内经曰。五脏六腑之精气。皆上注于目。而为之睛。睛之窠为眼。骨之精为瞳子。筋之精为
黑眼。血之精为络其窠。气之精为白眼。肌肉之精为约束。裹撷筋骨。血气之精而与脉并为系。
上属于脑。后出于项中。（后世五轮八廓盖本诸此。）是故瞳子黑眼法于阴。白眼赤脉法于阳。
阴阳合传而精明也。东方青色。入通于肝。开窍于目。藏精于肝。人卧则血归于肝。肝受血而能
视。心合脉。诸脉皆属于目。目者宗筋之所聚。上液之道也。泣不止。则液竭。液竭则精不灌。
精不灌。则目无所见矣。气脱者。目不明。目 外决于面者。为锐 。（属少阳。）近鼻上为内
。上为外 。（属太阳。）下为内 。（属阳明。）赤脉从上下者。太阳病。从下上者。阳明
病。从外走内者。少阳病。邪客阳跷之脉。令人目痛。从内 始。
东垣曰。经云。诸脉皆属于目。目得血而能视。又云。心事烦冗。饮食失节。劳役过度。故
脾胃虚弱。心火大盛。则百脉沸胜。血脉逆行。邪害空窍。夫五脏六腑之精气。皆禀受于脾土。
而上贯于目。目者血之宗也。故脾虚则五脏之精气皆失所司。不能归明于目。心者君火也。主人
之神。宜静而安。相火代行其令。相火者。胞络也。主百脉。皆荣于目。既劳役运动。势乃妄行。
及因邪气所并。而损其血脉。故诸病生焉。凡医者不理脾胃。及养血安神。治标不治本。不明正理也。
子和云。目不因火则不病。如气轮变赤。火乘肺也。肉轮赤肿。火乘脾也。黑水神光被医。火乘
肝与肾也。赤脉贯目。火自甚也。能治火者。一句可了。故内经云。热胜则肿。治火之法。在药
则咸寒。吐之下之。在针则神庭。上星。囟会。前顶。百会。血之翳者。可使立退。痛者可使立
已。昧者可使立明。肿者可使立消。惟小儿不可刺囟会。为肉分浅薄。恐伤其骨。然小儿水在上。
火在下。故目明。老人火在上。水不足。故目昏。内经云。血实者宜决之。又云。虚者补之。实
者泻之。如雀目不能夜视。及内障。暴怒大忧之所致也。皆禁出血。止宜补肝养肾。目暴肿。隐
涩难开者。以三棱针刺前顶百会穴。出血大妙。宜浅勿深。深则伤骨。惟后顶强间脑户风府四穴。
不可轻用针灸。以多忌犯故也。目忽盲不见物。此相火也。太阳阳明气血俱盛。乃刺其鼻中攒竹
穴与顶前五穴。大出血立明。他经出血。其病转剧。故曰。刺太阳阳明则目愈明。刺少阳阳明则
目愈昏。近世有以光明草于上下胞打出血丝。往往获效。即三棱针刺血之法。惟可施之于有余暴发耳。
外障属风热上壅。上下胞 肉。蓓蕾磨荡其睛。久之生翳蔽其睛明。当消风散热。外用点药退之。
内障属虚挟气郁。黑水神光昏翳。外似好眼而不能照物。不痛不痒。惟不能睹。须分气血脾胃治。
银海精微曰。夫眼者。乃五脏之精华。如日月丽天。昭明而不可掩者也。其首尾赤 属心。
其满眼白睛属肺。其乌睛裹撷属肝。其上下肉胞属脾。而中间一点黑瞳如漆者。肾实主之。是随
五脏各有证应。然论所主。则瞳子之关系重焉。何以言之。目者肝之外候也。肝取木。肾取水。
水能生木。子肝母肾。焉有子母而能相离者哉。故肝肾之气充。则精彩光明。肝肾之气乏。则昏
蒙眩晕。乌轮赤晕。刺痛浮浆。此肝热也。眼生新泪。枯黄绕睛。此肝虚也。瞳神开大。淡白偏
斜。此肾虚也。瞳神紧小。或带微黄。此肾热也。一虚一实。以此验之。凡热冲发于眼。皆当清
心补肝。又不可拘执其水生木之说。析而论之。则拘急牵飕。瞳胞白痒而清泪。不赤不痛。是谓
风眼。乌轮突起。胞硬红肿。眵泪湿浆。里热刺痛。是谓热眼。眼昏而泪。胞肿而软。上壅朦胧。
酸涩微赤。是谓气眼。其或风与热并。则痒而浮赤。风与气薄。则痒而昏沉。血热交聚。故生淫
肤粟肉红缕偷针之类。气血不至。故有眇视胞垂雀目盲障之形。淡紫而隐红者。为虚火。鲜红而
赤者。为实热。两 逞露。生 肉者。此心热血旺。白膜红膜如拘轮者。此气滞血凝。热证瞳
神肉壅。白睛带湿。色浮而赤者也。冷证瞳神青绿。白睛枯槁。气沉而浊也。眼热经久。复有风
冷所乘。则赤烂。眼中不赤。但为痰饮所注。则作痛。肝气不顺而挟热。所以羞明。肝热蓄聚而
伤胞。所以胞合。此外证之大概。然而五脏不可缺一。脾与肺独无预。何也。曰。白睛带赤。或
红筋者。其热在肺。上胞下睑。或目胞间如疥点者。其热在脾。脾主味也。五味荣养诸中。则精
神发于外。肺主气也。水火升降。荣卫流转。非气孰能使之。前所云五脏各有证应。于此又可推
矣。虽然。眼之为患。多生于热。其间用药。大抵以清心凉肝。调血顺气为先。有如肾家恶燥。
设遇虚证。亦不过以当归、地黄辈润养之。轻用温药不可也。至于退翳一节。尤关利害。凡翳起
肺。肺家受热。轻则朦胧。重则生翳。如珍珠。如碎米者易散。翳状如梅花者难消。虽翳自热生。
然治法先退翳而退热。若谓热极生翳。先去赤热。则血为之冰。而翳不能去矣。其有赤眼。凉药
与之过多。又且涤之以水。不反掌而水凝矣。眼特一团水。且水性澄清。尤不可拘拘于点洗。喜
怒失节。嗜欲过度。穷役眼力。泣涕过多。凌寒冲风。当暑触热。不避烟火。饮啖热多。此皆患
生于脏腑者也。专事点洗可乎。有能静坐澄神。爱护目力。放怀息虑。心逸目休。调和饮食以养
之。斟酌药饵以平之。明察秋亳。断可必矣。
五轮八廓所属。五轮者。肝属木。曰风轮。在眼为黑睛。心属火。曰血轮。在目为二 。脾属土。
曰肉轮。在目为上下胞。其上属脾。而下属胃。肺属金。曰气轮。在目为白仁。肾属水。曰水轮。
在目为瞳神。此为眼目之根本。又藉血为之胞络也。逮夫八廓。有名无位。胆之府为山廓。又名
清净廓。大肠之府为天廓。又名传送廓。膀胱之府为泽廓。又名津液廓。肝之府为风廓。又名养
化廓。肾之府为水廓。又名会阴廓。命门之府为火廓。又名抱阳廓。脾胃之府为地廓。又名水谷
廓。小肠之府为雷廓。又名关前廓。此虽眼目之源派。而实无关于治疗也。五脏或蕴积风热。或
有七情之气。郁结不散。上攻眼目。各随五脏所属而见。或肿而痛。羞涩多泪。或生冷翳障膜。
昏暗失明。治之须究其源。风则散之。热则清凉之。气结则调顺之。切不可轻用针刀钩割。偶得
其愈。出乎侥幸。倘或不然。终身之害。又目不可过用寒凉。恐冰其血。凝而不流。亦成痼疾。
当量人之老少。气体虚实用药。又有肾虚者。亦令人眼目无光。或生冷翳。当暖肾经。北方之
人患服。皆是目冒飞沙。夜卧热炕。二气交蒸。治宜多用凉药。禀气与南方不同也。又痘疹之后。
毒瓦斯郁于肝。气不能泻。发于眼目。伤于瞳神者。素无治法也。
《黄帝内经》说：五脏六腑的精气，都向上灌注于眼睛，从而形成视觉。眼的深部称为“眼窠”。其中，骨之精气汇聚为瞳孔；筋之精气汇聚为黑眼球（虹膜）；血之精气汇聚为眼内络脉及其周围组织；气之精气汇聚为白眼珠（巩膜）；肌肉之精气汇聚为眼睑（约束眼睑开合的组织）。这些组织包裹着筋骨，气血的精华与脉络结合形成目系，向上连接大脑，向后出于项部。（后世所说的五轮八廓理论，大概就源于此。）因此，瞳孔和黑眼球属阴，白眼珠和赤色血脉属阳。阴阳协调配合，人才能视物精明。东方对应青色，通应于肝，肝开窍于目，肝藏精。人卧睡时，血液回流至肝脏。肝得到血液的滋养，才能发挥视觉功能。心与脉相合，全身经脉都归属于目。眼睛是众多筋脉汇聚之处，也是体液上行的通道。如果眼泪不止，则津液枯竭；津液枯竭，则精气无法灌溉；精气无法灌溉，眼睛就无法看见东西。气脱失的人，视力会模糊不清。眼角外端在面部侧面的是锐眦（属少阳经）；靠近鼻梁内侧的是内眦；上方是外眦（属太阳经）；下方是内眦（属阳明经）。赤色血脉从上向下走的，是太阳病；从下向上走的，是阳明病；从外侧走向内侧的，是少阳病。邪气客居在阳跷脉，会导致眼睛疼痛，痛感从内眦开始。
李东垣说：经典记载：“所有经脉都归属于目，眼睛得到血液滋养才能视物。”又说：“如果心中烦乱冗杂，饮食不节制，劳累过度，就会导致脾胃虚弱，心火旺盛，致使百脉沸腾亢盛，血脉逆行，邪气侵害空窍。五脏六腑的精气，都依赖脾土受纳运化，然后上贯于目。眼睛是血液的宗主。所以脾虚则五脏的精气都失去主宰，不能使目光明亮。心是君火，主宰人的精神，应当安静安宁；相火代行其职能。相火即心包络，主管百脉，都荣养于目。既然因为劳累运动，相火之势就会妄行，再加上邪气侵犯，损伤血脉，各种疾病就产生了。凡是医生不调理脾胃，也不养血安神，只治标不治本，是不明白正理的表现。”
张子和说：眼睛如果不是因为火邪，就不会生病。比如气轮变红，是火邪乘袭肺脏；肉轮红肿，是火邪乘袭脾脏；黑水神光受损，是火邪乘袭肝和肾；赤脉贯穿眼睛，是火邪极盛。能治好火邪病，一句话就能解决。所以《内经》说：“热邪胜则肿胀。”治疗火邪的方法，用药方面用咸寒之品，或者采用吐法、下法；针灸方面取神庭、上星、囟会、前顶、百会穴。如果是血瘀形成的翳障，可以使它立即消退；疼痛的，可以使它立即停止；昏暗的，可以使它立即明亮；肿胀的，可以使它立即消除。只有小儿不可针刺囟会穴，因为那里肉质浅薄，恐怕伤及骨骼。然而小儿体内水在上，火在下，所以眼睛明亮；老人火在上，水不足，所以眼睛昏花。《内经》说：“血实者宜决之（放血）。”又说：“虚者补之，实者泻之。”如雀目（夜盲症）不能夜间视物，以及内障，多是由暴怒或大忧引起的，这类情况都禁止放血，只适宜补肝养肾。如果眼睛突然肿胀，隐涩难睁，可以用三棱针刺前顶、百会穴，放出少量血，效果很好。宜浅刺勿深，深了会伤骨。只有后顶、强间、脑户、风府这四个穴位，不可轻易使用针灸，因为禁忌较多。眼睛突然失明看不见东西，这是相火所致。此时太阳、阳明经气血俱盛，可以针刺鼻旁的攒竹穴以及头顶前五穴，大量出血，视力可立即恢复。其他经络放血，病情反而会加重。所以说：“刺太阳、阳明经则眼睛更明亮，刺少阳、阳明经则眼睛更昏花。”近代有人用光明草在上下眼睑打出血丝，往往获得疗效，这就是三棱针刺血的方法，只适用于实证、暴发性的眼病。外障属于风热上壅，上下眼睑的肉摩擦眼睛，久而久之产生翳障遮蔽睛明，应当疏散风热，外用点药退除。内障属于虚证兼气郁，黑水神光昏蒙有翳，外表看似好眼但不能照见物体，不痛不痒，只是看不见，必须分辨气血脾胃来治疗。
《银海精微》说：眼睛是五脏精华所在，如同日月悬挂天空，昭明显著而不可掩盖。眼首尾发红属心；满眼白睛属肺；乌黑的眼珠包裹部分属肝；上下眼睑属脾；中间一点漆黑如漆的瞳孔，由肾主司。这是随五脏各有对应的证候。然而论述其所主，瞳孔的关系最为重要。为什么这么说呢？眼睛是肝的外候。肝属木，肾属水，水能生木，肝为子，肾为母，哪有子母能够分离的呢？所以肝肾之气充盛，则眼神精彩光明；肝肾之气匮乏，则昏蒙眩晕。乌轮（黑眼球周围）发红晕、刺痛、浮浆，这是肝热；眼睛生新泪、枯黄环绕眼珠，这是肝虚；瞳神散大、淡白偏斜，这是肾虚；瞳神紧小或带微黄，这是肾热。一虚一实，据此可以验证。凡是热气冲发于眼，都应当清心补肝。但又不可拘泥于水生木的说法，要分析而论：拘急牵拉、瞳胞发白痒且流清泪、不红不痛的，称为风眼；乌轮突起、胞硬红肿、眼屎泪水湿浆、里热刺痛，称为热眼；眼睛昏花流泪、胞肿而软、上壅朦胧、酸涩微赤，称为气眼。如果风与热并见，则痒且浮红；风与气相搏，则痒且昏沉。血热交聚，所以生出淫肤、粟肉、红缕、偷针等病症。气血不至，所以有眇视、胞垂、雀目、盲障等形态。颜色淡紫而隐红的，为虚火；鲜红而赤的，为实热。两眦暴露、长出胬肉的，这是心热血旺；白膜红膜像拘挛车轮状的，这是气滞血凝。热证表现为瞳神肉壅、白睛带湿、色浮而赤；冷证表现为瞳神青绿、白睛枯槁、气沉而浊。眼热经久，又受风冷侵袭，则会出现赤烂。眼中不红，但被痰饮注渍，则会作痛。肝气不顺而挟热，所以羞明；肝热蓄积而伤及眼睑，所以眼睑闭合。这是外证的大概情况。然而五脏不可缺一，唯独脾和肺似乎没有参与，为什么呢？回答说：白睛带红，或有红筋的，热在肺；上胞下睑，或眼胞间像疥点一样的，热在脾。脾主味，五味营养内脏，则精神发于外部；肺主气，水火升降，营卫流转，不是气谁能使之运行？前面所说五脏各有证候，在此又可以推究了。虽然如此，眼睛患病，多生于热，其间用药，大体以清心凉肝、调血顺气为先。至于肾脏厌恶燥热，如果遇到虚证，也不过是用当归、地黄之类滋润养护，不可轻用温药。至于退翳这一环节，尤其关系重大。凡翳起于肺，肺家受热，轻则朦胧，重则生翳，如珍珠、如碎米形状的容易消散，形状如梅花的难以消除。虽然翳自热生，但治法应先退翳再退热。如果说热极生翳，先去赤热，那么血液就会像冰一样凝固，而翳就不能去除了。那些患有赤眼的人，凉药给予过多，又用水洗涤，不一会儿水就凝结了。眼睛特像一团水，且水性澄清，尤其不可拘泥于点洗。喜怒失节、嗜欲过度、穷尽眼力、哭泣涕泪过多、凌寒冲风、当暑触热、不避烟火、饮食过热，这些都是患生于脏腑的疾病。专门从事点洗治疗可以吗？如果能静坐澄神，爱护目力，放怀息虑，心神安逸则眼睛休息，调和饮食以滋养它，斟酌药饵以平衡它，就能明察秋毫，断然可以痊愈。
五轮八廓所属：五轮中，肝属木，称为风轮，在眼为黑睛；心属火，称为血轮，在眼为内外眦；脾属土，称为肉轮，在眼为上下眼睑，其上属脾而下属胃；肺属金，称为气轮，在眼为白仁（白睛）；肾属水，称为水轮，在眼为瞳神。这是眼目的根本，又借助血液作为胞络。至于八廓，有名而无固定位置：胆之府为山廓，又名清净廓；大肠之府为天廓，又名传送廓；膀胱之府为泽廓，又名津液廓；肝之府为风廓，又名养化廓；肾之府为水廓，又名会阴廓；命门之府为火廓，又名抱阳廓；脾胃之府为地廓，又名水谷廓；小肠之府为雷廓，又名关前廓。这虽然是眼目的源流派别，但实际上与治疗无关。五脏如果蕴积风热，或者有七情之气郁结不散，上攻眼目，各随五脏所属而显现症状。有的肿胀疼痛，羞涩多泪；有的生冷翳障膜，昏暗失明。治疗必须探究根源，风则疏散它，热则清凉它，气结则调顺它，切不可轻用针刀钩割，偶然治愈也是侥幸。倘若不然，会造成终身危害。另外，眼睛不可过度使用寒凉药物，恐怕会使血液凝固不流，也成痼疾。应当根据人的老少、体质虚实来用药。又有肾虚的人，也会使人眼睛无光，或生冷翳，应当温暖肾经。北方人患此病，多是眼睛冒飞沙感，夜间睡热炕，二气交蒸，治疗宜多用凉药，因为禀赋之气与南方不同。还有痘疹之后，毒瓦斯郁于肝，气不能宣泄，发于眼目，伤于瞳神的，素来没有固定的治疗方法。
The *Neijing* (Yellow Emperor's Inner Classic) states: The essence and qi of the five zang organs and six fu organs all ascend and pour into the eyes, thereby forming vision. The deep cavity of the eye is called the "eye nest." Among them, the essence of bone gathers in the pupil; the essence of sinews gathers in the black eyeball (iris); the essence of blood gathers in the intraocular vessels and surrounding tissues; the essence of qi gathers in the white eyeball (sclera); the essence of muscles gathers in the eyelids (the tissue that constrains the opening and closing of the eyelids). These tissues wrap around the sinews and bones, and the essence of qi and blood combines with the meridians to form the optic nerve system, connecting upward to the brain and exiting posteriorly from the nape. (The later theories of the Five Wheels and Eight Palaces are likely derived from this.) Therefore, the pupil and black eyeball correspond to Yin, while the white eyeball and red blood vessels correspond to Yang. When Yin and Yang coordinate and transmit together, clear vision is achieved. The East corresponds to the color green, communicating with the Liver, which opens into the eyes and stores essence. When a person sleeps, blood returns to the Liver. The Liver receives blood and thus enables vision. The Heart harmonizes with the vessels, and all vessels belong to the eyes. The eyes are the gathering place of numerous sinews and the pathway for fluids to ascend. If tears do not stop, body fluids will be depleted; if body fluids are depleted, essence cannot irrigate; if essence cannot irrigate, the eyes cannot see. When Qi escapes, vision becomes unclear. The outer canthus on the side of the face belongs to the Shaoyang meridian; the inner canthus near the nose belongs to the interior; the upper part is the outer canthus (belonging to the Taiyang meridian); the lower part is the inner canthus (belonging to the Yangming meridian). Red blood vessels running from top to bottom indicate a Taiyang disease; those running from bottom to top indicate a Yangming disease; those moving from the outside inward indicate a Shaoyang disease. When pathogenic factors lodge in the Yang Qiao vessel, it causes eye pain, starting from the inner canthus.
Li Dongyuan said: The classics state: "All meridians belong to the eyes, and the eyes can see when nourished by blood." It also says: "If the mind is troubled and cluttered, diet is irregular, and labor is excessive, it leads to Spleen-Stomach weakness and excessive Heart Fire. This causes the hundred vessels to boil and surge, blood vessels to flow in reverse, and pathogenic factors to harm the orifices. The essence and qi of the five zang and six fu organs all rely on the Earth of the Spleen for reception and transportation, then ascend to the eyes. The eyes are the master of blood. Therefore, Spleen deficiency causes the essence and qi of the five zang organs to lose their control, failing to brighten the gaze. The Heart is the Minister Fire, governing human spirit, and should be quiet and peaceful; the Minister Fire acts on its behalf. The Minister Fire is the Pericardium, governing the hundred vessels, which all nourish the eyes. Since labor and movement cause the force of Minister Fire to act recklessly, combined with pathogenic invasion damaging the blood vessels, various diseases arise. Any physician who does not regulate the Spleen and Stomach, nor nourish blood and calm the spirit, treating only symptoms and not the root, fails to understand the correct principle."
Zhang Zihe said: Eyes do not become diseased unless caused by Fire. For example, redness in the Qi Wheel indicates Fire attacking the Lung; swelling and redness in the Flesh Wheel indicate Fire attacking the Spleen; impairment of the Black Water Divine Light indicates Fire attacking the Liver and Kidney; red vessels penetrating the eye indicate extreme Fire. To treat Fire diseases, one sentence suffices. Thus, the *Neijing* states: "Excess heat causes swelling." The method to treat Fire involves using salty-cold herbs, or employing emetic and purgative methods; in acupuncture, points such as Shenting (GV24), Shangxing (GV23), Xinhui (GV22), Qian Ding (GV21), and Baihui (GV20) are selected. If there are opacities formed by blood stasis, they can be made to recede immediately; pain can be stopped immediately; dimness can be made bright immediately; swelling can be eliminated immediately. However, infants must not have the Xinhui point needled because the tissue is shallow, risking bone injury. Infants have Water above and Fire below, so their eyes are bright; the elderly have Fire above and insufficient Water, so their eyes are dim. The *Neijing* states: "Where blood is excess, it should be drained." It also says: "Deficiency is tonified, excess is reduced." Conditions like night blindness (Achanopia) and internal cataracts, often caused by sudden anger or great sorrow, are contraindicated for bloodletting; instead, tonifying the Liver and nourishing the Kidney is appropriate. If the eyes suddenly swell, feeling tight and difficult to open, pricking the Qian Ding and Baihui points with a three-edged needle to release a small amount of blood yields excellent results. Superficial needling is preferred to avoid bone injury. The points Hou Ding (GV19), Jiangjian (DU16), Naohu (GV17), and Fengfu (GV16) should not be lightly needled due to numerous contraindications. Sudden blindness is caused by Minister Fire. At this time, the Taiyang and Yangming meridians have abundant Qi and Blood; pricking the Zanzhu point (BL2) near the nose and the first five points on the vertex to release significant blood restores vision immediately. Bleeding other meridians worsens the condition. Thus, it is said: "Needling Taiyang and Yangming makes the eyes brighter; needling Shaoyang and Yangming makes the eyes dimmer." In recent times, using Guangming Cao (Euphrasia officinalis) to draw blood threads from the upper and lower eyelids has often been effective; this is the method of three-edged needle bloodletting, applicable only to excess and acute conditions. External obstructions belong to Wind-Heat congestion; the flesh of the upper and lower eyelids rubs against the eye, eventually generating opacities that obscure clarity. One should disperse Wind and clear Heat, applying external drops. Internal obstructions belong to deficiency with Qi stagnation; the Black Water Divine Light is dim and opaque. Externally the eyes look normal but cannot perceive objects, without pain or itching, only inability to see. Treatment must differentiate based on Qi, Blood, Spleen, and Stomach.
The *Yin Hai Jing Wei* (Silver Sea Sublime Microcosm) states: The eyes are the essence of the five zang organs, like the sun and moon hanging in the sky, bright and undeniable. Redness at the head and tail of the eye belongs to the Heart; the entire white sclera belongs to the Lung; the dark pupil wrapped within belongs to the Liver; the upper and lower eyelids belong to the Spleen; the central black pupil like lacquer is governed by the Kidney. Each zang organ has corresponding manifestations. However, regarding governance, the pupil is most critical. Why? Because the eyes are the external manifestation of the Liver. Liver belongs to Wood, Kidney to Water; Water generates Wood. Liver is the child, Kidney is the mother; how can child and mother be separated? Thus, when Liver and Kidney Qi are abundant, vision is bright and clear; when deficient, there is dimness, vertigo, red halos around the black wheel, stabbing pain, and floating turbidity, indicating Liver Heat. New tearing, dry yellow encircling the eyes indicates Liver Deficiency. Dilated pupils, pale and deviated indicate Kidney Deficiency. Constricted pupils, slightly yellowish, indicate Kidney Heat. One deficiency, one excess; verify by these signs. Whenever heat rushes to the eyes, clear the Heart and tonify the Liver. Do not rigidly adhere to the Water-generates-Wood theory; analyze specifically: tension, whitening and itching of the pupil and eyelids with clear tears, no redness or pain, is called Wind Eye; protrusion of the black wheel, hard and swollen red eyelids, sticky discharge, internal heat and stabbing pain, is called Heat Eye; dim vision with tearing, soft swollen eyelids, congestion and haziness, soreness and slight redness, is called Qi Eye. If Wind and Heat combine, there is itching and floating redness; if Wind and Qi clash, there is itching and heaviness. Blood-Heat aggregation produces conditions like skin flaccidity, millet-like bumps, red threads, and hordeolum. Lack of Qi and Blood leads to squinting, ptosis, night blindness, and visual obstruction. Pale purple with hidden red indicates Deficient Fire; bright red indicates Excess Heat. Exposed canthi with growing caruncle tissue indicate Heart Blood Heat and Prosperity; white or red membranes resembling constricted wheels indicate Qi Stagnation and Blood Coagulation. Heat patterns show congested pupil flesh, wet sclera, floating red color; Cold patterns show green-blue pupils, withered sclera, sinking turbid Qi. Chronic eye heat compounded by Wind-Cold causes redness and erosion. Non-red eyes but painful due to Phlegm-Fluid retention. Liver Qi stagnation with Heat causes photophobia; Liver Heat accumulation injuring eyelids causes lid closure. These are general external signs. However, the five zang organs cannot be excluded; why are Spleen and Lung seemingly absent? Answer: Redness in the sclera or red veins indicates Heat in the Lung; lesions on upper/lower lids or between eyelids like scabies spots indicate Heat in the Spleen. Spleen governs taste; five flavors nourish the interior, manifesting spirit externally. Lung governs Qi; water and fire ascend and descend, Ying and Wei circulate; who else but Qi drives this? The previous statement that each zang has specific signs can be deduced here. Although eye diseases mostly arise from Heat, medication generally prioritizes clearing the Heart, cooling the Liver, regulating Blood, and smoothing Qi. The Kidney dislikes dryness; in deficiency cases, use moistening agents like Dang Gui (Angelicae Sinensis Radix) and Di Huang (Rehmanniae Radix); warm herbs should not be used lightly. Regarding removing opacities, it is crucial. Opacities arising from the Lung, where Lung Heat is present, range from mild haziness to severe opacity. Pearl-like or broken-rice-like opacities are easy to dissipate; plum-blossom-shaped ones are hard to eliminate. Although opacities arise from Heat, treatment should first remove opacities before clearing Heat. If one argues that extreme Heat generates opacities and clears Heat first, the Blood will freeze like ice, and opacities cannot be removed. Patients with red eyes given too many cold herbs and washed with water find the water coagulates instantly. The eye is like a mass of water, and water nature is clear; thus, reliance on washing/drops is inadvisable. Irregular emotions, excessive desires, straining eyesight, excessive weeping, exposure to cold/wind, summer heat, smoke/fire, and hot diets all cause diseases originating from the zang-fu. Is topical treatment alone sufficient? By sitting quietly, clarifying the spirit, protecting eyesight, relaxing the mind, resting the eyes, harmonizing diet, and balancing medication, one can achieve sharp vision.
Regarding the Five Wheels and Eight Palaces: In the Five Wheels, Liver belongs to Wood, called the Wind Wheel, located at the cornea; Heart belongs to Fire, called the Blood Wheel, located at the canthi; Spleen belongs to Earth, called the Flesh Wheel, located at the upper and lower eyelids (upper connects to Spleen, lower to Stomach); Lung belongs to Metal, called the Qi Wheel, located at the sclera; Kidney belongs to Water, called the Water Wheel, located at the pupil. This is the root of the eyes, supported by Blood as the pericardium. As for the Eight Palaces, they have names but no fixed positions: Gallbladder is the Mountain Palace, also called Pure Clarity Palace; Large Intestine is the Heaven Palace, also called Transmission Palace; Bladder is the Marsh Palace, also called Fluids Palace; Liver is the Wind Palace, also called Nourishment Transformation Palace; Kidney is the Water Palace, also called Huiyin Palace; Mingmen is the Fire Palace, also called Embracing Yang Palace; Spleen/Stomach is the Earth Palace, also called Grain and Water Palace; Small Intestine is the Thunder Palace, also called Guanqian Palace. Although these are the sources of the eyes, they are practically irrelevant to treatment. If the five zang accumulate Wind-Heat or Seven Emotions stagnate and attack the eyes, symptoms appear according to the affected zang: swelling and pain, tearing, or cold opacities, dimness, and blindness. Treatment must investigate the source: disperse Wind, cool Heat, smooth Qi stagnation. Do not lightly use needles, knives, hooks, or cuts; accidental cure is mere luck. Otherwise, lifelong harm ensues. Also, avoid excessive cold/cold-natured herbs for the eyes, lest they freeze the Blood and cause chronic illness. Medication must be tailored to age and constitution. Kidney deficiency causes dull eyes or cold opacities; warm the Kidney Meridian. Northern patients often suffer from a sensation of flying sand; sleeping on heated kang beds creates steam from dual energies; treatment requires more cooling herbs due to different constitutional endowments compared to the South. Post-smallpox, toxic vapors stagnate in the Liver, Qi cannot vent, erupting into the eyes and damaging the pupil; historically, there was no standard treatment.