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Feng Luzhan stated: Cough in infants within one hundred days of birth is called "milk cough" (Ru Sou). At this stage, the lung lobes are particularly delicate and most susceptible to damage; urgent treatment is required. If neglected for a long time, blood vessels may penetrate the pupil, the eye sockets may turn purple-black, or the sclera (white part of the eye) may become red like blood, a condition known as "blood eye" (Xue Yan). One should grind Sheng Di Huang (Rehmanniae Radix) and Hei Dou (Black Soybean) together into a paste, apply it over the eyes, and the purple-black discoloration of the sockets will naturally subside, with blood discharging along with tears, leading to spontaneous recovery.

All conditions treated by gold-needle ophthalmology, including internal cataracts (Nei Zhang), external cataracts (Wai Zhang), epidemic eye diseases caused by wind and fire, and any foreign bodies such as wind filaments or dust entering the eye, are compiled in this section for easy reference and treatment consultation.

The *Secret Manual* states: The pupil is wrapped in a thin membrane containing fluid, capable of illuminating all directions. It is the primordial spirit originating from the congenital essence, the greatest treasure of the human body, like the sun and moon shining in the sky, bright and unobscurable.

Five Wheels Diagram [Image]

The outer canthus (small corner of the eye) belongs to the Heart and Small Intestine meridians; the upper and lower eyelids belong to the Spleen and Stomach, named the Flesh Wheel (Rou Lun); the pupil belongs to the Kidney, named the Water Wheel (Shui Lun); the black cornea/iris area belongs to the Liver, named the Wind Wheel (Feng Lun); the white sclera belongs to the Lung, named the Qi Wheel (Qi Lun); the inner canthus (large corner of the eye) belongs to the Heart, named the Blood Wheel (Xue Lun).

The Heart Meridian belongs to Fire. Red vessels invading the eyeball at the canthi, accompanied by itching, astringency, and excessive discharge, feeling like needle pricks, indicate various symptoms. If due to deficiency-heat in the Heart, it must be addressed urgently. If urine is red and dysuric, it indicates internal heat accumulation; physicians should not delay treatment. If the flesh wheel invades the eyeball without other symptoms, it is due to pathogenic factors in the Yang of the Bladder. Diseases of the small canthus should not be treated randomly; the San Jiao and Small Intestine meridians should be treated together.

The Liver Meridian belongs to Wood, corresponding to the black cornea/iris. A pale purple color indicates no disease. Blackness indicates the meridian has been overcome by wind; seeing flying flowers before the eyes indicates Liver deficiency. Dimness results from excessive alcohol and sexual activity. Redness often indicates stagnant blood and exogenous heat aggregation. Eye pain with yellow discharge indicates insufficient Liver blood, which heals with tonification.

The Spleen Meridian belongs to Earth, corresponding to the upper and lower eyelids. Redness and swelling are caused by excess wind-heat. Purple color indicates stagnant blood coagulation. Photophobia and fear of sunlight are induced by damp-heat. Swelling of both eyelids is due to disharmony of the Spleen and Stomach. Internal generation of macules and clam-like fleshy growths, with accumulated blood in the two meridoids difficult to dissipate. Soreness and pain in the brow bone and eye socket may be caused by wind-phlegm or sexual exhaustion. Swollen and astringent upper eyelids making vision difficult, or conditions like trichiasis and entropion, stem from Spleen and Lung deficiency and require early treatment.

The Lung Meridian belongs to Metal, corresponding to the white sclera. Purity and brightness indicate safety. Redness and high swelling indicate Lung Qi stagnation and constipation. Pale red indicates deficiency-heat; yellow indicates dampness; nasal congestion, runny nose, and tearing indicate wind invasion.

Twelve Meridians Diagram [Image]

Eight Palaces Diagram [Image]

The Kidney Meridian belongs to Water, corresponding to the pupil. Black like pepper seeds with spirited gaze is normal. Dilation is caused by Gallbladder and Kidney deficiency, or sudden fright. Yellow opacity obscuring the pupil with dimness and tearing indicates Kidney deficiency with frequent visual floaters. Redness indicates accumulated heat; darkness from alcohol/sex; tightness and constriction indicate essence deficiency, requiring urgent nourishment.

Foot-Taiyang Bladder Meridian manifestations: Severe headache on both sides, profuse tearing, suppuration at Jingming (BL1) acupoint, opacities emerging from within, pterygium covering horizontally, blood stasis in the sclera, excessive red vessels in the eye, frequent urination, sudden onset of carbuncles with intense heat, internal redness and swelling of the upper eyelid, and hordeolum (stye) symptoms.

Foot-Yangming Stomach Meridian manifestations: Toothache combined with headache, yellow membrane rising to cover the pupil, opacity blocking from below upwards, clam-like growths with vomiting, and redness/swelling of the lower eyelid.

Foot-Shaoyang Gallbladder Meridian manifestations: Bitter taste in the mouth with occasional deafness, red vessels and opacity at the canthus, hypochondriac pain due to Gallbladder disease.

Hand-Taiyang Small Intestine Meridian manifestations: Red vessels at the canthus, opacity growing from the superior margin, hyperemia of the sclera, red and astringent urine; urgent administration of decoctions/powders is required with caution.

Hand-Yangming Large Intestine Meridian manifestations: Swollen and red sclera, excessive discharge and tearing; constipation requires rapid purgation.

Hand-Shaoyang San Jiao Meridian manifestations: Red vessels tethering the canthus, opacity slanting downwards from guest to master palace; clearing prescriptions should be used according to the disease.

Foot-Taiyin Spleen Meridian manifestations: Obstruction of the nine orifices, lethargy and drowsiness, photophobia, swollen upper eyelids, closed eyelids resembling sleep, skin eruptions with yellow face, irregular fever with vomiting/diarrhea, internal entropion/trichiasis; physicians must recognize these patterns.

Foot-Jueyin Liver Meridian manifestations: Dilated pupils with frequent blinking, brain fat penetrating the eyeball, intermittent eye twitching, sudden elevation of the black cornea, inability to look straight with eye pain, tearing with vertigo, sinking of visual images due to severe deficiency, crab-eye appearance or night blindness, floating black spots; if any of these eye ailments occur, it is a Liver disease.

Dimness like fog/mist with flying flowers, tight/small pupils indicating Kidney essence deficiency, or dilation with turbid aqueous humor and fading light, cold tears and brain fat flowing down, headache with cold feet indicating extreme deficiency—all these manifestations of membranes entering the water wheel belong to the Foot-Shaoyin Kidney Meridian.

Hand-Jueyin Pericardium Meridian: Tight/small aqueous humor requires urgent medication; red ring around the eye with dry mouth and hot palms indicate impending illness.

Opacity growing from the superior margin, red vessels like threads piercing the eyeball, forgetfulness with palpitations, urgency with unclear vision, needle-like pain with occasional itching, blood flooding the pupil preventing blindness—all these symptoms originate from the Hand-Shaoyin Heart Meridian.

Painless spontaneous dimness, thickening like thin mist/smoke, flies appearing chaotically, or objects suspended in void—these conditions arise from heat-toxic wind lingering in the Liver. Loud crying, fright, and terror cause brain fat to flow into the black cornea. Initially one eye dims, then sequentially affects the other. All suffering stems from blocked Liver Qi. Long-term bilateral darkness indicates deep internal cataract where medicine fails. (*Internal Cataracts Upper Compilation*)

There are twenty-four types of round internal cataracts. Successors value transmission. Knowing when to use or avoid gold needles is crucial; confusion in diagnosis prevents cure. Needle distance must follow methods; needle shapes vary. For patients with deficiency, pregnancy, or postpartum, abstaining from needling is essential. Choose auspicious days without wind/rain. Seven days of pure fasting and sincere prayer are required. Calm mind and qi, endure patiently, avoid wind, lie quietly, ban noise. Harmonize cold/heat, address deficiency/excess, maintain broad-mindedness, forget worries, avoid sexual anxiety. Do not panic at bleeding; proceed with treatment. Wrap tightly in a warm, sealed room. If membranes suddenly rise again, take medicine for thirty days to see clarity. Unseal after seven days to restore vision; do not doubt if flowers appear and water moves. Continuously take Huan Jing Wan (Restore Vision Pill); after one hundred days, work is complete, and original vitality returns. (*Internal Cataracts Middle Compilation*)

When gold needles are inserted for internal cataracts, nursing care instructions must be known. In deep winter, keep tightly wrapped and warm; in summer, do not use silk fans. Sleep on a soft pillow securely; lie supine for three days without impatience. If slight pain occurs after sealing, do not suspect other causes as it is brain-wind traction. Needling or manipulation follows meridian methods; if pain is extreme, moxibustion warming is applied. Take Dou Zhi Jiao Tang (Soybean Pepper Decoction) urgently for vomiting; calming spirit and stabilizing stomach requires a good physician. Avoid movement and mental exertion; do not allow tumbling or lying upside down. Eat warm thin porridge for seven days; avoid clenching teeth. Urinate/defecate slowly; do not let go independently, provide support. Loud shouting and emotional agitation disturb the eye wheel causing snow-like visual disturbances. Restrain the mind, do not recall sexual matters, sever marital affection temporarily. Do not wash face with water for one month; wet needle marks cause slight pain. After five to seven days of nourishment, eye light returns; reducing desires clears the heart and removes disease. (*Internal Cataracts Lower Compilation*)

Heaven has two luminaries; humans have two eyes. Excessive alcohol and sex, improper regulation, and anger injuring Liver Qi cause impulse, leading brain fat to flow downward. The optic nerve connects to the brain and is linked to the Liver. Evil Qi from the brain enters through the optic nerve in front of the pupil. Over time, fat hardens and condenses into opacity, obscuring the pupil, causing blindness, commonly called "pupil reversal." The pupil is not "human" but "benevolence," also called the eye's core. It has no limbs, shaped like sun/moon, with light front and back; how could it reverse? Only brain fat flooding the eye obscures the pupil, named internal cataract. Using a gold needle to push aside brain fat makes the pupil float up and fat sink down; like clouds parting in wind and sun, clarity is achieved instantly.

Human eyes: sclera like apricot fruit, iris/cornea like apricot kernel, pupil like almond seed, called the eye's core. Sclera is hardest, belonging to Lung Metal. Fluids protecting the eye inside are as thick as egg white, supporting the pupil in the central cavity. Iris belongs to Liver, bound by a layer of floating skin externally, containing clear Qi enclosing the pupil internally. This tiny drop is formed by congenital Yuan Qi, following the natural way of life. The eye is the orifice of the Liver, round and large, with a stalk connecting to the brain, linking Fengfu (GV16), descending along the spine, penetrating the Liver. Liver stores blood, nourishing the eye. Youth: water and fire interact, Yin and Yang ascend/descend, hence brightness. Old age: Qi and blood decline, hence dimness. (*Theory of Pupil Origins*)

Li Dongyuan stated: Qi and blood from the five zang, six fu, twelve meridians, and 365 collaterals all ascend to the face and enter the orifices. Clear Yang Qi ascends to the eyes for vision and to the ears for hearing. Mental distress, excessive affairs, irregular diet, and overwork lead to Spleen/Stomach weakness and Heart Fire excess. Heart Fire is Ministerial Fire (Jun Huo), governing the spirit,宜 quiet and calm. Assistant Fire (Xiang Huo) acts on behalf of the ruler. Assistant Fire is the Pericardium. All meridians nourish the eyes. With overwork and movement, Qi flows recklessly, meridians boil, pathogens harm orifices. Shen Shui (Divine Water) in the pupil lacks nourishment and suffers from blazing fire, gradually dimming and causing blindness.

Do not needle internal cataracts that are green vegetable color; white like a plastered wall; yellow-centered; or caused by head wind. Do not needle those caused by shock/vibration; dilated pupils; or tightly constricted pupils.

If the cataract appears smaller in bright light and larger in dim light, the obstruction can be needled, provided there is proper retraction and release. If no retraction/release, do not needle. White opacities can be needled; slightly blue-white can be needled; coarse rice-colored opacities can be needled; blue opacities can be needled because they are tender.

Gold needle handles are made of rosewood, huanghuali, or rhino horn, 2.8 cun long, thick as a bowstring. Eyes drilled 0.4 cun deep at both ends. Use fine gold wire, 1 cun long, mixed with dry flour and clear lacquer, embedded in the eye, leaving 0.6 cun outside, slightly pointed but not too sharp to avoid damaging the pupil. Cover with goose quill tube, store in box, offer before Buddha before use; always effective. This is the style of Bodhisattva Nagarjuna's Divine Needle.

For needling internal cataracts, on new/full moon days, face gods/Buddha, state name/hometown, and pray for rescue. The practitioner chants mantra seven times, writes a talisman to seal the needle. Must fast beforehand, set up incense/candles, write another talisman to connect solar divine light with patient's eye light. Chant loudly: "Avalokitesvara Bodhisattva of Nanhai, Savior of Suffering!" The needle rotates itself, opening the practitioner's courage. Write the Three Lights Talisman first. Choose open, success, remove, or harvest days with clear weather. Avoid Zi day.

Mantra: Pure Eye, Purple Gold Lamp, Wine/Wine Water, Li Huang Sha, Full Canon, Thousand Eyes Hands Kings Dragon, Manjushri riding lion, Samantabhadra riding elephant king, Sun God Night God, cloud/membrane internal cataracts eliminated. Strong among strong, Auspicious among auspicious, special benefit at波罗 assembly, all in eyes obtain light, Pure Prajna Paramita. Open Iron Three Lights Talisman.

Draw talisman silently chanting three sentences: Take sunlight, connect divine light, bright eye light.

Gold Needle Style [Image]

Open Needle Three Lights Talisman [Image]

If pain after needling: Immediately take fresh mugwort or dried mugwort with one bunch of raw green onion, pound, stir-fry hot in copper pot, place in cloth bag, moxa compress Taiyang acupoints 3-5 times, stops immediately.

Water Method: For manipulating internal cataracts, first draw well water into a basin on table. Patient leans face to basin. Practitioner sits sideways, dips hand in water, pours over eye including brow bone, washing repeatedly until brain fat in eye coagulates from water. Wash thoroughly dozens of times, then needle, so it slides down smoothly without sticking.

Manipulation Technique: Physician using gold needle must know eight methods. Six are easy to transmit; two are subtle, relying on physician's hand/eye, understood intuitively, not verbally transmitted. Hard to teach. Eye like taking object through wall, hand like taking from pocket, only then can opacity be pushed down. Two eyes are essence of water; without these two methods, needling is difficult.

When using gold needle, first let patient wash eye with ice-cold water until Qi/blood flow stops. Use left thumb/index to fix eyeball, prevent rotation. Right hand holds triangular needle, 1 cun away from black cornea, puncture one point. If sclera is thick, hand must be accurate and force sufficient; heavy puncture breaks it. Then insert gold needle obliquely back, tip into hole, watch until tip reaches lesion then stop; if passing by hair's breadth, damages Heart vessel, patient vomits. Then use technique to gently push/press, opacity naturally embraces needle, allowed to push down, send to sclera, hide in protective fluid end. Then withdraw needle. Do not withdraw early, or opacity returns, wasting effort.

Seal Needle Talisman [Image]

First, wash/irrigate correctly. Second, know if Qi/blood coagulates. Third, know triangular needle sharpness depth. Fourth/Fifth, know insertion weight/depth. Sixth, know hiding opacity at bottom of protective fluid. Seventh/Eighth methods are subtle, from heart, matching hand/eye, hard to transmit by ink. After needling, seal according to method, regulate properly, naturally recover.

Eye Sealing Method: Collect half-old hibiscus green leaves, dry, powder. Mix with well water. Cut cotton paper into circle size of tea cup mouth. Apply medicine on brow ridge and lower orbit. Seal medicine with paper layer, add medicine layer, cover with paper layer, seal. When nearly dry, moisten with brush dipped in water. Several times day/night, double in summer. Change once daily. Lie supine, or place needle eye upward on pillow, prevent fat floating up. Rising/sitting, eating, defecating/urinating must be slow, no startling. First three days: only thin porridge, soft food, no tooth vibration. After three days: unseal, view objects, take medicine, rest primarily.