诊目形容之法。相士观人贤否。宜识其常。医家论病吉凶。当明其变。用是考古参今。删繁就简。约而言之。
其大纲有四。以形象察气质。以开阖分阴阳。以目睑辨虚实。以眼珠决死生。四者既明。而合之气色。参之
病情。庶乎其可见矣。以形象言之。目者。肝之外候也。目大者肝大。目小者肝小。目深者肝坚。目露者肝脆。
目高者肝高。目下者肝下。目偏倾者肝偏倾。目端正者肝端正。此形象之变。气质之常也。以开阖言之。
目者。阳证也。瞑目者。阴证也。目不合者。气留于阳。目不开者。气留于阴。目纲筋急而不合者。太阳阳明之
筋寒。目纲筋纵而不开者。太阳阳明之筋热。目圆者阳气绝。目小者阴气亡。口眼 斜者。阳明中风。口目
动作者。阳明将绝。昏睡露睛者。阴阳俱不足也。此开阖之变。阴阳之分也。以目睑言之。上睑属脾。下睑属
胃。睑动迟者脾动迟。睑动速者脾动速。上睑气壅者。脾衰于内。下睑微肿者。水聚于中。目胞肿痛者邪气
实。目眶陷下者正气虚。此目睑之变。虚实之辨也。以眼珠言之。目肿胀者为实。目陷下者为虚。上视者太
阳不足。下视者宗气亏虚。斜视者。少阳已绝。直视者。少阴已终。目转目运者。阴经之绝证。目HT 戴眼者。阳
经之死候也。此眼珠之变。死生之异也。盖察目之形容者。所以辨其脏腑经络也。观目之气色者。所以辨
其寒热虚实也。合形容气色以观之。参声音脉症以辨之。分其脏腑经络。以审其寒热虚实。庶乎知病之
所。而无泛治之虞。不则寒热虚实虽明。而脏腑经络未达。其犹风马牛不相及欤。
Methods for diagnosing the appearance of the eyes. Physiognomists observe a person's virtue or lack thereof and should understand their normal state; physicians discuss the auspiciousness or inauspiciousness of diseases and must clarify their variations. Therefore, examining ancient practices and referencing modern ones, deleting complexity and retaining simplicity, we summarize as follows:
There are four main principles: observing constitution through shape, distinguishing Yin and Yang through opening and closing, differentiating Deficiency and Excess through eyelids, and determining life and death through the eyeballs. Once these four are clear, and combined with Qi and Color (complexion), and cross-referenced with disease conditions, one can generally perceive the situation.
Speaking of shape: The eyes are the external manifestation of the Liver (Zang organ). Large eyes indicate a large Liver; small eyes indicate a small Liver. Deep-set eyes indicate a firm Liver; protruding eyes indicate a fragile Liver. High-set eyes indicate a high-positioned Liver; low-set eyes indicate a low-positioned Liver. Oblique eyes indicate an oblique-positioned Liver; straight eyes indicate a straight-positioned Liver. These are variations in shape, reflecting the constancy of constitution.
Speaking of opening and closing: Open eyes belong to Yang Syndromes (Yang Zheng); closed eyes belong to Yin Syndromes (Yin Zheng). Eyes that cannot close indicate Qi stagnating in the Yang aspect; eyes that cannot open indicate Qi stagnating in the Yin aspect. Eyelid muscles tense and unable to close indicate Cold (Han) in the tendons of the Taiyang (Greater Yang) and Yangming (Bright Yang) meridians; eyelid muscles flaccid and unable to open indicate Heat (Re) in the tendons of the Taiyang and Yangming meridians. Widely staring eyes indicate exhaustion of Yang Qi; squinting eyes indicate loss of Yin Qi. Deviation of the mouth and eye indicates Wind-Stroke (Zhong Feng) affecting the Yangming meridian; twitching of the mouth and eyes indicates impending exhaustion of the Yangming meridian. Sleeping with eyes half-open reveals the sclera, indicating insufficiency of both Yin and Yang. These are variations in opening/closing, representing the distinction between Yin and Yang.
Speaking of eyelids: The upper eyelid belongs to the Spleen (Zang organ); the lower eyelid belongs to the Stomach (Zang organ). Slow movement of the eyelid indicates slow Spleen Qi movement; fast movement of the eyelid indicates fast Spleen Qi movement. Qi congestion in the upper eyelid indicates Spleen deficiency internally; slight swelling of the lower eyelid indicates water accumulation centrally. Swelling and pain of the eye bags indicate Excess of pathogenic factors; sunken eye orbits indicate Deficiency of healthy Qi. These are variations in eyelids, representing the differentiation of Deficiency and Excess.
Speaking of eyeballs: Swollen eyeballs indicate Excess; sunken eyeballs indicate Deficiency. Upward gaze indicates insufficiency of the Taiyang meridian; downward gaze indicates deficiency of Zong Qi (Pectoral Qi). Oblique gaze indicates exhaustion of the Shaoyang (Lesser Yang) meridian; fixed stare indicates termination of the Shaoyin (Lesser Yin) meridian. Rolling or trembling eyes indicate terminal syndromes of the Yin meridians; upward deviation of the eyes (Dai Yan) indicates fatal signs of the Yang meridians. These are variations in eyeballs, representing differences between life and death.
Generally, observing the appearance of the eyes is to differentiate the Zang organs and meridians; observing the Qi and color of the eyes is to differentiate Cold, Heat, Deficiency, and Excess. Combining appearance and Qi/color for observation, and cross-referencing voice, pulse, and symptoms for differentiation, one divides the Zang organs and meridians to examine Cold, Heat, Deficiency, and Excess. Thus, one can know where the disease lies and avoid the danger of indiscriminate treatment. Otherwise, even if Cold, Heat, Deficiency, and Excess are clear, but the Zang organs and meridians are not understood, it would be like "wind and horses meeting cattle"—completely unrelated.