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Commentary states: The *Neijing* (Inner Canon) records, "When blood is excessive, it should be drained"; the *Nan Jing* (Classic of Difficult Issues) records, "For swelling and heat, bian stone therapy (stone pricking) should be used." This is because when pathogenic toxins accumulate and the condition is severe, there are indeed cases where medicinal power alone cannot eliminate them; therefore, the methods of hooking, cutting, and bian stone therapy must not be abandoned. Any conditions such as polyps, nodules, or yellow membranes appearing in the eyes are formed by wind-heat and toxic qi from the zang-fu organs steaming the Liver, causing stagnation of Qi and Blood. Treatment should first employ hooks, scalpels, or sickles to wash away noxious pathogens, followed by decoctions and powders for cleansing, and ointments for application.

Method of Hooking, Cutting, Needling, and Sickle-Therapy

For those with red vessels and polyps at both ends of the eyelids, they should be hooked up and cut off completely with a pi needle (flat-bladed needle). If not fully removed, continue cutting until complete. Alternatively, use a fine sewing needle threaded, hold the thread end in the mouth to pull it up, and use another pi needle to cut into the eye. After cutting, cauterize with a fire needle to sever the root; otherwise, recurrence within two or three years is likely. Recurrence leads to adhesion to the eyeball, making treatment difficult. For those with extremely thick pus invading the water wheel (pupil), use a curved-headed comb to lift carefully, avoiding traction damage to the pupil, as the pupil is very thin and easily damaged. Hooking, cutting, and needling should not be performed in the morning, when the abdomen is empty and the five zang organs are deficient, which can cause dizziness and fainting. Furthermore, these procedures should not be rushed but performed slowly.

For eye swelling with nodules inside the eyelid skin, initially the size of rice grains or beans, gradually growing to the size of plums or apricots, containing matter like pus or peach gum, this is caused by wind-heat. It can be punctured with a needle and squeezed out for recovery. However, one must still turn the eyelid and needle inward to avoid introducing wind-toxicity and preventing scarring on the outer eyelid.

For wind-toxic heat swelling结 (knotting) inside both eyelids, causing pain over a long period and gradually enlarging, often secretly damaging the pupil, needle-knives should be used to remove it for cure.

When spleen wind-heat obstruction attacks upward to the eyelids, causing unceasing hot pain and swollen closed eyes, turn the eyelid to inspect above and below the black cornea. If yellow nebulae roots connect to the eyelid, needle them out according to method, then apply medicine.

When wind-toxic heat knots form, swelling resembling [text missing], commonly called eye [text missing], this wind-heat toxic qi often stays at the lower lip edge of the eyelid, where the eyelid lip is hollow and curled. When liver and lung heat occur, it forms knots according to previous methods; needle out the condensed pus.

For eyes that are red, swollen, hard, tearing, difficult to open, and unbearably painful, starting in one eye and then affecting the other, gradually forming nebulae and obscuring vision, this is due to accumulated heat in the diaphragm and liver wind-toxicity rushing upward. First, use a sickle to wash away toxic blood, then administer internal medication.

For red eyes accompanied by sudden yellow qi rising from bottom to top in the black cornea with pain, this is caused by stomach-spleen heat-toxicity steaming and attacking. First, use a sickle on the upper and lower eyelids to disperse stasis, then take various medicines.

For stubborn nebulae in the eyes, lightly touch with a copper needle heated by fire. Apply "Xilin Zhi" (a mineral substance from Persian silver mines); this causes no pain. Do not use other methods.

For yellow membranes growing upward to cover the pupil, initial symptoms include pain, redness, dryness, intermittent onset, tearing, and difficulty opening the eyes. Gradually, nebulae form, directly covering the black cornea, blurring vision. This is due to spleen wind-heat steaming the eyes. Symptoms are as described; first perform hooking, cutting, and sickle-washing, then take medicines to cleanse spleen wind-heat.

For sudden eye redness, dryness, tearing, pain, and itching, gradually forming obstructions, with red membranes drooping and covering the eyeball like morning glow colors, urgently perform sickle-washing to remove stasis, then use eye drops and internal medicines.

For gelatinous coagulation inside the eye bags, this is due to stomach-spleen accumulated heat and wind rushing from the diaphragm into the eyelids. Initially like hemp seeds, later growing like peaches or plums, rubbing against and damaging the pupil, eventually forming nebulae. Puncture to bleed, then sickle-wash to remove stasis, and add decoction therapy.

For eyes pulled by wind (entropion/ectropion), initial symptoms fluctuate, intermittent onset, continuous tearing. This is stomach qi affected by wind, with liver-diaphragm accumulated heat, and wind-heat toxicity steaming the eyelids. Severe cases involve everted eyelid skin. Urgently use a sickle to disperse stasis, and treat with cauterization and internal medicine.

For wind millet (papillae) on the eyelids, caused by heart-lung obstructed toxicity and liver wind, resulting in flesh-like millet grains on upper and lower eyelids, tearing, dryness, pain, and eventual nebulae. Use a sickle to drain bad blood and remove the root.

For eye pain like needle pricks, initial symptoms include slight dizziness, tension in the eye tendons, night-time dryness/pain, tearing, and difficulty opening eyes. Later, pain flares like needle pricks. This is latent heart-toxic heat and wind obstruction in the diaphragm. Long-term results in nebulae and bilateral damage. Urgently perform sickle-washing to bleed, and needle the Yangbai acupoint.

If the eyeball is suddenly struck and protrudes, provided the optic nerve/tendon is not severed, push the eyeball back into the eyelid immediately without startling or touching it. Rub the surrounding area with Bifeng Gao (Wind-Avoiding Ointment) and apply mashed fresh Rehmannia root. For bad blood in the orifice, guide it out with a needle.