赵养癸曰∶经曰五脏六腑之精，皆上注于目而为之精，肾藏精，故治目者以肾为主。目虽肝之窍，子母
相生，肾肝同一治也。华元化云∶目形类丸，瞳神居中而前，如日月之丽东南而晦西北也。有神膏、神水、
神光、真气、真血、真精，此滋目之源液山。神膏者，目内包涵膏液，此膏由胆中渗润精汁而成者，能涵养
瞳神，衰则有损。神水者，由三焦而发源，先天真一元气所化，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。亏多益少，是以世无全精之目。神光者，原于命门，通于胆，发
于心，火之用事也。火衰则有昏瞑之患，火炎则有焚燥之殃。虽有两心，而无正轮。心，君主也，通于大 ，
故大 赤者，实火也；命门为小心，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。真血者，即肝中升运滋目注络之血也，此血非比肌肉间易行之血，即天一所生之水，
故谓之真也。真气者，即目之经络中往来生用之气，乃先天真一发生之元阳也。真精者，乃先天元气所化精汁
，起于肾，施于胆，而后及瞳神也。乃此数者，一有损目则病矣。
大概目圆而长，外有坚壳数重，中有消脆肉包黑稠神膏一函。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，是肾胆所聚之精华。惟此一点，烛照鉴视空阔无穷者，是曰水轮，内应于肾，北方壬癸
亥子之水也。五轮之中，惟瞳神乃照。或曰瞳神水耶，气耶，血耶，膏耶？曰∶非气，非血，非水，非膏，乃
先天之气所生，后天之气所成，阴阳之妙蕴，水火之精华，血养水，水养膏，膏护瞳神。气为运用，神即维
持。喻以日月，理实同之。男子右目不如左目精华，女子左目不如右目光彩，此皆各得其阴阳气分之正也。
许学士云，经曰足少阴之脉，是动则病坐而欲起，目KT KT 如无所见。又曰∶少阴所谓起则目KT KT
无所见者，阴内夺，故目KT KT 无所见也。此盖房劳目昏也。左肾阴虚，益阴地黄丸、六味丸；右肾阳虚，
八味丸、补肾丸。
东垣曰能远视而不能近视者，阳有余、阴气不足也。阴精不足，阳光有余，病于水者，此光华发见散
乱，而不能收敛近视。治之在心肾，心肾平则水火调而阴阳和。夫水之所化为血，在身为津液，在目为膏汁。
若贪淫欲，饥饱失节，形脉劳甚，过于悲泣，能斫丧真阴，阴精亏则阳火盛，火性炎而发见，阴精不能制伏
挽回，故越于外而远照，不能近之而反视也，治之当壮水之主以制阳光。能近视不能远视，阳不足，阴气有余
也。阳不足，阴有余，病于火者，故光华不能发越于外，而猥敛近视耳。治之在胆肾，胆肾足则木火通明，
神气宣畅，而精华远达矣。夫心之所用为气，在身为威仪，在目为神光。若纵恣色欲，丧其元阳，元阳既惫，
则云霾阴翳，肾中之阴水仅足以回光自照耳，焉能健运精汁以滋于胆，而使水中之火远布于空中？治之当益火
之源以消阴翳。
以上诸证，皆阴弱不能配阳，内障之病。其病无眵泪痛痒、羞明紧涩之证，初但昏如雾露中行，渐
空中有黑花，又
渐睹物成二体，又则光不收，遂为废疾。患者宜养先天根本，乘其初时而治之。况此病最难疗，服药必积
岁月，绝酒色，毋饥饱劳役，驱七情五贼，庶几有效，不然终不复也。世人不察，谓目昏无伤，及病成翳，直
曰热，致竟用凉药，药又伤胃，况凉为秋金，肝为春木，又伤肝矣，往往致废而后已。悲夫！
又有阳虚不能抗阴者。若因饮食失节，劳役过度，脾胃虚弱，下陷于肾肝，浊阴不能下降，清阳不能
上升，天明则日月不明，邪害空窍，令人耳目不明。夫五脏六腑之精，皆禀受于脾胃，而上贯于目。脾者
阴之首，目者血气之宗，故脾虚则五脏之精皆失所司，不能归明于目矣。况胃气下陷于肾肝，名曰重强，相火
挟心火而妄行，百脉沸腾，血气逆上，而目病矣。若两目昏暗，四肢不怠者，用东垣益气聪明汤。若两目紧
小，差明畏日者，或视物无力，肢体倦息，或手足麻木，乃脾肺气虚。不能上行也，用神效黄 汤。若病后，
或日晡，或灯下不能视者，阳虚下陷也，用决明夜光丸，或升麻镇阴汤。
张子和曰∶目不因火则不病，白轮病赤，火乘肺也；肉轮赤肿，火乘脾也；黑水神光被翳，火乘肝
与脾也；赤脉贯目，火自甚也。能治火者，一句可了。但子和一味寒凉治火，余独补水以配火，亦一句可了。至于
六淫七情，错杂诸证，见《原机启微》。而薛立斋又为之参补，深明壮水益火之法。其于治目，精于古矣。
赵养葵说：《内经》记载，五脏六腑的精气，都上注于眼睛，从而形成视觉的精华。肾主藏精，所以治疗眼病以补肾为主。眼睛虽然是肝的外窍，但肝肾之间母子相生，肾与肝在治疗上是相通的。华佗说：眼睛的形状像球体，瞳孔位于中央且向前突出，就像太阳和月亮照耀东南方而西北方昏暗一样。眼睛中有神膏、神水、神光、真气、真血、真精，这些是滋养眼睛的源头津液。所谓神膏，是指包裹在眼球内部的膏状液体，这种膏由胆中渗出的精汁滋润而成，能够涵养瞳孔，如果亏损就会造成损伤。所谓神水，是由三焦发源，由先天真一元气所化生，是滋润眼睛表面的水分。如果神水不足，就会有火旺燥烈的祸患；如果神水枯竭，就会导致眼睑大小异常的疾病；如果耗损干涩，就会有视力昏蒙的危险。亏损多而补充少，所以世上没有完全精良的眼睛。所谓神光，起源于命门，通达于胆，发源于心，属于火的作用。如果火衰，就会有昏瞑的祸患；如果火炎上，就会有焚烤干燥的灾殃。虽然有两个心（指君火与相火），但没有正中的轮廓。心是君主之官，通达于大络，所以大络发红，是实火；命门是小火，小火即相火，代替君主行使命令，通达于小络，所以小络发红，是虚火。如果君主（心）保持静默，那么相火自然清静安宁。所谓真血，就是肝脏中升运滋养眼睛脉络的血，这种血不同于肌肉间容易运行的血，它是天一之水所生，所以称为真。所谓真气，就是在眼睛经络中往来产生作用的气，是先天真一发生作用的元阳。所谓真精，是先天元气所化的精汁，起于肾，施用于胆，然后才到达瞳孔。这几种物质，只要有一种受损，眼睛就会生病。
大概眼睛呈圆形且长，外面有几层坚硬的壳，中间有消脆的肉包裹着黑色的稠厚神膏。膏的外面是白色的稠厚神水，水用来滋润膏；水的外面都是血，血用来滋润水；膏中间的一点黑色晶莹之物，是肾和胆汇聚的精华。只有这一点，能烛照鉴视无穷的空阔，这就是水轮，内应于肾，对应北方壬癸亥子的水。在五轮之中，只有瞳孔具有照明的功能。有人问：瞳孔是水呢？是气呢？是血呢？是膏呢？回答说：不是气，不是血，不是水，不是膏，而是由先天之气所生，后天之气所成，是阴阳奥妙的蕴藏，水火精华的结合，血滋养水，水滋养膏，膏保护瞳孔。气负责运用，神负责维持。用日月来比喻，道理其实是一样的。男子的右眼不如左眼精华足，女子的左眼不如右眼光彩好，这都是各自得到阴阳气分的正道。
许学士说：《内经》记载，足少阴肾经脉动时，病症表现为坐着想起来，眼睛KT KT（视物模糊不清）好像看不见东西。又说：少阴经所说的“站起来就眼睛KT KT看不见”，是因为阴气内部被夺失，所以眼睛KT KT看不见。这大概是房劳过度导致的眼昏。如果是左肾阴虚，用益阴地黄丸、六味地黄丸；如果是右肾阳虚，用八味丸、补肾丸。
李东垣说：能看远但不能看近的人，是阳气有余、阴气不足。阴精不足，阳光有余，病变在于水，这是因为光华发散散乱，而不能收敛来看近处。治疗要用心肾，心肾平和则水火调和而阴阳平衡。水所化生的为血，在身体里为津液，在眼睛里为膏汁。如果贪恋淫欲，饥饱失调，形体脉象劳累过度，过于悲伤哭泣，会斫丧真阴，阴精亏损则阳火旺盛，火性炎上而发散，阴精不能制约挽回，所以光芒越出体外向远处照射，不能近距离反向视物。治疗应当壮水之主以制阳光。能看近但不能看远的人，是阳气不足，阴气有余。阳气不足，阴气有余，病变在于火，所以光华不能发散于外，而只能收敛来看近处。治疗要在胆肾，胆肾充足则木火通明，神气宣畅，精华就能远达。心的作用为气，在身体里体现为威仪，在眼睛里体现为神光。如果放纵色欲，丧失元阳，元阳已经疲惫，就会产生云霾阴翳，肾中的阴水仅足以回光自照罢了，怎么能健运精汁以滋养胆，而使水中的火远布于空中？治疗应当益火之源以消阴翳。
以上各种证候，都是阴弱不能配阳，属于内障疾病。这种病没有眵泪痛痒、羞明紧涩的症状，起初只是像雾露中行路一样昏蒙，逐渐觉得空中有黑花，又逐渐看到物体变成两个影像，再后来光线不收摄，最终成为废疾。患者应该保养先天的根本，趁病情初起时治疗。况且这种病最难治疗，服药必须积累岁月，戒绝酒色，不要饥饱劳役，驱除七情五贼，或许有效，否则终究无法恢复。世人不加考察，认为眼昏无伤，等到病成翳障，直接说是热，导致竟然使用凉药，药物又伤了胃，况且凉药属秋金，肝属春木，又伤了肝，往往导致致残后才停止。可悲啊！
又有阳气虚弱不能抵抗阴邪的情况。如果因为饮食不节，劳役过度，脾胃虚弱，下陷于肾肝，浊阴不能下降，清阳不能上升，天亮后日月就不明亮，邪气侵害空窍，使人耳目不明。五脏六腑的精气，都禀受于脾胃，而上贯于眼睛。脾是阴之首，眼睛是血气的宗汇，所以脾虚则五脏的精气都失去主管，不能归明于眼睛了。况且胃气下陷于肾肝，名叫重强，相火挟带心火妄行，百脉沸腾，血气逆上，从而导致眼病。如果两眼昏暗，四肢不怠慢的，用李东垣的益气聪明汤。如果两眼紧缩变小，稍微明亮就畏日光的，或者视物无力，肢体疲倦懈怠，或者手足麻木，这是脾肺气虚，不能上行，用神效黄芪汤。如果病后，或者傍晚，或者在灯光下不能视物的，是阳虚下陷，用决明夜光丸，或者升麻镇阴汤。
张子和说：眼睛不因火就不会生病，白轮（巩膜）发红，是火乘肺；肉轮（眼睑）赤肿，是火乘脾；黑水神光被翳障遮挡，是火乘肝与脾；赤脉贯穿眼睛，是火气极盛。能治火的，一句话就可以解决。但张子和只用一味寒凉药治火，我唯独通过补水来配火，也是一句话就可以解决。至于六淫七情，错杂的各种证候，见《原机启微》。薛立斋又为之参补，深刻阐明壮水益火的方法。他对于治疗眼病，精通古法。
Zhao Yangkui stated: The *Classic of Internal Medicine* (*Huangdi Neijing*) records that the essence of the five zang and six fu organs all ascend to the eyes, thereby forming the essence of vision. The Kidney stores essence; therefore, in treating eye diseases, emphasis is placed on the Kidney. Although the eyes are the orifice of the Liver, due to the mutual generation between mother (Kidney) and child (Liver), the treatment of the Kidney and Liver is unified. Hua Tuo said: The shape of the eye resembles a sphere, with the pupil located centrally and protruding forward, similar to how the sun and moon shine upon the southeast while the northwest remains dim. Within the eye exist Shen Gao (Divine Paste), Shen Shui (Divine Water), Shen Guang (Divine Light), Zhen Qi (True Qi), Zhen Xue (True Blood), and Zhen Jing (True Essence); these are the source fluids that nourish the eye.
Shen Gao refers to the paste-like fluid contained within the eyeball, formed by the seepage and moistening of essence juice from the Gallbladder, which can nourish and protect the pupil; if deficient, it causes damage. Shen Shui originates from the San Jiao (Triple Burner), transformed from the primordial True One Yuan Qi, serving as the water that moistens the surface of the eye. If Shen Shui is deficient, there is a risk of excessive fire causing dryness and agitation; if exhausted, it leads to disorders of the eyelids' size; if consumed and dry, it brings the danger of visual obscurity. Since loss exceeds gain, there are no perfectly clear eyes in the world.
Shen Guang originates from the Mingmen (Gate of Life), connects to the Gallbladder, issues from the Heart, and pertains to the function of Fire. If Fire is deficient, there is a risk of dizziness and blindness; if Fire flares up, there is the disaster of burning and dryness. Although there are two "Hearts" (referring to Ministerial Fire and Sovereign Fire), there is no central wheel. The Heart is the Sovereign, connecting to the large collaterals; thus, redness in the large collaterals indicates Excess Fire. The Mingmen is the Small Fire, i.e., Ministerial Fire, acting on behalf of the Sovereign, connecting to the small collaterals; thus, redness in the small collaterals indicates Deficient Fire. If the Sovereign remains still and silent, Ministerial Fire naturally becomes clear and tranquil.
Zhen Xue is the blood rising and transporting from the Liver to nourish the eye collaterals; this blood differs from the easily flowing blood in muscles, being generated from the Water of Tian Yi (One), hence called "True." Zhen Qi is the qi circulating and functioning within the eye's meridians, which is the primordial Yang of the innate True One. Zhen Jing is the essence juice transformed from innate Yuan Qi, starting from the Kidney, applied to the Gallbladder, and then reaching the pupil. If any of these are damaged, eye disease ensues.
Generally, the eye is round and elongated, surrounded externally by several layers of hard shell, internally containing soft meat wrapping the black, thick Shen Gao. Outside the paste is white, thick Shen Shui, which nourishes the paste; outside the water is blood, which nourishes the water. The single point of black brilliance within the paste is the refined essence gathered by the Kidney and Gallbladder. Only this point illuminates and inspects infinite space, known as the Water Wheel, corresponding internally to the Kidney and the Water of Ren-Gui Hai-Zi in the North. Among the Five Wheels, only the pupil has the function of illumination. Some ask: Is the pupil water? Qi? Blood? Paste? The answer is: It is neither Qi, nor Blood, nor Water, nor Paste. It is generated by innate Qi, completed by acquired Qi, embodying the subtle mystery of Yin and Yang, and the essence of Water and Fire. Blood nourishes Water, Water nourishes Paste, and Paste protects the Pupil. Qi governs operation, and Spirit maintains stability. Using the Sun and Moon as an analogy, the principle is identical. In men, the right eye is less refined than the left; in women, the left eye is less brilliant than the right. This is because each obtains the correct balance of Yin and Yang Qi distribution.
Scholar Xu stated: The *Classic* says that when the Foot Shaoyin (Kidney) meridian moves, the disease manifests as sitting but wanting to rise, with eyes appearing blurry (*KT KT*, indicating blurred vision) as if unable to see. It also states: What Shaoyin calls "rising leads to blurry vision" occurs because Yin is internally depleted, leading to inability to see clearly. This is likely eye dimness caused by sexual exhaustion. For Left Kidney Yin deficiency, use Yiyin Dihuang Wan (Benefit-Yin Rehmannia Pill) or Liuwei Wan (Six-Ingredient Pill). For Right Kidney Yang deficiency, use Bawei Wan (Eight-Ingredient Pill) or Bushen Wan (Tonify-Kidney Pill).
Li Dongyuan stated: Those who can see far but not near have Excess Yang and Insufficient Yin. With insufficient Yin essence and excess Solar Light, the pathology lies in Water. The brilliance scatters and cannot converge for near vision. Treatment focuses on the Heart and Kidney; when balanced, Water and Fire harmonize, and Yin and Yang equilibrate. Water transforms into Blood, serves as Jin Ye (Body Fluids) in the body, and as Gao Zhi (Paste Juice) in the eyes. If one indulges in lust, suffers irregular eating, experiences severe physical/meridian fatigue, or excessive weeping, it damages True Yin. When Yin essence is deficient, Yang Fire flourishes. Due to its flaming nature, it disperses outward, and since Yin cannot restrain it, the light projects far outward, preventing near vision. Treatment should strengthen the Master of Water to control Solar Light.
Those who can see near but not far have Insufficient Yang and Excess Yin. With Yang deficiency and Yin excess, the pathology lies in Fire. Thus, brilliance cannot project outward and is constrained for near vision. Treatment focuses on the Gallbladder and Kidney; when sufficient, Wood and Fire become bright, Shen Qi flows freely, and essence reaches far. The Heart's function is Qi, manifesting as demeanor in the body and Shen Guang in the eyes. If one indulges in lust, losing Yuan Yang, and Yuan Yang becomes exhausted, cloud-like haze and shadow appear. The Yin Water in the Kidney is only enough to reflect light inward; it cannot vigorously transport essence juice to nourish the Gallbladder, nor allow the Fire within Water to spread far into the sky. Treatment should benefit the Source of Fire to dissipate Yin shadows.
All the above syndromes involve Yin weakness failing to match Yang, constituting internal cataract diseases. These present without discharge, tearing, pain, itching, photophobia, or tightness/dryness. Initially, vision is like walking through fog or dew; gradually, black spots appear in the air; then objects appear double; finally, light does not gather, resulting in disability. Patients should nourish the root of Innate Constitution and treat early. This disease is difficult to cure; medication requires years. One must abstain from alcohol and sex, avoid irregular eating and overwork, and dispel the Seven Emotions and Five Thieves. Otherwise, recovery is unlikely. People fail to realize that eye dimness is harmless initially; once cataracts form, they mistakenly attribute it to Heat, using cooling medicines that damage the Stomach. Since Cooling corresponds to Autumn Metal and the Liver to Spring Wood, this further injures the Liver, often leading to permanent disability. How sad!
There are also cases where Yang deficiency fails to resist Yin. Due to irregular diet and overwork, Spleen-Stomach weakness causes Qi to sink into the Kidney and Liver. Turbid Yin fails to descend, and Clear Yang fails to ascend. Like the sun and moon obscured at dawn, pathogenic factors harm the orifices, causing deafness and blindness. The essence of the five zang and six fu organs relies on the Spleen-Stomach and ascends to the eyes. The Spleen is the head of Yin, and the eyes are the congregation of Blood and Qi. Thus, Spleen deficiency causes the essence of all organs to lose control, failing to clarify the eyes. Furthermore, if Stomach Qi sinks into the Kidney-Liver, termed "Chong Qiang" (Heavy Rigidity), Ministerial Fire carries Heart Fire to run wild, boiling the vessels, causing Qi and Blood to rebel upward, leading to eye disease.
For dim vision in both eyes with non-fatigued limbs, use Li Dongyuan's Yiqi Congming Tang (Qi-Supplementing Brilliance-Decoction). For eyes that feel tight/small, fear sunlight even when slightly bright, or have weak vision, limb fatigue, or numbness in hands/feet, indicating Spleen-Lung Qi deficiency failing to ascend, use Shenxiao Huangqi Tang (Miraculous Astragalus Decoction). For post-illness vision loss, or inability to see at dusk or under lamplight, indicating Yang deficiency sinking, use Jueming Yeguang Wan (Clear-Bright Night-Light Pill) or Shengma Zhenyin Tang (Cimicifuga Subduing-Yin Decoction).
Zhang Zihe stated: Eye diseases arise from Fire. Redness of the White Wheel (Sclera) indicates Fire invading the Lung; redness and swelling of the Meat Wheel (Eyelids) indicate Fire invading the Spleen; obstruction of the Black Water and Divine Light indicates Fire invading the Liver and Spleen; red vessels penetrating the eye indicate extreme Fire. Treating Fire can be summarized in one sentence. However, Zhang Zihe used only cold-cooling herbs to treat Fire. I alone use tonifying Water to balance Fire, which is also one sentence. For complex syndromes of Six Evils and Seven Emotions, see *Yuanji Qiwei*. Xue Lizhai supplemented this, deeply clarifying methods of strengthening Water and benefiting Fire. His expertise in treating eye diseases was profound and rooted in ancient wisdom.