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In the context of Cold Damage (Shanghan), "fixed gaze" (Zhishi) refers to the condition where the eyes stare at an object without moving. The essence of Water is called Zhi (Will/Intent), and the essence of Fire is called Shen (Spirit). The eyes are the emissaries of the Heart. The bony structure associated with the Shen, along with the essence of Qi and Blood and the meridians, ascend and connect to the brain. When the Qi and Blood of the Five Zang Organs are harmonious and their Essence is abundant and nourishing, the eyes are smooth and bright.

If pathogenic factors are excessive and obstruct the Healthy Qi, causing the Spirit and Will to become dull, and the Essence of the Five Zang Organs fails to ascend to nourish the eyes, fixed gaze occurs. In Cold Damage, fixed gaze indicates that pathogenic factors have reached their extreme and the syndrome pattern has become inverted; it is generally difficult to treat. The Classics state: "Patients who frequently suffer from epistaxis should not undergo sweating therapy." If sweating is induced in error, it leads to depression of the forehead, tight pulse, fixed gaze with inability to move the eyes, and insomnia. This is because the Liver receives Blood to enable vision; in patients who have lost blood, Liver Qi is already deficient and Eye Qi is weak. Further inducing sweating causes loss of Yang, resulting from deficiency. Although this inversion is serious, it is not yet at the most critical stage.

However, if delirious speech, opisthotonos with fixed gaze occur, this indicates the exhaustion of Kidney Qi; if fixed gaze is accompanied by shaking of the head, this indicates the exhaustion of Heart Qi, representing a state of collapse and exhaustion. Fixed gaze accompanied by delirium, wheezing, and chest fullness indicates death; diarrhea also indicates death. In more severe cases, the patient becomes unrecognizable, gropes at clothes and beds, feels terrified and restless, suffers from wheezing and fixed gaze; all these indicate that pathogenic factors are excessive while Healthy Qi is exhausted.

If a patient experiences blurred vision ("mumu liao liao") and disordered eye movement, without exterior or interior syndromes, difficulty in defecation, and slight body heat, this is not fixed gaze. This is an internal excess condition, which can be treated with Da Cheng Qi Tang (Major Order the Qi Decoction) or Da Chai Hu Tang (Major Bupleurum Decoction) to purge the bowels. Fixed gaze is considered an untreatable disease, whereas "blurred vision" is a treatable sign. These two conditions appear similar but must be carefully distinguished.

The verse states: Fixed gaze lacks spirit and eyes do not turn; for those with epistaxis and blood deficiency, sweating is still mild. Incontinence, wheezing, diarrhea, and head-shaking signs; thready pulse, groping at clothes, and sudden collapse.

Furthermore, it is discussed that the essence of Water is Zhi, and the essence of Fire is Shen. The essence of the Five Zang and Six Fu Organs all ascends to the eyes. When a patient's pathogenic factors are extremely excessive and obscure the Healthy Qi, it leads to mental confusion and fright.

"Bu Ren" (Insensibility) means the loss of softness and responsiveness. Insensibility implies a lack of sensation: unawareness of itching, pain, cold, or heat. Regardless of limb flexion/extension, moxibustion, or acupuncture, there is no perception. This is due to Bi Syndrome (Painful Obstruction) stagnation causing unawareness of pain and itch. This state is not the complete unconsciousness of Shi Jue (Corpse-like Collapse). As stated in the Classics: "When the Shaoyin pulse is absent, Kidney Qi is faint, and Essence and Qi are scarce, Ben Qi (Rushing Qi) becomes urgent and presses upward into the chest and diaphragm. Zong Qi (Gathering Qi) gathers inversely below the heart. Yang Qi retreats downward, heat returns to the inner thighs, interacting with Yin, causing insensibility of the body. This is called Shi Jue." If the collapse is caused by cold invasion, accompanied by depression/fullness and insensibility, this can be understood through the case of Shi Jue.

For instance, when Bian Que diagnosed the Crown Prince of Guo as suffering from Shi Jue and interpreted depression/fullness as insensibility, it was treatable, and he recovered through acupuncture, demonstrating the skill of a divine physician. Alas! If the pulse is floating and thready, sweat flows like oil, wheezing does not cease, food and fluids cannot be taken, and the body is insensible, this indicates the extinction of Life Qi. Even with a physician like Bian Que, could he revive him?

The verse states: Insensibility affects the mouth, abdomen, and skin; pain, itch, cold, and warmth are all unknown. Healthy Qi is heavily suppressed by pathogenic factors; Ying (Nutritive) deficiency and Wei (Defensive) weakness lead to collapse resembling corpse-like stillness. The Classics state: Due to cold invasion...