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Eyelids are tight and small, essence and blood are exhausted, sinews and vessels are twisted and contracted, vision is dim, and the heart is filled with sorrow.
This condition refers to the upper and lower eyelids gradually becoming tight and narrow; in severe cases, they become as small as a jujube pit, nearly closing the eye. This is due to the exhaustion of ocular fluids and the emergency contraction of sinews and vessels. If treatment results in further shrinkage, it is an error in treatment.
If the eyelid skin is loose with inverted eyelashes, but only external measures are taken while neglecting internal regulation, the inversion and entrapment will recur. Eventually, the muscle tissue becomes dry and blood damaged, the ocular collaterals fail to circulate smoothly, and the eyelids daily tighten and shrink. Once shrunken, as years pass, can one expect the eyes to open normally again?
Some say this condition does not affect vision and is not difficult to treat. However, these eyes have been chronically ill. Crude practitioners merely treat symptoms without addressing the root, and pedantic scholars merely apply medicine to diseases, causing damage to the pupil first, before affecting the outer eyelid. With tight eyelids and curled lashes, intervention comes too late. Incompetent hands performing random procedures are already shocking; burning the flesh at the site of eyelid entrapment with lamps endlessly will inevitably lead to swelling and ulceration. Without waiting for further entrapment, the eyelid will be irreparably destroyed. Even if we were to encounter such patients now, we could only look to heaven and sigh, saying "What can be done?"
Removing eyelashes and applying eyelid clamps are crude external treatments. Yet, the eyes are the magnificent markers of the human body, so one must strictly follow protocols. Besides the correct methods of removing lashes and clamping, there should be no asymmetry like high on the left and low on the right, nor size disparity between right and left. Particular care and caution are required for women and virtuous scholars. After seven days, remove the clamp; after another seven days, the scab falls off. When scars vanish and traces disappear, the treatment has fulfilled its duty without shame. It is common to see people with triangular eyes, those pulled by scar disease, or those whose eyelid tissue is completely absent, exposing the eyeballs shockingly. Although this stems from ignorant fools acting recklessly, it is also due to dullness and decay of the senses, failing to self-reflect. As children, one cannot fail to understand medicine; this is what is meant.

At that time, combing hair near a bronze mirror, feeling desolate and lonely, intoxicated in the warm golden tent, the dream soul is weary. Suddenly, the rim of the eyelid turns black, resembling gray. Maintaining pure conduct with plum blossoms as wife and cranes as sons, the root of life remains firm.
This condition presents a specific abnormality in both eyes: the upper and lower outer eyelids are coal-black, like light ink soaked into old cotton paper. From afar, it resembles Mi Family landscape painting, misty and empty. This occurs because obese individuals suffer from deficiency in Lung and Spleen Qi, coupled with excessive eating. Undigested food fails to transform and transport, accumulating like silt in ditches over time. Furthermore, when Earth (Spleen) and Metal (Lung) are deficient, Water (Kidney) and Wood (Liver) pathogens rise from the middle to attack the upper, manifesting as the current appearance. Treatment should employ pungent-warm major tonification. Initially administer Zhenwu Tang (True Warrior Decoction), followed by San Jian Zhong Tang (Three Builders Middle Harmonizing Decoction), then Li Yin Jian (Regulating Yin Decoction), preventing phlegm-fluids from overflowing upward. To restore original purity, recovery need not wait long. If medicinal power is insufficient, or if one indulges further in wine and lust, Qi dissipates following wealth and desire. The primary disease changes, and malar spots and halos will surely increase on the cheeks. Dressed in actor's costumes, openly wearing a painted face, one fears neither laughter nor crying will come naturally.
This condition is also commonly seen in women. It generally arises from the decline and fatigue of Spleen Earth, which fails to perform its transporting and transforming functions. Consequently, cold fluids and hot phlegm do not descend but ascend, leaving these filthy marks. Or, due to unfavorable circumstances, inner depression causes frequent weeping, leading to Liver Wood excess suppressing Kidney Water. Blue spots and black dots stain the beautiful face. Covering them with cinnabar and hibiscus powder only invites ridicule from frivolous men, comparing the effort to painting up the ugly No-Yan. Is this not tragic? Is this not regrettable?