong Yuan's Yi Yin Shen Qi Wan (Nourish Yin and Kidney Qi Pill). Ability to see near but not far is treated with Di Zhi Wan (Cornus and Dogwood Pill); ability to see far but not near is treated with Ding Zhi Wan (Stabilize Spirit Pill). Thus, Mr. Dong Yuan stated: The essence of the five zang and six fu organs is received from the spleen and ascends to the eyes. The spleen is the head of all yin; the eyes are the congregation of blood vessels. Therefore, spleen deficiency causes the essence of the five zang organs to lose their governance, failing to clarify vision. The heart is the ministerial fire, governing human spirit,宜静而安 (should be quiet and peaceful), while ministerial fire acts on its behalf. Ministerial fire refers to the pericardium, which governs all vessels and nourishes the eyes. Due to physical exertion, the momentum of ministerial fire runs wild; combined with pathogenic invasion damaging the vessels, various diseases arise. Physicians who neglect regulating the spleen and stomach and nourishing blood/calming spirit, treating only the branch and not the root, fail to understand the correct principle. If one indiscriminately uses acrid-cool and bitter-cold agents, healthy qi is damaged, promoting the onset of internal cataracts.
Zhang Yugong, a Remonstrator, had red and unclear eyes. After taking wind-dispersing and heat-clearing medicines, he became more photophobic and experienced heavy hearing, with a large and empty pulse. This was due to excessive mental labor and irregular diet. I used Bu Zhong Yi Qi Tang added with Fu Shen (Poria with Hostwood), Suan Zao Ren (Ziziphus Seed), Shan Yao (Dioscorea Rhizome), Shan Zhu Yu (Cornus Fruit), and Wu Wei Zi (Schisandra Fruit), resulting in immediate recovery. Upon recurrence due to severe exertion, I used Shi Quan Da Bu Tang (Complete Great Tonifying Decoction) combined with the previous herbs, leading to gradual recovery, and finally cured by using Bu Zhong Yi Qi Tang with the aforementioned additions.