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The *Treatise by Chanter Longmu* states: Humans have two eyes, akin to the sun and moon in the heavens; they are the supreme treasures of the body, gathering the essence of the five Zang organs. The Five Wheels correspond to the Five Elements, and the Eight Palaces correspond to the Eight Trigrams. Causes of eye diseases include excessive consumption of the "Five Pungents" (garlic, chives, leeks, onions, shallots), frequent intake of roasted or fried foods and hot noodles, uncontrolled alcohol consumption, irregular sexual activity, prolonged intense gazing, frequent observation of the sun and moon, constant agitation of Heart Fire, reading small characters at night, reading under moonlight, excessive copying work, intricate carving, endless gambling, long-term exposure to smoke and fire, excessive crying and tearing, excessive bloodletting from the head, and similar factors that all dissipate the brightness of the eyes. Others who ride and hunt, rushing through dust and sand day and night, also injure their eyes. Furthermore, those who fail to protect themselves in their youth often experience gradual dimness and blurriness after age forty. Therefore, those skilled in health preservation should keep their eyes closed frequently when idle upon reaching middle age, avoid unnecessary looking, and not open them unless for essential matters; thus, even in old age, vision will not decline. Generally, if Ying and Wei Qi flow smoothly, such diseases do not arise; if Ying and Wei Qi decline, many diseases occur. For instance, wind-cold causes tearing, deficiency-fire causes dimness, overwork causes redness, white swelling indicates toxicity in the Lung, sores indicate wind-heat invading the Lung, yellowing indicates spleen injury from alcohol, blood flooding the pupil and redness indicate Heat in the Heart, fear of light with red flowers indicates Liver pathogenic factors, black flowers indicate Kidney deficiency, blue flowers indicate Cold in the Gallbladder, and flowers of five colors indicate Kidney deficiency with Heat; these cannot be treated uniformly. If deficiency is not tonified and excess is not purged, rescue is difficult. Upper deficiency refers to Liver deficiency, lower deficiency to Kidney deficiency; Liver deficiency causes dizziness, deafness, and vertigo, while Kidney deficiency causes visual floaters and tinnitus like cicadas, requiring strong tonification of the Liver and Kidney. Profuse hot tears and swollen, painful eyelids indicate extreme Heat in the Liver; tearing in the wind indicates deficient Kidney with guest Heat; clearing the Liver and draining the Kidney must be appropriate. The Five Zang can be inferred similarly. Deficiency generates Cold, Excess generates Heat; the use of tonification and purgation requires careful deliberation, as a slight error leads to great deviation. Other causes involve external triggers or sequelae of major illnesses. Sudden acute redness (Bao Chi) is often due to heat surging upward, irregular sleep and diet, eating full then near fire, combined with labor without proper care, or consuming toxic foods, turning into severe syndromes. Physicians who do not trace the origin may mistakenly treat sudden redness solely as Yang excess, using blood-dispersing agents or Heart-cooling medicines; although symptoms may subside, this can damage the Spleen channel with cold, leading to poor appetite, mental restlessness, and internal cataracts due to Zang deficiency. Seeing poor appetite, some prescribe hot medicines, causing violent heat to attack upward, resulting in blurry vision, sticky discharge, or anger-induced strain leading to pterygium (fleshy growth); Heart Qi unrest with wind-heat transforms into pterygium. These varied symptoms constitute external obstructions. Additionally, excessive mental labor from reading or gambling is called Liver Fatigue; treating only the Liver or other syndromes is ineffective. One must rest the eyes and avoid distant viewing for recovery.

For those with wind-rash, eye darkness often occurs; attacking the wind first resolves the darkness. Medication for women before and after childbirth requires caution. Pediatric eye conditions require gentle treatment, mainly involving washing. Scalpel surgery or acupuncture is strictly forbidden, as is frequent rubbing, which may cause irreversible eye damage. Specialists in ophthalmology should pay close attention to these cases.

Yang Renzhai states: The eyes are the essence of the Six Fu and Five Zang organs, shining like the sun and moon in the sky. The iris belongs to the Heart, the sclera to the Lung, the cornea/pupil area to the Liver, the eyelids to the Spleen, and the pupil itself to the Kidney. Although each Zang has corresponding signs, the pupil is paramount. Why? The eyes are the external manifestation of the Liver (Wood); the Kidney is Water. Water generates Wood; Liver is the child, Kidney is the mother. Can child and mother be separated? When Liver and Kidney Qi are abundant, vision is bright; when deficient, vision is dim and dizzy. Red halos around the cornea with stinging pain indicate Liver Heat; dryness, tearing, and yellowish rings indicate Liver Deficiency. Dilated, pale, deviated pupils indicate Kidney Deficiency; constricted, slightly yellow pupils indicate Kidney Heat. This distinguishes deficiency and excess. Liver and Kidney Qi support each other, but the Heart houses the Spirit and assists the Liver and Kidney, representing unity in diversity. The Heart governs Blood, the Liver stores Blood; for blood-heat attacking the eyes, one must clear the Heart and cool the Liver, not rigidly adhering to "Water generates Wood." The eye is water wrapped in membrane, illuminating all directions; ultimately governed by Heaven's generation of Water.

Analyzing further: tightness and pulling with blue pupils and white eyelids, itching with clear tears, no redness or pain, is Wind Eye. Protruding cornea, hard/swollen/red eyelids, sticky discharge, heat/stinging pain is Heat Eye. Cloudy eyes with tears, soft/swollen eyelids, upper obstruction/dimness, sourness/dryness/mild redness is Qi Eye. Wind and Heat together cause itching and floating redness. Wind and Qi struggle causes itching/dryness/dimness. Blood-heat aggregation causes skin flaps, millet-like bumps, red threads, or hordeolum. Lack of Qi and Blood causes blind spots, drooping eyelids, night blindness, or total blindness. Pale purple with hidden red indicates deficient Heat; bright red with jealousy indicates excess Heat. Fleshy growths on exposed eyelids indicate Heart Blood-Heat; red membranes on sclera like umbrella paper indicate Qi stagnation and Blood coagulation. Heat syndromes show bulging pupils and red sclera; Cold syndromes show green/blue pupils and withered sclera. Chronic eye heat attacked by wind-cold causes red/rotten eyes; non-red eyes with phlegm-fluid cause pain. Unsmooth Liver Qi with Heat causes photophobia; accumulated Heat damaging digestion causes postprandial closure. These are general external signs. However, why exclude Spleen and Lung? Red sclera or red veins indicate Lung Heat; eyelid or mouth-corner acne-like spots indicate Spleen Heat. The Spleen governs taste; flavors nourish the interior, manifesting externally. The Lung governs Qi; it directs Water/Fire circulation and Ying/Wei flow. Thus, the five syndromes per Zang can be deduced.

Although eye diseases mostly stem from Heat, treatment prioritizes clearing the Heart, cooling the Liver, regulating Blood, and smoothing Qi. Since the Kidney dislikes dryness, deficiency cases use moistening herbs like Dang Gui (Angelicae Sinensis Radix) and Di Huang (Rehmanniae Radix); warm herbs should be used lightly. The Lung generates dryness, and the Liver prefers moisture; ancient formulas use Xing Ren (Armeniacae Semen Amarum), dried persimmon, maltose, and honey as adjuncts for moistening. Removing nebulae is critical. Nebulae from Lung Heat range from mild cloudiness to severe opacity. Pearl nebulae (like rice grains) disperse easily; plum blossom nebulae (like petals) are hard to resolve. Although nebulae arise from Heat, removing nebulae before clearing Heat is easier; clearing Heat first may freeze the Blood, preventing nebula removal. Overuse of cooling meds and water washing on red eyes causes freezing. Eyes are essentially water; water is clear, so reliance on drops/washing is limited. Emotional imbalance, excessive desire, eye strain, excessive weeping, wind/fog exposure, summer sun, smoke/fire avoidance failure, and hot diets cause internal organ pathology; drops alone are insufficient. One must sit quietly, calm the spirit, protect vision, relax the mind, regulate diet, and balance medication for clear vision.

Zihe He states: While sages say eyes see via Blood, Blood can be excessive or deficient. Excess causes blockage and pain; deficiency causes exhaustion and blindness. Youth often have excess; elders often have deficiency. However, youth rarely have deficiency, and elders may still have excess; this must be noted. The inner canthus is the start of the Taiyang Channel (more Blood, less Qi). The outer canthus is the Shaoyang Channel (less Blood, more Qi). The upper eyelid margin is Taiyang (more Blood, less Qi). The lower eyelid margin is the Yangming Channel (more Blood and Qi). Yangming starts between the eyes, meeting Taiyang and Shaoyang there. Only the Jueyin Channel connects to the eye system. Blood excess relates to Taiyang/Yangming Excess patterns; blood deficiency relates to Jueyin Deficiency. Bleeding therapy suits Taiyang/Yangming due to high Blood volume; it is unsuitable for Shaoyang due to low Blood volume. Bleeding Taiyang/Yangming improves vision; bleeding Shaoyang worsens it. The goal is balancing Blood to nourish the eyes. Too much Blood overflows; too little dries up. Heat speeds Blood flow (more); Cold slows it (less).

The eyes are the external manifestation of the Liver (Wood). Wood, if too lush, blocks light; if too weak, withers. The Five Wheels gather essence and meridians: Qi Wheel (Lung/Metal), Flesh Wheel (Spleen/Earth), Red Veins (Heart/Fire), Black Water/Spirit Light (Kidney/Water, also Liver/Wood). Everyone knows this, yet ignores the role of Fire in eye disease. Qi wheel redness = Fire insulting Lung; Flesh wheel red/swelling = Fire insulting Spleen; Nebula on Black Water = Fire insulting Liver/Kidney; Red veins across eye = Self-excessive Fire. Treating Fire solves it quickly. *Neijing* states: "Excess heat causes swelling." Sudden red/swollen eyes, photophobia, tearing, cold-induced dimness are all due to Great Heat. Treatment: Herbs should be salty/cold to induce vomiting/purging. Acupuncture points: Shenting, Shangxing, Xinhui, Qian Ding, Baihui. Bleeding here clears nebulae, stops pain, restores vision, reduces swelling immediately. Do not needle Xinhui in children due to thin tissue/bone risk. Children have Water above/Fire below, hence clear vision. Elders have Fire above/Water deficiency, hence dim vision. *Neijing*: "Resolve Blood Excess." "Tonify Deficiency, Purge Excess." Night blindness/internal cataracts from anger/sorrow involve Liver Blood deficiency; prohibit bleeding, only tonify Liver/Kidney. Sudden red/swollen/painful eyes: bleed the first five points, apply salt/oil to hair roots; repeat if necessary until balanced. Zihe He once had red/swollen/nebulous eyes for 100 days. Zhang Zhong'an advised bleeding Shangxing, Baihui, Cuanzhu, Sikong, and inducing nosebleeds with grass stems (~1 sheng); improved significantly next day, fully recovered in three days. This is the method for breaking Blood Excess.

Li Dongyuan states: Essence of Five Zang/Six Fu derives from Spleen, ascending to eyes. Spleen is head of Yin; eyes are root of Blood vessels. Spleen deficiency loses control over essence, failing to illuminate eyes. Heart is Ministerial Fire (ruler's spirit), quiet and stable; Ministerial Fire (Pericardium) executes orders, governing vessels, nourishing eyes. Labor/agitation causes erratic flow; evil qi damages vessels, causing disease. Physicians ignoring Spleen/Stomach and Blood/Spirit, treating symptoms only, miss the root. Using acrid-cool/bitter-cold drugs damages True Qi, promoting internal cataracts. Li also states: Far-sightedness but near-blindness indicates insufficient Yang/excess Yin (Qi deficiency/Blood excess). Blood excess implies Yin Fire excess; Qi deficiency implies weak Qi (elderly state). Near-sightedness but far-blindness indicates excess Yang/insufficient Yin (Blood deficiency/Qi excess). Blood deficiency/Qi excess implies Fire excess/Original Qi deficiency. Fire is the thief of Original Qi.

Wang Haizang states: Far-sightedness implies Fire presence, near-blindness implies Water absence; treat with Dongyuan Dihuang Wan. Near-sightedness implies Water presence, far-blindness implies Fire absence; treat with Dongyuan Dingzhi Wan.

I argue these views contradict. Dongyuan sees near-blindness as Yang deficiency, far-blindness as Yin deficiency. Wang sees far-sightedness as Fire/Water lack, near-sightedness as Water/Fire lack. Liu Zongnong says: Yang is Sun/Fire; Yin is Metal/Water. Metal/Water are bright inside/dark outside; Sun/Fire are bright outside/dark inside. Inner brightness aids near vision; outer brightness aids far vision. Thus, far-blindness is Yin overcoming Yang; near-blindness is Yang overcoming Yin. Wang is correct, Dongyuan wrong. However, I suggest stating only deficiency: Far-blindness is Yang deficiency; near-blindness is Yin deficiency. If Dongyuan calls excess Yang/Yin "Fire," then normal vision is a Fire disease. If Wang attributes near-sightedness to Water and far-sightedness to Fire, then the attributed factors are pathological. I cannot accept these arguments.

Wang Jiezhai states: For red/swollen/painful eyes, internal decoctions use bitter-cold/acrid-cool to drain Fire; external washes use acrid-hot/acrid-cool to disperse Evil. Borax (Bing Pian) is best for drops; it is acrid-hot, using its pungency to draw out Fire Evil and disperse heat. Ancient methods used wine washing or ginger juice drops for this reason. Internal redness is Fire Evil rising; internal bitter-cold treats the root (removing fuel from pot bottom). External cold blocks Fire from escaping, causing internal stagnation. Thus, acrid-hot drops and hot water washes allow Fire to vent (following the path). People mistake Borax as cold, using it frequently, causing heat accumulation and blindness. External treatment forbids cold; using cold water/items causes blindness.

I note: Wang's theory has merit, but cold drops are not entirely unusable, depending on appropriateness. Cold drops treat Fire. Mild Fire (shallow, occasional wind-heat/smoke) can be cleared temporarily with Huanglian Gao (Coptis Ointment); floating heat clears, eyes heal. Severe Fire (originating in Zang, spreading to Three Yang) cannot be cured by a drop of cold; it fails to clear heat and traps it, harming the eye. Severe Fire eyes treated with cold drops suffer continuous pain due to trapped Heat. Long-term cold drop use ruins eyes. Wang's warning is crucial; surgeons treating carbuncles/sores must also understand this.

Xue Lizhai states: For previous syndromes with fatigue, poor appetite, blurry vision, or worsening with diet/labor: Spleen/Stomach Deficiency; use Buzhong Yiqi Tang. Sticky discharge, tightness, red veins across pupil, constipation: Use Shaoyao Qinggan San. Red nebula on white, photophobia, stabbing pain: Upper Jiao Wind-Heat; use Huanglian Yinzi. Floaters after long viewing, photophobia, foggy distance vision: Spirit/Qi injury; use Shenxiao Huangqi Tang. Pain worse in morning: Dongyuan Zhuyang Hexue Tang. Pain worse in afternoon: Huanglian Tianhuafen Wan. No pain but worse in afternoon: Dongyuan Yiyin Shenqi Wan.