或问曰，内经云、目受血而能视，掌受血而能握，指受血而能摄。又云、目者五脏六腑之精也。由此观之，
人必精气内充，而后能神采流露。何子治若卿费都督之疾，而以风药主之，曾亦思夫风药皆燥哉。答
曰、子但知夫归地杞菊之可以补水养血而明目乎。岂知都督身列戎行，风霜雨露之所感，浸淫其外，
蓄伏其中，数年之前曾患鹤膝风症，鹤膝者、风寒湿之痹于膝者也，嗣虽目赤多泪羞明，发则眉骨作
痛，谓之为水亏木旺，虚火肝阳上旋，固近似矣。不知人身一腑一脏，各相配合，脏阴腑阳阳升，阴降，所
以阳本升而必使之降，不降则有散越之忧，阴本降而必使之升，不升则有沦陷之虑。故脾为阴土，其
气上行，所以升其清，胃为阳土，其气下行，所以降其浊。故肝脏之气合脾脏之气上升，而心血以生，胆
腑之气，合胃腑之气下降，而命火以化。都督每发目疾，辄脉细濡而模糊，舌浓腻而色白。合诸前番鹤
膝等症，吾知其胃有湿寒，阳明不降，胆经之气，不能根据附胃气下行，肝木犹然上升，胆木忽失下降。至
但有肝升而无胆降，则肝之升也，不足以为化生心血之源，适足以成掀越鼓旋之害。目为肝窍，故欲
愈其目，必熄其肝，欲熄其肝，必降其胆，欲降其胆，必降其胃。胃何以不降湿，阻之也，风药所以胜湿，而
能疏其鼓旋掀越之势，所以经验屡屡也。又问曰、病发之时，全无痞满呕逆之类，何以为胃病，而了无
所疑乎。曰、大便必阻。所谓九窍不和皆胃病也。况病至则苔腻而浊，病退则浊苔全化，此见之于外者，
为可据也。阴虚者曾若是乎。又问曰、药既中病矣，何其频发而不获断绝其根蒂耶。曰、胃病传胆，胆病
传肝，本非肝脏之自病，而其始发数次，医以凉药折之，滋药补之，致鼓旋掀越之邪，深匿于络，所以根
蒂难除，一经外风而亦发者，即此意耳。又曰、曾闻风药不应，以柴胡愈之，何耶。曰、风药只能疏其掀越
之势，不能泄热，迨鼓旋于上，郁而生热，柴胡散胆经之专药，既能散其郁勃之气，复能解其郁结之热，
郁中有热，故风药不能治，而柴胡能治之也。又问曰、尝闻目疾之外，曾发胃痛，子以何法止之乎。曰、未
之止也。初发时理其气不应，温通不应，因忆五饮中之悬饮能作痛，投以星半劫之，大便畅行，而其痛
自止。此又胃病之一证矣。又问曰、曾闻胃痛之外，大发眩晕，岂能凡有疾苦，俱得谓之痰湿乎。曰、无痰
不成眩，吾以导痰汤下白金丸，如鼓应桴，非痰湿而何。或曰、吾喻之矣。子以目疾之发，非为肝虚，实因
胃有湿痰，阻其胆降，而肝升之太过也。胃痛者，胃为湿痰阻其气之通降也。眩晕者，即所谓胃痰聚而
胆逆也。其病虽殊，而其源则一。吾喻之矣。
有人问道：《内经》说，眼睛得到血的滋养就能视物，手掌得到血的滋养就能握持，手指得到血的滋养就能摄取。又说，眼睛是五脏六腑精气的汇聚之处。由此看来，人必须精气在内充盈，然后才能神采外现。为什么您治疗费都督若卿的疾病，却以祛风药为主治？难道没有考虑到祛风药大多性质燥烈吗？
我回答说：您只知道熟地黄、当归、枸杞子、菊花这些药物可以滋补肾水、养血明目，哪里知道都督身处军旅，长期感受风霜雨露，邪气浸淫于体表，潜伏于体内。几年前他曾患过鹤膝风症，所谓鹤膝风，就是风寒湿邪痹阻于膝关节所致。后来虽然出现眼睛发红、多泪、怕光等症状，发作时眉骨疼痛，人们认为这是肾水亏虚、肝木旺盛，导致虚火和肝阳上逆，这固然听起来有些道理。
但不知道人体每一腑一脏，都有相互配合的关系。脏属阴，腑属阳，阳气本应上升而必须使之下降，如果不下行，就有散失越出的忧虑；阴气本应下降而必须使之上升，如果不升发，就有沉沦陷下的顾虑。所以脾为阴土，其气上行，用来升发清阳；胃为阳土，其气下行，用来降泄浊阴。因此，肝脏之气配合脾脏之气上升，从而化生心血；胆腑之气配合胃腑之气下降，从而化生命门之火。
都督每次眼疾发作，脉象细弱濡软且模糊不清，舌苔厚腻且颜色白。结合他之前患过的鹤膝风等病症，我知道他是胃中有湿寒，阳明胃气不降，导致胆经之气不能依附胃气下行，肝木依然上升，而胆木突然失去下降的功能。既然只有肝气上升而没有胆气下降，那么肝气的上升，不足以成为化生心血的源头，反而足以造成气机掀动、旋越的危害。眼睛是肝的窍道，所以要治愈眼疾，必须平息肝气；要平息肝气，必须降低胆气；要降低胆气，必须降低胃气。
胃气为什么不降？是因为有湿邪阻滞。祛风药能够胜湿，并能疏通这种气机掀动旋越的趋势，所以屡次见效。
又问道：发病时，完全没有胸脘痞闷、呕吐逆气等症状，怎么能说是胃病，而且毫无怀疑呢？
我说：大便必然不通畅。这就是所谓的“九窍不和，皆属于胃”。况且病发时舌苔厚腻浑浊，病退时浊苔完全消退，这是表现在外部的证据，是可以依据的。阴虚证会有这种情况吗？
又问道：药物既然对症了，为什么病情频繁发作而不能断绝病根呢？
我说：胃病传变给胆，胆病传变给肝，这本来不是肝脏自身的病变。但在初期几次发作时，医生用凉药折损它，用滋阴药补益它，导致气机掀动旋越的邪气深伏于络脉之中，所以病根难以清除。一旦受到外风引动就会发作，就是这个意思。
又问：曾听说用祛风药无效，改用柴胡汤就好了，为什么呢？
我说：祛风药只能疏通气机掀动的趋势，不能清热。等到气机在上方鼓动旋转，郁结而生热时，柴胡是疏散胆经郁气的专用药，既能疏散其郁勃之气，又能解除其郁结之热。因为郁结中伴有热邪，所以祛风药不能治疗，而柴胡能治疗。
又问：曾听说除了眼疾之外，还发作胃痛，您用什么方法止住它的呢？
我说：并没有特意去止它。初发时调理气机无效，温通法也无效，于是想起五饮中的悬饮会导致疼痛，便投以天南星、半夏来攻逐痰饮，大便通畅后，疼痛自然停止。这也是胃病的一种证候。
又问：曾听说除了胃痛之外，还大发眩晕，难道所有的病痛都能称为痰湿吗？
我说：无痰不成眩，我用导痰汤送服白金丸，效果如击鼓应槌般迅速，如果不是痰湿是什么？
有人说：我明白了。您的意思是，眼疾的发作，不是因为肝虚，实在是因为胃中有湿痰，阻碍了胆气的下降，导致肝气上升太过。胃痛，是因为胃被湿痰阻碍，气机不能通降。眩晕，就是所谓的胃中痰聚而胆气上逆。虽然病症不同，但根源是一样的。我明白了。
A question was asked: The *Neijing* (Classic of Internal Medicine) states, "The eyes see when they receive blood; the palms grasp when they receive blood; the fingers manipulate when they receive blood." It also states, "The eyes are the essence of the five zang and six fu organs." From this, it can be observed that a person must have abundant jing-qi (vital essence and qi) internally before their spiritual brilliance can manifest externally. Why did you treat Governor Fei Ruqing's illness primarily with wind-dispelling herbs? Have you not considered that wind-dispelling herbs are generally drying in nature?
I replied: You only know that Shudi Huang Jing (Prepared Rehmannia Root), Dang Gui (Angelica Sinensis), Gou Qi Zi (Lycium Fruit), and Ju Hua (Chrysanthemum Flower) can nourish kidney water, nourish blood, and brighten the eyes. Do you not know that the Governor served in the military, exposed to wind, frost, rain, and dew, allowing pathogens to infiltrate the exterior and lie dormant within? Several years ago, he suffered from He Xi Feng (Crane Knee Wind, a type of bi syndrome affecting the knee joints). Crane Knee Wind refers to the obstruction of the knee joints by wind-cold-dampness. Later, although he experienced red eyes, excessive tearing, photophobia, and pain in the brow bones upon onset, people attributed this to Kidney Water Deficiency and Liver Wood Hyperactivity, causing deficient fire and liver yang to ascend. This interpretation is indeed plausible.
However, one must understand that every zang and fu organ in the body has specific cooperative relationships. Zang organs are yin, and fu organs are yang. Yang qi naturally ascends but must be guided to descend; if it does not descend, there is a risk of dispersion and hypermobility. Yin qi naturally descends but must be guided to ascend; if it does not ascend, there is a risk of sinking and collapse. Therefore, Pi (Spleen) is Yin Earth; its qi moves upward to raise the clear yang. Wei (Stomach) is Yang Earth; its qi moves downward to descend the turbid yin. Thus, Gan (Liver) qi combines with Pi qi to ascend, thereby generating Xin Xue (Heart Blood); Dan (Gallbladder) qi combines with Wei qi to descend, thereby transforming Ming Huo (Ministerial Fire).
Whenever the Governor's eye disease flares up, his pulse is fine, soggy, and indistinct, and his tongue coating is thick, greasy, and white. Considering his previous conditions such as Crane Knee Wind, I deduced that he had damp-cold in the Stomach, causing Yangming Stomach Qi to fail to descend. Consequently, Dan Jing (Gallbladder Meridian) Qi could not attach itself to Stomach Qi to descend. Meanwhile, Gan Mu (Liver Wood) continued to ascend, while Dan Mu (Gallbladder Wood) suddenly lost its ability to descend. With only Liver ascent and no Gallbladder descent, the Liver's ascent fails to serve as the source for generating Heart Blood and instead causes harmful turbulence and upward rebellion. Since the eyes are the orifice of the Liver, to cure the eyes, one must extinguish the Liver; to extinguish the Liver, one must descend the Gallbladder; to descend the Gallbladder, one must descend the Stomach.
Why does Stomach Qi fail to descend? Because it is obstructed by dampness. Wind-dispelling herbs can overcome dampness and unblock the trend of turbulent rebellion, which explains why they yielded repeated success.
Another question arose: At the time of onset, there were no symptoms such as chest/epigastric fullness or vomiting/regurgitation. How can you be certain it is a Stomach disease without doubt?
I answered: The stool must be obstructed/constipated. This aligns with the principle that "disharmony in the nine orifices all relates to the Stomach." Moreover, during the illness, the tongue coating is greasy and turbid; after recovery, the turbid coating completely disappears. This external manifestation provides reliable evidence. Would a Yin Deficiency pattern present like this?
Another question: If the medication was appropriate, why did the condition recur frequently without eradicating the root cause?
I answered: Stomach disease transmits to the Gallbladder, and Gallbladder disease transmits to the Liver. This is not originally a primary Liver disease. However, during the initial few episodes, physicians used cooling herbs to suppress it and yin-nourishing herbs to tonify it. This caused the pathogenic factor of turbulent rebellion to hide deeply within the collaterals, making the root difficult to eradicate. Once triggered by external wind, the disease recurs—this is the underlying mechanism.
Another question: I have heard that wind-dispelling herbs were ineffective, but Chai Hu Tang (Bupleurum Decoction) cured it. Why?
I answered: Wind-dispelling herbs can only unblock the trend of turbulent rebellion but cannot clear heat. When the qi rebels and rotates upward, stagnation generates heat. Chai Hu (Bupleuri Radix) is the specialized herb for dispersing Gallbladder meridian stagnation; it both dissipates stagnant, vigorous qi and resolves stagnant heat. Because there is heat within the stagnation, wind-dispelling herbs cannot treat it, whereas Chai Hu can.
Another question: I have heard that besides eye disease, stomach pain also occurred. What method did you use to stop it?
I answered: I did not specifically aim to stop it. Initially, regulating qi was ineffective, and warming/unblocking methods failed. I then recalled that Xuan Yin (Hanging Fluid), one of the Five Drinks, can cause pain. I administered Ban Xia (Pinelliae Rhizoma) and Tian Nan Xing (Arisaematis Rhizoma Preparata) to attack the phlegm-fluid retention. After the bowels moved freely, the pain ceased spontaneously. This is another manifestation of Stomach disease.
Another question: I have heard that besides stomach pain, severe vertigo also occurred. Can all ailments be attributed to phlegm-dampness?
I answered: Vertigo cannot occur without phlegm. I used Dao Tan Tang (Phlegm-Resolving Decoction) administered with Bai Jin Wan (White Gold Pill), achieving results as swift as striking a drum with a mallet. If this were not due to phlegm-dampness, what else would it be?
Someone said: I understand now. Your point is that the flare-up of eye disease is not due to Liver deficiency, but rather because damp-phlegm in the Stomach obstructs the descent of Gallbladder Qi, leading to excessive ascent of Liver Qi. Stomach pain occurs because the Stomach is obstructed by damp-phlegm, preventing the smooth descent of Qi. Vertigo is what is referred to as Phlegm accumulation in the Stomach with rebellious Gallbladder Qi. Although the diseases differ, their source is identical. I comprehend your explanation.