前达方书有“眼不医必瞎”之句,后人亥豕不辨,或音语相近,遂以讹传讹,乃有“眼不医不瞎”之说。夫
神农尝百草,虑生民之夭札。华佗立眼科,拯后世之昏盲。有是病即有是药,药犹未能中病焉,有不药而自愈者
也?今人疾厄,皆有不惜真元,妄加斫丧,致身子疲癃,精血竭而生火,故风邪得乘间而入。目为窍至高,火性
腾上,火得风而愈炎,邪又从火势而出,一旦疾作,医之少迟,终无全目,岂有不瞎之理。况目非火症不变,火
之燔目,犹物之落火,假袖手旁观而不急救,委之于数,夫宁有不尽焚者乎?救之急,火止者有之,物存者有之,
即不然亦免其半。所谓焦尾之鱼,犹能变化,爨下之桐,不废清越。是盖眼不医必瞎者,知者不待辨而明也。尝
见人目失治而废,曰∶吾悔不早医。非必瞎之验欤?前达正虑及此,故厉言以惕之,实欲夫人全受全归之意也。
人而一毛不拔,喜得以讹传讹,于父母病,曰眼不医不瞎,危言以谏。于婢仆病,曰眼不医不瞎,正言以止。既
以冷医人之心,又以塞病患之口,是好省费养财之绝法也。所以至今恒脍炙人口,家喻户晓云。虽然下病失治谓
之不仁,上病失治谓之不孝,不仁不孝谓之独夫,独夫如病,谓眼不医不瞎也可。
不尘子曰∶死生疾厄虽有定数,业医者不可出此言,延医者并不可设是想。盖医之为道,司人命,起沉 ,
补天所
不及。故良医功德,有时与良吏比隆。语云上医治国,国非医得治,医其能治国之人。若死生预定天命,药石尚
论功过,则病可不必医,医可不必有矣。而古今方书抉幽洞奥,充溢寰宇何为乎?由斯而论,临事不得言数。数
且不得言,而谓眼不医不瞎,岂理也哉?虽然眼亦难言医耳,病之初来也,有外感,有内伤,外感者为阳症,系
六气,其势纵急而易治;内伤者为阴症,系七情,其势却缓而治难。又有不内不外,盖荣卫素亏,饮食无算,不
时劳役,其症阴阳杂见,治法亦在难易之间。顾陋劣者不为审,往往在阴益阳,阳王而阴潜消;在阳抑阴,阴衰
而阳愈炽。当和而散,汗多亡阳亦能亡阴。当固而泄,下多亡阴亦能亡阳。补者攻之,攻则寒中,遏其生气。寒
则热之,热则助火,耗其元神。重阳则阴,其实无阴。譬夫炉炭正烘,置之密器,不使稍通其风,则火立死而寒,
所谓热蕴未发,再加闭闷,暴厥必矣。重阴则阳,抑其真阳,譬夫大暑酷烈,流金烁土,而石井清泉冷沁肌骨,
所谓阴盛于下,逼阳于上,水兼火化也。真假不辨,寒热倒施,且一遇是症,心慌手乱,砭针之摧败真血,炙熨
之激动贼邪,种种纰缪,迭为侵犯,致盘根错节,宋斤鲁削莫善其后。此眼之所以万不可医,而医所必瞎者也。
再则有目中无人,妄自尊大,不知辽东白豕之非异物,不宜医;虎视眈眈,乘人之危而利之,至覆人家国,不当
医;无眼界,无意识界,无声色香味触法,不用医。夫不用医、不当医、不宜医而固为医,此医者之眼自瞎,而
能保人之不瞎,未之有也。所以君子不域于数,而格于理,曰眼不医不瞎,以娇夫陋劣之弊。《易》曰∶知几其
神乎。又曰∶不远复,无祗悔,元吉。视思明者,幸于兹少留意焉。说者谓∶医无贵贱,艺精则高华;病无巨细,
伤性则险急。是故无名指屈,
如有能伸者,不远秦楚之路。乃一身主宰之眼,务欲禁人以勿医,非万全之道也。况医者,大公为心,所向惟怀
惠泽,曷可以危言沮人于无成。君子虚衷御物,无人不存忠恕,未闻以逆决弃人于无用。愿天下闻人懿士,不贪
以体仁,博搜以资识,矜慎以执事,道弘望重,自然而非偶然。眼病者方恨力莫能致,宁复有不医不瞎之言。然
余固治医,有医名者也,其亦可因而自警者夫。
前代医书中曾有“眼不医必瞎”的说法,后人因字形相近(亥豕)未能辨别,或因读音相似,于是以讹传讹,竟产生了“眼不医不瞎”这种错误说法。
神农氏尝遍百草,是担心百姓早夭短命。华佗创立眼科,是为了拯救后世患者的昏盲之疾。有这种病就有治这种病的药,如果药物还不能完全对症,难道还有不吃药而自愈的吗?
现在的人患病,往往不惜损耗自身的真元之气,胡乱地摧残身体,导致身体疲弱残疾,精血枯竭而生出虚火,所以风邪得以趁机侵入。眼睛是人体清窍中位置最高的部位,火性炎上,火遇到风会更加猛烈,邪气又随着火势向外发散,一旦疾病发作,医生治疗稍晚,最终眼睛就无法保全,哪里有不失明的道理呢?
况且眼病并非只有火证一种变化,火热焚烧眼睛,就像物体落入火中,如果袖手旁观而不紧急抢救,将其归结为命运注定,哪有不被烧尽的道理呢?抢救及时,火势停止的有,物体存留的有;即使不是这样,也能保住一半。这就好比烧焦尾巴的鱼,还能变化成龙;灶下被烧过的桐木,依然能发出清脆的声音。这说明“眼不医必瞎”,是有见识的人不用辩解就能明白的道理。
我曾经看到有人因为眼睛延误治疗而失明,说:“我后悔没有早点就医。”这难道不是“不医必瞎”的验证吗?前人正是考虑到这种情况,所以严厉地说话来警示世人,其实是希望人们能够保全父母给予的身体(全受全归)。
那些一毛不拔、喜欢以讹传讹的人,对于父母的病,用“眼不医不瞎”这种危言耸听的话来进谏(实则是为了省钱);对于婢仆的病,也用“眼不医不瞎”这种正言相告来阻止就医。既冷却了医生治病救人的心,又堵住了病患求医的口,这是节省费用、保养钱财的绝妙方法啊。所以这句话至今让人津津乐道,家喻户晓。
虽然如此,下位者患病而上级不治称为不仁,上位者患病而下级不治称为不孝,不仁不孝的人被称为独夫。对于独夫这样的人,说“眼不医不瞎”也是可以的。
不尘子说:生死疾病虽有定数,但行医者不可说出这样的话,延请医者也不应抱有这种想法。大概医学之道,掌管人的性命,挽救垂危的病人,弥补上天所不及之处。所以良医的功德,有时可以与好官吏相比肩。俗话说“上医治治国”,国家不是靠医药治理的,而是靠懂得运用医药治国的人才。如果生死早已预定由天命决定,那么药物就不必谈论功过,既然这样,疾病就不必医治,医学也就不必存在了。然而古今医书探究幽深奥妙的道理,充满天下,这是为什么呢?由此看来,面对疾病时不能谈论宿命。连宿命都不能谈,何况说“眼不医不瞎”,这难道是合理的吗?
虽然这样说,但眼病也确实难以简单地说“可医”。疾病初起时,有外感和内伤两种。外感属于阳证,与六淫邪气有关,病情急迫但容易治疗;内伤属于阴证,与七情内伤有关,病情缓慢但难治。又有既非纯粹外感也非纯粹内伤的情况,这是因为营卫之气素来亏虚,饮食无度,不时劳累,症状阴阳错杂,治疗方法也在难易之间。
但是见识浅陋的医生如果不仔细审察,往往会在阴证中误用补阳法,导致阳气亢盛而阴气潜消;在阳证中误用抑阴法,导致阴气衰败而阳气更加炽盛。应当调和而疏散时,发汗过多不仅亡阳也能亡阴;应当固涩而泄下时,泻下过多不仅亡阴也能亡阳。该补的时候反而攻伐,攻伐会导致寒邪中阻,遏制生机;该温热的反而用寒凉,寒凉会助长火势,耗损元神。
重阳会导致阴虚,其实是因为体内无阴。譬如炉中的炭火正在烘烤,如果放在密闭容器中,不让它稍微通风,火立刻就会熄灭变冷,这就是所谓的热蕴积未发,再加封闭闷压,必然导致暴厥。重阴会导致阳虚,抑制真阳,譬如大暑酷烈,熔化金属和泥土,而石井中的清泉冷透肌骨,这就是所谓阴盛于下,逼迫阳气上浮,水兼带火的性质。
真假不辨,寒热倒施,而且一遇到这类病症,就心慌手乱,砭针刺破真血,艾灸熨烫激动贼邪,种种谬误,接连侵犯,导致病情盘根错节,即使是宋国的斤、鲁国的削这样的利器也无法收拾残局。这就是为什么眼病万不可乱医,而乱医必定导致失明的原因。
再有那种目中无人、妄自尊大的医生,不知道辽东白豕(比喻少见多怪)并非异物,是不宜行医的;那种虎视眈眈、乘人之危谋取利益的人,甚至颠覆人家国运,是不当行医的;那种没有眼界、没有意识境界,无视声色香味触法的人,是不用行医的。凡是不用医、不当医、不宜医却强行行医的,这是医生的眼睛自己瞎了,而能保证别人的眼睛不瞎,从来没有过的事。
所以君子不被宿命束缚,而被理法格挡,指出“眼不医不瞎”这种说法,是为了矫正当下见识浅陋的弊端。《易经》说:“知几其神乎。”又说:“不远复,无祗悔,元吉。”视力清明的人,希望能在此处多加留意。
有人说:医生没有贵贱之分,技艺精湛就是高贵;疾病没有大小之分,损伤本性就是危险紧急。所以无名指弯曲,只要有可能伸直,就不惜远赴秦楚之路去治疗。既然是身体的主宰——眼睛,务必禁止人们不要就医,这不是万全之道。况且医生应该大公无私,心中只怀着恩惠泽被众生,怎么可以用危言耸听的话来阻碍人们取得疗效呢?君子虚心待人,对所有人都心存忠恕,没听说过用逆耳之言决绝地把人抛弃在无用的境地。愿天下的闻人懿士,不贪婪而以体察仁爱为本,广泛搜集以增长见识,矜持谨慎地处理事务,道德弘扬声望崇高,自然是水到渠成而非偶然。眼病患者正恨力量不足以救治,哪里还会听到“不医不瞎”这样的话呢?然而我本来就是一个行医且有医名的人,这也足以让我借此自我警醒吧。
The medical texts of the ancients contained the phrase "eyes left untreated will inevitably go blind." Later generations, failing to distinguish between similar characters (such as 'Hai' and 'Shi') or due to phonetic similarities, propagated this error, leading to the false saying that "eyes left untreated will not go blind."
Shennong tasted hundreds of herbs out of concern for the premature death of the people. Hua Tuo established ophthalmology to rescue future generations from blindness. Where there is a disease, there is a remedy; even if the medicine does not perfectly hit the target, can one recover without taking medicine?
Today's patients often disregard their vital essence (Zhen Yuan), recklessly damaging their bodies, resulting in physical debility and exhaustion of essence and blood, which generates internal fire. Consequently, wind pathogens take advantage of the opportunity to invade. The eyes are the highest orifices in the body. Fire has an upward nature; when fire meets wind, it burns more fiercely, and pathogens follow the fire's momentum outward. Once the disease strikes, if treatment is delayed even slightly, the eyes cannot be preserved, so how could they not go blind?
Moreover, eye diseases do not only manifest as fire syndromes. Fire burning the eyes is like objects falling into fire. If one stands by idly without urgent rescue and leaves it to fate, how could anything not be completely burned? If rescued promptly, some fires stop, some objects remain; even otherwise, half may be saved. This is like a fish with a scorched tail that can still transform, or a paulownia tree from under the stove that can still produce clear sounds. Thus, "eyes left untreated will inevitably go blind" is something those with wisdom understand without needing explanation. I have seen people whose eyes were ruined due to neglected treatment say, "I regret not treating it earlier." Is this not proof of "inevitable blindness"? The ancients feared this situation, hence their stern warnings to caution people, truly intending for individuals to preserve the body given by their parents (complete reception and return).
Those who are stingy and enjoy spreading rumors use the phrase "eyes left untreated will not go blind" as a shocking warning to dissuade treating their parents' illnesses, and as a straightforward statement to stop treating servants' illnesses. This cools the hearts of doctors and silences patients, serving as a supreme method for saving money and hoarding wealth. Hence, this saying remains popular and known to every household.
Nevertheless, neglecting the illness of a subordinate is called inhumanity; neglecting the illness of a superior is called unfilial piety. One who is both inhumane and unfilial is called a solitary man (tyrant/dictator). For such a person, saying "eyes left untreated will not go blind" might be acceptable.
Bu Chen Zi said: Although life, death, and illness have destined numbers, practitioners must not utter such words, nor should those seeking medical help entertain such thoughts. Medicine governs human life, rescues critical conditions, and supplements what Heaven fails to provide. Thus, the merit of a good physician sometimes rivals that of a good official. As the saying goes, "The highest physicians govern the state." The state is not governed by medicine, but by people who understand how to utilize medicine to govern. If life and death were predestined by heaven, then discussing the merits and faults of drugs would be unnecessary; consequently, illness would need no treatment, and medicine would not exist. Yet, ancient and modern medical texts explore profound mysteries and fill the world—why? From this perspective, one cannot speak of fate when facing illness. If one cannot even speak of fate, how can one claim "eyes left untreated will not go blind"? Is this reasonable?
Although so, eye diseases are indeed difficult to simply categorize as "treatable." When a disease first appears, it may be external contraction or internal injury. External contractions belong to Yang syndromes, related to the Six Qi (pathogenic factors), presenting with urgent symptoms but being easier to treat. Internal injuries belong to Yin syndromes, related to the Seven Emotions, presenting with slow progression but being difficult to treat. There are also cases that are neither purely external nor internal, where Ying and Wei (nutritive and defensive qi) are chronically deficient, diet is unregulated, and labor is frequent. Symptoms show a mix of Yin and Yang, and treatment methods fall somewhere between easy and difficult.
However, ignorant physicians who fail to examine carefully often tonify Yang in Yin syndromes, causing Yang to flourish while Yin dissipates; or suppress Yin in Yang syndromes, causing Yin to decline while Yang blazes. When harmonization and dispersion are indicated, excessive sweating leads not only to loss of Yang but also to loss of Yin. When consolidation and purging are indicated, excessive purgation leads not only to loss of Yin but also to loss of Yang. Tonifying when one should attack causes cold to settle in the middle, stifling vital energy. Warming when one should cool aids fire, consuming primordial spirit. Excessive Yang leads to Yin deficiency, essentially meaning there is no Yin. It is like charcoal roasting in a furnace; if placed in a sealed container without ventilation, the fire dies instantly and becomes cold. This is heat accumulation without release; adding closure and suffocation leads to sudden collapse. Excessive Yin leads to Yang deficiency, suppressing true Yang. It is like extreme summer heat melting metal and earth, while spring water from a stone well chills the bones. This is Yin flourishing below, forcing Yang upward, where water takes on the nature of fire.
Failing to distinguish true from false, reversing cold and heat treatments, and acting with panic and confusion upon encountering such syndromes, using needles to destroy true blood and moxibustion to agitate pathogenic evils, these various errors repeatedly invade, making the condition complex and entrenched, beyond repair even by the finest tools of Song and Lu. This is why eye diseases must never be treated recklessly, and why reckless treatment inevitably leads to blindness.
Furthermore, there are physicians who are arrogant and look down on others, unaware that they are like the white pig of Liaodong (a metaphor for ignorance), and thus unsuitable for practice. There are those who gaze greedily, taking advantage of others' crises for profit, even destroying families and states, who are improper practitioners. There are those lacking vision and consciousness, ignoring the senses and phenomena, who should not practice. Those who practice when they should not, ought not to, or are unfit to, have blinded their own eyes; it is unheard of for them to ensure others' eyes remain sighted.
Therefore, gentlemen are not bound by fatalism but guided by principle, pointing out that "eyes left untreated will not go blind" serves to correct the弊端 (drawbacks) of shallow knowledge. The *I Ching* says, "To know the subtle beginnings is divine." It also says, "Returning quickly after straying brings no great regret, supreme auspiciousness." Those with clear vision should pay attention to this. Some say: Physicians have no high or low status; skill makes one noble. Diseases have no major or minor distinction; damage to nature makes them dangerous and urgent. Therefore, if the little finger is bent, one travels far to straighten it. Since the eyes are the master of the body, forbidding treatment is not a perfect way. Moreover, physicians should have a heart of great public service, harboring only compassion. How can they use alarming words to discourage people from achieving results? Gentlemen handle matters with humility, practicing loyalty and forgiveness towards all. It is unheard of to use harsh words to abandon people to uselessness. I wish scholars and virtuous men of the world would not be greedy but embody benevolence, search widely to enrich knowledge, act with caution and reverence, and let their moral influence grow naturally, not by chance. Patients suffering from eye diseases lament their inability to find effective treatment; how could they hear "eyes left untreated will not go blind"? However, I am a practitioner with a reputation, and this serves as a warning for my own self-reflection.