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The *Longmu Lun* (Treatise on Dragon Wood) states: Ocular diseases include seventy-two types of internal obstructions, among which there are twenty-three syndromes; and forty-nine types of external obstructions. The clinical manifestations of each disease differ from one another. If the identification is made accurately based on these symptoms without error, treatment will necessarily have a reliable basis.

A careful review of various syndromes can be found in this treatise. However, internal obstructions manifest as dimness and obscuration of the black water (pupil) and divine light (spiritual brightness of vision), whereas external obstructions present with nebulae or membranes covering the eye. Although the current discussion lists all syndromes, the medications used are mostly based on wind-heat pathogens; therefore, they are briefly omitted here. Nevertheless, the etiologies of internal obstructions include phlegm-heat, qi stagnation, blood heat, sinking of yang qi, yin deficiency leading to depletion of nutritive blood, and others. These various causes are omitted and not discussed. Furthermore, regarding the nebulae of external obstructions, some arise internally, while others appear above the eyeball, below the eyeball, or within the eyeball. One must observe from which meridian the color of the nebula originates. For example, in Dongyuan’s treatment case, Lady Wei Bangyan’s ocular nebula developed from bottom to top, indicating that the pathogen originated from the Yangming Meridian. Green is not one of the five orthodox colors; this likely indicates a combined pathology of the Lung and Kidney. Consulting painters, ink was mixed with lead white (ni fen) to synthesize a color, which closely matched the color of the nebula upon close inspection. Since it is undoubtedly a pathology of the Lung and Kidney, the pathogenic factors in the Lung and Kidney were purged, and herbs entering the Yangming Meridian were used as guiding agents. The result was effective. However, the disease recurred multiple times later, with different meridians involved and varying nebula colors each time. Upon inquiry, it was determined that the underlying cause was disharmony of the meridians, preventing the resolution of the ocular disease. This proved accurate. When treated according to this theoretical framework, the disease ceased to recur. In cases where treatment fails despite identifying the nebula color, exploring the accompanying and root causes, the failure is due to long-standing accumulation of pathogens combined with insufficiency of primordial qi and yin qi. Treatment should follow the "kingly way" (gentle and harmonizing methods), which might lead to recovery. Unfortunately, laypeople fail to adhere to this principle, resulting in many cases of blindness. How sorrowful!

Li Dongyuan stated: Dilatation of the pupil is caused by excessive consumption of pungent and hot substances. Pungency primarily promotes dispersion and dissipation of heat, thereby assisting fire to ascend to the brain, causing the essence to scatter. When the essence scatters, vision appears enlarged or distorted. The clear and bright spirit is what enables one to perceive all things. Now, if vision is unclear, it indicates that the essence has declined. Fire and qi cannot coexist in excess; thus, the Classics state: "Excessive fire consumes qi; excessive fire scatters qi." Wind-heat, governed by the Hand-Shaoyin Heart Meridian and Foot-Jueyin Liver Meridian, connects to the visual system. Pathogenic factors enter the human body, following their respective affinities, and attack the head and eyes via this pathway, causing swelling, distension, and pain, along with pupillary dilatation. All these conditions stem from blood deficiency and yin weakness. Therefore, wind-heat should be dispelled, blood cooled and nourished, to consolidate the scattered qi, leading to recovery.