刺目眶外，以泻湿热，内服消风散，桑白皮煎汤调服。又倒睫拳毛，泪出涓涓，翳膜渐生，
乍愈乍发，经年不安，眼皮渐急，如针刺痛，瞳人不安，乃脾受风热，当去内热退火邪，令
眼皮缓，则毛出翳退。外用手法翻内睑向外，以三棱针横刺，用左手爪迎其针锋出血，再用
木鳖子捣烂，绵包成条，左患塞右，右患塞左鼻中，其毛自分。先宜泻肝散，后服五退散
。又上下睑俱翻出，或一睑翻出在外，乃脾风热也。热证，轻者睑红赤硬，睛疼泪出羞明
；重者两睑上下初生如粟，渐大如米，或赤或白，不甚疼痛坚硬，乃肝壅瘀血也，宜加味荆
黄汤。又睑内生如鸡冠、蚬肉，或青或黑，阻碍睛痛，乃脾风热也，须翻出看之，用观音草
每日轻轻微微，渐渐括去毫厘，血出，用金匙挑洗风毒药水，按而止之，刮后不时将药水点
入，则不复肿。
肾水一点黑瞳子；
骨之精，曰水轮。虚证，瞳人散大，视物不真。火盛则瞳人焦黄；虚冷则瞳人青
绿，少劳则痛。热证，瞳人内涌，轻者如不患眼人，但微有头旋生花，或劳力转加昏蒙，
或头旋相牵，瞳人连鼻膈皆痛，时起红白或黑花，吐逆。肝热则先左，肺热则先右，肝肺热
则左右齐发。重则生翳瞳人，上如凝脂色，涩痛无泪；或滑翳如水银珠子，微含黄色，遮绕
瞳人；或散翳形如鱼鳞点；或睑下起粟子而烂，瞳人痛甚，又白翳旋绕，瞳人点点如白花鳞
起，皆肝肺相传风热也。又黑水上横深瑕盘青色，沉沉深入，痛甚，乃肾脏风热也。或血灌
瞳人，无翳，其痛如刺，乃肝血无归，宜通血丸。又瞳人被物撞打，惊痛昏暗，眼眶停留瘀
血，宜贴地黄膏，次服决明散。如撞刺生翳，经久复被物撞，转加昏暗者，难治，经效散救
之。又飞丝砂尘入眼，瞳人不安，单瞿麦为末，鹅涎调敷，或新笔蘸京墨点之。又汤泡火烧
肿痛者，不可用冷药即点，待一日后，以五行汤温洗，及地黄膏敷之。风证，则瞳人青，
或瞳人连 头皆痒，不能收睑，乃胆受风热，宜防风一字散。不治证∶瞳人干缺，痛涩无泪
；或白藏在黑水下，向日细视方见；或两眼相传疼痛，早轻夜重；或内障，五色相间，头痛
无泪，日中如坐暗室；或雷头风，热毒瓦斯冲入睛中，牵引瞳人，或微或大不见。
八廓寄位始有名，
干为天廓，位两边白睛中间，属肺与大肠；坎为水廓，位瞳子，属肾；良为山廓
，位神光，属胆；震为雷廓，位白睛上截向小 ，属小肠；巽为风廓，位乌珠瞳人外，属肝
；离为火廓，位大、小 ，属心与命门；坤为地廓，位上下睑，属脾胃；兑为泽廓，位白睛
下截向大 ，属膀胱。
妇人小儿大同耳。
妇人活血为主，有孕忌用麝点。小儿眼患，多是胎毒及食毒，内服败毒散，外洗
解毒汤，切忌披镰针灸。小儿初生胎风，双目红而眶边赤烂，至三四岁不愈，宜消风散，桑
白皮煎汤下。又小儿通睛，欲观东边则见西畔，若振掉头脑，则睛方转，此肝受惊风，宜牛
黄丸。又小儿眼泡患斑疮，热气冲透睛中，疼痛泪出，翳如银片，肿涩难开，宜柴胡散、神
医散。又小儿睑中初生如麻仁，目渐如豆，悬垂睑内，乃风热攻脾，宜五退散加减。又小儿
疳眼，初起涩痒，久生疮翳肿痛，乃肝风所冲，或痢后虚热上攻者，俱忌点，宜还睛散。
痘疮眼，详疹痘。小儿不治证∶胎中受风，五脏不和，呕吐黄汁，两眼青盲不明；及初生
视物近看，转睛不快，至四五岁，瞳人结白，昏蒙不见。
暴赤肿痛涩且痒，
或饮食积热；或天行赤目，长幼相似；或伤寒后余热，以致血热痰壅，则目暴赤
肿。痛为热，痒为风，涩为毒，不可概用凉药，因成内障；亦不可误用温药助热，致令昏
涩眵泪， 肉攀睛等状，是成外障，决明散主之。又有睡觉目赤肿，良久无事者，血复散于
四肢也。宜地黄粥。又或读书、针刺过度而痛者，名曰肝劳，但须闭目调护。又中恶祟，卒
痛如针刺，或如火灸，及太阳穴痛，早轻夜重，宜决明散。
翳膜眵昏总是表；
暴赤后，热流肺经，轻则朦胧而已，稍重则生云膜。如黄膜从下生，而上冲黑睛
，痛涩难开，乃脾受风食毒，可治；如赤膜从上生，下遮覆黑睛，名垂帘膜，乃客热上冲也
，难治。又重则生翳障，状如珍珠、碎米，红色自下而上者易治；状如梅花叶，白绿自上而
下者难治。治法宜先去翳，而后清热，若先去热，则翳难去。眵泪热而交流两睑赤者，属肝
热之甚，或冲风泪出，由热甚而水化制之也。又肺受风寒，遇风冷则流泪尤甚者，白僵蚕散
；
风泪不止，食后吞当归龙荟丸数粒。目昏者，热郁也。甚则平白日无所见，故伤寒病热极，
则目盲而不识人。目微昏者，至近则转，难辨物，或如隔帘视，或视如蝇翅，或见黑花，皆
目之玄府闭密，而致荣卫精神不能升降故也。若患风疹者，必多眼暗，攻其风则暗自去。
抑论脾家受毒，则眼白亦肿；神劳，则眼睛亦痛；心热，则血灌瞳人；伤风，则泪亦出；虚
烦，则眼亦昏；劳力，则 亦赤；生痰，乃风热侵肺；黄，乃酒伤于脾，最宜活变。
里虚昏昧最羞明，
上虚，属肝虚，必头晕目眩耳聋；下虚，属肾虚，必眼花睛痛耳鸣。昏花者，伤
气；昏暗者，伤血。热证亦有羞明怕日，但内虚全不敢近阳光。
内障黑花瞳散杳。
内障昏蒙，外无翳膜，因脑脂下凝，乌珠转白，或如金色，或绿豆色，或如云烟
，或见五色，治比外障更难。如脑脂凝结瞳人反背者，不治。黑花者，肾虚也；五色花，为
肾虚客热；青花，胆虚；红花，火盛。散杳者，瞳人散大，视物杳冥。
近视阴虚远视阳，
能近视不能远视者，看一成二，属肝肾虚，宜肾气丸、地芝丸，或加降火之剂。
能远视不能近视者，属心虚，宜定心丸。
泪冷睛疼多缥缈；
有肝虚客热，迎风冷泪者，归葵汤、古木贼散。睛疼有火者，滋肾丸；无火者，
杞苓丸。
外因风热湿挟痰，
外因，风则胞白，两眼拘急，牵引 斜，
痒而青泪。肝风毒，菊花散；肾风毒，白蒺藜散、明目流气饮、拨云散、白僵蚕散、防风一
字散、犀角饮选用。热则珠突胞硬，肿红刺痛，洗肝散、洗心散、还睛散、通肝散、泻肝
散、决明散、羚羊角散、蔓荆散、加味荆黄散、泻青丸、凉胆丸、坠翳丸选用。湿则食减身
倦，地气冒明，如云雾掩日，或忽然不见，或略见不明，宜盐术散、单苍术膏。湿热甚者，
神芎丸。暴寒则目瞒不明，皆热所为也，人参败毒散。疼者，升麻葛根汤。历考眼科，无寒
而有虚，岂寒泣血而不上攻耶？挟痰者，则痛甚，宜小省风汤、南星丸。
内伤气血精神少。
内伤七情，气壅朦胧，胞肿而软，酸涩微赤，木香流气饮，加川芎、蒺藜。风与
气
搏，痒涩浑多泪者，羌活石膏散。因过思劳神，大志丸、育神夜光丸；因惊恐者，定心丸；
因怒者，当归龙荟丸。内伤饮食劳倦，损陷胃气，火盛血脉沸腾，益气聪明汤、磁砂丸、还
睛丸。气弱甚者，单人参膏、补中益气汤。如脾胃热兼有宿食者，秦艽、大黄为末，砂糖调
服利之。脾胃湿伤，内外障者，椒目丸、盐术散。伤热酒，胃气污浊，血死目盲者，苏木煎
汤调人参末；连鼻与手掌紫黑者，四物汤，加桃仁、红花，苏木煎汤调人参末服。内伤色欲
，
肾气虚者，补肾丸；肾精虚者，益阴肾气丸；肝血虚者，养肝丸、生熟地黄丸；肝肾虚者，
驻景丸。抑论五脏六腑精华，皆禀于脾，注于目，故理脾胃则气上升，而神清也。又肝之系
，虽总于目，而照彻光彩，实肾精、心神所主，故补精气安神者，乃治眼之本也。
风热兼虚亦有之，
热久复为风冷所乘，则眼中不赤，而弦赤且烂。若风与热并，则内外浮赤而痒甚
。大概表病，肥人多风热，防风、黄芩泻火为君，黄连、当归养血为臣，柴胡、升麻、白芷
消肿止痛为使。白睛红者，加白豆蔻少许。瘦人血虚，宜四物龙胆汤，或加羌活、蔓荆、荆
芥、玄参、山栀仁、菊花为佐。里证，肥人多风虚者，防风一字散、四生散、补肝散、还睛
丸。瘦人血虚挟风者，通血丸、明目地黄丸、滋阴地黄丸、熟地黄丸。通用羊肝丸。久甚者
，退翳丸、活命羊肝丸。
古人只消一（火）字了；
眼不过虚实而已。白轮变赤，火乘肺也；肉轮赤肿，火乘脾也；黑珠五色花翳
，
肾虚火也；神光青睛被翳，肝虚火也；赤脉瘀血贯目涩痛，心火自甚也。故童子水在上，则
视明了；老人火在上，则视昏 。实火气有
余，宜前
风热药中，加枳壳、杏仁以破气；虚火血不足，宜前养阴药中，加知母、黄柏以降火。黑
睛有翳者，倍之。盖散有余之火，在于破气；降不足之火，在于养阴。
阳衰火少却宜温，
或劳欲过度，或凉药过多，以致浑身手足麻木，九窍不利，两目紧急，青白坠见
大，视物无力者，宜补阳汤、黄 汤，或加黄柏，或菊睛丸。经曰∶壮水之源，以镇阳
光，滋阴是也；壮火之主，以消阴翳，养阳是也。今人不分阴阳，专以龙脑辛香石药搽点，
而不知辛散损明，悲夫！
外治点洗要手巧。
凡暴赤肿，血壅气凝者，一时连点三五次亦可，如气血稍虚者，宜服药以塞其源
，药水洗之。生有云膜，方可用点，若无翳膜，纵久，但可洗之，却忌过用凉药冷洗，冰
血开化为水。至于针刀火烙，古人忌用，惟太阳经热，生偷针痣，可刺去血。如烂翳用茜草
根烧灰，灯心草蘸点之，须臾大痛，以百节草刮去。他如金针拨转瞳人等法，另是一家传授
。
耳
耳聋虚热分新旧，
新聋多热，少阳、阳明火多故也，宜散风热、开痰郁之剂；旧聋多虚，肾常不足
故也，宜滋补兼通窍之剂。脉症以肾为主，迟濡为虚，浮动为火，浮大为风，沉涩为气，
数实为热。
两胃怒左相火右；
浓味动胃火，则左右俱聋；愤怒动胆火，则左耳聋；色欲动相火，则右耳聋。三
者，愤怒为多。
痰火风湿（气）闭可通，
痰火，因膏粱胃热上升，两耳蝉鸣。热郁甚，则气闭渐聋，眼中流火，宜二陈汤
加黄柏、木通、 蓄、瞿麦。因酒者，通圣散加南星、枳壳、大黄，或滚痰丸。风聋，因风
邪入耳，必内作痒，或兼头痛。风热或因郁者，防风通圣散，先将大黄酒煨，又酒炒三遍
，后人诸药俱用酒炒煎服。风壅连头目不清者，清神散。风虚者，排风汤、桂香饮、芎芷
散。湿聋，因雨水浸渍，必内肿痛，凉膈散加羌活、防风，俱用酒炒，或五苓散加陈皮、枳
壳、紫苏、生姜。湿痰，神芎丸。湿热挟气，木香槟榔丸。气聋，因脏气厥逆，上壅入耳
，痞塞不能，必兼眩晕。实人因怒者，当归龙荟丸；虚人因思者，妙香散。忧滞者，流气饮
子加菖蒲；上盛下虚者，秘传降气汤加菖蒲。
虚劳精气脱难救。
虚聋，因久泻，或大病后，风邪乘虚入耳，与气相搏，嘈嘈而鸣，或时眼见黑花
。阴虚者，四物汤加知、柏、菖蒲、远志，或肾气丸加磁石、故纸、菟丝子、黄柏。阳虚者
，八味丸、益肾散、磁石汤。劳聋，昏昏聩聩
，瘦瘁乏力。因劳力脱气者，补中益气汤加菖蒲；有火者
，加
知、柏、茯苓；因房劳脱精者，人参养荣汤加知、柏，或补骨脂丸。如久聋，肾虚气虚，绝
不闻者，难治。
耳鸣乃是聋之渐，
惟气闭多不鸣便聋。风热鸣者，解毒汤加生地、知母，或通圣散；痰火鸣甚，当
归龙荟丸；挟湿，神芎丸，或青木香丸；肾虚微鸡，滋肾丸。气虚，四君子汤下；血虚，四
物汤
下；阴虚，虎潜丸。
停脓疼皆风热凑；
耳，原有油液，风热搏击结核，鸣欲聋者，外用生猪脂、地龙、锅煤等分，姜
汁和丸枣核大，绵裹入耳，令润挑去；重者，内服柴胡聪耳汤。脓耳，风热上壅，流脓，
外用枯矾五分，陈皮、胭脂俱烧灰各二分，麝五厘，为末，吹耳；重者，内服犀角饮子。耳
疼如虫走者，风盛；干痛者，风热或属虚火；有血水者，风湿。外用蛇蜕烧存性为末吹入
，或枯矾末亦可。疼甚，用吴萸、乌头尖、大黄捣烂， 足掌心。重者，内服东垣鼠粘子汤
。
大要调气与开关（窍），
肾，水窍，耳而能闻声者，水生于金也。肺主气，一身之气贯于耳，故能听声。
凡治诸聋，必先调气开郁，间用磁石羊肾丸开窍。盖聋皆痰火郁结，非磁石镇坠，乌、桂、
椒、辛、菖蒲辛散流通，则老痰郁火何由而开？然亦劫剂也，愈后以通圣散和之可也。
外治暴聋亦可透。
暴聋，用甘遂为丸塞耳，内服单甘草汤；稍久，用松香五钱溶化，入巴豆二十粒
，葱汁捣丸，绵裹塞耳，左聋塞右，右聋塞左，双聋次第塞之。冻耳，用榄核烧灰，油调搽
；如烂，贝母末干糁。百虫入耳，用清油灌入，口吸气，久自出。如蜒蚰入耳，用信花、雄
黄各一钱为末，先用一字点耳中，次用猫尿灌之，取猫尿以生姜擦牙自出。又方用琴弦一段
Puncture the outer orbital margin to drain damp-heat, and internally administer Xiaofeng San (Wind-Dispersing Powder), taken with decoction of Sangbaipi (Morus Albae Cortex). For inverted eyelashes (Trichiasis) with continuous tearing, gradually forming pterygium, recurring intermittently for years without relief, tightening of the eyelids, needle-like pain, and instability of the pupil, this is caused by Spleen affected by Wind-Heat. One should clear internal heat and extinguish Fire Evil to relax the eyelids, allowing lashes to grow out and pterygium to recede. Externally, use manual technique to evert the inner eyelid, puncture horizontally with a Three-edged Needle, press the needle tip with the left hand's fingernails to induce bleeding, then mash Mumiezi (Semen Momordicae), wrap in cotton into a strip, insert into the right nostril for left eye affliction, or left nostril for right eye affliction, causing lashes to separate naturally. Initially, administer Xiegan San (Liver-Draining Powder), followed by Wu Tui San (Five-Shedding Powder). If both upper and lower eyelids evert outward, or one eyelid everts outward, this is due to Spleen Wind-Heat. In Heat Syndromes, mild cases present with red, hard eyelids, eye pain, tearing, and photophobia; severe cases present with millet-grain-sized bumps on both eyelids initially, growing larger like rice grains, either red or white, not very painful or hard, indicating Liver Blood Stasis and congestion, suitable for Jia Wei Jing Huang Tang (Modified Ephedra and Rhubarb Decoction). If growths resembling chicken combs or clam meat appear inside the eyelids, green or black, obstructing vision and causing pain, this is Spleen Wind-Heat; the eyelid must be everted for examination. Use Guanyincao (Perilla Frutescens Herb) daily, gently scraping off minute amounts gradually until bleeding occurs, then wash with Fengdu Yao Shui (Wind-Toxin Medicinal Water) using a gold spoon, press to stop bleeding, and instill the water occasionally after scraping to prevent swelling recurrence.
A dot of Kidney Water forms the black pupil:
The essence of bone is called the Water Wheel. In Deficiency Syndromes, the pupil dilates and vision is unclear. Excessive Fire causes the pupil to become scorched yellow; Deficiency-Cold causes the pupil to turn blue-green, with pain upon slight exertion. In Heat Syndromes, the pupil protrudes inward; mild cases resemble healthy eyes but with slight dizziness and visual spots, or worsening drowsiness upon physical exertion, or dizziness radiating to the pupil and nasal septum, accompanied by intermittent red/white/black spots and vomiting. Liver Heat affects the left side first, Lung Heat affects the right side first, and combined Liver-Lung Heat affects both sides simultaneously. Severe cases develop pterygium over the pupil, appearing like coagulated fat, with astringent pain and no tears; or smooth pterygium like mercury beads, slightly yellow, surrounding the pupil; or scattered pterygium like fish scales; or millet-like lesions under the eyelids with severe pupil pain, and white pterygium rotating around the pupil with white flower-like scales rising, all indicating Wind-Heat transmitted from Liver and Lung. A deep blue-black discoloration across the black water indicates Kidney Wind-Heat. Hemorrhage filling the pupil without pterygium, with needle-like pain, indicates Liver Blood having no root, suitable for Tongxue Wan (Blood-Unifying Pill). Trauma to the pupil causing shock, pain, and dimness with blood stasis in the orbit requires application of Dihuang Gao (Rehmannia Ointment), followed by Jueming San (Cassia Seed Powder). If trauma induces pterygium which worsens with subsequent impacts leading to dimness, it is difficult to treat; save with Jingxiao San (Effective Formula). For foreign bodies like silk or dust entering the eye causing pupil instability, use Qumai (Dianthus Herba) powder mixed with goose saliva applied topically, or apply Beijing Ink with a new brush. For burns or scalds, do not apply cold medicines immediately; wait one day, then wash with Wuxing Tang (Five Elements Decoction) and apply Dihuang Gao. Wind Syndromes present with blue pupils or itching extending from the pupil to the head, inability to close eyelids, due to Gallbladder Wind-Heat, suitable for Fangfeng Yizi San (Saposhnikovia One-Degree Powder). Incurable signs include dry/shrunken pupils with astringent pain and no tears; white pterygium hidden beneath the black pupil visible only in sunlight; bilateral pain worsening at night; internal cataracts with mixed colors, headache, no tears, blindness at noon; or Thunder Head Wind where toxic heat enters the eye affecting the pupil, causing variable vision loss.
The Eight Palaces derive their names from their positions:
Qian (Heaven Palace) is located between the whites of both eyes, belonging to Lung and Large Intestine; Kan (Water Palace) is at the pupil, belonging to Kidney; Gen (Mountain Palace) is at Shen Guang (Spiritual Light), belonging to Gallbladder; Zhen (Thunder Palace) is at the upper part of the sclera towards the canthus, belonging to Small Intestine; Xun (Wind Palace) is outside the pupil, belonging to Liver; Li (Fire Palace) is at the medial and lateral canthi, belonging to Heart and Mingmen (Gate of Life); Kun (Earth Palace) is at the upper and lower eyelids, belonging to Spleen and Stomach; Dui (Lake Palace) is at the lower part of the sclera towards the medial canthus, belonging to Bladder.
Women and children are largely similar.
Treatment for women focuses on invigorating Blood; Musk is contraindicated during pregnancy. Pediatric eye diseases often stem from fetal toxins or dietary toxins; internally administer Baidu San (Toxin-Resolving Powder) and externally wash with Jiedu Tang (Detoxifying Decoction); acupuncture and lancing are strictly forbidden. Infantile wind syndrome presenting as red eyes with erythematous, eroded orbital margins persisting until age three or four requires Xiaofeng San administered with Sangbaipi decoction. Strabismus (Crossed Eyes) where the child looks opposite to the intended direction, correcting only when shaking the head, indicates Liver affected by Shock-Wind, treated with Niuhuang Wan (Calculus Bovis Pill). Pediatric eczema with heat penetrating the eye, causing pain, tearing, silver-like pterygium, and swollen/astringent eyelids requires Chaihu San (Bupleurum Decoction) and Shenyi San (Divine Physician Powder). Millet-like growths in pediatric eyelids hanging inward indicate Wind-Heat attacking the Spleen, treated with modified Wu Tui San. Pediatric malnutrition eye disease starting with astringency/itching progressing to sores/pain indicates Liver Wind or post-dysentery deficiency-Heat ascending; topical drops are contraindicated, use Huanjing San (Restore Vision Powder). Measles/Rubella eye complications see detailed sections. Incurable pediatric signs include fetal wind causing five-organ disharmony, vomiting yellow fluid, and congenital blindness; or near-sightedness with slow eye movement progressing to white pupils and blindness by age four or five.
Sudden redness, swelling, pain, astringency, and itching:
Caused by dietary accumulation-Heat, epidemic conjunctivitis (Epidemic Red Eye), or residual heat from Taiyang Disease causing Blood-Heat and Phlegm congestion. Pain indicates Heat, itching indicates Wind, astringency indicates Toxin. Do not indiscriminately use Cold medicines to avoid internal cataracts; do not misuse Warm medicines to exacerbate Heat causing dimness, discharge, and pterygium (External Cataract), treated with Jueming San. Post-sleep redness/swelling resolving later indicates Blood redistributing to limbs; treat with Dihuang Zhou (Rehmannia Porridge). Eye pain from excessive reading or needling is named Liver Fatigue, requiring rest. Sudden needle-like or burning pain, especially at Taiyang acupoints, worsening at night, suggests evil qi possession, treated with Jueming San.
Pterygium, discharge, and dimness are always Exterior:
After sudden redness, Heat flows into the Lung Meridian; mild cases cause blurriness, severe cases form cloud-like membranes. Yellow membrane rising from below blocking the cornea with pain indicates Spleen affected by Wind/Food Toxin, treatable. Red membrane descending from above covering the cornea (Curtain Membrane) indicates invading Heat ascending, difficult to treat. Severe cases form pearly or rice-grain-like opacities; red rising from below is easier to treat; plum-blossom shaped white/green descending from above is difficult. Treatment priority: remove opacity first, then clear Heat; clearing Heat first makes opacity removal difficult. Hot discharge flowing between red eyelids indicates severe Liver Heat or Wind-induced tearing due to Heat overwhelming Water mechanism. Lung affected by Wind-Cold causes excessive tearing in cold weather, treated with Bai Jiangcan San (White Silkworm Powder). Continuous Wind-Teaering requires Danggui Longhui Wan (Angelica and Gardenia Pill) swallowed after meals. Dim vision indicates Heat stagnation; extreme cases in febrile diseases cause blindness. Mild dimness, difficulty focusing, or seeing flies/spots indicates closure of Xuanfu (Mysterious Gates) preventing Ying and Wei Spirit/Qi circulation. Treating Wind-Rash clears eye darkness.
Regarding Spleen Toxin causing scleral swelling; Spirit fatigue causing eye pain; Heart Heat causing hemorrhage into pupil; Wind-Cold causing tearing; Deficiency-Heat causing dimness; Labor causing redness; Phlegm from Wind-Heat invading Lung; Jaundice from Wine damaging Spleen—these require flexible adaptation.
Internal Deficiency dimness fears light most:
Upper Deficiency (Liver Deficiency) causes dizziness, vertigo, tinnitus; Lower Deficiency (Kidney Deficiency) causes blurred vision, eye pain, tinnitus. Blurring damages Qi; dimness damages Blood. Heat syndromes also fear light, but Internal Deficiency patients cannot tolerate sunlight at all.
Internal Cataracts with black spots and dilated pupils:
Internal cataracts present with dimness but no external opacity, caused by brain fat condensing downward, turning the eyeball white, golden, mung-bean colored, or cloudy, or seeing five colors; harder to treat than external cataracts. Brain fat condensing behind the pupil is incurable. Black spots indicate Kidney Deficiency; five-color spots indicate Kidney Deficiency with invading Heat; blue spots indicate Gallbladder Deficiency; red spots indicate Excess Fire. Dilated/blurred vision indicates pupil dilation and profound obscurity.
Myopia indicates Yin Deficiency, Hypermetropia indicates Yang:
Ability to see near but not far, seeing double, indicates Liver-Kidney Deficiency, treat with Shenqi Wan (Kidney Qi Pill) or Dizhi Wan, or add Fire-descending agents. Ability to see far but not near indicates Heart Deficiency, treat with Dingxin Wan (Heart-Calming Pill).
Cold tears and eye pain are often ethereal/vague:
Liver Deficiency with invading Heat causing cold tears in wind requires Guikui Tang (Abutilon Decoction) or Gumuye San (Old Wood Antimony Powder). Eye pain with Fire requires Zishen Wan (Nourish Kidney Pill); without Fire, use Qiling Wan (Lycium and Poria Pill).
Exterior factors: Wind, Heat, Dampness, and Phlegm:
Exterior Wind causes white eyelids, eye tightness, strabismus, itching, and blue tears. Liver Wind-Toxin uses Juhua San (Chrysanthemum Powder); Kidney Wind-Toxin uses Baijili San (Tribulus Powder), Mingmu Liuqi Yin (Brighten Eyes Qi-Flowing Drink), Boyun San (Cloud-Dispelling Powder), Baijiangcan San, Fangfeng Yizi San, or Xijiao Yin (Rhinoceros Horn Drink). Heat causes bulging eyes, hard/red swollen painful lids; select from Xiogan San, Xixin San, Huanjing San, Tonggan San, Xiegan San, Jueming San, Lingyangjiao San (Antelope Horn Powder), Manjing San (Vitex Powder), Jiawei Jinghuang San, Xieqing Wan (Drain Green Pill), Liangdan Wan (Cool Gallbladder Pill), or Zhuoyi Wan (Remove Opacity Pill). Dampness causes poor appetite, fatigue, obscured vision like clouds covering the sun, or sudden blindness; use Yanzhu San (Salt-Atractylodes Powder) or Dan Cangzhu Gao (Single Atractylodes Ointment). Severe Damp-Heat uses Shenxiong Wan (God Celery Pill). Sudden Cold causing blurry vision is actually Heat-driven, treated with Renshen Baidu San (Ginseng Toxin-Resolving Powder). Pain uses Shengma Gegen Tang (Cimicifuga and Kudzu Decoction). Historical ophthalmology notes no true Cold, only Deficiency; does Cold tear Blood upward? Phlegm-coupling causes severe pain, treated with Xiaoxingfeng Tang (Minor Wind-Expelling Decoction) or Nanxing Wan (Arisaema Pill).
Interior damage depletes Qi, Blood, and Spirit:
Seven Emotions damaging Qi cause blurriness, soft swollen eyelids, soreness, and slight redness; treat with Muxiang Liuqi Yin adding Chuanxiong and Tribulus. Wind-Qi conflict causing itching/astringency/tearing uses Qianghuo Shigao San (Notopterygium and Gypsum Powder). Overthinking/fatigue uses Dazhi Wan or Yushen Yeguang Wan; Shock/Fear uses Dingxin Wan; Anger uses Danggui Longhui Wan. Dietary/Labor damage sinking Stomach Qi with blazing Blood uses Yiqi Congming Tang (Benefit Qi and Brighten Eyes Decoction), Cisha Wan, or Huanjing Wan. Severe Qi weakness uses Single Ginseng Paste or Buzhong Yiqi Tang. Stomach-Spleen Heat with retained food uses Qinjiao and Dahuang powder with brown sugar. Stomach-Spleen Dampness with internal/external cataracts uses Jiaomu Wan or Yanzhu San. Alcohol damage causing turbid Qi and blind blood uses Sumu (Sappanwood) decoction with Ginseng powder; purple-black nose/palms use Siwu Tang with Taoren, Honghua, and Sumu decoction/Ginseng. Sexual excess damaging Kidney Qi uses Bushen Wan; Kidney Essence Deficiency uses Yiyin Shenqi Wan; Liver Blood Deficiency uses Yanggan Wan or Shengshu Dihuang Wan; Liver-Kidney Deficiency uses Zhujing Wan. The essence of organs flows from Spleen to Eyes; regulating Spleen raises Qi and clarifies Spirit. Liver tendons connect to Eyes, but clarity is governed by Kidney Essence and Heart Spirit; thus nourishing Essence/Spirit calming Mind is the root of eye treatment.
Wind-Heat combined with Deficiency exists:
Long-standing Heat invaded by Wind-Cold causes non-red but stringy-red/eroded eyes. Wind-Heat combined causes floating redness and severe itching. Generally, exterior syndromes in obese people involve Wind-Heat; Fangfeng and Huangqin (Scutellaria Root) are Sovereign for draining Fire; Huanglian and Danggui are Ministers for nourishing Blood; Chaihu, Shengma, and Baizhi are Envoys for reducing swelling/pain. Add Bai Doukou for red sclera. Thin people with Blood Deficiency use Siwu Longdan Tang, or add Qianghuo, Manjing, Jingjie, Xuanshen, Shanzhiren, Juhua as Auxiliaries. Interior syndromes in obese people with Wind-Deficiency use Fangfeng Yizi San, Sisheng San, Bugan San, or Huanjing Wan. Thin people with Blood Deficiency and Wind use Tongxue Wan, Mingmu Dihuang Wan, Ziyin Dihuang Wan, or Shudihuang Wan. Universal use: Yanggan Wan. Chronic/severe cases use Tuixi Wan or Huoming Yanggan Wan.
Ancients summarized it with one character: Fire.
Eye disorders are merely Excess or Deficiency. White wheel redness indicates Fire invading Lung; Flesh wheel redness/swelling indicates Fire invading Spleen; Five-color spotted black pearl indicates Kidney Deficiency Fire; Spiritual light/Green eye covered by opacity indicates Liver Deficiency Fire; Red vessels/Blood stasis piercing eye with astringent pain indicates Heart Fire self-excess. Youth have Water above, ensuring clear vision; Elderly have Fire above, causing dim vision. Excess Fire with Qi surplus requires breaking Qi (Zhiqiao, Xingren) added to Wind-Heat formulas; Deficient Fire with Blood insufficiency requires descending Fire (Zhimu, Huangbai) added to Yin-nourishing formulas. Double dosage for corneal opacities. Scattering Excess Fire relies on breaking Qi; Descending Insufficient Fire relies on nourishing Yin.
Yang Decline and Low Fire Require Warmth:
Overwork/libido or excessive Cold medicines causing limb numbness, nine orifices dysfunction, eye tightness, large pale pupils, and weak vision require Buyang Tang, Huang [missing] Tang, possibly adding Huangbai, or Juqing Wan. Classic says: Strengthen Water source to calm Yang (Yin nourishment); Strengthen Fire master to eliminate Yin opacity (Yang nourishment). Modern practitioners ignore Yin/Yang, using Dragon Brain (Borneol) and mineral drugs, unaware that pungent dispersal damages vision.
External treatment requires skill:
For sudden redness/swelling with Blood/Qi stagnation, immediate application 3-5 times is acceptable; for slight Qi/Blood deficiency, oral medicine to stop the source plus medicinal washing is better. Cloud membranes allow dropping; absence of opacity mandates washing only, avoiding excessive Cold washing which freezes Blood. Needles/knives/cautery are forbidden by ancients, except for Stye (Styes) on Taiyang meridian where blood can be pricked. Rotting opacity uses Qiancao root ash applied with rush pith, causing pain, scraped off with Baijiecao. Gold needle pupillary displacement is a separate lineage.
Ear
Deafness distinguishes New/Old based on Deficiency-Heat:
New deafness is mostly Heat (Shaoyang/Yangming Fire excess), treated with Wind-Heat dispersing and Phlegm-stagnation opening agents; Old deafness is mostly Deficiency (Kidney insufficiency), treated with tonification and orifice-opening agents. Pulse/symptoms focus on Kidney: Slow/Soft is Deficiency; Floating is Fire; Large is Wind; Deep/Astringent is Qi; Rapid/Solid is Heat.
Stomach Anger Left, Minister Fire Right:
Rich flavors stir Stomach Fire causing bilateral deafness; Anger stirs Gallbladder Fire causing left deafness; Sexual desire stirs Minister Fire causing right deafness. Anger is most common.
Phlegm-Fire/Wind-Dampness/Qi blockage can be unblocked:
Phlegm-Fire from rich diet stomach heat rising causes cicada-like tinnitus. Severe Heat stagnation causes Qi blockage and gradual deafness; treat Erchen Tang adding Huangbai, Mutong, Pianxi, Qumai. Alcohol-induced uses Tongsheng San adding Nanxing, Zhiqiao, Dahuang, or Untan Wan. Wind deafness from Wind-Evil entering ear causes internal itching/headache. Wind-Heat/Stagnation uses Fangfeng Tongsheng San (Rhizome prepared in wine, herbs wine-fried). Wind obstruction with head/eye confusion uses Qingshen San. Wind-Deficiency uses Paifeng Tang, Guixiang Yin, or Xiongzi San. Damp deafness from rain immersion causes internal swelling/pain; use Liangge San adding Qianghuo, Fangfeng (wine-fried), or Wuling San adding Chenpi, Zhiqiao, Zisu, Shengjiang. Damp-Phlegm uses Shenxiong Wan. Damp-Heat with Qi uses Muxiang Binglang Wan. Qi deafness from organ Qi reversal blocking ear with dizziness: Excess/Anger uses Danggui Longhui Wan; Deficiency/Overthinking uses Miaoxiang San. Sadness/stagnation uses Liuqi Yinzi adding Changpu; Upper Excess/Lower Deficiency uses Secret Transmission Jiangqi Tang adding Changpu.
Consumptive Depletion of Essence/Qi is Hard to Save:
Deficiency deafness from chronic diarrhea/post-illness Wind-Evil invading ear with Qi conflict causes buzzing/visual spots. Yin Deficiency uses Siwu Tang adding Zhimu, Huangbai, Changpu, Yuanzhi, or Shenqi Wan adding Cishi, Guzhi, Tusizi, Huangbai. Yang Deficiency uses Bawei Wan, Yishen San, or Cishi Tang. Labor deafness with lethargy/weakness: Qi depletion from labor uses Buzhong Yiqi Tang adding Changpu; with Fire adds Zhimu, Huangbai, Fuling; Essence depletion from sex uses Renshen Yangrong Tang adding Zhimu, Huangbai, or Boguzhi Wan. Chronic deafness with total hearing loss from Kidney/Qi Deficiency is incurable.
Tinnitus is the precursor to Deafness:
Qi blockage often leads to deafness without tinnitus. Wind-Heat tinnitus uses Jiedu Tang adding Shengdi, Zhimu, or Tongsheng San; Phlegm-Fire tinnitus uses Danggui Longhui Wan; with Dampness uses Shenxiong Wan or Qingmuxiang Wan; Kidney Deficiency mild tinnitus uses Zishen Wan. Qi Deficiency uses Sizijunzi Tang; Blood Deficiency uses Siwu Tang; Yin Deficiency uses Huyian Wan.
Retained Pus/Pain gather from Wind-Heat:
Ear oil blocked by Wind-Heat nodules causing tinnitus/deafness: External use of raw pig fat, Earthworm, Potsoot equal parts, ginger juice pills inserted in ear, removed when moist. Severe cases internal Chaihu Cong'er Tang. Suppurative otitis from Wind-Heat stagnation with pus: External Kaifan, Chenpi, Zhiyan ash, SheXiang powder blown into ear. Severe cases Xijiao Yinzi. Ear pain like insect crawling indicates Wind Excess; dry pain indicates Wind-Heat or Deficient Fire; bloody water indicates Wind-Damp. External Snake Slime ash or Kaifan powder. Severe pain uses Wuyu, Wutou, Dahuang paste applied to sole. Severe cases Dongyuan Ruanniu Zi Tang.
Key is Regulating Qi and Opening Orifices:
Kidney is Water Orifice; hearing depends on Metal generating Water. Lung governs Qi, whole body Qi penetrates ears for hearing. Treat all deafness by regulating Qi/opening stagnation, occasionally using Cishi Yangshen Wan. Deafness is Phlegm-Fire stagnation; without Cishi settling, and Wugong, Rougui, HuaJiao, Xin Yi, Changpu dispersing, old Phlegm/Fire cannot open. These are harsh remedies; follow with Tongsheng San to harmonize after cure.
External treatment for sudden deafness penetrates:
Sudden deafness: Kansui pills in ear, single Gancao Tang orally. Later: Pine resin melted with 20 BanDou seeds, scallion juice pills in ear (left ear block right nostril, etc.). Frostbite: Olive pit ash with oil; if eroded, Fumu powder. Insects: Sesame oil, inhale air. Slug: Xin Hua, Xionghuang powder instilled, then cat urine (obtained by rubbing ginger on teeth). Another method uses a piece of zither string...