详夫自古名人。无不从学而就功。推穷事理。尽因事以立文。须在理通。方当行用。若或言词无据。即不足与讨论。
臣从幼岁业此道留心。亦乃数世相传。岂敢妄违先哲。每逢同道。皆言眼疾有七十二般。及问其数。名迹难言一半。今
则谨按诸家眼论。夙夜搜求。敢推眼疾之名。果有七十二种。据其疾状。患者颇多。论录为歌。以贻后代。又自古诸家
之眼。各有条章。病状一一不同。数目皆书不足。或有画作图形。或有歌其药性。虽则救人为切。详之理未周全。遂乃
按其古今。缀为歌颂。名号审的歌矣。庶使心念其言。眼看疾状。认识既不差错。治疗又有所凭。将用救人。永无伤横。
近见庸医之辈。学不从师。自出己意。乱行针药。或虚则反泻。实则反补。或则翳嫩便针。疮痕割烙。或即不看血忌。
触犯人神。或即误针太深。损其荣卫。因兹疼痛。便致损伤。针刀伤触着五轮。汤药乖于脏腑。亦由病家无鉴。任信庸
医。遂使可瘥之眸。永沉昏暗之证。忝为人子。曷不愍伤。故书苦口之辞。发挥歌诀义理者也。
夫眼者。五脏之精明。一身之至宝。如天之有日月。其可不保护哉。然骨之精为瞳子。属肾。筋之精为黑眼。属肝。
血之精为络果。属心。气之精为白眼。属肺。肉之精为约束。属脾。契筋骨血气之精。与脉并为之系。系上属于脑。后
出于顶中。故六淫外伤。五脏内郁。饮食房劳。远视悲泣。抄写雕镂。刺绣博奕。不避烟尘。刺血发汗。皆能病目。故
方内有五轮八廓内外障等。各各不同。尤当分其所因。及脏腑阴阳。不可混滥。如决其面者为兑 。属少阳。近鼻上为
外。属太阳。下为内 。属阳明。赤脉上下者。太阳病。从下上者。阳明病。从外走内者。少阳病。此三阳病。不可
混也。睛色赤。病在心。色白。病在肺。色青。病在肝。色黑。病在肾。色黄。病在脾。色不可名者。病在胃中。此五
脏三阳病。不可混也。仍叙三因于后。
纵观自古以来,那些著名的医家,没有不通过求学而成就功业的。他们推究事物的原理,完全依据事实来确立文字记载。必须在道理通晓之后,才能付诸临床使用。如果言辞没有依据,就不足以与之讨论。
臣从幼年时便研习此道并用心钻研,这也是数代相传的技艺,怎敢违背先哲的智慧?每当遇到同行,都说眼疾有七十二种。但问及具体数量和名称,难以说出一半。如今我谨按照各家眼科论述,日夜搜求考证,敢于推断眼疾的名称,确实有七十二种。根据这些疾病的症状,患病者很多。于是将其论述记录成歌诀,以留给后代。另外,自古以来的各家眼科著作,各有章节条理,病症表现各不相同,数量繁多,书籍难以尽载。有的绘制图形,有的吟咏药性。虽然都是为了救人急切之需,但详细探究其理却不够周全。于是我综合古今资料,编纂为歌颂性的歌诀,命名为《审的歌》。希望使医者心中牢记这些言语,眼中看清疾病症状,认识既不差错,治疗又有依据。用来救治病人,永远避免误伤。
近来见到一些平庸的医生,学习不拜师,擅自凭自己的意思行事,胡乱施行针药。或者对虚证反而用泻法,对实证反而用补法;或者在翳膜初生嫩弱时就施针,对疮痕进行切割烙烫;或者不看血忌之日,触犯人神禁忌;或者误将针刺得太深,损伤营卫之气。因此导致疼痛,进而造成损伤。针刀伤害了五轮(指目之五部分,分别对应五脏),汤药违背了脏腑规律。这也因为患者缺乏鉴别能力,随意相信庸医,致使原本可以治愈的眼睛,永远陷入昏暗失明的境地。身为医者,怎能不怜悯伤痛?所以写下这苦口婆心的言辞,旨在发挥歌诀中的义理。
眼睛,是五脏精气的外在表现,是一身的至宝。就像天空中有太阳和月亮一样,怎么可以不保护它呢?然而,骨的精华表现为瞳子(瞳孔),归属于肾;筋的精华表现为黑眼(黑睛),归属于肝;血的精华表现为络果(血络),归属于心;气的精华表现为白眼(白睛),归属于肺;肉的精华表现为约束(眼睑),归属于脾。这些筋骨血气的精华,与脉管相连形成目系。目系向上连接大脑,向后出于头顶中部。所以,六淫(风、寒、暑、湿、燥、火)外感,五脏内郁,饮食不节,房劳过度,远视疲劳,悲伤哭泣,抄写雕刻,刺绣博弈,不避烟尘,刺血发汗等行为,都能导致眼病。因此,方书内有五轮八廓、内外障等分类,各自不同。尤其应当区分病因,以及涉及的脏腑阴阳,不可混淆滥治。例如,面颊外侧者为兑位,属于少阳经;靠近鼻子上方者为外眦,属于太阳经;下方者为内眦,属于阳明经。赤脉上下走行的,是太阳病;从下往上走的,是阳明病;从外向内走的,是少阳病。这三阳经的病,不可混淆。眼球颜色发红,病在心;颜色发白,病在肺;颜色发青,病在肝;颜色发黑,病在肾;颜色发黄,病在脾;颜色无法命名的,病在胃中。这五脏和三阳经的病,不可混淆。随后叙述三因(内因、外因、不内外因)。
Looking back at famous physicians since ancient times, none achieved success without studying. They investigated the principles of things and established texts based on facts. Only when the principles are thoroughly understood can they be applied clinically. If statements lack evidence, they are not worthy of discussion.
Since childhood, I have devoted myself to this discipline, which has been passed down through generations. How dare I deviate from the wisdom of the sages? Whenever I meet colleagues, they all claim that there are seventy-two types of eye diseases. However, when asked about the specific numbers and names, it is difficult to name even half. Now, relying on various ophthalmological treatises, I have searched day and night to verify them. I dare to deduce the names of eye diseases, confirming indeed that there are seventy-two types. Based on their symptoms, many patients suffer from them. Thus, I have recorded these discussions in verse to leave for future generations. Furthermore, ancient ophthalmological works each have their own chapters and regulations. The symptoms vary one by one, and the numbers are too numerous to be fully recorded in books. Some have drawn diagrams, while others have composed songs about drug properties. Although all aim to save people urgently, a detailed examination of the underlying principles is often incomplete. Therefore, I have compiled ancient and modern materials into eulogistic verses, naming it *Shen Ge* (Song of Examination). It is hoped that practitioners will keep these words in mind and observe disease symptoms with their eyes, ensuring accurate recognition and reliable treatment. This will serve to save patients and prevent harm.
Recently, I have seen mediocre doctors who learn without masters, act on their own whims, and recklessly use acupuncture and herbs. They may apply draining methods to deficiency patterns and tonifying methods to excess patterns; or puncture nascent, tender nebulae (cataracts/opacities); or cut and cauterize scar tissue; or ignore blood taboos (days when certain activities are forbidden) and offend the human spirits; or puncture too deeply, damaging Ying and Wei (Nutritive and Defensive Qi). Consequently, pain ensues, leading to injury. Needles and knives damage the Five Wheels (five parts of the eye corresponding to five Zang organs), and decoctions violate the laws of the Zang-Fu organs. This is also because patients lack discernment and blindly trust mediocre doctors, causing eyes that could have been cured to remain permanently dim and blind. As a physician, how can one not feel pity and sorrow? Therefore, I write these earnest words to expound the principles within the verses.
The eyes are the clarity of the Five Zang organs and the supreme treasure of the body. Just as the sky has the sun and moon, how can they not be protected? The essence of bone manifests as the pupil (Tongzi), belonging to the Kidney. The essence of sinew manifests as the black eye (Heiyan, i.e., cornea/iris), belonging to the Liver. The essence of blood manifests as the vascular network (Luoguo), belonging to the Heart. The essence of Qi manifests as the white eye (Baiyan, i.e., sclera/conjunctiva), belonging to the Lung. The essence of flesh manifests as the constraints (Yueshu, i.e., eyelids), belonging to the Spleen. These essences of bone, sinew, blood, and Qi, along with the vessels, form the ocular system (Muxi). The system connects upward to the brain and exits posteriorly at the vertex of the head. Therefore, external invasion by the Six Excesses (Liu Yin: Wind, Cold, Summerheat, Dampness, Dryness, Fire), internal stagnation of the Five Zang organs, improper diet, sexual exhaustion, prolonged strain of vision, weeping, copying or engraving, embroidery, playing games, exposure to smoke and dust, bloodletting, and sweating can all cause eye diseases. Thus, medical formulas classify conditions into Five Wheels, Eight Palaces, and internal/external obstructions, each distinct. One must distinguish the causes and the involved Zang-Fu organs and Yin-Yang aspects, avoiding confusion. For instance, the lateral cheek area corresponds to the Dui position and belongs to the Shaoyang channel. The area near the nose above corresponds to the outer canthus and belongs to the Taiyang channel. The lower area corresponds to the inner canthus and belongs to the Yangming channel. Red vessels moving up and down indicate a Taiyang disease; those moving from bottom to top indicate a Yangming disease; those moving from outside to inside indicate a Shaoyang disease. These three Yang channel diseases must not be confused. A red eyeball color indicates heart disease; white indicates lung disease; green/blue indicates liver disease; black indicates kidney disease; yellow indicates spleen disease; and unnamable colors indicate stomach disease. These Five Zang and Three Yang diseases must not be confused. The Three Causes (San Yin) are described subsequently.