眼疼属火，有虚火、实火不同。暴疼为实，久痛
为虚；肿起为实，细小沉陷为虚，实痛肿且胀，虚痛
陷且涩。此眼疼虚实之辨也。
治实痛则泄其火，治虚痛则养其气、生其血。泄火
不可骤用寒凉，补气不可遽为助长。且眼以气血为主，
养血不可损血，补气不可动火。然气乃阳明之火，补
气焉得不动火？盖气实则热，气虚则寒，气平则温。
故补气无动其火，而温补之，何动火之有，是以止痛
之法，亦不外补、泄二端矣。实疼外用拈痛散（方见
四卷），内点元灵丹（方见《秘诀》），虚痛点白玉锭。
治目之法多端，切忌刀针、割肉、刺血、生
生信诸般伯道。刀针易损精水，刺血易伤瞳人，
信、 中毒入深。且败血之药固当戒，凉血之药亦不
过多。败血药多，而生黑暗之疾患；凉血药多，而生
青黄之障翳。是木贼、蒺藜之类，虽止痛除风，能伤
肝与肾，可宜佐用，不宜久服，密蒙、谷精之类，虽
能明目，止可暂用为君，佐以养血和阳，方可通行。
大抵眼热之症，有虚热、实热、气热之不同。苟一
概视之，而昧昧从事，则热闭于中，精光因而失神。
今分指其详，大约虚则生寒、实则生热，补泄之法，
宜按症参之。
虚热者，乃新病后失保养，或房事劳伤，虚耗元
阳，相火炎上，熏蒸脾胃，以致两目赤涩，羞明怕光。
其目惟赤而不肿，故治法以血分为主，滋肾为佐，兼
除胃热，使邪火下降。此治虚热之法也。
实热者，其人禀气浓，或饮酒过多，或怒气冲上，
或动心火。心火既动，火克金，金克木，以致两目赤
肿难开，故治法宜泄心、平肝气、凉血为主。此治实
热之法也。
气热者，时气也。其疾多发于三伏秋后之际，人
不谨慎、感天地邪热之气，以致暴发赤肿，如火刺痛，
热泪流溢。治法宜发散降火之剂为主，先用白芍、柴
胡、干葛等类，次养血之药继之。此治气热之法也。
虚热点白玉锭、点元灵丹（方见《秘诀》）；实热
点梨汁膏（方见三卷）、扫雾丹。洗用小枣儿（方见
三卷）。气热点赛宝丹（方见一卷）、赛空青（方见
二卷）。
眼痛属于火证，分为虚火和实火两种不同情况。突然发作的疼痛属于实证，长期疼痛属于虚证；眼部肿胀突起属于实证，细小凹陷属于虚证。实证疼痛伴有肿胀且胀满，虚证疼痛伴有凹陷且干涩。这就是对眼痛虚实性质的辨别。
治疗实证疼痛应当清泄其火热，治疗虚证疼痛应当滋养其气、生发其血。清泄火热不可骤然使用寒凉药物，补气不可急于助长火势。况且眼睛以气血为主宰，养血不可损伤血液，补气不可扰动火邪。然而气属于阳明之火，补气怎么会不扰动火邪呢？大概气实则产生热，气虚则产生寒，气平则温和。因此，补气而不扰动火邪的方法，在于采用温补之法，这样又怎么会有动火的问题呢？所以止痛的方法，也不外乎补益和泄泻两个方面罢了。实证疼痛外用拈痛散（方剂见第四卷），内服点眼用元灵丹（方剂见《秘诀》）；虚证疼痛点用白玉锭。
治疗眼病的方法多种多样，切忌使用刀针、割肉、刺血、生生信等各种危险途径。刀针容易损伤精水，刺血容易伤害瞳人，生生信中毒深入体内。而且具有败血作用的药物固然应当戒除，凉血药物也不宜过多使用。败血药使用过多，会产生黑暗类的疾患；凉血药使用过多，会产生青黄类的障翳。像木贼、蒺藜这类药物，虽然能止痛祛风，但会损伤肝与肾，只适宜辅助使用，不宜长期服用；密蒙花、谷精草这类药物，虽然能明目，只能暂时作为主药使用，并辅以养血和阳的药物，才可以通行使用。
大抵眼部的热症，有虚热、实热、气热的不同。如果一概而论，糊里糊涂地处理，那么热邪就会闭塞于体内，精气光芒因而失去神采。现在分别详细指出，大致来说，虚证产生寒象，实证产生热象，补益和泄泻的方法，应当根据症状参考运用。
虚热症，是由于新病之后失于保养，或者房事劳伤，虚耗了元阳，导致相火上炎，熏蒸脾胃，致使两眼红赤干涩，畏光羞明。其眼睛只是红赤而不肿胀，所以治疗方法以调理血分为主，滋补肾阴为辅助，兼除胃热，使邪火下降。这就是治疗虚热的方法。
实热症，是患者禀赋厚实，或者饮酒过多，或者怒气冲上头部，或者心火妄动。心火一旦发动，火克金，金克木，致使两眼红赤肿胀难以睁开，所以治疗方法宜以清泄心火、平抑肝气、凉血为主。这就是治疗实热的方法。
气热症，即时行热病。这种疾病多发生在三伏天到秋后之际，人们如果不谨慎，感受天地间的邪热之气，以致突发红肿，如火灼刺痛，热泪流出。治疗方法宜以发散降火的方剂为主，先用白芍、柴胡、干葛等类药物，随后继以养血药物。这就是治疗气热的方法。
虚热点用白玉锭、点用元灵丹（方剂见《秘诀》）；实热点用梨汁膏（方剂见第三卷）、扫雾丹。洗眼用小枣儿（方剂见第三卷）。气热点用赛宝丹（方剂见第一卷）、赛空青（方剂见第二卷）。
Eye pain belongs to Fire syndromes, which are differentiated into Deficient Fire (Xu Huo) and Excess Fire (Shi Huo). Sudden onset of pain indicates an Excess syndrome (Shi Zheng), while chronic pain indicates a Deficient syndrome (Xu Zheng); swelling and protrusion indicate Excess, whereas smallness and depression indicate Deficiency. Pain in Excess conditions is accompanied by swelling and distension, while pain in Deficient conditions is accompanied by depression and dryness/stiffness. This constitutes the differentiation between Excess and Deficiency in eye pain.
To treat Excess pain, one must drain the Fire; to treat Deficient pain, one must nourish Qi and generate Blood. Draining Fire should not be done abruptly with cold and cool herbs; tonifying Qi should not be done hastily to aid growth. Since the eyes are governed by Qi and Blood, nourishing Blood must not damage Blood, and tonifying Qi must not stir up Fire. However, Qi is associated with the Yangming Fire; how can tonifying Qi fail to stir up Fire? Generally, when Qi is Excess, Heat is generated; when Qi is Deficient, Cold is generated; when Qi is balanced, it is warm. Therefore, the method of tonifying Qi without stirring up Fire lies in employing Warm Tonification (Wen Bu), thus avoiding the issue of stirring up Fire. Hence, the methods for relieving pain do not go beyond the two aspects of Tonification (Bu) and Draining (Xie). For Excess pain, externally apply Niantong San (Nianpain Powder, see Vol. 4); internally use Yuanling Dan (Yuanspirit Pill, see *Mijue*) as eye drops. For Deficient pain, apply Baiyu Ding (White Jade Tablet).
There are many methods for treating eye diseases, but one must strictly avoid dangerous practices such as using knives and needles, cutting flesh, pricking blood, and applying Shengshengxin (a toxic mineral preparation). Knives and needles easily damage Jing-Shui (Essence and Water); pricking blood easily harms the pupil (Tongren); Shengshengxin causes deep toxicity. Moreover, drugs that dissipate Blood (Bai Xue Yao) should certainly be avoided, and cooling-blood drugs should also not be used excessively. Overuse of blood-dissipating drugs leads to dark/blindness disorders; overuse of cooling-blood drugs leads to green-yellow opacities (Zhangyi). Herbs like Muzei (Equisetum Hiemale) and Jili (Tribulus Terrestris), although they relieve pain and dispel Wind, can damage the Liver and Kidney; they are suitable only as adjuvants and should not be taken for long periods. Herbs like Mimenghua (Montia chinensis) and Gujingcao (Galeopsis Spicata), although they brighten the eyes, should only be used temporarily as Chief herbs, supplemented by blood-nourishing and yang-harmonizing herbs, before they can be safely circulated/used.
Generally, heat syndromes in the eyes differ into Deficient Heat (Xu Re), Excess Heat (Shi Re), and Qi-Heat (Qi Re). If treated indiscriminately without clear understanding, Heat will close within, causing the essence and light to lose their spirit. Now, detailing them: generally, Deficiency generates Cold manifestations, and Excess generates Heat manifestations; the methods of tonification and draining should be applied according to symptoms.
Deficient Heat arises from lack of care after a new illness, or sexual exhaustion, which depletes Yuan-Yang (Primal Yang). The Ministerial Fire (Xiang Huo) flares upward, steaming the Spleen and Stomach, resulting in red, dry, and stiff eyes, photophobia, and aversion to light. The eyes are merely red without swelling. Thus, the treatment focuses on the Blood level, assists with Kidney nourishment, and simultaneously clears Stomach Heat, guiding the pathogenic Fire downward. This is the method for treating Deficient Heat.
Excess Heat occurs in individuals with strong constitution, excessive alcohol consumption, rising anger, or stirring of Heart Fire. Once Heart Fire moves, Fire controls Metal, and Metal controls Wood, resulting in red, swollen eyes that are difficult to open. The treatment should focus on draining Heart Fire, calming Liver Qi, and cooling Blood. This is the method for treating Excess Heat.
Qi-Heat refers to epidemic heat diseases. These often occur during the dog days of summer until autumn. If people are not careful and contract the pathogenic heat qi of heaven and earth, sudden redness and swelling occur, feeling like burning stinging pain, with hot tears flowing. The treatment should focus on formulas that disperse and descend Fire. Initially use herbs like Baishao (Paeonia Lactiflora), Chaihu (Bupleurum), and Gange (Pueraria Lobata), followed by blood-nourishing herbs. This is the method for treating Qi-Heat.
For Deficient Heat, apply Baiyu Ding and Yuanling Dan (see *Mijue*); for Excess Heat, apply Lizhigao (Pear Juice Paste, see Vol. 3) and Saowu Dan. Wash with Xiaozao'er (Small Date Fruit, see Vol. 3). For Qi-Heat, apply Saibao Dan (see Vol. 1) and Saikongqing (see Vol. 2).