三焦分上中下,目疾是上焦病,无有论及中下者。然细按之,则三焦各有见症,不可混
治。头
痛鼻塞,耳 面疮,目红肿痛,唇疮口糜,此皆上焦病也,治宜清火发散,疏肝养目。肚腹
膨胀,胸膈不舒,两目干涩或沿烂,此乃中焦病也,治宜消积行气。香港脚壅肿,步履艰难,
水道不通,湿热上浮,以致目患,此乃下焦病也,治宜利湿清热舒筋。腑病以通为补,故但
叙实症,其有虚症,另见各门,学人细心参之可也。
小肠为火府,与心经配合表里。凡心经之火上延于目者,兼责诸小肠,故古人治心火,
必
用导赤,以心为君火,无直折之理,但当通理小肠,则心火自降。此治脏先治腑之法也。
胆属少阳,经曰∶十二经皆取决于胆。为半表半里,两边头痛,法用小柴胡及逍遥散,
乃和
解之剂。目中神光,惟赖胆中清纯之气所养,倘胆精不足,胆汁不充,两目必昏,古方俱以
诸胆为治。所以清其邪热,乃同气相求之理也。然味太苦寒,防其碍胃,总宜以条达为主。
余详肝经。
胃为水谷之海,转输旋运,生化不穷,故治病先讲胃气。胃气一弱,饮食不纳,何以能
胜药
力乎?然胃病有虚有实,有热有寒,实宜硝黄之属,虚宜术草之属,寒宜香砂之类,热宜芩
斛之类配合。脾经为后天生养之基,故东垣专主脾胃立论,非虚说也,其见症详载脾经,但
须知阳土不耐温燥,方不误治。
三焦分为上、中、下三部,眼疾通常被归为上焦病,很少论及中焦和下焦。然而仔细分析,三焦各有其特定的临床表现,不可混淆治疗。头痛、鼻塞、耳部疾病、面部疮疡、眼睛红肿疼痛、嘴唇生疮、口腔糜烂,这些都属于上焦病,治疗应当采用清火发散、疏肝养目的方法。腹部膨胀、胸膈部不适、两眼干涩或眼睑溃烂,这是中焦病,治疗应当采用消积行气的方法。足胫肿胀、行走困难、小便不通、湿热上浮导致眼部患病,这是下焦病,治疗应当采用利湿清热舒筋的方法。腑病以通畅为补益的原则,因此这里只叙述实证,虚证则另见各章节,学习者需细心参考即可。
小肠被称为“火府”,与心经构成表里关系。凡是心经的火邪上延至眼部的,必须兼治小肠。因此古人治疗心火时,必定使用导赤散(导赤散:具有清心利水养阴功效的方剂),因为心为君火,没有直接折损其火的道理,只应当通调小肠,那么心火自然下降。这就是治疗脏病先治腑病的方法。
胆属于少阳经,医经说:“十二经脉都取决于胆。”胆位于半表半里之间,出现两侧头痛,治疗方法应选用小柴胡汤(小柴胡汤:和解少阳的代表方剂)及逍遥散(逍遥散:疏肝解郁、养血健脾的方剂),这两者都是和解剂。眼中的神光,完全依赖胆中清纯之气的滋养,如果胆精不足,胆汁不充盈,双眼必然昏花,古方常用各种动物胆汁来治疗。这是因为清除邪热符合“同气相求”的原理。然而胆汁味道过于苦寒,担心会妨碍脾胃功能,总体应以条达舒畅为主。详细内容参见肝经章节。
胃是水谷汇聚的海,负责转输和旋转运化,生化功能无穷无尽,所以治病首先要顾护胃气。胃气一旦虚弱,饮食无法接纳,怎么能承受药力呢?然而胃病有虚有实,有热有寒,实证适宜用芒硝、大黄之类的药物,虚证适宜用白术、甘草之类的药物,寒证适宜用木香、砂仁之类的药物,热证适宜用黄芩、石斛之类的药物配合治疗。脾经是后天生命养育的基础,所以李东垣专门从脾胃角度立论,并非空谈,其具体症状详细记载在脾经章节,但必须知道阳土(胃)不耐受温燥,这样才不会误治。
The Sanjiao (Triple Burner) is divided into the Upper, Middle, and Lower sections. Ocular diseases are typically classified as disorders of the Upper Jiao, with little discussion regarding the Middle and Lower Jiao. However, upon detailed analysis, each section of the Sanjiao presents specific symptoms and should not be treated indiscriminately. Headache, nasal congestion, ear disorders, facial sores, redness, swelling, and pain in the eyes, lip sores, and oral ulceration are all disorders of the Upper Jiao; treatment should focus on clearing fire and dispersing pathogenic factors, soothing the Liver, and nourishing the eyes. Abdominal distension, discomfort in the chest and diaphragm, dryness in both eyes, or crusting/ulceration of the eyelids constitute disorders of the Middle Jiao; treatment should focus on resolving accumulation and promoting Qi circulation. Swelling of the lower legs, difficulty walking, obstruction of urinary flow, and damp-heat floating upward causing ocular disease constitute disorders of the Lower Jiao; treatment should focus on promoting diuresis, clearing heat, and relaxing the sinews. For Fu organs (hollow organs), unblocking is considered tonification; therefore, only excess syndromes are discussed here. Deficiency syndromes are detailed in other chapters for careful study by practitioners.
The Small Intestine is referred to as the "Fire Mansion" and forms an interior-exterior relationship with the Heart Meridian. Whenever Fire from the Heart Meridian extends upward to affect the eyes, the Small Intestine must also be addressed. Therefore, ancient physicians always used Dao Chi San (Cognac Powder / Decoction for Guiding Out Redness) when treating Heart Fire. Since the Heart is the Monarch Fire, it cannot be directly suppressed; rather, by regulating the Small Intestine, the Heart Fire will naturally descend. This is the method of treating the Zang organs (solid organs) by first treating their corresponding Fu organs.
The Gallbladder belongs to the Shaoyang (Lesser Yang) meridian. The classics state: "All twelve meridians depend on the Gallbladder." Located at the half-exterior, half-interior level, bilateral headache is treated using Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Xiao Yao San (Free Wanderer Powder), which are harmonizing formulas. The spiritual light of the eyes relies solely on the pure Qi within the Gallbladder for nourishment. If Gallbladder Essence is insufficient and bile is not abundant, vision will inevitably become dim. Ancient formulas often utilize various animal gallbladders for treatment. This aligns with the principle of "seeking similar energies" to clear pathogenic heat. However, since the taste is too bitter and cold, caution is needed to prevent damage to the Stomach; overall, the approach should prioritize free and smooth flow. For details, refer to the Liver Meridian chapter.
The Stomach is the Sea of Water and Grain, responsible for transportation and transformation, with endless biochemical functions. Therefore, treating disease requires prioritizing Stomach Qi. If Stomach Qi becomes weak and food intake is impaired, how can the body withstand the power of medicinal herbs? Stomach diseases can be deficient or excess, hot or cold. Excess conditions are suitable for drugs such as Mangxiao (Natrii Sulfas) and Huanglian (Coptidis Rhizoma - *Note: Text says 硝黄, usually refers to Mangxiao and Dahuang*), deficiency conditions are suitable for Baizhu (Atractylodis Macrocephalae Rhizoma) and Gancao (Glycyrrhizae Radix), cold conditions are suitable for Xiangsha (Amomi Fructus and Aucklandiae Radix), and heat conditions are suitable for Qinhu (Scutellariae Radix and Dendrobii Caulis). The Spleen Meridian is the foundation of postnatal nourishment. Therefore, Li Dongyuan specifically established his theories based on the Spleen and Stomach, which is not empty talk. Specific symptoms are detailed in the Spleen Meridian chapter. One must understand that the Yang Earth (Stomach) cannot tolerate warm and drying agents, to avoid misdiagnosis and mistreatment.