目痕有二，一谓目 白眼痛，一谓目珠黑眼痛。盖目 白眼疼属阳，故昼则疼甚，点苦寒药则效。经所谓白
眼赤脉，法于阳故也。目珠黑眼疼属阴，故夜则疼甚，点苦寒则反剧。经所谓瞳子黑眼，法于阴故也。
娄全善云∶夏枯草治目珠疼，至夜则疼甚者
神效。或用苦寒药点眼上反疼甚者，亦神效。盖目珠者连目本，目本又名目系，属厥阴之经也。夜甚
及用苦寒点之反甚者，夜与寒亦阴故也。丹溪云∶夏枯草有补养厥阴血脉之功，其草三四月开花，遇
夏至阴生则枯，盖禀纯阳之气也。故治厥阴目疼如神者，以阳治阴也。予周师目珠疼，及连眉棱骨痛，
及头半边肿痛，遇夜则作，用黄连膏子点上则反大疼，诸药不效，灸厥阴、少阳则疼随止，半月又作，
又灸又止者月余，遂以夏枯草二两，香附二两，甘草四钱，同为细末。每服一钱五分，用茶清调服。
下咽则疼减大半，至四五日良愈。又一男子年六十岁，亦目珠连眉棱骨痛，夜甚，用苦寒剂点亦甚，
与前证皆同，但有白翳二点在黑目及外 ，与翳药皆不效。亦以此药间东垣选奇汤，又加四物黄连煎
服，并灸厥阴、少阳而安。倪仲贤论七情五贼劳役饥饱之病云∶阴阳应象大论曰，天有四时，以生长
收藏，以生寒暑燥湿风。寒暑燥湿风之发耶，发而皆宜时，则万物俱生。寒暑燥湿风之发耶，发而皆
不宜时，则万物俱死。故曰生于四时，死于四时。又曰人之五脏，化为五气，以生喜怒忧悲恐。喜怒
忧悲恐之发耶，发而皆中节，则九窍俱生。喜怒忧悲恐之发耶，发而皆不中节，则九窍俱死。故曰生
于五脏，死于五脏。目，窍之一也。光明视见，
纳山川之大，及毫芒之细，悉云霄之高，尽泉沙之深。至于鉴无穷为有穷，而有穷又不能为穷，反而
聚之，则乍张乍敛，乍动乍静，为一泓一点之微者，岂力为强致而能此乎，是皆生生自然之道也。或
因七情内伤，五贼外攘，饥饱不节，劳役异常，足阳明胃之脉，足太阴脾之脉，为戊己二土，生生之
源也。七情五贼，总伤二脉，饥饱伤胃，劳役伤脾，戊己既病，则生生自然之体，不能为生生自然之
用，故致其病，曰七情五贼劳役饥饱之病。其病红赤睛珠痛，痛如刺刺，应太阳。眼睫无力，常欲垂
闭，不敢久视，久视则酸疼。生翳者成陷下，所陷者，或圆或方，或长或短，或如点，或如缕，或如
锥，或如凿。有犯此者，柴胡复生汤主之，黄连羊肝丸主之。睛痛甚者，当归养荣汤主之，助阳活血
汤主之，加减地黄丸主之，决明益阴丸主之，加当归黄连羊肝丸主之，龙脑黄连膏主之。以上数方，
皆群队升发阳气之药，其中有用黄连黄芩之类者，去五贼也。搐鼻碧云散，亦可间用。最忌大黄、芒
硝、牵牛、石膏、栀子之剂，犯所忌则病愈剧。又论亡血过多之病曰∶六节脏象
论曰，肝受血而能视。宣明五气篇曰，久视伤血。气厥论曰，胆移热于脑，则辛 鼻渊，传为衄 瞑
目。四时刺逆从论曰，冬刺经脉，血气皆脱，令人目不明。由此推之，目为血所养明矣。手少阴心生
血，血荣于目，足厥阴肝开窍于目，肝亦主血，故血亡目病，男子衄血、便血，妇人产后崩漏，亡之
过多者，皆能病焉。其证睛珠痛，珠痛不能视，羞明瘾涩，眼睫无力，眉骨太阳因为酸疼。芎归补血
汤主之，当归养荣汤主之，除风益损汤主之，滋阴地黄丸主之。诸有热者，加黄芩。妇人产漏者，加
阿胶。脾胃不佳，恶心不进食者，加生姜。复其血，使得其所养则愈。然要忌咸物。宣明五气篇曰∶
咸走血，血病无多食咸是也。
【白眼痛】多有赤脉，视其从上而下者，太阳病也，羌活为使。从下而
上者，阳明病也，升麻为使。从外走内者，少阳病也，柴胡为使。太阳病宜温之散之，阳明病宜下之，
少阳病宜和之。又恶寒脉浮为有表，宜选奇汤、防风饮子等散之。脉实有力，大腑闭，为有里，宜泻
青丸、洗肝散等微利之。亦有不肿不红，但沙涩昏痛者，乃气分隐伏之火，脾肺络有湿热，秋天多有
此患，故俗谓之稻芒赤，亦曰白赤眼也。通用桑白皮散、玄参
丸、泻肺汤、大黄丸、洗眼青皮汤、朱砂煎。
【天行赤热证】目赤痛，或睥肿头重，怕热羞明，涕泪
交流等证，一家之内，一里之中，往往老幼相传者是也。然有虚实轻重不同，亦因人之虚实，时气之
轻重何如，各随其所以，而分经络以发病，有变为重病者，有变为轻病者，有不治而愈者，不可概言。
此一章专为天时流行热邪相感染，而人或素有目疾，及痰火热病，水少元虚者，则尔我传染不一。其
丝脉虽多赤乱，不可以为赤丝乱脉证，常时如是之比。若感染轻而源清，邪不胜正者，则七日而自愈。
盖火数七，故七日火气尽而愈。七日不愈而有二七者，乃再传也。二七不退者，必其犯触及本虚之故，
防他变证矣。
【暴风客热证】非天行赤热，尔我感染之比，又非寒热似疟，目痛则病发，病发则目痛
之比，乃素养不清，躁急劳苦，客感风热，卒然而发也。虽有肿胀，乃风热夹攻，火在血分之故。治
亦易退，非若肿胀如杯等证，久积退迟之比。
【火胀大头证】目赤痛而头面浮肿，皮肉燥赤也。状若
大头伤寒，夏月多有此患。有湿热、风热，湿热多泪而睥烂，风热多胀痛而憎寒。若失治则血滞于内，
虽得肿消而目必有变矣。
【羞明怕热证】谓明热之处而目痛涩，
畏避不能开也。凡病目者，十之六七，皆有此患。病源在于心、肝、脾三经。总而言之，不过一火燥
血热。病在阳分，是以见明见热则恶类而涩痛畏避。盖已之精光弱而不能敌彼之光，是以阴黑之所则
清爽。怕热无不足之证，羞明有不足之证。若目不赤痛而畏明者，乃不足之证，为血不足，胆汁少而
络弱，不能运精华以敌阳光之故。今人皆称为怕日羞明者，俗传音近之误。盖日热二音类近，习俗呼
误已久，不察其理，遂失其正，只以怕热羞明论之，其理灼然可见。夫明字所包已广，何用再申日字，
若以日字专主阳光言之，则怕热一证无所归矣。
【睑硬睛疼证】不论有障无障，但两睑坚硬而睛疼，
头或痛者尤急，乃风热在肝，肝虚血少，不能营运于目络，水无所滋，火反乘虚而入，会痰燥湿热，
或头风夹搏，故血滞于睥肉，睛因火击而疼，轻则内生椒疮，重则为肿胀如杯、瘀血灌睛等证。治当
傅退稍软，翻睥开导之吉。若坚硬之甚，且渐渐肿起，而痛及头脑，虽已退而复来，其胀日高，虽敷
治不退不软者，此头风欲成毒也。（宜服通肝散、二术散。若有障膜，用春雪膏点之。）
【赤痛如邪证】每目痛则头亦痛，寒热交作如疟状，凡病发则目痛，目痛则病发，轻则一年数发，
重则一月数发。盖肝肾俱虚之故。热者，内之阴虚，火动邪热也；寒者，荣卫虚，外之腠理不实而觉
寒也。若作风寒疟疾，或用峻削之治，则血愈虚而病愈深矣。宜小柴胡合四物汤主之。不效则活血益
气汤。
【气眼证】才怒气则目疼，宜酒调复元通气散。
【痛如针刺证】目珠痛如针刺，病在心经，实
火有余之证。若痛蓦然一二处如针刺，目虽不赤，亦是心经流火。别其痛在何部分，以见病将犯其经
矣。（宜服洗心散，次服还睛散，及乳香丸、补肝散。○按此证多有体劳目劳，荣气不上潮于目，而
如针刺之痛者，宜养其荣。若降火则殆矣。）
【热结膀胱证】目病则小便不通利而头疼寒热者方是。
若小便清利者，非也。乃热蒸于膀胱，先利清其水，后治其目则愈矣。盖太阳经脉，循目络上行巅顶，
故头疼，火极则兼水化。又血虚者表疏，故发寒热，热甚则水气闭涩，而神水被蒸乏润，安得不竭。
【大小雷头风证】此证不论偏正，但头痛倏疾而来，疼至极而不可忍，身热目痛，便秘结者，曰大雷
头风。若痛从小至大，大便先润后燥，小便先清后涩，曰小雷头风。大者害速，小者稍迟。虽有大小
之说，而治则同一。若失缓祸变不测，目必损坏，轻则HT 凸，重则结毒。宜早为之救，免于祸成而救
之不逮。世人每虑此患害速，故疑于方犯，惑于鬼祟，深泥巫祝，而弃医治，遂致祸成，悔无及矣。
【左右偏头风证】左边头痛右不痛，曰左偏风。右边头痛左不痛，曰右偏风。世人往往不以为虑，久则左发
损左目，右发损右目，有左损反攻右，右损反攻左，而二目俱损者。若外有赤痛泪热等病，则外证生。
若内有昏眇眩晕等病，则内证生矣。凡头风痛左害左，痛右害右，此常病易知者。若难知者，左攻右，
右攻左，痛从内起止于脑，则攻害也迟，痛从脑起止于内，则攻害也速。若痛从中间发，及眉梁内上
星中发者，两目俱害。亦各因其人之触犯感受，左右偏胜，起患不同，迟速轻重不等。然风之害人尤
惨。若能保养调护，亦可免患。愚者骄纵不知戒忌，而反触之，以致患成而始悔，良可痛哉。
【阴邪风证】额板骨、眉棱骨痛也。发则多于六阳用事之时。元虚精弱者，则有内证之患。若兼火者，则有
外证之病。
【阳邪风证】脑后枕骨痛也。多发于六阴用事之月。发则有虚运耳鸣之患，久而不治，内
障成矣。
【卒脑风证】太阳内如槌似钻一团而痛也。若痛及目珠，珠外有赤脉纵贯及瘀滞者，必有外
之恶证来矣。若珠不赤痛，只自觉视如云遮雾障，渐渐昏眇者，内证成矣。急早治之，以免后虑。
【巅顶风证】天灵盖骨内痛极如槌如钻也。阳分痛尤甚，阴分痛稍可。夹痰湿者，每痛多眩晕。若痛连及
珠子而胀急瘀赤者，外证之恶候。若昏眇则内证成矣。
成内证者，尤多于外者。
【游风证】头风痛无常位，一饭之顷，游易数遍，而不能度其何所起止也。
若痛缓而珠赤，赤而有障起者，必变外障。痛甚而肿胀紧急者，必有瘀滞之患。久而失治，不赤痛而
昏眇者内证来成外证者多，然为害迟如各风耳。
【邪风证】人素有头风因而目病，或素目病因而头风，
二邪并立搏夹而深入脑袋，致伤肝胆诸络，故成此患。头痛则目病，目病则头痛，轻则一年数发，重
则一月数发，头风目病常并行而不相悖也。非若雷头风风火搏激而瘀滞之急者，又非若天行赤热传染
之邪，客风暴热之风火寄旅无定，及诸火胀头痛之比。此专为自家本病久成者，非若彼之标病新来之
轻者。若赤痛胀急，则有外证之候。若无赤痛而只内胀，及赤痛不甚，无瘀滞之证，而只昏眇者，内
证成矣。
目部的瘢痕（病变）有两种：一种是白睛疼痛，另一种是黑睛疼痛。白睛疼痛属于阳证，所以白天疼痛加重，点用苦寒性质的眼药有效。医经所谓“白睛赤脉”，是因为其属性符合阳的特性。黑睛疼痛属于阴证，所以夜间疼痛加重，点用苦寒性质的眼药反而加剧。医经所谓“瞳子黑眼”，是因为其属性符合阴的特性。
娄全善说：夏枯草治疗黑睛疼痛，特别是夜间疼痛加重的情况，效果神奇。如果患者使用苦寒药物点眼后疼痛反而加剧的，用夏枯草也效果神奇。这是因为黑睛连着目本，目本又叫做目系，归属于厥阴肝经。夜间疼痛加重以及使用苦寒药点后疼痛加剧，是因为夜晚和寒性都属于阴的缘故。朱丹溪说：夏枯草具有补养厥阴血脉的功效，这种草在三四月份开花，遇到夏至阴气初生时就会枯萎，因为它禀受了纯阳之气。所以治疗厥阴经引起的目痛如神效，是以阳治阴的方法。
我的周老师患有黑睛疼痛，并牵连眉棱骨疼痛，以及头部半边肿痛，夜间发作，使用黄连膏点眼反而剧烈疼痛，其他药物无效，灸刺厥阴经、少阳经穴位则疼痛随即停止，半个月后又发作，反复灸刺一个月左右才止住。于是用夏枯草二两，香附二两，甘草四钱，共同研为细末。每次服用一钱五分，用茶汁调服。药液咽下后疼痛减轻大半，到四五日痊愈。
又有一名六十岁的男子，也是黑睛连及眉棱骨疼痛，夜间加重，使用苦寒药剂点眼也加重，与前例症状相同，只是黑睛及外眦有两处白色翳膜，使用退翳药物均无效。也用此方配合东垣的选奇汤，再加四物汤和黄连煎服，并灸刺厥阴、少阳经穴位而安宁。
倪仲贤论述七情、五贼、劳役、饥饱所致的疾病时说：《阴阳应象大论》说，天有四季，用来生长收藏，产生寒暑燥湿风。寒暑燥湿风的发作，如果都适时，那么万物都能生长。寒暑燥湿风的发作，如果不适时，那么万物都会死亡。所以说生于四时，死于四时。又说人的五脏化为五气，产生喜怒忧悲恐。喜怒忧悲恐的发作，如果都合乎节度，那么九窍都能正常运作。喜怒忧悲恐的发作，如果不合乎节度，那么九窍都会衰竭。所以说生于五脏，死于五脏。眼睛，是九窍之一。光明视见，能容纳山川的大景，以及毫芒的细微，尽览云霄的高远，穷尽泉沙的深度。至于将无穷转化为有限，而有限又不能成为无穷，反过来聚集起来，就成为乍张乍敛、乍动乍静的一泓一点微小的存在，难道是强力所能达到的吗？这都是生生不息的自然之道。
如果因为七情内伤，五贼外扰，饥饱不节，劳役异常，足阳明胃经、足太阴脾经，作为戊己二土，是生生之源。七情五贼总伤这两条经脉，饥饱伤胃，劳役伤脾，戊己既已生病，那么生生自然的本体，就不能发挥生生自然的作用，因此导致疾病，称为七情五贼劳役饥饱之病。其病症表现为红赤、睛珠疼痛，痛如针刺，对应太阳经。眼睑无力，常想闭合，不敢久视，久视则酸疼。生成翳膜的会形成陷下，所陷下的形状，或圆或方，或长或短，或如点，或如线，或如锥，或如凿。凡患此病的，用柴胡复生汤主治，黄连羊肝丸主治。睛痛严重的，用当归养荣汤主治，助阳活血汤主治，加减地黄丸主治，决明益阴丸主治，加当归黄连羊肝丸主治，龙脑黄连膏主治。以上几个方剂，都是升发阳气的药物群队，其中有用黄连、黄芩之类的，是为了去除五贼。搐鼻用的碧云散，也可以间歇使用。最忌讳大黄、芒硝、牵牛、石膏、栀子的药剂，触犯禁忌则病情更加严重。
又论述亡血过多的疾病说：《六节脏象论》说，肝受血而能视。《宣明五气篇》说，久视伤血。《气厥论》说，胆移热于脑，则鼻塞流浊涕成鼻渊，传变为衄血、昏瞑、目盲。《四时刺逆从论》说，冬季刺经脉，血气皆脱，使人目不明。由此推断，眼睛是由血液滋养而明亮的，这是很清楚的。手少阴心经主生血，血液荣润于目；足厥阴肝经开窍于目，肝也主血，所以血液亡失会导致眼病，男子衄血、便血，妇人产后崩漏，亡血过多者，都能引起眼病。其症状为睛珠疼痛，珠痛不能视物，羞明瘾涩，眼睑无力，眉骨和太阳穴因之酸疼。用芎归补血汤主治，当归养荣汤主治，除风益损汤主治，滋阴地黄丸主治。诸证有热者，加黄芩。妇人产褥漏下者，加阿胶。脾胃不佳，恶心不进食者，加生姜。恢复其血液，使其得到滋养就能痊愈。然而要忌食咸味食物。《宣明五气篇》说：咸走血，血病不要多吃咸味食物，就是这个道理。
【白眼痛】多有赤脉，观察赤脉从上而下走的，是太阳病，羌活为使药引导。从下而上走的，是阳明病，升麻为使药引导。从外走向内的，是少阳病，柴胡为使药引导。太阳病宜温散，阳明病宜攻下，少阳病宜和解。又有恶寒脉浮为有表证，宜用选奇汤、防风饮子等发散。脉实有力，大便闭结，为有里证，宜用泻青丸、洗肝散等轻微通利。也有不肿不红，只是沙涩昏痛的，这是气分隐伏之火，脾肺络脉有湿热，秋季多有此患，所以俗称稻芒赤，也称白赤眼。通用桑白皮散、玄参丸、泻肺汤、大黄丸、洗眼青皮汤、朱砂煎。
【天行赤热证】眼睛红赤疼痛，或者眼睑肿胀头重，怕热羞明，涕泪交流等症状，一家之内，一里之中，往往老幼相传。然而有虚实轻重的不同，也根据人的虚实、时气的轻重如何，各自随其病因，分经络发病，有的变为重病，有的变为轻病，有的不治自愈，不可一概而论。这一章专门讲述天时流行热邪相互感染，而人如果素有眼疾，以及痰火热病，水亏元虚者，则你我传染不一。其丝脉虽然多赤乱，不可以当作普通的赤丝乱脉证，那是平时就这样的比较。如果感染轻而源头清，邪不胜正，则七日自愈。因为火数七，所以七日火气尽而愈。七日不愈而有十四日的，是再次传变。十四日不退的，一定是触犯禁忌和本虚的缘故，要防止其他变证了。
【暴风客热证】不是天行赤热那种你我感染的情况，也不是寒热像疟疾那样，目痛则病发，病发则目痛的情况，而是平素修养不清，急躁劳苦，客感风热，突然发作的。虽然有肿胀，乃是风热夹攻，火在血分的缘故。治疗也容易消退，不像肿胀如杯等证，久积消退缓慢的情况。
【火胀大头证】眼睛红赤疼痛而头面浮肿，皮肉燥赤。状若大头伤寒，夏季多有此患。有湿热、风热，湿热多流泪且眼睑溃烂，风热多胀痛且憎寒。如果失治则血滞于内，即使消肿眼睛也必有变故。
【羞明怕热证】谓在明亮热处眼睛疼痛涩滞，畏惧回避不能睁开。凡是患眼病的，十之六七都有此患。病源在于心、肝、脾三经。总而言之，不过是一火燥血热。病在阳分，所以见到明亮见到热就厌恶、涩痛、畏惧回避。因为自己的精光弱而不能抵御外界的光，所以在阴暗之处则清爽。怕热没有不足的证候，羞明有不足的证候。如果眼睛不红痛而畏明，乃是不足的证候，为血不足，胆汁少而络脉弱，不能运化精华以抵御阳光的缘故。今人都称为怕日羞明，是俗传音近之误。因为日、热二音类似，习俗呼误已久，不察其理，遂失其正，只以怕热羞明论之，其理灼然可见。夫“明”字所包已广，何用再申“日”字，若以“日”字专主阳光言之，则怕热一证无所归矣。
【睑硬睛疼证】不论有障无障，只要两睑坚硬而睛疼，头或痛者尤为紧急，乃是风热在肝，肝虚血少，不能营运于目络，水无所滋，火反乘虚而入，会合痰燥湿热，或头风夹搏，故血滞于胞肉，睛因火击而疼，轻则内生椒疮，重则为肿胀如杯、瘀血灌睛等证。治疗应当敷药退热稍软，翻睑开导之吉。如果坚硬得很，且渐渐肿起，而痛及头脑，虽已退而复来，其胀日高，虽敷治不退不软者，这是头风欲成毒也。（宜服通肝散、二术散。若有障膜，用春雪膏点之。）
【赤痛如邪证】每每目痛则头亦痛，寒热交作如疟状，凡病发则目痛，目痛则病发，轻则一年数发，重则一月数发。盖肝肾俱虚的缘故。热者，内之阴虚，火动邪热也；寒者，营卫虚，外之腠理不实而觉寒也。若作风寒疟疾，或用峻削之治，则血愈虚而病愈深矣。宜小柴胡合四物汤主治。不效则用活血益气汤。
【痛如针刺证】目珠痛如针刺，病在心经，实火有余的证候。如果痛蓦然一二处如针刺，目虽不赤，亦是心经流火。辨别痛在何部分，以见病将犯其经矣。（宜服洗心散，次服还睛散，及乳香丸、补肝散。○按此证多有体劳目劳，荣气不上潮于目，而如针刺之痛者，宜养其荣。若降火则殆矣。）
【热结膀胱证】目病则小便不通利而头疼寒热者方是。如果小便清利者，非也。乃热蒸于膀胱，先利清其水，后治其目则愈矣。盖太阳经脉，循目络上行巅顶，故头疼，火极则兼水化。又血虚者表疏，故发寒热，热甚则水气闭涩，而神水被蒸乏润，安得不竭。
【大小雷头风证】此证不论偏正，但头痛倏疾而来，疼至极而不可忍，身热目痛，便秘结者，曰大雷头风。若痛从小至大，大便先润后燥，小便先清后涩，曰小雷头风。大者害速，小者稍迟。虽有大小之说，而治则同一。若失缓祸变不测，目必损坏，轻则眼球突出，重则结毒。宜早为之救，免于祸成而救之不逮。世人每虑此患害速，故疑于方犯，惑于鬼祟，深泥巫祝，而弃医治，遂致祸成，悔无及矣。
【左右偏头风证】左边头痛右不痛，曰左偏风。右边头痛左不痛，曰右偏风。世人往往不以为虑，久则左发损左目，右发损右目，有左损反攻右，右损反攻左，而二目俱损者。若外有赤痛泪热等病，则外证生。若内有昏眇眩晕等病，则内证生矣。凡头风痛左害左，痛右害右，此常病易知者。若难知者，左攻右，右攻左，痛从内起止于脑，则攻害也迟，痛从脑起止于内，则攻害也速。若痛从中间发，及眉梁内上星中发者，两目俱害。亦各因其人之触犯感受，左右偏胜，起患不同，迟速轻重不等。然风之害人尤惨。若能保养调护，亦可免患。愚者骄纵不知戒忌，而反触之，以致患成而始悔，良可痛哉。
【阴邪风证】额板骨、眉棱骨痛也。发则多于六阳用事之时。元虚精弱者，则有内证之患。若兼火者，则有外证之病。
【阳邪风证】脑后枕骨痛也。多发于六阴用事之月。发则有虚运耳鸣之患，久而不治，内障成矣。
【卒脑风证】太阳内如槌似钻一团而痛也。若痛及目珠，珠外有赤脉纵贯及瘀滞者，必有外之恶证来矣。若珠不赤痛，只自觉视如云遮雾障，渐渐昏眇者，内证成矣。急早治之，以免后虑。
【巅顶风证】天灵盖骨内痛极如槌如钻也。阳分痛尤甚，阴分痛稍可。夹痰湿者，每痛多眩晕。若痛连及珠子而胀急瘀赤者，外证之恶候。若昏眇则内证成矣。成内证者，尤多于外者。
【游风证】头风痛无常位，一饭之顷，游易数遍，而不能度其何所起止也。若痛缓而珠赤，赤而有障起者，必变外障。痛甚而肿胀紧急者，必有瘀滞之患。久而失治，不赤痛而昏眇者内证来成外证者多，然为害迟如各风耳。
【邪风证】人素有头风因而目病，或素目病因而头风，二邪并立搏夹而深入脑袋，致伤肝胆诸络，故成此患。头痛则目病，目病则头痛，轻则一年数发，重则一月数发，头风目病常并行而不相悖也。非若雷头风风火搏激而瘀滞之急者，又非若天行赤热传染之邪，客风暴热之风火寄旅无定，及诸火胀头痛之比。此专为自家本病久成者，非若彼之标病新来之轻者。若赤痛胀急，则有外证之候。若无赤痛而只内胀，及赤痛不甚，无瘀滞之证，而只昏眇者，内证成矣。
There are two types of ocular lesions (ocular scars/pathologies): one is pain in the white sclera (Baiyan), and the other is pain in the black cornea/pupil area (Heiyan). Pain in the white sclera belongs to Yang, so it worsens during the day and responds well to bitter-cold eye drops. As stated in the classics, "red vessels in the white sclera" follow the nature of Yang. Pain in the black cornea/pupil area belongs to Yin, so it worsens at night and aggravates with bitter-cold eye drops. As stated in the classics, "the pupil and black cornea" follow the nature of Yin.
Lou Quanshan said: Prunella vulgaris (Xiakucao) treats pain in the black cornea/pupil area, especially when pain worsens at night, with miraculous effect. If a patient experiences aggravated pain after using bitter-cold eye drops, Prunella vulgaris also works miraculously. This is because the black cornea connects to the root of the eye (Muben), also known as the visual system (Muxi), which belongs to the Jueyin Liver Meridian. Nighttime worsening and aggravation with bitter-cold drops occur because both night and cold belong to Yin. Zhu Danxi said: Prunella vulgaris has the function of nourishing the blood vessels of the Jueyin meridian. This herb flowers in the third and fourth lunar months and withers upon the Summer Solstice when Yin energy begins to generate, as it possesses pure Yang Qi. Therefore, treating Jueyin eye pain with it is effective because it uses Yang to treat Yin.
My teacher, Mr. Zhou, suffered from pain in the black cornea/pupil area, radiating to the supraorbital ridge, and swelling and pain on one side of the head, occurring at night. Using Coptis chinensis (Huanglian) ointment caused severe pain, and other medications were ineffective. Acupuncture on the Jueyin and Shaoyang meridians stopped the pain immediately, but it recurred after half a month. After repeated acupuncture for over a month, I prescribed two liang of Prunella vulgaris (Xiakucao), two liang of Cyperi Rhizoma (Xiangfu), and four qian of Glycyrrhiza uralensis (Gancao), ground into fine powder. Each dose was one qian five fen, taken with tea infusion. The pain reduced by more than half upon swallowing, and he recovered completely within four to five days.
Another sixty-year-old man suffered from pain in the black cornea/pupil area extending to the supraorbital ridge, worsening at night, and aggravating with bitter-cold eye drops, similar to the previous case, except for two white nebulae (Yi) spots on the black cornea and outer canthus. Nebula-resolving drugs were ineffective. He was treated with the same formula combined with Dongyuan's Xuanqi Tang, plus Siwu Decoction and Coptis chinensis (Huanglian) decocted and taken orally, along with acupuncture on the Jueyin and Shaoyang meridians, resulting in relief.
Ni Zhongxian discussed diseases caused by Seven Emotions, Five Thieves, labor/overwork, and irregular diet, stating: The *Great Treatise on the Correspondence of Yin and Yang* says that Heaven has four seasons for growth, flourishing, harvesting, and storing, generating Cold, Heat, Dryness, Dampness, and Wind. If these factors arise in due season, all things grow. If they arise out of season, all things die. Thus, life comes from the four seasons, and death comes from the four seasons. It also states that the five Zang organs transform into five Qi, generating Joy, Anger, Worry, Grief, and Fear. If these emotions arise in moderation, the nine orifices function well. If they arise immoderately, the nine orifices fail. Thus, life comes from the five Zang organs, and death comes from the five Zang organs. The eyes are one of the nine orifices. Bright vision allows one to perceive vast landscapes and minute details, high clouds and deep springs. Transforming the infinite into the finite, and the finite unable to encompass the infinite, gathering them results in a tiny drop of water that opens and closes, moves and rests. Is this achieved by force? No, it is the natural way of continuous generation.
If injured internally by the Seven Emotions, disturbed externally by the Five Thieves, irregular in diet, or excessive in labor, affecting the Foot-Yangming Stomach Meridian and Foot-Taiyin Spleen Meridian, which constitute Wu and Ji Earth, the source of generation. The Seven Emotions and Five Thieves injure these two meridians; irregular diet injures the Stomach, and labor injures the Spleen. Once Wu and Ji are diseased, the natural body cannot perform its natural functions, leading to disease, termed "Diseases of Seven Emotions, Five Thieves, Labor, and Irregular Diet." Symptoms include redness, pain in the eyeball like needle pricks, corresponding to the Taiyang meridian. Eyelid weakness, desire to close eyes, inability to gaze long without soreness. Nebulae may form depressions, round, square, long, short, dot-like, thread-like, cone-like, or chisel-like. For such cases, Chaihu Fusheng Tang is indicated, as is Huanglian Yanggan Wan. For severe eyeball pain, Danggui Yangrong Tang, Zhuyang Huoxue Tang, Jiadi Dihuang Wan, Jueming Yiyin Wan, Danggui Huanglian Yanggan Wan, and Longnao Huanglian Gao are indicated. These formulas consist mainly of herbs that ascend and generate Yang Qi; those containing Coptis chinensis (Huanglian) and Scutellaria baicalensis (Huangqin) are used to eliminate the Five Thieves. Biyun San for nasal insufflation may also be used intermittently. One must strictly avoid Rhubarb (Dahuang), Mirabilite (Mangxiao), Pharbitis seed (Qianniu), Gypsum (Shigao), and Gardenia (Zhizi); violating this contraindication worsens the condition.
Regarding excessive blood loss: The *Six Sections of Visceral Manifestations* states that the Liver receives blood to enable vision. The *Chapter on Clarifying the Five Qi* states that prolonged gazing damages blood. The *Chapter on Qi Reversal* states that Gallbladder heat transferring to the brain causes nasal congestion and discharge (Bi Yuan), progressing to epistaxis, dizziness, and blindness. The *Chapter on Four Seasons Needle Reversals* states that needling meridians in winter depletes Qi and Blood, causing poor vision. From this, it is clear that the eyes are brightened by blood nourishment. The Hand-Shaoyin Heart Meridian generates blood, which nourishes the eyes; the Foot-Jueyin Liver Meridian opens into the eyes and governs blood. Thus, blood loss causes eye disease: men with epistaxis or hematochezia, women with postpartum metrorrhagia or leukorrhea, if excessive, all suffer eye disease. Symptoms include eyeball pain, inability to see due to pain, photophobia, itching, eyelid weakness, and soreness in the supraorbital ridge and temporal region. Xiong Gui Buxue Tang, Danggui Yangrong Tang, Chufeng Yisun Tang, and Ziyin Dihuang Wan are indicated. Add Scutellaria baicalensis (Huangqin) for heat; add Donkey-hide gelatin (Ejiao) for postpartum bleeding; add Fresh Ginger (Shengjiang) for poor spleen/stomach function, nausea, and anorexia. Restoring blood and ensuring proper nourishment leads to recovery. However, salty foods must be avoided. The *Chapter on Clarifying the Five Qi* states: "Salty enters the Blood; do not consume much salt in blood diseases."
[White Sclera Pain] Often presents with red vessels. If vessels run from top to bottom, it is Taiyang disease, guided by Notopterygium root (Qianghuo). If from bottom to top, it is Yangming disease, guided by Angelica dahurica (Shengma). If from outside inward, it is Shaoyang disease, guided by Bupleurum root (Chaihu). Taiyang disease requires warming and dispersing; Yangming disease requires purging; Shaoyang disease requires harmonizing. Chills and floating pulse indicate exterior syndrome, treated with Xuanqi Tang or Fangfeng Yinzi. Solid pulse and constipation indicate interior syndrome, treated mildly with Xieqing Wan or Xiogan San. Cases without swelling or redness, only gritty and dim pain, involve hidden fire in the Qi level and damp-heat in Spleen/Lung collaterals, common in autumn,俗称 "Rice Awn Red Eye" or "White Red Eye." Commonly treated with Sangbaipi San, Xuanshen Wan, Xiefei Tang, Dahuang Wan, Xiyan Qingpi Tang, or Zhusha Jian.
[Seasonal Red Heat Syndrome] Red, painful eyes, swollen eyelids, heavy head, aversion to heat and light, profuse tears and mucus, often spreading among family or village members. Severity varies by deficiency/excess and seasonal pathogen strength. Some become severe, some mild, some self-heal. This chapter addresses infection by seasonal hot pathogens, especially in those with pre-existing eye disease, phlegm-fire, or Yin deficiency. Although red vessels appear chaotic, it differs from chronic "Red Thread Chaos Pulse." Mild cases with clear origin and strong Zheng Qi heal in seven days (Fire number is seven). If not healed in 14 days, it is a second transmission. Persistence beyond 14 days indicates contraindication violation or fundamental deficiency, risking complications.
[Violent Wind-Heat Syndrome] Not contagious like Seasonal Red Heat, nor alternating chills/fever like malaria. Caused by poor lifestyle, agitation, labor, and sudden invasion of wind-heat. Swelling occurs due to wind-heat attacking and fire in the Blood level. Treatment resolves easily, unlike persistent cup-like swelling.
[Fire Swelling Big Head Syndrome] Red, painful eyes with facial/head edema and dry red skin. Resembles Big Head Plague, common in summer. Damp-heat causes tearing and eyelid erosion; wind-heat causes distending pain and chills. Untreated, blood stasis occurs, leading to eye damage even after swelling subsides.
[Photophobia and Heat Aversion] Pain and grittiness in bright/hot environments, inability to open eyes. Occurs in 60-70% of eye diseases. Source is Heart, Liver, Spleen meridians. Essentially, Fire drying Blood Heat. Pathology in Yang level causes aversion to light/heat. Weak essence cannot resist external light, so darkness feels refreshing. Heat aversion implies no deficiency; photophobia can imply deficiency. Non-red/non-painful photophobia indicates deficiency: insufficient Blood, scant Gallbladder juice, weak collaterals failing to transport essence to resist sunlight. "Fear of Sun" is a phonetic error for "Fear of Heat." "Ming" (Bright) encompasses sun; adding "Sun" is redundant.
[Lid Hardness and Eyeball Pain] Regardless of nebulae, hard lids and painful eyeballs, possibly with headache, indicate Wind-Heat in Liver, Liver Blood deficiency, failure to nourish eye collaterals, Water failing to moisten, Fire invading deficiency, combining with Phlegm-Damp-Heat or Head Wind. Blood stasis in eyelid flesh causes pain. Mild cases develop Pepper Granuloma; severe cases cause cup-like swelling or Hemorrhagic Prolapse. Treatment should soften lids before manipulation. Extreme hardness with progressive swelling, headache, recurrence, and resistance to treatment indicates Head Wind turning into Toxin. (Tonggan San, Ershu San indicated. Nebulae treated with Chunxue Gao.)
[Red Pain Like Evil Syndrome] Eye pain accompanied by headache, alternating chills/fever like malaria. Recurrence frequency varies. Due to Liver/Kidney deficiency. Heat indicates internal Yin deficiency with Fire/Evil Heat; Cold indicates Ying-Wei deficiency with insecure pores causing cold sensation. Treating as Wind-Cold Malaria or using harsh depletion therapies worsens Blood deficiency and disease depth. Xiao Chaihu Tang combined with Siwu Tang is indicated. If ineffective, Huoxue Yiqi Tang.
[Qi Eye Syndrome] Eye pain immediately after anger. Treated with Fuyuan Tongqi San mixed with wine.
[Needle-Like Pain Syndrome] Eyeball pain like needle pricks indicates Heart Meridian excess Fire. Sudden prickling pain in one or two spots, even without redness, suggests Heart Fire flowing. Location indicates impending meridian involvement. (Xixin San, then Huanjing San, Rushui Wan, Bugan San indicated. Note: Often due to physical/visual fatigue, Ying Qi failing to reach eyes. Nourish Ying Qi; descending Fire is dangerous.)
[Heat Binding Bladder Syndrome] Eye disease with urinary difficulty, headache, chills/fever. Clear urine rules this out. Heat steaming in Bladder requires clearing water first, then treating eyes. Taiyang meridian runs up to vertex via eye collaterals, causing headache; extreme Fire transforms to Water. Blood deficiency causes loose exterior and chills/fever. Severe heat closes Water Qi, evaporating Shen Water (aqueous humor), leading to exhaustion.
[Big/Small Thunder Head Wind] Sudden, unbearable headache, fever, eye pain, constipation = Big Thunder Head Wind. Pain growing small-to-large, stool moist-to-dry, urine clear-to-impeded = Small Thunder Head Wind. Big is faster/dangerous; Small is slower. Treatment is same. Delay risks eye damage: mild proptosis, severe toxin formation. Early intervention prevents disaster. People fear speed, suspect ghosts, consult shamans, abandoning medicine, leading to regret.
[Left/Right Migraine] Left headache only = Left Migraine. Right headache only = Right Migraine. Chronic left attacks damage left eye, right attacks damage right eye. Cross-damage (left damaging right, etc.) can occur. External symptoms (redness, pain, hot tears) manifest externally; internal symptoms (dimness, vertigo) manifest internally. Usually, left pain harms left, right harms right. Complex patterns involve cross-attack or central origin affecting both eyes. Wind is particularly harmful. Care can prevent it. Foolish people ignore taboos, triggering disease, leading to regret.
[Yin Evil Wind] Pain in frontal bone and supraorbital ridge. Occurs during Six Yang periods. Deficient Essence/Yuan causes internal symptoms. Combined with Fire causes external symptoms.
[Yang Evil Wind] Pain in occipital bone. Occurs during Six Yin months. Causes vertigo/tinnitus. Untreated, leads to internal cataracts.
[Sudden Brain Wind] Pain in Taiyang region like hammering/drilling. Pain involving eyeball with vertical red vessels/stasis indicates external evil. Non-red/non-painful vision like cloud/fog obstruction indicates internal syndrome. Treat early.
[Vertex Wind] Extreme pain in skull like hammering/drilling. Yang level pain worse than Yin. Phlegm-Dampness causes vertigo. Pain extending to eyeball with distension/redness indicates external evil. Dimness indicates internal syndrome. Internal cases more common than external.
[Wandering Wind] Headache with no fixed location, moving rapidly. Slow pain with red eye/nebula changes to external cataract. Severe pain with urgent swelling indicates stasis. Untreated non-red/non-painful dimness indicates internal syndrome. Harm is slower than other winds.
[Evil Wind] Pre-existing Head Wind causing Eye Disease, or vice versa. Two evils combine, penetrating head, injuring Liver/Gallbladder collaterals. Headache and eye pain alternate. Mild: few episodes/year; Severe: few episodes/month. Unlike urgent Thunder Head Wind or contagious Seasonal Red Heat. This is chronic internal disease, not acute external. Redness/pain/distension indicates external syndrome. Internal distension without redness/pain, or dimness without stasis, indicates internal syndrome.