暴盲源流考

Investigation on origin and development of sudden blindness

暴盲属眼部疾病的一种,较早见于《华佗神方》。纵览历代医家对其论述,病因病机虽颇为复杂,然不出内外两因,内因由情致失调、恣酒嗜辣、相火妄动、阴亏水少等因素损肝血耗心神,阻血络伤阴精,以致目络失养受累,外因则湿邪阻络,玄府受损发为暴盲。治则分为内治外治两法,内治无外乎气、血、火、虚、湿,调气以疏肝降气为法,理血以活血导滞为用,治火以泄火滋阴为要,补虚以固元培补为本,祛湿以温阳燥湿为纲,外治则用针灸等方法。通过整理古代医籍中关于暴盲的论述,从病名、病因病机、治疗等方面,溯其发展源流而理其学术脉络,以期明理论启实践。

Sudden blindness is a kind of eye disease,which was earlier seen in"Hua Tuo Shen Fang".Looking at the discussion of doctors in previous dynasties,although the etiology and pathogenesis are quite complicated,internal and external factors are mainly involved.The internal factors include emotional disorder,alcohol addiction,spicy taste,reckless movement of excessive fire,Yin deficiency,and lack of water,which may damage liver blood,cause mental exhaustion,obstruct the blood collaterals and injure the Yin essence,thus resulting in the loss of nourishment of the eyes and collaterals.The external factors refer to dampness and evil,which blocks the collaterals,and injures Xuanfu,resulting in sudden blindness.The principle of treatment is divided into internal treatment and external treatment.The internal treatment is targeting on nothing more than dampness,fire,Qi,blood,and deficiency.The key to dispelling dampness is to warm Yang and dry dampness;the key to relieve fire is to purge fire and nourish Yin;the key to regulate Qi is to sooth the liver and direct Qi downwards;the key to regulate blood is to promote blood circulation and resolve stagnation;while the key to tonify deficiency is to replenish liver and kidney.The external treatments mainly include acupuncture and other methods.By sorting out the discussion on sudden blindness in ancient medical books,this paper traces its origin and development,and rationalizes its academic context from the aspects of disease name,etiology,pathogenesis,and treatment,in order to clarify the theory and inspire practice.