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Ji (accumulation) refers to the state where pathogenic factors overlap and stagnate without resolving. Heat belongs to Yang. When Yang Qi is balanced, it is normal; when Yang is excessive, it becomes pathogenic. Both normal and pathogenic states allow for movement; movement makes diseases easier to manifest, and easier manifestation makes them easier to treat. This describes the condition of excessive heat mentioned in the previous chapter. If the pathogen is deep, it does not move freely; lack of movement leads to concealment. Concealment upon concealment accumulates day by day and month by month, inevitably forming an accumulation. Long-standing accumulations must eventually ulcerate; only after ulceration do symptoms become apparent, making treatment difficult. "Difficult to treat" does not mean untreatable, but rather that because the pathogen has accumulated for a long time, the disease depth increases after ulceration. Why? Because "ulceration" implies decay. Understanding it as a decaying nature allows for potential rescue. The symptoms include a sensation of hidden discomfort and dryness in the eyes, slight blurring of vision, and the inner canthus (Jingming acupoint area) opening like a needle puncture, exuding pus upon pressure. It may affect both eyes or just one eye. The eyes are associated with the Liver, and the inner canthus is associated with the Bladder. This is caused by pathogenic accumulation in a single meridian. Hence, it is called "Heat Accumulation Ulceration Disease" or "Leaking Pupil Eye Disease," primarily treated with Zhuye Xiejing Tang (Bamboo Leaf Decoction for Draining the Eye Meridian). If the stool is not hard, reduce the dosage of Dahuang (Rhubarb Root) and use Miji Jiedu Wan (Honeyed Pill for Detoxification) as the primary treatment. Otherwise, medication errors combined with prolonged illness will ultimately lead to atrophy and damage.

A question was asked: "Some people see clearly during the day but cannot see anything at night; even with firelight or moonlight, they cannot perceive objects. Why?" The answer was: "This is a disease of Yang Qi deficiency failing to resist Yin, commonly known as 'sparrow blindness' (Nyctalopia)." The questioner asked: "How do you know this?" The answer was: "The *Suwen* (Basic Questions) chapter 'Shengqi Tongtian Lun' states: Since ancient times, those who understand the Heavenly Way recognize that life's root lies in Yin and Yang. Within heaven and earth, within the six directions, the Qi connects to the nine regions and nine orifices, five Zang organs, and twelve joints, all communicating with Heavenly Qi. It also states: Yin and Yang govern the exterior within a day. At dawn, human Qi generates; at noon, Yang Qi is robust; at sunset, Yang Qi is deficient, and the pores (Qi gates) close. Furthermore: If Yang cannot overcome Yin, the Qi of the five Zang organs becomes disordered, and the nine orifices become blocked. Thus, we know this." The questioner asked: "What exactly is Yang Qi?" The answer was: "Human Qi corresponds to the four seasons: Spring and Summer are Yang. It corresponds to a day: Dawn to dusk is Yang. It corresponds to the Zang and Fu organs: The Fu organs are Yang." The questioner asked: "Why can Yang not resist Yin?" The answer was: "Human existence relies primarily on the Spleen and Stomach in the central region. The *Linglan Midian Lun* states: The Spleen and Stomach are the officials of granaries, belong to Earth in the Five Elements, generate all things, and thus are the source of Yang Qi. Their nature favors growth and dislikes killing; they grow in Spring and Summer and store in Autumn and Winter. However, emotions such as worry, thought, fear, and anger, as well as overwork, hunger, and overeating, if excessive and unregulated, all damage the Spleen and Stomach. When the Spleen and Stomach are injured, Yang Qi sinks downward. When Yang Qi sinks, it becomes deficient in the four seasons, the day, and the Zang and Fu organs. Once Yang Qi is deficient, Yin Qi becomes predominant in the four seasons, the day, and the Zang and Fu organs. Since Yin Qi is strong, Yang cannot resist it." The questioner asked: "Why is there no vision at night?" The answer was: "The eyes belong to the Liver, which is the Foot Jueyin meridian. The Shen Shui (spiritual water/fluids of the eye) belongs to the Kidney, which is the Foot Shaoyin meridian. Liver is Wood, Kidney is Water; Water generates Wood, facilitating mutual generation. Moreover, anger injures the Liver, and fear injures the Kidney. If the Liver and Kidney are injured, they cannot generate each other. Day is Yang, the Heaven's Yang; humans correspond to it. Although damaged by worry, anger, overwork, etc., causing Yang Qi to sink, when encountering the time of Heaven's abundant Yang and deficient Yin, our deficient Yang Qi must still rise in response, allowing clear daytime vision. Night is Yin, the Heaven's Yin; humans correspond to it. Having been damaged by emotional and physical stress leading to sinking Yang Qi, when encountering Heaven's abundant Yin and deficient Yang, our already deficient Yang Qi must lie dormant in response. Therefore, vision is lost at night." The questioner asked: "How should it be treated?" The answer was: "Use herbs that anchor Yin and raise Yang, primarily Jueming Yeling San (Cassia Seed and Bat Dropping Powder)." The questioner asked: "Does this disease affect the rich or the poor more?" The answer was: "Are worry, anger, overwork, and dietary irregularities worse among the rich? Actually, the poor cannot escape their severity either." The questioner approved.