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[General Principle]
All meridians converge upon the eyes. The eyes are able to see when nourished by blood. It is also said that the essence of the five zang and six fu organs converges in the eyes, referred to as "Jing" (Pupil/Eye Essence). (From *Neijing*) If the essence is excessive, it causes congestion and pain; if insufficient, it leads to exhaustion and blindness. (From Liu Wansu/Zihe)

[Internal Causes]
(Exterior Causes) Wind pathogen invading the Naohu acupoint (B10), dampness soaking the head, cold pouring into the eyes, or long-term exposure to smoke and fire, sleeping improperly after drunkenness, being blinded by flying sand and dust, or suffering from blows, stabs, and falls—all these injure the superficial aspect (Biao) of the eyes. (From *Rumen*)
(Interior Causes) Overconsumption of roasted, fried, raw, and cold foods, as well as the "Five Pungent Spices," alcohol, and wheat products, leading to damp-heat infiltration; or excessive sexual activity damaging kidney essence, overwork damaging qi, crying and weeping damaging blood, excessive visual strain damaging spirit/shen, depression and anger stirring up fire—these all injure the fundamental aspect (Ben) of the eyes. (From *Rumen*)

[External Manifestations]
The eyes do not hurt unless caused by Fire pathogen. For instance, redness of the white sclera indicates Fire attacking the Lung; swelling and redness of the eyelids (Meat Wheel) indicate Fire attacking the Spleen; colored nebulae on the black cornea indicate Kidney deficiency with empty fire; vision obscured by nebulae on the green/black pupil indicates Liver deficiency with empty fire; red vessels traversing the eye with astringency and pain indicate Heart Fire flourishing internally. (From Liu Wansu/Zihe) Liver heat causes frequent swelling; Heart heat causes frequent ocular discharge (Chi); Excessive Fire causes frequent pain; Water metabolism issues cause frequent tearing; Blood deficiency causes frequent sourness; Qi deficiency causes frequent dryness/astringency; Essence exhaustion causes blurred vision; Spirit/Shen exhaustion causes darkness before the eyes. Wind excess causes itching; Heat excess causes distension; Dampness excess causes ulceration. (From *Shengmo*)

[The Five Wheels of the Eye]
The Five Wheels of the eye are the gathering place of the essence of the zang-fu organs and the convergence of the sinews. (From Liu Wansu/Zihe) The white part belongs to the Lung, called the Qi Wheel; the black part (cornea/pupil area) belongs to the Liver, called the Wind Wheel; the two canthi belong to the Heart, called the Blood Wheel; the upper and lower eyelids belong to the Spleen, called the Flesh Wheel; the pupil belongs to the Kidney, called the Water Wheel. (From *Rumen*)

[The Eight Palaces of the Eye]
Qian Palace represents Heaven, located in the middle of the white sclera on both sides; Zhen Palace represents Thunder, located in the upper section of the white sclera near the lateral canthus; Dui Palace represents Lake, located in the lower section of the white sclera near the medial canthus; Kun Palace represents Earth, belonging to the upper and lower eyelids; Li Palace represents Fire, located between the medial and lateral canthi; Xun Palace represents Wind, located on the black cornea; Gen Palace represents White, located at the center of the pupil (Shen Guang); Kan Palace represents Water, located at the pupil. (From *Rumen*)

[Meridians of the Eye]
The medial canthus of the eye is where the Foot-Taiyang Bladder Meridian originates; the lateral canthus is where the Foot-Shaoyang Gallbladder Meridian runs; the upper eyelid is governed by the Foot-Taiyang Bladder Meridian; the lower eyelid is governed by the Foot-Yangming Stomach Meridian; the Foot-Jueyin Liver Meridian only connects to the Eye System (Mai Xi). (From Liu Wansu/Zihe)

[Yin and Yang of the Eye]
The pupil and black cornea emulate Yin; the white sclera and red vessels emulate Yang. Thus, when Yin and Yang harmonize, vision becomes clear. (From *Neijing*) In children, Yang is above and Yin is below, so vision is bright; in the elderly, Yin is above and Yang is below, so vision is dim. (From Liu Wansu/Zihe)

[Long-sightedness and Short-sightedness]
Those who can see far but not near belong to Heart Qi deficiency, with insufficient Yang and excess Yin. Those who can see near but not far belong to Kidney Qi deficiency, with excess Yang and insufficient Yin. (From *Huibu*)

[Yin Deficiency and Yang Deficiency]
Insufficient Liver Blood causes blurred vision and seeing spots, with weakness after prolonged viewing; insufficient Kidney Water causes short-lived Shen Guang (visual spirit) and diplopia (seeing one object as two). Both belong to Yin Deficiency; one should strengthen the Master of Water (nourish Kidney Yin) to suppress the Sunlight (empty fire). Insufficient Spleen and Stomach function leads to dysfunction of the nine orifices and white nebulae in the eyes; insufficient Yin Fire (Mingmen Fire/Yang Qi) leads to numbness in hands and feet and tight, small eyes. These all belong to Yang Deficiency; one should benefit the Source of Fire (warm Yang) to eliminate Yin Nebulae (cold-damp/yin pathogens). (From *Huibu*)

[Pulse Diagnosis]
Cun pulse surging and rapid indicates Heart Fire; Guan pulse wiry and rapid indicates Liver Excess Heat; Chi pulse floating and rapid indicates Yin Fire (Deficiency Fire). If the pulse is floating, soft, and forceless, it is Qi Deficiency; if fine and weak, it is Yang Deficiency, which should not be treated as a Fire syndrome.

[Therapeutic Principles]
Disease in the Fu organs is exterior; disperse Wind-Heat. Disease in the Zang organs is interior; nourish Blood and calm the Spirit. Acute onset diseases are exterior and easy to treat; chronic diseases are interior and difficult to cure. (From *Jiyao*)

[Initial Treatment: Dispersal]
For internal decoctions, use mild, cool, and acrid-dispersing herbs to scatter Fire. For external washing/dropping, use acrid-warm or acrid-cool herbs to disperse pathogens. If bitter-cold herbs are indiscriminately used to suppress the fire, it will lead to constrained Fire attacking inward, preventing dispersion. (From Wang Kentang/Yulun)

[Long-term Contraindication for External Drops/Washes]
No herb is better for eye drops than Borneolum Syntheticum (Bingpian), but it is extremely acrid and warm. Long-term use causes accumulated heat to enter the eye, forming dark nebulae. Alternatively, reckless use of cooling teas or cold water washing can cause blindness. (From Wang Kentang/Yulun)

[Distinguishing Deficiency-Heat]
For Excess Fire with Qi surplus, scatter the excess Fire, focusing on breaking Qi stagnation. For Deficiency Fire with Blood insufficiency, descend the apparent lack of Fire, focusing on nourishing Yin. (From *Rumen*)

[Medication Usage]
In the initial stage, dispel Wind and scatter Heat. Use Siwu Tang (Four Substances Decoction) added with Puerariae Radix (Gegen), Saposhnikoviae Radix (Fangfeng), Chrysanthemi Flos (Ganju), Schizonepetae Herba (Jingjie), Gentianae Radix (Dancao), Gardeniae Fructus (Shanzhi), Scutellariae Radix (Huangqin), Coptidis Rhizoma (Hlian), Tribuli Fructus (Jili), Dicentrae Rhizoma (Mimeng), Forsythiae Fructus (Lianqiao), Viticis Fructus (Manjing), etc., modified according to symptoms.
For chronic disease, nourish Blood and yin. Use Siwu Tang added with Lycii Fructus (Gouqi), Dendrobii Caulis (Shihu), Schisandrae Fructus (Wuweizi), Cuscutae Semen (Tusizi), Tribuli Fructus (Jili), Ginseng Radix et Rhizoma (Renshen), [Missing Character, likely Astragali Radix], Corni Fructus (Shanyuzhu), Dioscoreae Rhizoma (Shanyao), Moutan Cortex (Danpi), Ophiopogonis Tuber (Maidendong), etc., treated according to the condition. Additionally, guide herbs for specific meridians should be added. There are cases where excessive use of cold/clearing herbs leads to Yang Deficiency, causing the Fire to intensify; in such cases, warming and tonifying following the disease trend (Congzhi) is required, after which the Fire naturally subsides and vision clears. Although rare, this must be carefully examined.

[Appendix: Hordeolum/Stye]
When a skin lesion suddenly forms at the medial canthus, producing pus within three to five days, it is commonly called "Stealing Needle." This is caused by Heat pathogen lodging in the canthus, agitating body fluids. (From Chao Yuanfang) Observe the area for small red pustules; puncture with a needle tip, and it heals immediately, resolving the exogenous pathogen of the Taiyang Meridian. (From *Yitong*)

[Appendix: Night Blindness]
Night blindness (Que Mu) is a sign of Liver Deficiency. Wood energy is born in Hai hour, prosperous in Yin hour, and extinct in Shen hour. By You and Xu hours, Wood energy is very weak, only regenerating in Hai hour, and slightly strengthening by Mao hour at sunrise. Hence, vision is poor at night but recovers at dawn. Treat with Siwu Tang (Four Substances Decoction) to tonify Liver and Kidney deficiencies; otherwise, it may transform into Yellow Distension disease and death.
Alternative method: Cook Atractylodis Rhizoma (Cangzhu) inside a pig liver and eat it to cure.

[Appendix: Trichiasis/Rolling Eyelid]
Eyelids belong to the Spleen; Spleen affected by Wind causes curled lashes rolling inward. (From *Yitong*) Tightness of the eyes is caused by skin contraction. (From Li Dongyuan) Manually pull the inner eyelid outward, quickly prick with a Three-edged Needle to bleed, and press immediately with the left thumb nail against the needle tip for instant relief. Alternatively, use a pair of Swallow Stones (Shiyanzi), one large male and female, grind with water, and apply to the eye. First remove curled lashes with tweezers, then apply drops. Wash eyes with Coptidis Rhizoma (Hlian) decoction.

[Selected Formulas for Eye Diseases]
Qingfeng Yangxue Tang (Clear Wind and Nourish Blood Decoction): Treats red, swollen, painful eyes due to exterior Excess pathogens.
Schizonepetae Herba (Jingjie), Viticis Fructus (Manjing), Chrysanthemi Flos (Ganju), Saposhnikoviae Radix (Fangfeng), Ligustici Chuanxiong Rhizoma (Chuanxiong), Forsythiae Fructus (Lianqiao), Gardeniae Fructus (Shanzhi), Angelicae Sinensis Radix (Danggui), Scutellariae Radix (Huangqin), Glycyrrhizae Radix et Rhizoma (Gancao).

Yiyin Shenqi Wan (Benefit Yin and Kidney Qi Pill): Treats dim vision due to Liver and Kidney deficiency.
Six Flavor Rehmannia Pill (Liujunzi Wan) minus Alisma Rhizoma (Zexie), plus Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Schisandrae Fructus (Wuweizi), Lycii Fructus (Gouqi), Bupleuri Radix (Chaihu).

Chonghe Yangwei Tang (Harmonize and Stomach-Nourishing Decoction): Treats internal cataracts, weak Yuan Qi, flourishing Heart Fire and Sanjiao, irregular diet, physical overwork, and lack of rest.
Astragali Radix (Huangqi - 1.5 qian), Ginseng Radix et Rhizoma (Renshen), Prepared Glycyrrhizae Radix et Rhizoma (Zhigancao), Angelicae Sinensis Radix (Danggui - each 1 liang), Atractylodis Macrocephalae Rhizoma (Baizhu - 5 qian), Saposhnikoviae Radix (Fangfeng - 5 qian), Coptidis Rhizoma (Hlian), Scutellariae Radix (Huangqin), Bupleuri Radix (Chaihu - each 7 qian), Zingiberis Rhizoma Recens (Ganjiang - 1 qian), Schisandrae Fructus (Wuweizi - 2 qian), Paeoniae Radix Alba (Baishao - wine-fried 6 qian), Poria (Fuling - 3 qian), Cimicifugae Rhizoma (Shengma), Puerariae Radix (Gegen - each 1 liang), Notopterygii Rhizoma et Radix (Qianghuo - 1.5 liang).
Decoct 1 liang in water.

Yanggan Wan (Sheep Liver Pill): Treats internal and external nebulae, blind spot with pain/swelling, pterygium invading the cornea, tearing, and photophobia.
Coptidis Rhizoma (Hlian - 1 liang), Chrysanthemi Flos (Juhua), Angelicae Sinensis Radix (Danggui), Ligustici Chuanxiong Rhizoma (Chuanxiong), Saposhnikoviae Radix (Fangfeng), Schizonepetae Herba (Jingjie), Notopterygii Rhizoma et Radix (Qianghuo), Menthae Haplocalycis Herba (Bohe - each 3 qian), Rehmanniae Radix Preparata (Shengdi - 5 qian), Bai Ru (White Milk/Cream), Sheep Liver.
Grind to powder, make pills with raw sheep liver. Take 30 pills per dose with warm water.

Zaopi Wan (Dry Spleen Pill): Treats ulceration of both eyelid margins due to Dampness invasion.
Atractylodis Rhizoma (Cangzhu), Saposhnikoviae Radix (Fangfeng), Pinelliae Rhizoma (Banxia), Notopterygii Rhizoma et Radix (Qianghuo), Glycyrrhizae Radix et Rhizoma (Gancao), Citri Reticulatae Pericarpium (Chenpi), Angelicae Dahuricae Radix (Baizhi), Bupleuri Radix (Chaihu), Cimicifugae Rhizoma (Shengma).

Yanggan Wan (Nourish Liver Pill): Treats Liver Blood deficiency.
Angelicae Sinensis Radix (Danggui), Ligustici Chuanxiong Rhizoma (Chuanxiong), Plantaginis Semen (Cheqianzi), Aurantii Fructus Immaturus (Zhishi), Paeoniae Radix Alba (Baishao), Pruni Semen Persicae (Ruiren - equal parts).
Make honey pills.

Mingmu Dihuang Wan (Brighten Eyes Rehmannia Pill):
Rehmannia Pill plus Angelicae Sinensis Radix (Danggui), Ligustici Chuanxiong Rhizoma (Chuanxiong), Dendrobii Caulis (Shihu), Ophiopogonis Tuber ( Maidong).

Quick Method: Treats cloud-like nebulae in the eye.
Ilex Aquifolium Leaf (Dongqing Ye - 7 leaves), Chinese Gall (Wubeizi - 3 qian).
Decoct in water to make one bowl. Dip the tip of the tongue into the hot liquid for a while; the nebula will fall off spontaneously.

For rheumatic-dry pain and eyelid margin ulceration of both eyes, use:
Mirabilite (Piaoxiao - 1 liang), Verdigris (Tonglv), Alum (Mingfan), Chrysanthemi Flos (Ganju), Platycladi Cacumen (Ce Bai Ye - each 3 qian), Morus Alba Cortex (Sangbaipi - 5 qian).
Decoct 5 bowls of water to 2 bowls. Wash eyes, eyebrow ridge, and bilateral Taiyang acupoints. Relief comes with nasal discharge. For pterygium invading the cornea, use a male pig gallbladder from the twelfth lunar month, insert Ma Ya Xiao (Marine Glauber Salt) inside, air-dry, grind to powder, add Borneolum Syntheticum (Bingpian) and Moschus (Shexiang), and apply to the eye.