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Chen Wuyue stated: Unregulated joy and anger, combined with worry and excessive thinking, lead to an imbalance of Qi in the Zang-Fu organs. Qi stagnation generates phlegm-fluids (Tan Yin), which ascend with the rebellious Qi. Taking advantage of the deficiency in the brain, it infiltrates the Eye System (Mu Xi) and pours into the eyes. Mild cases present with blurred vision and dryness; severe cases manifest as visual obstruction by nebulae (Yi Yi), increased discharge and tearing, growths on the eyelids (Chi Lei Rou), and white membranes covering the cornea. These are all due to internal causes. If one frequently exposes oneself to wind-cold or fails to avoid summer-heat and dampness, pathogenic factors invade the neck, enter the brain along the Eye System taking advantage of deficiency, and invade the eyes causing eye diseases; these are external causes. Indulgence without restraint, irregular eating habits, frequent consumption of the Five Pungent Foods, overeating roasted and fried foods, riding and hunting, exposure to smoke and dust, and physical labor from external desires are all root causes of blindness. These constitute internal and external causes.

Xu Yanchun stated: The human eyes possess the functions of the Zang-Fu organs and the Five Elements, mutually supporting each other to generate visual clarity, thus enabling sight. Internal obstructions (Nei Zhang) present with a small pupil and dimming of the divine light (Shen Guang). External obstructions (Wai Zhang) present with visible nebulae. Causes of internal obstructions include phlegm-heat, Qi stagnation, blood-heat, Yang deficiency, Yin deficiency, and depletion of Ying and Wei (Defensive and Nutritive Qi). They vary greatly. External obstructions may arise from the upper eyelid, lower eyelid, or within the eye itself. By observing the color of the nebulae and determining which meridian they originate from, treatment should be differentiated accordingly. Regarding eye diseases: Liver heat causes blurred vision; Heart heat causes irritability and pain; Wind-dampness and blood deficiency cause dryness and itching; Kidney deficiency leads to loss of containment, potentially resulting in protrusion or sinking of the eyeball; slow progression leads to dark nebulae.

The *Mai Jing* (Pulse Classic) states: A surging and rapid pulse at the Left Cun position indicates Heart Fire flaming upward. A wiry and surging pulse at the Left Guan position indicates abundant Liver Fire. A weak and thin pulse at the Left Chi position indicates that Kidney Water does not ascend, while Fire remains above. Surging and wiry pulses at both Right Cun and Guan positions indicate Liver Wood, carrying the momentum of Ministerial Fire, insulting Metal (which it normally controls) and damaging Earth (which controls it). A surging and rapid pulse at the Right Chi position indicates Ministerial Fire and pathogenic Fire flaming upward, carrying Liver Wood pathogens to scorch the eyes. Note: Floating, tight, and forceful pulses indicate Cold; deep, rapid, and forceful pulses indicate Heat; minute, fine, and weak pulses indicate Deficiency; surging, large, and slippery pulses indicate Excess. The Five Zang organs generally desire mutual harmony and generation: for instance, the Heart presents with a moderate pulse, the Liver with a surging pulse, the Lungs with a deep pulse, the Spleen with a choppy pulse, and the Kidneys with a wiry pulse. This is the principle of Zang-Zang combination and generation, imbued with Taihe Qi; how could disease arise? For patients, however, the Five Zang organs exhibit mutual overcoming and opposition: e.g., Heart presenting with deep/fine pulses, Liver with short/choppy pulses, Kidneys with slow/relaxed pulses, Lungs with surging/large pulses, Spleen with wiry/long pulses. This is the mechanism of Zang-Zang punishment and overcoming, leading to reciprocal changes, ensuring disease arises. The principles of generation and overcoming apply universally, not just to eye diseases. The Classics state: When the Five Zang are disharmonious, the Six Fu do not circulate; when the Six Fu do not circulate, the Nine Orifices become fatigued and obstructed; when the Nine Orifices are obstructed, Qi and Blood stagnate. This also causes aversion to cold, fever, aversion to wind, spontaneous sweating, chest and diaphragm fullness, resembling Taiyang syndrome or malaria. However, differences include: red eyes with prominent white sclera vessels but no headache, stiff neck, shivering during chills, or confusion during fever. If there is dizziness, blurred vision, headache, but non-red eyes, it is an internal obstruction. Due to excessive exposure to the Six Evils and Seven Emotions, improper diet, sexual excess, and inappropriate movement, how can one maintain perfect balance without being disturbed by pathogens? The Zang-Fu and orifices fail to circulate smoothly, leading to internal accumulation of phlegm-fluids. I specifically describe the pulses of phlegm-fluids as wiry, minute, deep, and slippery. Some say large pulses at the left and right Guan positions, or deep and large pulses, indicate phlegm. Eyelids and eyes appearing gray-black like smoke also indicate phlegm. However, in treatment, since phlegm moves due to Fire, reducing Fire is paramount; since Fire rises due to rebellious Qi, regulating Qi is essential. "Excess brings harm, subjugation brings control": extreme cold generates heat, extreme heat generates cold, extreme Wood resembles Metal, extreme Fire resembles Water, extreme Earth resembles Wood, extreme Metal resembles Fire, extreme Water resembles Earth. The Left Cun position is where the Heart and Small Intestine meridians emerge, belonging to Sovereign Fire. The Left Guan position is where the Liver and Gallbladder meridians emerge, belonging to Wind-Wood. The Left Chi position is where the Kidney and Bladder meridians emerge, belonging to Cold-Water. The Right Cun position is where the Lungs and Large Intestine meridians emerge, belonging to Dry-Metal. The Right Guan position is where the Spleen and Stomach meridians emerge, belonging to Damp-Earth. The Right Chi position is where the Mingmen and Sanjiao meridians emerge, belonging to Ministerial Fire.

The six pulses are floating, deep, slow, rapid, slippery, and choppy. Floating pulses belong to Yang, indicating exterior, wind, or deficiency. Deep pulses belong to Yin, indicating interior, dampness, or excess. Deep and slow pulses belong to Yin, indicating cold in the Zang organs. Floating and rapid pulses belong to Yang, indicating heat in the Fu organs. Slippery pulses indicate abundant blood and vigorous Qi. Choppy pulses indicate stagnant Qi and withered blood.

The Eight Essentials are exterior, interior, deficiency, excess, cold, heat, pathogen, and upright Qi. Exterior means the disease is not in the interior; interior means the disease is not in the exterior. Deficiency includes five signs: fine pulse, cold skin, shortness of breath, diarrhea, inability to eat/drink. If congee enters the stomach and diarrhea stops, life can be saved. Excess includes five signs: surging pulse, hot skin, abdominal distension, obstruction of urination and defecation, mental cloudiness. If urination and defecation become free and sweat appears, life can be saved. Cold indicates accumulated cold in the Zang-Fu; Heat indicates accumulated heat in the Zang-Fu; Pathogen indicates interference by external evils; Upright Qi indicates disease originating from the Zang-Fu themselves.

The *Nei Jing* states: Eye pain with red vessels moving from top to bottom is Taiyang disease; from bottom to top is Yangming disease; from outside to inside is Shaoyang disease; from inside to outside is Shaoyin disease. Taiyang disease should be treated with warming and dispersing; Yangming disease with purging and cooling; Shaoyang disease with harmonizing; Shaoyin disease with clearing.

The *Baoming Ji* states: Eye diseases in the Fu organs are exterior syndromes, requiring dispelling wind and dissipating heat; in the Zang organs, they are interior syndromes, requiring nourishing blood and calming the spirit. Acute onset indicates exterior syndromes, easy to treat; chronic illness indicates interior syndromes, difficult to treat. This clearly distinguishes exterior and interior. Using this theory to treat diseases is as effective as striking a drum with a mallet.

The *Ling Shu: Dian Kuang* chapter states: The outer corner of the eye on the face is called the acute canthus (Rui Zi); the inner part near the nose is the inner canthus; the upper part is the outer canthus; the lower part is the inner canthus.

Generally, men suffer more often from the left eye, and women from the right eye, due to differences in Yin-Yang and Qi-Blood. Cases where either side is affected randomly are due to attacking pathogenic heat. If a man injures the left eye first and the right eye repeatedly recurs, it cannot be preserved. If a woman injures the right eye first and the left eye repeatedly recurs, it cannot be saved. Treatment must prioritize observing the patient's age and constitution. Young and robust patients are easy to treat; old and weak patients are difficult. Easy cases require mild medication; difficult cases require tonification. Medication must follow symptoms and not be rigid. Although eye diseases are diverse, initial assessment determines prognosis. Conditions such as convex/concave pupils, green/white/red discoloration, pure black pupils, or lack of luster in the eyes are untreatable, representing blood decline in the elderly. Nebulae shaped like half-moons are difficult to treat. If the eyeball is round and undamaged, regardless of the number or thickness of nebulae, they are treatable. Smooth nebulae and nebulae located on the pupil are difficult to resolve. Thin nebulae and small spots are hard to eliminate. If nebulae are not fully resolved, surgical cutting must absolutely be avoided. Vision depends on blood; cutting damages blood. Moxibustion should also be avoided. Nebulae arise from Liver Fire; attacking them with fire is adding fuel to the fire, which is not a good method. One must first take oral medicine and use eye drops simultaneously so that the disease gradually recedes and is eradicated without recurrence.

Note: Eye diseases include exterior contractions and internal injuries. Exterior contractions involve wind, cold, summer-heat, dampness, dryness, and fire, representing branch symptoms. Patients experience sudden eye pain, redness and swelling of the white sclera, discharge, tearing, and redness/ulceration. Though urgent, these are easy to treat. Internal injuries stem from the Seven Emotions (joy, anger, worry, thought, grief, fear, fright). Patients present with sinking of the black cornea, crab-eye formation (crab-eye nebula), hazy nebulae, non-red white sclera, abnormal pupil size, and blurred vision. Various internal obstructions have a slow onset but are difficult to treat. There are also conditions neither purely internal nor external, caused by irregular diet, hunger/fullness, and fatigue, which should primarily regulate the Spleen and Stomach. Although eye diseases are numerous, they fall under wind-heat, deficiency, and excess patterns. Treatments involve dispersing, clearing, tonifying, and purging. Tonification should not excessively use Ginseng and Atractylodes to avoid aiding fire; only clear, harmonizing, and moistening agents should be used. Purging should not excessively use Mirabilite, Rhubarb, or Gentiana to avoid coagulating blood; only dispersing and stasis-resolving agents should be used. Proper medication leads to self-healing. Modern practitioners often use either strong tonics or sudden strong cold herbs, causing injury. Avoiding cold formulas is a key rule in treating eye diseases. One must also address the source of the disease: advise alcoholics to quit slowly, those lustful to curb desires gently, and those prone to rage to calm down through gentle persuasion. If they do not listen, treatment is difficult. The Heart generates blood, the Spleen controls blood, and the Liver stores blood. Blood flows when warm and coagulates when cold. Coagulation leads to nebulae and membranes, causing eye disease. Caution is essential. After eye diseases, nourishing Kidney Water is advisable. Why? The eyes are governed by the Liver, which opens into the eyes; vision depends on blood. Nourishing Kidney Water generates Wood (Liver); Wood generates Fire (Heart); Fire generates Earth (Spleen); Earth generates Metal (Lungs); Metal generates Water (Kidneys). This cycle continues infinitely, providing boundless benefit. If Kidney Water is depleted, Water cannot generate Wood, Wood cannot generate Fire, Fire cannot generate Earth, Earth cannot generate Metal, and Metal cannot generate Water. Liver Blood becomes deficient while Fire flares wildly; the harm is incalculable.