小儿通睛,与鹘眼凝睛、辘轳展开此三症颇同,然此症或因外物打着头颅,或被诸般人
物惊心,遂成惊风之症。风热伤肝魂不应目,风邪上壅黄仁不成关锁,瞳仁开,惟直视不辨
人物,致眼通睛,通者黄仁、水轮皆黑,似无黄仁,瞳仁水散,似无瞳仁,此黄仁与瞳仁通混
不分,号曰通瞳。亦风药摩擦二法,发散风邪宜服牛黄丸,不须点药,只服药,然前症牛黄
丸、通顶石楠散亦可用也。
\r小儿通睛图\p05-c20a57.bmp\r
牛黄丸 通顶石楠散 二方俱在前症条下。
五七犀角饮
犀角 人参 茯苓 甘草 远志(各一两) 麝香(少许) 龙胆草 黄芩(各五钱)
上 咀。水煎服。
小儿疹痘者,名为百岁疮也。不论大小俱患一度,疹痘入眼,疹有两分,痘疮初上皮肤
之际,眼闭不开,眼上即有痘疮点在黑睛上易治,急取益母草煎汤熏洗,日三度,更以阴一
阳五丹调鳝鱼血点,忌口及夜啼,乳母亦忌口,须疹痘痊可,其眼渐开,眼中之痘,亦随而痊
矣。又有一症,痘疹之后疮痂落尽,肌体肥壮,眼中忽然红涩,此乃余毒郁结于肝而发出,
此症十分利害,失治多能害目,只用车前草擂水频与饮下,洗却肝经之热毒,洗以益母草,
点以鳝鱼血调药。经曰∶疹痘之后,毒瓦斯郁结于肝而气不能泄,攻发于眼,伤于瞳仁者,素
无治法也。
\r小儿疹痘图\p05-c20a58.bmp\r
问曰∶小儿此症入眼者何也?答曰∶小儿痘疮之发,五脏皆热毒之气壅塞停留,热气在
肝膈充入眼,使疼痛泪出,怕日羞明难开,遂生疮于眼内,久发变为白膜。初觉疮入眼中赤
涩之时,急将药泄其毒,外以退翳之药,若不能为,终身之患也。先将秦皮汤洗目眼,红花
退翳散服之效。
秦皮汤 洗眼。
秦皮 秦艽 防风 细辛(各两) 甘草(一钱)
上将水二盏,煎至一半,热洗。
红花散
红花 连翘 当归 生地黄 紫草 大黄 甘草 赤芍药
上灯心竹叶,水煎服。
退翳散 即猪肝散
真蛤粉 谷精草 夜明砂
上为细末。用猪肝二两切开,掺药于内,以麻扎定煮,水冷,将肝同药细嚼,煮肝本汁
咽,诸般毒物莫吃。
小儿通睛(双眼向内斜视),与鹘眼凝睛(眼球固定偏向一侧)、辘轳展开(眼球震颤或转动异常)这三种病症颇为相似,然而此症往往是因为外物击打头部,或被各种事物惊吓,从而形成惊风之症。风热邪气损伤肝魂,导致目光不能正常调节;风邪上壅于目,致使黄仁(虹膜)无法正常开合锁闭,瞳仁(瞳孔)散大,只能直视而不能分辨人物,导致眼睛出现通睛。所谓“通”,是指黄仁与水轮(瞳孔区域)皆呈黑色,看起来好像没有黄仁;瞳仁水散,看起来好像没有瞳仁。这是因为黄仁与瞳仁通混不分,所以称为“通瞳”。治疗可采用风药摩擦和药物内服两种方法,发散风邪适宜服用牛黄丸,不需要点眼药,只需服药即可,当然前文提到的牛黄丸、通顶石楠散也可以使用。
小儿疹痘,被称为“百岁疮”。无论男女老少都会患一次。如果疹痘侵入眼部,疹子分为两类,痘疮刚发于皮肤之际,眼睛紧闭不开。如果眼上黑睛(角膜)上有痘疮点出,则容易治疗,应立即取益母草煎汤熏洗,每日三次,再用阴一阳五丹调和鳝鱼血点眼。需要忌口以及防止夜间啼哭,乳母也要忌口。必须等到疹痘痊愈,眼睛才会逐渐睁开,眼中的痘疮也会随之痊愈。又有一种症状,在痘疹之后疮痂落尽,身体强壮时,眼中忽然发红干涩,这是余毒郁结于肝脏而发出的表现,此症十分厉害,若失治大多会损害视力,只用车前草研磨取水频频饮用,以洗去肝经的热毒,外用益母草清洗,用鳝鱼血调药点眼。医经说:“疹痘之后,毒瓦斯郁结于肝脏而气机不能宣泄,攻发于眼部,伤害瞳仁的,原本没有固定的治疗方法。”
问:为什么小儿的这种病症会侵入眼睛?答:小儿痘疮发作时,五脏都被热毒之气壅塞停留,热气在肝膈充盛并进入眼睛,导致疼痛流泪,怕光羞明难以睁开,从而在眼内生疮,久病则变为白膜。初觉疮入眼中赤涩之时,应立即用药泄其毒,外用退翳之药,如果不能这样处理,将成为终身之患。先用秦皮汤清洗眼睛,服用红花退翳散有效。
秦皮汤,用于洗眼。
秦皮、秦艽、防风、细辛(各一两),甘草(一钱)。
以上药材切碎,用水两盏,煎至一半量,趁热清洗。
红花散
红花、连翘、当归、生地黄、紫草、大黄、甘草、赤芍药。
以上药材加灯心草、竹叶,用水煎服。
退翳散,即猪肝散。
真蛤粉、谷精草、夜明砂。
以上药材研为细末。用猪肝二两切开,将药掺入肝内,用麻线扎紧煮熟,待水冷后,将肝连同药一起细细咀嚼,吞下煮肝的原汁,期间不要吃各种毒物食物。
Xiao'er Tongjing (infant strabismus with eyes converging inward) is quite similar to Hu Yan Ning Jing (eyes fixed in one direction) and Lu Lu Zhan Kai (abnormal eye movement or nystagmus). However, this condition often arises from external trauma to the head or fright caused by various stimuli, leading to a syndrome of Wind-Convulsion. Wind-Heat pathogenic factors damage the Liver Hun (Liver Spirit), causing the gaze to lose normal regulation; Wind pathogenic factors ascend and obstruct the eyes, preventing the Huang Ren (iris) from opening and closing properly. The Tong Ren (pupil) becomes dilated, resulting in a fixed stare where the child cannot distinguish people, leading to Tongjing. "Tong" refers to the state where the Huang Ren and Shui Lun (pupil area) both appear black, making it seem as if there is no iris; the pupil water scatters, making it seem as if there is no pupil. This occurs because the Huang Ren and Tong Ren are mixed and indistinguishable, hence the name "Tongtong" (merged pupil). Treatment can employ two methods: friction with wind-dispersing agents and internal medication. To disperse Wind pathogenic factors, Niuhuang Wan (Calculus Bovis Pill) is suitable; eye drops are not necessary, only oral medication is required. Of course, Niuhuang Wan and Tongding Shi Nan San (Top-Penetrating Lithospermum and Fatsia Powder) mentioned earlier can also be used.
Xiao'er Zhendou (infant measles and smallpox) is known as "Bai Sui Chuang" (Hundred-Year Sore). Both males and females suffer from it once in their lifetime. If Zhendou invades the eyes, measles are divided into two types. When sores first appear on the skin, the eyes remain tightly closed. If sores appear on the Hei Jing (cornea/black part of the eye), it is easy to treat. Immediately take Motherwort Herb (Yimucao) decoction for fumigation and washing, three times daily, and apply Yinyi Yangwu Dan (Yin-One Yang-Five Powder) mixed with eel blood to the eyes. Dietary restrictions are necessary, as well as preventing night crying. The nursing mother must also observe dietary restrictions. Only after the measles and smallpox have healed will the eyes gradually open, and the sores in the eyes will heal accordingly. There is another symptom: after the scabs of smallpox/measles fall off and the body becomes robust, the eyes suddenly become red and dry. This is due to residual toxins stagnating in the Liver and erupting. This condition is very severe; if untreated, it often damages vision. One should grind Plantain Herb (Cheqiancao) and extract its juice to drink frequently, to wash away Heat-Toxins in the Liver Meridian. Externally, wash with Motherwort Herb (Yimucao) and apply medicine mixed with eel blood. The Classics state: "After measles and smallpox, if toxic vapors stagnate in the Liver and Qi cannot vent, attacking the eyes and damaging the pupil, there is originally no fixed treatment method."
Question: Why does this condition in infants invade the eyes? Answer: When infant smallpox/measles erupts, the Five Zang Organs are all blocked and stagnant with Heat-Toxin Qi. Heat Qi surges in the Liver and Diaphragm, entering the eyes, causing pain, tearing, photophobia, and difficulty opening them. Sores then grow inside the eyes, which over time transform into a white membrane. When initially feeling redness and dryness from sores entering the eyes, immediately use medicine to drain the toxins. Externally use medicines to remove nebulae (cloudy cornea). If this is not done, it will become a lifelong affliction. First, wash the eyes with Qinpi Tang (Bark Decoction); taking Honghua Tu Yi San (Safflower Nebula-Removing Powder) is effective.
Qinpi Tang, for washing eyes.
Qin Pi (Cortex Fraxini), Qin Jiao (Radix Gentianae Macrophyllae), Fang Feng (Radix Saposhnikoviae), Xi Xin (Herba Asari) (each 1 liang), Gan Cao (Radix Glycyrrhizae) (1 qian).
Chop the above ingredients. Add two cups of water, boil until half remains, and wash while hot.
Honghua San
Hong Hua (Flos Carthami), Lian Qiao (Fructus Forsythiae), Dang Gui (Radix Angelicae Sinensis), Sheng Di Huang (Radix Rehmanniae Preparata), Zi Cao (Radix Arnebiae/Lithospermi), Da Huang (Radix et Rhizoma Rhei), Gan Cao (Radix Glycyrrhizae), Chi Shao Yao (Radix Paeoniae Rubra).
Add Deng Xin Cao (Medulla Junci) and Zhu Ye (Folium Bambusae) to the above, boil in water, and take orally.
Tu Yi San (Nebula-Removing Powder), also known as Zhu Gan San (Pig Liver Powder).
Zhen Ha Fen (Concha Tridacnatis/Glass Shell Powder), Gu Jing Cao (Flores Eyebright), Ye Ming Sha (Feces Phalacrocoracis).
Grind the above into fine powder. Take 2 liang of pig liver, cut it open, sprinkle the medicine inside, tie securely with hemp, and boil. When cool, chew the liver and medicine finely, swallowing the original broth of the boiled liver. Avoid eating any toxic foods during this period.