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Chen Wuyue stated: When patients lack moderation in their emotions of joy and anger, and when sorrow and overthinking intertwine, it leads to an imbalance of the Qi within the Zang organs. The stagnation generates phlegm-fluids (Tan Yin), which ascend with the Qi and, encountering deficiency in the brain, invade and infiltrate the eye system, projecting into the eyes. Mild cases result in blurred vision and dryness; severe cases lead to visual obstructions (Yi Yi), excessive discharge and tearing, flesh growths, and white membranes covering the pupil. These are all caused by internal factors. Alternatively, repeated exposure to wind and cold, failure to avoid summer heat and dampness, allows pathogenic factors to strike the neck, entering the brain via the eye system due to deficiency. This produces external visual obstructions. Conditions described in medical texts such as Green Wind, Green Wind, Purple Wind, Black Wind, Red Wind, White Wind, White Obstruction, and Yellow Obstruction arise from the influence of the Eight Winds, generating various symptoms; these are all caused by external factors. Or, if desires and lusts are unregulated, eating is irregular, raw pungent foods are consumed, roasted meats are eaten while hot, one engages in horse riding and hunting, or exposes oneself to smoke and dust, laboring the external aspects of emotion, this constitutes the root cause of blindness and falls under the category of neither internal nor external factors. Treatment should be applied accordingly.

Commentary: The causes of disease discussed here are extremely detailed and comprehensive. It is a pity that the formulas often rely on clearing wind-heat and treating kidney Yang deficiency without being fully exhaustive. Students must learn to adapt and vary these principles flexibly.

Chao Yuanfang stated: Whenever a small hard nodule suddenly forms inside the eyelid, producing pus within three to five days, the world calls this "Stealing Needle" (Tou Zhen). This occurs because heat pathogens lodge between the eyelids, and heat condenses body fluids to form the lesion. In mild cases, where there is only minor aggregation, once the pus breaks and the heat subsides, recovery ensues.

Respectfully noted: Folk tradition holds that when an eye ailment first presents with a small nodule, observing the patient's back reveals fine red spots resembling sores. Pricking these spots with a needle cures the eye condition instantly, hence the name "Stealing Needle." This actually resolves the constrained heat in the Taiyang Meridian. Empirical tests confirm its efficacy. However, Chao Yuanfang only identified the etiology without further distinguishing the meridians involved, and many of the names and actual correspondences have been subject to extensive interpretation.

Li Dongyuan stated: In the sixth month of the Wushen year, Commander Xu suffered from an eye disease. Two black-and-white visual obstructions appeared beneath the upper eyelids, causing a hidden sensation of roughness and difficulty opening the eyes. Both eyes were constricted but painless. The Cun position of both wrists presented a thin and tight pulse, which felt surging yet powerless upon deep pressure. This indicated that the Foot-Taiyang Bladder Meridian was being scorched by the Ministerial Fire of the Gate of Life, reversing its flow to create a cold-water obstruction and a cold membrane obscuring the pupil. Symptoms included yawning, propensity for sadness and forgetfulness, sneezing with discharge and tears, frequent spontaneous tearing, a complexion alternating between red and pale, good appetite, difficult defecation, frequent urination accompanied by sighing, upward rushing of Qi leading to wheezing, and was treated with Bo Yun Tang.

Discussion on Pupil Dilation and Formulas: In early winter of the Wuxu year, Li Shuhe arrived at the Western Capital. Friends entertained him with pork pancakes eaten with garlic and vinegar. He subsequently drank excessively until drunk and slept on a warm kang. The next day, he fell ill with eye problems: both pupils dilated beyond the iris, vision became blurry, perceiving small objects as large and short distances as long, seeing non-existent things, stumbling while walking. Despite seeking various medical treatments, none cured him. By spring of the Jihai year, he sought treatment from my teacher, who said: The *Neijing* states: "The essence of the Five Zang and Six Fu organs all pours into the eyes to form visual clarity. The gathering place of essence is the eye; the essence of bone manifests as the pupil." It also says: "The essence of tendons, bones, Qi, and blood forms the vessels, converging into the eye system, connecting upwards to the brain." Furthermore, "The pupil and dark part of the eye follow the principle of Yin." Currently, the dilation of the pupil is due to excessive consumption of pungent and hot foods. Pungency promotes dispersion, and heat aids fire, which ascends to the brain, causing the essence to scatter. Scattered essence results in dispersed vision. Clarity is what allows us to perceive all things. Since perception is not true, the essence has declined. Fire and Qi cannot coexist in dominance. Thus, the classics state: "Excessive fire consumes Qi; excessive fire scatters Qi." The wind-heat governed by the Hand-Shaoyin Heart Meridian and Foot-Jueyin Liver Meridian connects to the eye system. Pathogens attacking humans follow their own kind, thus attacking via this pathway. Head and eye swelling, stuffiness, and pupil dilation are all due to Blood deficiency and Yin weakness. One should dispel wind-heat, cool the blood and nourish Blood, to gather the scattered Qi, and recovery will occur. Use Ziyin Dihuang Wan. The *Neijing* states: "When heat dominates, soothe it with salty-cold substances, assist with bitter-sweet ones, and astringe with sour ones." Use Coptidis Rhizoma (Huanglian) and Scutellariae Radix (Huangqin), both greatly bitter and cold, to eliminate rampant pathogenic factors as Sovereign drugs; Angelicae Sinensis Radix (Danggui Shen), acrid-warm, along with Rehmanniae Radix Preparata (Shu Dihuang) and Rehmanniae Radix (Sheng Dihuang), bitter-sweet and cold, to nourish and cool Blood as Ministers; Schisandrae Fructus (Wuweizi), sour-cold, light and floating upward, to astringe the dilated pupil; Ginseng Radix (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao), Lycii Cortex (Digupi), Asparagi Radix (Tianmendong), and Aurantii Fructus (Zhike), all bitter-sweet and cold, to drain heat and tonify Qi as Assistants; Bupleuri Radix (Chaihu) as the Guide drug. Avoid spicy foods that aid fire pathogens, and avoid cold foods that damage Stomach Qi, otherwise the medicine cannot ascend.

[Zhu Danxi]: A young man woke up unable to see objects. After lying down for a moment, he could see slightly but unclearly. His appetite decreased, and he was extremely fatigued. His pulse was slow and large, scattering and powerless upon deep pressure. I suspected dampness. Upon inquiry, he confirmed sleeping on a damp floor for half a month. I used Atractylodis Macrocephalae Rhizoma (Baizhu) as Sovereign, Astragali Radix (Huangqi), Poria (Fuling), and Citri Reticulatae Pericarpium (Chenpi) as Ministers, and Aconiti Lateralis Radix Praeparata (Fuzi) as Assistant. After more than ten doses, he recovered.

[Zhu Danxi]: An elderly man suddenly went blind with no other complaints. I diagnosed extreme deficiency and urgently decocted two jin of Ren Shen Gao (Ginseng Paste). After two days of ingestion, another physician administered Magnetitum (Cishi) medicine. I said, "He will die tonight." Indeed, he did.

[Zhu Danxi]: A robust man who enjoyed drinking hot wine suddenly went blind with a choppy pulse. This injury was caused by hot wine, resulting in turbid blood in the Stomach Qi and stagnant dead blood internally. I used Sappan Lignum (Sumu) decoction, mixed with Ginseng powder. After two days, his nose and palms turned purple-black. I said, "The stagnant blood is moving." I prescribed Si Wu Tang added with Sumu, Persicari Herba (Taoren), Carthami Flos (Honghua), and Chenpi, decocted and mixed with Ginseng powder. He recovered after several days. (The above three case records are from *Danxi Zuanyao*).

Qianfu stated: Director Zhang Zijian, aged 67, suffered from dim vision, slight blackening of the eyes, and lusterless skin. His six pulses were wiry, thin, and powerless. One day, he showed me two prescriptions for eye treatment and asked, "Can I take these?" I replied, "These two formulas use Huanglian, a greatly bitter herb, as the Sovereign, and various wind-dispelling herbs as Assistants. Moreover, after age fifty, Gallbladder juice diminishes, leading to poor vision. The *Neijing* states: 'For disorders of the Earth element, purge with bitterness; wind herbs can also purge Earth.' After age seventy, the Spleen and Stomach are deficient, and flesh is withered. Purging Earth heavily renders the Spleen and Stomach too weak to circulate Ying and Wei Qi, failing to nourish Yuan Qi. If Stomach Qi cannot ascend, diseases like chest oppression, vomiting, and food regurgitation will arise. Given his advanced age and frailty, it is better not to take these medicines. He should speak cautiously, regulate his diet, restrain anger, and curb desires. This is the method of curing without direct treatment." The following spring, Zhang was appointed Inspector General of Guanxi Road. Three years later, upon retirement, his spirit was clearer than before, and his pulse became peaceful. This demonstrates that one should not recklessly administer cold-cooling agents. The *Neijing* states: "Punitive measures without excess are called great confusion," which explains the situation.

Hai Zang's wife's niece was obese. She developed eye disease upon reaching marriageable age, recurring monthly or every two months. Attacks involved severe redness and swelling making eyes hard to open. This persisted for three years. After taking wind-dispelling and heat-clearing formulas, her left eye developed stubborn opacity spreading from the inner canthus to cover the pupil, and her right eye developed opacity rising from below. The classics state: "Spreading from inside out indicates Shaoyang disease; rising from below indicates Yangming disease." I believed there was accumulation in the Shaoyang and Yangming meridians. Her pulse was short, slippery, and solid, appearing short in the morning. Jiegu stated: "A short pulse indicates accumulation obstructing the Zang-Fu; purgation is indicated." I used Wen Bai Wan, reducing Chuanxiong Rhizoma (Chuanxiong) and Fuzi by two-thirds, adding significantly Gentianae Radix (Longdancao) and Huanglian. Following Dongyuan's method for five accumulations, starting with two pills, increasing by one pill daily. If severe diarrhea occurred, reduce the dose; then restart from two pills. Suddenly, on one day, she passed several black blood clots in her stool, hard and bean-sized. From then on, she gradually recovered, and the opacities completely disappeared. (See *Yixue Gangmu*).

Lou Quanshan stated: Xia Ku Cao (Prunella Vulgaris) is miraculously effective for eyeball pain that worsens at night. It is also miraculous for cases where using cold-bitter eye drops exacerbates the pain. The eyeball connects to the root of the eye and belongs to the Jueyin Meridian. Pain worsening at night or with cold-bitter applications occurs because night and cold belong to Yin. Danxi said: "Xia Ku Cao has the function of nourishing the Jueyin Blood vessels. It flowers in the third and fourth lunar months and withers when Yin arises at the Summer Solstice. It possesses pure Yang Qi." This is profound. Therefore, treating Jueyin eye pain effectively involves using Yang to treat Yin. My son suffered from nightly pain in the eyeballs extending to the supraorbital ridge, with unilateral head swelling and pain. Using Huanglian Gao (Coptis Ointment) exacerbated the pain severely, and hundreds of remedies failed. Moxibustion on Jueyin and Shaoyang points stopped the pain temporarily, but it returned after half a day. This cycle continued for over a month. Finally, I used two liang of Xia Ku Cao, two liang of Cyperi Rhizoma (Xiangfu) powder, and four qian of Gancao, ground into fine powder. Each dose was one and a half qian, taken with clear tea. The pain reduced by more than half upon swallowing, and full recovery occurred within four to five days.

A man in his sixties suffered identically to the previous case, except for two white opacities on the cornea. Various medicines failed. He was given the same formula combined with Dongyuan's Xuanqi Tang, Si Wu Tang, and Huanglian decoction, administered alternately, along with moxibustion on Jueyin and Shaoyang meridians, leading to stabilization.