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Exterior eye diseases are caused by fire pathogens. The nebulae float, presenting with redness, swelling, and pain, unlike the ice nebulae or sunken nebulae which are deep inside. The *Classic* states: Eye pain with red vessels extending from above or below indicates a Taiyang disease; progression from below upwards indicates a Yangming disease; transmission from exterior to interior indicates a Shaoyang disease. Since these conditions primarily affect the exterior, they must be accompanied by pain in the supraorbital ridge, or pain in the brain and neck, or swelling on one side of the head. The treatment method should employ warming and dispersing techniques, such as selecting formulas like Xiakucao San (Prunella Decoction) or Xuanqi Tang (Select Extraordinary Decoction). This is because Xiakucao (Herba Prunellae) possesses pure Yang Qi, can overcome turbid Yin, disperse various stagnations, nourish Liver Blood, and moderate Liver Fire; thus, it is miraculous in treating Jueyin eye pain that worsens at night.

As for Interior eye diseases, there is no fire pathogen. It presents as dimness inside the eyeball, resembling eyes without disease, except for a faint bluish-white hue within the pupil. However, cases without this faint bluish-white hue also exist; this indicates that True Yang has exhausted internally, and Jing Light is severing externally. Only through vigorous tonification of Yuan Yang might vision recover slightly. If treatment is delayed, even massive tonification will be ineffective.

The black cornea connects to the eye system and belongs to the Foot Jueyin Meridian, while also involving the Foot Taiyang and Hand Three Yin meridians. When Qi and Blood in these three meridians are deficient, pathogens enter via deficiency, causing meridian stagnation that enters the black cornea through the eye system, forming internal nebulae that obscure the pupil. This is referred to as "unclear brain fat flowing down to form nebulae." Treatment should follow pulse diagnosis and meridian pathways to vent turbid Yin, preventing it from attacking upward, while regulating and tonifying True Yin for internal nourishment. If the pulse is slow and Qi is weak, the main herbs should be Renshen (Radix Ginseng), Baizhu (Rhizoma Atractylodis Macrocephalae), and Gancao (Radix Glycyrrhizae). If one recklessly uses drugs to dissolve nebulae or attack and reduce, this accelerates blindness. In ophthalmology, Lingyangjiao (Cornu Saigae Tataricae) is often used because it enters the Jueyin Meridian most rapidly and clears Lung heat. It is most suitable only when nebulae are on the black cornea accompanied by heat; if used for non-Jueyin conditions, it is like opening the door to invite thieves, and for Yang-deficient syndromes, it will further freeze the nebulae.

Xuanfu (mystic pores) are the gates for the ascending, descending, entering, and exiting of Great Qi. The eyes, nose, mouth, and tongue all utilize Shen Spirit. Clarity exists because Shen is complete. Qi and Blood are the foundation of human Shen; when Shen declines, clarity diminishes, and Fire flares upward alone. Fire and Yuan Qi cannot coexist; when Fire blazes, Xuanfu become blocked. Attacking the ears causes tinnitus/deafness; attacking the eyes causes blurred vision; conditions of the mouth, nose, and tongue can be inferred similarly. One patient suffered from chronic eye disease; taking Yin-nourishing and cooling herbs long-term yielded no effect. Pulse diagnosis revealed weak pulses in both hands. Thus, Bazhen Tang (Eight-Treasure Decoction) was administered with Maidong (Radix Ophiopogonis) and Wuweizi (Fructus Schisandrae), resulting in full recovery after one month. One must understand that if dietary transport fails, intestines and stomach become dry; hair loss, wrinkled skin, dysphagia, stranguria, blurred vision, and deafness all stem from deficiencies in Qi fluids and blood vessels, failing to ascend, descend, enter, or exit. Consequently, turbid Fire flares upward, disturbing Shen Spirit. This applies to all diseases, not just eyes and ears. If only Siwu Tang (Four-Agent Decoction) is used, Spleen and Stomach are damaged; once the mechanism of transformation source is cut off, the generation of Qi and Blood has no pathway. Just as a tree must have strong roots before flowers and leaves flourish: Blood is the sap of the tree; Shen Light is its flowers and leaves; Spleen and Stomach are its roots. Can we not value this?

Danxi stated: All meridian collaterals travel to the face and traverse orifices. Clear Qi scatters into the eyes to become visual essence, and travels to the ears to become hearing. If mental burdens are heavy, diet is irregular, Spleen and Stomach Qi are deficient, and Heart Fire is excessive, hundred vessels boil, pathogens harm the orifices, leading to blindness. Moreover, the Spleen is the head of all Yin meridians, and the eyes are the congregation of blood vessels. Spleen deficiency causes the essence of five Zang organs to lose their residence. Neglecting the Spleen and Stomach to merely nourish Shen and Blood is treating the branch rather than the root. *Xue Shi Yi An* records Case of Censor Zhang: Red, unclear eyes; after taking wind-dispersing and heat-clearing herbs, he became photophobic and had heavy hearing. Pulse was large but empty. This was due to overwork of the mind and irregular diet. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was added with Fushen (Poria with Hostwood), Zaoren (Semen Ziziphi Spinosae), Shanyao (Rhizoma Dioscoreae), Shanzhuyu (Fructus Corni), and Wuweizi (Fructus Schisandrae), resulting in immediate recovery upon one dose. Later, due to severe labor relapse, Shiquan Dabu Tang (Ten Complete Tonifying Decoction) with the previous herbs cured him. Another young man, due to excess alcohol and sexual indulgence, had swollen and painful eyes; pulses at both Chi positions were surging and large. Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) material plus Maidong and Wuweizi resulted in sudden clarity after several doses. These are all treatments addressing the root while ignoring the branch, hence the swift efficacy. If eye drops are added, it is merely formalistic, lacking specific merit and practical effect.

Sudden loss of eye luster indicates severe deficiency of Yang Qi. Danxi once treated a person who suddenly lost sight but had no other discomfort. He urgently decocted Renshen Gao (Ginseng Paste) for him to take; sight returned after two days. Another person given Cishi (Magnetitum) died immediately after ingestion.

*Yi Yu Lu* states: There was a case of red eyes, abdominal pain, and Spleen deficiency with inability to eat. Liver pulse was excess, Spleen pulse was weak. Using cold herbs to treat the Liver would further weaken the Spleen; using warm herbs to treat the Spleen would further strengthen the Liver. By doubling Rougui (Cortex Cinnamomi) in warm-neutral herbs, one could suppress the Liver and benefit the Spleen, achieving both goals with one treatment.

A person who habitually drank hot wine suddenly went blind with a choppy pulse. This was injury from hot wine; turbid blood in the Stomach coagulated internally, blocking Clear Yang Qi from reaching the eyes for clarity. Danxi used Sumu (Lignum Sappan) decoction mixed with Renshen powder. After two doses, the nose and palms turned purple-black, indicating disease retreat and movement of stagnant blood. Then, Siwu Tang plus Sumu, Taoren (Semen Persicae), Honghua (Flos Carthami), and Chenpi (Pericarpium Citri Reticulatae) was decocted with Renshen powder. After several doses, he recovered. This illustrates Danxi's view that blood stasis in the center injures the harmonious Stomach Qi. Therefore, adding Renshen to blood-breaking herbs allows Stomach Qi to function, allowing stasis to descend. Once stagnation is removed without injuring Qi, the eyes naturally resume their bright function.

Any sudden blurring of vision is due to Yang deficiency and Qi collapse, requiring Qi-tonifying herbs to retrieve it. However, cases acquired from lying in or being exposed to dampness require adding Baizhu (Rhizoma Atractylodis Macrocephalae) and Fuling (Poria) to warm-tonifying formulas to dry dampness. Diplopia indicates scattered essence. Insufficiency of Kidney and Gallbladder juices, combined with independent flaming of Heart and Liver Fire, causes Sunlight to lose support, and Shen Water fails to converge, resulting in dilated pupils.

For patients with blurry vision, at any time, sit quietly and hold breath. Rotate both eyes left seven times, right seven times. Close them tightly for a moment, then suddenly open them wide. Practice this long without closing, so that stagnant Fire and turbid Yin are transported out, leaving only Clear Yang and Jing Essence to shine.

When treating nebulae, one must distinguish which meridian they originate from and their color, adding guiding herbs accordingly. For example, Dongyuan treated a woman whose green nebula rose from below, identifying it as originating from Yangming. Green is not the proper color of the five Zang organs, suggesting a combination of Lung and Kidney pathology. He used ink mixed with Nifen (Calamina) to match the nebula's color, confirming Lung-Kidney involvement. He made clearing Lung-Kidney pathogens the sovereign herb and Yangming herbs the minister, yielding excellent results. The disease recurred three times with different meridians and colors. He reasoned that meridian imbalance caused persistent eye disease. Inquiry confirmed this. He prescribed blood-nourishing and Yin-tonifying pills, preventing recurrence forever. This demonstrates that distinguishing color and dividing by meridian cannot be ignored!

Treating eye diseases with a three-edged needle to bleed cures some, reflecting the *Neijing* principle "blood should be drained." However, this is only suitable for early-stage conditions with abundant blood and heat, specifically in Taiyang and Yangming meridians, as these two have abundant Qi and Blood. Bleeding from other meridians worsens the condition. Thus: "Puncturing Taiyang and Yangming makes eyes clearer; puncturing Shaoyang and Yangming makes eyes dimmer."

Dongyuan treated a man who ate pork pancakes with garlic and vinegar, then lay drunk on a hot pit. Next day, his pupils were dilated, vision unclear. Various prescriptions failed. He used wine-fried Huangqin (Radix Scutellariae) and Huanglian (Rhizoma Coptidis) to clear heat as sovereign; Danggui Sheng (Radix Angelicae Sinensis) and Shengdi (Radix Rehmanniae) to nourish and cool blood as minister; Wuweizi (Fructus Schisandrae) to astringently secure dilated pupils; Renshen, Dongqing (Herba Asparagi), Maidong, Digupi (Cortex Lycii), Sheng Gancao, and Zhike (Fructus Aurantii) to tonify middle with bitter-sweet and suppress Qi as assistants; Chaihu (Radix Bupleuri) to guide as envoy. He recovered instantly.

Danxi treated a strong man who couldn't see clearly upon waking in the morning, seeing vaguely after sleeping briefly, with reduced appetite and severe fatigue. Pulse was slow and large, empty and powerless when pressed deeply. Suspecting dampness, inquiry confirmed he had slept on damp ground for half a month. He used Baizhu as sovereign, Huangqi (Radix Astragali) and Chenpi as ministers, Fuzi (Radix Aconiti Lateralis Preparata) as envoy. Ten doses cured him. These are divine manifestations of treating the root.

Haizang treated a girl who fell ill at puberty, suffering from red, swollen eyes hard to open for three years. Wind-dispersing and heat-clearing herbs caused nebulae to form, covering the pupil from the canthus. Right eye nebula rose from below. Pulse was short and excess. Jiegu said: Short indicates accumulation. *Neijing* states: From interior to exterior is Shaoyang disease; from below upwards is Yangming disease. Thus, Shaoyang-Yangming accumulation inhibited Zang-Fu, preventing Clear Yang from ascending and Turbid Yin from descending. He used accumulation-resolving herbs plus Huanglian and Longdancao (Herba Gentianae), taken dissolved each morning. One pill per day expelled black blood clods, bean-sized and hard, thereafter nebula receded and vision cleared.

*Xia Zi Yi Qi Ji Fang* states: Eyes suddenly droop to the nose, blocked like a black horn, unbearable pain, or frequent bloody stools with pain, named Liver Distension. Qianghuo (Radix Notopterygii) decocted alone, drinking several cups cures the eyes.