陈实功曰∶眼丹乃脾经有风,胃经多热,共结为肿。风多者则浮肿易消,热甚
者则坚肿难散,宜如意金黄散敷之。脓成即以针针之,迟则眼头自破,此乃睛明穴,
内空难敛,成漏者多,以致变为漏睛疮,久则损明。(《正宗》)
申斗垣曰∶眼胞属脾胃,谓之肉轮。如赤肿甚,不作脓者,名曰眼丹。(《启玄》)
胡公弼曰∶上下眼丹,虽小儿脾胃部位,其实心经受毒,热传脾胃,热毒升上,
血气凝聚而成丹毒也。(《青囊》)
李东垣曰∶凡眼丹赤肿作痒,痒后作痛,不治则成脓血,初起宜酒炒甘菊花,或
炒盐隔纸熨之。
《心法》曰∶眼丹若肿突下垂,不能视物者,偏于风盛也,浮肿易消;若 红色
紫,坚硬者,偏于热盛也,肿硬难消。
\r上眼丹下眼丹\p04-a41a54.bmp\r
验方 水调银朱敷之,自消。
又方(窦太师)
皂矾(五钱) 大粉草(二两)
同熬浓膏,加冰片少许,用鸭毛蘸润眼眶上。
又方 精猪肉切片如指甲大,用井水漂去其血,贴患处,不时易之。
窦汉卿曰∶夫漏睛疮者,肝脏毒瓦斯,小
肠邪风,外攻肾端,灌于瞳人。初生疼痛,渐成脓水,其色如泔,日久睛昏,气败肝
绝,难救之证。外用当归、地骨皮、黄连煎汤温洗。
《治方关要》云∶惟补肾宣肝为主。
《心法》曰∶此证生于目大 ,由肝热风湿,病发于足太阳膀胱经。(睛明穴)其
穴系藏泪之所,初起如豆、如枣,红肿疼痛,疮热虽小,根源甚深,溃后出粘白脓
者顺,出青黑脓者险。若疮口过出泪液,以致目内干涩者,收敛更迟,若溃断眼边弦者不治。
《秘笈》云∶此证皆因膀胱积热,深邪伏而不散,积久必溃,病始外见。目内
穴属膀胱,开窍如针,按之则浸浸脓出,视物微昏, 隐涩,宜服神效黄 汤。久
病不愈者,用乌金膏,以米糕和为条,晒干,插入窍内,每日换二次,化去白管,则
肌肉自生,脓自止矣。随以黄 汤为丸服之。
陈实功说:眼丹是由于脾经受风邪,胃经多热毒,风热共同结聚而形成的肿胀。风邪偏盛者,表现为浮肿,容易消退;热毒炽盛者,表现为坚硬肿胀,难以消散,适宜用如意金黄散外敷。脓液形成后应立即用针刺破排脓,若拖延则眼头部位会自行溃破,此处是睛明穴,内部空虚难以愈合,容易形成漏管,进而演变为漏睛疮,日久会损伤视力。(《外科正宗》)
申斗垣说:眼睑属于脾胃,在中医五轮学说中称为肉轮。如果红肿严重但不化脓的,叫做眼丹。(《启玄子眼科》)
胡公弼说:上下眼丹,虽然病变部位在小儿的脾胃区域,但实际上是心经受毒,热邪传至脾胃,热毒上攻,导致气血凝聚而成丹毒。(《青囊秘录》)
李东垣说:凡是眼丹出现赤肿且发痒,痒过后转为疼痛,若不治疗则会化脓出血。初起时适宜用酒炒过的甘菊花,或者用炒热的盐隔着纸熨烫患处。
《医宗金鉴·心法要诀》说:眼丹如果肿胀突起下垂,影响视物,说明风邪偏盛,浮肿容易消退;如果颜色红紫,质地坚硬,说明热邪偏盛,肿胀坚硬难以消退。
验方:用水调匀银朱外敷,可自行消退。
又一方(窦太师方)
皂矾(五钱) 大粉草(二两)
一同熬制成浓膏,加入少许冰片,用鸭毛蘸取涂抹于眼眶上。
又一方:精选猪肉切成指甲大小的薄片,用井水漂洗去血水,贴敷在患处,不时更换。
窦汉卿说:所谓漏睛疮,是肝脏的毒气,小肠的邪风,向外攻击肾部末端,灌注于瞳孔。初生时疼痛,逐渐化为脓水,颜色像米泔水一样,日久眼睛昏花,气败肝绝,是难治之证。外用当归、地骨皮、黄连煎汤温洗。
《医宗金鉴·心法要诀》说:此证生于目内眦(眼角),由肝热风湿引起,病发于足太阳膀胱经。(睛明穴)该穴位是藏泪之处,初起时如豆、如枣大小,红肿疼痛,虽然疮口热象不大,但根源很深,溃破后流出粘白色脓液为顺证,流出青黑色脓液为险证。如果疮口流泪过多,导致眼内干涩,收敛会更慢;如果溃烂断绝眼边弦线,则属不治之症。
《秘笈》说:此证皆因膀胱积热,深伏的邪气不散,积聚日久必然溃破,病症才显露于外。目内眦的穴位属膀胱,开口如针孔,按压则有脓液渗出,视物微昏,隐痛干涩,适宜服用神效黄芪汤。久病不愈者,使用乌金膏,用米糕调和做成条状,晒干后插入窍内,每日更换两次,化去白色的管状物,肌肉自然生长,脓液自止。随后服用黄芪汤制成的丸药。
Chen Shigong stated: Yan Dan (Eye Carbuncle) results from wind pathogen in the Spleen Meridian and excessive heat in the Stomach Meridian, which combine to form swelling. When wind is predominant, the swelling is edematous and easy to resolve; when heat is severe, the swelling is hard and difficult to dissipate. It is appropriate to apply Ruyi Jinhuang San (Ruyi Golden Yellow Powder). Once pus forms, it should be punctured with a needle immediately; delay will cause spontaneous rupture at the inner canthus of the eye. This area corresponds to Jingming (BL1), where the internal cavity is hollow and difficult to heal, often leading to fistula formation and evolving into Lou Jing Chuang (Leaking Pupil Ulcer), which may eventually impair vision. (Zhengzong)
Shen Douyuan stated: The eyelids belong to the Spleen and Stomach, referred to as the Flesh Wheel (Rou Lun). If there is severe redness and swelling without suppuration, it is called Yan Dan (Eye Carbuncle). (Qixuan)
Hu Gongbi stated: Upper and lower Yan Dan (Eye Carbuncle), although located in the Spleen and Stomach region in children, actually involves toxin accumulation in the Heart Meridian. Heat transmits to the Spleen and Stomach, rising upward with heat-toxin, causing Qi and Blood to coagulate and form carbuncle-toxin. (Qingnang)
Li Dongyuan stated: Whenever Yan Dan (Eye Carbuncle) presents with redness, swelling, and itching, followed by pain after itching, failure to treat will lead to suppuration and bleeding. In the initial stage, it is advisable to use Chrysanthemi Flos (Juhua) stir-fried with wine, or to apply hot salt through paper for moxibustion-like warming on the affected area.
Xinfa (Essentials of Medical Methods) stated: If Yan Dan (Eye Carbuncle) presents with protruding, drooping swelling that impairs vision, it indicates predominance of wind pathogen, and the edema is easy to resolve; if the color is red-purple and the texture is hard, it indicates predominance of heat pathogen, and the swelling and hardness are difficult to resolve.
Empirical Formula: Mix Yin Zhu (Cinnabar/Red Mercury Sulfide) with water and apply externally; it will resolve spontaneously.
Another Prescription (Grand Tutor Dou):
Zao Fan (Alum), 5 qian; Gan Cao (Licorice Root), 2 liang.
Boil together into a thick paste, add a small amount of Bing Pian (Borneol), and apply to the upper eye orbit using a duck feather.
Another Prescription: Slice lean pork into pieces the size of fingernails, rinse off the blood well water, and apply to the affected area, changing frequently.
Dou Hanqing stated: Regarding Lou Jing Chuang (Leaking Pupil Ulcer), it involves toxic qi of the Liver and evil wind of the Small Intestine attacking outwardly towards the Kidney end, pouring into the pupil. Initially painful, it gradually turns into pus resembling rice water. Over time, vision dims, Qi fails, and Liver function ceases, making it a difficult-to-cure condition. Externally, wash with warm decoction of Dang Gui (Angelica Sinensis), Digutpi (Cortex Lycii), and Huang Lian (Coptis Rhizome).
Zhifang Guanyao (Key to Treatment Prescriptions) stated: The treatment focuses primarily on tonifying the Kidney and promoting the Liver.
Xinfa (Essentials of Medical Methods) stated: This condition arises at the inner canthus of the eye due to Liver-heat and Wind-Dampness, originating in the Foot-Taiyang Bladder Meridian (Jingming BL1). This acupoint is where tears are stored. Initially, it appears like a bean or date, with redness, swelling, and pain. Although the local heat is mild, the root cause is deep. After ulceration, discharge of sticky white pus is a favorable sign (Shun), while discharge of green-black pus is dangerous (Xian). If excessive tearing occurs from the ulcer, causing dryness inside the eye, healing will be delayed. If the ulcer destroys the margin of the eyelid, it is incurable.
Miji (Secret Manual) stated: This condition is caused by accumulated heat in the Bladder, where deep-seated pathogens remain unresolved. After long accumulation, it must ulcerate before the disease manifests externally. The acupoint at the inner canthus belongs to the Bladder, opening like a needle hole; pressing it causes pus to seep out, vision becomes slightly dim, and there is a sensation of hidden pain and dryness. It is appropriate to administer Shenxiao Huangqi Tang (Miraculous Astragalus Decoction). For chronic cases that do not heal, use Wu Jin Gao (Black Gold Ointment). Mix with rice cake to form strips, dry them, and insert them into the orifice twice daily. As the white tubular tissue dissolves, muscle tissue regenerates naturally, and pus stops. Subsequently, take pills made from Huangqi Tang (Astragalus Decoction).