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Qian Yi stated: Redness in the inner canthus indicates Heart Excess-Heat (Shi Re); pale redness indicates Heart Deficiency-Heat (Xu Re). Blueness indicates Liver Excess-Heat; pale blueness indicates Liver Deficiency-Heat. Yellowing indicates Spleen Excess-Heat; slight yellowing indicates Spleen Deficiency-Heat. Whiteness of the sclera with tearing indicates Lung Excess-Heat; loss of luster in the pupils indicates Kidney Deficiency.

Tu Weisheng commented: Qian's theory is indeed accurate. However, the red flesh at the large canthus belongs to the Heart; only when it is protruding, swollen, and crimson red does it signify Heart Excess-Heat. The small canthus belongs to the Mingmen (Gate of Life); pale redness here indicates deficiency of Ministerial Fire (Xiang Huo), and one cannot generally attribute it to Heart Meridian Deficiency-Heat. Although yellowing of the eyes is a symptom of Excess-Heat, damp-heat syndromes often present with yellow eyes, so one cannot categorize them solely as Deficiency-Heat or Excess-Heat based on eye color alone. The sclera belongs to the Lung; whiteness with tearing is indeed Excess-Heat, but redness with swelling is also Excess-Heat. The former represents Heat in the Qi Level (Qi Fen), while the latter represents Heat in the Blood Level (Xue Fen). Such subtleties must be distinguished. The black part of the eye (cornea/pupil area) belongs to the Liver, and the pupil belongs to the Kidney; only when the pupil is dim and lacks luster can it be diagnosed as Kidney Deficiency.

Chen Feixia stated: The Liver corresponds to the Foot Jueyin Wood Meridian. In Excess syndromes, there is redness of the eyes, loud crying, yawning, and irritability; in Deficiency syndromes, there is yawning and teeth grinding. With Wind pathogen, the eyes blink frequently; with Heat pathogen, vision becomes blurred. In Gan syndrome (infantile malnutrition), a white membrane covers the pupil. Anger leads to irritability and loud crying; severe crying causes throat swelling. Heat causes difficulty in urination and defecation, grasping at clothing collars, fidgeting with objects, and in severe cases, grasping at empty air or touching the bed, which signifies the loss of Hun (Ethereal Soul). When an infant is ill, if the eyeballs do not move freely, or remain closed, or cry without tears, or weep without crying, these are signs of Liver Qi Exhaustion.

The Heart corresponds to the Hand Shaoyin Fire Meridian. In Excess syndromes, there is loud crying, fever, and thirst; in Deficiency syndromes, there is lethargy, palpitations, and restlessness. Abundant Heart Blood results in ruddy complexion and ease of recovery; deficient Heart Blood results in dull complexion and difficulty in recovery. Severe Heat dries up body fluids causing pathological thirst, disturbs the Shen (Spirit) causing restless sleep, preference for prone position, tongue ulcers, double tongue (Chong She), wooden tongue (Mu She), and inability to retract the tongue. Conditions such as erysipelas, tumors, macules, rashes, parasitic skin diseases, and sores are all Heart syndromes. If Heart disease persists, sweating with wet hair, inability to retract the tongue, sudden aphonia, confusion, or blackening of rashes are all caused by Heart pathology.

The Spleen corresponds to the Foot Taiyin Earth Meridian and is the Sea of Water and Grain. In Excess syndromes, there is lethargy, fever, and thirst; in Deficiency syndromes, there is vomiting, diarrhea, and wind-stirring. Spleen injury leads to edema, distension, jaundice, vomiting, diarrhea, and dysentery. Spleen Cold causes abdominal distension; Spleen Gan presents with a large abdomen and visible epigastric veins. Spleen Heat causes bad breath, lip ulcers, failure of food to nourish muscles, protrusion and manipulation of the tongue, dry mouth, and thirst; Spleen Cold causes drooling from the corners of the mouth, known as Zhi Yi (retained saliva). Qi stagnation causes frequent puckering of the lips; Deficiency causes muscle wasting and emaciation, anorexia, food accumulation leading to Gan or Pi masses. If Spleen disease persists, with wasting of thigh muscles, large abdomen with visible veins, generalized edema, intractable vomiting and diarrhea, inability to ingest food, polyphagia with emaciation, worms emerging from the mouth, or retraction and distortion of the lips, these are signs of Spleen Qi Exhaustion.

Tu Weisheng commented: Spleen Excess easily causes lethargy, but Spleen Deficiency also easily causes recumbency because the transformative Qi is scarce, and isolated Yin cannot perform actions independently. Spleen Heat easily causes thirst and heat sensation, but there is a distinction between Excess and Deficiency. Excess-Heat involves intense thirst with copious drinking and yellow tongue coating; Deficiency-Heat involves inability of fluids to ascend, self-rescue via drinking, scant intake, and non-yellow tongue coating. Abdominal distension should also be differentiated into Cold and Heat. Cold-damp stagnation causes food retention and distension; Fire-Heat expansion causes even more severe distension than Cold. However, this diagnostic method requires observing the facial complexion and tongue coating. Regarding generalized edema, one must check if the patient can eat; if they can eat, it indicates Qi recovery though Blood is still insufficient, which is a favorable sign, not necessarily Spleen Exhaustion. Lip retraction must be assessed alongside whether the mouth remains open to determine Spleen Exhaustion. The Philtrum (Ren Zhong) on the upper lip belongs to the Du Mai (Governing Vessel), and Chengjiang (Cheng Jiang) on the lower lip belongs to the Ren Mai (Conception Vessel); lip retraction often signifies exhaustion of both Du and Ren vessels.

The Lung corresponds to the Hand Taiyin Metal Meridian. In Excess syndromes, there is chest oppression, confusion, wheezing, and rapid breathing; in Deficiency syndromes, there is sighing and prolonged exhalation. The Classics state: Cold injures the Lung due to insufficient clothing in infants. Heat injures the Lung due to excessive clothing in infants. Cold and Heat injuring the Lung cause rebellious Qi leading to wheezing and coughing. Wind attacking the Lung causes sneezing and clear nasal discharge; Cold causes nasal congestion and difficult breathing; Heat causes dry nose or epistaxis; Gan syndrome causes red and ulcerated nose; persistent wheezing causes facial edema; persistent coughing causes high sternum, known as Turtle Chest (Gui Xiong). Dryness causes unquenchable thirst and preference for water, known as Ge Xiao (Diaphragm Consumption). If Lung disease persists, with continuous coughing, ceaseless wheezing, orthopnea (shoulder breathing), hemoptysis, black and dry nostrils, dilated nostrils with wheezing, intractable dysentery with dilated anus like a tube, pale and puffy face, and upward rebellious Qi, these are signs of Lung Qi Exhaustion.

Tu Weisheng commented: Wheezing and sighing each have Excess and Deficiency patterns; one cannot limit them strictly to Wheezing=Excess and Sighing=Deficiency. While cold/heat lung injury may result from improper clothing, this is occasional and not a definitive conclusion. Persistent wheezing with facial edema indicates Yin deficiency where Yang has no anchor, also a sign of Yang deficiency, as Yangming Qi travels on the face. Persistent coughing leading to turtle chest is hard to explain; other texts lack definitive discussion on this specific name. "Wei Xi" (Stomach Breath/Stop) is also confusing; it is unclear if it refers to cessation of gastric digestion or another disease name. Dysentery with a dilated anus named Tuo Yin (Yin Collapse) implicates Shaoyin and Jueyin, not exclusively Taiyin. Pale puffy face is most severe in women due to relative Yang weakness; puffiness indicates Yang collapse upwards. However, this diagnosis requires a history of severe/prolonged illness combined with anorexia to confirm Yang Collapse.

The Kidney corresponds to the Foot Shaoyin Water Meridian. In Deficiency syndromes, there is photophobia, excessive sclera relative to cornea, fontanelle non-closure, pallor, incomplete marrow filling, and aversion to cold. This often manifests as Wu Ruan (Five Softnesses): delayed sitting due to underdeveloped sacrum, delayed walking due to weak ankles, delayed teething due to insufficiency of True Yang, sparse hair due to poor blood nourishment, and delayed speech due to insufficient Heart Qi. Heat causes pus formation and Gan syndrome. If Kidney disease persists, with downward crawling, absence of pupils, hallucinations ("seeing ghosts"), weak bones unable to support lying down, or incontinence, these are signs of Kidney Failure.

Tu Weisheng commented: Kidney Yin deficiency causes heat intolerance; Kidney Yang deficiency causes cold intolerance. Generalizing all deficiency as cold intolerance shows a failure to distinguish Kidney Yin and Yang. Kidney disease does not typically present with "seeing ghosts"; such symptoms indicate Heat entering the Blood Chamber (Xue Shi) in both men and women. The Blood Chamber is governed by the Liver Meridian, and Hun Yang is also controlled by the Liver. "Ghost" refers to Po (Corporeal Soul), belonging to Yin Blood; when blood dies, Po dies, covering Hun, thus causing hallucinations. Since Shaoyin is not governed by the Liver, how could such symptoms occur? Incontinence cannot be purely diagnosed as Kidney Failure. Stool belongs to the Large Intestine, governed by the Lung; urine belongs to the Bladder. Since the Bladder is interior-exterior related to the Kidney, bladder incontinence can also diagnose Kidney Meridian deficiency and failure.