既述目色之提纲。当集目色之条目。谨按金匮要略云。目色青为痛。色黑为劳。色赤为风。色黄者便难。色
鲜明者有留饮。此固目色之要略也。然析而论之。又各不同。如白珠色赤者风也。目赤从内 始者。阴阳
二跷之病也。目色淡红者。虚热也。伤寒厥逆。目脉赤。睛不慧者。热多厥少也。面赤目脉赤。独头摇。卒口噤。
背反张者。痉也。少阳中风。两耳无所闻。目赤。胸中满而烦者。不可吐下。则悸而惊也。病者脉数无热。汗出
微烦。默默但欲卧。初得之三四日。目赤如鸠眼。七八日四 黑。若能食者。内痈之脓已成也。眼如醉眼而
含泪。发热腮赤。指梢冷者。痘疹也。伤寒目 红者。将发疹疡之兆也。疳病上攻于眼。时痒赤烂。眼胞肿疼。
白睛起膜。大时流泪。闭目羞明者。眼疳也。白珠色鲜明者。有留饮也。眼白失色者。胆蒸也。目色及目
肉。爪甲俱白者。血亏也。目下有卧蚕。面目鲜泽。脉伏者。病水而消渴也。面赤目白者。忧恚思虑。心气内索
也。面黑目白者。肾气内伤。病因留积也。肝先病。目则为之无色。肝前死。目则为之脱精者。神气先衰也。白
珠色青者痛也。面目青。身痛如被杖。咽喉痛者。阴毒也。面黄目青者。风入胃。胆气泄也。面目爪甲皆青。眼
生眵泪。摇头揉目。眼涩难睁。腹大筋青。羸瘦烦渴。粪青如苔者。肝疳也。白珠色黄者。小便难也。面赤目黄
者。心主所生病也。目黄善笑者。心所生病也。肥人目黄者。风热在阳明也。伤寒发汗已。身目为黄者。寒湿
在里不解也。尺脉浮。目睛晕黄者。衄未止也。目晕黄。去而慧了者。知衄今止也。外感目色若赤若黄者。邪
已传里也。白睛淡黄者。脾虚泄利也。目黄如金者。将发黄也。目黄且浊如烟熏者。黄胆湿甚也。目老黄色
者。湿热也。黄如橘明者。黄胆湿热也。面黄、目黄、溺黄、齿垢黄、爪甲上黄者。黄胆也。目黄白目胞肿者。谷疸
也。目淡黄色者。积聚也。目黄青紫脉芤者。瘀血在胸中也。妇人眉低眼皱。目色微黄。其脉阴搏阳别者。妊
子也。病患目黄而大烦。脉不和者。其病为进。以其邪胜也。黑珠纯是黄色者。凶证也。白珠色黑者。劳也。五
劳虚极羸瘦。腹满不能饮食。肌肤甲错。两目黯黑者。内有干血也。目黑颊赤者。痰也。目黑面黄者。四肢痿
痹也。面白目黑者。荣华已去。血脉空索也。瞳子内不见黑莹。或红紫。或青白者。血贯瞳仁。目病而人不久
也。瞳仁变绿者。绿水灌瞳仁。难治之症也。瞳黄唇白。面红中有青点者。中风之先兆也。瞳仁或微黄。或淡
白者。肾虚也。瞳仁或散大。或集小者。皆肾虚也。瞳仁散大。左右不均者。中风极险之证也。病者瞳仁渐散
渐大。不能舒缩。视一物见两形。手足摇颤。面色青白。身出冷汗。二便遗泄。不省人事者。死证也。瞳仁无光
彩。发黄者。肾气不足也。晚视不见。瞳子如金色者。名曰黄风。不治之证也。瞳仁黑减。或停滞不活者。目将
坏也。目无精光。牙齿黑者。瘰 不治之候也。目无精华者。肾精枯涸也。羸瘦气少无力。身无膏泽。眼无精
光。立不能定。身体苦痒者。精极也。眼目青盲者。精不灌目也。目无神者。寿促之征也。目无光者。命绝之候
也。目光晦暗者。此为神短。病死之候也。目光清莹。了了分明者。此为神足。不病之候也。若夫寒热瘰 。反
其目视之。中有赤脉。上下贯瞳子。见一脉。一岁死。见一脉半。一岁半死。见二脉。二岁死。见二脉半。二岁半
死。见三脉。三岁死。其赤脉不下贯瞳子者。可治也。此皆目之气色也。
既然已经阐述了目色诊断的总纲，现在应当汇集目色诊断的具体条目。谨依据《金匮要略》所述：目色发青主疼痛；色黑主劳损；色赤主风邪；色黄主大便困难；色泽鲜明者体内有留饮（水液停聚）。这确实是目色诊断的大致纲要。然而若进一步分析论述，则情况各不相同。例如：白眼球颜色发红是风邪所致；眼睛发红从内部开始的，是阴阳二跷脉（阴跷脉、阳跷脉）的病变；目色淡红的是虚热；伤寒病出现四肢厥冷，眼脉络发红，眼神呆滞无光的，是热多而厥少（阳气被郁，热盛于内）的表现；面部红赤，眼脉络发红，唯独头部摇动，突然牙关紧闭，角弓反张的，是痉病（以项背强直、口噤不开、角弓反张为特征的病证）；少阳中风，两耳听不见，眼睛红赤，胸中满闷而烦躁的，不可使用吐法和下法，否则会导致心悸和惊骇；患者脉数但身体无发热，出汗且轻微烦躁，沉默只想睡觉，初得病的三四天，眼睛红得像斑鸠的眼睛一样，到了七八天眼角变黑，如果能吃饭的，说明体内痈脓已经形成；眼睛像醉眼含着泪水，发热腮部红赤，手指梢头冷的，是痘疹；伤寒病眼睛发红的，是将要发出疹疡的先兆；疳病（小儿脾胃虚弱引起的慢性消耗性疾病）上攻于眼，时常瘙痒、红赤溃烂，眼睑肿胀疼痛，白眼球起膜，经常流泪，闭目畏光的，是眼疳；白眼球色泽鲜明的，是有留饮；眼白色泽失神的，是胆经有蒸热；目色及眼睑肉、指甲都白的，是血亏；眼下有卧蚕状浮肿，面目光泽，脉象沉伏的，是病水（水肿）兼消渴；面红目白的，是忧恚思虑导致心气内耗；面黑目白的，是肾气内伤，病因留积；肝脏先发病，眼睛就会失去神采（无色）；肝气将绝前死，眼睛就会脱精（神气衰败）；白眼球色青主痛；面目青，身体疼痛如被棍棒打过，咽喉痛的，是阴毒（寒毒深重之证）；面黄目青的，是风邪入胃，胆气外泄；面目指甲皆青，眼生眵泪，摇头揉眼，眼涩难睁，腹部胀大筋脉显露，消瘦烦渴，粪便青如苔藓的，是肝疳；白眼球色黄的，是小便困难；面赤目黄的，是心主所生的疾病；眼睛发黄且爱笑的，是心所生的疾病；肥胖人眼睛发黄的，是风热在阳明经；伤寒发汗后，身体和眼睛发黄的，是寒湿在里不解；尺脉浮，眼珠周围晕黄的，是鼻衄（流鼻血）未止；眼晕黄消退且眼神清爽的，知道鼻衄已止；外感病目色若赤若黄的，是邪气已传入里；白眼球淡黄的，是脾虚泄泻；眼睛黄如金子的，是将要发黄疸；眼睛黄且浑浊如烟熏的，是黄疸湿气很重；眼睛老黄色的，是湿热；黄如橘子明亮色的，是黄疸湿热；面黄、目黄、尿黄、齿垢黄、指甲上黄的，是黄疸；眼睛黄且眼睑肿的，是谷疸（因饮食不节引起的黄疸）；目淡黄色的，是积聚（腹内结块）；目黄伴青紫脉芤（中空无力）的，是瘀血在胸中；妇人眉毛低垂眼睛皱纹，目色微黄，脉象阴搏阳别的，是怀孕；病患眼睛黄且非常烦躁，脉象不和的，病情在进展，因为邪气胜；黑眼球纯是黄色的，是凶证；白眼球色黑的，是劳损；五劳（久视、久卧、久坐、久立、久行等过度劳累）虚极消瘦，腹部胀满不能饮食，肌肤甲错（皮肤干燥粗糙如鳞甲），两目黯黑的，是内有干血（瘀血日久化燥）；目黑颊赤的，是痰；目黑面黄的，是四肢痿痹（肢体软弱无力，运动障碍）；面白目黑的，是荣华已去，血脉空虚；瞳仁内不见黑亮光泽，或红紫，或青白的，是血贯瞳仁（眼底出血等严重眼病），目病而人不久也；瞳仁变绿的，是绿水灌瞳仁（绿内障等），难治之症；瞳仁黄嘴唇白，面红中有青点的，是中风的先兆；瞳仁或微黄，或淡白的，是肾虚；瞳仁或散大，或集小（缩小）的，都是肾虚；瞳仁散大，左右不均的，是中风的极险之证；病人瞳仁逐渐散大，不能舒缩，看一个物体见到两个形状（复视），手足摇颤，面色青白，身上出冷汗，大小便失禁，不省人事的，是死证；瞳仁无光彩，发黄的，是肾气不足；晚上看不见，瞳子如金色的，名叫黄风，是不治之证；瞳仁黑色减少，或停滞不活的，眼睛将要坏掉；目无精光，牙齿黑的，是瘰疬（颈部淋巴结结核）不治之候；目无精华的，是肾精枯涸；消瘦气少无力，身体没有光泽，眼睛无精光，站立不稳，身体苦痒的，是精极（精气极度亏损）；眼睛青盲（失明）的，是精不灌注于目；目无神的，是寿命短促的征兆；目无光的，是命绝的征候；目光晦暗的，这是神气短少，病死之候；目光清莹，清晰分明的，这是神气充足，不病的征候；至于寒热瘰疬，反过来观察其目视，中间有赤脉，上下贯穿瞳仁，见一条脉，一年死；见一条半脉，一年半死；见两条脉，两年死；见两条半脉，两年半死；见三条脉，三年死；其赤脉不向下贯穿瞳仁的，可以治疗。这些都是目之气色的表现。
Having discussed the general principles of eye color diagnosis, we now compile the specific entries. According to *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet): Eye color green indicates pain; black indicates exhaustion (Lao); red indicates wind; yellow indicates difficulty in defecation; and a bright, lustrous color indicates retained fluid (Liuyin). This constitutes the essential overview of eye color diagnosis. However, upon detailed analysis, the manifestations vary. For instance: Redness of the sclera indicates wind pathogen; redness starting from the interior of the eye indicates pathology of the Yin and Yang Qiao vessels (Yin Qiao Mai and Yang Qiao Mai); pale red eye color indicates deficiency-heat; in Taiyang Cold Damage with cold extremities, if the eye vessels are red and the eyes lack clarity, it indicates excess heat with insufficient yang circulation (Re Duo Jue Shao); if the face is red, eye vessels are red, accompanied by head tremor, sudden lockjaw, and opisthotonos, it is Jing disease (Spasm disease); in Shaoyang Wind Strike, with bilateral deafness, red eyes, chest fullness, and irritability, emetic and purgative methods must not be used, lest palpitations and fright occur; if the patient has a rapid pulse but no fever, sweating, slight irritability, and a desire to lie down silently, and after three to four days the eyes become red like a dove's eyes, turning black at the corners by the seventh or eighth day, yet the patient can eat, it indicates that an internal abscess pus has formed; eyes resembling drunken eyes holding tears, with fever, red cheeks, and cold fingertips indicate variola (smallpox) or exanthems; red eyes in Cold Damage indicate an impending eruption of rashes or sores; when Gan disease (infantile malnutrition syndrome) attacks the eyes, causing itching, redness, ulceration, swollen eyelids, membrane formation on the sclera, tearing, and photophobia, it is called Yan Gan (Eye Gan); bright white sclera indicates retained fluid; loss of luster in the sclera indicates steaming heat in the Gallbladder; whiteness in the eye color, eyelid flesh, and nails indicates blood deficiency; "lying silkworm" swelling under the eyes, glossy complexion, and deep pulse indicate water disease (Edema) combined with Xiao Ke (Wasting-Thirst); red face with white eyes indicates heart qi depletion due to worry and anxiety; black face with white eyes indicates kidney qi injury with stagnant pathogens; if the Liver is diseased first, the eyes lose their spirit (colorlessness); before death from liver failure, the eyes show depletion of essence (spirit decline); green sclera indicates pain; green face and eyes, body pain as if beaten, and sore throat indicate Yin Du (Yin Toxin); yellow face with green eyes indicates wind entering the Stomach and leakage of Gallbladder qi; green face, eyes, and nails, with discharge, head shaking, eye rubbing, dryness, abdominal distension with visible veins, emaciation, thirst, and green stool like moss indicates Gan Gan (Liver Gan); yellow sclera indicates difficult urination; red face with yellow eyes indicates disease originating from the Heart Master; yellow eyes with excessive laughter indicates disease of the Heart; yellow eyes in obese individuals indicate wind-heat in the Yangming channel; jaundice of the body and eyes after sweating in Cold Damage indicates unresolved cold-dampness in the interior; floating Radial Pulse (Chi Mai) with halos around the eyeballs indicates unceasing epistaxis; fading of the halos and return of clear vision indicate cessation of epistaxis; red or yellow eye colors in external contraction indicate transmission of pathogenic factors into the interior; pale yellow sclera indicates Spleen deficiency with diarrhea; golden-yellow eyes indicate impending jaundice; turbid, smoke-like yellow eyes indicate severe dampness in Jaundice; old yellow eyes indicate damp-heat; bright orange-yellow eyes indicate damp-heat in Jaundice; yellow face, eyes, urine, dental plaque, and nails indicate Jaundice; yellow eyes with swollen eyelids indicate Gu Dan (Grain Jaundice); pale yellow eyes indicate accumulation masses; yellow eyes with cyanotic, knotted pulses indicate blood stasis in the chest; low eyebrows, wrinkled eyes, slightly yellow eye color, and distinct yin pulse in women indicate pregnancy; yellow eyes with severe irritability and discordant pulse indicate disease progression due to excess pathogen; pure yellow iris indicates a fatal prognosis; black sclera indicates exhaustion; extreme deficiency from five labors, emaciation, abdominal fullness, anorexia, skin scaling, and dark eyes indicate internal dry blood (chronic blood stasis); black eyes with red cheeks indicate phlegm; black eyes with yellow face indicate limb flaccidity and bi-syndrome; white face with black eyes indicates loss of luster and empty blood vessels; absence of black luster in the pupil, or presence of red-purple or blue-white, indicates blood penetrating the pupil (severe ocular hemorrhage), a sign of imminent death; green pupil indicates Green Water Penetrating Pupil (glaucoma), a difficult-to-treat condition; yellow pupil with white lips and bluish spots on a red face indicates premonitory signs of stroke; slightly yellow or pale white pupils indicate Kidney deficiency; dilated or constricted pupils both indicate Kidney deficiency; asymmetrically dilated pupils indicate a critical stage of stroke; gradually dilating pupils unable to constrict, diplopia, tremors, cyanotic-pale face, cold sweat, incontinence, and unconsciousness indicate a fatal case; dull, yellowish pupils indicate insufficient Kidney qi; inability to see at night with golden pupils is named Huang Feng (Yellow Wind), an incurable condition; reduced or immobile black pigment in the pupil indicates impending blindness; lack of brilliance in eyes and black teeth indicate incurable Luoli (scrofula); lack of essence in eyes indicates exhaustion of Kidney essence; emaciation, shortness of breath, weakness, lack of bodily luster, dull eyes, instability, and pruritus indicate Jing Ji (Extreme Essence Depletion); blindness (Qing Mang) indicates essence failing to nourish the eyes; lack of spirit in eyes indicates shortened lifespan; lack of light in eyes indicates approaching death; dull gaze indicates shortness of spirit and impending death; clear, bright, and distinct gaze indicates sufficient spirit and health; regarding cold-heat and Luoli, observing the eye reveals red vessels passing through the pupil vertically: one vessel indicates death in one year; one and a half vessels in one and a half years; two vessels in two years; two and a half vessels in two and a half years; three vessels in three years; if the red vessels do not pass through the pupil, the condition is treatable. These are all manifestations of Qi and color in the eyes.