怒气并邪横入肝,入肝筋脉早伤残,通睛凸出不堪看。风月素耽精血竭,觥觞数举胃皮寒,一般为祸请从宽。
目形类丸还类橘,下稍着蒂圆动极,元虚筋弛忽逢邪,橘蒂长垂成怪疾。
此症,通睛突然凸出眶外,非鱼睛因滞而慢慢胀高者比。其故颇多∶有虚风痒极擦出者,有烂醉狂呕激出者,
有热病关格胀出者,有暴怒吼哮挣出者。究竟皆水衰精败,脉络焦脆,邪火亢害,内无从泄,则上走空窍,泄之
不及,故涨涌而出。至打扑猝凸者,不在此论。凡出未全离睑,而神色不变,可乘热捺入。但筋脉损动,终是无
光。凸而犹含者易入,光且不熄。若悬空如铃,膏液转为血肉,不能救矣。至乃不知不觉,通睛和盘托出,长垂
至鼻而不能收缩,世谓之肝胀,不知此神魂将绝,谬作肝胀持论,势必用疏风之药落井下石耳。何以言之,夫肝
所以藏魂,心所以凝神。比人元气大虚,则神魂颠倒,所得之症皆奇。又且肝主筋,心主脉,神去魂失,则筋脉
散驰,散驰之际,邪至窍出,是以随意直下。病者惊心,观者骇目,而医者窘手。然业已如斯,虽未见惯,不必
恐,用软帛盛住,好生安置眶内,令渠闭睑嘿
坐,煎大补元汤温经益元散,乘热呷之。一面 磁石淬醋,对鼻熏蒸,肝得浓浓酸气,虽散合收。俟微汗欲发,
开襟将冷泉水于胸前、背心不时喷之。俾肌肤一挠,脉络一缩,尽昼夜可定。然后适情顺养,或可侥万一之幸。
东邻吴氏女,夜窗绣鞋,目忽不见。初以为灯落,举头觉有物在颧间,摸之,乃睛也。捶胸大恸。家人惊呼,
余亦起视。时天严寒,系已僵。浣小盘,置温泉,将睛涵养片刻,纳入睑。治以前法,越月而痊。然神光熹微,
妙语莫能形容。
平生阅睛凸多矣,尚有奇恶二种,经书不载,谨编附症末,开发来学。一小儿右目甫病,金井随散,风轮渐
大渐高,绝肖张睢阳死为厉鬼杀贼之像。越一夕,高硕如酒杯,直挺射二寸许,日夜叫哭。寻睛破,非脓似血。
叠请知名外科,一筹莫展,卒而毙命;一书生无因无故,左目通睛胀出,大寸半,上圆硬,下微尖而匾,垂长几
与鼻齐,然能睹不疼。继复于大 侧气轮内,另生毒物硬如石,俨若皮膜包着橄榄,将黑睛碍过一边。始昏 作
痛,畏光难耐,终焉浑睛溃腐,痛连头脑,不能食与坐起,其势亦必死而后已。总二症幻变无理,脏腑分属亦背
常。何为?凡病纵暴险,须风生火,火生风,风火酷烈睛始坏,未有一患即爆凸者。且风火合在心肝部分,怎灾
及脾肺?金轮无因下垂主气脱,却肿实,又加毒结。此脾肺火亢后先蕴酿,应伤残右目,曷废左眼。将谓斫耗真
睛,小儿元无知识。将谓罪招恶报,书生有甚奸回。顾百药不对,坐以待毙。嗟夫!天道之微渺,人事之不可问。
方书未足以尽信也,有如此。
怒气与邪气横逆侵入肝脏,入肝后筋脉早已受损残破,导致通睛(眼球向内斜视并突出)凸出,景象不堪入目。若平素沉溺于风月之事致使精血枯竭,或频繁饮酒导致胃壁受寒,通常都会酿成此祸,请对此类病因宽容审视。
眼睛的形状既像丸子又像橘子,下方连接着蒂部,转动灵活至极。若元气虚弱、筋脉松弛,忽然遭遇邪气侵袭,橘蒂般的眼球长垂下来,便形成了这种怪病。
这种病症,是通睛突然从眼眶中凸出,不同于鱼睛因瘀滞而慢慢胀高的情况。其成因很多:有因虚风瘙痒难忍抓挠而挤出的,有因烂醉狂呕激惹而出的,有因热病导致关格(上下不通)胀出的,有因暴怒吼叫用力挣出的。究其根本,都是由于肾水衰退、精气败坏,脉络焦枯脆弱,邪火亢盛为害,体内无法宣泄,于是向上冲走空窍,排泄不及,所以涨涌而出。至于因打扑撞击突然凸出的,不在此讨论范围内。凡是眼球未完全脱离眼睑,且神色没有改变的,可以趁着热敷时将其按回。但既然筋脉已经损伤动摇,终究会失去光明。眼球凸出但仍含在眼窝内的容易推回,视力尚存;若悬空如铃铛,膏液转化为血肉,则无法救治了。至于不知不觉间,通睛和盘托出,长垂至鼻尖而不能收缩,世人称之为“肝胀”,却不知道这是神魂即将断绝的征兆,错误地按照“肝胀”来论述治疗,势必会使用疏风药物,这无异于落井下石。为什么这样说呢?肝是用来藏魂的,心是用来凝神的。当人元气大虚时,神魂就会颠倒,所出现的症状都属怪异。况且肝主筋,心主脉,神去魂失,筋脉就会散乱弛缓,在散驰之际,邪气到达孔窍并排出,因此随意向下坠落。病人惊心,旁观者骇目,医生也束手无策。然而病情已然如此,虽然未曾见过,也不必恐惧,用软布包裹住,小心安置回眼眶内,让患者闭眼静坐,煎煮大补元汤和温经益元散,趁热服用。同时用磁石淬醋,对着鼻子熏蒸,肝得到浓郁的酸气,即使散乱的也能收敛。等到微微出汗将要发作时,解开衣襟,将冷泉水不时喷洒在胸前和背心。使肌肤受到刺激,脉络收缩,经过一昼夜即可稳定。然后顺应情志调养,或许能侥幸获得万一的痊愈机会。
东邻吴姓女子,夜间在窗下绣鞋,眼睛突然看不见东西。起初以为是灯落了,抬头觉得颧骨间有物体,摸了一下,竟是眼球。捶胸大哭。家人惊呼,我也起身查看。当时天气严寒,眼球已经僵硬。用小盘子盛放温水,将眼球涵养片刻,纳入眼睑。用前面的方法治疗,一个月后痊愈。然而神光微弱,美妙的语言也无法形容那种状态。
平生见过的眼球凸出病例很多,还有两种奇特恶劣的情况,医书未曾记载,谨编附在病症末尾,以启发后来学者。一是有一个小儿右眼刚发病,瞳仁随即散开,黑睛逐渐变大变高,极像张巡(张睢阳)死后化为厉鬼杀贼的形象。过了一夜,高耸如酒杯,挺直射出约二寸多,日夜哭叫。随后眼球破裂,流出的不是脓而是血。多次邀请知名外科医生诊治,一筹莫展,最终死亡;二是有一个书生无缘无故,左眼通睛胀出,大一寸半,上部圆硬,下部微尖而扁平,下垂长度几乎与鼻子齐平,然而能看见且不疼痛。接着在大眦侧的气轮内,另生出毒物,坚硬如石头,俨然像皮膜包着的橄榄,将黑睛挤到一边。开始昏沉作痛,畏光难耐,最终整个眼球溃烂腐败,疼痛牵连头脑,不能进食和坐起,这种形势也必然死而后已。总之这两种病症变幻无理,脏腑归属也违背常理。为什么呢?凡是大病纵然暴险,必须风生火,火生风,风火酷烈眼球才会毁坏,没有一种患病立即爆凸的。况且风火合于心肝部分,怎么会灾及脾肺?金轮(白睛)无故下垂主气脱,却反而肿实,又加上毒结。这是脾肺火亢盛先后蕴酿,理应伤残右目,为何废弃左眼?如果说耗损真精,小儿原本无知。如果说罪招恶报,书生有什么奸邪。面对百药无效,坐以待毙。唉!天道的微妙渺茫,人事的不可追问。方书不足以完全相信,就是这样的。
Anger and pathogenic factors invade the Liver horizontally; once in the Liver, the sinews and vessels are already damaged and impaired, leading to strabismus with protrusion (Tongjing) that is unsightly. Indulgence in sexual activities depletes essence and blood, while frequent drinking causes coldness in the stomach lining; generally, one should consider these causes leniently when addressing this disaster.
The shape of the eye resembles both a ball and an orange, with a stalk-like attachment at the lower end allowing for extreme mobility. If primordial Qi is deficient and sinews are lax, suddenly encountering pathogenic factors can cause the "orange stalk" (the eyeball) to hang long, resulting in this strange disease.
This condition involves the sudden protrusion of the eyeball outside the orbit, which differs from fish-eye conditions where swelling rises slowly due to stagnation. The causes are numerous: some are squeezed out by severe itching from deficiency-wind causing rubbing; some are forced out by violent vomiting after excessive drunkenness; some swell out due to heat diseases causing obstruction (Guan Ge); some strain out from furious roaring. Ultimately, all stem from declining Kidney water and deteriorated essence, making the vessels brittle and scorched. When pathogenic fire becomes hyperactive and cannot be discharged internally, it rushes upward through the orifices. Since discharge is insufficient, it swells and erupts. Cases of sudden protrusion due to trauma/blows are not discussed here. If the eyeball has not completely detached from the eyelids and the patient's spirit remains unchanged, it can be pressed back in while applying heat. However, since the sinews and vessels have been damaged, vision will ultimately be lost. Protruding eyes still contained within the socket are easy to reduce, and vision may remain intact. If the eye hangs suspended like a bell and the ocular fluid transforms into flesh and blood, it cannot be saved. In cases where, unknowingly, the eyeball protrudes completely, hanging long to the nose without retracting, the world calls it "Liver Distension." This is unknown as a sign of impending loss of soul and spirit; erroneously treating it as Liver Distension inevitably leads to the use of wind-dispersing herbs, which is adding insult to injury. Why? The Liver stores the Soul (Hun), and the Heart consolidates the Spirit (Shen). When primordial Qi is severely deficient, the Soul and Spirit become disordered, resulting in bizarre symptoms. Furthermore, the Liver governs sinews, and the Heart governs vessels. When Spirit departs and Soul is lost, sinews and vessels scatter and relax. During this scattering and relaxing state, pathogens reach the orifices and exit, falling downward at will. The patient is startled, observers are horrified, and physicians are at a loss. Yet, given the situation, even if unfamiliar, there is no need for fear. Wrap the eye in soft cloth, carefully place it back into the orbit, instruct the patient to close their eyelids and sit quietly. Decoct Da Bu Yuan Tang (Great Tonification of Primordial Qi Decoction) and Wen Jing Yi Yuan San (Warm Meridians and Benefit Primordial Qi Powder), and sip them warm. Simultaneously, quench magnetite in vinegar and steam the vapors toward the nose. The Liver, receiving the strong sour aroma, will contract scattered elements. Wait until slight sweating is about to occur, then unbutton the clothes and occasionally spray cool spring water on the chest and back. This stimulates the skin and contracts the vessels, stabilizing the condition within a day and night. Then, nourish according to emotional needs, perhaps achieving a slim chance of recovery.
A woman surnamed Wu from the eastern neighbor was embroidering shoes by the window at night when her vision suddenly failed. Initially thinking the lamp had fallen, she looked up and felt something on her cheekbone; touching it, she found her eyeball. She beat her chest in great grief. Her family cried out in alarm, and I also rose to look. At that time, the weather was bitterly cold, and the eyeball had stiffened. Using a small basin with warm water, I soaked the eyeball for a moment before placing it back into the eyelid. Treating with the aforementioned methods, she recovered after a month. However, the divine light was faint, beyond description by beautiful words.
I have seen many cases of eyeball protrusion in my life, including two more bizarre and severe types not recorded in medical texts. I hereby append them to the end of the symptoms section to enlighten future learners. First, a child’s right eye just began to show illness; the pupil dispersed immediately, and the black cornea gradually enlarged and elevated, resembling the image of Zhang Xun (Zhang Suiyang) who died and became a vengeful ghost killing thieves. After one night, it stood high like a wine cup, straight out for about two cun, crying day and night. Subsequently, the eyeball ruptured, discharging not pus but blood. Numerous renowned surgeons were invited but could do nothing, and the child eventually died. Second, a scholar, for no reason, had his left eye protrude with strabismus, measuring one and a half cun wide. The upper part was round and hard, the lower part slightly pointed and flat, hanging down almost level with the nose, yet he could see without pain. Later, within the Qi wheel (white sclera) near the outer canthus, another toxic growth emerged, hard as stone, resembling an olive wrapped in membrane, pushing the black cornea to one side. He initially suffered dizziness and pain, intolerable photophobia, and finally, the entire eyeball ulcerated and rotted, with pain radiating to the head, inability to eat or sit up, a condition destined to end in death. In summary, these two cases change irrationally, and their organ affiliations contradict normal principles. Why? Generally, even severe and dangerous diseases require wind generating fire, and fire generating wind; only when wind and fire are fierce does the eye fail. No disease causes immediate explosive protrusion. Moreover, wind and fire combine in the Heart and Liver regions; how could disaster affect the Spleen and Lungs? The Jin wheel (white sclera) drooping without cause indicates Qi collapse, yet here it is swollen and solid, plus toxic accumulation. This suggests Spleen and Lung fire accumulating sequentially; it should damage the right eye, why destroy the left? If claiming depletion of true essence, the child had no knowledge. If claiming karmic retribution, what evil did the scholar commit? Facing ineffective medicines and waiting for death, alas! The Way of Heaven is subtle and obscure, human affairs are inexplicable. Medical formulas cannot be fully trusted, as evidenced by this.