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Dizziness and blurred vision. A sensation of body rotation, tinnitus, and deafness. Feeling as if standing on a moving boat or carriage. Desire to fall when rising. This is caused by extreme deficiency combined with cold pathogen invasion. Alternatively, it may arise from the stagnation of the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright) generating phlegm and stirring fire, which ascends with Qi to rebel upwards. This is deficiency induced by emotional factors. Excessive indulgence in alcohol and sexual activity leads to Kidney Qi deficiency, failing to grasp Qi and return it to its source, causing Qi to rebel and surge upward. This is Qi deficiency. After vomiting or epistaxis, metrorrhagia, or postpartum blood loss, Spleen deficiency fails to control Ying Qi, causing blood to wander recklessly outside its vessels. This is vertigo due to Blood deficiency.

In one type, dizziness and unconsciousness occur upon exposure to wind-cold, accompanied by profuse cold sweat. This condition is named "Yu Mao" (Depression and Daze), also known as "Xue Jue" (Blood Syncope). It is common in women. Baiwei Tang (Baiwei Decoction) is appropriate.
Baiwei (Radix Wittemanniae), Danggui (Radix Angelicae Sinensis) (each 1 liang); Renshen (Radix Ginseng), Gancao (Radix Glycyrrhizae) (each 1 qian). Divide into five doses, decoct in water.

Zhixuan Tang (Zhi Xuan Decoction): Treats dizziness and headache, fearfulness, and chest fullness.
Fushen (Poria Cum Radix Pini) (1 qian), Yuanzhi (Radix Polygalae), Fangfeng (Radix Saposhnikoviae), Xixin (Rhizoma Asari), Baizhu (Rhizoma Atractylodis Macrocephalae), Qianhu (Radix Peucedani), Renshen (Radix Ginseng), Guixin (Cortex Cinnamomi), Shudi (Radix Rehmanniae Preparata), Ganju (Flos Chrysanthemi Indici) (each 7 fen), Zhike (Fructus Aurantii) (5 fen).

Qingyang Tang (Qing Yang Decoction): Treats visual dizziness, fighting in dreams, fear, and facial color changes. This belongs to Gallbladder deficiency.
Fangfeng (Radix Saposhnikoviae) (1 qian), Renshen (Radix Ginseng) (7 fen), Xixin (Rhizoma Asari), Chuanxiong (Rhizoma Chuanxiong), Gancao (Radix Glycyrrhizae), Fuling (Poria), Duhuo (Radix Angelicae Pubescentis), Qianhu (Radix Peucedani) (each 5 fen).

Zihezi stated: Although sages say that the eyes can see only when nourished by blood, blood can also be in excess or insufficient. Excess causes ocular congestion and pain. Insufficiency leads to ocular exhaustion and blindness. Therefore, young people often have excess, while old people often have insufficiency. However, occasional cases of excess in the elderly must not be overlooked.

The inner canthus is the starting point of the Foot-Taiyang Bladder Meridian, where there is abundant blood and scarce Qi. The outer canthus is traversed by the Foot-Shaoyang Gallbladder Meridian, where there is scarce blood and abundant Qi. The upper eyelid is governed by the Hand-Taiyang Small Intestine Meridian, also having abundant blood and scarce Qi. The lower eyelid is governed by the Foot-Yangming Stomach Meridian, where both blood and Qi are abundant. However, the Yangming Meridian originates at the sides of the eyes and meets at the middle of the forehead, converging with the Taiyang and Shaoyang meridians at the eyes. Only the Foot-Jueyin Liver Meridian connects directly to the eye system (ocular connection to the brain). Thus, conditions of blood excess are excess patterns of the Taiyang and Yangming meridians; conditions of blood insufficiency are deficiency patterns of the Jueyin meridian. Pricking the Taiyang and Yangming meridians to bleed cures the condition and brightens vision. Pricking the Shaoyang meridian to bleed worsens vision. One must know not to allow excess or insufficiency, but simply to nourish the eyes with blood. When blood is too much, it overflows; when too little, it dries up. Heat accelerates blood flow and increases volume; cold slows it down and decreases volume. This is the general principle.

The eyes are the external manifestation of the Liver. The Liver governs blood storage and corresponds to Wood in the Five Elements. Wood, as a plant, becomes dense and obscuring when overly lush, and withers when excessively depleted.

The Five Wheels of the eye represent the essence of the Zang-Fu organs and the gathering point of the Zong Mai (Gathering Vessels). The white sclera belongs to the Lung and is called the Qi Wheel. The eyelids belong to the Spleen and are called the Flesh Wheel. The canthi belong to the Heart and are called the Blood Outlet. The pupil belongs to the Kidney and is called the Water Wheel. The iris/black part belongs to the Liver and is called the Wind Wheel. Redness of the Qi Wheel indicates Fire attacking the Lung. Redness and swelling of the Flesh Wheel indicate Fire attacking the Spleen. Opacity covering the Black Water (pupil) and Shen Guang (spirit light/iris) indicates Fire attacking the Liver and Kidney. Red vessels penetrating the eye with dryness and pain indicate excessive Heart Fire. Sudden redness, swelling, and pain of the eyes, photophobia, grittiness, and continuous tearing are all caused by severe Heat pathogens. (This states that eye diseases are mostly due to Fire pathogens, but there are also conditions like Yin deficiency with cold tears, dimness, and Yang collapse).

Exterior obstructions refer to cloudiness blocking the exterior of the eyeball, often resulting from redness and pain, or forming pterygium (fleshy growth climbing onto the cornea) or polyps. Treatment focuses on relaxing the middle and opening depression, regulating Qi and clearing phlegm, nourishing Yin and descending Fire, tonifying the Kidney, and dispersing Wind. Observe the color of the external opacity to determine the affected meridian and prick accordingly. Generally, Liver heat causes dim vision; Heart heat causes irritability and pain; Wind-Dampness causes itching; Blood deficiency causes dryness; Kidney deficiency damages the eyeball, leading to protrusion or retraction in severe cases, or membrane formation in mild cases.

Interior obstructions lack discharge, tearing, pain, itching, photophobia, or tightness. Patients perceive vision as if covered by thin gauze, immersed in fog or dew, seeing black spots, seeing flying flies, or seeing suspended pearls. Yet the gaze remains bright, similar to a healthy person, making differentiation difficult. Only by observing slight immobility of the eyeball can it be distinguished. Xu Yanchun said: Interior obstruction involves a small pupil and dim spirit light. *Bencao Gangmu* states there are opacities inside the black cornea blocking the pupil. *Longmu Lun* states that brain fluid flowing down creates opacities, and Liver wind rushing up creates opacities. (These are pathogens of the Foot-Taiyang and Foot-Jueyin meridians). Acupoints such as Tianzhu, Fengfu, Tongli, and Taichong can be pricked. Another method uses a gold needle to push aside the opacity within the black eye, restoring sight instantly.

The eyes belong to the Liver, and the Liver governs anger. Anger stirs Fire and generates Phlegm. Phlegm-Fire blocks the channels of the Liver and Gallbladder, obstructing the apertures for light transmission. Thus, both eyes become hazy like smoke or fog. Since the eyes are dim, depression arises. Hence, chronic illness generates depression, and chronic depression generates illness. Those who do not understand this principle merely administer herbs to tonify the Liver and Kidney. This exacerbates the pathogenic qi in the Liver and Gallbladder channels, further obstructing them and worsening vision daily. One must investigate whether the Liver and Kidney truly have pathogenic qi or are genuinely deficient. If truly deficient, administer tonics. If Zheng Qi (Upright Qi) is deficient but Pathogenic Qi is excessive, first expel the pathogen, then tonify the upright Qi. This avoids the drawback of aiding the pathogen and harming the upright Qi. (Regardless of internal or external lesions, experts in eye diseases first deliberate using Internal Medicine principles, especially when dealing with complex cases, to avoid uncertainty).

Eye diseases in the Fu organs are Exterior patterns, requiring dispersion of Wind and clearance of Heat. Eye diseases in the Zang organs are Interior patterns, requiring nourishment of Blood and calming of the Spirit. Sudden onset indicates an Exterior pattern, which is easy to treat. Chronic illness indicates an Interior pattern, which is difficult to treat. For example, if a man injures his left eye first and the right eye repeatedly recurs, it cannot be saved. If a woman injures her right eye first and the left eye repeatedly recurs, it cannot be saved. One must primarily observe the age and strength of the patient to predetermine the difficulty. Conditions with convex/concave pupils, green/white/red discoloration, pure black pupils, or lackluster eyeballs are untreatable. These are signs of aging and Blood depletion. Opacities shaped like half-moons are also difficult to treat. If the eyeball is round and undamaged, regardless of the number of star-like spots or thickness of the opacity, it is treatable. Smooth opacities are feared; star spots located on the pupil are feared. Generally, thin opacities and fine star spots are favorable. If opacities remain incomplete, knife surgery must not be used. Because the eyes need blood to see, cutting damages blood and membranes. Opacities arising from Liver Fire should not be treated with moxibustion. Medication should be administered first, combined with topical drops, so the disease gradually recedes without recurrence.

If the eye does not hurt in the morning but hurts severely in the afternoon, it is Deficient Heat. If it hurts severely in the morning but not in the afternoon, it is Excess Heat. Profuse tearing indicates Deficient Heat; scant tearing indicates Excess Heat.

If an opacity gradually covers the pupil without pain or itch, and feels cold, it is Cold. If painful, it is Heat.

An interior membrane that is white indicates Cold. An interior membrane that is red indicates Heat.

Eyes that are pale white with redness indicate Deficient Heat.