1.目为五脏六腑精, 气白筋黑骨精瞳, 血为眦络肉约束, 里撷系属
脑项中. 经热腠开因风入, 合邪上攻赤肿疼, 轻者外障生云翳, 重者
积热顿伤睛.
【注】经曰: 五脏六腑之精气, 皆上注于目而为之精. 精之窠为眼,
气之精为白眼, 筋之精为黑眼, 骨之精为瞳子, 血之精为络眦, 肉之
精为约束, 即眼胞也, 里撷筋骨血气之精, 而与脉系上属于脑, 后出
于项中. 因经热蒸开腠理, 故风邪得以入之, 风热之邪合上攻于目,
赤肿疼痛. 轻者则为外障, 或暴生云翳, 重者则积热之甚, 陡然痛伤
睛也.
2.火眼赤肿泪涩痛, 硬肿多热软多风, 睑粟烂弦鸡蚬肉, 努肉赤脉
贯瞳睛, 血灌瞳人高突起, 旋螺尖起蟹睛疼, 拳毛风泪风痒极, 赤膜
下垂黄膜冲.
【注】风热上攻, 目赤肿痛多泪, 隐涩难开, 火眼也. 肿而硬者, 属
热盛也, 宜先下之. 肿而软者, 属风盛也, 宜先发散. 两睑上, 下初
生如粟, 渐大如米, 或赤或白, 不甚疼痛, 谓之睑生风粟. 两睑粘睛
,赤烂痒痛, 经年不愈, 谓之烂弦风, 又名赤瞎. 睑内如鸡冠, 蚬肉
翻出, 视物阻碍, 痛楚羞明, 谓之鸡冠蚬肉. 此皆脾经风热为病也.
两眦筋膜努出, 谓之努肉攀睛. 两眦赤脉渐渐侵睛, 谓之赤脉贯睛.
两眼混赤如朱, 痛如针刺, 谓之血灌瞳人. 两眼痒痛, 忽然突起, 谓
之突起睛高. 目中大痛, 忽生翳膜, 状如旋螺, 谓之旋螺尖起. 目中
大痛, 忽然瞳睛努如蟹目, 谓之蟹睛疼痛, 又名损翳. 此皆肝, 心二
经积热也. 两睑燥急, 睫毛倒刺, 谓之倒睫拳毛. 两目冲风, 泪出涓
涓,冬月尤甚, 谓之迎风流泪. 两目连眦痒极不痛, 谓之风痒难任.
目中从下忽生黄膜, 侵睛疼痛, 谓之黄膜上冲. 目中从上忽生赤膜,
垂下遮睛, 谓之赤膜下垂; 又名垂帘翳. 此皆心, 肝, 脾三经风热为
病也.
1. 眼睛汇聚了五脏六腑的精气：白睛（巩膜）由肺之精气所主，黑睛（角膜及虹膜部分）由肝之精气所主，瞳神（瞳孔）由肾之精气所主；血络汇聚于内外眦（眼角），眼睑的约束功能由脾之精气所主，这些精气通过脉络联系上属于脑，后出于项部。若经络有热，腠理（皮肤纹理及汗孔）开泄，风邪便乘虚而入，与内热相合，向上攻冲眼部，导致红肿疼痛。轻者表现为外障病证，生成云翳（角膜混浊）；重者则因积热过甚，突然损伤目睛。
【注】《内经》说：五脏六腑的精气，都上注于眼睛以形成视觉。眼的结构如同一个窝巢，其中：气的精华表现为白眼（白睛），筋的精华表现为黑眼（黑睛），骨的精华表现为瞳子（瞳孔），血的精华表现为络脉和眦角，肉的精华表现为约束（即眼睑）。这些筋骨血气的精华，与脉络相连，上属于脑，从项部后方穿出。因为经络热气蒸腾，打开腠理，所以风邪得以侵入。风热邪气结合，向上攻冲于目，导致赤肿疼痛。轻的成为外障，或者突然生出云翳；重的则是积热非常严重，陡然地痛伤目睛。
2. 火眼表现为红肿胀痛、流泪且涩痛；肿胀坚硬的多属热盛，肿胀柔软的多属风盛。眼睑初起如粟米状颗粒，或弦边溃烂，或有鸡冠蚬肉样赘生物，或胬肉（翼状胬肉）生长，赤脉贯穿瞳孔。血液灌注瞳孔，眼球高突，或如旋螺尖起，或如蟹睛般疼痛，睫毛卷曲倒刺，迎风流泪，风痒难忍，赤膜下垂，黄膜上冲。
【注】风热邪气上攻，导致目赤肿痛、多泪、隐涩难睁，这是火眼。肿胀而坚硬者，属于热盛，应当先用泻下法治疗。肿胀而柔软者，属于风盛，应当先用发散法治疗。上下眼睑初生如粟米，逐渐增大如米粒，或红或白，疼痛不剧烈，称为睑生风粟。两眼睑粘连眼球，红烂瘙痒疼痛，经年不愈，称为烂弦风，又名赤瞎。眼睑内部像鸡冠或蚬肉翻出，阻碍视线，疼痛怕光，称为鸡冠蚬肉。这些都是脾经受风热邪气侵袭所致。两眼角筋膜隆起，称为胬肉攀睛。两眼角赤脉逐渐侵入黑睛，称为赤脉贯睛。双眼混红如朱砂，疼痛如针刺，称为血灌瞳人。双眼痒痛，突然高突，称为突起睛高。眼中剧痛，忽然生出翳膜，形状如旋螺，称为旋螺尖起。眼中剧痛，忽然瞳孔突出如蟹目，称为蟹睛疼痛，又名损翳。这些都是肝、心二经积热所致。两眼睑干燥紧缩，睫毛倒向刺入眼球，称为倒睫拳毛。双目受风刺激，泪水涓涓流出，冬季尤其严重，称为迎风流泪。双目连同眼角极度瘙痒但不疼痛，称为风痒难任。眼中从下方忽然生出黄膜，侵入黑睛并疼痛，称为黄膜上冲。眼中从上方忽然生出赤膜，垂下遮蔽黑睛，称为赤膜下垂；又名垂帘翳。这些都是心、肝、脾三经受风热邪气侵袭所致。
1. The eyes gather the essence and qi of the five zang organs and six fu organs: the white part (sclera) is governed by the essence of the Lung, the black part (cornea and iris) by the essence of the Liver, and the pupil by the essence of the Kidney; blood collaterals converge at the inner and outer canthi (corners of the eyes), and the restraining function of the eyelids is governed by the essence of the Spleen. These essences connect via meridians to ascend to the brain and emerge from the nape. If there is heat in the meridians, the cou li (skin texture and pores) open, allowing wind pathogen to enter. It combines with internal heat and attacks upward to the eyes, causing redness, swelling, and pain. Mild cases manifest as external obstructions (wai zhang), generating cloud-like opacities (yun yi); severe cases result in sudden injury to the eye due to excessive accumulated heat.
[Note] The *Neijing* states: "The essence and qi of the five zang organs and six fu organs all ascend to the eyes to form vision." The eye structure is like a nest, wherein: the essence of Qi manifests as the white eye (bai yan/sclera), the essence of Sinew manifests as the black eye (hei yan/cornea and iris), the essence of Bone manifests as the pupil (tong zi), the essence of Blood manifests as the collaterals and canthi, and the essence of Flesh manifests as the restraint (yue shu/eyelids). These essences of sinew, bone, blood, and qi connect with the vessels, ascend to the brain, and exit from the nape. Because meridian heat steams and opens the cou li, wind pathogen is able to invade. Wind-heat pathogens combine and attack upward to the eyes, causing redness, swelling, and pain. Mild cases become external obstructions, or suddenly generate cloud-like opacities; severe cases involve very serious accumulated heat, suddenly injuring the eye painfully.
2. Huo Yan (Fire Eye) presents with redness, swelling, tearing, and astringent pain. Swelling that is hard indicates excess Heat, while swelling that is soft indicates excess Wind. Eyelids may initially show millet-like granules, or the margins may ulcerate, or there may be growths resembling chicken combs or clam meat, or pterygium (nu rou) grows with red vessels penetrating the pupil. Blood may flood the pupil, the eyeball may protrude high, or it may rise like a spiral shell tip, or the pupil may bulge like a crab's eye causing pain. Eyelashes may curl inward (quan mao), tears flow upon exposure to wind, itching caused by wind is unbearable, red membranes may droop downward, and yellow membranes may rush upward.
[Note] When Wind-Heat attacks upward, causing redness, swelling, pain, tearing, and difficulty opening the eyes due to astringency, this is Huo Yan (Fire Eye). Swelling that is hard belongs to Excess Heat and should first be treated with purgation. Swelling that is soft belongs to Excess Wind and should first be treated with dispersion. Initially, millet-like bumps appear on the upper and lower eyelids, gradually enlarging to rice-grain size, either red or white, with mild pain; this is called Jian Sheng Feng Su (Wind Millet on Eyelids). The two eyelids adhere to the eyeball, becoming red, ulcerated, itchy, and painful, persisting for years without healing; this is called Lan Xian Feng (Rotting Margin Wind), also known as Chi Xia. Inside the eyelids, tissue resembling a chicken comb or clam meat protrudes, obstructing vision and causing pain and photophobia; this is called Ji Guan Xian Rou (Chicken Comb and Clam Meat). All these are diseases caused by Wind-Heat in the Spleen Meridian. Fascia in the two canthi protrudes, called Nu Rou Pan Jing (Pterygium Climbing the Eye). Red vessels in the two canthi gradually invade the cornea, called Chi Mai Guan Jing (Red Vessels Penetrating the Eye). Both eyes are mixed red like cinnabar, with pain like needle pricking, called Xue Guan Tong Ren (Blood Flooding the Pupil). Both eyes itch and hurt, suddenly protruding high, called Tu Qi Jing Gao (Sudden Protrusion of the Eye High). Severe pain in the eye, suddenly generating an opacity shaped like a spiral shell, called Xuan Luo Jian Qi (Spiral Shell Tip Rising). Severe pain in the eye, suddenly the pupil bulges like a crab's eye, called Xie Jing Teng Tong (Crab Eye Pain), also known as Sun Yi (Damaged Opacity). All these are due to accumulated Heat in the Liver and Heart meridians. Dryness and tightness of the two eyelids, with eyelashes turning inward to prick the eyeball, called Dao Jie Quan Mao (Inverted Lashes and Curled Hairs). Exposure to wind causes tears to flow continuously, especially in winter, called Ying Feng Liu Lei (Tearing Upon Facing Wind). Extreme itching in both eyes and canthi without pain, called Feng Yang Nan Ren (Wind Itching Unbearable). A yellow membrane suddenly appears from below in the eye, invading the cornea and causing pain, called Huang Mo Shang Chong (Yellow Membrane Rushing Upward). A red membrane suddenly appears from above in the eye, drooping down to cover the cornea, called Chi Mo Xia Chui (Red Membrane Dropping Downward); also known as Chui Lian Yi (Drooping Curtain Opacity). All these are diseases caused by Wind-Heat in the Heart, Liver, and Spleen meridians.