倪仲贤论强阳搏实阴之病曰∶强者盛而有力也，实者坚而内充也。故有力者强而欲搏，内充者实
而自收，是以阴阳无两强，亦无两实。惟强与实，以偏则病，内搏于身，上见于虚窍也。足少阴肾为
水，肾之精上为神水。手厥阴心包络为相火，火强搏水，水实而自收。其病神水紧小，渐小而又小，
积渐至如菜子许，又有神水外围相类虫蚀者，然皆能睹而不昏，但微觉 羞涩耳。是皆阳气强盛而
搏阴，阴气坚实而有御，虽受所搏，终止于边鄙皮肤也，内无所伤动。治法当抑阳缓阴则愈。以其强
耶故可抑，以其实耶惟可缓，而弗宜助，助之则反胜。抑阳酒连散主之。大抵强者则不易入，故以酒
为之导引，欲其气味投合，入则可展其长，此反治也。还
阴救苦汤主之，疗相火药也。亦宜用搐鼻碧云散。《秘要》云∶瞳子渐渐细小如簪脚，甚则小如针，
视尚有光，早治可以挽住，复故则难。患者因恣色之故，虽病目亦不忌淫欲，及劳伤血气，思竭心意，
肝肾二经俱伤，元气衰弱，不能升运精汁，以滋于胆，胆中三合之精有亏，则所输亦乏，故瞳中之精
亦日渐耗损，甚则陷没俱无，而终身疾矣。亦有头风热证，攻走蒸干精液而细小者，皆宜乘初早救，
以免噬脐之悔也。
谓瞳神歪斜不正，或如杏仁、枣核、三角、半月也。乃肾胆神膏损耗，瞳神将尽矣。若风轮破损，
神膏流绽，致瞳神欹侧者，轮外必有蟹睛在焉。蟹睛虽平，而瞳神不得复圆，外亦结有脂翳，终身不
脱。若轮外别无形证，而瞳神欹侧者，必因内伤肾水肝血，胆乏化源，故膏液日耗而瞳神欲没，甚为
可畏，宜急治之。虽难复圆，亦可挽住，而免坠尽无光之患。
倪仲贤论述强阳搏实阴的病症说：所谓“强”，是指邪气盛而有力；所谓“实”，是指体内充实而坚硬。因此，有力者表现为强盛且想要搏击，体内充实者表现为坚实且具有防御能力。所以，阴阳不会同时处于过强的状态，也不会同时处于过实的状态。只有当“强”与“实”出现偏颇时才会致病，这种病邪内迫于身体，向上反映在虚窍（此处指眼目）上。足少阴肾属水，肾的精气上行化为神水（瞳孔及晶状体等视觉结构）。手厥阴心包络属相火，若相火强盛搏击肾水，肾水因实而自我收敛。其病症表现为神水紧缩变小，逐渐越来越小，最终积渐至如菜籽大小；又有神水外围类似被虫蛀蚀的情况，但患者仍能视物而不昏花，只是略微感到涩滞不适。这些都是阳气强盛而搏击阴气，阴气坚实而有抵御，虽然受到搏击，但仅限于边缘皮肤部位，内部没有受到损伤动摇。治疗方法应当抑制阳气、缓和阴气即可痊愈。因为它是“强”的缘故，所以可以抑制；因为它是“实”的缘故，只可缓和，而不宜助长，助长则反而胜邪。主方用抑阳酒连散。大抵“强”邪不易直接进入，所以用酒作为引导，希望药味气味相投合，进入后可以发挥药效，这是反治法。还阴救苦汤主之，这是治疗相火的药物。也适宜使用搐鼻碧云散。《秘要》说：瞳仁渐渐细小如针脚，严重时小如针尖，看东西尚有光亮，早期治疗可以挽回，恢复原状则很难。患者因为放纵房事的缘故，即使眼睛生病也不忌淫欲，加上劳累损伤血气，思虑竭尽心意，肝肾两经都受伤，元气衰弱，不能升运精汁以滋养胆腑，胆中三合之精有亏损，那么所输注的精液也就匮乏，所以瞳中的精气也日渐耗损，严重时陷没全无，成为终身残疾。也有头风热证，攻走蒸干精液而导致瞳神细小的，都应当趁初起早治，以免后悔莫及。
如果说瞳神歪斜不正，或者形状像杏仁、枣核、三角形、半月形等。这是肾和胆的神膏损耗，瞳神即将耗尽的表现。如果风轮（角膜）破损，神膏流绽，导致瞳神歪斜的，轮外一定会有蟹睛（虹膜脱出嵌顿于角膜伤口处）存在。蟹睛虽然平复，但瞳神不能恢复圆形，外部也会结有脂翳（角膜瘢痕），终身不脱落。如果轮外没有其他形态症状，而瞳神歪斜的，必定是因为内伤肾水和肝血，胆缺乏化源，所以膏液日渐消耗而瞳神欲没，非常可怕，应当紧急治疗。虽然难以恢复圆形，也可以挽回，避免坠尽无光（完全失明）的祸患。
Ni Zhongxian discussed the disease of "Strong Yang Forcing Real Yin," stating: "Qiang" (Strong) refers to pathogenic factors being abundant and powerful; "Shi" (Real/Excess) refers to internal fullness and solidity. Therefore, that which is powerful manifests as strong and aggressive, while that which is internally full manifests as solid and self-defensive. Thus, Yin and Yang do not simultaneously exist in a state of extreme strength or excess. Only when "Qiang" and "Shi" are imbalanced does disease arise; this pathogen forces inward upon the body and manifests outwardly at the hollow orifices (referring here to the eyes). The Foot-Shaoyin Kidney channel belongs to Water, and the essence of the Kidney ascends to become Shen Shui (spiritual water, referring to the aqueous humor and visual structures). The Hand-Jueyin Pericardium channel houses Ministerial Fire. If Ministerial Fire becomes strong and forces against Kidney Water, the Kidney Water, due to its solidity, contracts itself. The manifestation of this disease is that the Shen Shui tightens and shrinks, gradually becoming smaller and smaller, eventually accumulating to the size of a vegetable seed. Additionally, there may be cases where the periphery of the Shen Shui resembles insect-eaten tissue. However, patients can still see without blurring, merely feeling slight astringency and discomfort. These conditions result from Strong Yang forcing Yin, while Yin Qi is solid and defensive. Although subjected to force, the damage remains confined to the peripheral skin, with no injury to the interior. The treatment method should involve suppressing Yang and moderating Yin for recovery. Because it is "Qiang" (strong), it can be suppressed; because it is "Shi" (excess), it can only be moderated, and should not be assisted, as assisting it would cause the pathogen to prevail further. The primary formula is Yiyang Jiulian San (Suppress Yang Wine-Soaked Coptis Powder). Generally, "Qiang" pathogens are difficult to penetrate directly, so wine is used as a guide to ensure the medicinal properties harmonize and enter effectively, allowing them to exert their full effect; this constitutes a contrary treatment approach. Huanyin Jiuku Tang (Restore Yin Rescue Bitterness Decoction) is also indicated, as it treats Ministerial Fire. It is also appropriate to use Chubi Biyun San (Snuffing Jade Cloud Powder). The *Mi Yao* states: "The pupil gradually becomes small like the tip of an awl, or even as small as a needle. Vision retains light. Early treatment can reverse it, but restoring it completely is difficult." Patients, due to excessive sexual indulgence, do not abstain from sexual desires even when eye diseases occur. Coupled with fatigue damaging blood and Qi, and mental exhaustion injuring the Liver and Kidney channels, Yuan Qi (Original Qi) becomes weak. It cannot ascend and transport Jing Zhi (essence fluid) to nourish the Gallbladder. With a deficiency in the Gallbladder's three-combined essence, the transmitted fluids become scarce. Consequently, the essence within the pupil is day by day depleted. In severe cases, it sinks and disappears entirely, resulting in lifelong disability. There are also cases of Head Wind Heat syndrome, where heat attacks and evaporates essence fluids, causing the pupil to shrink. All such cases should be treated early in the initial stage to avoid regretting too late.
If the Tong Shen (pupil spirit/pupil) is tilted and irregular, or shaped like an almond, jujube pit, triangle, or half-moon, this indicates that the Shen Gao (spiritual paste, referring to intraocular fluids/tissues) of the Kidney and Gallbladder is depleted, and the Tong Shen is nearing exhaustion. If the Feng Lun (Wind Wheel, referring to the cornea) is damaged and Shen Gao leaks out, causing the Tong Shen to tilt, there must be Xie Jing (Crystal Pupil/Iris prolapse) outside the wheel. Even if the Xie Jing flattens, the Tong Shen cannot return to a round shape, and lipid films (corneal opacities) will form externally, persisting for life. If there are no other external morphological signs, but the Tong Shen is tilted, it must be due to internal injury to Kidney Water and Liver Blood, with the Gallbladder lacking its source of transformation. Thus, the paste fluids are consumed daily, and the Tong Shen is about to disappear, which is extremely alarming. Urgent treatment is required. Although it may be difficult to restore roundness, it can be stabilized to prevent the disaster of total loss of vision.