目者，肝之窍，经曰∶肝受血而能视。又肝虚则目晃晃无所见。又曰∶五十岁肝气始衰，肝叶
始薄，胆汁始减，目视不明。以肝为木脏，木得水则荣，失水则枯也。又曰∶肾之精为瞳子。又曰∶
肾病则目晃晃如无所见。盖目之精明在瞳子，故真水内亏，必目多昏黑，譬之水浅混浊，则不能照
物，故绝无障翳遮睛。是以治目者，当养肝血，补肾水为主。然经又言∶心者，五脏之转精也。目
者，其窍也。又云∶目者，心使也，心者，神之舍也。因事冗心烦，则神劳血虚火旺而目病，故清心
养血安神，亦为治目之要务。东垣云∶五脏六腑之精气，皆上注于目。而为精明之用。然脏腑
之精气，皆禀受于脾土，因饮食失节，劳役过度，致脾胃受伤，脾虚则脏腑之精气皆失所司，不能归
于明目也。是则脾胃所宜理也，故仲淳治目病，每用杞菊地黄丸，天王补心丹二方，朝夕并进，药品
甘寒，不伤脾胃。故云∶久服自效，深合六经东垣之旨。丹溪云∶目能远视，不能近视者，肾水虚也，
宜地黄丸；目能近视，不能远视者，心血少也，宜补心丹。倪氏云∶心为君火，肝为相火，火炎无
治，神水受伤，上为内障。又言诸脉皆属于目。相火者，心胞火主百脉，上荣于目，火盛则百脉沸腾，
上为内障。其症初起，视物微昏，空中常见黑花，神水色变淡绿，急宜杞菊地黄丸、补心丹治之。次则
视歧，睹一成二，色变淡白，失此不治，久则不能睹物，色变纯白，永为废疾。此症亦有因暴怒伤
肝，致神水渐散昏花者，急宜滋肾水，养肝血，收其散大之神瞳，镇其上冲之逆气，当宜杞菊地黄丸合
磁朱丸治之。但内障之病，最为难疗，服药须累月经年，又当远房帏，戒恼怒，释忧思，免劳碌，庶几
有效，不然必废，终不可复。或有因大怒气逆上冲空窍，神水随散者，此属不治之症。又有因为物所击，
神水随散者，亦不可治。有因悲哀过度，泪多液竭，渐至丧明者，《内经》命曰夺精，亦最难治。有因
诸失血过多，睛珠作痛，不能视物，羞明酸涩，眼睫无力者，但宜滋阴养血为主，杞菊地黄丸加减，加
白芍、胡麻、天冬、人乳之属。若目暴赤肿，多泪痛痒，羞明紧涩
者，此属肝经火盛血热，宜凉血清火。或热极生风，是为内发，或因热而召，是为外来，统于凉血清火
药中，加薄荷、荆、柴之属。盖热极则翳生，加之以风则更易，譬之豆浆，其锅下以火燔之，上以风
扬之，翳即生焉。治之者，但熄去风火，复加退翳之药，其明自复。又如尘蒙清水之面，拂去之而仍能照
物也。经言∶热甚目瞑眼黑。仲淳言∶伤寒病热极则不识人。皆由热气拂郁于目，而致之然也。《正理
论》云∶目昏而见黑花者，由热气甚而发之于目，亢则害，承乃制，而反见其象。又冲风而即泪下者，
经言∶火气燔目，故见风则泣下。譬之火疾风生，乃能雨也。张子和云∶夫目之五轮乃五脏之精华，宗脉
之所聚。故经云∶肾之精为瞳子，肝之精为黑珠，肺之精为白珠，心之精为 络，脾之精为眼胞，此人
皆知之，及有目疾，则不知疾之理。岂知目不因火则不病，故白轮病赤，火乘肺也；肉轮赤肿，火乘脾也；
赤脉贯目，心火自甚也；黑水神光被翳，火乘肝与肾也，能治火者，一句可了。赵氏云∶子和一句可了，
但一味寒凉治火。余用壮水以制火，亦一句可了。以上诸论，皆治目之大略也，盖目为五官之一，非明无
以作哲，故甚重之，而有专科，若求详悉，自有书存。
杞菊地黄丸〔亦作煎服。〕通治肝血肾水虚衰目疾，主此加减。
六味去泽泻〔嫌其利小便而耗肾阴，扁鹊谓其多服昏目故也。〕枸杞〔补肾经，益肝
血。〕甘菊〔养目血，去翳
膜。〕麦冬〔清心则火不炎，而神水不受伤，清肺则金生水，而肾精得充足。〕北五味〔滋不
足之肾水，收散大之瞳神。各六两。〕白蒺藜〔补肝明目，炒去刺，五两。〕可合磁朱丸用。〔
磁石四两，入肾，镇养真精，使肾水不外移，朱砂二两，入心。清镇君火，使心火不上炎。原方治内障
目昏，如因怒气逆冲渐昏者，二方合用最效。〕如养血，白芍、胡麻、柏仁。清肾热，玄参、女贞、龟
甲。清肝热，羚羊角、犀角、〔兼能退翳。〕槐角，〔兼止热泪。〕须用羊肝为引导。退翳，决明、谷
精、木贼。随意采用。〔炼蜜丸，桐子大，空心淡盐汤下四钱。〕
此方滋阴固精明目，不寒不热，和平之剂，久服最效。
天王补心丹〔见虚劳。〕因事冗心烦，致
神劳血虚火旺而目病者用之。
此生精养血，清热镇心安神之剂。仲淳云∶世医治目，多补肾，不知补心。余遇目疾久不愈者，令朝
服杞菊地黄丸，晚服天王补心丹，久久自效。
广笔记方 治虚人目疾，下焦有湿热者。
生地 枸杞〔补肝肾。〕 麦冬〔清心火。各三钱。〕龙胆草〔清下焦湿热，治目赤肿
痛。酒炒，一钱。〕如脾气不佳，加白蔻仁末。〔五、六分。〕
清肝明目饮〔自制。〕治目暴赤肿，
多泪痛痒，羞明紧涩等症。
龙胆草〔酒炒。〕槐角 黄芩〔清肝胆之火。猪胆汁炒。〕连翘仁〔清心胞之火。
炒。〕黑山栀 木通〔利水以泻火。〕生地 玄参〔壮水以制火。〕赤芍〔凉血行滞，以
血热极则干而凝也。〕生甘草〔泻火缓急，以火势
甚则急而痛也，〕甘草〔祛风除热，而治目疼欲脱。〕薄荷〔消风散热，而治目赤肿痛。〕火
甚者加黄连〔泻心火。〕或胡黄连，〔泻肝火。〕或黄柏。〔泻肾火。〕热甚便秘者，加〔酒蒸。〕大
黄。〔通泄其热，所谓上病下疗也。〕赤肿痛甚者，宜用三棱针刺破眼眶肿处，捋出热血，立解。〔经
谓火实宜决之，迟则血贯瞳神而损目。〕外用人乳浸黄连，入冰片少许点之。〔内服宜苦寒以泻火，
是釜底去薪之义。外点佐辛温以散邪，则火郁则发之义。毋过用寒凉点洗。以遏火在内。〕
此一派苦寒泻火之剂，宜中病即止，久服伤胃，盖暂用之药也。
决明夜灵散 治目至夜则昏，虽有灯月，亦不能睹，俗名雀盲。
石决明〔咸寒。入血除热，入肾补阴。〕夜明砂〔辛寒。乃蚊蚋之眼，夜视光明。故主
明目，取其气类相从也。另研，各二钱。〕猪肝或羊肝〔导引入肝。一两。〕〔将肝用竹刀切作二
片，以二药末铺于一片，上以一片合之，用麻皮缠定，勿令药泄出，用米泔水一大碗，沙锅内煮至半
碗，临卧连肝药汁尽食之。忌犯铁器。〕
搐鼻碧云散 治目暴赤肿，多泪痛痒，羞明紧涩。
鹅不食草〔解毒，二钱。〕青黛〔清热。〕川芎〔散邪，各一钱。〕
〔为细末，先噙水满口，以少许搐入鼻内，泪出为度。〕
此方宜常用搐之，使邪毒有出路，则易愈。
仲淳洗眼方
皮硝〔治风眼、红烂赤肿作痛，一两。〕侧柏叶〔祛风湿。三钱。〕甘菊 杏仁〔散
风热。〕桑白皮〔泻火散血。各五钱。〕铜绿、明矾〔除热燥湿。各三钱。〕
〔河水五碗，煎二大碗，置铜盆内，频频洗眼及眉棱骨两太阳，泪出即爽然。一服，冬可半月，
夏十日。〕
飞丝 垢入目方
磨京墨浓汁，点入目中立出。
Eyes are the orifice of the Liver. The Classics state: "The Liver receives blood and enables vision." It is also said: "When the Liver is deficient, the eyes become dizzy and unable to see clearly." Furthermore, it states: "At fifty years of age, Liver Qi begins to decline, the Liver lobes begin to thin, bile production decreases, and vision becomes unclear." This is because the Liver belongs to the Wood element; Wood flourishes when nourished by Water but withers when deprived of it. It is further stated: "The essence of the Kidney manifests as the pupil." And again: "When the Kidney is diseased, the eyes become dizzy as if unable to see anything." Essentially, the clarity of vision depends on the pupil. Therefore, if the True Yin (Kidney Water) is internally deficient, the eyes will frequently appear dim and dark, much like shallow, turbid water that cannot reflect objects; thus, this condition involves no opacity obstructing the eyeball. Consequently, treating eye diseases should primarily focus on nourishing Liver Blood and tonifying Kidney Water.
However, the Classics also state: "The Heart is the hub where the essence of the five Zang organs converges." The eyes are its orifice. It is also said: "The eyes are the emissary of the Heart; the Heart is the residence of the Spirit." When overwhelmed by trivial matters and mental distress, the Spirit becomes fatigued, Blood becomes deficient, and Fire flares up, leading to eye disease. Therefore, clearing the Heart, nourishing Blood, and calming the Spirit are also crucial tasks in treating eye conditions. Li Dongyuan stated: "The essence and qi of the five Zang and six Fu organs all ascend to the eyes to enable clear vision." Yet, the essence and qi of these organs are derived from the Spleen and Stomach (Earth). If dietary habits are irregular or physical labor is excessive, damaging the Spleen and Stomach, Spleen deficiency causes the essence and qi of the organs to lose their control, preventing them from ascending to brighten the eyes. This explains the rationale for regulating the Spleen and Stomach. Thus, Chen Shigong (courtesy name Zhongchun), when treating eye diseases, often administered both Qiju Dihuang Wan (Goji and Chrysanthemum Rehmannia Pill) and Tianwang Buxin Dan (Emperor of Heaven's Heart-Nourishing Decoction) together, morning and evening. The herbs are sweet and cold, not damaging to the Spleen and Stomach. Hence, it is said: "Long-term use yields natural results," deeply aligning with the principles of Zhang Zhongjing and Li Dongyuan. Zhu Danxi stated: "If one can see far but not near, it is due to Kidney Water deficiency; Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) is suitable. If one can see near but not far, it is due to Heart Blood insufficiency; Tianwang Buxin Dan is suitable." Ni Shi stated: "The Heart is the Sovereign Fire, and the Liver is the Ministerial Fire. If Fire flares without restraint, it damages Shen Shui (Spiritual Water), ascending to form internal cataracts." He also noted that all meridians connect to the eyes. Ministerial Fire, governed by the Pericardium Fire, nourishes the hundred vessels and ascends to the eyes. When Fire is excessive, the hundred vessels boil, ascending to form internal cataracts. Initially, vision is slightly blurred, with frequent black spots floating in the visual field, and Shen Shui turns pale green. Urgent treatment with Qiju Dihuang Wan and Tianwang Buxin Dan is required. Subsequently, diplopia (seeing double) may occur, where one object appears as two, and the color shifts to pale white. If untreated, vision may eventually be lost entirely, turning pure white, resulting in permanent disability. This condition can also arise from sudden anger injuring the Liver, causing Shen Shui to gradually scatter and vision to blur. Urgent nourishment of Kidney Water and Liver Blood is needed to收敛 (astringe) the dilated pupil and suppress rebellious Qi ascending upward. Qiju Dihuang Wan combined with Cizhu Wan (Magnetite and Cinnabar Pill) is appropriate. However, internal cataracts are extremely difficult to treat, requiring months or even years of medication. Patients must abstain from sexual activity, avoid anger, release worries, and prevent overwork for any chance of success; otherwise, blindness is inevitable and irreversible. Cases where severe anger causes Qi to rush upward into the empty orifices, scattering Shen Shui, are considered incurable. Similarly, trauma causing Shen Shui to scatter is untreatable. Excessive grief leading to abundant tears and fluid exhaustion, gradually causing blindness, is termed "Jing Deprivation" (Duo Jing) in the Inner Canon and is also very difficult to treat. Excessive hemorrhage causing globe pain, inability to see, photophobia, soreness, dryness, and eyelid weakness requires primarily nourishing Yin and Blood, using modified Qiju Dihuang Wan with added Bai Shao (White Peony Root), Hu Ma (Sesame), Tian Dong (Asparagus Tuber), and Ren Ru (Human Milk). For sudden redness and swelling of the eyes, with excessive tearing, pain, itching, photophobia, and tightness, this indicates excess Fire and Heat Blood in the Liver Meridian; cooling Blood and clearing Fire is indicated. If extreme Heat generates Wind (internal origin) or attracts external Wind due to Heat, add Bo He (Mint), Jing Jie (Schizonepeta), and Chai Hu (Bupleurum) to the cooling Blood and clearing Fire formula. Extreme Heat generates opacities (Yi); adding Wind makes it more likely, akin to soy milk being heated from below and blown from above, causing scum to form. Treatment requires extinguishing Wind and Fire, followed by herbs that resolve opacities, restoring vision naturally. Like dust on a clear surface, once wiped away, reflection returns. The Classics state: "Extreme Heat causes the eyes to close and vision to darken." Chen Zhongchun stated: "In Shanghan (Cold Damage) disease, extreme heat leads to confusion and inability to recognize people." All result from Heat Qi stagnating in the eyes. The Zheng Li Lun states: "Blurred vision with black spots arises from excessive Heat manifesting in the eyes; when亢 (excess) causes harm, 承 (subjugation) restores balance, revealing the symptom." Wind-induced tearing occurs because, as the Classics say: "Fire blazes the eyes, causing tears upon exposure to wind," similar to how fire generates wind to produce rain. Zhang Zihe stated: "The Five Wheels of the eye are the essence of the five Zang organs and the gathering point of major meridians." Thus, the Classics state: "Kidney essence forms the pupil; Liver essence forms the black pearl (iris/cornea); Lung essence forms the white pearl (sclera); Heart essence forms the collaterals; Spleen essence forms the eyelids." While everyone knows this, they fail to understand the pathology when eye diseases arise. One must know that eyes do not become diseased without Fire. Therefore, redness of the white wheel (sclera) indicates Fire invading the Lung; redness and swelling of the flesh wheel (eyelids) indicate Fire invading the Spleen; red vessels traversing the eye indicate excessive Heart Fire; obstruction of the black water and divine light by opacities indicates Fire invading the Liver and Kidney. Treating Fire resolves the issue in one sentence. Zhao Shi commented: "Zhang Zihe's 'one sentence' relies solely on cold-cooling herbs to treat Fire. My approach of strengthening Water to subdue Fire also resolves it in one sentence." These discussions outline the general principles of treating eye diseases. Since the eyes are one of the five sense organs and essential for wisdom, they are highly valued and have specialized treatments. For details, refer to other texts.
Qiju Dihuang Wan (also decocted): Universally treats eye diseases due to Liver Blood and Kidney Water deficiency. Modifications include removing Ze Xie from Liuwei Dihuang Wan [as it promotes urination and depletes Kidney Yin; Bian Que warned against long-term use causing blurred vision]. Add Gou Qi (Goji Berry) [tonifies Kidney Meridian, benefits Liver Blood], Gan Ju (Chrysanthemum) [nourishes eye blood, removes opacities], Mai Dong (Ophiopogon Tuber) [clears Heart so Fire does not flare, protecting Shen Shui; clears Lung so Metal generates Water, sufficing Kidney Essence], Bei Wu Wei Zi (Schisandra Berry) [nourishes insufficient Kidney Water, astringes dilated pupils] (each 6 liang). Add Bai Ji Li (Tribulus Fruit) [benefits Liver and brightens eyes, stir-fried to remove spines, 5 liang]. Can be used with Cizhu Wan. [Ci Shi (Magnetite) 4 liang enters Kidney to stabilize true essence, preventing Kidney Water from drifting; Zhu Sha (Cinnabar) 2 liang enters Heart to calm Sovereign Fire, preventing Heart Fire from flaming upward. The original formula treats internal cataracts; for cases of gradual blurring due to angry Qi rushing upward, combining both formulas is most effective.] For nourishing Blood, add Bai Shao (White Peony Root), Hu Ma (Sesame), Bai Ren (Betel Nut Seed/Bai Zi Ren). To clear Kidney Heat, add Xuan Shen (Scrophularia Root), Nv Zhen Zi (Ligustrum Fruit), Gui Jia (Tortoise Shell). To clear Liver Heat, add Ling Yang Jiao (Antelope Horn), Xi Jiao (Rhinoceros Horn - note: substitute with Buffalo Horn in modern practice) [also resolves opacities], Huai Jiao (Sophora Fruit) [stops hot tears]. Use Yang Gan (Sheep Liver) as a guiding herb. To resolve opacities, add Jue Ming Zi (Cassia Seed), Gu Jing Cao (Sparganium Rhizome), Mu Zei (Equisetum). Choose freely. [Honey pills, size of paulownia seeds, taken on an empty stomach with light salt water, 4 qian.] This formula nourishes Yin, consolidates essence, and brightens eyes; it is neither cold nor hot, a balanced preparation, most effective with long-term use.
Tianwang Buxin Dan (see Xu Lao chapter): Used for eye disease caused by mental fatigue, Blood deficiency, and Fire flaring due to stress and vexation. This is a formula that generates essence, nourishes Blood, clears Heat, calms the Heart, and pacifies the Spirit. Chen Zhongchun stated: "Doctors usually tonify the Kidney for eye diseases, neglecting the Heart. For chronic eye conditions, I prescribe Qiju Dihuang Wan in the morning and Tianwang Buxin Dan in the evening; long-term use yields results."
Guang Bi Ji Formula: Treats eye disease in deficient patients with Damp-Heat in the Lower Jiao.
Sheng Di (Rehmannia Root) [tonifies Liver and Kidney], Gou Qi (Goji Berry) [tonifies Liver and Kidney], Mai Dong (Ophiopogon Tuber) [clears Heart Fire] (each 3 qian). Long Dan Cao (Gentiana Root) [clears Damp-Heat in Lower Jiao, treats red swollen painful eyes, wine-fried, 1 qian]. If Spleen Qi is poor, add Bai Kou Ren (Amomum Cardamomum Seed) powder (5-6 fen).
Qing Gan Ming Mu Yin (Self-made): Treats sudden redness and swelling of eyes, excessive tearing, pain, itching, photophobia, and tightness.
Long Dan Cao (Gentiana Root, wine-fried), Huai Jiao (Sophora Fruit), Huang Qin (Scutellaria Root) [clears Liver/Gallbladder Fire, pig bile-fried], Lian Qiao Ren (Forsythia Seed) [clears Pericardium Fire, fried], Hei Shan Zhi (Black Gardenia), Mu Tong (Akebia Stem) [promotes urination to drain Fire], Sheng Di (Rehmannia Root), Xuan Shen (Scrophularia Root) [strengthens Water to subdue Fire], Chi Shao (Red Peony Root) [cools Blood and moves stasis, as extreme Heat Blood dries and coagulates], Sheng Gan Cao (Raw Licorice Root) [drains Fire and relieves urgency/pain caused by intense Fire), Gan Cao (Licorice Root) [dispels Wind and clears Heat, treats eye pain feeling like dislocation], Bo He (Mint) [dispels Wind and clears Heat, treats red swollen painful eyes]. If Fire is severe, add Huang Lian (Coptis Rhizome) [drains Heart Fire], or Hu Huang Lian (Picrorhiza Rhizome) [drains Liver Fire], or Huang Bo (Phellodendron Bark) [drains Kidney Fire]. For severe Heat with constipation, add Da Huang (Rhubarb Root) [wine-steamed] [drains Heat downward, treating upper disease via lower route]. For severe redness and swelling, puncture the swollen orbital area with a San Leng needle to draw out hot blood for immediate relief. [The Classics state: "Excess Fire should be drained"; delay allows blood to penetrate the pupil and damage the eye.] Topically, soak Huang Lian in Human Milk with a little Bing Pian (Borneol) for instillation. [Internal use employs bitter-cold herbs to drain Fire, akin to removing fuel from under the pot. External application uses pungent-warm herbs to disperse pathogens, following the principle of releasing constrained Fire. Avoid excessive cold-cooling washes to prevent trapping Fire inside.] This is a bitter-cold draining formula; stop upon cure to avoid damaging the Stomach. It is for temporary use only.
Jue Ming Ye Ling San: Treats night blindness (Què Mang), where vision is blurred at night despite moonlight or lamps.
Shi Jue Ming (Abalone Shell) [salty, cold; enters Blood to remove Heat, enters Kidney to tonify Yin], Ye Ming Sha (Bat Droppings) [pungent, cold; eyes of mosquitoes, see brightly at night; thus brightens eyes by sympathetic resonance] (separately ground, each 2 qian). Pig Liver or Sheep Liver [guides into Liver, 1 liang]. [Slice liver with a bamboo knife into two pieces, spread the two herb powders on one piece, cover with the other, tie tightly with hemp rope to prevent leakage. Boil in one large bowl of rice washing water in a clay pot until half remains. Consume the liver and broth completely before bed. Avoid iron utensils.]
Chu Bi Yun San (Nasal Snuff): Treats sudden redness and swelling of eyes, excessive tearing, pain, itching, photophobia, and tightness.
E Bu Shi Cao (Centipeda Herb) [detoxifies, 2 qian], Qing Dai (Indigo Naturalis) [clears Heat], Chuan Xiong (Ligusticum Rhizome) [dispels pathogens, each 1 qian]. [Grind to fine powder. Fill mouth with water, snuff a small amount into the nose until tears flow.] This formula is suitable for regular nasal snuffing to provide an exit path for pathogens, facilitating recovery.
Zhong Chun Eye Wash Formula:
Pi Xiao (Mirabilite), Ce Bai Ye (Biota Leaf) [dispels Wind-Damp, 3 qian], Gan Ju (Chrysanthemum), Xing Ren (Apricot Seed) [dispels Wind-Heat], Sang Bai Pi (Mulberry Root Bark) [drains Fire and disperses Blood, each 5 qian], Tong Lv (Verdigris), Ming Fan (Alum) [clears Heat and dries Damp, each 3 qian]. [Boil five bowls of river water to two large bowls. Place in a copper basin. Frequently wash eyes and brow bones/temples. Relief comes with tearing. One dose lasts half a month in winter, ten days in summer.]
Fe Si Gou Ru Mu Fang (Formula for Foreign Bodies/Dust in Eyes):
Grind Jing Mo (Beijing Ink) into thick juice and apply to the eye to expel the foreign body immediately.