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In the *Ling Shu: Da Huo Lun* (Great Confusion Chapter of the Spirit Pivot), Qibo stated: The essence and qi of the five zang organs and six fu organs all ascend to pour into the eyes, thereby forming the essence of the eyes. The gathering place of this essence is the eye; the essence of bone manifests as the pupil (Tongzi); the essence of sinews manifests as the black eye (Heiyan, referring to the iris/cornea area); the essence of blood manifests as the collaterals (Luo, referring to conjunctival vessels); the gathering place of the essence of qi manifests as the white eye (Baiyan, referring to the sclera); and the essence of muscles manifests as the constraints (Yueshu, referring to the eyelids). These structures envelop and extract the essence of sinews, bones, blood, and qi, connecting with the meridians to form the optic nerve system (Mu Xi), which ascends to connect with the brain and emerges posteriorly from the nape of the neck.

Therefore, when pathogenic factors invade the nape, coinciding with a deficiency in the body's healthy qi, if the invasion is deep, it follows the optic nerve system into the brain. Once entering the brain, it causes dizziness or rotation of the head; this rotation pulls on the optic nerve system, causing tension; such tension leads to vertigo and visual spinning.

When pathogenic factors interfere with the essence, causing the essence to lose its proper coordination with its supporting structures, the essence scatters. When the essence scatters, diplopia (Shi Qi, seeing double) occurs, resulting in the perception of two objects. The eyes are the gathering place of the essence of the five zang and six fu organs; they are constantly nourished by Ying-Wei (Nutritive and Defensive Qi), Hun, and Po; and they are the source where Shen (Spirit) arises. Therefore, mental fatigue causes Hun and Po to scatter and Zhi (Will) to become chaotic.

Thus, the pupils and black eyes follow Yin, while the white eyes and red vessels follow Yang. When the qi of Yin and Yang harmoniously distributes, clear vision (Ming Jing) is achieved. The eyes are the messengers of the Heart; the Heart is the residence of Shen. Therefore, when Shen and Jing (Essence) are chaotic and fail to function normally, suddenly seeing unusual scenes causes Shen, Hun, and Po to scatter and lose coordination; this state is called "Huo" (Confusion/Delusion).

If the heart harbors likes and the spirit harbors dislikes, and these opposing stimuli suddenly affect the interior, it leads to chaos in essence and qi, erroneous vision, and thus confusion. Only when the Shen stabilizes and emotions shift can normalcy be restored. Hence, auditory stimulation causing mild emotional disturbance is termed "Mi" (Lost/Confused), while visual stimulation causing intense emotional disturbance is termed "Huo" (Confused/Deluded).

This passage details that the eyes are formed by the gathering of essence from the five zang and six fu organs. The pupil, being the essence of bone, is rooted in the Kidney; it is the brilliance of Marrow and houses Shen, enabling sight. If the pupil dilates and Shen Guang (Spirit Light) fails to gather, even with intact black eyes, vision is lost. The Brain is the Sea of Marrow; hence, the vascular system of the eyeball connects upward to the brain. The Taiyang Meridian connects to the brain above and descends along the nape below. Thus, pathogenic factors invade the nape due to constitutional weakness and insufficient brain marrow. Deep invasion follows the optic nerve into the brain, causing the brain to rotate due to pathogenic influence, pulling the optic nerve tight, leading to vertigo and visual spinning. Consequently, patients perceive rotating objects, although the objects themselves are stationary; this is due to the instability of visual perception.

When the essence of the eye is affected by pathogens, chaotic qi and blood fail to coordinate, causing the essence to scatter and resulting in diplopia (seeing one object as two). This describes damage caused by external pathogens. Generally, the eyes are gathered from the essence of zang-fu, nourished by Ying-Wei, Hun, and Po, and generated by Shen. Mental fatigue causes Hun and Po to scatter and Zhi to become chaotic. The pupils and black eyes are internal and follow Yin; the white eyes and vessels are external and follow Yang. Harmonious distribution of Yin and Yang qi ensures clear vision. However, the eyes are governed by the Heart; thus, the eyes are the messengers of the Heart, representing the function of Shen. Since the Heart is the residence of Shen, if Shen and Jing scatter chaotically, the gaze becomes flickering. Suddenly seeing unusual realms agitates the Heart, causing Shen, Hun, and Po to scatter and lose coordination, hence termed "Huo." If the heart has likes and dislikes, and these are suddenly triggered, essence and qi become chaotic, vision becomes erroneous, and confusion ensues. Over time, with stabilized Shen and shifted emotions, forgetting likes and dislikes allows recovery. Thus, hearing causing mild emotion is "Mi"; seeing causing intense emotion is "Huo."

These discussions attribute confusion to erratic mind-will, scattering of essence, and shifting of Shen, leading to the perception of abnormal objects and resulting in delusion. Severe cases may transform into dementia, mania, or chronic diseases, not caused by external pathogens.