眼目之疾，本有专科，致病多端，非可枚举。兹因痛病，姑拈虚实两条，以发其凡。
目睛红肿，眵泪多而目中如有沙子者，风火盛也。黄连清火汤主之。
黄连清火汤（自制）
黄连（五分） 元参（一钱五分） 归尾（一钱五分） 赤芍（一钱） 丹皮（一钱五
分） 贝母（二钱） 荆芥（一钱） 防风（一钱） 桑叶（一钱） 蝉衣（一钱）
前胡（一钱） 菊花（二钱） 竹叶（十张） 灯芯（三尺） 芝麻（三钱）
本方以黄连、元参对荆、防，以芝麻、归尾、赤芍、丹皮对蝉衣、前胡、桑、菊，以贝母、竹
叶、灯芯清心火。头痛之火专属肝，眼痛之火，心肝俱有，黄连、归尾、赤芍、丹皮，俱是心肝同治
之药。祖怡注。
目睛不肿，微红羞明，眼珠作痛，此为阴虚夹火，滋阴降火汤主之。
滋阴降火汤（自制）
生地（六钱） 女贞（二钱） 山药（三钱） 丹皮（二钱） 茯苓（二钱）
料豆（三钱） 沙参（四钱） 麦冬（二钱） 贝母（二钱） 杏仁（三钱） 谷精
珠（一钱五分） 蝉衣（一钱） 生石决（六钱打碎）
本方以生地、女贞、料豆、沙参、麦冬滋阴。以茯苓、山药合生地、丹皮，得六味三分之二，滋肾
即所以降火。
以石决、丹皮、谷精、蝉衣清肝明目，作眼痛之引经。杏、贝所以宣肺。眼与五脏皆有关系，而
肝肾是其重心。祖怡注。
眼目的疾病，本来有专门的学科，致病原因多种多样，无法一一列举。这里因为讨论疼痛病症，暂且选取虚证和实证两条纲领，来阐明其基本要点。
眼球红肿，眼屎多且流泪，眼中感觉像有沙子一样，这是风火炽盛的表现。主治方剂为黄连清火汤。
黄连清火汤（自制方）
黄连（五分） 玄参（一钱五分） 当归尾（一钱五分） 赤芍药（一钱） 牡丹皮（一钱五分） 贝母（二钱） 荆芥（一钱） 防风（一钱） 桑叶（一钱） 蝉蜕（一钱）
前胡（一钱） 菊花（二钱） 竹叶（十张） 灯心草（三尺） 芝麻（三钱）
本方以黄连、玄参配伍荆芥、防风，以芝麻、当归尾、赤芍药、牡丹皮配伍蝉蜕、前胡、桑叶、菊花，用贝母、竹叶、灯心草清泻心火。头痛之火专属于肝，眼痛之火，心和肝都有涉及，黄连、当归尾、赤芍药、牡丹皮，都是心肝同治的药物。（祖怡注）
眼球不红肿，微红且畏光，眼球疼痛，这是阴虚夹杂火邪的表现。主治方剂为滋阴降火汤。
滋阴降火汤（自制方）
生地黄（六钱） 女贞子（二钱） 山药（三钱） 牡丹皮（二钱） 茯苓（二钱）
炒黑豆（三钱） 沙参（四钱） 麦冬（二钱） 贝母（二钱） 杏仁（三钱） 谷精草（一钱五分） 蝉蜕（一钱） 石决明（六钱，捣碎）
本方用生地黄、女贞子、炒黑豆、沙参、麦冬来滋阴。用茯苓、山药配合生地黄、牡丹皮，构成了六味地黄丸三分之二的功效，滋补肾阴即是为了降火。
用石决明、牡丹皮、谷精草、蝉蜕清肝明目，作为治疗眼痛的引经药。杏仁、贝母用来宣通肺气。眼睛与五脏都有关系，但肝肾是其核心所在。（祖怡注）
Ocular diseases have their own specialized disciplines, and the causes of illness are numerous and cannot be enumerated. Here, focusing on pain conditions, I briefly outline the two main categories of deficiency (Xu) and excess (Shi) to elucidate the general principles.
Redness and swelling of the eyeballs, accompanied by excessive discharge and tearing, with a sensation of sand in the eyes, indicates an excess of wind-fire. The primary formula is Huanglian Qinghuo Tang (Coptis Fire-Clearing Decoction).
Huanglian Qinghuo Tang (Self-made Formula)
Coptidis Rhizoma (Huanglian, 5 fen)
Scrophulariae Radix (Yuanshen, 1.5 qian)
Angelicae Sinensis Radix Rubra (Guiwei, 1.5 qian)
Paeoniae Radix Rubra (Chishao, 1 qian)
Moutan Cortex (Danpi, 1.5 qian)
Fritillariae Bulbus (Beimu, 2 qian)
Schizonepetae Spica (Jingjie, 1 qian)
Saposhnikoviae Radix (Fangfeng, 1 qian)
Mori Folium (Sangye, 1 qian)
Cicadae Periostracum (Chanyi, 1 qian)
Peucedani Radix (Qianhu, 1 qian)
Chrysanthemi Flos (Juhua, 2 qian)
Bamboo Leaves (Zhuye, 10 leaves)
Juncus Effusus Stamen (Dengxin, 3 chi)
Sesamum Indicum Seed (Zhimai, 3 qian)
This formula pairs Coptidis Rhizoma and Scrophulariae Radix with Schizonepetae Spica and Saposhnikoviae Radix; it pairs Sesamum Indicum Seed, Angelicae Sinensis Radix Rubra, Paeoniae Radix Rubra, and Moutan Cortex with Cicadae Periostracum, Peucedani Radix, Mori Folium, and Chrysanthemi Flos; and uses Fritillariae Bulbus, Bamboo Leaves, and Juncus Effusus Stamen to clear Heart fire. Fire causing headache belongs exclusively to the Liver, whereas fire causing eye pain involves both the Heart and the Liver. Coptidis Rhizoma, Angelicae Sinensis Radix Rubra, Paeoniae Radix Rubra, and Moutan Cortex are all herbs that treat both the Heart and the Liver simultaneously. (Note by Zuyi)
Absence of redness and swelling in the eyeballs, slight redness with photophobia, and pain in the eyeball indicate Yin deficiency with accompanying fire. The primary formula is Ziyin Jianghuo Tang (Yin-Nourishing Fire-Reducing Decoction).
Ziyin Jianghuo Tang (Self-made Formula)
Rehmanniae Radix Preparata (Shengdihuang, 6 qian)*
Ligustri Lucidi Fructus (Nvzhenzi, 2 qian)
Dioscoreae Rhizoma (Shanyao, 3 qian)
Moutan Cortex (Danpi, 2 qian)
Poria (Fuling, 2 qian)
Sojae Semen Nigrum Praeparatum (Liaodou, 3 qian)
Glehniae Radix (Shashen, 4 qian)
Ophiopogonis Tuber (Maidong, 2 qian)
Fritillariae Bulbus (Beimu, 2 qian)
Pruni Semen (Xingren, 3 qian)
Euphrasiae Flos (Gujingzhu, 1.5 qian)
Cicadae Periostracum (Chanyi, 1 qian)
Concha Haliotidis (Shijueming, 6 qian, crushed)
*Note: "Shengdi" usually refers to Rehmanniae Radix (raw), but in many modern contexts or specific formulas like this, it may imply prepared or raw depending on context. Given "Ziyin", Sheng Di Huang is standard. I will use Rehmanniae Radix (Shengdihuang).
This formula uses Rehmanniae Radix, Ligustri Lucidi Fructus, Sojae Semen Nigrum Praeparatum, Glehniae Radix, and Ophiopogonis Tuber to nourish Yin. Poria and Dioscoreae Rhizoma, combined with Rehmanniae Radix and Moutan Cortex, constitute two-thirds of Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia); nourishing Kidney Yin is the method for reducing fire. Concha Haliotidis, Moutan Cortex, Euphrasiae Flos, and Cicadae Periostracum clear the Liver and brighten the eyes, serving as guiding herbs for treating eye pain. Pruni Semen and Fritillariae Bulbus are used to diffuse Lung Qi. The eyes are related to all five Zang organs, but the Liver and Kidney are the central focus. (Note by Zuyi)