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Case Study on Taiji, Yin-Yang, Motion, and Stillness Causing Eye Diseases

The Classic states: The pupil (Tongzi, referring to the black part of the eye) follows the principle of Yin, while the sclera (Baiyan, white part) and red vessels (Chimai, blood vessels) follow the principle of Yang. Therefore, when Yin and Yang coordinate and rotate, vision becomes clear; this indicates that the eye possesses both Yin and Yang characteristics.

It is also stated: The essence and qi of the Five Zang and Six Fu organs all ascend to the eyes, thereby forming visual function. The socket is called the "eye"; the essence of bone manifests as the pupil; the essence of sinew manifests as the black part of the eye (Heiyan); the essence of blood manifests as the collaterals (Luo); the essence of qi within the socket manifests as the white part of the eye (Baiyan); the essence of muscle manifests as the eyelids (Yueshu, constraints). These wrap and gather the essence of sinew, bone, Qi, and blood, connecting with the meridians to form the optic nerve system (Mu Xi), ascending to connect with the brain, and exiting posteriorly at the nape. This indicates that the eye embodies the functions of the Five Zang and Six Fu organs. The later theories of the Five Wheels (Wu Lun) and Eight Palaces (Ba Kuo) are likely based on this. There are two main aspects regarding the relationship between Zang-Fu organs and the eyes: one is the Liver. The Classic states: The color of the East is green, internally communicating with the Liver, opening into the eyes, and storing essence in the Liver. It further states: When a person sleeps, blood returns to the Liver; the Liver receives blood and thus can see. It also states: Liver Qi communicates with the eyes; when Liver Qi is harmonious, the eyes can distinguish the five colors. The second is the Heart. The Classic states: The Heart combines with the vessels, and all vessels belong to the eyes. Later, Li Dongyuan extended this theory to include the Spleen, as mentioned below: Li Dongyuan said: The *Chapter on the Generation of Five Zang* states: All vessels belong to the eyes, and the eyes can see when nourished by blood. The *Needle Classic, Nine Volumes · Da Huo Lun* states: If the mind is troubled and cluttered, diet is irregular, and labor/exertion is excessive, leading to Spleen-Stomach weakness and excessive Heart Fire, then the hundred vessels will boil, blood vessels will flow in reverse, and pathogenic factors will harm the orifices, similar to how the sun and moon lose their brightness at dawn. The essence and qi of the Five Zang and Six Fu organs are all derived from Spleen Earth and ascend to penetrate the eyes. The Spleen is the head of all Yin, and the eyes are the patriarch of Blood and Qi. Therefore, if the Spleen is deficient, the essence and qi of the Five Zang organs lose their control and cannot bring clarity to the eyes. The Heart is the Ministerial Fire (Jun Huo), governing the spirit of humans, and should be quiet and peaceful. The Ministerial Fire (Xiang Huo) acts on its behalf; the Ministerial Fire refers to the Pericardium Collateral (Bao Luo), which governs the hundred vessels and nourishes the eyes. Since physical exertion causes these forces to act recklessly, combined with Yin pathogenic qi damaging the blood vessels, various diseases arise. Any physician who does not regulate the Spleen and Stomach, nor nourish blood and calm the spirit, treating only symptoms and not the root, fails to understand the correct principles.

Zhang Zihe said: Although the Sages stated that the eyes can see when nourished by blood, blood can also be in excess or deficiency. Excess leads to eye congestion and pain; deficiency leads to eye exhaustion and blindness. Thus, young people tend to have excess, while old people tend to have deficiency. However, among the elderly, there are still cases of excess, which must not be overlooked. The inner canthus (Nei Nang) is where the Taiyang Meridian begins, characterized by abundant blood and scarce Qi; the outer canthus (Rui Nang) belongs to the Shaoyang Meridian, characterized by scarce blood and abundant Qi; the upper eyelid (Shang Gang) belongs to the Taiyang Meridian, also with abundant blood and scarce Qi; the lower eyelid (Xia Gang) belongs to the Yangming Meridian, with abundant blood and Qi. The Yangming Meridian originates at the junction beside the eyes, meeting with the Taiyang and Shaoyang meridians at the eye. Only the Foot-Jueyin Liver Meridian connects directly to the optic nerve system. Therefore, blood excess is an excess syndrome of the Taiyang and Yangming meridians, while blood deficiency is a deficiency syndrome of the Jueyin meridian. Hence, bloodletting therapy is suitable for the Taiyang and Yangming meridians because these two meridians have abundant blood. The Shaoyang meridian should not undergo bloodletting because it has scarce blood. Pricking the Taiyang and Yangming meridians to release blood makes the eyes clearer; pricking the Shaoyang meridian to release blood makes the eyes dimmer. One must know not to allow blood to be excessive or deficient, but rather to nourish the blood vessels. If blood is too much, it overflows; if too little, it dries up. Heat causes blood to flow fast and abundantly; cold causes blood to flow slow and sparingly; this is the general rule. The eyes are the external manifestation of the Liver. The Liver stores blood and belongs to Wood in the Five Elements. Although Wood plants, if too lush, become dense and obscuring; if too withered, they become dry and brittle. The Five Wheels of the eye are the essence of the Five Zang and Six Fu organs and the gathering place of the principal vessels. The white sclera belongs to Lung Metal; the flesh wheel (eyelids) belongs to Spleen Earth; the red vessels belong to Heart Fire; the black water and divine light (pupil and vision) belong to Kidney Water, and also relate to Liver Wood. This is known to the secular world. However, when eye diseases occur, people often do not understand the pathology. How can we say that eyes do not get sick without Fire? Consider this: Reddening of the white wheel indicates Fire invading the Lung; redness and swelling of the flesh wheel indicate Fire invading the Spleen; opacity covering the black water and divine light indicates Fire invading the Liver and Kidney. Red vessels penetrating the eye indicate intensifying Fire. Treating Fire resolves the issue in one sentence. Thus, the *Inner Classic* states: Excessive heat leads to swelling. All sudden cases of red, swollen, painful eyes, photophobia, astringency, continuous tearing, and squinting due to sudden cold are caused by excessive heat. Herein, the affiliations of the Five Wheels and the diseases governed by the Eight Palaces are listed as a guide for practitioners.