双蛾症之虚实从何辨之大约外感者为实内伤者为虚而外感内伤又从何而辨之大约外感者
鼻必
寒舌必燥身必先热而后寒痰必黄而白目必赤而浮此邪气之实也用杀蛾丹治之用鹅翎吹入喉中
必吐痰涎碗许而愈神方也内伤者虽同是为蛾喉肿而日间少轻痰多而舌必不燥吐痰如涌泉而下
身必畏寒两足必如冰冷此正气之虚也用八味汤必然奏功吾今更定一方名为三陆同补汤此方之
妙妙在水中补火水足而肺经有养亦火温而土气有生则肺经兼有养也况方中原有生肺之品而
肺金有不安宁者哉肺肾脾三
经俱安则邪何所藏自难留恋于皮肤之内邪退而肿自消双蛾顿失其形真有莫知其然而然者矣
杀蛾丹
硼砂(一分) 丹砂(三分) 牛黄(一分) 冰片(一分) 儿茶(一钱) 麝香(一分) 石膏(一钱)
各为绝细末
三陆同补汤
熟地(一两) 山茱萸(五钱) 麦冬(一两) 北五味(二钱) 薏仁(一两) 肉桂(二钱) 人参(
一钱) 白芥子(五钱)茯苓(五钱) 白术(五钱) 水煎服
目痛有虚有实实痛之症必然红肿流泪结眵或如锥伤或如砂入羞明喜暗见日光而如触对灯
影而
若刺起障生星发寒发热吐痰吞酸大便实而小便黄此皆邪火之实症也治之法必须散邪解热祛痰
为主倘遽以补药为先愈助其火势之焰痰且不得消而邪且不易散方用泻火全明汤治之此方之妙
妙在用玄参之多以解散浮游之火而各药无非入肝舒木之品去湿热而除风邪消痰结而培土气不
治
目而正所以治目也虚痛之症色必淡红即红而亦不甚痛虽羞明而无泪虽畏明而无星大便如平时
小便必清长有痰亦不黄畏寒而无涕此肾肝之虚症也治之法必须补水舒肝为主倘然以逐邪散
火为先势必轻变重而重必变盲矣方用温补救目散治之此方肝肾两补而尤注意于肝虽肝
木之
枯由于肾水之竭以致肝木不能养目然而肝气虽必得肾水以相资必竟目为肝养补肝则目自然有
光
故补肾尤须补肝之为先也世人治虚眼之方原无佳法一见目痛动以风药治之往往坏人之目倘闻
吾之教而辨其虚实毋论或先或后实者用前方虚者用后方则目病必能随手回春何致有失明之叹
哉可见虚实之必宜辨明而用药之不宜少差也
泻火全明汤
柴胡(二钱) 草决明(三钱) 甘菊花(二钱) 玄参(五钱) 炒栀子(二钱) 甘草(一钱) 天花
粉(三钱) 白芍(三钱) 泽泻(一钱) 车前子(一钱) 龙胆草(一钱)水煎服
温补救目散
熟地(五钱) 当归(五钱) 白芍(一两) 山茱萸(五钱) 甘菊花(五钱) 葳蕤(五钱) 枸杞(
三钱) 薏仁(五钱) 柴胡(五分) 车前子(二钱) 白芥子(二钱)水煎服
双蛾(喉痹的一种,咽喉两侧红肿如蚕蛾)的虚实如何辨别?大致而言,外感引起的属于实证,内伤引起的属于虚证。那么外感和内伤又该如何区分呢?大致来说,外感者鼻子必然怕冷,舌苔必然干燥,身体必然先发热而后发冷,痰液必然是黄色或白色,眼睛必然发红且浮肿,这是邪气盛实的表现。使用杀蛾丹治疗,用鹅毛管将药粉吹入喉中,必然会吐出约一碗多的痰涎而痊愈,这是一个神奇的方子。
内伤者虽然同样表现为喉蛾,但咽喉肿胀在白天会稍微减轻,痰多且舌苔不干燥,吐出的痰像泉水涌出一样,身体必然畏寒,两脚必然像冰一样冷,这是正气虚弱的表现。使用八味汤必然能取得疗效。我现在重新制定一个方子,名为三陆同补汤。这个方子的妙处在于水中补火,水足则肺经得到滋养,火温则土气得以生发,这样肺经兼有滋养。况且方中原有生润肺的药物,肺金怎能不安宁呢?肺、肾、脾三经都安宁了,邪气哪里还有藏身之处?自然难以留恋于皮肤之内,邪气退去而肿胀自消,双蛾顿时失去其形态,真是不知不觉中就好了。
【杀蛾丹】
硼砂(一分)、丹砂(三分)、牛黄(一分)、冰片(一分)、儿茶(一钱)、麝香(一分)、石膏(一钱),各研成极细末。
【三陆同补汤】
熟地黄(一两)、山茱萸(五钱)、麦冬(一两)、北五味子(二钱)、薏苡仁(一两)、肉桂(二钱)、人参(一钱)、白芥子(五钱)、茯苓(五钱)、白术(五钱),水煎服。
目痛有虚有实。实痛的症状必然伴有红肿、流泪、眼屎增多,或者感觉像被锥子刺伤,或者像沙子进入眼中,羞明喜暗,见到日光就像被触碰一样疼痛,对着灯光影子就像针刺一样,起障生星,伴有恶寒发热、吐痰、吞酸、大便干结、小便黄赤,这些都是邪火盛的实证。治疗方法必须以散邪解热、祛痰为主,如果急于先用补药,只会助长火势,痰液不能消除,邪气不易散去。方用泻火全明汤治疗。这个方子的妙处在于多用玄参来解散浮游之火,而其他药物无非是入肝舒肝之品,去除湿热而驱除风邪,消除痰结而培补土气,看似不治目,实则正是治目的方法。
虚痛的症状颜色必然淡红,即使红也不怎么痛,虽然羞明但没有眼泪,虽然畏光但没有星翳,大便像平时一样,小便必然清长,有痰也不黄,畏寒而没有鼻涕,这是肝肾的虚证。治疗方法必须以补水舒肝为主,如果以驱逐邪气、散火为先,势必轻症变重,重症变盲。方用温补救目散治疗。这个方子滋补肝肾,尤其注重补肝。虽然肝木的枯槁是由于肾水的枯竭导致肝木不能滋养眼睛,然而肝气虽然必须得到肾水的资助,毕竟眼睛是由肝所养的,补肝则眼睛自然有神采,所以补肾尤其需要先补肝。世人治疗虚性眼病的方子原本没有好方法,一见目痛就动不动用风药治疗,往往损害人的眼睛。倘若听从我的教导辨别其虚实,不论先治还是后治,实证用前方,虚证用后方,则眼病一定能随手回春,何至于发出失明的叹息呢?可见虚实必须辨明,用药不宜有一点差错。
【泻火全明汤】
柴胡(二钱)、草决明(三钱)、甘菊花(二钱)、玄参(五钱)、炒栀子(二钱)、甘草(一钱)、天花粉(三钱)、白芍(三钱)、泽泻(一钱)、车前子(一钱)、龙胆草(一钱),水煎服。
【温补救目散】
熟地黄(五钱)、当归(五钱)、白芍(一两)、山茱萸(五钱)、甘菊花(五钱)、葳蕤(五钱)、枸杞(三钱)、薏苡仁(五钱)、柴胡(五分)、车前子(二钱)、白芥子(二钱),水煎服。
The differentiation of deficiency and excess in Shuang'e (a type of throat obstruction characterized by bilateral swelling of the tonsils resembling silkworm moths) is as follows: generally, those caused by external contraction are excess patterns, while those caused by internal injury are deficiency patterns. How then to differentiate between external contraction and internal injury? Generally speaking, in cases of external contraction, the nose must be sensitive to cold, the tongue coating must be dry, the body must first experience fever followed by chills, the phlegm must be yellow or white, and the eyes must be red and swollen; this indicates an excess of pathogenic factors. Treat with Sha'e Dan (Killing Moth Powder). Blow the powder into the throat using a goose feather; the patient will inevitably vomit about one bowlful of phlegm and saliva and recover. This is a miraculous prescription.
In cases of internal injury, although the presentation is similar with throat swelling, the swelling is slightly relieved during the day, there is excessive phlegm, the tongue coating is not dry, the expectorated phlegm flows out like a gushing spring, the body must feel aversion to cold, and both feet must be ice-cold; this indicates a deficiency of healthy Qi. Treat with Ba Wei Tang (Eight-Ingredient Decoction), which will surely achieve success. I now revise a formula named San Lu Tong Bu Tang (Three Earths Simultaneous Tonification Decoction). The brilliance of this formula lies in tonifying fire within water; when water is sufficient, the Lung Meridian is nourished, and when fire is warm, the Spleen Qi is generated, thereby providing dual nourishment to the Lung Meridian. Moreover, since the formula originally contains herbs that generate Lung Yin, how can the Metal of the Lung remain unsettled? Once the Lung, Kidney, and Spleen meridians are all stabilized, where can pathogens hide? They will naturally find it difficult to linger within the skin. As pathogens retreat, swelling subsides spontaneously, and Shuang'e loses its form entirely, recovering without conscious effort.
[Sha'e Dan]
Borax (1 fen), Cinnabar (3 fen), Calculus Bovis (1 fen), Borneolum Syntheticum (1 fen), Camellia Seed (1 qian), Moschus (1 fen), Gypsum Fibrosum (1 qian). Grind each into an extremely fine powder.
[San Lu Tong Bu Tang]
Prepared Rehmanniae Radix (1 liang), Corni Fructus (5 qian), Ophiopogonis Radix (1 liang), Schisandrae Fructus (2 qian), Coicis Semen (1 liang), Cinnamomi Cortex (2 qian), Ginseng Radix et Rhizoma (1 qian), Brassicae Semenis Albus (5 qian), Poria (5 qian), Atractylodis Macrocephalae Rhizoma (5 qian). Decoct in water and take orally.
Ocular pain can be either deficiency or excess. Symptoms of excess pain necessarily include redness, swelling, tearing, and ocular discharge, or sensations as if pierced by an awl or sand entering the eye. There is photophobia and preference for darkness; exposure to sunlight feels like being touched, and looking at light shadows feels like needle pricks. Opacities and nebulae may arise, accompanied by aversion to cold, fever, expectoration, acid regurgitation, solid stools, and yellow urine. These are all excess patterns of evil fire. The treatment method must focus on dispersing pathogens, clearing heat, and resolving phlegm. If tonifying herbs are used prematurely, they will only exacerbate the fire, preventing phlegm resolution and pathogen dispersion. Use Xie Huo Quan Ming Tang (Fire-Draining Complete Clarity Decoction). The brilliance of this formula lies in the heavy use of Scrophulariae Radix to dissipate floating fire, while other herbs primarily enter the Liver to soothe Liver Qi, eliminate damp-heat and wind pathogens, resolve phlegm nodules, and fortify Spleen Qi. Although it does not directly treat the eyes, it precisely treats them.
Symptoms of deficiency pain present with pale redness; even if red, pain is mild. There is photophobia without tearing, and fear of bright light without nebulae. Stools are normal, urine is clear and copious, phlegm is not yellow, and there is aversion to cold without nasal discharge. These are deficiency patterns of the Liver and Kidney. The treatment method must focus on nourishing Water and soothing the Liver. If expelling pathogens and clearing fire are prioritized, mild conditions will worsen, and severe conditions may lead to blindness. Use Wen Jiu Mu Mu San (Warm Rescue Eye-Nourishing Powder). This formula tonifies both Liver and Kidney, with particular emphasis on the Liver. Although Liver Wood withers due to the exhaustion of Kidney Water, leading to the Liver's inability to nourish the eyes, Liver Qi requires Kidney Water for support. However, since the eyes are nourished by the Liver, tonifying the Liver ensures visual clarity; thus, tonifying the Kidney should prioritize tonifying the Liver. Previously, there were no excellent formulas for treating deficiency-type eye diseases. Seeing ocular pain, practitioners often indiscriminately use Wind-dispelling herbs, often damaging patients' vision. If one follows my guidance to differentiate deficiency and excess, applying the former formula for excess and the latter for deficiency regardless of sequence, eye diseases will respond promptly, avoiding the lament of blindness. Thus, it is evident that deficiency and excess must be clearly differentiated, and medication must not deviate even slightly.
[Xie Huo Quan Ming Tang]
Bupleuri Radix (2 qian), Cassiae Semen (3 qian), Chrysanthemi Flos (2 qian), Scrophulariae Radix (5 qian), Gardeniae Fructus Preparatus (2 qian), Glycyrrhizae Radix et Rhizoma (1 qian), Trichosanthis Radix (3 qian), Paeoniae Radix Alba (3 qian), Alismatis Rhizoma (1 qian), Plantaginis Semen (1 qian), Gentianae Radix (1 qian). Decoct in water and take orally.
[Wen Jiu Mu Mu San]
Prepared Rehmanniae Radix (5 qian), Angelicae Sinensis Radix (5 qian), Paeoniae Radix Alba (1 liang), Corni Fructus (5 qian), Chrysanthemi Flos (5 qian), Polygonati Rhizoma (5 qian), Lycii Fructus (3 qian), Coicis Semen (5 qian), Bupleuri Radix (0.5 qian), Plantaginis Semen (2 qian), Brassicae Semenis Albus (2 qian). Decoct in water and take orally.