夫六识之中。以眼为上。称为日月。喻以骊珠。记二两下以玄黄。脏四气而通胆。胆视故得身安。明达规矩。全躯
莫贵乎斯。上士之人。自调五脏。而能养神之安。即使脏和。和则眼目清洁。时遇失养。治疗易痊。纵有微 。容可驱
遣。中士之人。犹能眼动静。自晓节宜,设使气厄。亦能除矣。下等之类。损益既昧。寒暄失宜。但有疾证。不能疗矣。
遂有所伤者也。故致如目者。惟轻膜果里水。水之性澄清。不奈纤埃。易致其损。皎洁莹净。无不鉴明。贵如宝珠。故
曰明珠者。凡举动瞻视。假借三光。设若外视昧则内视。昧则内视不明。内明则外视即耀。故眼五脏之中主也。瞳人及
黑晴。肾之主也。白睛应肺。总管于肝。明孔遍通于五脏。气若少乱。目生患也。五脏既安。何敢有损。是以枝病花衰。
根枯叶落。若内有所伤。则外生诸疾也。又曰。目者。精气之余也。心之主。肝之管也。五脏之精。气皆主于目。骨之
精气为瞳人。筋之精为白睛。肉之精为约束。是以筋血气骨之精。为目瞳人共成也。夫忧愁思虑。皆会于心神。肝藏魂。
肾藏志。肝为中将。取决于胆。会气于心。而主于目。目者。五脏之精气也。五脏有病。皆形于目。目赤。则病在于心。
目白在肺。目青在肝。目黄在脾。目黑在肾。不可明者。病在胸中。气失则目瞑。气绝则目暗。肝气通于目。肝气和。
则色明。肝有病。则目夺精而眩。肝中寒。则目昏而瞳人痛。邪伤肝。则目青目黑。瞻视不明。肝有实热。则眼痛如刺。
肝若虚寒。则目眩流涕。瞻视生花。肝若劳寒。则混而不欲开。肝气不足。则目昏暗。迎风有泪。视物不明。然冲睛目
皆赤痛。瘀肉生息。睛目黄。胆与肝合。胆虚。则阴邪所伤。目中生花。肝热。则目中多赤痛泪出。肝不和。则昏而热。
中风欲疼则泪出。文云肝久实热。目赤涩痛息肉。故目者。五脏中气所成也。又曰目中有五轮。夫五轮者。有风轮。有
血轮。有气轮。有水轮。有肉轮。乃应于五脏。随气所产也。肝之色青。其味酸。属东方甲乙木也。旺于春。气通于左
目。属甲为阳。右目属乙为阴。肝主风。故曰风轮也。虽有其名。而形状难晓。与水轮相辅之也。心之色赤。其味苦。
属南方丙丁火也。旺于夏。心主血。故曰血轮也。血轮与肉轮相辅。赤黑色是也。此轮忌之针。脾之色黄。其味甘。属
中央戊己土。旺于四季。各一十八日。脾主肉。故曰肉轮也。肉轮在外。郁郁黄白金色也。白睛也。肺之色白。其味辛。
属西方庚辛金也。旺于秋。故肺主气。故曰气轮也。在肉轮之下。隐而不显也。肾之色黑。其味咸。属北方壬癸水也,
旺于冬,故曰水轮也,水轮在四轮之内。为四轮之母。能以克明视万物。故乃呼为瞳仁。肝脏有病。应于风轮。病则迎
风有泪。视物烟生。夜退昼增。涩疼裹白。或青翳拂拂。似蝇联之状。此乃肺家之病也。宜治肺经。心脏有病。应于血
轮。病则满眼飞花兢起。散乱纵横。 肉渐沿目睛。两 泪淹赤烂。此心经之病也。脾脏有病。应于肉轮。病则睑生肉。
瞳人有病。 乱涩疼。眼见飞花撩乱。文如毛发纵横。夜半即甚。黄昏日午增于早起。此脾经之病也。肺脏有病。应于
气轮,病则如云遮日。逡巡即渐分明。一如云影申花。或似飞蝇相赶。此乃肝经受病也。肾脏有病。应于水轮。病则满
眼黑花簇簇。雾气昏昏。视一物如二物。睹太阳如底。此肾病也。宜治肾经。余皆仿此。且夫病有多端。其说非一。今
将眼科不能言详细。妄说多端。在夫精妙。一一具载于后。
在六识之中,眼睛居于首位。它被称为“日月”,比喻为黑色的珍珠。记载其重二两,色泽玄黄;内藏五脏之气而通达于胆。胆的功能正常则身体安康,目光明亮能洞察规矩法度。保全躯体没有比这更珍贵的了。
上等资质的人,能够自我调理五脏,从而养护精神的安宁。即使脏腑调和,调和则眼目清澈明亮。如果偶尔遇到失于调养的情况,治疗也容易痊愈。即便有轻微的病症,也可以驱除。中等资质的人,还能通过观察眼睛的动静,自己懂得节制和适宜之道,假使气机阻滞,也能自行消除。下等资质的人,既不懂损益的道理,又寒暑调节不当,一旦有病证,就无法治疗了,最终导致损伤。
所以说到眼睛,就像轻膜包裹着果实里的水。水的性质是澄清的,容不得细微的尘埃,容易受到损害。它皎洁晶莹,无不清晰明亮,珍贵如同宝珠,所以称为明珠。凡是举动和视物,都借助于日、月、星三光。如果外部的视觉昏暗,那么内部的视觉也不明;内部清明,外部视觉就耀眼。因此,眼睛是五脏的主宰。瞳孔和黑睛(角膜),由肾主宰。白睛(巩膜)对应肺,总管于肝。明孔(瞳孔及眼内结构)遍通于五脏。气只要稍有紊乱,眼睛就会产生病患。五脏既然安宁,怎么会有损伤呢?这就好比树枝生病花朵就会衰败,树根枯死叶子就会掉落。如果内部有所损伤,外部就会产生各种疾病。
又说:眼睛是精气的外露。它是心的主宰,肝的总管。五脏的精气都汇聚于目。骨的精气形成瞳孔,筋的精气形成白睛,肉的精气形成眼睑(约束)。因此,筋、血、气、骨的精华共同构成了眼睛的瞳孔等部分。忧愁思虑都会影响心神,肝藏魂,肾藏志。肝作为中枢,取决于胆,气会聚于心,而主宰于目。眼睛是五脏精气的体现。五脏有病,都会反映在眼睛上。眼睛发红,病在心;眼睛发白,病在肺;眼睛发青,病在肝;眼睛发黄,病在脾;眼睛发黑,病在肾。看不清楚的,病在胸中。气失调则眼睛闭合,气绝则眼睛失明。肝气通达于目,肝气调和,则面色光明。肝有病,则眼睛失去神采而眩晕。肝受寒,则眼睛昏花且瞳孔痛。邪气伤肝,则眼睛发青发黑,视物不明。肝有实热,则眼睛疼痛如针刺。肝若虚寒,则眼睛眩晕流涕,视物出现幻象(生花)。肝若劳损受寒,则眼睛浑浊不想睁开。肝气不足,则眼睛昏暗,迎风流泪,视物不明。然而眼球红肿疼痛,瘀肉生长,眼睛发黄,这是胆与肝相合的缘故。胆虚,则被阴邪所伤,眼中生花。肝热,则眼中多红痛流泪。肝不和,则昏沉发热。中风欲痛时流泪。文中说肝久有实热,会导致眼睛红涩痛且有息肉。所以说眼睛是由五脏中的气所形成的。
又说眼中分为五轮。所谓五轮,有风轮、血轮、气轮、水轮、肉轮,分别对应五脏,随气而产生。肝的颜色是青色,味道是酸味,属于东方的甲乙木,旺盛于春季,气通达于左眼。属甲为阳,右眼属乙为阴。肝主风,所以称为风轮。虽然有其名,但形状难以确切知晓,它与水轮相辅助。心的颜色是赤色,味道是苦味,属于南方的丙丁火,旺盛于夏季。心主血,所以称为血轮。血轮与肉轮相辅助,呈现赤黑色。这一轮忌讳针刺。脾的颜色是黄色,味道是甘味,属于中央戊己土,旺盛于四季的最后十八天。脾主肉,所以称为肉轮。肉轮在外,郁郁呈现黄白金色,即眼睑部分。肺的颜色是白色,味道是辛味,属于西方的庚辛金,旺盛于秋季。所以肺主气,称为气轮。它在肉轮之下,隐蔽而不显。肾的颜色是黑色,味道是咸味,属于北方的壬癸水,旺盛于冬季,所以称为水轮。水轮在四轮之内,是四轮之母,能够明察秋毫看清万物,所以称之为瞳仁。
肝脏有病,反映在风轮。患病则迎风流泪,视物如烟生成,夜晚减轻白天加重,干涩疼痛伴有白色分泌物,或者像苍蝇翅膀一样的青翳飘动。这是肺家的病,应当治疗肺经。心脏有病,反映在血轮。患病则满眼飞花竞起,散乱纵横,瘀肉逐渐蔓延至眼球,两眼流泪淹没并红肿溃烂。这是心经的病。脾脏有病,反映在肉轮。患病则眼睑长出肉赘。瞳孔有病,则混乱干涩疼痛,眼见飞花撩乱,纹路如毛发纵横,半夜加重,黄昏和中午比早起时更严重。这是脾经的病。肺脏有病,反映在气轮。患病则像云遮太阳,不久渐渐分明,一如云影映花,或似苍蝇追赶。这是肝经受病。肾脏有病,反映在水轮。患病则满眼黑花簇拥,雾气昏昏,看一个物体像两个物体,看太阳像深渊。这是肾病,应当治疗肾经。其余的都仿照这个规律。况且疾病有多种端绪,说法不一。现在将眼科不能详尽言说的内容,妄加多说多种情况,在于精妙之处,一一详细记载在后面。
Among the six senses, the eye is supreme. It is called the "Sun and Moon," compared to a black pearl. It is recorded as weighing two liang, with colors of dark yellow; it contains the qi of the five zang organs and connects to the Gallbladder. When the Gallbladder functions normally, the body remains healthy, and the vision is bright enough to discern rules and standards. There is nothing more precious for preserving the whole body than this.
A person of superior ability can self-regulate the five zang organs, thereby nourishing the peace of the spirit. Even if the zang organs harmonize, resulting in clear and bright eyes, occasional neglect in care may occur, but treatment will easily lead to recovery. Even with minor ailments, they can be dispelled. A person of average ability can still observe the movement and stillness of the eyes, understanding moderation and appropriateness themselves; even if qi stagnation occurs, they can eliminate it. A person of inferior ability, ignorant of benefit and loss, and improper in adjusting to cold and heat, cannot treat illnesses once they arise, ultimately leading to injury.
Therefore, regarding the eye, it is like water inside a fruit wrapped by a thin membrane. The nature of water is clear and pure, intolerant of fine dust, and easily damaged. It is bright and crystal clear, reflecting everything without obstruction, precious like a gem, hence called the "Bright Pearl." All movements and visual perceptions rely on the light of the Sun, Moon, and Stars. If external vision is dim, internal vision is also unclear; if internal vision is clear, external vision shines brightly. Thus, the eye is the master among the five zang organs. The pupil and the black cornea are governed by the Kidney. The white sclera corresponds to the Lung, and is managed by the Liver. The aperture (pupil and internal structures) connects through all five zang organs. If qi is slightly disturbed, eye diseases arise. If the five zang organs are peaceful, how could there be damage? This is like branches getting sick causing flowers to wither, or roots drying up causing leaves to fall. If there is internal injury, various external diseases will manifest.
It is said: The eye is the surplus of essence and qi. It is the master of the Heart and the manager of the Liver. The essence and qi of the five zang organs all converge in the eye. The essence of bone forms the pupil, the essence of sinew forms the white sclera, and the essence of flesh forms the eyelids (constraints). Thus, the essence of sinew, blood, qi, and bone jointly form the eye's pupil and other parts. Sorrow and worry affect the heart spirit; the Liver stores the Hun (Ethereal Soul), and the Kidney stores the Zhi (Willpower). The Liver acts as the central hub, depending on the Gallbladder, with qi converging in the Heart and governing the Eye. The eye is the manifestation of the essence of the five zang organs. Diseases in the five zang organs manifest in the eyes. Redness indicates disease in the Heart; whiteness indicates disease in the Lung; blueness indicates disease in the Liver; yellowness indicates disease in the Spleen; blackness indicates disease in the Kidney. Inability to see clearly indicates disease in the chest. Qi imbalance causes the eyes to close; qi exhaustion causes blindness. Liver qi connects to the eye; when Liver qi is harmonious, the complexion is bright. Liver disease causes loss of luster and dizziness. Cold in the Liver causes blurry vision and pupil pain. Pathogenic invasion of the Liver causes blue/black eyes and unclear vision. Excess heat in the Liver causes stabbing eye pain. Deficiency-cold in the Liver causes dizziness, runny nose, and visual hallucinations (seeing flowers). Labor-induced cold in the Liver causes turbid eyes reluctant to open. Insufficiency of Liver qi causes dim vision, tearing in the wind, and unclear sight. However, redness and pain of the eyeball, growth of fleshy tumors, and yellowing of the eye are due to the combination of the Gallbladder and Liver. Gallbladder deficiency allows yin pathogens to injure, causing flowers in the eyes. Liver heat causes excessive redness, pain, and tearing. Disharmony of the Liver causes turbidity and heat. Wind-stroke impending pain causes tearing. The text states that chronic excess heat in the Liver leads to red, dry, painful eyes with polyps. Therefore, the eye is formed by the qi of the five zang organs.
It is further said that there are five wheels in the eye. These five wheels are the Wind Wheel, Blood Wheel, Qi Wheel, Water Wheel, and Flesh Wheel, corresponding to the five zang organs and produced by qi. The color of the Liver is green, its taste is sour, belonging to the East, Jia-Yi Wood, flourishing in Spring, with qi connecting to the left eye. Jia is Yang, Yi is Yin, governing the right eye. The Liver governs Wind, hence called the Wind Wheel. Although it has a name, its shape is difficult to grasp precisely, assisting the Water Wheel. The color of the Heart is red, its taste is bitter, belonging to the South, Bing-Ding Fire, flourishing in Summer. The Heart governs Blood, hence called the Blood Wheel. The Blood Wheel assists the Flesh Wheel, appearing reddish-black. This wheel contraindicates acupuncture. The color of the Spleen is yellow, its taste is sweet, belonging to the Center, Wu-Ji Earth, flourishing during the last eighteen days of each season. The Spleen governs Flesh, hence called the Flesh Wheel. The Flesh Wheel is external, appearing lush yellow-white-gold, which is the eyelid. The color of the Lung is white, its taste is pungent, belonging to the West, Geng-Xin Metal, flourishing in Autumn. Thus, the Lung governs Qi, hence called the Qi Wheel. It lies beneath the Flesh Wheel, hidden and not obvious. The color of the Kidney is black, its taste is salty, belonging to the North, Ren-Gui Water, flourishing in Winter, hence called the Water Wheel. The Water Wheel is within the other four wheels, being the mother of the four wheels, capable of seeing all things clearly, hence called the Pupil.
Liver disease manifests in the Wind Wheel. Symptoms include tearing in the wind, visual obscurity like smoke, worsening during the day and improving at night, dryness and pain with white discharge, or blue cataracts fluttering like fly wings. This is a Lung pathology, and should be treated via the Lung Meridian. Heart disease manifests in the Blood Wheel. Symptoms include flying flowers filling the vision, chaotic and scattered, with fleshy tumors gradually spreading over the eyeball, eyes flooded with tears, redness, and ulceration. This is a Heart pathology. Spleen disease manifests in the Flesh Wheel. Symptoms include growth of fleshy protrusions on the eyelids. Pupil disease involves confusion, dryness, pain, chaotic visual spots resembling hair strands, worsening at midnight, and increasing at dusk and noon compared to early morning. This is a Spleen pathology. Lung disease manifests in the Qi Wheel. Symptoms resemble clouds obscuring the sun, gradually becoming clearer, like cloud shadows on flowers or chasing flies. This is a Liver Meridian pathology. Kidney disease manifests in the Water Wheel. Symptoms include clusters of black spots in the vision, hazy mist, diplopia (seeing one object as two), and viewing the sun as if looking into an abyss. This is a Kidney pathology, and should be treated via the Kidney Meridian. The rest follow this pattern.
Diseases have many manifestations and explanations. Here, detailed descriptions of ophthalmology are provided, avoiding superficial generalizations, focusing on subtleties, which are recorded in detail below.