\r太极阴阳动静致病例\p05-c21b.bmp\r
经云∶瞳子眼黑法于阴，白眼赤脉法于阳。故阴阳合转而睛明，此则眼具阴阳也。
又曰∶五脏六腑之精气，皆上注于目，而为之睛，睛之窠为眼，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。后世五轮八廓之说，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，藏精于肝。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
脉皆属于目是也。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
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，邪害空窍，如天明则日月不明也。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
火者胞络也，主百脉，皆荣于目，既劳役运动，势乃妄行，及阴邪气并，损其血脉，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。
张子和曰∶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。故少年之人太过多，老年之人不及多，但年老之人，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。然阳明经起于两目旁交
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
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。凡血太多则滥，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，肝藏血，在五行属木，虽木之为物，太茂则蔽密，太衰则枯瘁矣。夫目
五轮，乃五脏六腑之精华，宗脉之所聚。其白睛属肺金，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，火益炽也。能治火者，一句可了。故《内经》云∶热胜则肿。凡目暴赤肿痛，羞明
瘾涩，泪出不止，暴寒目瞒者，皆太热之所为也。今列五轮所属，八廓主病，以令施治者指
南焉。
经文说：黑眼（瞳孔及周围黑色部分）的法度属于阴，白眼（巩膜及白色部分）和赤脉（血管）的法度属于阳。因此，阴阳协调转动则眼睛明亮，这说明眼睛具备阴阳的特性。
又说：五脏六腑的精气，都向上灌注于眼睛，从而形成视觉功能。眼眶称为“眼”，骨骼的精气表现为瞳孔，筋的气血精气表现为黑眼，血液的精气表现为络脉，眼眶中气的精气表现为白眼，肌肉的精气表现为眼睑（约束），它们包裹着筋骨气血的精气，并与经脉相连成为目系，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，大概就源于此。脏腑与眼睛的关系主要有两点：一是肝。经文说：东方青色，内通于肝，开窍于目，精气藏于肝。又说：人卧睡时血液回归肝脏，肝得到血液滋养就能视物。又说：肝气通达于目，肝气调和则眼睛能辨别五色。二是心。经文说：心与脉相合，所有脉络都归属于眼睛。到了李东垣又进一步推演涉及脾脏，如下文所述，李东垣说：《五脏生成篇》中说：所有脉络都归属于眼睛，眼睛得到血液滋养就能视物。《针经九卷·大惑论》中说：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，血脉运行逆行，邪气侵害空窍，就像天刚亮但日月无光一样。五脏六腑的精气，都禀受于脾土，并向上贯通于眼睛，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，不能使眼睛看清事物了。心是君火，主宰人的精神，应当安静安宁；相火代行其命令，相火即心包络，主管百脉，都荣养于眼睛，既然经过劳累运动，势态就会妄行，加上阴邪之气合并，损伤血脉，各种疾病就产生了。凡是医生不调理脾胃，也不养血安神，只治标不治本，是不明白正理的表现。
张子和说：圣人虽然说过眼睛得到血液滋养就能视物，然而血液也有过多和不足的情况。过多则眼睛壅塞而疼痛，不足则眼睛耗竭而失明。所以年轻人血液过多者多，老年人血液不足者多，但在老年人中，也有血液过多的情况，不可不仔细考察。眼的内眦，是太阳经起始的地方，血多气少；外眦，是少阳经所在，血少气多；上眼睑，是太阳经所在，也是血多气少；下眼睑，是阳明经所在，血气都多。然而阳明经起于两眼旁交汇之处，与太阳、少阳经都在眼睛处会合，只有足厥阴肝经，连接于目系而已。所以血液过多，是太阳、阳明经的实证；血液不足，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。少阳经不宜放血，因为它血少。刺太阳、阳明经放血，眼睛会更明亮；刺少阳经放血，眼睛会更昏暗。要知道不要使血液过多或过少，以养护血脉为主。凡血液太多则泛滥，太少则干枯。人受热则血液运行快且多，受寒则血液运行慢且少，这是常理。眼睛是肝的外在表现，肝藏血，在五行中属木，虽然木这种植物，过于茂盛则遮蔽严密，过于衰败则干枯憔悴。眼的五轮，是五脏六腑的精华，宗脉汇聚之处。白睛属肺金，肉轮（眼睑）属脾土，赤脉属心火，黑水神光（瞳孔及视力）属肾水，同时也兼属肝木，这是世俗都知道的了。等到发生眼疾，却不知道病的原理，怎么知道眼睛不因火邪就不会生病呢？为什么这样说？白轮变红，是火邪侵犯肺；肉轮红肿，是火邪侵犯脾；黑水神光被翳障遮挡，是火邪侵犯肝与肾。赤脉贯穿眼睛，是火势更加炽盛。能治疗火邪，一句话就可以解决。所以《内经》说：热邪胜则肿胀。凡是突然发生的眼睛红赤肿痛，怕光涩痛，流泪不止，突然受寒导致眼睛眯缝不开，都是太热所致。现在列出五轮的归属，八廓的主病，作为施治者的指南。
Case Study on Taiji, Yin-Yang, Motion, and Stillness Causing Eye Diseases
The Classic states: The pupil (Tongzi, referring to the black part of the eye) follows the principle of Yin, while the sclera (Baiyan, white part) and red vessels (Chimai, blood vessels) follow the principle of Yang. Therefore, when Yin and Yang coordinate and rotate, vision becomes clear; this indicates that the eye possesses both Yin and Yang characteristics.
It is also stated: The essence and qi of the Five Zang and Six Fu organs all ascend to the eyes, thereby forming visual function. The socket is called the "eye"; the essence of bone manifests as the pupil; the essence of sinew manifests as the black part of the eye (Heiyan); the essence of blood manifests as the collaterals (Luo); the essence of qi within the socket manifests as the white part of the eye (Baiyan); the essence of muscle manifests as the eyelids (Yueshu, constraints). These wrap and gather the essence of sinew, bone, Qi, and blood, connecting with the meridians to form the optic nerve system (Mu Xi), ascending to connect with the brain, and exiting posteriorly at the nape. This indicates that the eye embodies the functions of the Five Zang and Six Fu organs. The later theories of the Five Wheels (Wu Lun) and Eight Palaces (Ba Kuo) are likely based on this. There are two main aspects regarding the relationship between Zang-Fu organs and the eyes: one is the Liver. The Classic states: The color of the East is green, internally communicating with the Liver, opening into the eyes, and storing essence in the Liver. It further states: When a person sleeps, blood returns to the Liver; the Liver receives blood and thus can see. It also states: Liver Qi communicates with the eyes; when Liver Qi is harmonious, the eyes can distinguish the five colors. The second is the Heart. The Classic states: The Heart combines with the vessels, and all vessels belong to the eyes. Later, Li Dongyuan extended this theory to include the Spleen, as mentioned below: Li Dongyuan said: The *Chapter on the Generation of Five Zang* states: All vessels belong to the eyes, and the eyes can see when nourished by blood. The *Needle Classic, Nine Volumes · Da Huo Lun* states: If the mind is troubled and cluttered, diet is irregular, and labor/exertion is excessive, leading to Spleen-Stomach weakness and excessive Heart Fire, then the hundred vessels will boil, blood vessels will flow in reverse, and pathogenic factors will harm the orifices, similar to how the sun and moon lose their brightness at dawn. The essence and qi of the Five Zang and Six Fu organs are all derived from Spleen Earth and ascend to penetrate the eyes. The Spleen is the head of all Yin, and the eyes are the patriarch of Blood and Qi. Therefore, if the Spleen is deficient, the essence and qi of the Five Zang organs lose their control and cannot bring clarity to the eyes. The Heart is the Ministerial Fire (Jun Huo), governing the spirit of humans, and should be quiet and peaceful. The Ministerial Fire (Xiang Huo) acts on its behalf; the Ministerial Fire refers to the Pericardium Collateral (Bao Luo), which governs the hundred vessels and nourishes the eyes. Since physical exertion causes these forces to act recklessly, combined with Yin pathogenic qi damaging the blood vessels, various diseases arise. Any physician who does not regulate the Spleen and Stomach, nor nourish blood and calm the spirit, treating only symptoms and not the root, fails to understand the correct principles.
Zhang Zihe said: Although the Sages stated that the eyes can see when nourished by blood, blood can also be in excess or deficiency. Excess leads to eye congestion and pain; deficiency leads to eye exhaustion and blindness. Thus, young people tend to have excess, while old people tend to have deficiency. However, among the elderly, there are still cases of excess, which must not be overlooked. The inner canthus (Nei Nang) is where the Taiyang Meridian begins, characterized by abundant blood and scarce Qi; the outer canthus (Rui Nang) belongs to the Shaoyang Meridian, characterized by scarce blood and abundant Qi; the upper eyelid (Shang Gang) belongs to the Taiyang Meridian, also with abundant blood and scarce Qi; the lower eyelid (Xia Gang) belongs to the Yangming Meridian, with abundant blood and Qi. The Yangming Meridian originates at the junction beside the eyes, meeting with the Taiyang and Shaoyang meridians at the eye. Only the Foot-Jueyin Liver Meridian connects directly to the optic nerve system. Therefore, blood excess is an excess syndrome of the Taiyang and Yangming meridians, while blood deficiency is a deficiency syndrome of the Jueyin meridian. Hence, bloodletting therapy is suitable for the Taiyang and Yangming meridians because these two meridians have abundant blood. The Shaoyang meridian should not undergo bloodletting because it has scarce blood. Pricking the Taiyang and Yangming meridians to release blood makes the eyes clearer; pricking the Shaoyang meridian to release blood makes the eyes dimmer. One must know not to allow blood to be excessive or deficient, but rather to nourish the blood vessels. If blood is too much, it overflows; if too little, it dries up. Heat causes blood to flow fast and abundantly; cold causes blood to flow slow and sparingly; this is the general rule. The eyes are the external manifestation of the Liver. The Liver stores blood and belongs to Wood in the Five Elements. Although Wood plants, if too lush, become dense and obscuring; if too withered, they become dry and brittle. The Five Wheels of the eye are the essence of the Five Zang and Six Fu organs and the gathering place of the principal vessels. The white sclera belongs to Lung Metal; the flesh wheel (eyelids) belongs to Spleen Earth; the red vessels belong to Heart Fire; the black water and divine light (pupil and vision) belong to Kidney Water, and also relate to Liver Wood. This is known to the secular world. However, when eye diseases occur, people often do not understand the pathology. How can we say that eyes do not get sick without Fire? Consider this: Reddening of the white wheel indicates Fire invading the Lung; redness and swelling of the flesh wheel indicate Fire invading the Spleen; opacity covering the black water and divine light indicates Fire invading the Liver and Kidney. Red vessels penetrating the eye indicate intensifying Fire. Treating Fire resolves the issue in one sentence. Thus, the *Inner Classic* states: Excessive heat leads to swelling. All sudden cases of red, swollen, painful eyes, photophobia, astringency, continuous tearing, and squinting due to sudden cold are caused by excessive heat. Herein, the affiliations of the Five Wheels and the diseases governed by the Eight Palaces are listed as a guide for practitioners.