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Those who have already read the chapters on "Five Colors of Face and Eyes: Generation and Restriction" and "Doors, Wells, and Stoves" need not repeat them here to avoid verbosity; they should be consulted together with the preceding and following chapters.

When the Qi of the Qiao Mai (Extraordinary Vessel governing eyelid opening and closing) fails to nourish the eyes, the eyes cannot close. (The following content is from *Huangdi Neijing*.)

Observe the area above the eyes (eye sockets); if there is slight swelling, resembling the appearance after just waking up, and the neck pulse beats visibly, accompanied by occasional coughing,
and pressing the dorsum of the hands and feet leaves an indentation that does not immediately recover, this is Feng Shui Skin Distension (Wind-Water Edema). (Any swelling or bulging of the upper and lower eyelids indicates Dampness in the Spleen and Stomach.)

If the upper and lower eyelids are dark like soot or coal smoke, it indicates Cold Phlegm. (The following content is from Li Shicai.)

Gray color under the eyes indicates Cold Fluid Retention; black circles around the eyes with red cheeks indicate Hot Phlegm. Black circles around the eyes with difficulty walking and groaning indicate Cold-Dampness invading the bones. Black circles around the eyes with a sallow-red complexion like earth,
along with flaccidity and numbness of the four limbs and difficulty bending and extending them, indicate Wind-Phlegm. A cyan halo around the eyes often results from excessive sexual activity and fatigue, leading to poor spirit, or lack of sleep at night.
A yellowish-white face with swelling extending to the eyelids indicates Gu Dan (Grain Jaundice); such a person must have epigastric fullness.

Ulceration at the inner canthus indicates Wind in the Lung. Ulceration at the outer canthus indicates Heat in the Heart. Swelling of the upper eyelid indicates Spleen injury. Cyan color of the lower eyelid indicates Cold in the Stomach. Accumulated Heat in the Spleen and
undigested food retention will cause Tou Zhen (Hordeolum/Stye).
Note: Slight swelling of the eyelids in children is normal because milk and food enter the stomach, causing abundant Stomach Dampness;
if the swelling is severe, it indicates stagnation within. In young adults, persistent eyelid swelling indicates congenital deficiency of Spleen Qi, constantly constrained by Liver Wood; such individuals tend to be irritable and have shorter lifespans.

The Twelve Meridians and the 365 Collaterals all send their Blood and Qi upward to the face and flow into the orifices. The refined Yang Qi ascends to the eyes, forming the eyeballs.
Note: Even in severe illnesses, if both eyes have spirit and move flexibly, the prognosis is auspicious, because the eyes are where the essence and Qi of the Five Zang and Twelve Meridians manifest.
The essence and Qi of the Five Zang and Six Fu organs all ascend to the eyes, forming their function. The gathering place of essence is the eye; the essence of Bone forms the pupil; the essence of Sinew forms the black part of the eye (iris); the essence of Blood forms the blood vessels (scleral vasculature);
the gathering place of Qi's essence is the white part of the eye (sclera); the essence of Muscle forms the constraints (eyelids); these wrap and gather the essence of sinew, bone, blood, and Qi, merging with the meridians to form the Eye System (Optic Nerve/Pathway),
ascending to connect with the brain, and exiting posteriorly at the nape. Thus, when pathogenic factors strike the nape, coinciding with bodily deficiency, and penetrate deeply, they follow the Eye System into the brain. Entering the brain causes dizziness/spinning sensation; spinning sensation pulls the Eye System tight; tightness of the Eye System causes vertigo and visual rotation. Pathogens striking the essence cause essence to lose coordination; scattered essence leads to diplopia (seeing double objects). The eyes are the gathering place of the essence of the Five Zang and Six Fu organs, where Ying and Wei, Hun and Po frequently circulate, and Shen Qi arises. Therefore, mental labor scatters Hun and Po and confuses Yi Zhi. Thus, the pupil and black part emulate Yin, while the white part and red vessels emulate Yang; Yin and Yang combine and transmit to make the eyes bright. The eyes are the emissary of the Heart; the Heart is the residence of Shen. Therefore, if Shen Jing becomes chaotic and unresponsive, sudden perception of unusual phenomena occurs due to scattered Spirit, Hun, Po, and lack of harmony, termed "Huo" (Confusion/Delusion).

When the Taiyang Meridian Qi ends, Dai Yan (eyes fixed upward staring) occurs. When Shaoyang Meridian Qi ends, deafness and severance of the Eye System occur. When Yangming Meridian Qi ends, mouth and eye twitching/deviation occur. When all Five Yin Meridian Qi perishes, the Eye System twists, causing vertigo; those with vertigo die. (Eyes fixed straight open are untreatable.)

Jing Ming (Clear Vision) is used to view all things, distinguish black and white, and judge length and shortness. If one perceives long as short and white as black, then Jing Essence has declined. (Withered bones, depleted flesh, panting, sunken eyes, inability to see people indicates death; ability to see people but dying during the time of its overcoming element also indicates death.)

A slightly slippery Kidney Pulse indicates Gu Wei (Bone Atrophy/Wasting Syndrome); sitting and rising are difficult, and upon rising, vision is lost. (*Qianjin Fang* states:
Patients with wind-rash inevitably suffer from blurry vision; first attack the Wind, and the darkness will heal itself.)

Yang Qi, when subjected to excessive fatigue, becomes hyperactive; essence is exhausted. Accumulating into summer, this causes Jian Jue (Frying Collapse), resulting in blindness and inability to see, and deafness and inability to hear. (Qi depletion causes unclear vision; Yin depletion causes blindness; unclear vision in heat diseases indicates death; insufficiency of Marrow Sea causes dizziness, tinnitus, leg soreness, and inability to see.)

Redness of the eyes indicates disease in the Heart; whiteness indicates disease in the Lung; blueness/greenness indicates disease in the Liver; yellowness indicates disease in the Spleen; blackness indicates disease in the Kidney; indeterminate yellow indicates disease in the Chest Center.
Blue, yellow, red, white, and black colors of the eyes indicate disease in the Sinews. Yellow eyes with yellow nails indicate Huang Dan (Jaundice).

In diagnosing Han Re Luo Li (Cold-Heat Scrofula), if red vessels run vertically through the pupil, seeing one vessel predicts death in one year; half a vessel, one and a half years; two vessels, two years; two and a half vessels, two and a half years; three vessels, three years. Red vessels running through the pupil predict mortality based on extent. If red vessels are seen but do not run vertically through the pupil, it is treatable. (Methods for diagnosing red vessels in the eyes are detailed in the Location Chapter.)

In diagnosing Yong Ju (Abscesses and Sores), if the white part is blue and the black part is small, it is a Ni (Rebellious/Opposite) condition and untreatable. (*Neijing*.)

Cough with rebellious Qi indicates Fei Zhang (Lung Distension); the patient pants, eyes protrude as if falling out, and the pulse is floating and large; Yue Bi Jia Ban Xia Tang (Yuebi Decoction plus Banxia) is the primary treatment.

Floating Chi Pulse, yellow halos around the eyes, and unceasing Nosebleed (Xu); when halos disappear and eyes become clear, it is known that nosebleed has stopped now. (Zhongjing.)

Whiteness turning red indicates Fire attacking the Lung. Flesh Wheel (Eyelids) redness and swelling indicate Fire attacking the Spleen. Black Water Shen Guang (Spirit Light of the Pupil/Iris) obscured by nebula indicates Fire attacking Liver and Kidney. Red vessels penetrating the eye indicate self-excess of Fire. All cases of sudden eye redness and swelling, photophobia, grittiness, continuous tearing, and sudden nebula formation are caused by Fire and Heat. (Zihehe.)

Forced gazing with rotating eyeballs indicates Wind. Fixed staring without rotation indicates Liver Extinction. Pure yellow iris is a凶 (Ominous) sign. Blue sclera indicates Liver Wind insulting the Lung. Pale yellow indicates Spleen stagnation. Old yellow indicates Lung affected by Damp-Heat, a Dan syndrome. The pupil belongs to the Kidney; lackluster appearance combined with yellowness indicates Kidney Qi deficiency. (Yellowing of the black part indicates Kidney Water being overcome by Spleen Earth; if it is a new Damp-Heat condition, it is still treatable. Chronic illness with heavy body and inability to turn over, regardless of Cold-Damp or Damp-Heat, is difficult to manage. Shiwan.)

Obese individuals with abundant Qi and ascending Wind-Heat suffer from blurry, gritty eyes due to turbid Qi ascending in the chest. Severe cases lead to Tan Jue (Phlegm Collapse), which can also damage the eyes. Keeping the chest Qi clear prevents this disease. Sudden blindness indicates Yang blocked by Yin, suggesting an unpredictable disease. Nebulae indicate severe Wind-Heat, or macules entering the eye; this is Liver Qi excess manifesting upward, requiring dispersing and releasing methods. If purgatives/laxatives are used, pathogens accumulate internally, and nebulae deepen. One should use uplifting agents to stir the pathogens again, making nebulae float, assisted by anti-nebula drugs, so they naturally dissipate. Chronic conditions cannot be cured quickly; resolution takes months or years. (*Yi Shuo*.)

Eye pain is a Yangming Exterior Syndrome. Red eyes indicate Excess Heat in the Meridians. Closing eyes, desire to rinse mouth without swallowing, and dry nose indicate Excess Yang Pathogens ascending; resolution requires Nosebleed. Yellow eyes with head sweat indicate impending Jaundice. Blurred vision indicates Yangming Fu Organ Excess. Incoherent eye movement indicates Shaoyin Heat. Vertigo indicates Phlegm driven by Fire. Yellow sclera indicates impending Dan syndrome. Fixed staring without blinking, or yellow sclera, indicates erroneous sweating leading to impending Nosebleed. Eyes fixed straight open are untreatable. Post-purgative eye closure indicates Injury to Yin Blood. Eyes rolling upward indicate Rebellious Yin Qi. (Shiwan. This clause concerns Shanghan.)

The Liver opens into the Eyes. Dryness syndromes present with bright, sharp gaze; Dampness syndromes present with dim, cloudy gaze. Severe dryness causes anhydrosis and dry, gritty eyes; severe Dampness causes yellow, ulcerated eyeballs or swollen eyelids resembling silkworms. Eyes with discharge and tears, containing inner brilliance, possess Shen Qi (Spirit); absence of discharge and tears, blue sclera, dull iris, loss of inner brilliance, and exposed superficial light all indicate absence of Spirit. Patients who open eyes to see others exhibit Yang; those who close eyes and avoid seeing others exhibit Yin. Ability to recognize people indicates mild condition; confusion and inability to recognize people indicates critical condition. Fixed, crossed, upward, or downward gaze, with eyes slightly fixed then moving slightly after a while, may be caused by Phlegm obstruction and should not be dismissed as untreatable. (*Yi Yuan*. This clause concerns Wen Bing; *Nan Jing* states that patients closing eyes avoiding sight,) the pulse should be Xian (Wiry), indicating Liver Pathogen Excess.