The Essence of the five Yin and six Yang organs all reach the eyes which are the ‘nest’ of the Essence. The Essence of the bones [and therefore of the Kidneys] manifests in the pupil; the Essence of the sinews [and therefore of the Liver] manifests in the iris; the Essence of Blood [and therefore of the Heart] manifests in the blood vessels and the canthus [of the eye]; the Essence of Qi [and therefore of the Lungs] manifests on the sclera; the Essence of the muscles [and therefore of the Spleen] manifests in the eyelids; therefore, the Essence of bones, sinews, blood and Qi together with the blood vessels form the Eye System which goes upwards entering the brain and backwards exiting at the nape of the neck.⁶

The eyes manifest the Essence of the five Yin and six Yang organs, the Nutritive and Defensive Qi, and they are the place where the Qi of the Mind is generated … the eyes are the messengers of the Heart which houses the Mind. If the Mind and Essence are not co-ordinated and not transmitted one has visual hallucinations. The Mind, Ethereal Soul and Corporeal Soul are scattered so that one has bewildering perceptions.⁷

The eyes and the Liver

The relationship between the eyes and the Liver is, of course, very well known owing to the Five-Element correspondence. The Liver-Blood nourishes the eyes and produces normal vision. For example, the ‘Spiritual Axis’ in Chapter 17 says: ‘Liver-Qi reaches the eyes, when the Liver is harmonized the eyes can distinguish the five colours.’⁸ It also says: ‘The Liver stores Blood which allows us to see.’⁹ The ‘Simple Questions’ in Chapter 5 says: ‘The Liver governs the eyes;’¹⁰ and in Chapter 4: ‘The East corresponds to the green colour and the Liver which opens into the eyes.’¹¹

Liver-Yin also nourishes the eyes and, more specifically, it moistens them: in fact, dry eyes are often a symptom of Liver-Yin deficiency, while blurred vision is a symptom of Liver-Blood deficiency.

The eyes and the Kidneys

Like Liver-Blood, the Kidneys nourish the eyes; they also moisten the eyes and control the normal fluids that lubricate them. Many eye problems, especially in the elderly, are due to Kidney-Yin deficiency. The Kidneys also influence the intraocular pressure and glaucoma is often due to a Kidney deficiency.

The eyes and the Heart

The Heart Main channel reaches the eye internally, the Heart Connecting channel also reaches the eye, and the Heart Divergent channel connects with the Small Intestine channel at the inner canthus of the eyes.

The ‘Spiritual Axis’ in Chapter 10 says: ‘The Heart channel connects with the Eye System.’¹² In Chapter 11 it says: ‘The Divergent channel of the Heart connects with the Eye System.’¹³ The same chapter also says: ‘The Heart channel reaches the face and connects with the inner canthus of the eye.’¹⁴

Therefore, Heart-Blood also nourishes the eye in a similar way to Liver-Blood, or, to put it differently, for Blood to reach the eye it needs the transporting action of Heart-Qi. The ‘Simple Questions’ also mentions the connection between the eye and the Heart in several places and Chapter 81 says: ‘The Spirit and the Essence of the Heart gather in the eye.’¹⁵ It also says: ‘The Heart is the focus of the Essence of the five Yin organs and its orifice is the eye.’¹⁶ The ‘Spiritual Axis’ in Chapter 80 says: ‘The eye is the ambassador of the Heart.’¹⁷

The significance of all the above statements is twofold. First, like the Liver, the Heart nourishes the eye and therefore many eye problems are related to a Heart pathology. Secondly, the Essence of the Heart, and therefore the Mind and Spirit, manifests in the eyes: this is an extremely important aspect of diagnosis as a careful observation of the eyes reveals the state of the Mind and Spirit.

The eyes and the Stomach and Spleen

The Stomach channel is closely connected to the eye as it starts just under the orbit of the eye. It transports the Food Essences to the eyes. The Spleen influences the eyelids and the muscles that control their opening and closing. Chapter 62 of the ‘Spiritual Axis’ says: ‘Stomach-Qi flows upwards to the Lungs and on to the head via the throat and connects with the Eye System and from here enters the brain.’¹⁸ Chapter 31 of the ‘Simple Questions’ says: ‘The Bright Yang controls the muscles and its channel flows to the nose and eyes.’¹⁹ Chapter 21 of the ‘Spiritual Axis’ says: ‘The leg Bright Yang channel goes to the nose, the mouth and enters the Eye System.’²⁰ Both the Divergent and the Muscle channels of the Stomach enter the eye. Chapter 13 of the ‘Spiritual Axis’ says: ‘The Muscle channel of the Stomach … connects with the Greater Yang channel which controls the upper eyelid, while the Bright Yang channel controls the lower eyelid.’²¹ However, the prevalent view is that the Spleen controls both eyelids.

The eyes and the Gall-Bladder

The Gall-Bladder channel is closely connected to the eye as it starts at its outer corner. Chapter 10 of the ‘Spiritual Axis’ says: ‘The Gall-Bladder channel starts from the lateral corner of the eye.’²² Chapter 11 of the same book says: ‘The Gall-Bladder Divergent channel … scatters on the face, enters the Eye System and joins the Main channel at the external corner of the eye.’²³ Chapter 13 says: ‘The Muscle channel of the Gall-Bladder … binds around the external corner of the eye.’²⁴ Thus, both the Divergent and the Muscle channel of the Gall-Bladder reach the eye.

The eyes and the Bladder

The Bladder channel starts at the inner corner of the eye. Its influence on the eye is a close one. Chapter 10 of the ‘Spiritual Axis’ says: ‘The Bladder channel starts at the inner corner of the eye.’²⁵ The Bladder Muscle channel is wrapped around the eye socket. Chapter 21 of the same book says: ‘The leg Greater Yang channel penetrates the occiput, enters the brain, it connects with the eye and is called the Eye System.’²⁶

The eyes and the Small Intestine

Chapter 10 of the ‘Spiritual Axis’ says: ‘A branch of the Small Intestine channel departing from the clavicle, goes to the neck and cheek to reach the lateral corner of the eye … another branch reaches the nose and arrives at the inner corner of the eye.’²⁷ The Muscle channel of the Small Intestine also reaches the outer corner of the eye.

Box 6.1 and Figure 6.2 summarizes the relationships between the Internal Organs and the eyes.

The Five Wheels

The ‘Five Wheels’ is an ancient expression to indicate five areas of the eyes: the pupil, iris, corners of the sclera, the rest of the sclera and the eyelids. These Five Wheels are the Water Wheel, the Wind Wheel, the Blood Wheel, the Qi Wheel and the Muscle Wheel respectively. Figure 6.3 illustrates the Five Wheels.

The Five Wheels are as follows:

The significance of the Five Wheels is that it establishes a physiological relationship between those five parts of the eye and the Internal Organs. For example, the pupil pertains to the Kidneys and if it is excessively dilated it may indicate Kidney-Yang deficiency; the iris pertains to the Liver and its inflammation may indicate Liver-Heat; the sclera pertains to the Lungs and a change in its colour or texture may indicate a Lung pathology such as Lung-Heat; the corners of the eye pertain to the Heart and a redness there may indicate Heart-Fire; the eyelids pertain to the Stomach and Spleen and if, for example, they are drooping this may indicate sinking of Spleen-Qi, while if they are swollen and red they indicate Spleen-Heat. However, as always in the Chinese medicine system of correspondences, there are pathologies which escape such correspondences; for example, a redness of the sclera may be related to Heat in any organ and not just the Lungs.

The Eight Ramparts

The ‘Eight Ramparts’ are another way of classifying areas of the eye in relation to the Internal Organs. The classification according to the Eight Ramparts is broadly the same as that according to the Five Wheels, except that it is more detailed, especially in relation to the sclera, which is divided into three areas corresponding to the Lungs, Minister Fire and Triple Burner. (Fig. 6.4).

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