辘轳展开者,与鹘眼凝睛症同,鹘眼凝睛者睛凝不运之貌,辘轳展开而大者,此胆肾之
水散焉,瞳仁之大小随黄仁之展缩,黄仁展则瞳仁小,黄仁缩则瞳仁大,人不知瞳仁能大小
者非也,此乃肝受风而不展辘轳,则瞳仁 圆也,随肝轮而缩,觉见瞳仁大不收,号曰辘轳
展开症。风充入脑眼带吊起,此症小儿急慢惊风受之,治法同前,姜汁调香油摩风膏摩擦,
药用蚌壳频频灌下,乳母忌口。
\r辘轳展开图\p05-c20a56.bmp\r
问曰∶瞳仁开大眼不收而展缩者何也?答曰∶肝受风,痰盛也。治法∶僻巽锭子、牛黄丸
,石楠散,初起者宜发表,小儿如患此,治法亦同。
僻巽锭子 治肝胆受风,变成前症,小儿通睛,瞳仁阔大,并皆治之。
牛胆南星(七钱) 防风 干姜(各三钱) 白附子(五钱) 牛黄(三分) 川乌 白芷 薄荷 木香
白术 白茯苓 人参(各五钱) 朱砂(一钱) 麝香(五分) 白僵蚕(二十个,生用) 片脑(五分)
上将前药俱研为细末,冬用蜜二斤甘草半斤煎作膏稀稠得宜,将次药末和作锭子,金箔
为衣。小儿急慢惊风,手足搐搦,金银箔磨汤化下一锭;大人破伤风,酒化下三四锭子,约
一钱一个,或七分一个,夏用麻黄一斤甘草半斤,用水三四碗砂锅内煎至一钟之时,入蜜一
斤,缓缓熬炼,滴水内成珠,方将前药搜和为丸,即作锭子也。
牛黄丸 能去风痰。
牛黄(二分) 白附子 全蝎 肉桂 川芎 石膏(各一两) 白芷(三分) 藿香(五钱) 麝香(少许)
朱砂(二钱)
上为细末,炼蜜为丸,如梧桐子大。每服二三丸,临卧薄荷汤下。
通顶石楠散 能利膈开风痰。
石楠藤 藜芦(各一两) 瓜蒂(七分)
上为末。米汤下一匙,日一二度,灌入口内,去风痰。
辘轳展开症,与鹘眼凝睛症相同。所谓鹘眼凝睛,是指眼球固定不动、凝视不转的状态。而辘轳展开症表现为瞳孔散大,这是由于胆和肾的水液(精气)涣散所致。瞳孔的大小随着黄仁(虹膜)的舒展或收缩而变化:黄仁舒展则瞳孔变小,黄仁收缩则瞳孔变大。人们不知道瞳孔之所以能调节大小,这种观点是错误的。这是因为肝脏受到风邪侵袭,导致无法舒展辘轳(此处指代眼部调节机制),从而使瞳孔保持圆形;它随肝经气机而收缩,结果看到瞳孔散大而不能收敛,因此称为辘轳展开症。
风邪充塞并侵入脑部及眼带,将其吊起,此症多见于小儿因急惊风或慢惊风所引发,治疗方法与前文所述相同。可用姜汁调和香油摩风膏进行摩擦按摩,药用蚌壳粉频频灌服,乳母需注意饮食禁忌。
[辘轳展开图]
问:为什么瞳孔开大、眼睛不能收敛且出现展缩异常?答:这是因为肝脏受风邪侵袭,且体内痰湿壅盛。治疗方法:使用僻巽锭子、牛黄丸、石楠散。疾病初起时宜采用解表法。如果小儿患此病,治疗方法也相同。
僻巽锭子:治疗肝胆受风,从而变成上述症状,以及小儿通睛(斜视)、瞳孔阔大等症,均有疗效。
处方组成:牛胆南星(七钱)、防风、干姜(各三钱)、白附子(五钱)、牛黄(三分)、川乌、白芷、薄荷、木香、白术、白茯苓、人参(各五钱)、朱砂(一钱)、麝香(五分)、白僵蚕(二十个,生用)、片脑(冰片,五分)。
制法与用法:将上述药物全部研为细末。冬季制作时,用蜂蜜二斤、甘草半斤煎制成稀稠适宜的膏状,然后将药末混合做成锭剂,外裹金箔。小儿患急惊风或慢惊风,出现手足抽搐时,用金银箔磨水化开,送服一锭;成人患破伤风,用酒化开,送服三四锭。每锭约重一钱或七分。夏季制作时,用麻黄一斤、甘草半斤,加水三四碗在砂锅内煎煮至一碗量,加入蜂蜜一斤,缓缓熬炼,直到滴水成珠的程度,再将前述药末混合制成丸剂,即成为锭剂。
牛黄丸:能够祛除风痰。
处方组成:牛黄(二分)、白附子、全蝎、肉桂、川芎、石膏(各一两)、白芷(三分)、藿香(五钱)、麝香(少许)、朱砂(二钱)。
制法与用法:以上药物研为细末,用炼蜜制成丸剂,大小如梧桐子。每次服用二三丸,睡前用薄荷汤送服。
通顶石楠散:能够通利膈部,开通风痰。
处方组成:石楠藤、藜芦(各一两)、瓜蒂(七分)。
制法与用法:以上药物研为粉末。用米汤送服一匙,每日一次或两次,灌入口中,以祛除风痰。
Lulu Zhankai (Wheel Unfolding) syndrome is identical to Hu Yan Ning Jing (Hawk Eye Fixed Gaze) syndrome. Hu Yan Ning Jing refers to the appearance of the eyeball being fixed and unmovable, gazing without rotation. Lulu Zhankai, characterized by a dilated pupil, results from the dispersion of the water essence of the Gallbladder and Kidney. The size of the pupil changes according to the expansion or contraction of the Huang Ren (Iris): when the Iris expands, the pupil becomes small; when the Iris contracts, the pupil becomes large. It is incorrect for people not to understand that the pupil's ability to change size is due to this mechanism. This condition occurs because the Liver is affected by Wind pathogen, preventing the "wheel" (ocular adjustment mechanism) from unfolding, thus keeping the pupil round. As it contracts following the Liver wheel, the pupil appears dilated and unable to converge, hence named Lulu Zhankai syndrome.
Wind pathogen fills and enters the brain and eye tendons, pulling them upward. This syndrome is commonly contracted by children suffering from Ji Jing Feng (Acute Convulsive Disorder) or Man Jing Feng (Chronic Convulsive Disorder). The treatment method is the same as described previously. Apply Mo Feng Gao (Wind-Rubbing Ointment) mixed with ginger juice and sesame oil for friction massage, and frequently administer Bhe Ke (Mussel Shell) powder orally. The nursing mother must observe dietary restrictions.
[Image: Lulu Zhankai Diagram]
Question: Why does the pupil open widely, the eye fail to converge, and exhibit abnormal expansion and contraction? Answer: This is caused by the Liver being affected by Wind pathogen and excessive phlegm accumulation. Treatment methods include using Pi Xun Ding Zi (Pi Xun锭剂), Niu Huang Wan (Calculus Bovis Pill), and Shi Nan San (Stemnan Vine Powder). In the early stages, surface-releasing methods should be employed. If children suffer from this condition, the treatment remains the same.
Pi Xun Ding Zi: Treats conditions where the Liver and Gallbladder are affected by Wind, leading to the aforementioned symptoms, as well as Tong Jing (Strabismus) in children and wide pupils.
Ingredients: Niu Dan Nan Xing (Arisaema cum Bile, 7 qian), Fang Feng (Saposhnikovia Root), Gan Jiang (Dried Ginger) (each 3 qian), Bai Fu Zi (Typhonii Rhizoma, 5 qian), Niu Huang (Calculus Bovis, 3 fen), Chuan Wu (Aconiti Radix), Bai Zhi (Angelicae Dahuricae Radix), Bo He (Menthae Haplocalycis Herba), Mu Xiang (Aucklandiae Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bai Fu Ling (Poria), Ren Shen (Ginseng Radix) (each 5 qian), Zhu Sha (Cinnabar, 1 qian), She Xiang (Moschus, 5 fen), Bai Jiang Can (Bombyx Batryticatus, 20 pieces, raw use), Pian Nao (Borneolum Syntheticum, 5 fen).
Preparation and Administration: Grind all the above herbs into fine powder. For winter preparation, boil two jin of honey and half a jin of Gan Cao (Licorice Root) to make a paste of appropriate consistency, then mix with the herb powder to form ingots, coated with Jin Bo (Gold Leaf). For children with Ji Jing Feng or Man Jing Feng presenting with convulsions of hands and feet, dissolve one ingot in water prepared by grinding Jin Yin Bo (Silver and Gold Leaf). For adults with Po Shang Feng (Traumatic Tetanus), dissolve three to four ingots in wine. Each ingot weighs approximately one qian or seven fen. For summer preparation, boil one jin of Ma Huang (Ephedrae Herba) and half a jin of Gan Cao (Licorice Root) in three to four bowls of water in a clay pot until reduced to one bowl, add one jin of honey, and slowly simmer until drops form beads in water. Then mix with the aforementioned herb powder to form pills, which constitute the ingots.
Niu Huang Wan (Calculus Bovis Pill): Capable of dispelling Wind-Phlegm.
Ingredients: Niu Huang (Calculus Bovis, 2 fen), Bai Fu Zi (Typhonii Rhizoma), Quan Xie (Scorpio), Rou Gui (Cinnamomi Cortex), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Shi Gao (Gypsum Fibrosum) (each 1 liang), Bai Zhi (Angelicae Dahuricae Radix, 3 fen), Huo Xiang (Agastaches Herba, 5 qian), She Xiang (Moschus, a little), Zhu Sha (Cinnabar, 2 qian).
Preparation and Administration: Grind the above into fine powder, mix with refined honey to form pills the size of Sophora seeds. Take two or three pills each time, administered with Bo He Tang (Mint Decoction) before bedtime.
Tong Ding Shi Nan San (Stemnan Vine Powder for Opening the Crown): Capable of benefiting the diaphragm and opening Wind-Phlegm.
Ingredients: Shi Nan Teng (Stemnan Vine), Li Lu (Veratri Rhizoma) (each 1 liang), Gua Di (Cucumeris Fructus, 7 fen).
Preparation and Administration: Grind the above into powder. Administer one spoonful with Mi Tang (Rice Decoction), once or twice daily, instilled into the mouth to expel Wind-Phlegm.