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The patient's emotions, joy and anger, are unregulated. Sorrow and worry coexist, causing the Qi of the Zang organs to become imbalanced. Stagnation generates phlegm (phlegm), which rises with the Qi and strikes the head. Encountering deficiency in the brain, it infiltrates the eye meridians and nourishes the eyes. Mild cases present with blurred vision and dryness; severe cases develop nebulae (membranous opacities covering the pupil), accompanied by excessive discharge and tears, or even growths, with white membranes obscuring the visual axis. These are all caused by internal factors.

Alternatively, repeated exposure to wind-cold, without avoiding summer dampness, allows pathogenic factors to strike the neck. Riding on deficiency, they enter the brain along the meridians, thus generating external nebulae. As described in the *Treatise on Nebulae*, conditions such as Green Wind, Green Wind, Purple Wind, Black Wind, Red Wind, White Wind, White Nebula, and Yellow Nebula arise from invasion by the Eight Winds, transforming into various syndromes. These are caused by external factors.

Or, indulgence in desires without restraint, irregular eating habits, consumption of raw pungent herbs (Five Pungent Spices), hot roasted foods, riding and hunting, exposure to smoke and dust, and overexertion damaging the eyes constitute the root cause of blindness. Indulging in momentary leisure leads to chronic, incurable ailments lasting a century. These belong to neither internal nor external causes, termed "neither internal nor external causes." Treatment varies according to the specific formula for each cause.

Red nebulae in the eye belong to the Blood Wheel, governed by the Heart (if small red vessels appear on white nebulae, it indicates the Blood Wheel governs the Heart); the cornea belongs to the Kidney, constituting the Water Wheel, located deeply; the sclera belongs to the Lung, constituting the Qi Wheel; the Liver corresponds to the Wind Wheel, located deep and formless; the Spleen governs the Flesh Wheel (eyelids); both eyelids are governed by the Spleen, and diseases also invade here. The pupil belongs to the Gallbladder, deep and bright like the Huai River, precious as gold. If one Zang organ is disharmonious, pathogens attack the eye; physicians should treat early without hesitation.

Foolish people do not treat initial onset; when asked about acupuncture and medicine initially, they doubt. Instead, they seek gods and ghosts, burning moxa in their leisure. When pain becomes extreme and the mind frantic, praying to gods is futile. Wind-heat has gradually deepened and solidified; only when blurred and membranous does one seek medical help. Even if cured and recovery occurs, relying on medication and famous doctors takes long days and months.

Painless and itchless, vision gradually dims, like thin fog and light smoke thickening. One may see flies flying or flowers scattering, or objects hanging suspended in the void. How are these symptoms acquired? Heat and wind stagnate in the Liver. Loud shouting, crying, fright, and anger cause brain fluid to flow into the black eye (cornea/pupil). Initially, one eye dims first, then sequentially transmits to the other, affecting both. Bitter medicine need not fear being harsh; simply state that Liver Qi is不通 (blocked). At this time, taking medicine hopes to resolve it. However, if nursing care is improper, efforts fail. After many days, if total darkness ensues, it is specifically named Internal Cataract, blocking both pupils. Names are divided into sixteen types based on shape; Master Longshu (Nagarjuna) and sages will deduce their origins. Spiritual medicines rarely take effect now; only golden needle manipulation can restore clarity like the sun in the sky. Strengthen rest and nursing, follow instructions, and do not let the disease recur as before.