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The *Neijing* (Yellow Emperor's Inner Classic) states: The essence and qi of the five zang organs and six fu organs all ascend and pour into the eyes, thereby forming vision. The deep cavity of the eye is called the "eye nest." Among them, the essence of bone gathers in the pupil; the essence of sinews gathers in the black eyeball (iris); the essence of blood gathers in the intraocular vessels and surrounding tissues; the essence of qi gathers in the white eyeball (sclera); the essence of muscles gathers in the eyelids (the tissue that constrains the opening and closing of the eyelids). These tissues wrap around the sinews and bones, and the essence of qi and blood combines with the meridians to form the optic nerve system, connecting upward to the brain and exiting posteriorly from the nape. (The later theories of the Five Wheels and Eight Palaces are likely derived from this.) Therefore, the pupil and black eyeball correspond to Yin, while the white eyeball and red blood vessels correspond to Yang. When Yin and Yang coordinate and transmit together, clear vision is achieved. The East corresponds to the color green, communicating with the Liver, which opens into the eyes and stores essence. When a person sleeps, blood returns to the Liver. The Liver receives blood and thus enables vision. The Heart harmonizes with the vessels, and all vessels belong to the eyes. The eyes are the gathering place of numerous sinews and the pathway for fluids to ascend. If tears do not stop, body fluids will be depleted; if body fluids are depleted, essence cannot irrigate; if essence cannot irrigate, the eyes cannot see. When Qi escapes, vision becomes unclear. The outer canthus on the side of the face belongs to the Shaoyang meridian; the inner canthus near the nose belongs to the interior; the upper part is the outer canthus (belonging to the Taiyang meridian); the lower part is the inner canthus (belonging to the Yangming meridian). Red blood vessels running from top to bottom indicate a Taiyang disease; those running from bottom to top indicate a Yangming disease; those moving from the outside inward indicate a Shaoyang disease. When pathogenic factors lodge in the Yang Qiao vessel, it causes eye pain, starting from the inner canthus.

Li Dongyuan said: The classics state: "All meridians belong to the eyes, and the eyes can see when nourished by blood." It also says: "If the mind is troubled and cluttered, diet is irregular, and labor is excessive, it leads to Spleen-Stomach weakness and excessive Heart Fire. This causes the hundred vessels to boil and surge, blood vessels to flow in reverse, and pathogenic factors to harm the orifices. The essence and qi of the five zang and six fu organs all rely on the Earth of the Spleen for reception and transportation, then ascend to the eyes. The eyes are the master of blood. Therefore, Spleen deficiency causes the essence and qi of the five zang organs to lose their control, failing to brighten the gaze. The Heart is the Minister Fire, governing human spirit, and should be quiet and peaceful; the Minister Fire acts on its behalf. The Minister Fire is the Pericardium, governing the hundred vessels, which all nourish the eyes. Since labor and movement cause the force of Minister Fire to act recklessly, combined with pathogenic invasion 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 principle."

Zhang Zihe said: Eyes do not become diseased unless caused by Fire. For example, redness in the Qi Wheel indicates Fire attacking the Lung; swelling and redness in the Flesh Wheel indicate Fire attacking the Spleen; impairment of the Black Water Divine Light indicates Fire attacking the Liver and Kidney; red vessels penetrating the eye indicate extreme Fire. To treat Fire diseases, one sentence suffices. Thus, the *Neijing* states: "Excess heat causes swelling." The method to treat Fire involves using salty-cold herbs, or employing emetic and purgative methods; in acupuncture, points such as Shenting (GV24), Shangxing (GV23), Xinhui (GV22), Qian Ding (GV21), and Baihui (GV20) are selected. If there are opacities formed by blood stasis, they can be made to recede immediately; pain can be stopped immediately; dimness can be made bright immediately; swelling can be eliminated immediately. However, infants must not have the Xinhui point needled because the tissue is shallow, risking bone injury. Infants have Water above and Fire below, so their eyes are bright; the elderly have Fire above and insufficient Water, so their eyes are dim. The *Neijing* states: "Where blood is excess, it should be drained." It also says: "Deficiency is tonified, excess is reduced." Conditions like night blindness (Achanopia) and internal cataracts, often caused by sudden anger or great sorrow, are contraindicated for bloodletting; instead, tonifying the Liver and nourishing the Kidney is appropriate. If the eyes suddenly swell, feeling tight and difficult to open, pricking the Qian Ding and Baihui points with a three-edged needle to release a small amount of blood yields excellent results. Superficial needling is preferred to avoid bone injury. The points Hou Ding (GV19), Jiangjian (DU16), Naohu (GV17), and Fengfu (GV16) should not be lightly needled due to numerous contraindications. Sudden blindness is caused by Minister Fire. At this time, the Taiyang and Yangming meridians have abundant Qi and Blood; pricking the Zanzhu point (BL2) near the nose and the first five points on the vertex to release significant blood restores vision immediately. Bleeding other meridians worsens the condition. Thus, it is said: "Needling Taiyang and Yangming makes the eyes brighter; needling Shaoyang and Yangming makes the eyes dimmer." In recent times, using Guangming Cao (Euphrasia officinalis) to draw blood threads from the upper and lower eyelids has often been effective; this is the method of three-edged needle bloodletting, applicable only to excess and acute conditions. External obstructions belong to Wind-Heat congestion; the flesh of the upper and lower eyelids rubs against the eye, eventually generating opacities that obscure clarity. One should disperse Wind and clear Heat, applying external drops. Internal obstructions belong to deficiency with Qi stagnation; the Black Water Divine Light is dim and opaque. Externally the eyes look normal but cannot perceive objects, without pain or itching, only inability to see. Treatment must differentiate based on Qi, Blood, Spleen, and Stomach.

The *Yin Hai Jing Wei* (Silver Sea Sublime Microcosm) states: The eyes are the essence of the five zang organs, like the sun and moon hanging in the sky, bright and undeniable. Redness at the head and tail of the eye belongs to the Heart; the entire white sclera belongs to the Lung; the dark pupil wrapped within belongs to the Liver; the upper and lower eyelids belong to the Spleen; the central black pupil like lacquer is governed by the Kidney. Each zang organ has corresponding manifestations. However, regarding governance, the pupil is most critical. Why? Because the eyes are the external manifestation of the Liver. Liver belongs to Wood, Kidney to Water; Water generates Wood. Liver is the child, Kidney is the mother; how can child and mother be separated? Thus, when Liver and Kidney Qi are abundant, vision is bright and clear; when deficient, there is dimness, vertigo, red halos around the black wheel, stabbing pain, and floating turbidity, indicating Liver Heat. New tearing, dry yellow encircling the eyes indicates Liver Deficiency. Dilated pupils, pale and deviated indicate Kidney Deficiency. Constricted pupils, slightly yellowish, indicate Kidney Heat. One deficiency, one excess; verify by these signs. Whenever heat rushes to the eyes, clear the Heart and tonify the Liver. Do not rigidly adhere to the Water-generates-Wood theory; analyze specifically: tension, whitening and itching of the pupil and eyelids with clear tears, no redness or pain, is called Wind Eye; protrusion of the black wheel, hard and swollen red eyelids, sticky discharge, internal heat and stabbing pain, is called Heat Eye; dim vision with tearing, soft swollen eyelids, congestion and haziness, soreness and slight redness, is called Qi Eye. If Wind and Heat combine, there is itching and floating redness; if Wind and Qi clash, there is itching and heaviness. Blood-Heat aggregation produces conditions like skin flaccidity, millet-like bumps, red threads, and hordeolum. Lack of Qi and Blood leads to squinting, ptosis, night blindness, and visual obstruction. Pale purple with hidden red indicates Deficient Fire; bright red indicates Excess Heat. Exposed canthi with growing caruncle tissue indicate Heart Blood Heat and Prosperity; white or red membranes resembling constricted wheels indicate Qi Stagnation and Blood Coagulation. Heat patterns show congested pupil flesh, wet sclera, floating red color; Cold patterns show green-blue pupils, withered sclera, sinking turbid Qi. Chronic eye heat compounded by Wind-Cold causes redness and erosion. Non-red eyes but painful due to Phlegm-Fluid retention. Liver Qi stagnation with Heat causes photophobia; Liver Heat accumulation injuring eyelids causes lid closure. These are general external signs. However, the five zang organs cannot be excluded; why are Spleen and Lung seemingly absent? Answer: Redness in the sclera or red veins indicates Heat in the Lung; lesions on upper/lower lids or between eyelids like scabies spots indicate Heat in the Spleen. Spleen governs taste; five flavors nourish the interior, manifesting spirit externally. Lung governs Qi; water and fire ascend and descend, Ying and Wei circulate; who else but Qi drives this? The previous statement that each zang has specific signs can be deduced here. Although eye diseases mostly arise from Heat, medication generally prioritizes clearing the Heart, cooling the Liver, regulating Blood, and smoothing Qi. The Kidney dislikes dryness; in deficiency cases, use moistening agents like Dang Gui (Angelicae Sinensis Radix) and Di Huang (Rehmanniae Radix); warm herbs should not be used lightly. Regarding removing opacities, it is crucial. Opacities arising from the Lung, where Lung Heat is present, range from mild haziness to severe opacity. Pearl-like or broken-rice-like opacities are easy to dissipate; plum-blossom-shaped ones are hard to eliminate. Although opacities arise from Heat, treatment should first remove opacities before clearing Heat. If one argues that extreme Heat generates opacities and clears Heat first, the Blood will freeze like ice, and opacities cannot be removed. Patients with red eyes given too many cold herbs and washed with water find the water coagulates instantly. The eye is like a mass of water, and water nature is clear; thus, reliance on washing/drops is inadvisable. Irregular emotions, excessive desires, straining eyesight, excessive weeping, exposure to cold/wind, summer heat, smoke/fire, and hot diets all cause diseases originating from the zang-fu. Is topical treatment alone sufficient? By sitting quietly, clarifying the spirit, protecting eyesight, relaxing the mind, resting the eyes, harmonizing diet, and balancing medication, one can achieve sharp vision.

Regarding the Five Wheels and Eight Palaces: In the Five Wheels, Liver belongs to Wood, called the Wind Wheel, located at the cornea; Heart belongs to Fire, called the Blood Wheel, located at the canthi; Spleen belongs to Earth, called the Flesh Wheel, located at the upper and lower eyelids (upper connects to Spleen, lower to Stomach); Lung belongs to Metal, called the Qi Wheel, located at the sclera; Kidney belongs to Water, called the Water Wheel, located at the pupil. This is the root of the eyes, supported by Blood as the pericardium. As for the Eight Palaces, they have names but no fixed positions: Gallbladder is the Mountain Palace, also called Pure Clarity Palace; Large Intestine is the Heaven Palace, also called Transmission Palace; Bladder is the Marsh Palace, also called Fluids Palace; Liver is the Wind Palace, also called Nourishment Transformation Palace; Kidney is the Water Palace, also called Huiyin Palace; Mingmen is the Fire Palace, also called Embracing Yang Palace; Spleen/Stomach is the Earth Palace, also called Grain and Water Palace; Small Intestine is the Thunder Palace, also called Guanqian Palace. Although these are the sources of the eyes, they are practically irrelevant to treatment. If the five zang accumulate Wind-Heat or Seven Emotions stagnate and attack the eyes, symptoms appear according to the affected zang: swelling and pain, tearing, or cold opacities, dimness, and blindness. Treatment must investigate the source: disperse Wind, cool Heat, smooth Qi stagnation. Do not lightly use needles, knives, hooks, or cuts; accidental cure is mere luck. Otherwise, lifelong harm ensues. Also, avoid excessive cold/cold-natured herbs for the eyes, lest they freeze the Blood and cause chronic illness. Medication must be tailored to age and constitution. Kidney deficiency causes dull eyes or cold opacities; warm the Kidney Meridian. Northern patients often suffer from a sensation of flying sand; sleeping on heated kang beds creates steam from dual energies; treatment requires more cooling herbs due to different constitutional endowments compared to the South. Post-smallpox, toxic vapors stagnate in the Liver, Qi cannot vent, erupting into the eyes and damaging the pupil; historically, there was no standard treatment.