经云∶瞳子黑眼法于阴，白眼赤脉法于阳。故阴阳合转而精明。此则眼具阴阳也。又曰∶五脏六
腑之精气，皆上注于目而为之精。精之窠为眼，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，裹撷筋骨气血之精而与脉并为系，上属于脑，后出于项中。此则眼具
五脏六腑也。后世五输八廓之说，盖本诸此。脏腑主目有二∶一曰肝。经云∶东方青色，入通于肝，
开窍于目，脏精于肝。又云∶人卧血归于肝，肝受血而能视。又云∶肝气通于目，肝和则目能
辨五色矣。二曰心。经云∶心合脉。诸脉者，皆属于目是已。至东垣又推之而及于脾，如下文所云。
东垣曰∶五脏生成篇云，诸脉者，皆属于目，目得血而能视。《针经九卷》大惑论云∶心事烦冗，饮
食失节，劳役过度，故脾胃虚弱，心火太盛，则百脉沸腾，血脉逆行，邪害孔窍，天明则日月不明也。
夫五脏六腑之精气，皆禀受于脾土而上贯于目，脾者诸阴之首也。目者血气之宗也。故脾虚则五脏之
精气皆失所司，不能归明于目矣。心者君火也，主人之神，宜静而安，相火代行其令。相火者包络也，
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。阳主散，阳虚则眼楞急，而为倒睫拳毛。阴主敛，阴虚不敛，
则瞳子散大，而为目昏眼花。《灵枢》颠狂篇云∶目 外决于面者为锐 ，在内近鼻者为内 ，上为
外，下为内 。论疾诊尺篇云∶诊目痛，赤脉从上下者，太阳病；从下上者，阳明
病；从外走内者，少阳病。太阳病宜温之散之，阳明病宜下之寒之，少阳病宜和之。《保命集》云∶
眼之为病，在腑则为表，当除风散热。在脏则为里，当养血安神。暴发者为表而易疗，久病者为里而
难治。除风散热者，泻青丸主之。养血安神者，定志丸主之。妇人熟地黄丸主之。或有肥体气盛，风
热上行，目昏涩，槐子散主之。此由胸中浊气上行也，重则为痰厥，亦能损目。常使胸中气清，自无
此病也。又有因目疾服凉药多则损气者，久之眼渐昏弱，乍明乍暗，不能视物，此则失血之验也。熟
干地黄丸、宣风散、定志丸，相须养之。或有视物不明，见黑花者，此之谓肾气
弱也。当补肾水，驻景丸是也。或有暴失明者，谓眼居诸阳交之会也，而阴反闭也，此风邪内满，当有
不
测之病也。子和曰∶圣人虽言目得血而能视，然血亦有太过不及也。太过则目壅塞而发痛，不及则目
耗竭而失明。故年少之人多太过，年老之人多不及。但年少之人则无不及，年老之人，其间犹有太过
者，不可不察也。夫目之内 ，太阳经之所起，血多气少。目之锐 ，少阳经也，血少气多。目之上
纲，太阳经也，亦血多气少。目之下纲，阳明经也，血气俱多。然阳明经起于目两旁交 之中，与太
阳、少阳俱会于目，惟足厥阴经连于目系而已。故血太过者，太阳、阳明
之实也。血不及者，厥阴之虚也。故出血者，宜太阳阳明，盖此二经血多故也。少阳一经，不宜出血，
血少故也。刺太阳、阳明出血则目愈明，刺少阳出血则目愈昏。要知无使太过不及，以养血脉而已。
凡血之为物，太多则溢，太少则枯。人热则血行疾而多，寒则血行迟而少，此常理也。目者，肝之外
候也。肝主目，在五行属木。虽木之为物，太茂则蔽密，太衰则枯瘁矣。夫目之五轮，乃五脏六腑之
精华，宗脉之所聚，其白轮属肺金，肉轮属脾土，赤脉属心火，黑水神光属肾水，兼属肝木，此世俗
皆知之矣。及有目疾，则不知病之理。岂知目不因火则不病，何以言之？白轮变赤，火乘肺也。肉轮
赤肿，火乘脾也。黑水神光被翳，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》曰∶热胜则肿。凡目暴赤肿起，羞明瘾涩，泪出不止，暴翳目瞒皆火热之所为也。治火之法，在
药则
咸寒，吐之下之。在针则神廷、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》曰∶血实者宜决之。又经曰∶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。皆肝主目血少禁出血，止宜补肝养肾。至于暴赤肿痛，
皆宜以 针刺前五穴出血而已，次调盐油以涂发根，甚者虽至于再，至于三可也。量其病势，以平为
期。按此谓目疾出血，最急于初起热痛暴发，或久病郁甚，非三棱针宣泄不可，然年高之人，及久病
虚损并气郁者，宜从毫针补泻之则可，故知子和亦大略言耳。于少阳一经，不宜出血，无使太过不及，
以养血脉而已，斯意可见。
【五轮】金之精腾结而为气轮，木之精腾结而为风轮，火之精腾结而为血
轮，土之精腾结而为肉轮，水之精腾结而为水轮。气轮者，目之白睛是也。内应于肺，西方庚辛申酉
之令，肺主气，故曰气轮。金为五行之至坚，故白珠独坚于四轮。肺为华盖，部
位至高，主气之升降，少有怫郁，诸病生焉。血随气行，气若怫郁，则火胜而血滞，火胜而血滞则病
变不测。火克金，金在木外，故气轮先赤。金克木而后病及风轮也。金色尚白，故白泽者顺也。风轮
者，白内青睛是也。内应于肝，东方甲乙寅卯厥阴风木，故曰风轮。目窍肝，肝在时为春，春生万物，
色满宇宙，惟目能鉴，故属窍于肝也。此轮清脆，内包膏汁，有涵养瞳神之功。其色青，故青莹者顺
也。世人多黄浊者，乃湿热之害。唯小儿之色最正，至长食味，则泄其气而色亦易矣。血轮者，目两
角大小 是也。内应于心，南方丙丁巳午火，心主血，故曰血轮。夫火在目为神光，火衰则有昏瞑之
患，火炎则有焚燎之殃。虽有两心，而无正轮。心、君主也，通于大 ，故大 赤者，实火也。心包
络为小心，小心、相火也，代君行令，通于小 ，故小 赤者，虚火也。若君主拱默，则相火自然清
宁矣。火色赤，唯红活为顺也。肉轮者，两睥是也。中央戊己辰戌丑未之土，脾主肉，故曰肉轮。脾
有两叶，运动磨化水谷，外亦两睥，动静相应，开则万用，如阳动之发生，闭则
万寂，如阴静之收敛。土脏万物而主静，故睥合则万有寂然而思睡，此脏纳归静之应也。土为五行之
主，故四轮亦为睥所包涵，其色黄，得血而润，故黄泽为顺也。华元化云∶目形类丸，瞳神居中而前，
如日月之丽东南而晚西北也。内有大络六，谓心、肺、脾、肝、肾、命门各主其一。中络八，谓胆、
胃、大小肠、三焦、膀胱各主其一。外有旁支细络，莫知其数，皆悬贯于脑下，连脏腑，通畅血气往
来，以滋于目。故凡病发则有形色丝络显见，而可验内之何脏腑受病也。外有二窍以通其气，内有诸
液出而为泪。有神膏、神水、神光、真气、真元、真精，此皆滋目之源液也。神膏者，目内包涵膏液，
如破则黑稠水出是也。此膏由胆中渗润精汁积而成者，能涵养瞳神，衰则有损。神水者，由三焦而发
源，先天真一之气所化，在目之内，虽不可见，然使触物损破，则见黑膏之外，有似稠痰者是也。在
目之外，则目上润泽之水是也。水衰则有火胜燥暴之患，水竭则有目轮大小之疾，耗涩则有昏眇之危。
亏者多，盈者少，是以世无全精之目。神光者，谓目自见之精华也。夫神光发于心，原于胆火之用事，
神之在人也大矣。在足能行，在手能握，在舌能言，在鼻能嗅，在耳能听，在目能视。神舍心，故发
于心焉。真血者，即肝中升运滋目
经络之血也。此血非比肌肉间易行之血，因其脉络深高难得，故谓之真也。真气者，盖目之经络中往
来生用之气，乃先天真一发生之元阳也。大宜和畅，少有郁滞，诸病生焉。真精者，乃先后天元气所
化精汁，起于肾，施于胆，而后及瞳神也。凡此数者，一有所损，目则病矣。大概目圆而长，外有坚
壳数重，中有清脆，内包黑稠神膏一函，膏外则白稠神水，水以滋膏，水外则皆血，血以滋水，膏中
一点黑莹是也。胆所聚之精华，唯此一点，烛照鉴视，空阔无穷者，是曰水轮。内应于肾，北方壬癸
亥子水也。其妙在三，胆汁、肾气、心神也。五轮之中，四轮不鉴，唯瞳神乃照物者。风轮则有包卫
涵养之功，风轮有损，瞳神不久留矣。或曰瞳神水也、气也、血也、膏也，曰，非也。非血、非气、
非水、非膏，乃先天之气所生，后天之气所成。阴阳之妙用，水火之精华，血养水，水养膏，膏护瞳
神，气为运用，神则维持，喻以日月，理实同之。而午前则小，午后则大，亦随天地阴阳之运用也。
大抵目窍于肝，主于肾，用于心，运于肺，脏于脾。有大有小，有圆有长，亦由禀
受之异。男子右目不如左目精华，女子左目不如右目光彩，此各得其阴阳气分之王也。然聪愚佞直柔
刚寿夭，亦能验目而知之，神哉。岂非人身之至宝乎。
【八廓】应乎八卦，脉络经纬于脑，贯通脏腑，
达血气往来，以滋于目。廓如城郭，然各有行路往来，而匡廓卫御之意也。干居西北，络通大肠之腑，
脏属肺，肺与大肠相为阴阳，上运清纯，下输糟粕，为传送之官，故曰传道廓。坎正北方，络通膀胱
之腑，脏属于肾，肾与膀胱相为阴阳，主水之化源以输津液，故曰津液廓。艮位东北，络通上焦之腑，
脏配命门，命门与上焦相为阴阳，会合诸阴，分输百脉，故曰会阴廓。震正东方，络通胆腑，脏属于
肝，肝胆相为阴阳，皆主清净，不受浊秽，故曰清净廓。巽位东南，络通中焦之腑，脏属肝络，肝与
中焦相为阴阳，肝络通血以滋养，中焦分气以化生，故曰养化廓。离正南方，络通小肠之腑，脏属于
心，心与小肠相为脏腑，为谓阳受盛之胞，故曰胞阳廓。坤位西南，络通胃之腑，脏属于脾，脾胃相
为脏腑，主纳水谷以养生，故曰水谷廓。兑正西方，络通下焦之腑，脏配肾络，肾与下焦相为脏腑，
关主阴精化生之源，故曰关泉廓。脏腑相配，《内经》已有定
法，而三焦分发肝肾者，此目之精法也。盖目专窍于肝，而主于肾，故有二络之分发焉。左目属阳，
阳道顺行，故廓之经位法象亦以顺行。右目属阴，阴道逆行，故廓之经位法象亦以逆行。察乎二目两
之分，则昭然可见阴阳顺逆之道矣。
【开导说】夫目之有血，为养目之源，充和则发生长养之功全
而目不病，亏滞则病生矣。犹物之有水，为生物之泽时中，则灌溉滋生之得宜而物秀，旱涝则物坏矣，
皆一气使之然也。是故天之六气不和，则阴阳偏胜，旱涝承之，水之盈亏不一，物之秀稿不齐，雨
失时而为物害也。譬之山崩水涌，滂沛妄行，不循河道而流，任其所之，不得已而 塞决堤以泄其溢，
使无沦溺昏垫之患。人之六气不和，水火乖违，淫亢承之，血之旺衰不一，气之升降不齐，营卫失调，
而为人害也。盖由阴虚火盛，炎炽错乱，不遵经络而来，郁滞不能通畅，不得已而开涩导瘀以泻其余，
使无胀溃损珠之患，与战理同。其所有六，谓迎香、内睥、上星、耳际、左右太阳穴也。内睥正队之
冲锋也，其功虽迟，渐收而平顺；两太阳击其左右翼也，其功次之；上星穴绝其饷道也；内迎香抵贼
之巢穴也，成功虽速，乘险而征；耳际击其游骑耳，道远功卑，智者不取。此实拯危之良术，挫敌之
要机，与其闭门捕贼，不若开门逐之为良法
也。盖病浅而邪不胜正者，固内治而邪自退矣。倘或六阳炎炽，不若开导通之，纵使其虚，虽有所伤，
以药内治之功而补其所亏，庶免瘀滞至极，而有溃烂枯凸之患。惜乎开导之法，利害存焉。有大功于
目而人不知，有隐祸于目而人亦不知，其摧锋挫锐，临大敌而拯祸乱，此其功之大也。耗液伤膏，弱
光华而乏滋生，此其祸之隐也。唯能识证之轻重，目之虚实而伐之，无过不及之弊，庶可为医之良者。
【点服药说】病有内外，治各不同。内疾已成，外证若无，点之何益。外有红丝赤脉，若初发乃微邪，
退后乃余贼，点亦可消，服之犹愈。内病始盛而不内治，只泥外点者，不唯徒点无功，且有激发之患。
内病既成，外病已见，必须内外夹攻，点服并行。奈之何，人有愚拗不同，有喜服而畏点者，有喜点
而畏服者。不知内疾既发，非服不除；外疾既成，非点不退。 其流、不若塞其源，伐其枝、不若斫
其根，扬汤止沸、不如釜底抽薪，此谓治本也。内病既发，不服而除者，吾未之见也。物污须濯，镜
垢须磨，脂膏之釜，不经洗涤，乌能清净，此谓治标也。若外障既成，不点而去者，吾亦未之见也。
若内障不服而点者，徒激其火，动其气血，反损无益。
服而不点者亦然。外障服而不点，病初发浮嫩不定者，亦退。既已结成者，服虽不发不长，所结不除，
《黄帝内经》说：黑眼球和瞳仁效法阴，白眼球和赤脉效法阳。所以阴阳协调转动，眼睛就能视物精明。这说明眼睛具备阴阳的属性。又说：五脏六腑的精气，都上注于眼睛以形成视觉功能。精气的汇聚处称为眼，骨之精气表现为瞳仁，筋之精气表现为黑眼球，血之精气表现为血络，气之精气汇聚处为白眼，肌肉之精气表现为眼睑（约束眼睑开合的组织），这些组织包裹着筋骨气血的精气，与脉络结合成为目系，向上连接大脑，向后出于项部。这说明眼睛具备五脏六腑的功能联系。后世的五轮八廓理论，大概都源于此。脏腑中与眼睛关系密切的主要有两个：一是肝。《内经》说：东方青色，内通于肝，开窍于目，肝藏精。又说：人卧则血归于肝，肝得到血液的滋养才能视物。还说：肝气通于目，肝气调和则眼睛能辨别五色。二是心。《内经》说：心主血脉。所有的脉络，都归属于眼睛。到了李东垣又进一步推演到脾，如下文所述。李东垣说：《素问·五脏生成篇》说，所有的脉络都归属于眼睛，眼睛得到血液的滋养才能视物。《灵枢·大惑论》说：如果心中烦乱冗杂，饮食不节制，劳累过度，导致脾胃虚弱，心火过盛，那么全身血脉沸腾，血脉运行逆乱，邪气侵害孔窍，就像天亮了但日月无光一样。五脏六腑的精气，都禀受于脾土，然后上贯于眼睛，脾是诸阴之首。眼睛是血气的宗主。所以脾虚则五脏的精气都失去主宰，不能使眼睛明亮。心属于君火，是主人精神的主宰，宜静而安，由相火代行其职能。相火即心包络，主管全身血脉，使血脉荣养于目。既然因为劳累运动，势必要妄行，再加上因邪气侵犯而损伤血脉，所以各种疾病就产生了。凡是医生不调理脾胃及养血安神，只治标不治本，是不明白正理的。阳主发散，阳虚则眼睑拘急，导致倒睫拳毛。阴主收敛，阴虚不能收敛，则瞳仁散大，导致视力模糊、眼花。《灵枢·癫狂篇》说：面部外侧眼角称为外眦，内侧近鼻角称为内眦，上部为上睑，下部为下睑。《灵枢·论疾诊尺篇》说：诊断眼痛，如果赤脉从上向下走，是太阳病；从下向上走，是阳明病；从外向内走，是少阳病。太阳病宜温散，阳明病宜攻下寒凉，少阳病宜和解。《保命集》说：眼睛的疾病，在腑属于表证，应当祛风散热。在脏属于里证，应当养血安神。突然发作的属于表证，容易治疗；久病的属于里证，难以治愈。祛风散热，用泻青丸主治。养血安神，用定志丸主治。妇人用眼，用熟地黄丸主治。如果有身体肥胖、气盛的人，风热上行，导致眼睛昏涩，用槐子散主治。这是由于胸中浊气上行所致，严重时会发生痰厥，也能损害眼睛。常使胸中气机清利，自然没有这种病。又有因为眼疾服用过多凉药从而损伤正气的人，久而久之眼睛逐渐昏弱，时明时暗，不能视物，这是失血的征象。用熟干地黄丸、宣风散、定志丸，相互配合调养。有的人视物不明，看见黑花飞舞，这叫做肾气弱。应当补肾水，用驻景丸。有的人突然失明，这是因为眼睛位于诸阳经交汇之处，而阴气反而闭塞，这是风邪内盛，可能会有不可测度的疾病。张子和说：圣人虽然说过眼睛得到血液滋养才能视物，但是血液也有太过和不及的情况。太过则眼部壅塞而疼痛，不及则眼部耗竭而失明。所以年轻人多属太过，老年人多属不及。但是年轻人只有太过而没有不及，老年人中间还有太过的情况，不可不仔细考察。眼的内眦，是太阳经起始的地方，血多气少。眼的外眦，是少阳经所在，血少气多。眼的上睑，是太阳经所主，也是血多气少。眼的下睑，是阳明经所主，血气俱多。然而阳明经起于眼旁交睛之中，与太阳、少阳经都在眼睛会合，只有足厥阴肝经连接于目系。所以血太过的，是太阳、阳明经的实证。血不及的，是厥阴经的虚证。所以放血疗法，适宜用于太阳、阳明经，因为这两条经血多。少阳一经，不宜放血，因为血少。刺太阳、阳明经放血则眼睛更明亮，刺少阳经放血则眼睛更昏暗。要知道不要使血液太过或不及，以养护血脉为主。凡血这种东西，太多则溢出，太少则枯槁。人受热则血行快而多，受寒则血行慢而少，这是常理。眼睛，是肝的外候。肝主目，在五行中属木。虽然木这种植物，长得太茂盛则遮蔽严密，太衰弱则干枯憔悴。眼的五轮，是五脏六腑的精华，宗脉聚集之处，白轮属肺金，肉轮属脾土，赤脉属心火，黑水神光属肾水，兼属肝木，这是世俗都知道的。等到有眼疾时，却不知道病的原理。岂不知眼睛不因火邪就不会生病，为什么这样说？白轮变红，是火邪乘袭肺。肉轮红肿，是火邪乘袭脾。黑水神光被翳障遮蔽，是火邪乘袭肝与肾。赤脉贯穿眼睛，是火邪极盛。能治火，一句话就可以解决。所以《内经》说：热胜则肿。凡是眼睛突然红肿，羞明隐涩，泪出不止，突然生翳遮目，都是火热所为。治火的方法，在药物方面用咸寒之品，通过吐法或下法。在针灸方面，针刺神庭、上星、囟会、前顶、百会穴放血。翳障可以使它立即消退，疼痛可以使它立即停止，昏暗可以使它立即明亮，肿胀可以使它立即消除。只有小儿不宜刺囟会穴，因为那里肉质浅薄，恐怕伤及其骨骼。然而小儿水在上，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）。又经说：虚者补之，实者泻之。如雀目（夜盲）不能夜间视物及内障，是由暴怒大忧所致。都因肝主目，血少禁止放血，只宜补肝养肾。至于突然红肿疼痛，都适宜用针刺上述五个穴位放血，其次调配盐油涂抹发根，严重的即使进行两三次也可以。根据病情轻重，以平和为标准。按此说法，眼疾放血，最急于初起热痛暴发，或久病郁结甚重，非用三棱针宣泄不可，然而年高之人，以及久病虚损并气郁者，适宜用毫针进行补泻，所以知道张子和的话也是大略而言。对于少阳一经，不宜放血，不要使血液太过或不及，以养护血脉为主，这个意思可见一斑。
【五轮】金的精华升腾凝结而成气轮，木的精华升腾凝结而成风轮，火的精华升腾凝结而成血轮，土的精华升腾凝结而成肉轮，水的精华升腾凝结而成水轮。气轮，就是眼的白睛部分。内应于肺，对应西方庚辛申酉的时令，肺主气，所以叫气轮。金是五行中最坚硬的，所以白珠独自比四轮坚硬。肺为华盖，位置最高，主气的升降，稍有郁结，各种疾病就会产生。血随气行，气若郁结，则火胜而血滞，火胜而血滞则病变不可测。火克金，金在木之外，所以气轮先变红。金克木而后病及风轮。金色尚白，所以白泽润泽是顺证。风轮，就是白睛内的青睛部分。内应于肝，对应东方甲乙寅卯厥阴风木，所以叫风轮。目窍通于肝，肝在时为春，春生万物，色彩充满宇宙，只有眼睛能鉴察，所以窍属于肝。此轮清脆，内包膏汁，有涵养瞳神的功能。其色青，所以青莹润泽是顺证。世人多为黄浊，是湿热的危害。只有小儿的颜色最纯正，长大进食五味后，就会泄其气而颜色也易改变。血轮，就是眼两角的大小眦部分。内应于心，对应南方丙丁巳午火，心主血，所以叫血轮。火在眼中为神光，火衰则有昏瞑的祸患，火炎则有焚燎的灾殃。虽然有两心，但没有正轮。心为君主，通于大眦，所以大眦红者是实火。心包络为小心，相火代君行令，通于小眦，所以小眦红者是虚火。如果君主拱默不动，则相火自然清宁。火色赤，唯有红活润泽是顺证。肉轮，就是两眼皮。中央戊己辰戌丑未之土，脾主肉，所以叫肉轮。脾有两叶，运动磨化水谷，外面也有两眼皮，动静相应，开则万用，如阳动之发生，闭则万寂，如阴静之收敛。土脏万物而主静，所以眼皮闭合则万有寂然而思睡，这是脏气纳归安静的应验。土为五行之主，所以四轮也被眼皮包涵，其色黄，得血而润，所以黄泽润泽是顺证。华元化说：眼睛形状像丸子，瞳神居中向前，像日月照耀东南而傍晚偏向西北。内部有大络六条，谓心、肺、脾、肝、肾、命门各主其一。中络八条，谓胆、胃、大小肠、三焦、膀胱各主其一。外部有旁支细络，数量不知多少，都悬挂贯通于脑下，连接脏腑，通畅血气往来，以滋养老眼睛。所以凡是发病则有形色丝络显现，可以验证内部哪个脏腑受病。外部有二窍以通气，内部有各种液体流出成为泪。有神膏、神水、神光、真气、真元、真精，这些都是滋润眼睛的源液。神膏，是眼内包涵的膏液，如破裂则流出黑稠水。此膏由胆中渗润精汁积累而成，能涵养瞳神，衰退则有损害。神水，由三焦而发源，由先天真一之气所化，在眼内虽不可见，但如果触物损破，则在黑膏之外，有似稠痰的物质。在眼外，则是眼上润泽的水。水衰则有火胜燥暴的祸患，水竭则有眼轮大小的疾病，耗涩则有昏眇的危险。亏的多，盈的少，所以世上没有完全精良的眼睛。神光，是指眼睛自见的精华。神光发于心，源于胆火的作用，神在人身上很大。在脚能行走，在手能握持，在舌能言语，在鼻能嗅闻，在耳能听声，在眼能视物。神舍于心，所以发于心。真血，即肝中升运滋润目经络的血。此血不同于肌肉间容易运行的血，因其脉络深高难得，所以称为真。真气，大概是目中经络中往来生用的气，乃先天真一发生之元阳。大宜和畅，稍有郁滞，各种疾病就会产生。真精，乃先后天元气所化的精汁，起于肾，施于胆，然后及于瞳神。凡此数者，一旦有所损伤，眼睛就病了。大概眼睛圆而长，外部有坚硬壳数层，内部清脆，内包黑稠神膏一盒，膏外则是白稠神水，水以滋润膏，水外则全是血，血以滋润水，膏中一点黑莹润泽。胆所聚的精华，唯此一点，烛照鉴视，空阔无穷，这叫水轮。内应于肾，北方壬癸亥子水。其妙处有三：胆汁、肾气、心神。五轮之中，四轮不鉴察，只有瞳神才是照物的。风轮则有包卫涵养之功，风轮有损，瞳神不久留了。有人说瞳神是水、是气、是血、是膏，回答说：不对。不是血、不是气、不是水、不是膏，乃是先天之气所生，后天之气所成。阴阳的妙用，水火精华，血养水，水养膏，膏护瞳神，气为运用，神则维持，比喻为日月，道理其实相同。而且午前则小，午后则大，也随着天地阴阳的运用而变化。大致目窍于肝，主于肾，用于心，运于肺，脏于脾。有大有小，有圆有长，也由禀受不同。男子右眼不如左眼精华，女子左眼不如右目光彩，这是各自得其阴阳气分之王。然而聪明愚笨、奸佞正直、柔弱刚强、长寿夭折，也能通过眼睛查验得知，神奇啊。岂不是人身至宝吗。
【八廓】对应八卦，脉络经纬于脑，贯通脏腑，达血气往来，以滋养老眼睛。廓如同城郭，各有行路往来，而有匡廓卫御的意思。乾居西北，络通大肠之腑，脏属肺，肺与大肠相为阴阳，上运清纯，下输糟粕，为传送之官，所以叫传道廓。坎正北方，络通膀胱之腑，脏属于肾，肾与膀胱相为阴阳，主水之化源以输津液，所以叫津液廓。艮位东北，络通上焦之腑，脏配命门，命门与上焦相为阴阳，会合诸阴，分输百脉，所以叫会阴廓。震正东方，络通胆腑，脏属于肝，肝胆相为阴阳，皆主清净，不受浊秽，所以叫清净廓。巽位东南，络通中焦之腑，脏属肝络，肝与中焦相为阴阳，肝络通血以滋养，中焦分气以化生，所以叫养化廓。离正南方，络通小肠之腑，脏属于心，心与小肠为脏腑，称为阳受盛之胞，所以叫胞阳廓。坤位西南，络通胃之腑，脏属于脾，脾胃相为脏腑，主纳水谷以养生，所以叫水谷廓。兑正西方，络通下焦之腑，脏配肾络，肾与下焦为脏腑，关主阴精化生之源，所以叫关泉廓。脏腑相配，《内经》已有定法，而三焦分发肝肾者，这是眼的精法。盖眼专窍于肝，而主于肾，所以有二络之分发。左目属阳，阳道顺行，所以廓的经位法象也以顺行。右目属阴，阴道逆行，所以廓的经位法象也以逆行。观察两眼之分，则昭然可见阴阳顺逆之道。
【开导说】眼睛有血，是养育眼睛的源头，充盛调和则发生长养之功全而眼睛不病，亏损阻滞则疾病产生。就像物体有水，是生物之泽，适时则灌溉滋生得宜而物体秀丽，旱涝则物体毁坏，都是一气使之然。所以天之六气不和，则阴阳偏胜，旱涝随之，水的盈亏不一，物体的秀枯不齐，雨失时而成为物的害处。譬如山崩水涌，滂沛妄行，不循河道而流，任其所之，不得已而堵塞决堤以泄其溢，使无沦溺昏垫之患。人的六气不和，水火乖违，淫亢随之，血的旺衰不一，气的升降不齐，营卫失调，而成为人的害处。大概由于阴虚火盛，炎炽错乱，不遵经络而来，郁滞不能通畅，不得已而开涩导瘀以泻其余，使无胀溃损珠之患，与战理相同。所谓的“六”，指迎香、内眦、上星、耳际、左右太阳穴。内眦是正队的冲锋，其功虽迟，渐收而平顺；两太阳穴击其左右翼，其功次之；上星穴断其饷道；内迎香抵贼之巢穴，成功虽速，乘险而征；耳际击其游骑，道远功卑，智者不取。这实际上是拯危的良术，挫敌的要机，与其闭门捕贼，不如开门逐之为良法。大概病浅而邪不胜正者，固守内治而邪自退矣。倘若六阳炎炽，不如开导通之，纵然使其虚，虽有损伤，以药内治之功而补其所亏，庶免瘀滞至极，而有溃烂枯凸之患。可惜开导之法，利害并存。有大功于目而人不知，有隐祸于目而人亦不知，其摧锋挫锐，临大敌而拯祸乱，这是其功之大。耗液伤膏，弱光华而乏滋生，这是其祸之隐。唯有能识证之轻重，目之虚实而伐之，无过不及之弊，庶可为医之良者。
【点服药说】病有内外，治各不同。内疾已成，外证若无，点眼何益。外有红丝赤脉，若初发乃微邪，退后乃余贼，点眼亦可消，服药犹愈。内病始盛而不内治，只泥于外点者，不唯徒点无功，且有激发之患。内病既成，外病已见，必须内外夹攻，点服并行。奈何人有愚拗不同，有喜服而畏点者，有喜点而畏服者。不知内疾既发，不服药不能除；外疾既成，不点眼不能退。疏其流，不如塞其源，伐其枝，不如斫其根，扬汤止沸，不如釜底抽薪，这叫治本。内病既发，不服药而除的，我没见过。物体污须濯洗，镜子垢须磨擦，脂膏之釜，不经洗涤，怎能清净，这叫治标。若外障既成，不点眼而去掉的，我也没见过。若内障不服药而点眼，徒激其火，动其气血，反损无益。服药而不点眼的也一样。外障服药而不点眼，病初发浮嫩不定者，也会退。既已结成者，服药虽不发不长，所结不除，
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The pupil and the black part of the eye follow the principle of Yin, while the white sclera and red vessels follow the principle of Yang. Thus, when Yin and Yang coordinate and rotate, vision becomes clear and sharp. This indicates that the eye possesses both Yin and Yang attributes. It further states: The essence and qi of the five zang organs and six fu organs all ascend to the eyes to form visual function. The gathering place of essence is called the eye; the essence of bone manifests as the pupil, the essence of sinew as the black part of the eye, the essence of blood as the blood vessels, the gathering place of the essence of qi as the white sclera, and the essence of muscle as the eyelids (the tissue constraining the opening and closing of the eyelids). These tissues wrap around the essence of sinew, bone, qi, and blood, combining with the meridians to form the optic nerve (eye system), which connects upward to the brain and exits posteriorly at the nape of the neck. This indicates that the eyes are functionally connected to the five zang and six fu organs. The later theories of the Five Wheels and Eight Palaces are largely derived from this. Among the zang and fu organs, two are primarily associated with the eyes: one is the Liver. The *Neijing* states: The color green corresponds to the East and internally connects to the Liver, opening into the eyes, with the Liver storing essence. It also states: When a person rests, blood returns to the Liver; the Liver receives blood and thus enables vision. Furthermore: Liver qi connects to the eyes; when Liver qi is harmonious, the eyes can distinguish the five colors. The second is the Heart. The *Neijing* states: The Heart governs the blood vessels. All meridians belong to the eyes. Later, Li Dongyuan extended this theory to include the Spleen, as described below. Li Dongyuan stated: In the *Suwen · Chapter on the Generation of the Five Zang Organs*, it says that all meridians belong to the eyes, and the eyes can see only when nourished by blood. In the *Lingshu · Da Huo Lun*, it says: If the mind is troubled and cluttered, diet is irregular, and labor is excessive, leading to Spleen-Stomach weakness and excessive Heart Fire, then the body's blood vessels will boil, blood flow will reverse, pathogenic factors will damage the orifices, resembling the sun rising but the sun and moon lacking light. The essence and qi of the five zang and six fu organs are all derived from the Earth of the Spleen, which then ascends to the eyes. The Spleen is the head of all Yin. The eyes are the master of blood and qi. Therefore, if the Spleen is deficient, the essence and qi of the five zang organs lose their control and cannot brighten the eyes. The Heart belongs to Ministerial Fire (Jun Huo), governing the spirit, and should be quiet and stable; its functions are performed by Ministerial Fire (Xiang Huo), which is the Pericardium (Bao Luo). The Pericardium governs the blood vessels, ensuring they nourish the eyes. Due to labor and movement, blood tends to move recklessly, and when combined with pathogenic invasion damaging the vessels, various diseases arise. Physicians who do not regulate the Spleen-Stomach and nourish blood to calm the spirit, treating only symptoms rather than the root, fail to understand the correct principles. Yang governs dispersion; Yang deficiency leads to eyelid tension, causing trichiasis (in-turned eyelashes). Yin governs contraction; Yin deficiency fails to contract, leading to pupil dilation and blurred vision. The *Lingshu · Dian Kuang Pian* states: The outer corner of the eye is called the outer canthus, the inner corner near the nose is the inner canthus, the upper part is the upper eyelid, and the lower part is the lower eyelid. The *Lingshu · Lun Ji Zhen Chi Pian* states: To diagnose eye pain, if red vessels run from top to bottom, it is a Taiyang disease; from bottom to top, it is a Yangming disease; from outside to inside, it is a Shaoyang disease. Taiyang disease should be treated with warming and dispersing methods; Yangming disease with purgative and cooling methods; Shaoyang disease with harmonizing methods. The *Baoming Ji* states: Eye diseases in the fu organs are exterior patterns, requiring wind-dispelling and heat-clearing. Diseases in the zang organs are interior patterns, requiring blood-nourishing and spirit-calming. Sudden onset indicates an exterior pattern, which is easy to treat; chronic illness indicates an interior pattern, which is difficult to treat. For wind-dispelling and heat-clearing, use Xieqing Wan (Drain Green Pill). For blood-nourishing and spirit-calming, use Dingzhi Wan (Stabilize Spirit Pill). For women, use Shudihuang Wan (Rehmannia Pill). In obese individuals with excess qi, where wind-heat rises causing blurry and gritty eyes, use Huaizi San (Sophora Seed Powder). This is due to turbid qi ascending from the chest; severe cases may lead to Phlegm-Jue (syncope), also damaging the eyes. Keeping the chest qi clear prevents this. Conversely, excessive use of cold medicines for eye diseases damages qi, leading to gradual blurriness, fluctuating vision, and inability to see, indicating blood loss. Treat with Shugan Dihuang Wan (Prepared Rehmannia Pill), Xuanfeng San (Disperse Wind Powder), and Dingzhi Wan, used together. For unclear vision and seeing black spots, this is Kidney Qi weakness; tonify Kidney Water with Zhujing Wan (Residence Light Pill). Sudden blindness occurs because the eyes are at the convergence of all Yang meridians, yet Yin blocks them; this is internal fullness of Wind Pathogen, predicting unpredictable disease. Zhang Hezi said: Although sages state that eyes see when nourished by blood, blood can be either excessive or deficient. Excess causes blockage and pain; deficiency causes exhaustion and blindness. Youth tend toward excess; old age toward deficiency. However, youth rarely has deficiency, and some elderly still have excess; careful examination is necessary. The inner canthus is the starting point of the Taiyang Meridian, rich in blood and poor in qi. The outer canthus is the Shaoyang Meridian, poor in blood and rich in qi. The upper eyelid is governed by Taiyang, rich in blood and poor in qi. The lower eyelid is governed by Yangming, rich in both blood and qi. The Yangming Meridian begins beside the eyes, converging with Taiyang and Shaoyang at the eyes. Only the Foot Jueyin Liver Meridian connects to the optic nerve. Thus, blood excess is a Fullness pattern of Taiyang and Yangming. Blood deficiency is a Deficiency pattern of Jueyin. Bleeding therapy is suitable for Taiyang and Yangming due to their abundance of blood. Shaoyang should not be bled due to its scarcity. Bleeding Taiyang and Yangming improves vision; bleeding Shaoyang worsens it. One must avoid excess and deficiency to nourish the blood vessels. Blood, if too abundant, overflows; if too scant, dries up. Heat accelerates blood flow; cold slows it. The eyes are the external manifestation of the Liver. The Liver governs the eyes and belongs to Wood in the Five Elements. Wood, if too lush, obscures; if too weak, withers. The Five Wheels of the eye are the essence of the zang and fu organs and the gathering of major meridians. The white wheel belongs to Lung Metal, the flesh wheel to Spleen Earth, red vessels to Heart Fire, and the black water/divine light to Kidney Water, also relating to Liver Wood. This is common knowledge. Yet, when eye diseases occur, people often ignore the pathology. Do you not know that eyes do not become diseased without Fire? If the white wheel turns red, Fire invades the Lung. If the flesh wheel swells, Fire invades the Spleen. If the divine light is obscured, Fire invades the Liver and Kidney. If red vessels penetrate the eye, Fire is extreme. Treating Fire resolves the issue. The *Neijing* states: Excess heat causes swelling. Sudden redness, swelling, photophobia, grittiness, tearing, and sudden cataracts are all caused by Fire. Treatment involves salty-cold herbs, emesis, or purgation. Acupuncture involves bleeding Shen Ting, Shangxing, Xinhui, Qian Ding, and Baihui points. Cataracts recede, pain stops, vision clears, and swelling subsides immediately. Children should not have Xinhui bled due to thin tissue and risk of bone injury. Children have Water above and Fire below, hence clear vision. The elderly have Fire above and insufficient Water, hence blurry vision. The *Neijing* states: Fullness of blood requires drainage (bleeding). Also: Tonify deficiency, drain excess. Night blindness and internal cataracts result from rage and grief, depleting Liver blood; bleeding is contraindicated; instead, tonify Liver and Kidney. Sudden redness and swelling require bleeding the aforementioned five points, followed by applying salt-oil to hair roots. Severe cases may require repetition. Balance the condition. Bleeding is most urgent for acute heat-pain or chronic stagnation, using a three-edged needle. However, for the elderly, chronic deficiency, or qi stagnation, fine needles with tonification and sedation are appropriate. Zhang Hezi’s general advice holds: Shaoyang should not be bled to maintain blood vessel balance.
[Five Wheels] The essence of Metal condenses into the Qi Wheel; Wood into the Wind Wheel; Fire into the Blood Wheel; Earth into the Flesh Wheel; Water into the Water Wheel. The Qi Wheel is the white sclera, corresponding to the Lung, West, Geng/Xin/Shen/You times. The Lung governs qi, hence "Qi Wheel." Metal is the hardest element, so the white sclera is harder than the other four wheels. The Lung is the canopy, highest in position, governing qi ascent/descent; slight stagnation causes disease. Blood follows qi; qi stagnation leads to Fire excess and blood stasis, causing unpredictable changes. Fire conquers Metal; Metal is outside Wood, so the Qi Wheel reddens first. Metal conquers Wood, affecting the Wind Wheel. White luster is favorable. The Wind Wheel is the cornea within the sclera, corresponding to the Liver, East, Jia/Yi/Yin/Mao, Jueyin Wind-Wood. Hence "Wind Wheel." The eye orifice connects to the Liver; Spring generates all things, filling the universe with color, visible only through the eyes. This wheel is crisp, containing fluid to nourish the pupil. Its green color is favorable; yellow/turbid indicates Damp-Heat. Children have pure colors; diet alters this. The Blood Wheel is the canthi (inner and outer corners), corresponding to the Heart, South, Bing/Ding/Si/Wu, Fire. The Heart governs blood, hence "Blood Wheel." Fire in the eye is Divine Light; deficiency causes dimness; excess causes burning. There are two hearts but no single wheel. The Heart Monarch connects to the outer canthus; redness here indicates Excess Fire. The Pericardium (Minister Fire) connects to the inner canthus; redness here indicates Deficient Fire. If the Monarch is still, Minister Fire is peaceful. Red vitality is favorable. The Flesh Wheel is the eyelids, corresponding to Central Earth, Wu/Ji/Chen/Xu/Chou/Wei. The Spleen governs flesh, hence "Flesh Wheel." The Spleen has two lobes, grinding food; eyelids correspond, opening/closing like Yang activity and Yin rest. Earth governs all and is quiet; closed eyelids induce sleep, reflecting quietude. Earth is central; eyelids encompass the four wheels. Yellow luster is favorable. Hua Yuanhua said: Eyes are spherical, pupils centered forward, like the sun/moon in the southeast/northwest. Six major internal collaterals connect to Heart, Lung, Spleen, Liver, Kidney, and Mingmen. Eight middle collaterals connect to Gallbladder, Stomach, Large Intestine, Small Intestine, Triple Burner, and Bladder. Numerous external fine collaterals hang from the brain, connecting organs, circulating blood/qi to nourish the eyes. Disease manifests as colored threads, revealing affected organs. Two external orifices vent qi; internal fluids produce tears. Divine Paste (Shen Gao), Divine Water (Shen Shui), Divine Light (Shen Guang), True Qi (Zhen Qi), True Yuan (Zhen Yuan), and True Essence (Zhen Jing) nourish the eyes. Divine Paste is internal fluid; rupture releases black thick fluid. Formed from Gallbladder essence, it nourishes the pupil; decline causes damage. Divine Water originates from the Triple Burner, transformed from Primordial Qi. Internally invisible, externally visible as lubricating fluid. Water deficiency causes Fire dryness; depletion causes wheel disorders; consumption causes dimness. Deficits exceed盈 (fullness), so perfect eyes are rare. Divine Light is the eye's self-illuminating essence, originating from the Heart and Gallbladder Fire. Spirit enables walking, grasping, speaking, smelling, hearing, and seeing. Spirit resides in the Heart. True Blood is Liver blood nourishing eye meridians; deep and hard to access, hence "True." True Qi is the vital qi circulating in eye meridians, Primordial Yang. Stagnation causes disease. True Essence is post/natal essence transforming from Kidney, applied to Gallbladder, reaching the pupil. Damage to any causes eye disease. The eye is round/long, hard-shelled, crisp inside, containing Divine Paste, surrounded by Divine Water, then blood. The Gallbladder's essence concentrates in the pupil, enabling infinite vision; this is the Water Wheel, corresponding to Kidney Water (North, Ren/Gui/Hai/Zi). Its wonder lies in Gallbladder bile, Kidney Qi, and Heart Spirit. Among the five wheels, only the pupil sees. The Wind Wheel protects and nourishes; damage to it endangers the pupil. Some say the pupil is water/qi/blood/paste; this is incorrect. It is generated by Pre-heaven Qi, formed by Post-heaven Qi, the miracle of Yin/Yang, essence of Water/Fire. Blood nourishes Water, Water nourishes Paste, Paste protects Pupil, Qi operates, Spirit maintains. Like sun/moon, size changes with day/night Yin/Yang cycles. Generally, eyes open via Liver, governed by Kidney, used by Heart, operated by Lung, stored by Spleen. Sizes/shapes vary by constitution. Men's right eyes lack left eye essence; women's left eyes lack right eye brilliance, due to Yin/Yang dominance. Intelligence, character, longevity are reflected in eyes. Truly the body's treasure.
[Eight Palaces] Correspond to the Eight Trigrams, meridians weave through the brain, connecting organs, circulating blood/qi to nourish the eyes. Palaces are like city walls, with pathways for defense. Qian (NW) connects to Large Intestine Fu, Lung Zang; Lung/LI are Yin/Yang, transporting purity down and waste out; hence "Transmission Palace." Kan (N) connects to Bladder Fu, Kidney Zang; Kidney/Bladder are Yin/Yang, governing water source and fluid distribution; hence "Fluid Palace." Gen (NE) connects to Upper Burner Fu, Mingmen Zang; Mingmen/Upper Burner are Yin/Yang, merging Yin and distributing to vessels; hence "Meeting Yin Palace." Zhen (E) connects to Gallbladder Fu, Liver Zang; Liver/GB are Yin/Yang, maintaining purity; hence "Purity Palace." Xun (SE) connects to Middle Burner Fu, Liver Collateral; Liver/Middle Burner are Yin/Yang, Liver collateral nourishes with blood, Middle Burner transforms qi; hence "Nourishment Transformation Palace." Li (S) connects to Small Intestine Fu, Heart Zang; Heart/SI are Zang/Fu, receiving and transforming; hence "Yang Receiving Palace." Kun (SW) connects to Stomach Fu, Spleen Zang; Spleen/Stomach are Zang/Fu, accepting food for life; hence "Food and Fluid Palace." Dui (W) connects to Lower Burner Fu, Kidney Collateral; Kidney/Lower Burner are Zang/Fu, governing Yin essence source; hence "Spring Gate Palace." Organ pairing follows *Neijing*. Triple Burner distributes to Liver/Kidney specifically for eye essence. Eyes open via Liver, governed by Kidney, hence dual connections. Left eye is Yang, moves clockwise; palaces follow clockwise order. Right eye is Yin, moves counter-clockwise; palaces follow counter-clockwise order. Observing both eyes reveals Yin/Yang directionality.
[Opening and Guiding Theory] Blood nourishes the eyes; sufficient and harmonious blood ensures health; deficiency/stagnation causes disease. Like water for plants: timely rain promotes growth; drought/flood destroys. This is driven by Qi. Heaven's Six Qi disharmony causes Yin/Yang imbalance, leading to drought/flood. Water levels vary, plant health varies; mistimed rain harms. Like landslides and floods overflowing channels, forcing embankment breaches to prevent drowning. Human Six Qi disharmony causes Water/Fire conflict, leading to blood/qi imbalance, Ying/Wei disorder. Yin deficiency with Fire excess causes chaotic flow, blocking meridians. Opening blockages and guiding stasis drains excess, preventing globe rupture, similar to warfare. The "Six" points refer to Yingxiang, Nei Pi (Inner Canthus), Shangxing, Ear Margin, and bilateral Taiyang points. Inner Canthus is the main assault, slow but steady. Taiyang points attack flanks, secondary effect. Shangxing cuts supply lines. Yingxiang attacks the enemy nest, fast but risky. Ear margin attacks cavalry, distant and less effective, avoided by wise practitioners. This is a critical rescue technique. Compared to trapping thieves indoors, opening doors to chase them is better. For mild pathogens, internal treatment suffices. For intense Yang Fire, opening/guiding is necessary; even if it causes temporary deficiency, internal medicine can restore it, preventing ulceration. This method has great merit and hidden risks. It saves lives but consumes essence. Only by assessing severity and deficiency/fullness can one avoid excess/deficiency errors, becoming a good physician.
[Eye Drops and Oral Medication Theory] Diseases are internal or external, treated differently. If internal disease exists without external signs, drops are useless. External red veins indicate minor initial pathogen or residual pathogen after resolution; drops can resolve them, oral medication is better. If internal disease is strong but untreated, relying only on drops is ineffective and may provoke disease. If both internal and external diseases exist, simultaneous internal and external treatment is required. People differ: some prefer pills, fear drops; some prefer drops, fear pills. Internal disease requires oral medication to cure; external disease requires drops to resolve. Clearing the stream is inferior to damming the source; cutting branches is inferior to chopping roots; stirring boiling water is inferior to removing firewood from under the pot. This is treating the root. I have never seen internal disease cured without oral medication. Dirt needs washing; mirrors need polishing; greasy pots need cleaning. This is treating the branch. I have never seen external cataracts resolved without drops. Treating internal cataracts with drops alone激 (provokes) Fire, disturbs blood/qi, causing harm. Treating with pills alone is also insufficient. For external cataracts, early floating/unstable stages may resolve with pills. Once formed, pills stop progression but do not remove the formation.