Formulas · Text · Donguibogam 東醫寶鑑

The Eye

한글 눈 · Pinyin Yan

The five wheels and the eight enclosures — why there is no cold in eye disease, the screen inside and the screen outside, and twenty-three names for a clouding pupil

眼

The longest chapter in the Outer Form volumes, and the one with the most machinery. The Lingshu gives it its anatomy: the essence of the bone makes the pupil, of the sinew the black of the eye, of the blood the network vessels, of the qi the white, of the flesh the binding lids — and all of them, with the eye's connecting vessel, run up into the brain and out at the nape, which is why a blow at the nape can set the brain turning and the eyes spinning, and why an evil that scatters the essence makes one object look like two. On that the chapter builds the five wheels and the eight enclosures, mapping every part of the eye to a viscus, and then states the rule the whole subject rests on: there is no cold in eye disease, only vacuity and heat. Jahwa puts it as a catalogue — the white turning red is fire in the lung, the lids red and swollen fire in the spleen, the dark water screened fire in the liver and kidney — and Dongwon adds the other half, that all of it is carried by the blood the spleen sends up, so that treating the spleen and settling the spirit is treating the root. Then the two great divisions: the internal obstruction, painless and tearless, where a fat descends from the brain and congeals on the dark pupil, with twenty-three named forms of it; and the external, where a screen sits on the surface and is read by the direction its vessels run — down from above is the greater yang and is warmed, up from below is the yang brightness and is drained, in from the outer corner is the lesser yang and is harmonized. The causes are a list worth reading on its own: eating the five pungent things raw, reading fine print at night, weeping too much, staring at the sun and moon, carving minute work, years of copying. Of the pharmacy, the internal formulas are mostly sound and several are still used; the eye drops are lead, mercury, arsenic and copper salts laid on the cornea, and none of them can be made.

3.1 The Eye Is the Essence of the Viscera and Bowels 眼爲臟腑之精

3.1.1

Source원문

五藏六府之精氣, 皆上注於目而爲之精. 精之窠爲眼, 骨之精爲瞳子, 筋之精爲黑眼, 血之精爲絡其窠, 氣之精爲白眼, 肌肉之精爲約束褁擷. 筋骨血氣之精而與脉系上屬於腦, 後出於項中. 故邪中於項, 因逢其身之虛, 其入深, 則隨眼系以入於腦; 入於腦則腦轉, 腦轉則引目系急, 目系急則目眩以轉矣卽因風眩暈也. 邪中其精, 其精所中不相比也, 則精散; 精散則視歧, 視歧見兩物也視一物爲兩也.

Translation영역

The essential qi of the five viscera and six bowels all pours upward into the eye and becomes its essence. The nest of the essence is the eye: the essence of the bone makes the pupil, the essence of the sinew the black of the eye, the essence of the blood the network vessels that enclose the nest, the essence of the qi the white of the eye, and the essence of the flesh the binding and gathering lids. The essences of sinew, bone, blood and qi, together with the vessel's connection, run upward and belong to the brain, and come out behind at the middle of the nape. So when an evil strikes at the nape and meets with vacuity in the body, it enters deep and follows the eye's connecting vessel into the brain; entering the brain it makes the brain turn, and the brain turning draws the eye's connection tight, and the connection tight makes the eyes spin and turn — this is the dizziness that comes of wind. And when an evil strikes the essences so that the essences struck no longer match one another, the essence scatters; scattered, the sight divides, and divided sight sees two things — that is, one object seen as two.

Yeongchu 靈樞

3.1.2

Source원문

目者五藏六府之精也, 榮衛魂魄之所常營也, 神氣之所生也. 故神勞則魂魄散, 志意亂. 是故瞳子ㆍ黑眼法於陰, 白眼ㆍ赤脉法於陽也, 故陰陽合傳而爲精明也. 目者心之使也, 心者神之舍也. 故神精亂而不轉, 卒然見非常之處, 精神魂魄散不相得, 故曰惑也. 《靈樞》

Translation영역

The eye is the essence of the five viscera and six bowels, where the construction and defence and the ethereal and corporeal souls are always at work, and where the spirit qi is engendered. So when the spirit is taxed the souls scatter and the will is disordered. The pupil and the black of the eye follow the pattern of yin; the white and the red vessels follow the pattern of yang; and so yin and yang joined and transmitted make the clarity of the essence. The eye is the heart's envoy, and the heart is the dwelling of the spirit. So when the spirit's essence is disordered and will not turn, and one suddenly sees an unaccustomed place, the essence, spirit and the two souls scatter and do not meet each other — and this is called bewilderment.

Yeongchu 靈樞

3.1.3

Source원문

是以五藏六府ㆍ十二經脉ㆍ三百六十五絡, 其血氣皆稟受於脾土, 上貫於目而爲明. 故脾虛則五藏之精氣皆失所使, 不能歸明於目矣. 《綱目》

Translation영역

And so the five viscera and six bowels, the twelve channel vessels and the three hundred and sixty-five network vessels all receive their blood and qi from the spleen earth, which threads upward into the eye and makes it bright. So when the spleen is vacuous, the essential qi of the five viscera all loses what directs it and cannot return as brightness to the eye.

Clinical note임상 주석

The Lingshu passage is the foundation of the whole chapter and repays slow reading. It assigns each part of the eye to the essence of a tissue, routes them all into the brain and out at the nape, and then explains two symptoms mechanically from that route: a blow at the nape setting the brain turning and the eyes spinning, and an evil that puts the essences out of register making one object appear as two. Both are correct accounts of real signs. The Gangmok's addition shifts the clinical weight to the spleen, and the rest of the chapter divides between these two readings — the eye as the brain's outpost, and the eye as what the spleen's blood reaches last.

Gangmok 綱目

3.2 The Chart of the Five Wheels 五輪之圖

3.2.1

Source원문

上瞼ㆍ下瞼ㆍ心ㆍ脾ㆍ肺ㆍ肝ㆍ腎ㆍ胃

Translation영역

Upper lid, lower lid, heart, spleen, lung, liver, kidney, stomach

Clinical note임상 주석

The labels of the section's figure — an eye with its parts marked and the viscera written beside the parts that belong to them. The stomach is among them although the five wheels below name only the five viscera: the figure gives the lower lid to the stomach and the upper to the spleen, where the prose gives both lids to the spleen together.

Donguibogam · An

3.2.2

Source원문

白睛屬肺, 氣之精爲氣輪. ○黑睛屬肝, 筋之精爲風輪. ○上下瞼屬脾, 肉之精爲肉輪. ○大小眥屬心, 血之精爲血輪. ○瞳人屬腎, 骨之精爲水輪. 《得效》

Translation영역

The white of the eye belongs to the lung: the essence of the qi makes the qi wheel. The black of the eye belongs to the liver: the essence of the sinew makes the wind wheel. The upper and lower lids belong to the spleen: the essence of the flesh makes the flesh wheel. The greater and lesser corners belong to the heart: the essence of the blood makes the blood wheel. The pupil belongs to the kidney: the essence of the bone makes the water wheel.

Deukhyo 得效

3.2.3

Source원문

氣輪. 病因凌寒冒暑, 受飮寒漿, 肌體虛疏, 寒邪入內. 其候或痛或昏, 傳在白睛, 筋多腫赤, 視日如隔霧, 看物似生烟. 日久不治, 變成白膜黑暗難開. 《得效》

Translation영역

The qi wheel. The disease comes of braving cold and exposure to summer heat, of drinking cold draughts, and of the flesh being vacuous and loose so that cold evil enters within. Its signs are pain or dimness, passing into the white of the eye, with the vessels much swollen and red, the sun seen as through mist and objects as though smoke were rising. Left untreated for long it turns into a white membrane with darkness, and the eye is hard to open.

Deukhyo 得效

3.2.4

Source원문

風輪. 病因喜怒不常, 作勞用心, 晝視遠物, 夜讀細書. 其候眥頭尤澁, 睛內偏疼, 視物不明, 胞弦緊急. 宜去風藥. 《得效》

Translation영역

The wind wheel. The disease comes of joy and anger out of measure, of labouring and using the mind, of looking at distant things by day and reading fine print by night. Its signs are the corner of the eye especially rough, pain to one side within the eye, objects seen unclearly, and the lid margin drawn tight. Wind-dispelling medicines should be used.

Deukhyo 得效

3.2.5

Source원문

肉輪. 病因多食熱物, 好喫五辛, 遠道奔馳, 食飽耽眠, 風積痰壅. 其候眼胞赤腫昏蒙, 多淚倒睫, 澁痛瘀血侵睛. 宜疏醒脾藥. 《得效》

Translation영역

The flesh wheel. The disease comes of eating much hot food, of a liking for the five pungent things, of running long roads, of sleeping heavily on a full stomach, and of wind accumulating and phlegm congesting. Its signs are the lids red, swollen and dim, much tearing with inturned lashes, roughness and pain, and static blood invading the eye. Medicines that free and rouse the spleen should be used.

Deukhyo 得效

3.2.6

Source원문

血輪. 病因七情煩勞, 內動於心, 外攻於目. 其候赤筋纏眥, 白膜侵睛, 胞腫難開, 昏澁. 日久不治, 失明愈深. 宜洗心凉血藥. 《得效》

Translation영역

The blood wheel. The disease comes of the seven affects with vexation and taxation, stirring the heart within and striking the eye without. Its signs are red vessels winding at the corner, a white membrane invading the eye, the lids swollen and hard to open, and dimness with roughness. Left untreated for long, the loss of sight grows deeper. Medicines that wash the heart and cool the blood should be used.

Deukhyo 得效

3.2.7

Source원문

水輪. 病因勞役過度, 嗜慾無厭, 又傷七情, 加之多飡酒麪, 好啖醎辛, 因動腎經, 通於黑水. 其候冷淚鎭流於臉上, 飛蠅相趂於睛前, 積聚風虛, 或澁或痒, 結成瞖障, 常多昏暗. 宜用補腎藥. 《得效》

Translation영역

The water wheel. The disease comes of taxation beyond measure and of appetite without restraint, with damage from the seven affects besides, and to that is added much eating of wine and wheat and a liking for salt and pungent food, which stirs the kidney channel and reaches the dark water. Its signs are cold tears running constantly down the face, flying midges chasing each other before the eye, wind vacuity gathering, roughness or itching, an obstructing screen forming, and constant dimness. Kidney-supplementing medicines should be used.

Clinical note임상 주석

The five wheels turn a map into a clinical instrument: each part of the eye is assigned a viscus, and then each wheel is given its own aetiology, its own signs and its own class of medicine. The result is a diagnostic algorithm — look at which part of the eye is affected, and the treatment follows. It is the clearest systematization in the chapter, and the water wheel's description of cold tears and flying midges is the Bogam's best account of floaters.

Deukhyo 得效

3.3 The Chart of the Eight Enclosures 八廓之圖

3.3.1

Source원문

天ㆍ地ㆍ火ㆍ風ㆍ水ㆍ天ㆍ雷ㆍ山ㆍ澤

Translation영역

Heaven, earth, fire, wind, water, heaven, thunder, mountain, marsh

Clinical note임상 주석

The labels of the section's figure — the eight trigram names written around the eye, one to each enclosure. There are nine marks for eight enclosures because 天 is written twice in the figure, and the two middle labels stand in the reverse of the order the prose uses; the list below is the authority for which enclosure is which.

Donguibogam · An

3.3.2

Source원문

天廓, 肺大腸, 傳道. ○地廓, 脾與胃, 水糓. ○火廓, 心命門, 抱陽. ○水廓, 腎, 會陰. ○風廓, 肝, 養化. ○雷廓, 小腸, 關泉. ○山廓, 膽, 淸淨. ○澤廓, 膀胱, 津液. 《得效》

Translation영역

The heaven enclosure: lung, large intestine, the conveying road. The earth enclosure: spleen and stomach, water and grain. The fire enclosure: heart, life gate, embracing the yang. The water enclosure: kidney, the meeting of yin. The wind enclosure: liver, nourishing and transforming. The thunder enclosure: small intestine, the barrier spring. The mountain enclosure: gallbladder, the clear and pure. The marsh enclosure: bladder, the fluids.

Clinical note임상 주석

Eight enclosures laid over the same eye the five wheels divide, this time by trigram, each taking a bowel or a viscus and a function. The two schemes do not reconcile and the chapter does not try to reconcile them; the wheels are what it actually uses in treatment, while the enclosures are kept because the tradition kept them.

Deukhyo 得效

3.3.3

Source원문

天廓, 病因雲中射鴈, 月下看書, 多食腥膻, 侵冒寒暑. 其候視物生烟, 眥疼難開, 不能辨認. 《得效》

Translation영역

The heaven enclosure. Its causes: shooting geese up in the clouds, reading by moonlight, eating much rank and gamy flesh, and being overtaken by cold and heat. Its signs: things are seen as through smoke, the canthus is sore and hard to open, and one cannot make things out.

Clinical note임상 주석

The first of the eight, and the pattern all eight follow: a list of causes, then a list of signs, with no treatment. Three of its four causes are strain of the eye at a distance or in poor light, which is this chapter's standing explanation for failing sight.

Deukhyo 得效

3.3.4

Source원문

地廓, 病因濕漬頭上, 冷灌睛眸. 其候眼弦緊急, 瘀血生瘡. 《得效》

Translation영역

The earth enclosure. Its causes: damp soaking the top of the head, and cold poured over the eyes. Its signs: the lid margins tight and drawn, with static blood engendering sores.

Deukhyo 得效

3.3.5

Source원문

火廓, 病因心神恐怖, 赤脉侵眥, 血灌瞳人. 其候瞼頭紅腫, 睛內偏疼, 熱淚如傾. 《得效》

Translation영역

The fire enclosure. Its causes: the heart-spirit in dread, red vessels invading the canthus, and blood flooding the pupil. Its signs: the lid margin red and swollen, pain deep within the eye on one side, and hot tears as though poured out.

Clinical note임상 주석

血灌瞳人 — blood flooding the pupil — is a section of its own at 3.13.37, where it is a hyphaema from a blow. Here it stands as a cause rather than a sign, which is how the enclosure scheme works: the same finding can be the gate a disease enters by.

Deukhyo 得效

3.3.6

Source원문

水廓, 病因努力爭鬪, 擊棒開弓, 驟騎强力生病. 其候常多昏暗, 睛眩淚多. 《得效》

Translation영역

The water enclosure. Its causes: straining in quarrels and fights, striking with staves and drawing the bow, hard riding and forcing the strength, so that disease arises. Its signs: constantly much clouding and darkness, the eye swimming, and much tearing.

Deukhyo 得效

3.3.7

Source원문

風廓, 病因枕邊窓穴有風, 不能遮閉, 坐臥當之, 腦中風邪. 其候黑睛多痒, 兩瞼常爛, 或昏多淚. 《得效》

Translation영역

The wind enclosure. Its causes: a gap in the window beside the pillow with wind coming through it, left unshuttered and sat or lain in, so that a wind evil lodges in the brain. Its signs: much itching of the black of the eye, both lids constantly raw, or clouding with much tearing.

Deukhyo 得效

3.3.8

Source원문

雷廓, 病因失枕睡臥, 酒後行房, 血脉滿溢, 虱邪內聚. 其候眥頭赤腫, 瞼內生瘡, 倒睫拳毛遮睛, 努肉. 《得效》

Translation영역

The thunder enclosure. Its causes: sleeping with the pillow lost, intercourse after wine, the blood vessels brimming over, and a wind evil gathering within. Its signs: the canthus red and swollen, sores on the inner lid, lashes turned in and curled against the eye, and flesh growing out over it.

Clinical note임상 주석

Three of its signs are sections of their own below: 倒睫拳毛 at 3.13.20, 努肉攀睛 at 3.13.3 and 瞼生風粟 at 3.13.13. The enclosure scheme is a second index over the same diseases, sorting them by the channel they belong to rather than by what they look like.

Deukhyo 得效

3.3.9

Source원문

山廓, 病因撞刺磕損, 致令肉生兩瞼, 瞖閉雙睛. 若不早治, 永沈昏暗, 瘀血侵睛. 《得效》

Translation영역

The mountain enclosure. Its causes: a blow, a stab or a knock, so that flesh grows on both lids and an opacity closes both eyes. If it is not treated early, it sinks into darkness for good, with static blood invading the eye.

Deukhyo 得效

3.3.10

Source원문

澤廓, 病因春不宣解, 冬聚陽毒, 多飡熱物, 致令腦脂凝聚. 血淚攻潮, 有如霧籠, 飛蜂黑花常見. 《得效》

Translation영역

The marsh enclosure. Its causes: spring failing to let things out and winter gathering a yang toxin, with much eating of hot food, so that the fat of the brain congeals. Bloody tears surge up, it is as though a mist lay over the eye, and flying bees and black flowers are constantly seen.

Clinical note임상 주석

飛蜂黑花 — flying bees and black flowers. The chapter's phrase for floaters, and 眼花 at 3.15 is given to them entirely. Here they close the eight enclosures, which end as they began, with what the patient sees rather than what the examiner finds.

Deukhyo 得效

3.4 The Eye Belongs to the Five Viscera 眼睛屬五臟

3.4.1

Source원문

首尾赤眥屬心, 滿眼白睛屬肺, 其烏睛圓大屬肝, 其上下肉胞屬脾, 而中間黑瞳一點如漆者, 腎實主之. 《直指》

Translation영역

The red corners at either end belong to the heart; the white filling the eye belongs to the lung; the round black of the eye belongs to the liver; the fleshy lids above and below belong to the spleen; and the single black pupil in the middle, like a spot of lacquer, is truly governed by the kidney.

Jikji 直指

3.4.2

Source원문

白睛屬肺, 名曰氣輪; 赤者屬心, 行血脉也. 再於黑睛上分暈, 微靑者屬肝也, 次黑者屬腎也, 中間一點瞳人屬膽也. 《入門》

Translation영역

The white of the eye belongs to the lung and is called the qi wheel; the red belongs to the heart and moves in the blood vessels. Further, dividing the haloes on the black of the eye: the faintly blue-green belongs to the liver, the next darker to the kidney, and the single point of the pupil in the middle belongs to the gallbladder.

Clinical note임상 주석

Two versions of the same assignment, and the Immun's differs on the pupil — gallbladder rather than kidney — and divides the dark of the eye into graded haloes. The disagreement matters in practice, since the whole method is to read the diseased part back to its viscus, and which viscus owns the pupil decides whether an internal obstruction is treated at the kidney or at the gallbladder.

Immun 入門

3.5 The Eye Has an Inner and an Outer Corner 眼有內外眥

3.5.1

Source원문

目眥外決于面者爲銳眥, 在內近鼻者爲內眥. 上爲外眥, 下爲內眥. 《靈樞》

Translation영역

The corner of the eye that opens outward on the face is the sharp corner; the one within, near the nose, is the inner corner. The upper is the outer corner and the lower the inner.

Yeongchu 靈樞

3.5.2

Source원문

足太陽爲目上綱, 足陽明爲目下綱. 《靈樞》 ○眥謂四際瞼睫之本也. 《內經註》

Translation영역

The foot greater yang is the upper cord of the eye and the foot yang brightness the lower cord. The corner means the four margins, the root of the lids and lashes.

Yeongchu 靈樞 · Naegyeong-ju 內經註

3.5.3

Source원문

目之內眥, 太陽經之所起, 血多氣少; 目之銳眥, 少陽經也, 血少氣多; 目之上綱, 太陽經也, 亦血多氣少; 目之下綱, 陽明經也, 血氣俱多. 此三經俱會于目, 惟足厥陰經連於目系而已. 故血太過者, 太陽ㆍ陽明之實也; 血不及者, 厥陰之虛也. 故出血者宜太陽ㆍ陽明, 蓋此二經血多故也; 少陽一經不宜出血, 血少故也. 刺太陽ㆍ陽明出血則目愈明, 刺少陽出血則目愈昏矣. 《子和》

Translation영역

The inner corner of the eye is where the greater yang channel arises, with much blood and little qi; the sharp corner is the lesser yang, with little blood and much qi; the upper cord is the greater yang, likewise with much blood and little qi; the lower cord is the yang brightness, with both blood and qi abundant. These three channels all meet at the eye, and only the foot reverting yin connects with the eye's connecting vessel. So where the blood is in excess it is a repletion of the greater yang and yang brightness, and where the blood is deficient it is a vacuity of the reverting yin. Therefore bleeding should be done at the greater yang and yang brightness, since these two channels have much blood; the lesser yang alone should not be bled, since its blood is scant. Needling the greater yang and yang brightness to let blood makes the eye brighter; needling the lesser yang to let blood makes it dimmer.

Clinical note임상 주석

Jahwa's rule is the most practical thing in the opening sections and it is a surgical one: bleed at the greater yang and the yang brightness, never at the lesser yang. He grounds it in the blood-to-qi ratio of each channel at the eye, and states the consequence of getting it wrong — the eye grows dimmer. For a practitioner who bled for red eyes, this was the difference between help and harm.

Jahwa 子和

3.6 All the Vessels Belong to the Eye 諸脉屬目

3.6.1

Source원문

心合脉, 諸脉者皆屬於目. 《內經》

Translation영역

The heart pairs with the vessels, and all the vessels belong to the eye.

Naegyeong 內經

3.6.2

Source원문

五藏六府精華皆稟於脾, 注於目. 故理脾胃則氣上升而神淸也. 肝之系雖總於目, 而照徹光彩實腎精心神所主. 故補精安神者, 乃治眼之本也. 《入門》

Translation영역

The flower of the essence of the five viscera and six bowels is all received from the spleen and poured into the eye. So when the spleen and stomach are put in order the qi ascends and the spirit is clear. Although the liver's connection gathers at the eye, the shining brightness is truly governed by the kidney's essence and the heart's spirit. So supplementing the essence and settling the spirit is the root of treating the eye.

Immun 入門

3.6.3

Source원문

因心事煩冗, 飮食失節, 勞役過度, 故脾胃虛弱, 心火太盛, 則百脉沸騰, 血脉逆行, 邪害孔竅, 所謂天明則日月不明是也. 脾者諸陰之首也, 目者血脉之宗也. 故脾虛則五藏之精氣皆失所司, 不能歸明於目矣. 心者君火也, 主人之神, 宜静而安, 相火代行其令; 相火者包絡也, 主百脉皆榮於目. 旣勞役運動, 損其血脉, 故諸病生焉. 醫者不理脾胃及養血安神, 是治標不治本, 不明此理也. 《東垣》

Translation영역

When the affairs of the heart are vexed and crowded, food and drink out of measure and taxation beyond bounds, the spleen and stomach grow vacuous and weak and the heart fire becomes too exuberant; then the hundred vessels boil up, the blood vessels run counter, and the evil harms the orifices — which is what is meant by saying that when the heavens shine the sun and moon do not. The spleen is the head of all the yin, and the eye is the ancestor of the blood vessels. So when the spleen is vacuous, the essential qi of the five viscera all loses what directs it and cannot return as brightness to the eye. The heart is the sovereign fire and governs a person's spirit; it should be still and at peace, and the ministerial fire carries out its orders in its place. The ministerial fire is the pericardium, and it governs the hundred vessels, all of which flourish at the eye. Once taxation and exertion have damaged those vessels, all the diseases arise. A physician who does not put the spleen and stomach in order and nourish the blood and settle the spirit is treating the branch and not the root, and has not understood this principle.

Clinical note임상 주석

Dongwon's statement of the chapter's other half, against the liver-and-wind approach that dominates its pharmacy. The eye is the ancestor of the blood vessels, the spleen is what supplies them, and a physician who treats the eye without putting the middle in order is treating the branch. The quoted line about the heavens shining is the Suwen's figure for a fire so general that nothing shines in particular.

Dongwon 東垣

3.7 The Pulse 脉法

3.7.1

Source원문

左寸脉洪數, 心火炎也; 關脉弦而洪, 肝火盛也; 右寸關俱弦而洪, 肝木挾相火之勢, 侮肺金而乗脾土也. 《醫鑑》

Translation영역

A surging rapid pulse at the left inch is the heart fire blazing; a stringlike and surging pulse at the bar is the liver fire exuberant; and the right inch and bar both stringlike and surging is liver wood with the force of the ministerial fire behind it, insulting the lung metal and overwhelming the spleen earth.

Uigam 醫鑑

3.7.2

Source원문

眼本火病, 心肝數洪, 右寸關見相火上衝. 《回春》

Translation영역

Eye disease is fundamentally a fire disease: the heart and liver pulses are rapid and surging, and at the right inch and bar the ministerial fire is seen surging upward.

Hoechun 回春

3.7.3

Source원문

眼見黑花者, 從腎虛而起, 診左手尺脉當沉而數者是也. 《類聚》

Translation영역

Seeing black flowers before the eyes arises from kidney vacuity; on examination the left cubit pulse is sunken and rapid, and that is the sign.

Clinical note임상 주석

Three short entries and they divide the chapter between them: the first two find fire and the third finds vacuity. The one practical discrimination is the Yuchwi's — floaters with a sunken rapid cubit pulse point to the kidney, which is why the floater formulas are tonics while everything else in the chapter is cold.

Yuchwi 類聚

3.8 The Eye Is the Liver's Orifice 目者肝之竅

3.8.1

Source원문

肝在竅爲目. 《內經》 ○東方靑色, 入通於肝, 開竅於目, 藏精於肝. 《內經》

Translation영역

The liver's orifice is the eye. The blue-green colour of the east enters and communicates with the liver, opens its orifice at the eye, and stores its essence in the liver.

Naegyeong 內經

3.8.2

Source원문

人卧則血歸於肝, 肝受血而能視. 《內經》

Translation영역

When a person lies down the blood returns to the liver; the liver receives the blood and so one can see.

Naegyeong 內經

3.8.3

Source원문

肝氣通於目, 肝和則能辨五色. 《難經》 ○肝虛則目䀮䀮無所見. 《內經》 ○目瞑者, 肝氣不治也. 《海藏》

Translation영역

The liver qi communicates with the eye, and when the liver is harmonious one can distinguish the five colours. When the liver is vacuous the eyes are dim and see nothing. Closed eyes mean the liver qi is not in order.

Nangyeong 難經 · Naegyeong 內經 · Haejang 海藏

3.8.4

Source원문

目者肝之外候. 肝取木, 腎取水, 水能生木, 子母相合, 故肝腎之氣充則精彩光明, 肝腎之氣乏則昏蒙暈眩. 心者神之舍, 又所以爲肝腎之副焉. 蓋心主血, 肝藏血, 血能生熱, 凡熱衝發於眼, 皆當淸心凉肝. 《直指》

Translation영역

The eye is the liver's outward sign. The liver takes wood and the kidney water, and water can engender wood; child and mother join together, so that when the qi of liver and kidney is full the eye is bright and lustrous, and when it is lacking there is dimness and dizziness. The heart is the dwelling of the spirit, and is besides the second to liver and kidney. For the heart governs the blood and the liver stores it, and blood can engender heat; so whenever heat surges and breaks out in the eye, one should clear the heart and cool the liver.

Jikji 直指

3.8.5

Source원문

肝藏血, 熱則目赤腫, 虛則眼前生花詳見眼花. 赤腫宜地黃粥. 《入門》

Translation영역

The liver stores blood: when it is hot the eyes are red and swollen, and when it is vacuous flowers appear before them (see the Flowers Before the Eyes section in detail). For redness and swelling, Jihwang-juk should be used.

Clinical note임상 주석

The liver chapter of the eye, and the argument runs through the mother-child relation: water engenders wood, so the kidney feeds the liver, and the eye is bright or dim according to both. The Jikji's practical conclusion — clear the heart and cool the liver for any heat breaking out in the eye — is the sentence most of the chapter's formulas answer to.

Immun 入門

3.9 There Is No Cold in Eye Disease 眼病無寒

3.9.1

Source원문

歷考眼科之病, 無寒而有虛與熱. 豈寒澁血而不上攻歟. 《入門》

Translation영역

Going through the diseases of the eye one by one, there is no cold, but there is vacuity and there is heat. Is it not that cold makes the blood rough so that it does not strike upward?

Clinical note임상 주석

One sentence and it governs the whole chapter. No cold in eye disease — only vacuity and heat — with a reason offered in the form of a question: cold thickens the blood so that it does not rise, and what does not rise cannot trouble the eye. The two formulas in the chapter that do warm, Napcha-eum and Ganghwal-toeye-tang, both get round the rule by locating the cold in a channel rather than in the eye.

Immun 入門

3.10 Without Fire the Eye Does Not Fall Ill 眼無火不病

3.10.1

Source원문

目不因火則不病. 何以言之? 白輪變赤, 火乗肺也; 肉輪赤腫, 火乗脾也; 黑水神光被瞖, 火乗肝與腎也; 赤脉貫目, 火自甚也. 能治火者一句了. 故內經曰, 熱勝則腫. 凡目暴赤腫起, 羞明隱澁, 淚出不止, 暴寒目瞞, 皆火熱之所爲也. 治火之法, 在藥則醎寒吐之ㆍ下之; 在鍼則神庭ㆍ上星ㆍ顖會ㆍ前頂ㆍ百會血之. 瞖者可使立退, 痛者可使立已, 昧者可使立明, 腫者可使立消矣. 《子和》

Translation영역

Unless it is because of fire the eye does not fall ill. How is this said? The white wheel turning red is fire overwhelming the lung; the flesh wheel red and swollen is fire overwhelming the spleen; the dark water and its spirit light screened over is fire overwhelming the liver and kidney; red vessels threading the eye is fire of itself at its height. One able to treat fire has it all in a phrase. So the Neijing says: when heat prevails there is swelling. Whenever the eye is suddenly red and swollen, shrinking from light, with a hidden roughness and tears that will not stop, or suddenly chilled and the eye clouded — all of it is the work of fire and heat. The method of treating fire: in medicines, salty cold ones to make him vomit or to purge him; in needling, to let blood at Sinjeong, Sangseong, Sinhoe, Jeonjeong and Baekhoe. A screen can be made to withdraw at once, pain to cease at once, dimness to brighten at once, and swelling to dissolve at once.

Jahwa 子和

3.10.2

Source원문

大凡眼之爲患, 多生於熱. 治法以淸心凉肝ㆍ調血順氣爲先. 《直指》

Translation영역

On the whole the troubles of the eye arise mostly from heat. The method of treatment puts clearing the heart and cooling the liver, regulating the blood and smoothing the qi first.

Clinical note임상 주석

Jahwa's catalogue is the chapter's most quotable passage: each part of the eye turning red is fire overwhelming the viscus that owns it, and one able to treat fire has the whole subject in a phrase. The five scalp points he bleeds are all on the midline of the skull, and the four promises at the end — screen withdrawn, pain ceased, dimness brightened, swelling dissolved — are the confidence of a man who used them often.

Jikji 直指

3.11 The Causes of Eye Disease 眼病所因

3.11.1

Source원문

生食五辛. ○接熱飮食. ○刺頭出血多. ○極目遠視. ○夜讀細書. ○久處烟火. ○博奕不休. ○夜間讀書. ○飮酒不已. ○熱飡麪食. ○抄寫多年. ○雕鏤細作. ○泣淚過多. ○房室不節. ○數向日月輪看. ○月下讀書. ○夜視星月. ○極目瞻視山川草木, 皆喪明之由也. ○又有馳騁畋獵. ○冒涉風霜. ○迎風逐獸, 日夜不息, 皆傷目之由也. 《千金》

Translation영역

Eating the five pungent things raw. Taking food and drink while hot. Needling the head and letting much blood. Straining the eyes to look far. Reading fine print at night. Staying long in smoke and fire. Gambling without a break. Reading at night. Drinking without ceasing. Eating hot wheaten food. Copying for many years. Carving and engraving minute work. Weeping too much. Sexual activity without measure. Looking often at the discs of the sun and moon. Reading by moonlight. Watching the stars and moon at night. Straining the eyes to gaze at hills, rivers, grass and trees — all of these are ways of losing sight. And there is also galloping and hunting; braving wind and frost; facing into the wind to chase game day and night without rest — all of these are ways of damaging the eyes.

Cheongeum 千金

3.11.2

Source원문

眼病屬風熱與血少ㆍ神勞ㆍ腎虛. 《丹溪》

Translation영역

Eye disease belongs to wind heat, and to scant blood, taxed spirit and kidney vacuity.

Clinical note임상 주석

The Cheongeumbang's list is the best thing in the chapter to read aloud, and most of it is still true: reading fine print at night, years of copying, engraving minute work, smoke, and looking at the sun. Dangye's single line then sorts the whole list into four heads, and those four are what the chapter's formulas are arranged on.

Dangye 丹溪

3.12 The Internal Obstruction 內障

3.12.1

Source원문

內障者肝病也. 《回春》 ○內障在睛裏昏暗, 與不患之眼相似, 唯瞳人裏有隱隱靑白者; 無隱隱靑白者亦有之. 《綱目》

Translation영역

The internal obstruction is a disease of the liver. The internal obstruction lies within the eye as a dimness, and the eye looks like one that is not diseased, except that within the pupil there is a faint blue-white; though there are also cases with no faint blue-white at all.

Hoechun 回春 · Gangmok 綱目

3.12.2

Source원문

內障先患一眼, 次爲兩目俱損者, 皆有瞖在黑睛內遮瞳子而然. 夫通黑睛之脉者, 目系也; 目系屬足厥陰ㆍ足太陽ㆍ手少陰三經. 三經虛則邪從目系入黑睛內爲瞖. 以鍼言之, 則當取三經之兪穴, 如天柱ㆍ風府ㆍ大衝ㆍ通黑等穴是也. 《綱目》

Translation영역

In the internal obstruction one eye is affected first and then both are damaged, and this is always because there is a screen within the black of the eye veiling the pupil. The vessel that reaches the black of the eye is the eye's connecting vessel, and that belongs to three channels — the foot reverting yin, the foot greater yang and the hand lesser yin. When these three are vacuous the evil enters by the connecting vessel into the black of the eye and becomes a screen. Speaking of needling, one should take the transport points of the three channels, such as Cheonju, Pungbu, Taechung and Tonghyeok.

Gangmok 綱目

3.12.3

Source원문

內障者, 不疼不痛, 無淚無眵. 細觀如薄霧之形, 久視如輕烟之狀; 飛蠅散亂, 懸蟢虛空; 日漸月增, 腦脂下結於烏輪, 瞖障漸生於黑水. 《類聚》

Translation영역

In the internal obstruction there is neither ache nor pain, no tears and no discharge. Looked at closely it has the form of a thin mist; looked at long, the appearance of light smoke; flying midges scatter about, and spiders hang in the empty air. Day by day and month by month it increases: a fat from the brain settles below on the dark wheel, and an obstructing screen gradually breeds on the dark water.

Yuchwi 類聚

3.12.4

Source원문

內障昏蒙, 外無瞖膜, 因腦脂下凝, 烏珠轉白, 或如金色, 或菉豆色, 或如雲烟, 或見五色. 治比外障更難. 如腦脂凝結ㆍ瞳人反背者不治. 《入門》

Translation영역

The internal obstruction is dim and clouded with no screen or membrane outside; because a fat from the brain congeals below, the dark pearl turns white, or takes a gold colour, or a mung-bean colour, or looks like cloud and smoke, or shows five colours. It is harder to treat than the external obstruction. Where the brain fat has congealed and the pupil is turned away, it cannot be treated.

Immun 入門

3.12.5

Source원문

屬血少ㆍ神勞ㆍ腎虛也, 宜養血ㆍ補水ㆍ安神以調之. 《丹心》 ○凡昏弱不欲視物, 內障見黑花, 瞳子散大, 皆裏病也. 《丹心》

Translation영역

It belongs to scant blood, taxed spirit and kidney vacuity, and should be regulated by nourishing the blood, supplementing the water and settling the spirit. Whenever there is dimness and weakness with no wish to look at things, with black flowers seen in the internal obstruction and the pupil dilated, these are all interior disease.

Dansim 丹心

3.12.6

Source원문

內傷色慾ㆍ腎精虛者, 宜益陰腎氣丸; 肝血虛者, 養肝丸ㆍ生熟地黃丸; 肝腎俱虛者, 宜駐景元ㆍ加減駐景元ㆍ明目壯水丸. 《入門》

Translation영역

For one damaged within by sexual desire with the kidney essence vacuous, Igeum-singi-hwan; for liver blood vacuity, Yanggan-hwan or Saengsukjihwang-hwan; for liver and kidney both vacuous, Jujong-won, Gagam-jujong-won or Myeongmok-jangsu-hwan.

Immun 入門

3.12.7

Source원문

血少ㆍ神勞ㆍ腎虛, 宜滋陰地黃丸ㆍ滋腎明目湯.

Translation영역

For scant blood, taxed spirit and kidney vacuity, Jaeum-jihwang-hwan or Jasin-myeongmok-tang.

Donguibogam · An

3.12.8

Source원문

內障宜補肝散ㆍ墜瞖丸ㆍ羊肝元ㆍ本事方羊肝元ㆍ補腎丸ㆍ杞苓丸ㆍ五退散ㆍ密蒙花散ㆍ衝和養胃湯ㆍ當歸湯ㆍ還睛丸方見通治ㆍ撥雲退瞖還睛丸.

Translation영역

For the internal obstruction use Bogan-san, Chuye-hwan, Yanggan-won, Bonsabang-yanggan-won, Bosin-hwan, Giryeong-hwan, Otoe-san, Milmonghwa-san, Chunghwa-yangwi-tang, Danggui-tang, Hwanjeong-hwan (its formula is in the General Treatment section) or Balun-toeye-hwanjeong-hwan.

Donguibogam · An

3.12.9

Source원문

內障有圓瞖ㆍ氷瞖ㆍ滑瞖ㆍ澁瞖ㆍ散瞖ㆍ橫開瞖ㆍ浮瞖ㆍ沉瞖ㆍ偃月瞖ㆍ棗花瞖ㆍ黃心瞖ㆍ黑花瞖ㆍ胎患ㆍ五風變ㆍ雷頭風ㆍ驚振ㆍ綠風ㆍ烏風ㆍ黑風ㆍ靑風ㆍ肝虛雀目ㆍ高風雀目ㆍ肝虛目暗, 共二十三. 《得效》

Translation영역

The internal obstruction has the round screen, the ice screen, the slippery screen, the rough screen, the scattered screen, the crosswise-opening screen, the floating screen, the sunken screen, the half-moon screen, the jujube-flower screen, the yellow-hearted screen, the black-flower screen, the foetal affliction, the five-wind change, the thunder head wind, the fright shock, green wind, black wind, dark wind, blue wind, liver-vacuity sparrow eye, high-wind sparrow eye and liver-vacuity dim eye — twenty-three in all.

Clinical note임상 주석

The chapter's longest and most consequential section, and its description of cataract is the clearest in the pre-modern literature: no pain, no tears, no discharge, an eye that looks normal except for a faint blue-white behind the pupil, mist and then smoke and then flying midges, one eye first and the other after, and the dark pearl at last turning white. The explanation — a fat descending from the brain and congealing on the pupil — is wrong, but the observation is exact, and the colour grading from gold to mung-bean to white tracks a lens opacifying. The judgement at the end is the honest one: harder to treat than the external obstruction, and once the pupil is turned away, untreatable. Of the twenty-three named forms, four — green, black, dark and blue wind — are the glaucomas, and the chapter treats those as the acute emergencies they are.

Deukhyo 得效

3.12.1 Round Opacity 圓瞖

3.12.1.1

Source원문

在黑珠上一點圓, 日中見之差小, 陰處見之卽大. 視物不明, 轉見黑花. 此由肝腎俱虛而得, 宜補肝散ㆍ補腎元. 《得效》

Translation영역

A single round point on the black of the eye; seen in daylight it is rather small, seen in a shaded place it is at once large. Things are seen unclearly, and in time black flowers appear. This comes of liver and kidney both being vacuous, and Supplement the Liver Powder and Supplement the Kidney Pill are appropriate.

Clinical note임상 주석

The first of the eighteen opacities, and the pattern the rest follow: where on the eye, what shape, how it behaves in light and shade, what the patient sees. 日中見之差小, 陰處見之卽大 — smaller in daylight, larger in shade — is the pupil dilating around a central lens opacity, and the observation is exact: a nuclear cataract blocks more of a wide pupil than a narrow one.

Deukhyo 得效

3.12.2 Ice Opacity 氷瞖

3.12.2.1

Source원문

如氷凍堅實, 傍觀自透於瞳人內, 陰處及日中看之, 其形一同. 疼而淚出. 此肝膽病, 宜通肝散. 《得效》

Translation영역

Like ice frozen hard and solid; looked at from the side it is seen to go right through into the pupil, and in shade or in daylight its form is the same. It is sore and the eye waters. This is a disease of the liver and gallbladder, and Free the Liver Powder is appropriate.

Clinical note임상 주석

傍觀自透於瞳人內 — looked at from the side it goes right through. Oblique illumination is still how a corneal or lens opacity is examined for depth, and the section uses it to tell 氷瞖 from 浮瞖 and 沈瞖 below: this one is full thickness, and unlike 圓瞖 it does not change with the light.

Deukhyo 得效

3.12.3 Smooth Opacity 滑瞖

3.12.3.1

Source원문

有如水銀珠子, 但微含黃色, 不疼不痛無淚, 遮繞瞳人. 《得效》

Translation영역

Like a bead of quicksilver, only faintly holding a yellow colour; it neither aches nor pains and there is no watering, and it veils and encircles the pupil.

Deukhyo 得效

3.12.4 Rough Opacity 澁瞖

3.12.4.1

Source원문

微如赤色, 或聚或開, 兩傍微光, 瞳人上如凝脂色, 時復澁痛, 無淚出. 《得效》

Translation영역

Faintly reddish, now gathering and now opening out, with a little light at either side; over the pupil the colour is like congealed fat, and from time to time it is rough and painful, without watering.

Deukhyo 得效

3.12.5 Scattered Opacity 散瞖

3.12.5.1

Source원문

形如鱗點, 或瞼下生粟, 日夜痛楚, 瞳人最疼, 常下熱淚. 此三證皆肝肺相傳, 宜八味還睛散. 《得效》

Translation영역

Shaped like scale-like points, or with millet grains arising under the lid; it is in pain day and night, the pupil hurting most, and hot tears constantly run. These three patterns are all a passing between liver and lung, and Eight Ingredients Restore the Eye Powder is appropriate.

Clinical note임상 주석

此三證 — these three patterns — gathers 滑瞖, 澁瞖 and 散瞖, which is why the two before it are given without treatment. The grouping is by cause rather than by appearance: all three are read as a traffic between liver and lung, and one formula answers the three.

Deukhyo 得效

3.12.6 Crosswise Opacity 橫開瞖

3.12.6.1

Source원문

上橫如劍脊, 下面微微甚薄, 不赤不痛. 此病稀少. 《得效》

Translation영역

Above, it lies crosswise like the ridge of a sword; below it is very faint and extremely thin. It is neither red nor painful. This disease is uncommon.

Deukhyo 得效

3.12.7 Floating Opacity 浮瞖

3.12.7.1

Source원문

上如氷光白色, 環繞瞳人, 生自小眥頭至黑珠上, 不痛不痒, 無血色相潮. 《得效》

Translation영역

On the surface it is white with the glint of ice, encircling the pupil; it arises from the head of the lesser canthus and reaches onto the black of the eye. It is neither painful nor itching, and no blood colour surges with it.

Deukhyo 得效

3.12.8 Sunken Opacity 沈瞖

3.12.8.1

Source원문

白點藏在黑水下, 向日細視方見. 其白眼睛疼痛, 晝輕夜重, 間或出淚, 宜空靑元. 《得效》

Translation영역

A white point hidden beneath the black water, seen only on looking closely towards the light. The white of the eye is sore and painful, lighter by day and worse by night, with watering now and then; Azurite Pill is appropriate.

Clinical note임상 주석

浮 and 沈, floating and sunken, are a pair: the one sits on the surface and the other beneath, and the examination that tells them apart is to look towards the light. Together with 氷瞖's oblique view, these three are the chapter's method for judging how deep an opacity lies.

Deukhyo 得效

3.12.9 Crescent Moon Opacity 偃月瞖

3.12.9.1

Source원문

膜如凝脂, 一邊厚一邊薄, 如缺月, 其色光白無瑕疵. 前四證幷皆難治. 《得效》

Translation영역

A membrane like congealed fat, thick on one side and thin on the other like a waning moon, bright white in colour and without a blemish. The four patterns before it are all hard to treat.

Deukhyo 得效

3.12.10 Jujube Flower Opacity 棗花瞖

3.12.10.1

Source원문

周回如鋸齒, 四五枚相合, 赤色, 刺痛如鍼, 視物如烟, 晝則痛楚多淚昏暗. 《得效》

Translation영역

Its rim is like saw teeth, four or five of them joined together; it is red, stabbing like a needle, things are seen as through smoke, and by day there is pain with much watering and clouding.

3.12.19.1

Source원문

此與綠風相似, 但時時黑花起, 乃腎受風邪, 熱攻於眼, 宜凉腎. 《得效》

Translation영역

This resembles green wind, only that black flowers rise from time to time. It is the kidney taking in a wind evil with heat attacking the eye, and the kidney should be cooled.

Deukhyo 得效

3.12.20 Blue Wind 靑風

3.12.20.1

Source원문

此眼不痛不痒, 瞳人儼然如不患者, 但微有頭旋及生花, 轉加昏蒙. 前二證宜服還睛散. 《得效》

Translation영역

This eye neither pains nor itches, and the pupil is as composed as in someone with nothing wrong; there is only a slight swimming of the head and flowers before the eyes, with the clouding increasing by degrees. For the two patterns before it, Restore the Eye Powder is given.

Clinical note임상 주석

瞳人儼然如不患者 — the pupil as composed as in a person with nothing wrong. The last of the five winds and the most quietly described: nothing to see, nothing to feel, and the sight going by degrees. It closes the group the way it should, with the warning that the eye which looks well is not therefore well.

Deukhyo 得效

3.12.21 Sparrow Eye from Liver Vacuity 肝虛雀目

3.12.21.1

Source원문

雀目者, 日落卽不見物也. 《綱目》因肝虛血少, 時時花起, 或時頭疼, 年深則雙目盲. 小兒因疳得之, 宜蛤粉丸. 《得效》小兒肝虛雀目, 宜風疳丸. 《入門》晝明晩暗, 謂之雀目, 言如鳥雀之瞑, 便無所見也. 《類聚》雀目宜雀盲散. 《直指》雀頭取血點眼中卽效, 羊肝淡煮食之亦佳. 《本草》治雞盲雀目, 用鮮地黃炒猪肝食之. 《種杏》牛肝作膾食之妙. 《俗方》

Translation영역

Sparrow eye is to see nothing as soon as the sun goes down. It comes of liver vacuity with scant blood, with flowers rising from time to time and headache now and then; where the years are many both eyes go blind. Children get it from gan disorder, and Clam Shell Powder Pill is appropriate. For sparrow eye in a child from liver vacuity, Wind Gan Pill. Bright by day and dark at evening is what is called sparrow eye — as much as to say that like a bird at dusk one can see nothing. For sparrow eye, Sparrow Blindness Powder. Blood taken from a sparrow's head and dabbed in the eye works at once, and sheep's liver lightly boiled and eaten is also good. To treat chicken blindness and sparrow eye, fresh rehmannia fried with pig's liver and eaten. Ox liver made into a raw dish and eaten is excellent.

Clinical note임상 주석

Night blindness, and the remedies are the answer: sheep's liver, pig's liver, ox liver, three times over from four different sources. Liver is among the richest sources of retinol there is, and vitamin A deficiency is the commonest cause of night blindness in the world. The tradition reached the right organ by the doctrine that the liver opens into the eye, and the treatment works.

Gangmok 綱目 · Deukhyo 得效 · Immun 入門 · Yuchwi 類聚 · Jikji 直指 · Boncho 本草 · Jonghaeng 種杏 · Sokbang 俗方

3.12.22 High Wind Sparrow Eye 高風雀目

3.12.22.1

Source원문

與前證雖同, 但纔至黃昏便不見物, 經年瞳子如金色, 名曰黃風, 不治. 《得效》雀目之證, 暮則不見物, 至曉復明, 何也. 曰, 肝虛也. 經曰, 目得血而能視, 所旣無血則目瞀而不明矣. 其暮暗而曉復明者何也. 曰, 木生於亥而旺於卯, 絶於申. 至於酉戌之時, 木氣衰甚故瞑; 至於卯之分, 木氣稍盛而目復明矣. 曰, 雀目終變爲黃脹而死, 何也. 曰, 木絶於申, 乃水土長生之地, 木衰而土盛, 故變爲黃脹. 宜平胃散方見內傷以平土氣, 四物湯方見血門以補肝虛. 《正傳》高風雀目, 宜還睛丸. 《類聚》

Translation영역

Though it is the same as the pattern before it, here as soon as dusk comes nothing is seen, and after years the pupil turns the colour of gold; this is called yellow wind, and it is not treated. Why, in the sparrow-eye pattern, does one see nothing at evening and see again by dawn? Because the liver is vacuous. The classic says the eye can see when it gets blood, and the liver having no blood the eye is blurred and does not see clearly. And why dark at evening and bright again at dawn? Because wood is engendered at hae, flourishes at myo and is cut off at sin; by the hours of yu and sul the wood qi has declined badly and so the eye closes, and when the hour of myo comes round the wood qi is a little stronger and the eye sees again. And why does sparrow eye end by turning into yellow distension and death? Because wood is cut off at sin, which is the place where water and earth are engendered: the wood declines and the earth flourishes, and so it turns into yellow distension. Stomach-Calming Powder formula in the Internal Damage chapter is used to level the earth qi, and Four Substances Decoction formula in the Blood chapter to supplement the liver vacuity. For high wind sparrow eye, Restore the Eye Pill is appropriate.

Clinical note임상 주석

瞳子如金色 — the pupil turning the colour of gold, after years of night blindness that never lets up. Retinitis pigmentosa runs this course, and the gold is the tapetal sheen of an advanced retinal dystrophy; 不治 was correct and remains close to it. What follows is the chapter's one piece of sustained reasoning: the daily return of sight at dawn is explained by the hourly rise and fall of wood qi, and the progression to 黃脹 by wood failing where earth is engendered. The physiology is wrong and the clinical observation underneath it is exact — the sight does return each morning, and chronic deficiency does end in wasting.

Deukhyo 得效 · Jeongjeon 正傳 · Yuchwi 類聚

3.12.23 Dim Eyes from Liver Vacuity 肝虛目暗

3.12.23.1

Source원문

遠視不明, 眼前花子頻起, 眥目赤痛, 有時看一成二, 宜補肝散. 《得效》與眼暗參看.

Translation영역

Distant things are seen unclearly, flowers rise often before the eyes, the canthus and eye are red and sore, and at times one thing is seen as two; Supplement the Liver Powder is appropriate. To be read together with Dim Eyes.

Clinical note임상 주석

看一成二, one thing seen as two, has a section of its own at 3.22, and 眼昏 at 3.17 covers the dimness; this entry is the liver-vacuity reading of both, which is why the transcription ends it by sending the reader to the other section.

Deukhyo 得效

3.13 The External Obstruction 外障

3.13.1

Source원문

外障者肺病也. 《回春》 ○在睛外遮暗. 《綱目》

Translation영역

The external obstruction is a disease of the lung. It lies outside the eye, veiling and darkening it.

Hoechun 回春 · Gangmok 綱目

3.13.2

Source원문

靈樞曰, 診目痛, 赤脉從上下者太陽病, 從下上者陽明病, 從外走內者少陽病.

Translation영역

The Lingshu says: in examining a painful eye, red vessels running from above downward are a greater yang disease, from below upward a yang brightness disease, and from the outside running inward a lesser yang disease.

Yeongchu 靈樞

3.13.3

Source원문

凡赤脉瞖初從上而下, 屬太陽, 主表, 必眉稜骨痛, 或腦項痛, 或半邉頭腫痛. 治法宜溫之ㆍ散之: 溫則臘茶飮, 散則夏枯草散ㆍ選奇湯方見頭部之類.

Translation영역

Whenever a red-vessel screen first runs from above downward it belongs to the greater yang and governs the exterior, and there is sure to be pain in the brow ridge, or pain of the brain and nape, or swelling and pain of one side of the head. The method is to warm it and to disperse it: to warm, Napcha-eum; to disperse, Hagocho-san or Seongi-tang (its formula is in the Head chapter) and the like.

Gangmok 綱目

3.13.4

Source원문

赤脉瞖初從下而上者, 或從內眥出外者, 皆屬陽明, 主裏, 故其證多熱或便實. 治法宜下之ㆍ寒之: 下則明目流氣飮ㆍ錢氏瀉靑丸方見五藏ㆍ局方溫白元方見積聚加黃連ㆍ黃栢之類, 累用有驗; 寒則一味黃連ㆍ羊肝元之類.

Translation영역

A red-vessel screen that first runs from below upward, or comes out from the inner corner outward, belongs in both cases to the yang brightness and governs the interior, so the pattern is mostly heat, or the stool is bound. The method is to purge it and to cool it: to purge, Myeongmok-yugi-eum, Jeon's Sacheong-hwan (its formula is in the Five Viscera chapter), or the Gukbang's Onbaek-won (its formula is in the Accumulations chapter) with coptis and phellodendron added — I have used these repeatedly with effect; to cool, coptis alone, or Yanggan-won and the like.

Gangmok 綱目

3.13.5

Source원문

赤脉瞖初從外眥入內者, 爲少陽, 主半表半裏. 治法宜和解之, 神仙退雲丸之類. 《綱目》

Translation영역

A red-vessel screen that first runs in from the outer corner is the lesser yang and governs the half exterior and half interior. The method is to harmonize and resolve it, with Sinseon-toeun-hwan and the like.

Gangmok 綱目

3.13.6

Source원문

外障有肝藏積熱ㆍ混睛ㆍ努肉攀睛ㆍ兩瞼粘睛ㆍ膜入水輪ㆍ釘瞖根深ㆍ黑瞖如珠ㆍ花瞖白陷ㆍ水瑕深瞖ㆍ玉瞖浮滿ㆍ順逆生瞖ㆍ雞冠蜆肉ㆍ瞼生風粟ㆍ胞肉膠凝ㆍ漏睛膿出ㆍ蟹睛疼痛ㆍ突起睛高ㆍ風起喎偏ㆍ倒睫拳毛ㆍ風牽瞼出ㆍ神祟疼痛ㆍ旋螺尖起ㆍ鶻眼凝睛ㆍ轆轤轉關ㆍ被物撞打ㆍ撞刺生瞖ㆍ血灌瞳人ㆍ眯目飛塵飛絲ㆍ天行赤目ㆍ暴赤眼後生瞖ㆍ胎風赤爛ㆍ風赤瘡疾ㆍ衝風淚出ㆍ暴風客熱ㆍ瞼硬睛痛ㆍ痛如鍼刺ㆍ痒極難任ㆍ瞳人乾缺ㆍ黃膜上衝ㆍ赤膜下垂ㆍ小眥赤脉ㆍ偸鍼ㆍ小兒通睛ㆍ小兒胎中生贅ㆍ小兒靑盲. 《得效》

Translation영역

The external obstruction has heat accumulated in the liver viscus; the muddied eye; proud flesh creeping over the eye; both lids sticking to the eye; a membrane entering the water wheel; a nail screen with a deep root; a black screen like a pearl; a flower screen with a white hollow; a deep water-flaw screen; a jade screen floating and full; a screen breeding with and against the grain; cock's comb and clam flesh; wind millet breeding on the lid; the lid flesh glued together; the leaking eye with pus coming out; crab-eye pain; the eye starting out and standing high; wind arising with a twist to one side; inturned and curled lashes; wind dragging the lid outward; spirit-haunting pain; the spiral peak rising; the falcon eye with the gaze fixed; the windlass turning on its axle; being struck by an object; a screen breeding from a blow or a prick; blood flooding the pupil; dust or threads in the eye; epidemic red eye; a screen breeding after a sudden red eye; foetal wind with the lids red and raw; wind-red sore disease; tears running in the wind; sudden wind with visiting heat; the lid hard and the eye painful; pain as if needled; itching beyond bearing; the pupil dry and deficient; the yellow membrane rising upward; the red membrane hanging down; red vessels at the lesser corner; the stye; a child's crossed eye; a child's growth from the womb; and a child's blue blindness.

Clinical note임상 주석

The organizing device here is the one piece of pre-modern ophthalmology that still reads as method: the direction a vessel runs tells you the channel, and the channel tells you the treatment. Down from above is the greater yang and the exterior, so warm and disperse; up from below or out from the inner corner is the yang brightness and the interior, so purge and cool; in from the outer corner is the lesser yang and the half-and-half, so harmonize. Nothing in the chapter is more usable than that, and the Gangmok says plainly that he has used it repeatedly. The forty-five named forms that follow are the chapter's working nosology, and a good number of them — the stye, inturned lashes, the pterygium, the hypopyon, the perforation with the iris coming through — are named exactly.

Deukhyo 得效

3.13.1 Accumulated Heat in the Liver Viscus 肝臟積熱

3.13.1.1

Source원문

眼先患赤腫疼痛, 怕日羞明, 淚澁難開, 忽生瞖膜. 初患一目不見, 以致兩目齊患. 此肝臟積熱, 宜石決明散. 《得效》風眼腫則軟, 熱眼腫則硬. 《直指》眼赤而痛者, 肝實熱也. 《回春》眼赤腫而足寒者, 必以溫湯頻洗其足, 甚妙. 《綱目》肝臟風熱, 宜撥雲散ㆍ局方密蒙花散ㆍ蟬花散ㆍ洗肝明目湯ㆍ散熱飮子. 肝臟積熱, 宜洗肝散方見五藏ㆍ瀉肝散方見上ㆍ瀉靑丸方見五藏ㆍ柴胡湯ㆍ四物龍膽湯, 洗以湯泡散方見下.

Translation영역

The eye first suffers redness, swelling and pain, dreads the sun and shuns the light, waters and grates and is hard to open, and then suddenly an opacity arises. At the onset one eye does not see, and it goes on until both eyes are afflicted together. This is accumulated heat in the liver viscus, and Haliotis Powder is appropriate. A wind eye swells soft; a heat eye swells hard. An eye red and painful is a repletion heat of the liver. Where the eye is red and swollen and the feet are cold, the feet should be washed often in warm water, which is excellent. For wind heat of the liver viscus: Part the Clouds Powder, the Jubang's Buddleia Powder, Cicada Flower Powder, Wash the Liver and Brighten the Eye Decoction and Disperse the Heat Drink. For accumulated heat of the liver viscus: Wash the Liver Powder formula in the Five Viscera chapter, Drain the Liver Powder formula above, Drain the Blue Pill formula in the Five Viscera chapter, Bupleurum Decoction and Four Substances and Gentian Decoction, washing with Steep in Hot Water Powder formula below.

Clinical note임상 주석

The head of the outer obstructions, and the one line in it worth keeping is 風眼腫則軟, 熱眼腫則硬 — a wind eye swells soft, a heat eye hard. Washing the feet in warm water for a red eye with cold feet is the chapter's one piece of counter-direction treatment: draw the heat down rather than cool it where it is.

Deukhyo 得效 · Jikji 直指 · Hoechun 回春 · Gangmok 綱目

3.13.2 Muddied Eye 混睛

3.13.2.1

Source원문

白睛先赤, 後痒痛淚下, 閉澁難開. 年深則睛變成碧色, 滿目如凝脂, 赤脉橫貫, 宜地黃散. 《得效》

Translation영역

The white of the eye reddens first; then it itches and pains with tears running, and is shut and grating and hard to open. Where the years are many the eye turns a blue-green colour, the whole of it like congealed fat, with red vessels running across it; Rehmannia Powder is appropriate.

Clinical note임상 주석

睛變成碧色, 滿目如凝脂, 赤脉橫貫 — a blue-green eye like congealed fat with vessels running across. That is interstitial keratitis: a scarred, hazy cornea carrying new vessels, and the course over years is right.

Deukhyo 得效

3.13.3 Flesh Climbing Over the Eye 努肉攀睛

3.13.3.1

Source원문

或眼先赤爛多年, 肝經爲風熱所衝而成; 或用力作勞而得. 或痒或痛, 自兩眥頭努出筋膜. 心氣不寧, 憂慮不已, 遂乃攀睛, 宜二黃散ㆍ定心元. 《得效》兩眥呈露生努肉者, 心熱血旺也. 《直指》攀睛努肉者, 心熱也. 大眥赤紅肉堆起者, 心經實熱也; 小眥赤紅絲血脹者, 心經虛熱也. 《回春》努肉宜速效散. 《醫鑑》洗努肉侵睛, 當歸尾ㆍ荊芥穗ㆍ黃連ㆍ防風ㆍ薄荷ㆍ朴硝ㆍ硼砂等分, 剉煎湯溫洗. 《入門》梨汁浸黃連, 又初男乳和雄雀屎點之, 皆效詳見單方.

Translation영역

Either the eye has been red and raw for many years and the liver channel has been struck by wind heat, or it comes of forcing the strength at labour. It itches or pains, and a sinewy membrane pushes out from the heads of both canthi. Where the heart qi is unquiet and anxiety does not let up, it goes on to climb over the eye; Two Yellows Powder and Settle the Heart Pill are appropriate. Flesh growing out where both canthi stand exposed is heart heat with the blood exuberant. Flesh climbing over the eye is heart heat. Where the greater canthus is red and the flesh heaps up, it is a repletion heat of the heart channel; where the lesser canthus has red threads and the blood is distended, a vacuity heat of the heart channel. For the flesh, Swift Effect Powder. To wash flesh encroaching on the eye: angelica tails, schizonepeta spikes, coptis, saposhnikovia, mint, mirabilite and borax in equal parts, cut and decocted, and the eye washed warm with it. Coptis steeped in pear juice, and the milk of a woman's first-born son mixed with cock-sparrow droppings and dabbed on, are both effective treated in detail under Simple Medicinals.

Clinical note임상 주석

Pterygium: a wedge of fibrovascular tissue growing from the canthus across the cornea. The two causes named — years of a raw, red eye, and heavy outdoor labour — are the two risk factors still recognised, chronic surface irritation and sun exposure. Washing a pterygium will not remove it; the chapter's own 3.13 sections on cutting are where that belongs.

Deukhyo 得效 · Jikji 直指 · Hoechun 回春 · Uigam 醫鑑 · Immun 入門

3.13.4 Both Lids Sticking to the Eye 兩瞼粘睛

3.13.4.1

Source원문

此乃爛弦風也. 雙目赤爛, 或痒或痛, 經年不愈. 《得效》目眶赤爛, 歲久, 俗呼爲赤瞎是也. 當以三稜鍼刺目眶外, 以瀉濕熱卽愈. 《東垣》爛弦風者, 風沿眼系, 上膈有積熱, 自飮食中挾怒氣而成, 積而久也. 眼沿因膿潰而腫, 其中生細小虫絲, 遂年久不愈而多痒者是也. 用還睛紫金丹以銀釵股點之. 若痒者, 又當去虫以絶根本. 又與防風通聖散去硝黃方見風門爲細末, 酒拌晒乾, 依法服之, 禁諸厚味. 《綱目》點以爐甘石散, 洗以驅風散ㆍ廣大重明湯. 去虫宜聖草散. 小兒初生雙目紅而眶邊赤爛, 至三四歲不愈, 宜消風散方見頭部以桑白皮煎湯調下. 《入門》

Translation영역

This is raw-margin wind. Both eyes are red and raw, itching or painful, and do not heal from one year to the next. Lid margins red and raw for years are what is commonly called a red blind eye. A three-edged needle should be used to prick outside the lid margin, draining the damp heat, and it heals. Raw-margin wind is wind running along the eye's tie, with accumulated heat above the diaphragm, formed out of food taken with anger carried in it, and built up over a long time. The lid margin swells where it has broken down into pus, and fine small worm-threads grow in it, so that it does not heal from year to year and itches greatly. Restore the Eye Purple Gold Elixir is applied with the shank of a silver hairpin. Where it itches, the worms must also be got rid of, to cut off the root of it. Saposhnikovia Sagely Unblocking Powder with the mirabilite and rhubarb removed formula in the Wind chapter is also given: powdered fine, mixed with wine and dried in the sun, taken by the method, with all rich flavours forbidden. For dabbing, Calamine Powder; for washing, Dispel Wind Powder and Broad and Great Redoubled Brightness Decoction. To get rid of the worms, Sagely Herb Powder. Where a newborn child has both eyes red with raw lid margins and it has not healed by three or four years, Disperse Wind Powder formula in the Head chapter is given, stirred into a mulberry root bark decoction.

Clinical note임상 주석

Chronic blepharitis, and the chapter gets two things right about it: it is a disease of the lid margin rather than of the eye, and it does not resolve. 其中生細小虫絲 — fine worm-threads growing in it — is an observation, not a theory: Demodex mites live in the lash follicles and are a recognised cause of chronic blepharitis, and 去虫以絶根本 is the treatment still aimed at. The infant case at the end is ophthalmia neonatorum left untreated.

Deukhyo 得效 · Dongwon 東垣 · Gangmok 綱目 · Immun 入門

3.13.5 A Membrane Entering the Water Wheel 膜入水輪

3.13.5.1

Source원문

此因黑珠上生瘡, 稍安, 其痕不沒, 浸入水輪. 雖光未絶, 終亦難治. 《得效》

Translation영역

This comes of a sore arising on the black of the eye which quietens somewhat, but the scar does not go and soaks inward into the water wheel. Though the light is not yet gone, it is in the end hard to treat.

Clinical note임상 주석

A corneal ulcer that heals to a scar reaching the pupil. 雖光未絶 — the light is not yet gone — is the chapter's way of saying that vision remains but is lost to the scar, which is exactly the problem with a central corneal opacity.

Deukhyo 得效

3.13.6 A Nail Opacity Deep-Rooted 釘瞖根深

3.13.6.1

Source원문

心肝留熱, 致使眼疼痛, 生瞖膜經久, 其色如銀, 釘入黑睛, 不可治. 《得效》睛上生瞖如銀釘子頭, 故謂之釘瞖, 宜石決明散點之. 《類聚》

Translation영역

Heat lodging in the heart and liver makes the eye ache, and an opacity arises and lasts long; its colour is like silver, and it is driven into the black of the eye like a nail. It cannot be treated. An opacity arising on the eye like the head of a silver nail is why it is called a nail opacity; Haliotis Powder is dabbed on it.

Deukhyo 得效 · Yuchwi 類聚

3.13.7 A Black Opacity Like a Bead 黑瞖如珠

3.13.7.1

Source원문

此起在黑水上, 如小黑豆, 疼痛淚出, 不可用點藥. 乃腎虛受風熱而得, 宜先服羚羊角散, 後服補腎元. 《得效》

Translation영역

This rises on the black water like a small black bean, aching and watering, and dabbing medicines must not be used on it. It comes of kidney vacuity taking in wind heat; Saiga Antelope Horn Powder is given first and Supplement the Kidney Pill after.

Clinical note임상 주석

不可用點藥 — do not dab anything on it. A black bead standing up on the cornea is a staphyloma or a descemetocele, where the eye is close to perforating, and not touching it is the right instinct. Saiga antelope horn is CITES-listed and the species critically endangered; the first formula cannot be prepared as written.

Deukhyo 得效

3.13.8 A Flower Opacity White and Sunken 花瞖白陷

3.13.8.1

Source원문

白瞖旋繞瞳人, 點點如花白鱗砌者, 此因肝肺伏藏積熱, 宜點磨瞖膏, 後服羚羊角散. 《得效》花瞖者, 睛上忽生白瞖, 如棗花之砌, 魚鱗相似, 宜點龍腦散. 《類聚》

Translation영역

A white opacity circling the pupil, point by point like a flower or like white scales laid in courses; this comes of accumulated heat lying hidden in liver and lung. Grind the Opacity Ointment is dabbed on, and Saiga Antelope Horn Powder given after. A flower opacity is a white opacity suddenly arising on the eye, laid out like jujube blossom and resembling fish scales; Borneol Powder is dabbed on it.

3.13.14.1

Source원문

眼胞皮肉, 有似膠凝, 腫高如桃李, 時出熱淚, 乃風毒所注, 宜服消風散方見頭部點花草膏. 《得效》上下胞腫如桃者, 脾熱也. 《回春》熱氣蓄聚而傷飽, 所以胞合. 《直指》宜羚羊角散ㆍ洗眼湯.

Translation영역

The skin and flesh of the lid are as though congealed with glue, swollen high as a peach or plum, with hot tears from time to time; a wind toxin has poured into it. Disperse Wind Powder formula in the Head chapter is given and Flower and Herb Ointment dabbed on. Upper and lower lids swollen like a peach is spleen heat. Heat qi gathers and is injured by surfeit, and that is why the lids close. Saiga Antelope Horn Powder and Wash the Eye Decoction are appropriate.

Deukhyo 得效 · Hoechun 回春 · Jikji 直指

3.13.15 A Leaking Eye Discharging Pus 漏睛膿出

3.13.15.1

Source원문

眥頭結聚生瘡, 流出膿汁, 無瞖障, 不疼痛. 因心氣不寧, 幷風熱在瞼中, 宜白薇元. 《得效》風熱客於瞼眥之間, 令眥內結聚, 津液乗之, 故成膿出不止, 俗呼爲漏睛. 或眼因患瘡出膿血後, 大眥頭常出膿涎, 亦名漏睛. 若不早治, 日久則眼生黑點, 侵損於目, 卽難治, 宜黃芪散及點藥. 《類聚》

Translation영역

At the head of the canthus it gathers and forms a sore which runs with pus; there is no opacity and no pain. It comes of the heart qi being unquiet together with wind heat in the lid, and White Swallowwort Pill is appropriate. Wind heat lodges between the lid and the canthus and makes it gather within; the fluids ride on it, and so pus forms and does not stop — what is commonly called a leaking eye. Or where the eye has had a sore that discharged pus and blood and the head of the greater canthus afterwards constantly runs with a purulent discharge, that too is called a leaking eye. If it is not treated early, in time black points arise on the eye and encroach on it, and then it is hard to treat; Astragalus Powder and a dabbing medicine are appropriate.

Clinical note임상 주석

漏睛 is a chronically discharging fistula at the inner canthus — a dacryocystitis that has broken through the skin. 無瞖障, 不疼痛 marks it off from the painful eye diseases around it: the eye itself is well and the trouble is in the tear sac beside it.

Deukhyo 得效 · Yuchwi 類聚

3.13.16 Crab Eye with Pain 蟹睛疼痛

3.13.16.1

Source원문

如大豆子出黑珠上, 疼痛不可忍, 又名損瞖, 宜石決明散. 《得效》肝有積熱, 上衝於目, 令目痛甚, 當黑睛上生黑珠子, 如蟹之目, 以爲名. 或有如豆者, 名曰損瞖, 極難治, 宜服羚羊角散及點藥. 《類聚》

Translation영역

Something like a large bean comes out on the black of the eye, with pain beyond bearing; it is also called a damaged opacity, and Haliotis Powder is appropriate. The liver has accumulated heat which surges up to the eye and makes it severely painful, and a black bead arises on the black of the eye like a crab's eye, from which it takes its name. Where it is like a bean it is called a damaged opacity, is extremely hard to treat, and Saiga Antelope Horn Powder with a dabbing medicine is appropriate.

Clinical note임상 주석

A black bead standing out of the cornea with unbearable pain: iris prolapsing through a perforated corneal ulcer. The name is exact — it does look like a crab's eye on a stalk — and 極難治 is honest about an eye that has already opened. Saiga antelope horn is CITES-listed and the species critically endangered; the second formula cannot be prepared as written.

Deukhyo 得效 · Yuchwi 類聚

3.13.17 The Eye Starting Up High 突起睛高

3.13.17.1

Source원문

風毒流注, 五藏不能消散, 忽然突起痒痛, 乃熱極所致, 宜瀉肝散方見上. 《得效》風熱痰飮漬於藏府, 蘊積生熱, 熱衝於目, 故令眼珠子突出, 是名睛脹, 宜服凉藥瀉肝. 凡瞳人脹起者, 水輪脹也. 《類聚》烏輪突起, 裏熱刺痛, 謂之熱眼. 《直指》井水灌眼中詳見下. 黑睛脹宜龍膽散, 白睛脹宜淸肺散.

Translation영역

A wind toxin pours in and the five viscera cannot disperse it; the eye suddenly starts up, itching and painful, brought on by heat at its height. Drain the Liver Powder formula above is appropriate. Wind heat and phlegm rheum steep the viscera and bowels, gather and engender heat, and the heat surges up to the eye, so that the eyeball starts out — this is called a distended eye, and cooling medicines are given to drain the liver. Wherever the pupil is distended and raised, it is the water wheel that is distended. Where the dark wheel starts up with heat and stabbing pain within, it is called a hot eye. Well water is poured into the eye treated in detail below. For distension of the black of the eye, Gentian Powder; for distension of the white, Clear the Lung Powder.

Clinical note임상 주석

眼珠子突出 — the eyeball starting out of the orbit, suddenly, with pain. Orbital cellulitis presents this way and remains an emergency; so does thyroid eye disease, more slowly. The cold water poured into the eye is the only part of the treatment that would be felt as relief.

Deukhyo 得效 · Yuchwi 類聚 · Jikji 直指

3.13.18 Wind Rising and the Eye Pulled Awry 風起喎偏

3.13.18.1

Source원문

偏風牽引, 雙目喎斜, 淚出頻頻, 却無瞖膜, 不痒不痛, 宜消風散方見頭部荊芥湯調下, 或蟬花無比散. 《得效》眼偏視者, 風邪攻肝, 牽引瞳人, 故令偏視, 宜服槐子丸. 《類聚》

Translation영역

A one-sided wind draws on the eye so that both eyes are pulled awry, with tears running again and again; there is no opacity and no itching or pain. Disperse Wind Powder formula in the Head chapter is given stirred into a schizonepeta decoction, or Cicada Flower Incomparable Powder. Where the eye looks to one side, a wind evil has attacked the liver and draws on the pupil, and so it looks aside; Sophora Seed Pill is appropriate.

Clinical note임상 주석

A deviated eye with watering, no pain and nothing to see on the eye itself: a palsy of one of the nerves that move it. The chapter files it with wind, which is where it files facial palsy too, and the grouping is not wrong about the suddenness.

Deukhyo 得效 · Yuchwi 類聚

3.13.19 Lashes Turned In and Curled 倒睫拳毛

3.13.19.1

Source원문

淚出涓涓, 瞖膜漸生, 眼皮漸急, 睫倒難開, 瞳人如刺樣痛. 此脾受風熱, 先服瀉肝散方見上, 後服五退散. 《得效》神效明目湯ㆍ明目細辛湯. 《東垣》倒睫拳毛, 卽眼睫毛倒入眼中央是也. 《綱目》眼楞緊急縮少者, 倒睫拳毛之漸也. 盖陽虛則眼楞緊急, 陰虛則瞳子散大. 《綱目》倒睫拳毛, 由目緊急皮縮之所致也. 盖內伏熱攻陰氣外行, 當去其內熱幷火邪, 使眼皮緩則毛立出, 瞖自退. 用手法攀出內瞼向外, 刺以三稜鍼出熱血, 以左爪甲迎住鍼鋒, 立愈. 《綱目》治法, 無名異石藥也爲末, 糝捲在紙中作撚子, 點火吹殺, 以烟熏之, 其毛自起. 又摘去拳毛, 用虱子血點入眼內, 數次卽愈. 《綱目》又法, 木鼈子一箇去殼擣爛, 綿裹塞鼻中, 左目塞右, 右目塞左, 一二夜其睫自正. 《正傳》

Translation영역

Tears run and run, an opacity gradually arises, the lid skin gradually tightens, the lashes turn in so that the eye is hard to open, and the pupil hurts as though pricked. This is the spleen taking in wind heat: Drain the Liver Powder formula above is given first and Five Sloughs Powder after. Spirit Effect Brighten the Eye Decoction and Brighten the Eye Asarum Decoction. Lashes turned in and curled is simply the lashes of the lid turning into the middle of the eye. Where the lid margin is tight and drawn and shrunken, it is the beginning of lashes turning in. For where the yang is vacuous the lid margin is tight and drawn, and where the yin is vacuous the pupil is scattered wide. Lashes turning in and curling comes of the eye being tight and the skin shrunken. Heat lying hidden within attacks and drives the yin qi outward; the inner heat and the fire evil should be got rid of, and when the lid skin is slackened the lashes stand out of themselves and the opacity retreats. By hand, the inner lid is pulled out and turned outward and pricked with a three-edged needle to let out hot blood, the left thumbnail held against the needle point, and it heals at once. For treatment: pyrolusite a mineral drug powdered, sprinkled and rolled in paper into a taper, lit and blown out, and the eye smoked with it, and the lashes rise of themselves. Or pull out the curled lashes and dab louse blood into the eye; a few times and it heals. Another method: one cochinchina gourd seed, husked and pounded to a mash, wrapped in cotton and plugged into the nostril — for the left eye the right nostril, for the right eye the left — and in a night or two the lashes straighten of themselves.

Clinical note임상 주석

Trichiasis from a scarred, contracted lid, which is how blinding trachoma ends, and the chapter has the sequence right: the lid tightens first, the lashes turn in, the cornea opacifies. 眼楞緊急縮少者, 倒睫拳毛之漸也 — the tightening margin is the beginning of it — is the observation that matters, because that is when the lid can still be operated on. Of the treatments, pulling the lashes is the only one that helps and it is temporary; the modern answer is surgery to rotate the lid margin.

Deukhyo 得效 · Dongwon 東垣 · Gangmok 綱目 · Jeongjeon 正傳

3.13.20 Wind Dragging the Lid Out 風牽瞼出

3.13.20.1

Source원문

上下瞼俱赤, 或翻出一瞼在外. 此脾受風毒, 宜五退散. 若年深瞼內俱赤, 則不治. 《得效》

Translation영역

Both the upper and lower lid are red, or one lid is turned out and hangs outside. This is the spleen taking in a wind toxin, and Five Sloughs Powder is appropriate. Where the years are many and the inner surfaces of both lids are red, it is not treated.

Clinical note임상 주석

A lid turned outward and hanging — ectropion, from a lid that has scarred and contracted the other way. It is the companion of the section before it, and like that one it is a surgical problem.

Deukhyo 得效

3.13.21 Pain from a Spirit Visitation 神祟疼痛

3.13.21.1

Source원문

舊無根因, 忽然疼痛, 或如鍼刺, 或如火炙, 兩太陽穴掣痛, 早輕晩重. 先宜求福, 却服石決明散. 《得效》犯土傷眼痛, 點三光膏. 《醫鑑》

Translation영역

With no root or cause before it, pain comes on suddenly, like a needle or like a burn, with a drawing pain at both Taeyang points, lighter in the morning and worse at evening. First one should seek a blessing, and then take Haliotis Powder. For an eye injured and painful from offending the earth, dab on Three Lights Ointment.

Clinical note임상 주석

先宜求福 — first seek a blessing. The Bogam prints the ritual remedy and the prescription side by side, and the order is the striking thing: the rite comes first and the medicine 却, after it. A sudden severe pain with no cause found is where the period's medicine handed the case over, and 犯土 — offending the earth by digging — is the explanation it reached for.

3.13.31.1

Source원문

小兒初生便有此證, 至三四歲雙目紅而弦邊赤爛, 時復痒痛. 先服消風散方見頭部以湯泡散洗之, 以龍腦膏點之. 《得效》

Translation영역

A newborn child has this pattern from birth, and by three or four years both eyes are red with the lid margins red and raw, itching and painful from time to time. Disperse Wind Powder formula in the Head chapter is given first, the eye washed with Steep in Hot Water Powder and Borneol Ointment dabbed on.

Deukhyo 得效

3.13.32 Wind Red Sore Disease 風赤瘡疾

3.13.32.1

Source원문

眼兩瞼似朱砂塗而生瘡, 黑睛端然無所染. 此因脾藏風熱, 久不治則生瞖膜, 宜服五退散, 洗以湯泡散. 《得效》

Translation영역

Both lids of the eye look as though painted with cinnabar and break out in sores, while the black of the eye is perfectly clear and untouched. This comes of wind heat in the spleen viscus; left untreated long it breeds an opacity. Five Sloughs Powder is given and the eye washed with Steep in Hot Water Powder.

Clinical note임상 주석

黑睛端然無所染 — the cornea perfectly clear and untouched. The lid is scarlet and ulcerated and the eye itself is well, which is the distinction the section exists to make: this is a disease of the skin of the lid, and the warning is only that it may spread inward if left.

Deukhyo 得效

3.13.33 Tears Running on Facing the Wind 衝風淚出

3.13.33.1

Source원문

至冬月尤甚. 此因肺虛遇風冷而發, 宜白殭蚕散. 《得效》衝風淚出, 俗言作冷淚者非也. 風衝于內, 火發于外, 風熱相搏, 由是淚出, 宜服當歸飮子方未詳. 外以貝母大而白膩者一枚, 加胡椒七粒, 不犯銅鐵, 硏爲細末, 臨臥點眼, 妙. 《子和》眵淚熱而交流, 兩瞼赤者, 屬肝熱之甚, 食後呑當歸龍薈丸方見五藏. 肝虛客熱, 迎風冷淚者, 歸葵湯ㆍ木賊散. 《入門》眼出冷淚, 虛則四物湯加木賊ㆍ防風ㆍ甘菊ㆍ白芷, 實則用蒼朮散. 《類聚》

Translation영역

In the winter months it is worse still. It comes of lung vacuity meeting wind and cold, and White Silkworm Powder is appropriate. To call tears running on facing the wind cold tears, as is commonly said, is wrong: wind surges within and fire breaks out without, wind and heat strike against each other, and the tears run from that. Korean Angelica Drink the formula is not known is appropriate. Externally, one fritillaria bulb, large and smooth and white, with seven peppercorns added, ground fine without touching copper or iron, dabbed in the eye at bedtime, is excellent. Where a hot discharge and tears run together and both lids are red, it belongs to severe liver heat, and Angelica, Gentian and Aloe Pill formula in the Five Viscera chapter is swallowed after food. For liver vacuity with a visiting heat and cold tears on meeting the wind: Return and Mallow Decoction and Equisetum Powder. For cold tears running from the eye: if vacuous, Four Substances Decoction with equisetum, saposhnikovia, chrysanthemum and angelica dahurica added; if replete, Atractylodes Powder.

Clinical note임상 주석

Epiphora — a watering eye, worse in cold and wind. The chapter's argument with the common name is a real distinction: the tears are not cold but reflex, and 風衝于內, 火發于外 is its way of saying the eye is irritated rather than chilled. A blocked tear duct, which the chapter treats under 漏睛 at 3.13.15, gives the same symptom.

Deukhyo 得效 · Jahwa 子和 · Immun 入門 · Yuchwi 類聚

3.13.34 A Sudden Wind with Visiting Heat 暴風客熱

3.13.34.1

Source원문

眼爲暴風熱所攻, 白睛起障, 覆黑珠, 瞼腫痒痛, 宜服瀉肝散ㆍ淸肺散. 《得效》

Translation영역

The eye is attacked by a sudden wind heat; a screen rises on the white of the eye and covers the black, and the lid swells, itching and painful. Drain the Liver Powder and Clear the Lung Powder are appropriate.

Deukhyo 得效

3.13.35 Lid Hard and Eye Painful 瞼硬睛痛

3.13.35.1

Source원문

瞼中紅赤而堅硬, 眼睛疼痛而淚出, 怕日羞明, 宜通肝散. 若有瞖障, 點春雪膏. 《得效》

Translation영역

Inside the lid it is red and hard, the eye aches and waters, and it dreads the sun and shuns the light; Free the Liver Powder is appropriate. Where there is an opacity, Spring Snow Ointment is dabbed on.

3.13.40.1

Source원문

眼中有膜自上垂下, 遮黑睛, 名垂簾膜, 望風淚出, 怕日羞明. 此客邪上衝, 用百點膏點之, 次服通肝散. 《得效》

Translation영역

In the eye a membrane hangs down from above and covers the black of the eye; it is called a hanging-curtain membrane, and the eye waters on looking into the wind, dreads the sun and shuns the light. This is a visiting evil surging upward: Hundred Dabs Ointment is dabbed on and Free the Liver Powder given after.

Deukhyo 得效

3.13.41 Red Vessels at the Lesser Canthus 小眥赤脉

3.13.41.1

Source원문

小眥中生赤脉, 漸漸衝眼, 急宜早治. 此三焦積熱, 宜服犀角飮, 忌熱毒物及房事. 《得效》

Translation영역

Red vessels arise within the lesser canthus and little by little advance on the eye; it is urgent to treat it early. This is accumulated heat of the triple burner, and Rhinoceros Horn Drink is appropriate, with hot and toxic foods and sexual intercourse forbidden.

Clinical note임상 주석

**Rhinoceros horn is prohibited under CITES and all species are endangered; this must not be prepared.** Vessels creeping from the outer canthus onto the cornea is the beginning of the pterygium at 3.13.3, and 急宜早治 is right about the stage at which anything can be done.

Deukhyo 得效

3.13.42 Through-Eye in a Child 小兒通睛

3.13.42.1

Source원문

嬰兒雙眼睛通者, 欲觀東邊則見西邊. 若振掉頭腦, 則睛方轉. 此肝受驚風, 宜服牛黃丸. 《入門》

Translation영역

In an infant whose two eyes look through, wanting to look east he sees west; and only if the head is shaken does the eye turn. This is the liver taking in a fright wind, and Bovine Bezoar Pill is appropriate.

Clinical note임상 주석

欲觀東邊則見西邊 is a strabismus in a baby, and 若振掉頭腦則睛方轉 — the eye moves only when the head is shaken — is the doll's-head manoeuvre, used exactly so to show that an eye which will not move to command still moves reflexly. **Bovine bezoar is taken from slaughtered cattle and is not obtainable; the formula is recorded, not prescribed.**

3.14.1

Source원문

瞖膜者, 風熱重則有之; 或癍痘後亦生瞖. 此肝氣盛而發在表也, 宜發散而去之. 若反疏利, 則邪氣內蓄爲瞖益深. 邪氣未定, 謂之熱瞖而浮; 邪氣已定, 謂之氷瞖而沉; 邪氣牢而深者, 謂之陷瞖. 當用焮發之物, 使其邪氣再動, 瞖膜乃浮, 佐之以退瞖之藥, 而能自去也. 病久者不能速效, 宜以歲月除之. 《綱目》

Translation영역

A screen and membrane is present where wind heat is severe, and a screen also breeds after macules and pox. This is the liver qi exuberant and breaking out at the exterior, and it should be removed by dispersing outward. If instead one frees and drains downward, the evil qi gathers within and the screen becomes deeper still. While the evil qi is not yet settled it is called a hot screen, and it floats; once the evil qi has settled it is called an ice screen, and it is sunken; and where the evil qi is firm and deep it is called a hollowed screen. One should use things that inflame and raise, so that the evil qi stirs again and the screen floats, assisted by medicines that push back the screen, and then it can go of itself. For a long-standing illness there can be no quick effect, and it should be removed over months and years.

Gangmok 綱目

3.14.2

Source원문

凡瞖起於肺家受熱, 輕則矇朧, 重則生瞖. 雖瞖自熱生, 然治法先退瞖而後退熱者, 謂熱極生瞖; 若先去赤熱, 則血爲之水而瞖不能去矣. 《直指》

Translation영역

Every screen arises from the lung receiving heat: mild, there is a blurring; severe, a screen breeds. Although the screen arises from heat, the method is to push back the screen first and only afterwards to take away the heat — for it is said that heat at its height breeds a screen, and if one first removes the red heat, the blood turns to water and the screen can no longer be got away.

Jikji 直指

3.14.3

Source원문

瞖膜輕重, 詳見內障. ○黑睛有瞖, 皆用知母ㆍ黃栢, 宜益本滋腎丸ㆍ明目地黃丸. 《丹心》

Translation영역

For the degrees of screen and membrane, see the Internal Obstruction section in detail. Where there is a screen on the black of the eye, anemarrhena and phellodendron are used in every case, and Ikbon-jasin-hwan or Myeongmok-jihwang-hwan should be given.

Dansim 丹心

3.14.4

Source원문

勞慾過度, 或凉藥過者, 以致九竅不利, 靑白瞖見大眥, 乃陽氣衰少也. 宜補陽湯連加益陰丸ㆍ菊睛元. 經曰, 益火之源以消陰瞖, 是也. 《東垣》

Translation영역

Where taxation and desire have gone beyond measure, or cooling medicines have been given to excess, so that the nine orifices do not work freely and a blue-white screen appears at the greater corner, this is the yang qi declining and scant. Boyang-tang should be given with Yeonbaek-ikeum-hwan following, or Gukjeong-won. The classic says: boost the source of fire so as to dissolve a yin screen — this is it.

Dongwon 東垣

3.14.5

Source원문

新瞖所生, 宜表散, 羌活退瞖湯; 血虛有熱, 宜神仙退雲丸. 若氷瞖久不去, 宜羚羊角散; 欲焮發陷瞖, 亦羚羊角散, 兼服神仙退雲丸. 《綱目》

Translation영역

For a newly bred screen, disperse at the exterior with Ganghwal-toeye-tang; for blood vacuity with heat, Sinseon-toeun-hwan. If an ice screen has long failed to go, Yeongyanggak-san; and to inflame and raise a hollowed screen, Yeongyanggak-san again, taken together with Sinseon-toeun-hwan.

Gangmok 綱目

3.14.6

Source원문

因眼病漸生瞖膜, 宜決明元ㆍ蟬花散ㆍ菊花散ㆍ地黃散.

Translation영역

Where an eye disease has gradually bred a screen and membrane, Gyeolmyeong-won, Seonhwa-san, Gukhwa-san or Jihwang-san.

Donguibogam · An

3.14.7

Source원문

瞖膜通用撥雲退瞖丸ㆍ正傳羊肝元ㆍ五秀重明丸ㆍ退雲散ㆍ磨光散ㆍ道人開障散ㆍ補肝散ㆍ決明散ㆍ撥雲湯, 兼用點藥.

Translation영역

For screens and membranes generally, Baldun-toeye-hwan, Jeongjeon-yanggan-won, Osu-jungmyeong-hwan, Toeun-san, Maggwang-san, Doin-gaejang-san, Bogan-san, Gyeolmyeong-san or Baldun-tang, with drops used alongside.

Donguibogam · An

3.14.8

Source원문

膚瞖者, 眼睛上有物如蠅翅者是也. 烏賊魚骨ㆍ龍腦各一錢, 爲細末, 日點三四度, 妙. 《類聚》

Translation영역

The skin screen is a thing on the eye like a fly's wing. Cuttlebone and borneol 1 don each, ground to a fine powder and dotted on three or four times a day — excellent.

Clinical note임상 주석

The Gangmok's three-stage grading is the section's real content and is a clinical sequence rather than a theory: a hot screen while the evil is unsettled, floating; an ice screen once it has settled, sunken; a hollowed screen when it is firm and deep. That tracks an acute infiltrate, a settled scar and a stromal excavation, and the treatment follows the stage. The Jikji's warning is the one most worth keeping — take the screen first and the heat after, because clearing the redness first leaves the opacity fixed — and the closing admission, that a long-standing screen must be removed over months and years, is the chapter at its most honest.

Yuchwi 類聚

3.15 Flowers Before the Eyes 眼花

3.15.1

Source원문

眼見黑花, 乃肝腎俱虛也. 《局方》 ○上虛屬肝虛, 必頭暈ㆍ目眩ㆍ耳聾; 下虛屬腎虛, 必眼花ㆍ睛痛ㆍ耳鳴. 《入門》

Translation영역

Black flowers seen before the eyes are the liver and the kidney both vacuous. Vacuity above belongs to liver vacuity, and there will be dizziness of the head, swimming of the vision and deafness; vacuity below belongs to kidney vacuity, and there will be flowers before the eyes, pain in the eyeball and ringing in the ears.

Gukbang 局方 · Immun 入門

3.15.2

Source원문

昏花者, 傷氣; 昏暗者, 傷血. 熱證亦有羞明怕日, 但內虛者全不敢近陽光. 《入門》

Translation영역

A blurring with flowers is damage to the qi; a dimming into darkness is damage to the blood. A heat pattern also has shrinking from the light and dread of the sun, but one vacuous within dares not come near the sunlight at all.

Immun 入門

3.15.3

Source원문

黑花者, 腎虛也; 五色花, 爲腎虛客熱也; 靑花, 膽虛也; 紅花, 火盛也; 散杳者, 瞳人散大, 視物杳冥也. 《入門》

Translation영역

Black flowers are kidney vacuity; flowers of the five colours are kidney vacuity with visiting heat; blue-green flowers are gallbladder vacuity; red flowers are fire exuberant; and the scattered-and-dim is the pupil scattered wide, so that things are seen as through a darkness.

Immun 入門

3.15.4

Source원문

陽主散, 陽虛則眼楞急而爲倒睫拳毛; 陰主歛, 陰虛不歛則瞳子散大而爲目昏眼花. 《東垣》

Translation영역

The yang governs scattering, so when the yang is vacuous the lid margin draws tight and there are inturned, curled lashes; the yin governs gathering in, so when the yin is vacuous and does not gather, the pupil scatters wide and there is dimness of vision with flowers before the eyes.

Dongwon 東垣

3.15.5

Source원문

或見飛蠅散亂ㆍ懸蟢虛空, 皆內障腎虛之證也. 《類聚》

Translation영역

Seeing flies scattering in disorder, or a spider hanging in empty air, is in every case a sign of internal obstruction with kidney vacuity.

Yuchwi 類聚

3.15.6

Source원문

腎主骨, 骨之精爲瞳子. 瞳子散大者, 因腎水虛ㆍ骨枯而心包絡之火得以乘之也. 治法宜苦ㆍ宜酸ㆍ宜凉, 大忌辛熱之物. 除風熱ㆍ凉血益血, 以收耗散之氣, 滋陰地黃丸最妙. 方見上《東垣》

Translation영역

The kidney governs the bones, and the essence of the bones becomes the pupil. The pupil scattering wide is because the kidney water is vacuous and the bone withered, so that the fire of the heart enclosing network can take advantage of it. The method calls for bitter, for sour and for cooling, and things acrid and hot are greatly to be avoided. To remove wind heat, cool the blood and boost the blood, and so gather in the qi that has been squandered and scattered, Jaeum-jihwang-hwan is best of all.

Dongwon 東垣

3.15.7

Source원문

眼花宜服熟地黃丸ㆍ三花五子丸ㆍ還睛丸ㆍ椒目丸ㆍ駐景元方見上ㆍ補腎丸方見上ㆍ醫鑑還睛丸方見下ㆍ益本滋腎丸方見上ㆍ明目壯水丸方見上, 點服五膽膏.

Translation영역

For flowers before the eyes, give Sukjihwang-hwan, Samhwa-oja-hwan, Hwanjeong-hwan, Chomok-hwan, Jujong-won, Bosin-hwan, the Uigam's Hwanjeong-hwan, Ikbon-jasin-hwan or Myeongmok-jangsu-hwan, with Odam-go both dotted on and taken.

Clinical note임상 주석

The section is the chapter's catalogue of entoptic phenomena, and it reads more precisely than one expects: black floaters, flies scattering in disorder, a spider hanging in empty air. Those are vitreous floaters described by someone who had listened carefully to patients, and the Yuchwi is right that they go with the beginnings of an internal obstruction. The colour scheme that assigns black to the kidney and blue-green to the gallbladder is doctrine rather than observation, but Dongwon's note is worth keeping for its symmetry — yang failing to scatter tightens the lid into entropion, yin failing to gather lets the pupil dilate — and a fixed dilated pupil with dim vision is a real and serious sign. The Immun's distinction in the second entry is the practical one: flowers mean the qi, a dimming means the blood, and photophobia so complete that the patient will not face the sun at all is vacuity rather than heat.

Donguibogam · An

3.16 Pain in the Eye 眼疼

3.16.1

Source원문

目疼有二: 一謂目眥白眼疼, 二謂目珠黑眼疼也. 目眥白眼疼屬陽, 故晝則疼甚, 點苦寒藥則效, 經所謂白眼赤脉法於陽故也. 目珠黑眼疼屬陰, 故夜則疼甚, 點苦寒藥則反劇, 經所謂瞳子黑眼法於陰故也. 《綱目》

Translation영역

Pain in the eye is of two kinds: the first is pain of the corners and the white of the eye, the second pain of the eyeball and the black of the eye. Pain of the corners and the white belongs to the yang, so the pain is worse by day and dotting on bitter cold medicines is effective — for the classic says that the white of the eye and the red vessels take their pattern from the yang. Pain of the eyeball and the black belongs to the yin, so the pain is worse by night and dotting on bitter cold medicines makes it fiercer instead — for the classic says that the pupil and the black of the eye take their pattern from the yin.

Gangmok 綱目

3.16.2

Source원문

一人目珠疼, 連眉稜ㆍ額角皆痛, 遇夜則甚, 點苦寒藥則反甚, 諸藥不效. 灸厥陰ㆍ少陽則痛止, 半月復作. 遂以夏枯草散茶淸調下, 初服疼減太半, 四五日良愈, 後試亦驗. 《綱目》

Translation영역

A man had pain in the eyeball running on to the brow ridge and the corner of the forehead, all of it painful, worse when night came; dotting on bitter cold medicines made it worse instead, and no medicine answered. Moxa at the reverting yin and the lesser yang stopped the pain, but it returned in a fortnight. He was then given Hagocho-san stirred into clear tea: at the first dose the pain was more than half reduced, in four or five days it was well healed, and it has proved itself on later trial too.

Gangmok 綱目

3.16.3

Source원문

目赤而痛者, 肝實熱也. 《回春》

Translation영역

Where the eye is red and painful, it is repletion heat of the liver.

Hoechun 回春

3.16.4

Source원문

睛疼難忍, 當歸ㆍ防風ㆍ細辛ㆍ薄荷等分爲末, 每二錢, 麥門冬湯調下, 日三. 《本事》

Translation영역

For pain of the eyeball hard to bear: tangkuei, saposhnikovia, asarum and mint in equal parts, powdered; 2 don each time, stirred into a decoction of ophiopogon, three times a day.

Bonsa 本事

3.16.5

Source원문

黑睛疼, 知母ㆍ黃栢瀉腎火, 當歸養陰水. 《丹心》

Translation영역

For pain of the black of the eye, anemarrhena and phellodendron drain the kidney fire and tangkuei nourishes the yin water.

Dansim 丹心

3.16.6

Source원문

目赤痛, 脉實ㆍ大便秘者, 以瀉靑丸方見五藏ㆍ洗肝散方見五藏微利之卽愈, 或救苦湯. 《入門》

Translation영역

Where the eye is red and painful, the pulse replete and the stool bound, freeing it slightly with Sacheong-hwan or Segan-san heals it at once; or Gugo-tang.

Immun 入門

3.16.7

Source원문

湯火傷眼腫痛, 不可用冷藥點之, 以五行湯溫洗, 地黃膏付之. 方見上《入門》

Translation영역

Where boiling water or fire has injured the eye with swelling and pain, cold medicines must not be dotted on; wash it warm with Ohaeng-tang and apply Jihwang-go.

Immun 入門

3.16.8

Source원문

若讀書鍼刺過度而眼痛, 名曰肝勞, 但須閉目調護. 《入門》

Translation영역

If the eye is painful from reading or needlework carried to excess, it is called liver taxation, and nothing is wanted but to close the eyes and nurse them.

Clinical note임상 주석

The Gangmok's division is the best piece of differential reasoning in the chapter and it survives translation into modern terms almost intact. Pain in the white, worse by day, relieved by cold drops is surface disease — conjunctival and episcleral; pain in the globe itself, worse at night, made worse by cold drops is deep disease, and the ciliary and scleral pains do behave that way. The case that follows is a ciliary neuralgia or a scleritis radiating into the brow, unhelped by topical treatment and answered by Prunella internally. The warning about thermal burns — never cold drops, wash warm — runs against instinct and against modern first aid, which irrigates copiously and does not insist on warmth. Liver taxation is eye strain, and the prescription for it is rest.

Immun 入門

3.17 Dim Vision 眼昏

3.17.1

Source원문

五藏精明聚於目, 目精全則目明. 《得效》 ○夫精明者, 所以視萬物ㆍ別白黑ㆍ審長短. 以長爲短, 以白爲黑, 如是則精衰矣. 《內經》

Translation영역

The essence-brightness of the five viscera gathers in the eye, and when the essence of the eye is whole the eye sees clearly. Now the essence-brightness is that by which one sees the ten thousand things, distinguishes white from black and judges long from short. To take the long for the short and the white for the black — when it is so, the essence has declined.

Deukhyo 得效 · Naegyeong 內經

3.17.2

Source원문

足少陰之脉病, 目䀮䀮無所見. 《靈樞》 ○肝虛則目䀮䀮無所見. 《內經》

Translation영역

When the vessel of the foot lesser yin is diseased, the eyes are clouded and see nothing. When the liver is vacuous, the eyes are clouded and see nothing.

Yeongchu 靈樞 · Naegyeong 內經

3.17.3

Source원문

靈樞曰, 氣脫者目不明; 難經曰, 脫陰者目盲. 夫陰陽合傳而爲精明, 氣血不足則目昏. ○視物不明ㆍ見黑花者, 腎氣弱也. 《保命》

Translation영역

The Lingshu says: where the qi has collapsed, the eye does not see clearly. The Nanjing says: where the yin has collapsed, the eye is blind. Now yin and yang together are handed on to become the essence-brightness, and when qi and blood are insufficient the eye is dim. Seeing things unclearly and seeing black flowers is the kidney qi weak.

Bomyeong 保命

3.17.4

Source원문

目昧不明, 熱也. 然玄府者, 無物不有. 人之藏府ㆍ皮毛ㆍ肌肉ㆍ筋膜ㆍ骨髓ㆍ爪牙, 盡皆有之, 乃氣出入升降之道路門戶也. 有所閉塞不能爲用者, 悉由熱氣怫欎, 玄府閉密而致氣液ㆍ血脉ㆍ榮衛ㆍ精神不能升降出入故也. 各隨欎結微甚而爲病之輕重, 故知熱欎於目則無所見也. 或目昏而見黑花者, 由熱氣甚而發之於目也. 《河間》

Translation영역

A clouded eye that does not see clearly is heat. Now the dark palaces are in everything: in a person's viscera and bowels, skin and hair, flesh, sinew membranes, bone marrow, nails and teeth — in all of them — for they are the roads and gateways by which qi goes out and in, ascends and descends. Where something is shut and blocked so that it cannot serve, it is in every case because hot qi has become pent and depressed and the dark palaces have closed tight, so that fluids and qi, the blood vessels, the construction and defence, and the essence-spirit cannot ascend, descend, go out or come in. Each is a light or a heavy disease according as the depression is slight or severe; so one knows that when heat is pent in the eye, nothing is seen. And where the eye is dim and black flowers are seen, it is because hot qi is severe and breaks out in the eye.

Hagan 河間

3.17.5

Source원문

目昏者, 熱甚也. 傷寒熱極則目盲不識人; 目微昏者, 至近則轉難辨物, 或如隔簾視, 或視如蠅翅, 或見黑花, 皆目之玄府閉密而榮衛精神不能升降故也. 《入門》

Translation영역

A dim eye is heat at its height. In cold damage, when the heat is extreme the eye is blind and does not know people; where the eye is slightly dim, things become harder to make out the nearer they come, or it is like looking through a blind, or like seeing through a fly's wing, or black flowers are seen — all because the dark palaces of the eye have closed tight and the construction, the defence and the essence-spirit cannot ascend or descend.

Immun 入門

3.17.6

Source원문

凡人目暴不見物, 皆是氣脫, 用人參膏方見氣門以補之, 血藥以行之. 《丹心》

Translation영역

Whenever a person's eye suddenly sees nothing, it is in every case collapse of the qi: supplement it with Insam-go and move it with blood medicines.

Dansim 丹心

3.17.7

Source원문

久病昏暗者, 腎藏眞陰之虛也. 《回春》

Translation영역

Dimness and darkness in a long illness is vacuity of the true yin of the kidney viscus.

Hoechun 回春

3.17.8

Source원문

眼昏宜駐景元ㆍ加減駐景元方並見上ㆍ滋陰地黃元方見上ㆍ加味磁朱丸ㆍ四物五子元ㆍ蔓菁子丸ㆍ還睛丸方見下. ○傷寒熱病後目昏, 或生瞖膜, 宜服石決明散方見上, 點春雪膏方見下. ○婦人眼昏, 宜服抑靑明目湯.

Translation영역

For a dim eye, Jujong-won, Gagam-jujong-won, Jaeum-jihwang-won, Gami-jaju-hwan, Samul-oja-won, Mancheongja-hwan or Hwanjeong-hwan. Where the eye is dim after cold damage or a heat disease, or a screen and membrane has bred, give Seokgyeolmyeong-san and dot on Chunseol-go. For a woman's dim eye, give Eokcheong-myeongmok-tang.

Clinical note임상 주석

Hejian's dark-palace passage is the most ambitious piece of physiology in the chapter and deserves to be read as the argument it is: every tissue has microscopic gateways through which qi and fluid pass, disease is these gateways closing, and pent heat is what closes them. It is a theory of obstruction at the smallest scale, offered three centuries before anyone could see a capillary, and it is applied here to explain why heat should cause blindness rather than redness. The Immun's list of what slight dimness is like — harder to make out the nearer it comes, as through a blind, as through a fly's wing — is a careful clinical description, and reduced near vision with veiling is what cataract and vitreous opacity actually produce. The blindness of extreme heat in cold damage is the encephalitic or meningitic blindness of a severe febrile illness.

Donguibogam · An

3.18 Dim Vision in the Old 老人眼昏

3.18.1

Source원문

人年老而目昏者, 血氣衰而肝葉薄, 膽汁減而目乃昏矣. 《脉訣》

Translation영역

When a person is old and the eye is dim, it is that the blood and qi have declined and the lobes of the liver are thin, the gallbladder's fluid is diminished, and so the eye is dim.

Maekgyeol 脉訣

3.18.2

Source원문

童子水在上, 故視明瞭; 老人火在上, 故視昏睡. 《入門》

Translation영역

In a child the water is above, so the sight is bright and clear; in an old person the fire is above, so the sight is dim and drowsy.

Immun 入門

3.18.3

Source원문

老人眼昏, 宜還睛丸方見通治ㆍ夜光育神丸ㆍ明眼地黃丸ㆍ滋陰地黃丸方見上ㆍ呂仙翁方. 勞傷昏暗, 宜益氣聦明湯.

Translation영역

For a dim eye in the old, Hwanjeong-hwan, Yagwang-yuksin-hwan, Myeongan-jihwang-hwan, Jaeum-jihwang-hwan or Yeo Seonong's formula. For dimness and darkness from taxation damage, Ikgi-chongmyeong-tang.

Clinical note임상 주석

Two explanations of presbyopia and the senile cataract, neither anatomical in the modern sense but both locating the change in a decline rather than a disease: the Maekgyeol in the thinning of the liver and the lessening of bile, the Immun in the fire having risen to the place where water used to be. The treatments are all enriching, and the last of them, Ikgi-chongmyeong-tang, is the formula this chapter gives for the eyes and ears failing together in the old — the only such formula in the book, and a reasonable one.

Donguibogam · An

3.19 Unable to See Far and Unable to See Near 不能遠視不能近視

3.19.1

Source원문

能遠視不能近視者, 陽氣有餘ㆍ陰氣不足也, 乃血虛氣盛. 氣盛者, 火有餘也. 能近視不能遠視者, 陽氣不足ㆍ陰氣有餘, 乃氣虛血盛也. 血盛者, 陰火有餘也; 氣虛者, 元氣衰弱也. 此老人桑楡之象也. 《東垣》

Translation영역

One who can see far but not near has yang qi in surplus and yin qi insufficient — it is blood vacuity with qi exuberant, and qi exuberant means fire in surplus. One who can see near but not far has yang qi insufficient and yin qi in surplus — it is qi vacuity with blood exuberant; blood exuberant means yin fire in surplus, and qi vacuous means the original qi declined and weak. This is the old man's image of the mulberry and the elm at sunset.

Dongwon 東垣

3.19.2

Source원문

目能遠視, 責其有火; 不能近視, 責其無水. 法當補腎, 宜服地芝丸, 或六味地黃丸方見虛勞加牡蠣. 《海藏》

Translation영역

That the eye can see far is to be charged to its having fire; that it cannot see near is to be charged to its having no water. The method is to supplement the kidney: give Jiji-hwan, or Yukmi-jihwang-hwan with oyster shell added.

Haejang 海藏

3.19.3

Source원문

目能近視, 責其有水; 不能遠視, 責其無火. 法當補心, 宜定志丸方見神門加茯苓. 《海藏》

Translation영역

That the eye can see near is to be charged to its having water; that it cannot see far is to be charged to its having no fire. The method is to supplement the heart: give Jeongji-hwan with poria added.

Haejang 海藏

3.19.4

Source원문

不能近視, 晨服地黃元; 不能遠視, 卧服定志丸. 《東垣》

Translation영역

For inability to see near, take Jihwang-won in the morning; for inability to see far, take Jeongji-hwan on lying down.

Clinical note임상 주석

This is presbyopia and myopia set out as a matched pair, and the pairing is exact: far but not near is the old eye, near but not far the young short-sighted one. The attributions run the way one would expect from the chapter's physiology — the old eye wants water, the short-sighted eye wants fire — and Dongwon's phrase for presbyopia, the image of mulberry and elm at sunset, is the kindest name any tradition has given it. The dosing instruction in the last entry is characteristic of the eye chapter at its most careful: the water-supplementing pill in the morning and the fire-supplementing pill at bedtime, matched to the time of day when each need is greatest. None of it corrects refraction, and the tradition had no lens to offer; what it had was a taxonomy that got the two conditions the right way round.

Dongwon 東垣

3.20 The Eye Cannot Open or Close 目不得開合

3.20.1

Source원문

足太陽之筋爲目上綱, 足陽明之筋爲目下綱. 熱則筋縱, 目不開. 《綱目》

Translation영역

The sinew of the foot greater yang makes the upper net of the eye, and the sinew of the foot yang brightness the lower net. When there is heat the sinew slackens and the eye does not open.

Gangmok 綱目

3.20.2

Source원문

眼不得開, 羞明怕日, 乃風熱牽閉所致. 芎芷香蘇散方見寒門加前胡ㆍ連鬚葱白三莖, 煎服. 《得效》

Translation영역

Where the eye cannot be opened, with shrinking from the light and dread of the sun, it is brought about by wind heat dragging it shut. Gungji-hyangso-san with peucedanum and three stalks of scallion white with the roots on, decocted and taken.

Deukhyo 得效

3.20.3

Source원문

一乳婦因大恐, 目張不得瞑. 公煮郁李仁酒飮之, 使醉則愈. 所以然者, 目系肝膽, 恐則氣結, 膽橫不下. 惟郁李仁去結, 隨酒入膽, 結去膽下, 則目能瞑矣. 《入門》

Translation영역

A nursing woman, after a great fright, had her eyes wide open and could not shut them. He boiled bush-cherry kernel in wine and made her drink it, and when she was drunk she was healed. The reason is this: the eye is tied to the liver and gallbladder, fright makes the qi bind, and the gallbladder lies athwart and does not come down. Only bush-cherry kernel removes a binding, and following the wine it entered the gallbladder; the binding gone and the gallbladder come down, the eye could close.

Immun 入門

3.20.4

Source원문

上氣不足, 目爲之瞑. 《靈樞》

Translation영역

When the qi above is insufficient, the eye closes of itself.

Clinical note임상 주석

The sinews of the greater yang and the yang brightness as the upper and lower nets of the eye is a tidy and not inaccurate account of the levator and orbital musculature, and heat slackening the sinew so that the lid will not lift describes a ptosis. The case in the third entry is the memorable one — a lid retraction after a severe fright, treated by getting the patient drunk on bush-cherry kernel in wine — and whatever one makes of the gallbladder lying athwart, the sedation would have worked.

Yeongchu 靈樞

3.21 Discharge Breeding in the Eye 眼生眵糞

3.21.1

Source원문

凡眼有血紅, 或有紅絲及生糞, 此是熱眼, 宜服經效散. 方見上《得效》

Translation영역

Whenever the eye has blood-red in it, or red threads, and discharge breeds, this is a hot eye, and Gyeonghyo-san should be given.

Deukhyo 得效

3.21.2

Source원문

眵多結硬者, 肺實也; 眵稀不結者, 肺虛也. 《回春》

Translation영역

Where the discharge is copious and sets hard, the lung is replete; where the discharge is thin and does not set, the lung is vacuous.

Hoechun 回春

3.21.3

Source원문

凡眼疾痛不生糞, 此元氣憊ㆍ腎經虛, 夜間小便二三次, 耗傷陽氣, 致生內障; 或腦脂流下, 或瞳人開大, 此皆腎憊黑水散也. 宜服八味丸方見虛勞, 或十全大補湯加枸杞子ㆍ甘菊. 方見虛勞《得效方》

Translation영역

Whenever an eye ailment is painful and no discharge breeds, this is the original qi worn out and the kidney channel vacuous: passing water two or three times in the night wastes and injures the yang qi and brings on an internal obstruction; or the brain fat flows down, or the pupil opens wide — all of these being the kidney worn out and the black water scattered. Palmi-hwan should be given, or Sipjeon-daebo-tang with lycium fruit and chrysanthemum added.

Clinical note임상 주석

A short section organized around one good observation: a painful eye that produces no discharge is not an infection. The Hoechun's reading of the discharge itself — copious and crusting for repletion, thin and unsetting for vacuity — is the distinction between a bacterial and a viral or allergic conjunctivitis, arrived at from the material rather than the microbe. The third entry links nocturia to cataract through a shared vacuity of the kidney, which is not a causal chain anyone would defend now, though old men who get up at night do also get cataracts. The brain fat flowing down is the chapter's standing image for the lens clouding.

Deukhyobang 得效方

3.22 Seeing One Thing as Two 視一物爲兩

3.22.1

Source원문

有人視一物爲兩, 醫作肝氣盛, 服瀉肝藥不驗. 予記靈樞云, 目之系上屬於腦, 後出於項中, 邪中其精, 精散則視歧, 故見兩物. 令服驅風入腦藥得愈, 宜驅風一字散方見上ㆍ保肝散. 《本事》

Translation영역

There was a man who saw one thing as two. The physician took it for liver qi exuberant, and medicines to drain the liver had no effect. I recalled that the Lingshu says: the tie of the eye runs up to the brain and comes out behind in the nape; when evil strikes its essence the essence scatters and the sight forks, and so two things are seen. I had him take a medicine that drives wind from the brain and he was healed: Gupung-iljja-san or Bogan-san.

Bonsa 本事

3.22.2

Source원문

昏暗不能遠視, 看一成二成三, 屬肝腎虛, 宜腎氣丸方見虛勞ㆍ地芝丸. 方見上《入門》

Translation영역

Dimness and darkness with inability to see far, one thing looking like two or three, belongs to liver and kidney vacuity; Singi-hwan or Jiji-hwan.

Clinical note임상 주석

The best passage in the chapter, and the only one where a physician explicitly abandons the standing doctrine because it did not work. Draining the liver failed, so he went back to the Lingshu and found the anatomy — the optic tract running up to the brain and out behind in the nape — and reasoned that diplopia must be a lesion along that path rather than a disorder of the liver. That is correct: binocular diplopia is a nerve or muscle problem, not an ocular one. The second entry is a different thing, the monocular polyopia of a cataract, and the tradition does not distinguish the two — but it put them in the same section, which is more than nothing.

Immun 入門

3.23 Reading Injures the Eyes 讀書損目

3.23.1

Source원문

內經曰, 目得血而能視, 然久視傷血, 亦能損目. 《綱目》

Translation영역

The Neijing says the eye gets blood and so can see; yet long looking injures the blood, and this too can injure the eye.

Gangmok 綱目

3.23.2

Source원문

久視傷血, 血主肝, 故勤書則傷肝. 肝傷則自生風熱, 熱氣上騰, 致目昏. 不可專服補藥, 宜服益血ㆍ鎭肝ㆍ明目藥自愈, 宜服地黃元. 《綱目》

Translation영역

Long looking injures the blood, and the blood is governed by the liver, so diligence at books injures the liver. When the liver is injured it breeds wind heat of itself, the hot qi rises, and dimness of the eye follows. One must not take supplementing medicines alone; give medicines that boost the blood, settle the liver and brighten the eye and it heals of itself — Jihwang-won.

Gangmok 綱目

3.23.3

Source원문

讀書之苦傷肝損目. 晋范寗目疾, 就張湛求方. 湛戱曰: 損讀書一, 減思慮二, 專內視三, 簡外觀四, 宜起晩五, 宜早眠六. 凡六物, 熬以神火, 下以氣篩, 蘊於胷中七日, 然後納諸方寸. 修之一年, 近能數其目睫, 遠視尺箠之餘; 長明不已, 洞見墻壁之外矣. 雖是朝戱, 亦奇方也. 《本事》

Translation영역

The hardship of reading injures the liver and damages the eyes. Fan Ning of the Jin, having an eye ailment, went to Zhang Zhan to ask for a formula. Zhan said in jest: cut down reading, one; reduce brooding, two; look wholly inward, three; simplify looking outward, four; rise late, five; sleep early, six. These six things: parch them over a spirit fire, sift them down through a qi sieve, store them in the breast for seven days, and then put them in the square inch of the heart. Practise it for a year and you will be able to count your own lashes near at hand and to see beyond a foot-rule far off; keep the brightness up and you will see clear through a wall. A mockery it may be, but it is also a marvellous formula.

Bonsa 本事

3.23.4

Source원문

古人云, 讀書之苦傷肝損目, 誠然. 其讀書ㆍ博奕等過度患目者, 名曰肝勞. 若欲治之, 非三年閉目不視則不可得差; 徒自瀉肝及諸治, 終是無效. 《資生》

Translation영역

The ancients said that the hardship of reading injures the liver and damages the eyes, and it is true. Those who suffer in the eyes from reading, chess and the like carried to excess are said to have liver taxation. If one would treat it, there is no cure short of three years with the eyes closed and not looking; merely draining the liver and the other treatments come to nothing in the end.

Jasaeng 資生

3.23.5

Source원문

讀書鍼刺過度而眼痛, 名曰肝勞, 但須閉目調護. 《入門》

Translation영역

Where the eye is painful from reading or needlework carried to excess, it is called liver taxation, and nothing is wanted but to close the eyes and nurse them.

Clinical note임상 주석

Eye strain named, described and treated by rest, which is still the treatment. Zhang Zhan's prescription is a joke whose six ingredients are all behavioural — read less, brood less, look inward, simplify what you look at, rise late, sleep early — compounded in the pharmacist's idiom and swallowed into the heart, and the Bonsa's comment that a mockery may also be a marvellous formula is the most likeable sentence in the chapter. The Jasaeng's three years with the eyes closed is the same counsel without the humour, and its judgement that draining the liver comes to nothing is an unusually blunt admission that the pharmacy has nothing for this.

Immun 入門

3.24 Weeping Loses the Sight 哭泣喪明

3.24.1

Source원문

黃帝問曰: 人之哀而涕泣者, 何氣使然? 歧伯對曰: 心者, 五藏六府之主也; 目者, 宗脉之所聚也, 上液之道也; 口鼻者, 氣之門戶也. 故悲哀愁憂則心動, 心動則五藏六府皆揺, 揺則宗脉感, 宗脉感則液道開, 液道開故涕泣出焉. 液者, 所以灌精濡空竅者也, 故上液之道開則泣不止, 泣不止則液竭, 液竭則精不灌, 精不灌則目無所見矣. 命曰奪精. 《靈樞》

Translation영역

The Yellow Emperor asked: when a person grieves and weeps, what qi brings it about? Qi Bo answered: the heart is the ruler of the five viscera and six bowels; the eye is where the ancestral vessels gather and is the road of the upper fluid; the mouth and nose are the gateways of the qi. So sorrow, grief, care and worry stir the heart; when the heart stirs the five viscera and six bowels all shake; when they shake the ancestral vessels are affected; when the ancestral vessels are affected the fluid road opens; and because the fluid road is open, tears and weeping come out. Fluid is that which waters the essence and moistens the empty orifices, so when the road of the upper fluid is open the weeping does not stop; when the weeping does not stop the fluid is exhausted; when the fluid is exhausted the essence is not watered; and when the essence is not watered the eye sees nothing. It is called the robbing of the essence.

Clinical note임상 주석

A whole section given to one dialogue, and it is a physiology of grief: the heart stirs, the viscera shake, the ancestral vessels are affected, the fluid road opens, and the tears that come out are the same fluid that was watering the eye. Weeping that does not stop therefore drains the eye of what it lives on, and the name for the end of it — the robbing of the essence — is the tradition's term for the blindness of unrelieved mourning. Nothing in it is anatomically true, and the connection it draws is not: grief does not blind. But it is one of the few places in the book where a visual symptom is traced entirely to an emotion, and the chain is set out with enough care that one can see exactly where it goes wrong.

Yeongchu 靈樞

3.25 Eye Disease Must Be Divided by Exterior and Interior, Vacuity and Repletion 眼病當分表裏虛實

3.25.1

Source원문

眼之爲病, 在府則爲表, 當除風散熱; 在藏則爲裏, 當養血安神. 《保命》

Translation영역

As to the eye becoming diseased: when it is in the bowels it is the exterior, and one should remove wind and disperse heat; when it is in the viscera it is the interior, and one should nourish the blood and quiet the spirit.

Bomyeong 保命

3.25.2

Source원문

如暴失明ㆍ昏澁ㆍ瞖膜ㆍ眵淚, 皆表也, 宜表散以去之. 如昏暗不欲視物ㆍ內障見黑花ㆍ瞳散, 皆裏也, 宜養血ㆍ補水ㆍ安神以調之. 《入門》

Translation영역

Sudden loss of sight, blurring and grittiness, screens and membranes, discharge and tearing are all the exterior, and should be removed by dispersing at the exterior. Dimness with no wish to look at things, internal obstruction with black flowers seen, and a scattered pupil are all the interior, and should be regulated by nourishing the blood, supplementing the water and quieting the spirit.

Immun 入門

3.25.3

Source원문

聖人雖言目得血而能視, 然血亦有太過不及也. 太過則目壅塞而發痛, 不及則目耗竭而失明. 故年少之人多太過, 年老之人多不及, 不可不察也. 《子和》

Translation영역

Though the sages said that the eye gets blood and so can see, blood too may be in excess or in deficit. In excess, the eye is congested and blocked and pain breaks out; in deficit, the eye is wasted and exhausted and the sight is lost. So the young are mostly in excess and the old mostly in deficit, and this must be looked into.

Jahwa 子和

3.25.4

Source원문

眼疾所因, 不過虛實二者而已. 虛者, 眼目昏花, 腎經眞水之微也; 實者, 眼目腫痛, 肝經風熱之甚也. 實則散其風熱, 虛則滋其眞陰; 虛實相因則散熱滋陰兼之, 此內治之法也. 至於日久熱壅血凝而爲攀睛ㆍ瘀肉ㆍ瞖膜ㆍ赤爛之類, 不假點洗外治之法, 則何由而得痊乎? 《丹心》

Translation영역

What eye disease is caused by comes to no more than the two, vacuity and repletion. In vacuity the eye is dim with flowers, the true water of the kidney channel being scant; in repletion the eye is swollen and painful, the wind heat of the liver channel being severe. For repletion, disperse its wind heat; for vacuity, enrich its true yin; and where vacuity and repletion give rise to one another, disperse heat and enrich the yin together — this is the method of internal treatment. But when the days have run long and congested heat and congealed blood have made a pterygium, stagnant flesh, a screen and membrane, or redness and rawness, then without recourse to the external method of drops and washes, by what means is a cure to be got?

Clinical note임상 주석

The chapter's methodological section, and the clearest statement anywhere in it of how to proceed. Two axes: bowel or viscus, which is to say surface or depth; and vacuity or repletion. Everything acute, discharging and visible is exterior and gets dispersed; everything dim, inward and pupillary is interior and gets enriched. Jahwa's refinement is the one with real clinical weight — blood may be in excess as well as deficient, the young tend to the first and the old to the second — and it licenses opposite treatments for the same complaint at different ages. The Dansim closes with the admission that the internal method alone cannot answer a pterygium or a corneal scar, which is why the chapter's last third is given to drops and washes.

Dansim 丹心

3.26 Distinguishing Eye Disease Easy to Treat from Hard 眼病易治難治辨

3.26.1

Source원문

外障易治, 內障難治. ○暴發者爲表, 易治; 久病者爲裏, 難治. 《保命》

Translation영역

The external obstruction is easy to treat and the internal obstruction hard. What breaks out suddenly is the exterior and easy to treat; a long illness is the interior and hard to treat.

Bomyeong 保命

3.26.2

Source원문

眞珠瞖狀如碎米者, 易散; 梅花瞖狀如梅花葉者, 難消. 《直指》

Translation영역

A pearl screen, shaped like broken grains of rice, is easily scattered; a plum-blossom screen, shaped like the petals of a plum flower, is hard to dissolve.

Jikji 直指

3.26.3

Source원문

瞳人乾缺ㆍ痛澁無淚者, 或白瞖藏在黑水下ㆍ向日細視太見者, 或兩眼相傳ㆍ疼痛晝輕夜重者, 或內障五色相間ㆍ頭痛無淚ㆍ日中如坐暗室者, 或雷頭風熱毒氣衝入睛中ㆍ或微或大ㆍ昏暗不見者, 皆不治. 《入門》

Translation영역

The pupil dry and deficient, painful and gritty with no tears; or a white screen lying hidden beneath the black water, seen only on close looking toward the sun; or both eyes passing it one to the other, with pain light by day and heavy by night; or an internal obstruction with the five colours interspersed, headache and no tears, and sitting as in a dark room at midday; or thunder-head wind, the hot toxic qi thrusting into the eye, the pupil now small now large, dim and unseeing — none of these can be treated.

Clinical note임상 주석

A prognostic section, and its judgements hold up remarkably well. Surface disease treats and deep disease does not; a fine granular corneal infiltrate clears and a confluent branching one scars. The list of untreatable conditions in the last entry is a list of exactly the things that still blind people: a dry pupil fixed and painful without tears (an anterior uveitis gone to seclusion of the pupil), a deep stromal opacity visible only against the light, bilateral sympathetic involvement with night pain, an internal obstruction with coloured haloes, headache and functional blindness in daylight — which is glaucoma — and a fulminant toxic infection with a pupil that will not hold its size. The tradition could not treat any of them and says so without hedging.

Immun 入門

3.27 Fire Breeding in the Eye 眼中生火

3.27.1

Source원문

唯陰陽易病, 及婦人臨産時有之. 《入門》

Translation영역

It occurs only in the yin-yang exchange disease, and in a woman at the time of giving birth.

Clinical note임상 주석

Three lines of section for a sign the Bogam evidently could not place. Seeing fire or sparks in the eye is restricted here to two situations: the yin-yang exchange disease, a relapse of a febrile illness attributed to sexual contact during convalescence, and the moment of childbirth. Photopsia in labour is real and well described in eclampsia and in severe pre-eclampsia, where it is a warning sign of some seriousness; the chapter records the observation and offers nothing for it.

Immun 入門

3.28 What Is Forbidden in Eye Disease 眼病禁忌

3.28.1

Source원문

酒色七情, 最宜痛斷. ○凡眼疾忌雞ㆍ魚ㆍ酒ㆍ麪ㆍ糯米ㆍ醎酸ㆍ熱油ㆍ諸般毒物. 眼乃一身之主, 不能忌口, 藥亦無功, 自陷此身也. 每日白煮精猪肉嚥飯, 或山藥ㆍ蘿葍ㆍ菜果, 皆可啖. 《得效》

Translation영역

Wine, sexual indulgence and the seven affects are above all to be cut off sharply. In every eye ailment, avoid chicken, fish, wine, wheat noodles, glutinous rice, salty and sour things, hot oil and all manner of toxic foods. The eye is the master of the whole body, and if one cannot restrain the mouth, medicine too will have no effect and one brings oneself down. Each day, lean pork plainly boiled, eaten down with rice, or yam, radish, greens and fruit — all of these may be eaten.

Clinical note임상 주석

A dietary proscription of the usual pre-modern shape, forbidding the rich, the fried and the fermented, and the only part of it with modern support is the first clause: alcohol and the seven affects. What is worth noting is the sentence in the middle, that if the mouth cannot be restrained the medicine will not work either — the chapter's standing position that treatment and regimen are one thing, and that a patient who ignores the second has wasted the first.

Deukhyo 得效

3.29 Nursing the Eyes in Disease 眼病調養

3.29.1

Source원문

養目力者常瞑. 《養生》

Translation영역

He who would nurture the strength of his eyes keeps them closed much of the time.

Yangsaeng 養生

3.29.2

Source원문

讀書博奕過度患目, 名曰肝勞, 非三年閉目不可治. 《資生》

Translation영역

Suffering in the eyes from reading and chess carried to excess is called liver taxation, and cannot be treated short of three years with the eyes closed.

Jasaeng 資生

3.29.3

Source원문

古人治肝勞有養之之法. 彭眞人患目疾, 不計晝夜瞪目注視, 閉之少頃, 依法再行, 積功而視秋毫. 徐眞人亦患目疾, 暗室正坐, 運睛旋還八十一數, 閉目集神再運, 不數年而神光自現, 狀如金輪, 永除昏暗. 施眞人歌曰, 運睛除目暗. 皆養之之法也. 《資生》

Translation영역

The ancients had a method of nurturing for the treatment of liver taxation. The Perfected Peng, suffering an eye ailment, would stare fixedly without counting day or night, close the eyes a little while, and then by the method do it again; the merit accumulated and he could see an autumn hair. The Perfected Xu, also suffering an eye ailment, would sit upright in a dark room and turn the eyes round eighty-one times, then close them, gather the spirit and turn them again; in not many years a spirit light appeared of itself, shaped like a golden wheel, and the dimness was gone for good. The Perfected Shi's song says: turning the eyes removes the eye's darkness. All these are methods of nurturing.

Jasaeng 資生

3.29.4

Source원문

熱摩手心, 熨兩眼, 每二七遍, 使人眼目自無障瞖. 明目去風, 無出於此. 《養性》

Translation영역

Rub the palms hot and press them on both eyes, fourteen times at each session; it keeps a person's eyes free of obstruction and screen of themselves. For brightening the eye and driving out wind, nothing surpasses it.

Yangseong 養性

3.29.5

Source원문

常以手按兩眉後小空中三九過, 又以手心及指摩兩目下顴上, 以手提耳四十過, 摩令微熱, 輒以手逆乘額三九過, 從眉中上行入髮際, 以口嚥唾無數. 如此常行, 目卽淸明, 一年可夜讀書. 《養性》

Translation영역

Press with the hand on the little hollow behind both brows twenty-seven times; rub with the palm and fingers below both eyes and above the cheekbones; pull the ears forty times and rub them slightly warm; then run the hand up against the forehead twenty-seven times, from between the brows upward to the hairline; and swallow the saliva without counting. Do this regularly and the eyes become clear and bright — in a year one can read by night.

Yangseong 養性

3.29.6

Source원문

五色皆損目, 惟皂糊屛風可養目力. 《延壽》

Translation영역

All five colours injure the eye; only a screen pasted over in black can nurture the strength of the eyes.

Clinical note임상 주석

The regimen section, and it is the part of the chapter a modern reader can use. Palming — rubbing the hands warm and pressing them over closed eyes — is still taught; the orbital and temple massage described in the fifth entry traces the supraorbital notch, the infraorbital rim and the frontalis, which is where tension headache and eye strain actually sit; and the eye-rotation exercises of the two Perfected are what any orthoptist would recognize as a version of ocular mobility work, whatever the golden wheel was. The last line, that all colours tire the eye and only a plain black screen rests it, is a piece of advice about visual load that an ophthalmologist could give today, and the three years with the eyes closed is the same counsel pushed to its hopeless extreme.

Yeonsu 延壽

3.30 Fatal Signs in the Gaze 目視凶證

3.30.1

Source원문

病人目直視者死. 《扁鵲》

Translation영역

A sick person whose eyes stare straight ahead dies.

Pyeonjak 扁鵲

3.30.2

Source원문

瞳子高者, 太陽不足; 戴眼者, 太陽已絶. 此決死生之要, 不可不察也. 《內經》

Translation영역

Where the pupils are raised, the greater yang is insufficient; where the eyes are turned up, the greater yang is already cut off. This is the essential of deciding death from life, and must be looked into.

Naegyeong 內經

3.30.3

Source원문

太陽之脉, 其終也戴眼. 又曰, 足太陽氣絶者死, 必戴眼. 《內經》

Translation영역

The vessel of the greater yang, at its ending, turns the eyes up. It is also said: where the qi of the foot greater yang is cut off, the person dies, and the eyes will certainly be turned up.

Naegyeong 內經

3.30.4

Source원문

目內陷者死. 太陽之脉起於目內眥, 目內陷者, 太陽絶也, 故死. 《內經》

Translation영역

Where the eyes are sunken in, the person dies. The vessel of the greater yang arises at the inner corner of the eye, so sunken eyes are the greater yang cut off, and therefore death.

Naegyeong 內經

3.30.5

Source원문

眼胞忽陷定知亡. 《脉訣》

Translation영역

When the lids suddenly fall hollow, know for certain that he is going.

Maekgyeol 脉訣

3.30.6

Source원문

戴眼者, 目直視不能轉動也. 《綱目》

Translation영역

Eyes turned up means the eyes stare straight ahead and cannot be moved.

Gangmok 綱目

3.30.7

Source원문

藏府精華皆上注於目. 目直視者, 反目倒竄, 眼精上騰, 乃死證也. 《入門》

Translation영역

The flowering essence of the viscera and bowels all pours upward into the eye. Eyes staring straight ahead, with the eyes rolled back and bolting upward and the ocular essence mounting, is a fatal sign.

Immun 入門

3.30.8

Source원문

足少陽終者, 百節皆縱, 目睘絶系. 註曰, 目系絶, 故目不轉而直視. 睘謂直視如驚貌, 睘音瓊. 《內經》

Translation영역

Where the foot lesser yang comes to its end, all the hundred joints slacken and the eyes are staring, the tie cut off. The commentary says: the tie of the eye is cut off, so the eye does not turn and stares straight ahead. Staring means looking fixedly as if startled; the character is pronounced 'gyeong'.

Naegyeong 內經

3.30.9

Source원문

直視者, 視物而目睛不轉動者是也; 若目睛動者, 非直視也. 傷寒直視者, 邪氣壅盛, 藏府之氣不上榮於目, 則爲之直視, 多難治. 衂家不可發汗, 發汗則目直視不能瞬ㆍ不能眠, 猶未甚也; 逮狂言反目直視, 與直視揺頭, 皆藏府氣奪絶也, 卽死. 《綱目》

Translation영역

Staring straight ahead is looking at a thing with the eyeball not turning; if the eyeball moves, it is not a straight stare. A straight stare in cold damage is the evil qi congested and exuberant, so that the qi of the viscera and bowels does not rise to construct the eye — this is mostly hard to treat. One subject to nosebleeds must not be made to sweat; if made to sweat, the eyes stare straight ahead and cannot blink or sleep, and that is not yet the worst. But when it reaches raving speech with the eyes rolled back and staring, or a straight stare with the head shaking, the qi of the viscera and bowels is robbed and cut off, and death is immediate.

Clinical note임상 주석

The chapter's closing prognostic section, and the signs it names are the signs of brainstem failure and terminal dehydration. A fixed stare that does not follow, the eyes rolled up with the globes deviated, the lids suddenly sunken, raving with the head shaking — these are described exactly, and the judgement attached to each is correct: they mean death is close. The Gangmok's definition in the last entry is as careful as anything in the book, insisting that a stare only counts if the globe does not move, and its warning about sweating a patient prone to haemorrhage is sound in its own terms. The character gloss, with its reading given, is the Bogam's editor at work rather than the physician.

Gangmok 綱目

3.31 Medicines Dotted into the Eye 點眼藥

3.31.1

Source원문

凡點洗之法: 若暴赤腫ㆍ血壅氣滯者, 一時連點三五次; 如氣血稍虛者, 宜服藥以塞其源, 藥水洗之. 生有雲膜, 方可用點; 若無瞖膜, 但可洗之, 却忌過用凉藥及冷水洗滌. 至如鍼刀火烙, 古人忌用; 如金篦刮撥, 另是一家傳授, 不可妄施. 《入門》

Translation영역

The method of dotting and washing in general: where there is sudden redness and swelling with blood congested and qi stagnant, dot three to five times in succession at one sitting; where the qi and blood are somewhat vacuous, medicine should be taken to stop the source and a medicinal water used to wash. Only where a cloudy membrane has bred may dotting be used; if there is no screen and membrane, washing alone will do, and overuse of cooling medicines and washing with cold water are to be avoided. As for needle, knife and cautery, the ancients avoided using them; and the scraping and dislodging with the golden probe is a separate lineage's transmission and must not be applied rashly.

Immun 入門

3.31.2

Source원문

點藥有磨瞖膏ㆍ春雪膏ㆍ百點膏ㆍ還睛紫金丹ㆍ點瞖膏ㆍ三光膏ㆍ龍腦膏ㆍ蕤仁膏ㆍ明鏡膏ㆍ二百味花草膏ㆍ五膽膏ㆍ楓膏ㆍ石決明散ㆍ龍腦散ㆍ點爛弦風藥ㆍ點漏睛膿出藥ㆍ點蟹眼疼痛藥ㆍ點撞打傷眼藥ㆍ點眼生肉瞖藥.

Translation영역

The medicines for dotting are Maye-go, Chunseol-go, Baekjeom-go, Hwanjeong-jageum-dan, Jeomye-go, Samgwang-go, Yongnoe-go, Yuin-go, Myeonggyeong-go, Ibaekmi-hwacho-go, Odam-go, Pung-go, Seokgyeolmyeong-san, Yongnoe-san, the drops for raw lid margins, the drops for the leaking eye with pus coming out, the drops for crab-eye pain, the drops for an eye injured by a blow, and the drops for flesh and screen breeding in the eye.

Clinical note임상 주석

The opening entry is the chapter's protocol for topical treatment and it is unusually disciplined. Dotting is for an acute red eye with a corneal opacity already formed; where there is no opacity, washing only; cold water and an excess of cooling drops are themselves harmful. Then the three warnings: needle, knife and cautery are to be left alone, and the golden-probe couching of a cataract belongs to another lineage and must not be attempted by someone who has not been taught it. That is a physician declining a procedure on the grounds that he has not been trained in it, which is both rare in the literature and exactly right — couching a lens with a probe is a blinding operation in untrained hands. The nineteen preparations that follow include five named not for a drug but for an indication, which is how this section organizes the things no single formula covers.

Donguibogam · An

3.32 Medicines for Washing the Eye 洗眼藥

3.32.1

Source원문

洗眼宜湯泡散ㆍ洗眼湯ㆍ驅風散ㆍ廣大重明湯ㆍ五行湯ㆍ秦皮散.

Translation영역

For washing the eye, Tangpo-san, Sean-tang, Gupung-san, Gwangdae-jungmyeong-tang, Ohaeng-tang or Jinpi-san.

Clinical note임상 주석

One line of section, listing six washes. The eye bath is the gentler half of the chapter's external treatment — used where there is no corneal opacity and dotting would be wrong — and the six range from a simple warm infusion of copper-dish herbs to the Jinpi-san whose single drug, ash bark, carries the esculin and fraxin that still appear in European ophthalmic preparations.

Donguibogam · An

3.33 Medicines Treating Eye Disease Generally 通治眼病藥

3.33.1

Source원문

脾家受熱, 則眼胞赤腫; 神勞, 則眼睛痛; 心熱, 則血灌瞳人; 傷風, 則淚出; 虛煩, 則眼昏; 勞力, 則眥赤. 其生瘡, 乃風熱侵肺; 黃, 乃酒傷於脾. 最宜活變. 《入門》

Translation영역

When the spleen receives heat, the lids are red and swollen; when the spirit is taxed, the eyeball is painful; when the heart is hot, blood floods the pupil; when wind has done injury, tears run; in vacuity vexation, the eye is dim; from hard labour, the corners are red. That it breeds sores is wind heat invading the lung; that it is yellow is wine having injured the spleen. One should above all adapt and vary.

Immun 入門

3.33.2

Source원문

先賢治目昏見花, 如羊肝丸用羊肝引黃連等藥入肝, 解肝中諸欎. 肝欎解, 則目之玄府通利而明矣. 故黃連之類解熱欎也, 椒目之類解濕欎也, 茺蔚子之類解氣欎也, 芎歸之類解血欎也, 木賊之類解積欎也, 羌活之類解經欎也, 磁石之類解頭目欎ㆍ墜邪氣使下行也, 蔓菁子下氣通中, 理亦同也. 凡氣血欎則目昏, 河間之言信不誣矣. 《綱目》

Translation영역

The worthies of old, in treating a dim eye seeing flowers — as in Yanggan-hwan, which uses sheep's liver to draw coptis and the other drugs into the liver — resolved the several depressions within the liver. The liver's depression resolved, the dark palaces of the eye pass freely and it sees clearly. So coptis and its like resolve heat depression; zanthoxylum seed and its like, damp depression; leonurus seed and its like, qi depression; chuanxiong and tangkuei, blood depression; horsetail and its like, accumulation depression; notopterygium and its like, channel depression; loadstone and its like resolve depression of the head and eyes and bear the evil qi downward; and turnip seed, which sends qi down and frees the centre, works on the same principle. Whenever qi and blood are depressed, the eye is dim: Hejian's words are to be trusted and are no falsehood.

Gangmok 綱目

3.33.3

Source원문

內外障諸證通治, 宜還睛丸ㆍ神仙退雲丸方見上ㆍ撥雲退瞖還睛丸方見上ㆍ固本還睛丸ㆍ大明復光散ㆍ石膏羌活散ㆍ速效散方見上ㆍ石決明散方見上ㆍ加減撥雲散ㆍ通聖散加減法.

Translation영역

For treating all the patterns of internal and external obstruction generally, Hwanjeong-hwan, Sinseon-toeun-hwan, Balun-toeye-hwanjeong-hwan, Gobon-hwanjeong-hwan, Daemyeong-bokgwang-san, Seokgo-ganghwal-san, Sokhyo-san, Seokgyeolmyeong-san, Gagam-baldun-san, or the Tongseong-san added and subtracted.

Donguibogam · An

3.33.4

Source원문

凡補腎治眼之藥, 必須於五更初腎氣開ㆍ未言語前服之乃效. 《直指》

Translation영역

Every medicine that supplements the kidney to treat the eye must be taken at the beginning of the fifth watch, when the kidney qi opens, and before a word has been spoken — only then is it effective.

Clinical note임상 주석

The second entry is the chapter's most interesting piece of pharmacological reasoning: a single mechanism, depression, with a drug class assigned to each kind of it, and sheep's liver used as a carrier to take the other drugs where they are wanted. The idea that a food substance directs a formula to an organ is not pharmacokinetics, but the structure of the argument — one pathology, seven agents differentiated by what they unblock — is as close to a rational materia medica as the eye chapter comes, and it closes by endorsing Hejian's dark-palace theory by name. The last entry, on taking kidney-supplementing medicines at the fifth watch before speaking, is chronotherapy on doctrinal rather than observed grounds, and the insistence on silence tells you which it is.

Jikji 直指

3.34 Simple Medicinals 單方

3.34.1

Source원문

凡五十種. 有白龍散ㆍ立消散ㆍ鹽朮散.

Translation영역

Fifty kinds in all. Among them are White Dragon Powder, Disperse at Once Powder and Salt and Atractylodes Powder.

Clinical note임상 주석

The head of the section names three compound powders that are counted among the simple medicinals, because each is built on one of them and is given under it: White Dragon Powder under mirabilite, Disperse at Once Powder under salt, and Salt and Atractylodes Powder under atractylodes. 單方 in this chapter therefore means one principal drug rather than one ingredient.

Donguibogam · An

3.34.2

Source원문

馬牙硝 去眼赤腫ㆍ生瞖障ㆍ澁淚痛. 爲末點眼良. 《本草》 ○白龍散, 明目退瞖. 馬牙硝厚紙裹, 在懷內着肉養一百二十日, 取硏如粉, 入龍腦少許, 取兩米許點目中. 治眼昏生瞖, 瞳人不破者, 幷醫得. 《本草》

Translation영역

Mirabilite (馬牙硝): Removes redness and swelling of the eye, screens and shades that form on it, and roughness with tearing and pain. Powder it and apply it to the eye — good. ○ Baengnyong-san 白龍散 brightens the eyes and drives back screens. Mirabilite wrapped in thick paper, carried inside the clothes against the flesh and nurtured for a hundred and twenty days, then ground to a powder with a little borneol added; take about two grains' worth and apply it in the eye. It treats clouded vision with a screen forming, and wherever the pupil is not destroyed a cure can be had.

Clinical note임상 주석

The hundred and twenty days against the skin is the strangest instruction in the section and it has a pharmaceutical point: mirabilite is sodium sulphate decahydrate, and held at body heat in paper it slowly loses its water of crystallization and crumbles to a fine anhydrous powder. What the method produces is a powder soft enough to put in an eye, which is what the entry is for.

Boncho 本草

3.34.3

Source원문

空靑空靑法木, 故色靑而入肝. 主靑盲, 明目, 去瞖膜. 瞳人破者, 再得見物. 其殼入磨瞖膏, 神效. 《本草》

Translation영역

Azurite (空靑): Azurite takes wood as its model, and so its colour is blue-green and it enters the liver. It governs blue blindness, brightens the eyes and removes screens and membranes. Even where the pupil is destroyed, sight of things may be had again. Its shell put into Grind-Away-the-Screen Paste is miraculously effective.

Clinical note임상 주석

法木, taking wood as its model — the colour is blue-green, blue-green belongs to wood, wood is the liver, and the liver opens into the eyes. The whole indication is derived from the colour, and the claim that a destroyed pupil may see again is the point at which that reasoning has clearly outrun observation. Azurite is a basic copper carbonate, so the astringent and antibacterial action of the copper salts is real; restoring a ruptured globe is not.

Boncho 本草

3.34.4

Source원문

鹽煎湯, 乘溫洗眼, 去昏赤. 蓋鹽能散血故也. 《直指》 ○立消散, 治浮瞖ㆍ粟瞖ㆍ霧膜遮睛. 雪白鹽硏極細, 以燈心草蘸鹽, 輕輕點瞖上, 屢效. 《直指》 ○早起以鹽湯漱齒吐, 以洗眼, 最能明目固齒. 《本草》

Translation영역

Salt (鹽): Decoct it and wash the eyes with it while it is still warm; it removes clouding and redness — for salt is able to disperse blood. ○ Ipso-san 立消散 treats floating screens, millet screens and a misty membrane veiling the pupil. Snow-white salt ground extremely fine; dip a rush pith in the salt and apply it gently on the screen — effective time and again. ○ On rising in the morning, rinse the teeth with salt water and spit it out, then wash the eyes with it; nothing is better for brightening the eyes and firming the teeth.

Clinical note임상 주석

Warm saline as an eye wash is still what an eye is irrigated with, and the third method — salt water for the teeth first and then the eyes — is a morning routine rather than a treatment. The second is the one to be careful of: dry salt crystals rubbed onto a corneal opacity with a rush pith would abrade the epithelium, which is presumably why 屢效, effective time and again, is claimed for it.

Jikji 直指 · Boncho 本草

3.34.5

Source원문

靑鹽明目. 煎湯洗眼良. 《本草》 ○目澁, 以鹽精揩目而愈. 鹽精尙爾, 況靑鹽乎? 煎湯洗ㆍ入藥服幷佳. 《資生》

Translation영역

Blue rock salt (靑鹽): Brightens the eyes. Decoct it and wash the eyes with it — good. ○ For a rough eye, rubbing the eye with salt crystal cures it. If salt crystal does this much, how much more blue rock salt? Decocted as a wash, or put into medicine and taken, both are good.

Boncho 本草 · Jasaenggyeong 資生

3.34.6

Source원문

白礬治目瞖及努肉. 取明礬黍米大, 納眼中, 淚出拭之, 日久自消. 《本草》

Translation영역

Alum (白礬): Treats screens on the eye and excrescent flesh. Take clear alum the size of a millet grain, put it into the eye, and when the tears come wipe them away; in time it dissolves of itself.

Boncho 本草

3.34.7

Source원문

銅靑卽銅綠也. 明目, 去膚赤ㆍ息肉, 又治爛弦風. 白礬煆一兩ㆍ銅靑三錢, 同硏細, 每取半錢, 以熱湯一合泡澄, 溫洗眼. 初必澁, 但閉目坐待, 澁止自然眼開, 有效. 一日洗四五次. 《得效》

Translation영역

Verdigris (銅靑): That is, copper rust. It brightens the eyes, removes film and redness and proud flesh, and also treats the ulcerated-lid wind. Alum, calcined, 1 nyang; verdigris 3 don; ground fine together; take half a don each time, steep it in a hop of hot water and let it settle, and wash the eyes with it warm. At first it is bound to sting; just sit with the eyes closed and wait, and when the stinging stops the eyes open of themselves — it is effective. Wash four or five times a day.

Clinical note임상 주석

爛弦風, the ulcerated-lid wind, is blepharitis, and a dilute copper-and-alum lotion is a plausible treatment for it — copper salts are antibacterial and alum astringent, and weak copper sulphate drops were standard ophthalmic practice into the twentieth century. The instruction about the sting is good clinical sense: it tells the patient what to expect and gives them something to do instead of rubbing the eye.

Deukhyo 得效

3.34.8

Source원문

井華水 洗目赤, 去膚瞖. ○眼睛無故腫脹突出一二寸, 以井華水灌漬眼中, 頻爲之, 睛自入. 新汲水亦可. 仍以麥門冬ㆍ桑白皮ㆍ梔子仁水煎服. 《本草》

Translation영역

Dawn-drawn well water (井華水): Washes redness from the eye and removes film and screens. ○ Where the eyeball swells and protrudes an inch or two for no reason: pour dawn-drawn well water into the eye and let it soak, doing so repeatedly, and the eyeball goes back in of itself. Newly drawn water will serve as well. Then take ophiopogon, mulberry root bark and gardenia kernel decocted in water.

Clinical note임상 주석

An eyeball protruding an inch or two is acute proptosis, and the two causes that present that way — orbital cellulitis and a retrobulbar haemorrhage — are both emergencies that cold irrigation will not touch. What is sound in the entry is the internal prescription: ophiopogon, mulberry root bark and gardenia are the chapter's standing trio for heat in the lung and liver, and in an orbital infection cooling and draining is at least aimed at the right thing.

Boncho 本草

3.34.9

Source원문

鵬砂冶努肉瘀突. 鵬砂一錢ㆍ龍腦半分, 爲末, 以燈心草蘸點肉上, 日三. 《入門》

Translation영역

Borax (鵬砂): Treats excrescent flesh risen in a stagnant lump. Borax 1 don, borneol half a pun, powdered; dip a rush pith in it and apply it on the flesh, three times a day.

Clinical note임상 주석

Borax with borneol is the pair the whole corpus uses for anything applied to the surface of the eye, and it survives in Korean and Chinese practice as a mild ophthalmic antiseptic. 努肉瘀突 — excrescent flesh risen in a stagnant lump — is a pterygium or a pinguecula, and powdering it three times a day will not remove it; what the preparation does is settle the inflammation around it.

Immun 入門

3.34.10

Source원문

爐甘石 治風眼流淚不止. 爐甘石ㆍ烏賊魚骨等分, 入龍腦少許, 爲細末, 點眼中, 其淚卽止. 《入門》

Translation영역

Calamine (爐甘石): Treats a wind eye with tearing that will not stop. Calamine and cuttlefish bone in equal parts, with a little borneol added, powdered fine and applied in the eye; the tearing stops at once.

Clinical note임상 주석

Calamine is zinc carbonate, and zinc sulphate eye lotion was in the pharmacopoeias within living memory for exactly this complaint — a chronically irritated, watering eye. The cuttlefish bone is calcium carbonate and acts as the abrasive and the bulk.

Immun 入門

3.34.11

Source원문

石菖蒲 治飛絲入眼腫痛. 以菖蒲槌破, 如入左目塞右鼻中, 如入右目塞左鼻中, 卽效. 《得效》

Translation영역

Acorus (石菖蒲): Treats a flying thread entering the eye with swelling and pain. Crush acorus; if it went into the left eye plug the right nostril with it, and if into the right eye plug the left — it takes effect at once.

Clinical note임상 주석

The crossed sides are the point: this is the contralateral-nostril method the corpus uses whenever something must be drawn out of one eye, and the mechanism it is counting on is the sneeze and the flood of tears that a pungent aromatic in the nose produces. Washing a foreign body out with the eye's own tears is sound; which nostril it is put in is not.

Deukhyo 得效

3.34.12

Source원문

甘菊去瞖膜, 明目, 養目血, 治內障, 止風淚. 末服ㆍ煎服幷佳. 《本草》

Translation영역

Chrysanthemum (甘菊): Removes screens and membranes, brightens the eyes, nourishes the blood of the eyes, treats the inner shade and stops wind tearing. Powdered or decocted, both are good.

Clinical note임상 주석

養目血 is the phrase that sets chrysanthemum apart from everything else in this section: it is the one drug here given for the eye from the inside rather than applied to it, and it is in nearly every formula in the chapter for that reason. 杞菊地黃丸 is built on it, and the indication — a dry, tired, watering eye in someone whose liver blood is thin — is still where it is used.

Boncho 本草

3.34.13

Source원문

蒼朮治內外障. 蒼朮四兩剉ㆍ靑鹽一兩, 同炒黃, 去鹽, 木賊二兩童便製, 同爲末, 每一錢, 溫米泔調下, 日二三, 最驗, 名鹽朮散. 《直指》 ○治雀目. 蒼朮末三錢, 猪肝二兩, 批開糝藥, 麻線縛定, 粟米一合ㆍ水一椀, 煮熟, 取以熏眼, 後喫之, 大效. 《綱目》

Translation영역

Black atractylodes (蒼朮): Treats both the inner and the outer shade. Black atractylodes 4 nyang, cut up, and blue rock salt 1 nyang, stir-fried together until yellow and the salt then discarded; horsetail 2 nyang, processed with child's urine; powdered together, and 1 don taken each time stirred into warm rice-washing water, two or three times a day — most proven. It is called Yeomchul-san 鹽朮散, Salt and Atractylodes Powder. ○ For sparrow eye: black atractylodes powder 3 don and pig's liver 2 nyang, the liver split open and the powder sprinkled in, bound with hemp thread and boiled through with 1 hop of millet and a bowl of water; take it, steam the eyes over it, and then eat it — greatly effective.

Clinical note임상 주석

The second method is the best piece of medicine in the section. 雀目, sparrow eye, is night blindness, and night blindness is vitamin A deficiency; liver is the richest food source of vitamin A there is. Two nyang of pig's liver eaten repeatedly will cure it, and the same remedy appears under pig's liver, ox liver, sheep's liver and rabbit's liver further down — four separate entries arriving at the same correct answer. The steaming of the eyes over the pot does nothing; the eating does everything.

Jikji 直指 · Gangmok 綱目

3.34.14

Source원문

草龍膽 治兩目赤腫ㆍ睛脹ㆍ生瞖膜ㆍ瘀肉高起ㆍ痛不可忍. 眼疾必用之藥. 丸服ㆍ煎服皆佳. 《湯液》

Translation영역

Gentian (草龍膽): Treats both eyes red and swollen, the eyeball distended, screens and membranes forming, stagnant flesh risen high, and pain beyond bearing. It is a medicine that must be used in eye disease. Pilled or decocted, both are good.

Clinical note임상 주석

眼疾必用之藥, the medicine that must be used in eye disease — the same formula the 大便 chapter uses of peony in dysentery. Gentian is the bitterest cold drug in the materia medica and the indication is an acutely red, distended, agonizing eye, which is the picture of acute glaucoma or of a severe uveitis. A bitter cold purge is the tradition's answer to both.

Tangaek 湯液

3.34.15

Source원문

細辛明目. 得草決明ㆍ鯉魚膽ㆍ靑羊肝, 共療目痛. 《本草》

Translation영역

Asarum (細辛): Brightens the eyes. With cassia seed, carp gall and sheep's liver it cures pain in the eyes.

Boncho 本草

3.34.16

Source원문

黃連明目. 主靑盲ㆍ障瞖ㆍ熱氣目痛ㆍ眥爛淚出. 煎服ㆍ末服幷佳. ○黃連浸乳汁點眼, 治目中百病. ○眥傷淚出, 黃連煎汁, 漬綿頻拭眼, 妙. 《本草》

Translation영역

Coptis (黃連): Brightens the eyes. It governs blue blindness, shades and screens, pain in the eyes from heat qi, and ulcerated canthi with tearing. Decocted or powdered, both are good. ○ Coptis steeped in breast milk and applied to the eye treats a hundred diseases of the eye. ○ For an injured canthus with tearing: decoct coptis, soak cotton wool in the liquid and wipe the eye with it repeatedly — excellent.

Clinical note임상 주석

Coptis steeped in breast milk is the corpus's most frequently repeated eye preparation, and the vehicle is not sentimental: milk is isotonic, buffered and protein-rich, so it is far kinder to a cornea than water, and berberine, which is what coptis contributes, is a genuine antibacterial. Berberine eye drops were in common use in East Asia until recently for bacterial conjunctivitis and trachoma.

Boncho 本草

3.34.17

Source원문

決明子 主靑盲及目中淫膚ㆍ雲瞖ㆍ赤白膜ㆍ腫痛淚出, 除肝家熱. 每朝取一匙, 挼令淨, 空心呑之, 百日夜見物. ○久年失明, 決明子二升, 擣末, 每二錢, 食後米飮調下, 妙. ○決明葉作菜常食, 最明目. 《本草》 ○治雀目. 決明子一兩ㆍ地膚子五錢, 爲末, 粥丸服之差. 《千金》

Translation영역

Cassia seed (決明子): Governs blue blindness and overgrown film in the eye, cloud screens, red and white membranes, and swelling with pain and tearing; it removes heat from the liver. Each morning take a spoonful, rub it clean and swallow it on an empty stomach, and in a hundred days one sees things at night. ○ For a blindness of many years: cassia seed 2 seung, pounded to a powder, 2 don each time taken after food stirred into rice water — excellent. ○ Cassia leaves made into a vegetable and eaten regularly are best of all for brightening the eyes. ○ For sparrow eye: cassia seed 1 nyang and broom cypress seed 5 don, powdered and made into pills with gruel, taken — it cures.

Clinical note임상 주석

百日夜見物 — in a hundred days one sees at night — is the same claim as the pig's-liver method above, and the drug named is the one the chapter calls 草決明, the seed that "opens up" sight. Cassia seed is not a source of vitamin A, so the night-vision claim does not transfer; what carries it is probably the leaves, 決明葉作菜常食, since dark leafy greens are a real source of the carotenoids the retina needs.

Boncho 本草 · Cheongeum 千金

3.34.18

Source원문

靑箱子 治肝藏熱毒衝眼, 生赤障瞖ㆍ靑盲及腫, 又治內障. 炒爲末, 每一錢, 米飮調下. 《本草》

Translation영역

Celosia seed (靑箱子): Treats heat toxin in the liver viscus surging into the eye, with red shades and screens forming, blue blindness and swelling; it also treats the inner shade. Stir-fry and powder it, and take 1 don each time stirred into rice water.

Boncho 本草

3.34.19

Source원문

木賊益肝膽, 明目, 治目疾, 退瞖膜. 童便浸一宿, 曬乾去節, 爲末點服, 或煎服幷佳. 《本草》

Translation영역

Horsetail (木賊): Benefits the liver and gallbladder, brightens the eyes, treats eye disease and drives back screens and membranes. Steep it in child's urine for a night, dry it in the sun and remove the nodes; powdered and taken, or decocted and taken, both are good.

Boncho 本草

3.34.20

Source원문

夏枯草 治目睛痛, 至夜則甚. 夏枯草五錢ㆍ香附子一兩, 爲末, 每一錢, 茶淸調下. 《本草》 ○此草三四月開花, 遇夏至陰生則枯, 稟純陽之氣, 有補養厥陰血脉之功, 故治黑睛疼如神者, 以陽治陰故也. 《綱目》

Translation영역

Selfheal (夏枯草): Treats pain in the eyeball that grows worse towards night. Selfheal 5 don and cyperus 1 nyang, powdered, 1 don each time stirred into clear tea. ○ This plant flowers in the third and fourth months and withers when the summer solstice comes and yin is engendered. It receives the qi of pure yang, and so it has the power to supplement and nourish the blood vessels of the reverting yin; and that it treats pain of the black of the eye as if by a spirit is because yang is used to treat yin.

Clinical note임상 주석

至夜則甚, worse towards night, is the key sign and the reasoning is built entirely on it: a pain that worsens as yin rises is treated with a plant that lives in the yang half of the year and dies when yin begins. Whatever one makes of the argument, the clinical observation it starts from is a real one — scleritis and uveitis both characteristically worsen at night — and selfheal with cyperus remains a standard pair for a deep, boring eye pain.

Boncho 本草 · Gangmok 綱目

3.34.21

Source원문

槐實明目, 去昏暗. 十月上巳日採槐角, 納缸中, 漬牛膽汁, 封口, 經百日取出. 初服一枚, 空心呑下; 再服二枚, 三日三枚, 十日服十枚, 還從一枚始. 久服良. 《本草》

Translation영역

Pagoda tree fruit (槐實): Brightens the eyes and removes dimness. On the first snake day of the tenth month gather the pagoda tree pods, put them in a jar, steep them in ox bile, seal the mouth and after a hundred days take them out. For the first dose take one pod, swallowed on an empty stomach; for the second, two; on the third day three; by the tenth day ten; then begin again from one. Taken over a long time it is good.

Clinical note임상 주석

A ten-day ladder up and then back to the beginning — the dosing schedule is the whole method, and it is the only one in the section built that way. Pagoda tree pods are strongly purgative, which is why the dose has to be worked up and then reset rather than simply increased.

Boncho 本草

3.34.22

Source원문

楮實子 治肝熱生瞖, 亦治氣瞖細點, 又治攀睛瞖膜. 硏爲細末, 蜜湯調下一錢, 食後. 《直指》

Translation영역

Paper mulberry fruit (楮實子): Treats screens forming from liver heat; it also treats the qi screen with its fine specks, and the climbing-over-the-pupil screen and membrane. Grind it to a fine powder and take 1 don after food, stirred into honey water.

Jikji 直指

3.34.23

Source원문

黃栢治目熱赤痛多淚, 洗肝明目. 煎湯洗眼甚效. 《本草》 ○栢皮拌乳汁煨, 絞取汁點眼, 痛甚妙. 《綱目》

Translation영역

Phellodendron (黃栢): Treats heat in the eye with redness, pain and much tearing; it washes the liver and brightens the eyes. Decocted as an eye wash it is very effective. ○ Phellodendron bark mixed with breast milk and roasted in the embers, the juice pressed out and applied to the eye — for pain it is excellent.

Boncho 本草 · Gangmok 綱目

3.34.24

Source원문

桑枝煎湯 治靑盲, 令視物如鷹鶻. 正月八日ㆍ二月八日ㆍ三月六日ㆍ四月六日ㆍ五月五日ㆍ六月二日ㆍ七月七日ㆍ八月二十五日ㆍ九月十二日ㆍ十月十二日ㆍ十一月二十七日ㆍ十二月晦日, 每遇上件神日, 用桑柴灰一合, 以沸湯沃之, 磁器中令澄淸, 稍溫洗之. 如冷再溫洗, 神效. 《本草》 ○迎風冷淚, 冬桑不凋葉, 銅器煎湯, 溫洗眼. 《綱目》

Translation영역

Mulberry twig decoction (桑枝煎湯): Treats blue blindness and makes one see things as a hawk or a falcon does. The eighth of the first month, the eighth of the second, the sixth of the third, the sixth of the fourth, the fifth of the fifth, the second of the sixth, the seventh of the seventh, the twenty-fifth of the eighth, the twelfth of the ninth, the twelfth of the tenth, the twenty-seventh of the eleventh, and the last day of the twelfth month: on each of these spirit days, take 1 hop of mulberry-wood ash, pour boiling water over it, let it settle clear in a porcelain vessel, and wash with it slightly warm. If it goes cold, warm it and wash again — miraculously effective. ○ For cold tears on facing the wind: the winter mulberry leaves that have not fallen, decocted in a copper vessel, and the eyes washed with it warm.

Clinical note임상 주석

Twelve fixed dates in the year on which alone the wash is to be used — the only entry in the section governed by a calendar, and nothing in the method depends on the day. What the method does produce is a strongly alkaline lye: wood ash steeped in boiling water gives potassium carbonate solution, and even decanted clear that is a caustic to put near an eye. The second method, warm mulberry-leaf decoction for a watering eye in cold wind, is harmless and reasonable.

Boncho 本草 · Gangmok 綱目

3.34.25

Source원문

竹瀝治目赤眥痛不得開, 或生瞖障. 竹瀝浸黃連一宿, 取汁點眼. 《本草》

Translation영역

Bamboo sap (竹瀝): Treats a red eye with the canthi so painful it cannot be opened, or a screen and shade forming. Steep coptis in bamboo sap for a night and apply the liquid to the eye.

Boncho 本草

3.34.26

Source원문

秦皮主目中靑瞖白膜, 去兩目赤腫痛淚不止. 秦皮一升, 水煎澄淸, 冷洗極效, 益睛明目. ○赤眼及睛上瘡, 或生瞖暈, 秦皮一兩, 水一升浸之, 看碧色出, 以綿纏子仰卧點眼中, 微疼不妨, 良久瀝去熱汁, 更點新者, 每日十度, 不過兩日差. 《本草》

Translation영역

Ash bark (秦皮): Governs blue-green screens and white membranes in the eye, and removes redness, swelling, pain and unceasing tearing from both eyes. Ash bark 1 seung, decocted in water and let settle clear, used cold as a wash, is extremely effective, and it benefits the pupil and brightens the eyes. ○ For a red eye, or sores on the eyeball, or a screen with a halo forming: ash bark 1 nyang steeped in 1 seung of water, and when the blue-green colour is seen to come out, wind cotton wool on a stick and, lying on the back, apply it in the eye. A slight pain does no harm; after a good while let the heated liquid drain away and apply fresh, ten times a day — in not more than two days it is cured.

Clinical note임상 주석

The second method is the most carefully described eye treatment in the section — the patient supine, cotton on a stick, the liquid replaced as it warms, ten applications a day, a cure expected in two days. 看碧色出, watching for the blue-green colour to come out, is the extraction endpoint: ash bark contains aesculin and fraxin, which fluoresce blue in water, so the colour genuinely marks when the active principles have come across. This is the closest thing in the chapter to a standardized preparation.

Boncho 本草

3.34.27

Source원문

五倍子 治風毒上攻, 眼腫痒痛, 兩瞼赤爛, 浮瞖瘀肉侵睛. 五倍子一兩ㆍ蔓荊子一兩半, 爲末, 每二錢, 水二盞, 銅石器煎至一盞, 澄熱淋洗目二三, 大能明目, 去澁痒. 《本草》

Translation영역

Chinese gall (五倍子): Treats wind toxin surging upward, with the eye swollen, itching and painful, both lids red and ulcerated, and floating screens and stagnant flesh encroaching on the pupil. Chinese gall 1 nyang and vitex fruit 1½ nyang, powdered; 2 don each time with 2 jan of water, decocted in a copper or stone vessel down to 1 jan, settled and used hot to bathe the eye two or three times. It is greatly able to brighten the eyes and to remove the roughness and itching.

Boncho 本草

3.34.28

Source원문

石決明 主靑盲障瞖. 取殼水漬洗眼明目; 火煆硏水飛, 點眼磨去瞖膜. ○肉則鰒魚, 啖之明目. 《本草》

Translation영역

Abalone shell (石決明): Governs blue blindness with shades and screens. Take the shell, steep it in water and wash the eyes with it to brighten them; or calcine it in the fire, grind it and levigate it in water, and apply it to the eye to grind away screens and membranes. ○ The flesh is the abalone; eating it brightens the eyes.

Clinical note임상 주석

石決明, the stone that opens up sight, is named on the same pattern as 草決明, the plant that does — and the pairing is how the chapter organizes its two chief eye drugs, one mineral and one botanical. Water levigation, 水飛, is the preparation that matters: the calcined shell is ground under water and only the fraction that stays in suspension is kept, which is the only way to get a mineral powder fine enough not to scratch a cornea.

Boncho 本草

3.34.29

Source원문

鯉魚膽 主目熱赤痛ㆍ靑盲瞖障, 點眼最良. ○雀目, 膽及腦點之, 燥痛卽明. 《本草》

Translation영역

Carp gall (鯉魚膽): Governs heat in the eye with redness and pain, and blue blindness with screens and shades; applied to the eye it is best of all. ○ For sparrow eye, apply the gall and the brain; the dryness and pain go and sight comes at once.

Clinical note임상 주석

Another of the section's night-blindness remedies, and another that is right for reasons the text does not state: fish liver and the fat around the brain are among the densest natural sources of vitamin A, which is why cod liver oil became the standard treatment. The bile itself is not the active part, but it comes out of the fish with the liver.

Boncho 本草

3.34.30

Source원문

蠐螬主目中淫膚ㆍ靑瞖白膜, 又去瞖障, 療靑盲. 取汁滴目中. 又焙乾作末服. 盛彦母食之, 眼復明. 雖是孝感, 亦物性宜然. ○稻麥芒入眼不出, 以新布覆目上, 取蠐螬從布上摩之, 其芒出着布上, 良. 《本草》

Translation영역

Beetle grub (蠐螬): Governs overgrown film in the eye and blue-green screens and white membranes; it also removes screens and shades and cures blue blindness. Take the juice and drop it into the eye. Or dry it over a fire, powder it and take it. Seong Eon's mother ate it and her sight came back. Though that was the response to filial devotion, it is also what the nature of the thing would do. ○ Where a husk of rice or barley has entered the eye and will not come out: lay fresh cloth over the eye and rub a grub over it through the cloth, and the husk comes out and sticks to the cloth — good.

Clinical note임상 주석

The second method is sound and the mechanism is obvious once stated: a grub rubbed over fine cloth leaves it tacky, and a tacky surface laid against the eye lifts a loose husk off the conjunctiva. It is the same principle as a cotton bud, with the adhesive supplied by the insect. 雖是孝感, 亦物性宜然 — though that was the response to filial devotion, it is also what the nature of the thing would do — is the compiler quietly declining to let a miracle story stand in for a pharmacological claim.

Boncho 本草

3.34.31

Source원문

烏賊魚骨 主目中浮瞖及赤白瞖. 硏水飛, 和蜜點之, 入少龍腦尤佳. 《本草》

Translation영역

Cuttlefish bone (烏賊魚骨): Governs floating screens in the eye and red and white screens. Grind it and levigate it in water, mix it with honey and apply; with a little borneol added it is better still.

Boncho 本草

3.34.32

Source원문

夜明砂 蝙蝠屎也. 治內外障, 明目, 去昏花. 淘洗焙爲末, 或丸服或散服良. 《本草》

Translation영역

Bat droppings (夜明砂): That is, bat dung. It treats both the inner and the outer shade, brightens the eyes and removes clouding and flowering of vision. Wash it clean, dry it over a fire and powder it; taken as pills or as a powder, both are good.

Clinical note임상 주석

夜明, night brightness — the name records the reasoning, that a creature which sees in the dark confers the same. And the reasoning, by an accident the tradition could not have known, lands near something true: bat guano is largely insect remains, and insect cuticle carries carotenoids. It is a poor source compared with the liver entries above, but it is not nothing.

Boncho 本草

3.34.33

Source원문

田螺汁 主肝熱目赤腫痛. 大田螺水養去泥, 擘去掩, 入黃連末一錢ㆍ麝香少許在內, 仰置地上, 露一宿, 次日以雞羽蘸螺中汁刷病眼上, 卽差. 《綱目》

Translation영역

Rice-field snail juice (田螺汁): Governs liver heat with the eye red, swollen and painful. Keep a large rice-field snail in water until the mud is out, prise off and discard the operculum, put inside it coptis powder 1 don and a little musk, set it face up on the ground and leave it a night in the dew; next day dip a chicken feather in the liquid within the shell and brush it over the diseased eye — it is cured at once.

Clinical note임상 주석

The snail is the vessel, not the drug. Left overnight it dissolves into a viscous fluid that holds the coptis powder in suspension — in effect a gel preparation, which stays on the eye far longer than a watery drop. The chicken feather as applicator is soft enough not to scratch, and the active principle is still the berberine of the coptis.

Gangmok 綱目

3.34.34

Source원문

蜣蜋沙塵入眼不可出. 取蜣蜋一枚, 手持其背, 於眼上影之, 沙塵自出. 《本草》

Translation영역

Dung beetle (蜣蜋): Where sand or grit has entered the eye and cannot be got out. Take one dung beetle, hold it by the back and cast its shadow over the eye, and the sand comes out of itself.

Clinical note임상 주석

A piece of sympathetic magic set directly beside the grub entry above, which solves the same problem by a method that works. The two sitting together is a fair picture of what this literature is: observation and analogy recorded side by side without the compiler marking which is which.

Boncho 本草

3.34.35

Source원문

梨汁卒患赤目生努肉. 好梨一箇, 擣絞汁, 黃連三枝剉, 綿裹浸之, 候色黃, 取以點目中. 《綱目》

Translation영역

Pear juice (梨汁): For a sudden red eye with excrescent flesh forming. One good pear, pounded and the juice pressed out; coptis, three pieces, cut up, wrapped in cotton wool and steeped in it, and when the colour turns yellow take it and apply it in the eye.

Clinical note임상 주석

候色黃, waiting for the colour to turn yellow, is the same extraction endpoint as the blue-green of the ash bark above — berberine is bright yellow, so the colour tells the preparer when enough has come out of the root. Pear juice is slightly acid and sugary and makes a tolerable vehicle.

Gangmok 綱目

3.34.36

Source원문

大麥汁 麥芒入目不出. 煮大麥取汁洗之, 卽出. 《本草》

Translation영역

Barley water (大麥汁): Where a barley husk has entered the eye and will not come out. Boil barley, take the liquid and wash the eye with it, and it comes out at once.

Clinical note임상 주석

Barley water to wash out a barley husk — the like-cures-like logic is explicit, and this time it happens to be good practice: a mucilaginous, roughly isotonic liquid is a better irrigant than plain water, and copious irrigation is still the first thing done for a foreign body on the conjunctiva.

Boncho 本草

3.34.37

Source원문

蔓菁子 主靑盲, 能明目洞視, 但瞳子不壞者, 十得九愈. 取子六升蒸之, 以釜中熱湯淋之, 曝乾, 又淋, 如是三遍, 乃擣爲末, 食後酒服二錢, 日再. ○蔓菁子三升ㆍ醋三升, 煮熟, 目乾擣末, 井華水服一二錢, 日三次, 服盡夜能視物. 《本草》

Translation영역

Turnip seed (蔓菁子): Governs blue blindness, and is able to brighten the eyes and give piercing sight; provided only that the pupil is not destroyed, nine in ten are cured. Take 6 seung of the seed and steam it, pour the hot water from the cauldron over it, dry it in the sun, pour again, and so three times over; then pound it to a powder and take 2 don in wine after food, twice a day. ○ Turnip seed 3 seung and vinegar 3 seung, boiled through and dried, pounded to a powder and taken 1 or 2 don in dawn-drawn well water, three times a day; when the course is finished one can see things at night.

Boncho 本草

3.34.38

Source원문

薺菜子 一名菥蓂子. 主靑盲不見物, 明目, 去瞖障. 擣爲末, 散服丸服皆佳. ○根療目疼, 作羹常食, 作葅亦佳. ○暴赤眼痛磣, 取薺菜根汁點目中, 差. 《本草》

Translation영역

Shepherd's purse seed (薺菜子): Also called pennycress seed. It governs blue blindness with inability to see things, brightens the eyes and removes screens and shades. Pound it to a powder; taken as a powder or as pills, both are good. ○ The root cures pain in the eyes; make a soup of it and eat it regularly, and pickled it is also good. ○ For a sudden red eye, painful and gritty: take the juice of shepherd's purse root and apply it in the eye — it cures.

Boncho 本草

3.34.39

Source원문

首生男子乳 療目赤痛多淚, 點之佳. ○乳汁治目之功多, 何也? 人心生血, 肝藏血, 肝受血則能視. 蓋水入於經, 其血乃成. 又曰, 上爲乳汁, 下爲月水. 故知乳汁則血也. 用以點目, 豈不宜哉? 《本草》

Translation영역

Milk of a woman whose first child is a son (首生男子乳): Cures a red eye with pain and much tearing; applied to the eye it is good. ○ Why is the power of breast milk to treat the eyes so great? The heart in a person engenders blood, the liver stores blood, and when the liver receives blood one can see. For water enters the channels and the blood is thereby formed. And it is said: above it becomes milk, below it becomes the menses. So we know that milk is blood. Used to apply to the eye, how could it not be fitting?

Clinical note임상 주석

The argument is laid out step by step, which is unusual for this literature, and the conclusion — that milk is blood in another form, so milk feeds the eye as blood does — is a piece of pure physiological reasoning. It is wrong about where milk comes from and right about what to put in an eye: human milk is isotonic, buffered near the tear film's own pH, rich in immunoglobulin A and lysozyme, and it is still used in some places for infant conjunctivitis. The stipulation that the woman's first child be a son carries no weight at all.

Boncho 本草

3.34.40

Source원문

人尿主明目, 去赤腫昏瞖. 童子尿服之ㆍ洗之佳. 《本草》 ○余平生有赤眼之患, 用之如神. 凡眼目赤澁, 自己小便張目尿出, 用一指接抹眼中三四次便畢, 閉目少頃卽效. 此眞氣逼去邪熱也. 《綱目》

Translation영역

Human urine (人尿): Governs the brightening of the eyes and removes redness, swelling, clouding and screens. A boy's urine, taken internally or used as a wash, is good. ○ All my life I have been troubled with red eyes and have used this as if by a spirit. Whenever the eyes are red and rough: pass your own urine with the eyes held open, catch it on one finger and wipe it into the eye three or four times until done, then close the eyes a little while and it takes effect at once. This is the true qi driving out the evil heat.

Clinical note임상 주석

A first-person note from Li Shizhen, and one of the few places in the materia medica where the compiler puts himself in the entry. **This is not to be done.** Fresh urine is not sterile, the bladder and urethra carry commensal organisms, and instilling it into a rough, inflamed eye risks a keratitis far worse than the complaint. The honesty of the report is worth preserving as a record; the method is not.

Boncho 本草 · Gangmok 綱目

3.34.41

Source원문

蟬殼去目昏障瞖. 去翅足, 末服煎服皆佳. 《本草》

Translation영역

Cicada moulting (蟬殼): Removes clouding of the eyes with shades and screens. Remove the wings and legs; powdered or decocted, both are good.

Boncho 本草

3.34.42

Source원문

蛇蛻主明目, 去障瞖. 醋浸灸乾, 末服丸服幷佳. ○蛇蛻時從口翻出, 眼睛亦退去瞖膜, 取此意也. 《本草》

Translation영역

Snake slough (蛇蛻): Governs the brightening of the eyes and removes shades and screens. Steep it in vinegar and roast it dry; powdered or pilled, both are good. ○ When a snake sloughs, it turns itself inside out from the mouth, and the eye too is shed and the screen and membrane drawn away with it; the idea is taken from that.

Clinical note임상 주석

取此意也 — the idea is taken from that — is the compiler stating the reasoning outright: the snake sheds the covering of its own eye, so the slough will shed the covering of a human one. Cicada moulting in the entry before works by the same analogy, and the two drugs are still paired in Korean practice for corneal opacity. The analogy is all there is; the keratin is inert.

Boncho 本草

3.34.43

Source원문

烏雄雞膽汁 療眼目昏暗, 卧時常常點之, 妙. 《本草》

Translation영역

Gall of a black cock (烏雄雞膽汁): Cures clouded and dim vision; applied regularly at bedtime it is excellent.

Boncho 本草

3.34.44

Source원문

雄雀屎 主目中生努肉ㆍ赤脉貫瞳子及膚瞖赤白膜. 取屎和首生男乳點之, 卽消, 神效. 《本草》 ○去白膜, 雄雀屎ㆍ龍腦各少許, 乳汁硏勻點之. 《類聚》 ○小兒雀目, 取雀頭血頻點之. 《本草》

Translation영역

Cock sparrow's droppings (雄雀屎): Governs excrescent flesh forming in the eye, red vessels running across the pupil, and film, screens and red and white membranes. Take the droppings mixed with the milk of a woman whose first child is a son and apply; it dissolves at once — miraculously effective. ○ To remove a white membrane: cock sparrow's droppings and borneol, a little of each, ground evenly with breast milk and applied. ○ For sparrow eye in a child: take blood from a sparrow's head and apply it repeatedly.

Clinical note임상 주석

赤脉貫瞳子, red vessels running across the pupil, is corneal neovascularization, and nothing applied to the surface will reverse it. The last method is the name-magic of the section at its plainest — 雀目, sparrow eye, treated with the blood of a sparrow's head — and it sits only a few entries away from the pig's-liver method that actually cures the condition.

Boncho 本草 · Yuchwi 類聚

3.34.45

Source원문

熊膽治目疾赤爛生瞖多淚. 取眞熊膽水硏常點, 神效. 《資生》

Translation영역

Bear bile (熊膽): Treats eye disease with redness, ulceration, screens forming and much tearing. Take genuine bear bile, grind it with water and apply it regularly — miraculously effective.

Clinical note임상 주석

**This is not to be used.** Every bear species is listed on CITES Appendix I or II and trade in bile is prohibited; the bile on the market comes from bears held in extraction cages. The active constituent is ursodeoxycholic acid, which is manufactured synthetically and available as a licensed medicine, so nothing of value is lost by refusing the animal product. The entry is translated as a record of what the Bogam taught.

Jasaenggyeong 資生

3.34.46

Source원문

牛肝明目. 作膾食之, 煮食亦可. 小兒雀目, 生食之. ○烏牛膽明目, 可點之. 《本草》

Translation영역

Ox liver (牛肝): Brightens the eyes. Eat it raw and dressed, or boiled — either will do. For sparrow eye in a child, eat it raw. ○ The gall of a black ox brightens the eyes and may be applied to them.

Boncho 本草

3.34.47

Source원문

靑羊肝 主靑盲, 能明目, 去昏暗. ○羖羊肝一具, 薄切, 鋪瓦上焙乾, 草決明半升ㆍ蓼子一合幷炒香, 同擣爲末, 蜜漿下一錢, 食後, 日三, 加至二錢, 不過二劑, 目極明, 夜見細字. 《本草》 ○目赤暗痛, 羊肝薄切, 以五味和食之, 神效. 《本草》 ○熱病後失明, 羊肝薄切, 付貼眼上, 又生食之尤妙. 《本草》 ○靑羊膽主靑盲明目, 點眼中, 去赤障白膜風淚. ○熱病後失明, 羊膽汁點之妙. 《本草》 ○眼目諸疾, 羊膽一枚, 入蜜一錢, 線扎封口, 鍋內煮熟, 候冷點眼, 效. 《得效》 ○目疾靑羊肝最佳, 黑羊白羊次之. 《丹心》

Translation영역

Black sheep's liver (靑羊肝): Governs blue blindness, is able to brighten the eyes and removes clouding and dimness. ○ One ram's liver, sliced thin, spread on a tile and dried over a fire; cassia seed half a seung and water-pepper seed 1 hop, both stir-fried until fragrant; pounded together to a powder and taken 1 don in honey water after food, three times a day, increasing to 2 don. In not more than two courses the eyes are perfectly bright and one can read fine characters at night. ○ For a red, dim, painful eye: sheep's liver sliced thin, dressed with the five flavours and eaten — miraculously effective. ○ For blindness following a heat disease: sheep's liver sliced thin and laid on the eye, and eaten raw besides, which is better still. ○ Black sheep's gall governs blue blindness and brightens the eyes; applied in the eye it removes red shades, white membranes and wind tearing. ○ For blindness following a heat disease, sheep's gall applied to the eye is excellent. ○ For all diseases of the eye: one sheep's gall with 1 don of honey put in, the mouth bound shut with thread, boiled through in a pan, and applied to the eye when cold — effective. ○ In eye disease black sheep's liver is best of all, and black or white sheep next.

Clinical note임상 주석

The longest entry in the section, and the one that gets furthest on the strength of a single correct observation. 夜見細字, reading fine characters at night, after not more than two courses of liver with cassia seed — the claim is specific, bounded in time, and almost certainly true, because the condition it describes is vitamin A deficiency and liver cures it in about that long. 熱病後失明, blindness following a heat disease, is the other indication worth noting: measles and the severe febrile illnesses of childhood precipitate keratomalacia in a child already depleted, and the tradition's answer — liver, eaten — is the right one. The ranking at the end, black sheep best, is the kind of detail that accumulates around a remedy that works.

Boncho 本草 · Deukhyo 得效 · Dansim 丹心

3.34.48

Source원문

犬膽明目, 去眼中膿水. 六月上伏日採膽, 以酒調服. ○眼痒赤澁磣, 膽汁點之. 《本草》

Translation영역

Dog's gall (犬膽): Brightens the eyes and removes pus and water from the eye. On the first dog-day of the sixth month take the gall and take it stirred into wine. ○ For an itching, red, rough and gritty eye, apply the bile to it.

Boncho 本草

3.34.49

Source원문

猪肝明目, 又治肝熱目赤磣痛. 猪肝一具, 薄切, 以五味醬醋食之. 《本草》 ○雀目, 猪肝米泔煮熟, 熏病眼, 因食之. 《本草》 ○療靑盲, 猪膽一枚, 微火煎之, 丸如黍米, 納眼中良. 《本草》 ○治外障瞖, 猪膽一枚, 銀石器煎成膏, 入龍腦少許, 點眼中. 仍取猪膽白皮, 曝乾, 撚作繩, 釵股大, 燒一頭作灰, 冷點瞖上, 三五度差. 《得效》

Translation영역

Pig liver (猪肝): Brightens the eyes, and also treats liver heat with the eye red, gritty and painful. One pig's liver, sliced thin, eaten dressed with the five flavours, soy and vinegar. ○ For sparrow eye: pig's liver boiled through in rice-washing water, the diseased eye steamed over it, and then the liver eaten. ○ To cure blue blindness: one pig's gall, boiled down over a low fire and rolled into pills the size of a millet grain, put into the eye — good. ○ To treat the outer shade and screen: one pig's gall, boiled down to a paste in a silver or stone vessel with a little borneol added, and applied in the eye. Then take the white membrane of the gall bladder, dry it in the sun, twist it into a cord the thickness of a hairpin's shank, burn one end to ash, and apply it cold on the screen; in three to five applications it is cured.

Clinical note임상 주석

The fourth of the section's night-blindness entries, and the same method as under black atractylodes above: liver boiled, the eyes steamed over the pot, the liver eaten. Only the last of those three steps matters. The cord twisted from the dried gall-bladder wall and burned at one end is a moxa-like applicator for grinding at a corneal opacity, and the instruction to let it cool first is the only thing keeping it from being a cautery.

Boncho 本草 · Deukhyo 得效

3.34.50

Source원문

獺膽主眼生障瞖ㆍ黑花飛蠅上下ㆍ視物不明. 取汁點目中, 亦入點眼藥中用良. 《本草》

Translation영역

Otter gall (獺膽): Governs shades and screens forming on the eye, black flowers and flying flies moving up and down, and seeing things unclearly. Take the liquid and apply it in the eye; put into eye medicines it is also good.

Clinical note임상 주석

黑花飛蠅上下 — black flowers and flies moving up and down — is the best description of vitreous floaters in the chapter, and it is exact: specks that drift with the eye's movement rather than staying put. Floaters are degenerative and benign and need no treatment, which is the useful clinical point. Otters are protected under CITES and under domestic law in Korea; the drug is not to be obtained.

Boncho 本草

3.34.51

Source원문

菟肝明目, 治昏暗. 和草決明作丸服之. ○熱毒上衝眼昏, 取肝生食之, 如服羊肝法. ○眼昏眼疼, 取生肝絞汁, 入人乳相和, 點目中良. 《本草》

Translation영역

Rabbit liver (菟肝): Brightens the eyes and treats clouding and dimness. Make pills of it with cassia seed and take them. ○ For heat toxin surging upward with the eyes clouded: take the liver and eat it raw, as in the method for sheep's liver. ○ For clouded and painful eyes: take raw liver, press out the juice, mix it with human milk and apply it in the eye — good.

Clinical note임상 주석

The section closes on its fifth liver entry, cross-referred to the sheep's-liver method — 如服羊肝法, as in the method for sheep's liver — which is the compiler acknowledging that these are all one remedy. Five animals, one active principle, and the Bogam arrived at it without any way of knowing what it was.

Boncho 本草

3.35 Needling and Moxibustion 鍼灸法

3.35.1

Source원문

眼睛痛, 取風府ㆍ風池ㆍ通里ㆍ合谷ㆍ申脉ㆍ照海ㆍ大敦ㆍ竅陰ㆍ至陰. 《綱目》

Translation영역

For pain of the eyeball, take Pungbu GV-16, Pungji GB-20, Tongri HT-5, Hapgok LI-4, Sinmaek BL-62, Johae KI-6, Daedon LR-1, Gyueum GB-44 and Jieum BL-67.

Gangmok 綱目

3.35.2

Source원문

目赤腫瞖ㆍ羞明隱澁, 取上星ㆍ百會ㆍ攢竹ㆍ絲竹空ㆍ睛明ㆍ瞳子髎ㆍ太陽ㆍ合谷. 又以草莖刺鼻孔, 出血數升卽愈. 《子和》

Translation영역

For the eye red, swollen and screened, shrinking from the light and gritty, take Sangseong GV-23, Baekhoe GV-20, Chanjuk BL-2, Sajukgong TE-23, Jeongmyeong BL-1, Dongjaryo GB-1, Taeyang and Hapgok LI-4. Also, prick the nostril with a grass stalk and let several seung of blood out — it heals at once.

Jahwa 子和

3.35.3

Source원문

眼暴赤腫痛, 取神庭ㆍ上星ㆍ顖會ㆍ前頂ㆍ百會, 出血卽愈. 又取光明ㆍ地五會. 《綱目》

Translation영역

For the eye suddenly red, swollen and painful, take Sinjeong GV-24, Sangseong GV-23, Sinhoe GV-22, Jeonjeong GV-21 and Baekhoe GV-20 and let blood — it heals at once. Also take Gwangmyeong GB-37 and Jiohoe GB-42.

Gangmok 綱目

3.35.4

Source원문

諸障瞖, 取睛明ㆍ四白ㆍ太陽ㆍ百會ㆍ商陽ㆍ厲兌ㆍ光明, 各出血; 合谷ㆍ三里ㆍ命門ㆍ肝兪ㆍ光明, 各灸之. 《綱目》

Translation영역

For all obstructions and screens, take Jeongmyeong BL-1, Sabaek ST-2, Taeyang, Baekhoe GV-20, Sangyang LI-1, Yeotae ST-45 and Gwangmyeong GB-37, letting blood at each; and moxa Hapgok LI-4, Samri ST-36, Myeongmun GV-4, Ganyu BL-18 and Gwangmyeong GB-37.

Gangmok 綱目

3.35.5

Source원문

內障, 取足厥陰ㆍ足少陰ㆍ陽蹻. 《綱目》

Translation영역

For the internal obstruction, take the foot reverting yin, the foot lesser yin and the yang springing vessel.

Gangmok 綱目

3.35.6

Source원문

去瞖法: 以鵝翎切之, 近黑睛及當白睛嗍之, 膜自聚上, 以鍼鉤挽之, 割去卽明見物. 以綿着眼斷血, 三日差. 《千金》

Translation영역

The method of removing a screen: cut with a goose quill, drawing it up close to the black of the eye and over the white; the membrane gathers of itself, and it is hooked up with a needle and cut away, whereupon one sees clearly at once. Press cotton on the eye to stop the bleeding, and in three days it is healed.

Cheongeum 千金

3.35.7

Source원문

努肉攀睛, 取睛明ㆍ風池ㆍ期門ㆍ太陽, 出血. 《綱目》

Translation영역

For proud flesh creeping over the eye, take Jeongmyeong BL-1, Pungji GB-20, Gimun LR-14 and Taeyang, and let blood.

Gangmok 綱目

3.35.8

Source원문

爛弦風, 取大骨空, 灸九壯, 以口吹火滅; 小骨空, 灸七壯, 亦吹火滅. 又以三稜鍼刺眶外出血卽愈. 《綱目》

Translation영역

For the raw-margin wind, take Daegolgong and moxa nine cones, blowing the fire out with the mouth; and Sogolgong, moxa seven cones, likewise blowing the fire out. Also prick outside the orbit with a three-edged needle and let blood — it heals at once.

Gangmok 綱目

3.35.9

Source원문

迎風冷淚ㆍ眵䁾黑花, 取大骨空ㆍ小骨空, 灸之, 吹火滅. 又取臨泣ㆍ合谷. 《綱目》

Translation영역

For cold tears in the wind, and discharge with black flowers, take Daegolgong and Sogolgong and moxa them, blowing the fire out. Also take Imgeup GB-41 and Hapgok LI-4.

Gangmok 綱目

3.35.10

Source원문

靑盲, 灸巨髎. 又取肝兪ㆍ命門ㆍ商陽. 《得效》

Translation영역

For blue blindness, moxa Georyo ST-3. Also take Ganyu BL-18, Myeongmun GV-4 and Sangyang LI-1.

Deukhyo 得效

3.35.11

Source원문

目昏暗, 灸三里, 鍼承泣. 又取肝兪ㆍ瞳子髎. 《綱目》

Translation영역

For the eye dim and dark, moxa Samri ST-36 and needle Seungeup ST-1. Also take Ganyu BL-18 and Dongjaryo GB-1.

Gangmok 綱目

3.35.12

Source원문

雀目, 取神庭ㆍ上星ㆍ前頂ㆍ百會ㆍ睛明, 出血卽愈. 又取肝兪ㆍ照海. 《綱目》

Translation영역

For sparrow eye, take Sinjeong GV-24, Sangseong GV-23, Jeonjeong GV-21, Baekhoe GV-20 and Jeongmyeong BL-1 and let blood — it heals at once. Also take Ganyu BL-18 and Johae KI-6.

Gangmok 綱目

3.35.13

Source원문

暴盲不見物, 鍼攢竹及頂前五穴. 又刺鼻中大出血, 立明. 《子和》

Translation영역

For sudden blindness seeing nothing, needle Chanjuk BL-2 and the five points forward of the vertex. Also prick inside the nose and let blood freely — the sight comes back at once.

Jahwa 子和

3.35.14

Source원문

眼腫痛睛欲出, 須八關大刺手十指間, 出血卽愈. 《易老》

Translation영역

Where the eye is swollen and painful and the globe seems about to come out, one must make the great pricking of the eight passes between the ten fingers of the hands and let blood — it heals at once.

Yeokro 易老

3.35.15

Source원문

眼戴上不能視, 灸脊第二顀骨ㆍ第五顀骨上各七壯, 一齊下火, 立愈. 《寶鑑》

Translation영역

Where the eyes are turned up and cannot see, moxa seven cones each on the second and the fifth vertebra of the spine, setting fire to both at once — it heals at once.

Clinical note임상 주석

The needling section is where the chapter turns bloody. Bloodletting dominates it: the vertex points pricked for an acute red eye, the nasal mucosa pricked with a grass stalk until several seung run, the eight passes between the fingers for a globe about to burst — and the quantities named are not survivable as written, so the seung must be read as the figure of speech it is. Two things stand out. The first is the pterygium operation in the sixth entry, which is a real surgical description: the growth lifted with a goose quill, hooked on a needle, cut away, and the bleeding pressed with cotton, three days to heal — which is, allowing for the instruments, how it is still done. The second is the distribution of points, which is consistent across the entries and sensible: the local orbital points (Jeongmyeong, Chanjuk, Sajukgong, Dongjaryo, Seungeup, Sabaek), the gallbladder channel's Gwangmyeong, named "bright light" and used for every screen in the section, and Ganyu and Hapgok as the distal pair. That the chapter should end with moxa on the second and fifth vertebrae for upturned eyes — a sign it has just finished calling fatal — is the Bogam's way: a treatment offered even where the prognosis has been refused.

Bogam 寶鑑

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Outer Form, Volume 1, Eye chapter. The Chinese text is collated against a transcription carrying the printed edition's leaf numbers and its first-edition variant readings; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.