(附论)
夫肝心二脏。久积热毒。攻发于目。能生钉翳。盖肝水也。在窍为目。心火也。于肝为
子。今心脏积热。热乘于肝。熏发结聚。故为钉翳。钉翳根深外障。此眼初患之时。眼中疼
痛。作时赤涩。泪出怕日。总然治疗失时。致令睛上有翳。如银钉头子相似。此眼不宜钩割
熨烙。难得痊效。宜令服药。此是热毒积于肝心。致使然也。宜服除热饮子、镇心丸即瘥。
龙木论歌曰。滞留偏热在肝心。疼痛生疮讵可任。热毒即深开得后。银钉翳入黑睛深。
万
方
青葙子丸 治肝心毒热钉翳入黑睛。
青葙子 蓝实 枳壳(去瓤麸炒) 大黄(锉炒) 菊花 甘草(炙各二两) 草决明 黄
连(去
胆(各一枚阴干
后温水下。日三。兼治内外障。一切眼病。
青葙子汤 治肉翳风邪钉翳。
青葙子 蕤仁 白茯苓(去黑皮) 葳蕤 黄连(去须各一两半) 秦皮(二分) 山
栀子仁 秦
上粗捣筛。每服三钱。以水二盏。煎至八分。去滓。食后服。
黄芩汤 治白膜赤脉侵睛生翳。横冲瞳仁。久成钉翳。
黄芩(去黑心) 黄连(去须) 木通(锉) 柴胡(去苗) 赤芍药(各二两) 地
骨皮 山栀子(
两半) 朴硝(研五两) 上粗捣筛。每服五钱。以水二盏。煎至一盏。去滓。食后温服。
日再。
葳蕤丸 治顽翳钉眼。
独活(去芦头) 葳蕤 芎 青葙子 黄连(去须) 黄芩(去黑心) 防风(去叉)
赤芍药
为细末。炼蜜和丸。如梧桐子大。食后。温熟水下四十丸。日再。
退膜丸 治阳气炎上。血脉贯冲。目赤肿痛。睑 生疮。暴生钉翳。渐染睛轮。视
物羞涩。紧急难开。兼倒睫拳挛。
熊胆(半两研) 牛胆汁(一合) 猪胆(五枚取汁) 牵牛子(炒) 黄连(去须) 栀
子仁 甘草(各一两) 车前子 决明子 枸杞子(各半两) 上除牛胆、猪胆汁外。八味
同为末。用二胆汁和丸。梧桐子大。每服五十丸。食后。荆芥汤下。一方用温熟水下三十丸。
随胆汁以丸得为度。如硬。入炼蜜少许不妨。
羚羊角散 治眼生钉翳风热上攻。泪出赤涩。
羚羊角 防风(去芦头) 川升麻 茯神 地骨皮 蕤仁(汤浸去赤皮) 麦门冬(去
心焙) 决
煎至六分。去滓。每于食后温服。
除热饮子 治钉翳。根深外障。
黄芩 黑参 桔梗 知母 芒硝(各二两) 防风 大黄 茺蔚子(各一两) 上为末。
每服散
镇心丸 治钉翳。根深外障。
远志 人参 茯苓 柏子仁 细辛(各二两) 干山药 茺蔚子(各一两) 车前子(一
两)
上
决明子散(出圣惠方)治肝膈热毒。眼生钉翳。
决明子 川升麻 地骨皮 柴胡(各一两去苗) 葳蕤 玄参 犀角屑 甘草(炙微赤
锉各半
远志丸(出圣惠方)治眼生钉翳。日月深久。
远志(去心) 人参(去芦头) 白茯苓 柏子仁(各一两) 车前子(一两半) 决
明子(二两)
大。每于空心及夜临
抵圣散(出圣惠方)治眼生钉翳。
乌贼鱼骨 马牙硝 定粉(各半两) 食盐(一分) 白龙脑(一钱) 蕤仁(一两去
赤皮) 上同
升麻汤(出圣济总录)治膀胱热。肝膈中风毒。生钉翳。
升麻 黄 犀角屑(镑) 葳蕤(汤浸去赤皮) 玄参(各一两) 上锉如麻豆大。
每服五
钱。
决明散(出圣惠方)治钉翳。根脚极浓。经久不瘥。
石决明(捣研水飞) 真珠末 琥珀(各三分) 乌贼鱼骨(半两) 龙脑(一钱研) 上
同研极细
琥珀煎(出圣惠方)治眼生钉翳。久不瘥。
琥珀(一分) 贝齿(半分) 朱砂(半分) 龙脑(一分) 马牙硝(三分炼过者) 上
同研如
面。
即住
葳蕤汤(出圣济总录)治目赤。并黑睛上生钉翳疼痛。
葳蕤 桔梗 黄 (锉各一两半) 羚羊角(镑一两) 上粗捣筛。每服五钱。以水一
盏。煎至
又方(出圣惠方)\x治眼生钉翳。根脚极浓。经久不瘥。
马牙硝(一分) 贝齿(烧灰) 上同研如面以青驴乳三合。调入铜器中。以慢火炒干。
又细
(附论)
肝脏和心脏,长期积聚热毒,攻冲发作于眼睛,能够生出钉翳。大概因为肝属水,在窍穴上对应眼睛;心属火,在五行生克中对于肝来说是子脏。现在心脏积热,热气传导侵犯肝脏,熏蒸发作并结聚,所以形成钉翳。钉翳根深且属于外障,这是眼睛初患时的症状:眼中疼痛,发作时红肿干涩,流泪怕光。纵然治疗不及时,导致眼球表面出现翳膜,像银钉头一样。这种眼病不适宜用钩割、熨烫或烙法治疗,很难获得痊愈的效果。应当让患者服用药物。这是因为热毒积聚在肝心二脏,致使如此。适宜服用除热饮子、镇心丸即可痊愈。
《龙木论》歌诀说:“滞留偏热在肝心,疼痛生疮讵可任。热毒即深开得后,银钉翳入黑睛深。”
方剂:
青葙子丸 治疗肝心毒热导致的钉翳侵入黑睛。
药材:青葙子、蓝实、枳壳(去除瓤麸炒)、大黄(锉碎炒制)、菊花、甘草(炙制,各二两)、草决明、黄连(去胆,各一枚阴干)。
用法:研为细末,温水送服,每日三次。兼治内外障及一切眼病。
青葙子汤 治疗肉翳风邪引起的钉翳。
药材:青葙子、蕤仁、白茯苓(去除黑皮)、葳蕤、黄连(去须,各一两半)、秦皮(二分)、山栀子仁、秦皮(此处原文重复或残缺,依文意应为秦皮或其他配伍,按原文列出)。
用法:粗捣筛过,每次服用三钱,用水二盏,煎至八分,去渣,饭后服用。
黄芩汤 治疗白膜赤脉侵睛生翳,横冲瞳仁,久成钉翳。
药材:黄芩(去除黑心)、黄连(去须)、木通(锉碎)、柴胡(去苗)、赤芍药(各二两)、地骨皮、山栀子(各一两半)、朴硝(研细五两)。
用法:粗捣筛过,每次服用五钱,用水二盏,煎至一盏,去渣,饭后温服,每日两次。
葳蕤丸 治疗顽翳钉眼。
药材:独活(去芦头)、葳蕤、川芎、青葙子、黄连(去须)、黄芩(去黑心)、防风(去叉)、赤芍药。
用法:研为细末,炼蜜调和做成丸剂,如梧桐子大小。饭后,温熟水送服四十丸,每日两次。
退膜丸 治疗阳气炎上,血脉贯冲,目赤肿痛,眼睑生疮,暴生钉翳,逐渐染及黑睛轮,视物羞涩,紧急难开,兼有倒睫拳挛。
药材:熊胆(半两研细)、牛胆汁(一合)、猪胆汁(五枚取汁)、牵牛子(炒制)、黄连(去须)、栀子仁、甘草(各一两)、车前子、决明子、枸杞子(各半两)。
用法:除去牛胆、猪胆汁外,其余八味共同研为细末,用两种胆汁调和做成丸剂,如梧桐子大小。每次服用五十丸,饭后,荆芥汤送服。另一法用温熟水送服三十丸。随胆汁使丸剂软硬适中为宜。如果太硬,加入少许炼蜜不妨碍药效。
羚羊角散 治疗眼生钉翳风热上攻,流泪出赤涩。
药材:羚羊角、防风(去芦头)、川升麻、茯神、地骨皮、蕤仁(汤浸去除赤皮)、麦门冬(去心焙干)、决明子等。
用法:煎至六分,去渣,每次于饭后温服。
除热饮子 治疗钉翳,根深外障。
药材:黄芩、黑参、桔梗、知母、芒硝(各二两)、防风、大黄、茺蔚子(各一两)。
用法:研为细末,每次服用散剂(原文此处残缺,通常指调服或煎服,依前例推测为散剂用法,但原文仅写“每服散”,后续文字缺失,故仅译现有部分)。
镇心丸 治疗钉翳,根深外障。
药材:远志、人参、茯苓、柏子仁、细辛(各二两)、干山药、茺蔚子(各一两)、车前子(一两)。
用法:(原文此处残缺,通常为研末制丸)。
决明子散(出自《圣惠方》)治疗肝膈热毒,眼生钉翳。
药材:决明子、川升麻、地骨皮、柴胡(各一两去苗)、葳蕤、玄参、犀角屑、甘草(炙微赤锉,各半两)。
用法:(原文此处残缺,通常为粗捣筛,煎服)。
远志丸(出自《圣惠方》)治疗眼生钉翳,日久深久。
药材:远志(去心)、人参(去芦头)、白茯苓、柏子仁(各一两)、车前子(一两半)、决明子(二两)。
用法:(原文此处残缺,通常为制丸,空心及夜临卧服)。
抵圣散(出自《圣惠方》)治疗眼生钉翳。
药材:乌贼鱼骨、马牙硝、定粉(各半两)、食盐(一分)、白龙脑(一钱)、蕤仁(一两去赤皮)。
用法:(原文此处残缺,通常为同研极细,外用或内服)。
升麻汤(出自《圣济总录》)治疗膀胱热,肝膈中风毒,生钉翳。
药材:升麻、黄芪、犀角屑(镑片)、葳蕤(汤浸去赤皮)、玄参(各一两)。
用法:锉如麻豆大,每次服用五钱。
决明散(出自《圣惠方》)治疗钉翳,根脚极浓,经久不愈。
药材:石决明(捣研水飞)、真珠末、琥珀(各三分)、乌贼鱼骨(半两)、龙脑(一钱研)。
用法:共同研极细。
琥珀煎(出自《圣惠方》)治疗眼生钉翳,久不愈。
药材:琥珀(一分)、贝齿(半分)、朱砂(半分)、龙脑(一分)、马牙硝(三分炼过者)。
用法:共同研如面。(原文后续残缺,通常为调敷或内服)。
葳蕤汤(出自《圣济总录》)治疗目赤,并黑睛上生钉翳疼痛。
药材:葳蕤、桔梗、黄芩(锉,各一两半)、羚羊角(镑,一两)。
用法:粗捣筛,每次服用五钱,用水一盏,煎至(原文残缺,通常为一盏或八分)。
又方(出自《圣惠方》)治疗眼生钉翳,根脚极浓,经久不愈。
药材:马牙硝(一分)、贝齿(烧灰)。
用法:共同研如面,以青驴乳三合,调入铜器中,以慢火炒干,又细(原文残缺,通常为研磨极细备用)。
(Attached Discussion)
The Liver and Heart organs, having accumulated heat-toxin for a long time, attack and manifest in the eyes, causing the formation of "Ding Yi" (Nail-like Pterygium/Corneal Opacity). This is because the Liver belongs to Water and opens into the Eyes; the Heart belongs to Fire and is the "Son" organ relative to the Liver in the Five Elements generation cycle. Currently, with Heat accumulating in the Heart, the Heat transmits to invade the Liver, steaming and condensing, thus forming Ding Yi. Ding Yi has deep roots and belongs to External Obstruction. At the initial onset of this eye disease, there is pain in the eyes, redness and dryness during attacks, tearing, and photophobia. Even if treatment is delayed, resulting in opacity on the cornea resembling the head of a silver nail, this condition should not be treated with hooking, cutting, moxibustion, or cauterization, as it is difficult to achieve a cure. Medication should be administered. This is caused by Heat-toxin accumulating in the Liver and Heart. It is appropriate to take Chure Yinzi (Heat-Removing Drink) and Zhenxin Wan (Heart-Calming Pill) for recovery.
The Song from *Longmu Lun* states: "Stagnant Heat favors the Liver and Heart; how can one bear the pain and sores? Once the Heat-Toxin is deeply cleared, the Silver Nail Opacity recedes from the dark pupil."
Formulas:
Qingxiangzi Wan (Celosia Seed Pill) treats Ding Yi invading the black pupil due to toxic heat in the Liver and Heart.
Ingredients: Qingxiangzi (Celosiae Semen), Lanshi (Isatidis Folium), Zhike (Aurantii Fructus, pulp removed, bran-fried), Dahuang (Rhei Radix et Rhizoma, sliced and fried), Juhua (Chrysanthemi Flos), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 2 liang), Caojueming (Cassiae Semen), Huanglian (Coptidis Rhizoma, gall-bladder removed, each 1 piece, dried in shade).
Usage: Grind into fine powder, take with warm water, three times daily. Also treats internal and external obstructions and all eye diseases.
Qingxiangzi Tang (Celosia Seed Decoction) treats Ding Yi caused by flesh pterygium and wind-pathogen.
Ingredients: Qingxiangzi (Celosiae Semen), Ruiren (Pruni Semen), Baifuling (Poria, black skin removed), Weirui (Polygonati Rhizoma), Huanglian (Coptidis Rhizoma, whiskers removed, each 1.5 liang), Qinpi (Fraxini Cortex, 2 fen), Shanzhizi Ren (Gardeniae Semen), Qinpi (Fraxini Cortex - *Note: Text repeats Qinpi*).
Usage: Coarsely grind and sieve. Take 3 qian per dose, decoct in 2 zhan of water until reduced to 8 fen, remove dregs, take after meals.
Huangqin Tang (Scutellaria Decoction) treats white membrane and red vessels invading the eye causing opacity, crossing the pupil, eventually forming Ding Yi.
Ingredients: Huangqin (Scutellariae Radix, black heart removed), Huanglian (Coptidis Rhizoma, whiskers removed), Mutong (Akebiae Caulis, sliced), Chaihu (Bupleuri Radix, sprouts removed), Chishaoyao (Paeoniae Radix Rubra, each 2 liang), Digupi (Lycii Cortex), Shanzhizi (Gardeniae Fructus, each 1.5 liang), Puxiao (Natrii Sulfas, ground, 5 liang).
Usage: Coarsely grind and sieve. Take 5 qian per dose, decoct in 2 zhan of water until reduced to 1 zhan, remove dregs, take warm after meals, twice daily.
Weirui Wan (Polygonatum Pill) treats stubborn opacity and nail-eye.
Ingredients: Duohuo (Angelicae Pubescentis Radix, rhizome removed), Weirui (Polygonati Rhizoma), Xiong (Ligustici Chuanxiong Rhizoma), Qingxiangzi (Celosiae Semen), Huanglian (Coptidis Rhizoma, whiskers removed), Huangqin (Scutellariae Radix, black heart removed), Fangfeng (Saposhnikoviae Radix, forked parts removed), Chishaoyao (Paeoniae Radix Rubra).
Usage: Grind into fine powder, mix with refined honey to make pills the size of Sophora seeds. Take 40 pills after meals with warm cooked water, twice daily.
Tuimo Wan (Membrane-Removing Pill) treats Yang Qi flaring upward, blood vessels penetrating and rushing, red and swollen painful eyes, sores on eyelids, sudden Ding Yi gradually affecting the limbus, blurred vision, tightness making opening difficult, accompanied by trichiasis and entropion.
Ingredients: Xiongdan (Ursi Bile, half liang, ground), Niudan Zhi (Bovis Bile, 1 he), Zhudan Zhi (Porci Bile, juice from 5 pigs), Qianniuzi (Pharbitidis Semen, fried), Huanglian (Coptidis Rhizoma, whiskers removed), Zhizi Ren (Gardeniae Semen), Gancao (Glycyrrhizae Radix et Rhizoma, each 1 liang), Cheqianzi (Plantaginis Semen), Juemingzi (Cassiae Semen), Gouqizi (Lycii Fructus, each half liang).
Usage: Except for Bovine and Porcine bile, grind the other eight herbs into powder. Mix with the two biles to make pills the size of Sophora seeds. Take 50 pills after meals with Jingjie Tang (Schizonepeta Decoction). Another method uses 30 pills with warm cooked water. Adjust consistency with bile; if too hard, add a little refined honey.
Lingyangjiao San (Antelope Horn Powder) treats Ding Yi caused by wind-heat attacking upward, with tearing, redness, and dryness.
Ingredients: Lingyangjiao (Saigae Tataricae Cornu), Fangfeng (Saposhnikoviae Radix, rhizome removed), Chuanshengma ( Cimicifugae Rhizoma), Fushen (Poria with Hostwood), Digupi (Lycii Cortex), Ruiren (Pruni Semen, soaked in water, red skin removed), Maimendong (Ophiopogonis Radix, core removed, baked), Juemingzi (Cassiae Semen).
Usage: Decoct until reduced to 6 fen, remove dregs, take warm after each meal.
Chure Yinzi (Heat-Removing Drink) treats Ding Yi with deep roots and external obstruction.
Ingredients: Huangqin (Scutellariae Radix), Heishen (Polymorphanthi Rhizoma), Jiegeng (Platycodonis Radix), Zhimu (Anemarrhenae Rhizoma), Mangxiao (Natrii Sulfas, each 2 liang), Fangfeng (Saposhnikoviae Radix), Dahuang (Rhei Radix et Rhizoma), Chongweizi (Leonuri Fructus, each 1 liang).
Usage: Grind into powder. Take the powder per dose (*text incomplete regarding specific dosage/method*).
Zhenxin Wan (Heart-Calming Pill) treats Ding Yi with deep roots and external obstruction.
Ingredients: Yuanzhi (Polygalae Radix), Renshen (Ginseng Radix), Fuling (Poria), Baiziren (Platycladi Semen), Xixin (Asari Radix et Rhizoma, each 2 liang), Dry Shanyao (Dioscoreae Rhizoma), Chongweizi (Leonuri Fructus, each 1 liang), Cheqianzi (Plantaginis Semen, 1 liang).
Usage (*text incomplete*, typically ground and made into pills).
Juemingzi San (Cassia Seed Powder) (from *Shenghui Fang*) treats liver-diaphragm heat-toxin and eye Ding Yi.
Ingredients: Juemingzi (Cassiae Semen), Chuanshengma (Cimicifugae Rhizoma), Digupi (Lycii Cortex), Chaihu (Bupleuri Radix, sprouts removed, each 1 liang), Weirui (Polygonati Rhizoma), Xuanshen (Scrophulariae Radix), Xijiao Xie (Rhino Ceris Cornu, shaved), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried slightly red and sliced, each half liang).
Usage (*text incomplete*, typically coarsely ground and decocted).
Yuanzhi Wan (Polygala Pill) (from *Shenghui Fang*) treats eye Ding Yi that has persisted for a long time.
Ingredients: Yuanzhi (Polygalae Radix, core removed), Renshen (Ginseng Radix, rhizome removed), Baifuling (Poria), Baiziren (Platycladi Semen, each 1 liang), Cheqianzi (Plantaginis Semen, 1.5 liang), Juemingzi (Cassiae Semen, 2 liang).
Usage (*text incomplete*, typically taken on an empty stomach and before bed).
Diseng San (Miracle-Saving Powder) (from *Shenghui Fang*) treats eye Ding Yi.
Ingredients: Wuzeiyu Gu (Sepiae Endoconcha), Mayaxiao (Natrii Sulfas, each half liang), Dingfen (Cerussa/Lead Carbonate), Yanshi (Natrii Chloridum, 1 fen), Bailongnao (Borneolum Syntheticum, 1 qian), Ruiren (Pruni Semen, red skin removed, 1 liang).
Usage (*text incomplete*, typically ground together finely).
Shengma Tang (Cimicifuga Decoction) (from *Shengji Zonglu*) treats bladder heat, liver-diaphragm wind-toxicity, and Ding Yi.
Ingredients: Shengma (Cimicifugae Rhizoma), Huangqi (Astragali Radix), Xijiao Xie (Rhino Ceris Cornu, sliced), Weirui (Polygonati Rhizoma, soaked in water, red skin removed), Xuanshen (Scrophulariae Radix, each 1 liang).
Usage: Cut like hemp beans. Take 5 qian per dose.
Jueming San (Cassia Powder) (from *Shenghui Fang*) treats Ding Yi with very thick roots that persists for a long time without healing.
Ingredients: Shijueming (Haliotidis Concha, pounded, ground, and washed), Zhenzhumo (Margarita Pulvis), Hupo (Amber, each 3 fen), Wuzeiyu Gu (Sepiae Endoconcha, half liang), Longnao (Borneolum, 1 qian, ground).
Usage: Grind together extremely finely.
Hupo Jian (Amber Decoction/Paste) (from *Shenghui Fang*) treats eye Ding Yi that persists for a long time without healing.
Ingredients: Hupo (Amber, 1 fen), Beichi (Concha Arcae), Zhusha (Cinnabaris, each half fen), Longnao (Borneolum, 1 fen), Mayaxiao (Natrii Sulfas, refined, 3 fen).
Usage: Grind together into a powder (*text incomplete regarding application*).
Weirui Tang (Polygonatum Decoction) (from *Shengji Zonglu*) treats red eyes and pain from Ding Yi on the black pupil.
Ingredients: Weirui (Polygonati Rhizoma), Jiegeng (Platycodonis Radix), Huangqin (Scutellariae Radix, sliced, each 1.5 liang), Lingyangjiao (Saigae Tataricae Cornu, sliced, 1 liang).
Usage: Coarsely grind and sieve. Take 5 qian per dose, decoct in 1 zhan of water (*text incomplete regarding reduction level*).
Another Formula (from *Shenghui Fang*) treats eye Ding Yi with very thick roots that persists for a long time without healing.
Ingredients: Mayaxiao (Natrii Sulfas, 1 fen), Beichi (Concha Arcae, burned to ash).
Usage: Grind together into a powder. Mix with 3 he of green donkey milk, stir in a copper vessel, and stir-fry over slow fire until dry. Then grind finely (*text incomplete*).