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Generally speaking, the generation of corneal opacity (Yunyi) arises from long-standing accumulation of heat in the Liver and Lung meridians, which then ascends to the eyes, forming symptoms such as red filaments (Hongsi) and cloud-like opacities. This disease does not develop overnight; how can one expect immediate efficacy through rash treatment? Those treating this condition employ methods of applying eye drops, resting periods, days of taking oral medicine, and days of abstaining from it. Taking medicine and applying drops are for eliminating pathogenic heat; abstaining is to support healthy Qi (Zhengqi). Moreover, the root cause of cloudiness in the Liver and Lung must first be removed using Sun Simiao's "blowing and flushing" method, so that the red filaments and opacities in the eyes can gradually recede. This requires waiting for time to pass and treating step by step, which is what is meant by saying that the "Kingly Way" yields no quick results. It is often seen that patients, cherishing small gains and desiring rapid cure, abandon treatment halfway. This cannot be blamed on destiny but is truly self-inflicted!

When eye conditions persist for two or three years, they become entrenched diseases. One must first support healthy Qi and then eliminate pathogenic factors; this cannot be accomplished without the passage of years. I frequently see practitioners who use knives, scissors, and grinding methods to remove opacities, and administer cold-natured herbs to clear fire, thereby trapping toxic heat to achieve quick effects, thus establishing lifelong pathological roots. This is due not only to a lack of profound guidance but also to a desire for profit. Little do they know that intentionally leaving pathology behind is worse than a mediocre doctor killing a patient; it incurs guilt in the unseen world and brings disaster upon descendants. Those engaged in this profession should certainly be cautious!

The above thirty-two paragraphs were derived from Sun Simiao's *Secret Manual* over more than fifty years of clinical variation. They are presented as common-sense advice to guide those lost in confusion, allowing patients to carefully select medications and attain visual clarity, thereby honoring Sun Simiao's intent in passing down prescriptions. To claim expertise in ophthalmology would be presumptuous.

Sun Simiao's secret transmission yields miraculous effects when treating youths and middle-aged individuals with robust Qi and Blood. However, if the patient is elderly and suffering from long-term depletion of Qi and Blood, with external opacities obscuring vision and internal dimness of the pupil, these cases are incurable.

In the Bingchen year, I met Mr. Zhang Xiongfei from Jiangzuo, who handed me a booklet on treating elderly eye conditions. For various elderly eye ailments, adjusting formulas according to the text yielded remarkable results. Therefore, I had it printed for widespread dissemination, hoping it serves as an aid to rejuvenation.

Human eyes are like the sun and moon in the sky. If clouds and mist interfere in the air, the light of the sun and moon is obscured. Similarly, dimness in human eyes is caused by pathogenic factors interfering with the clear orifices, blocking the luminous clarity.

The Classics state: The Liver opens into the eyes; the eyes can see when nourished by Blood. If Liver Wood is imbalanced, eye diseases arise. Current practitioners follow books such as *Yin Hai Jing Wei* and *Long Shu*, discussing theories of the Five Wheels and Eight Passages, and analyzing the generation and restriction of the Five Elements. Internal medications mostly consist of wind-dispelling and heat-clearing agents, along with Qi-moving and blood-invigorating herbs; external treatments predominantly use minerals (Gold/Stone), musk, and camphor. Mild cases are treated with washing and dropping; severe cases involve grinding or even acupuncture. Such methods may still yield results in youths with sufficient Qi and Blood; but in the elderly with depleted Qi, they lead to blindness. Why? Excessive internal wind-dispelling drugs dry up Ying (Nutritive) and Wei (Defensive) Qi; excessive Qi-moving depletes True Qi; excessive blood-invigorating scatters True Yin; excessive external application of Gypsum and Litharge dries and consumes Blood; minerals damage muscles and cause hardening; camphor and musk scatter Qi due to their aromatic nature. Furthermore, grinding injures flesh and blood, and acupuncture damages Yuan (Original) Qi. Consequently, the spiritual orifices become blocked, Qi and Blood dissipate, and the eyeball sinks. Alas!

One fails to reflect that the *Ling Shu* chapter of the *Nei Jing* speaks little about eye diseases, merely stating that the Liver opens into the eyes, the eyes see when nourished by Blood, and that pathogenic factors interfere with clear orifices, just as darkness obscures the sun and moon. It contains no discussion of the Five Elements' generation and restriction. In the *Su Wen* and *Nan Jing*, eye diseases are attributed to the Liver because this addresses the root (*Ben*); whereas *Yin Hai Jing Wei* discusses the Five Wheels and Eight Passages, addressing the branch (*Biao*). Since the Liver belongs to Wood and corresponds to the Xun trigram, excess Wood leads to surplus Heart Fire, causing wind and fire to interact, Qi and Blood to boil, resulting in conditions like crab-eye, spiral corns, and pterygium. If initially presenting with redness, swelling, and unceasing pain, wind-dispelling and heat-clearing formulas are appropriate. However, if there is no pain after a long duration, this method is ineffective. This indicates insufficient Kidney Water failing to nourish Heart Fire, and essence of Qi and Blood failing to ascend to the eyes, resulting in green blindness, dimness, and internal cataracts. The treatment should focus on tonifying the Liver and nourishing the Kidneys, guiding Spirit to open orifices. This method is also used for chronic external obstructions where opacities do not recede. It is commonly seen that many practitioners fail to achieve efficacy even with tonifying herbs, excusing themselves by saying internal cataracts and long-term aging make full restoration of vision impossible.

In the Bingchen year, at the residence of Governor Zhu of Wenyang, a young woman suffered from an eye condition characterized by white opacities on the black pupil, hard as ice. Despite morning and evening applications and grinding, there was no effect. I invited Mr. Zhang Xiongfei from Jiangzuo. His treatment methods aligned profoundly with the principles of the *Nei Jing*, revealing insights previously unexpressed by sages. Within less than a month, he achieved seven or eight successes out of ten attempts. Desiring to obtain this prescription for public benefit, Mr. Zhang generously revealed its secrets to me, ensuring that the world might have fewer blind people. The specific treatment methods are as follows:

1. Mr. Zhang's method prioritizes opening orifices before tonification. During tonification, adjustments are made based on Qi, Blood, Cold, and Heat, assisted by herbs that brighten the eyes and resolve opacities. Internal and external treatments attack simultaneously, ensuring continuous medicinal action while nurturing the Spirit. When the Spirit is calm, Yin generates; when Yin generates, vision clarifies.

2. Regarding the method of resolving opacities: Opacities result from the blockage of the spirit-connecting orifices in the eyes, where Qi, Blood, and Body Fluids coagulate and stagnate, forming cloud-like masses. The primary approach should be to open the orifices. Once the orifices are patent, Qi and Blood circulate freely, allowing tonifying and opacity-resolving medicines to enter effectively.