两目当空 ，墨白分明好，童时无大今无小，可知为至宝，可知为至宝。因何倏忽水干木槁，瞳神收缩精光
少，看看盲到老，看看盲到老。
此症谓金井倏尔收小，渐渐小如针孔也，盖因劳伤精血，阳火散乱，火衰不能鼓荡山泽之气生水滋木，致目
自凋，而水亦随涸，故肾络下缩，水轮上敛。甚则紧合无隙，生理残障终身矣。治宜大补气血，略带开郁镇邪，使无
形之火得以下降，有形之水因而上升，其血归元，而真气不损，或少挽回一二。
原案∶倪氏《原机》为强阳搏实阴之病，抄书奴皆从之。庭镜特辟其谬，可谓反古，窃亦有所见而云然。一
少年武闱下第，目忽不见，瞳神小如青葙子。某医谨遵渠，用抑阳酒连丸、搐鼻碧云散、还阴清肾等汤，未十日
死矣。又一老丈亦得此症，近视略见指动，人咸曰寿微，余曰∶病也。诊之脉沉迟而涩，饵以人参养荣及理阴煎
十余剂，视稍远。一戚属仍处倪方，竟失明。由此验之，其为阴阳两虚无疑。且即据《原机》而论，阳强阴实，
水火既济，何病之有？内无所伤，能睹不昏，何药之有？火强搏水，水实而自收，是犹月对照，固当明察秋毫，
何微觉 燥？况瞳神小者，金井小之也，于心胞络何事。至云，又有神水外围相类虫蚀，此眼目心腹之病，何止
边鄙皮肤。老朽疯话，公然梓以行世，不仁熟有甚焉。《瑶函》颇更其说，而仍录其方，根据次主治。非故口不从
心，处此决无佳谋。然则少者之死，与老者之瞽，皆天也。岂抑阳、清肾之为祸哉。剔灯孤
坐，忧从中来，不知涕之奚自。
抑阳清肾固不对症，然遇偏阳鳏夫，服亦或效，未足深非；碧云散，主风热蔽郁，目暴赤肿；搐鼻窍而喷嚏，
则邪从涕泪而泄。顾两肾自病，毫无表证，怎想到攻散法上，实可笑而不可解。
两只眼睛在眼眶中，黑白分明且状态良好，瞳孔大小正常，这可以说是珍贵的宝物，确实是珍贵的宝物。为何突然之间像水干涸、树木枯槁一样，瞳孔收缩，精气光芒减少，眼看就要盲到老，眼看就要盲到老。
这种病症称为“金井”（指瞳孔）突然收小，逐渐缩小如针孔一般。大概是因为劳损伤及精血，导致阳火散乱，火力衰弱不能鼓动山泽之气以生水滋木，致使眼睛自然凋谢，而肾水也随之枯竭，所以肾络向下收缩，水轮（指瞳神）向上收敛。严重时紧紧闭合没有缝隙，生理功能残损残疾终身了。治疗应当大补气血，略带疏解郁结和镇摄邪气的方法，使无形的火气得以下降，有形的津液因而上升，血液回归本源，真气不致受损，或许能挽回一二希望。
原始医案：倪维德《原机启微》将此病归为强阳搏实阴之病，抄书的人都遵从这一说法。黄庭镜特意驳斥其谬误，可谓违背古法，但我私下也有所见才这样说。有一个少年武举考试落第后，眼睛突然看不见，瞳孔小得像青葙子种子。某位医生严格遵守倪氏的说法，使用抑阳酒连丸、搐鼻碧云散、还阴清肾等汤剂，不到十天就死了。又有一位老翁也得了这个病，近视时还能略见手指晃动，人们都说他寿命短促，我说：“这是病。”诊脉沉迟而涩，服用人参养荣汤及理阴煎十余剂后，视力稍能看远。另一位亲戚仍沿用倪氏的方子，竟然失明了。由此验证，这无疑是阴阳两虚。况且即使依据《原机启微》来说，如果是阳强阴实，水火既济，会有什么病呢？体内没有受伤，能看清而不昏花，需要什么药呢？如果火强搏水，水实而自收，这就好比月亮对照太阳，本来应当明察秋毫，怎么会稍微觉得干燥呢？何况瞳孔小的，是金井小，与心包络有什么关系。至于说，又有神水外围相类似虫蚀的情况，这是眼目心腹的疾病，何止是边鄙皮肤的问题。老朽疯话，公然刊印流行于世，不仁还有比这更严重的吗？《瑶函》虽然修改了说法，但仍收录其方，按照次序主治。并非故意口不对心，处在此种情况下确实没有好办法。那么少年的死亡，与老者的失明，都是天命啊。难道是抑阳、清肾造成的祸害吗？剔灯独坐，忧愁从心中涌来，不知眼泪从何而来。
抑阳清肾固然不对症，然而遇到偏阳体质的鳏夫，服用或许有效，不值得深责；碧云散，主治风热蔽郁，眼睛突然红肿；通过搐鼻窍引起喷嚏，则邪气随涕泪排出。但是两肾自身生病，毫无表证，怎么能想到用攻散的方法上，实在可笑而不可理解。
Both eyes within the orbits, with clear distinction between black and white, in good condition; pupils are neither too large nor too small as in childhood, indicating they are a supreme treasure, truly a supreme treasure. Why do they suddenly become like dried water and withered wood, with pupil contraction and loss of essence and light, seemingly heading towards blindness until old age, seemingly heading towards blindness until old age.
This condition is referred to as the "Jingjing" (Golden Well, referring to the pupil) suddenly shrinking, gradually becoming as small as a needle hole. It is likely due to fatigue injuring essence and blood, causing Yang fire to scatter; the weakened fire fails to stir the Qi of mountains and marshes to generate water and nourish Wood, leading to the natural withering of the eyes and the subsequent drying up of Kidney Water. Consequently, the Kidney collaterals contract downward, and the Water Wheel (referring to the pupil) gathers upward. In severe cases, it closes tightly without any gap, resulting in lifelong physiological disability. Treatment should focus on greatly tonifying Qi and Blood, with slight methods to resolve depression and suppress pathogens, allowing formless Fire to descend and tangible fluids to ascend, so that Blood returns to its origin and True Qi remains undamaged, perhaps recovering one or two hopes.
Original Case: Ni Weide's *Yuanji Qiuwei* attributes this disease to Strong Yang clashing with Solid Yin, a view followed by copyists. Huang Tingjing specifically refutes this error, which may be considered contrary to ancient methods, but I state this based on my own observations. A young man who failed the military examination suddenly lost his sight, with pupils as small as seeds of *Celosia argentea*. A certain physician strictly followed Ni's approach, using Yiyang Jiulian Wan (Coptis Decoction for Suppressing Yang), Chubi Biyun San (Bi Yun Powder for Nasal Insufflation), and Huanyin Qing Shen Tang (Decoction for Nourishing Yin and Clearing Kidney), but the patient died within ten days. Another elderly gentleman suffered from the same condition; he could barely see finger movements when nearsighted. People said his lifespan was short, but I said, "It is a disease." His pulse was deep, slow, and choppy. After taking Renshen Yangrong Tang (Ginseng Decoction for Nourishing Ying) and Liyin Jian (Infusion for Regulating Yin) for more than ten doses, his vision improved slightly for distant objects. Another relative still used Ni's formula and eventually became blind. This verifies that it is undoubtedly a deficiency of both Yin and Yang. Furthermore, even according to *Yuanji Qiuwei*, if there were Strong Yang and Solid Yin with mutual interaction of Water and Fire, what disease would exist? If there is no internal injury, how can one see clearly without blurriness, requiring medication? If strong Fire clashes with Water, causing Water to solidify and contract, it is like the moon reflecting the sun; one should naturally see fine details clearly, why feel dryness? Moreover, a small pupil refers to a small Jingjing, what does this have to do with the Pericardium Collateral? As for the claim that there are cases resembling insect erosion around the outer edge of Shenshui (Divine Fluid), these are diseases of the eyes, heart, and abdomen, not merely peripheral skin issues. An old man's mad words are publicly printed and circulated; what greater inhumanity exists? *Yaohan* revised the theory but still recorded the formulas, listing them in order for treatment. It is not that I speak against my heart; under these circumstances, there is indeed no good strategy. Thus, the death of the youth and the blindness of the elder are matters of Heaven's will. Could it be the disaster caused by Yiyang and Qingren methods? Sitting alone by the trimmed lamp, sorrow rises from within, and I do not know where the tears come from.
Although Yiyang and Qingren are indeed inappropriate for this syndrome, for widowers with a Yang-biased constitution, taking them might yield some effect, so it is not worth severe criticism; Biyun San primarily treats wind-heat obstruction and depression, causing sudden redness and swelling of the eyes; insufflating into the nasal aperture induces sneezing, allowing pathogens to exit via mucus and tears. However, when the two Kidneys are diseased themselves, with no exterior symptoms, how can one think of using attacking and dispersing methods? This is truly laughable and incomprehensible.