TCM Five Wheel Principles


Based on the descriptions in Yellow Emperor’s Classic of Internal Medicine, and thought clinical practice, ancient specialists created the Five Wheel Principles as a clinical guidance for eye problems. The eye region is divided into five parts (known as wheels), which are correlated with the five organs systems respectively. By applying the affiliating relationships between the eyes and organs, TCM physicians can observe changes in the eye region and link them up with internal disharmonies, that help them understand what internal organs have involved as well as blood and qi disturbances. This is a unique eye diagnostic method of Traditional Chinese medicine (TCM), physicians usually combine other diagnostic routine to get a comprehensive evaluation for their patients and finalize the treatment plan.



  Names of wheel Parts of the eyes Corresponding organ systems
1 Flesh Wheel Eye lids Spleen (spleen dominates muscles)
2 Blood Wheel Eye corners Heart (heart dominates blood)
3 Qi Wheel White part of the eyes Lung (Lung dominates qi)
4 Wing Wheel Black part of the eyes Liver (Liver dominates wind) 
5 Water Wheel Puplis of the eyes Kidney (kidney dominates water)

 
  • Red and puffy eyelids tend to indicate heat accumulated in spleen and stomach.
  • Itchy eyelid with marginal wet ulcer indicates damp-heat in spleen meridian, or external wind attacking.
  • A hard nodule under eyelid that is not red and painful indicate accumulation of phlegm and dampness.
  • Nodules under eyelid that attached with excess sticky and thick discharge indicate damp-heat accumulating in spleen and stomach. 
  • Drooping of upper eyelid tends to indicate deficiency of middle qi.
  • Paleness of inner eyelids tend to indicate blood insufficiency and spleen deficiency.
  • Generalized puffy eyelids that are soft and tight in surface and without redness and pain tend to indicate spleen deficiency and dampness flooding, or yang deficiency of spleen and kidney.
  • Twitching eyelid tends to indicate blood deficiency generating wind evils.
  • Frequent eye blinking tends to indicate spleen deficiency and hyperactive liver.
  • In kids, sleeping with open eyes may indicate weakness in spleen and stomach.
  • Dark brown or yellowish lump appeared on the eyelids and near the inner eye corners may indicate a higher level of cholesterol, individuals may have a risk of developing atherosclerosis, coronary disease and cerebrovascular accidence. 
  • Dark circles under the eyes may indicate extreme fatigue, lack of sleep, chronic insomnia, chronic diseases, too much sex, or mental distress. Dark circles can also appear in individuals with urinary or reproductive problems, and hemorrhoids.
  • Darkened, loose skin or mild swelling beneath the eyes, known as “periorbital dark circles,” is commonly seen in allergic rhinitis and paranasal sinusitis.                   
 
 
 
 
  • Bright red and burning feeling in the white part of eyes tend to indicate wind and heat in lung meridian.
  • Bloodshot eyes tend to indicate excess heat in lung meridian.
  • Swelling in the white part indicates dysfunction of lung qi; 
  • Bright red and swelling in the white part indicates toxic heat in lung.
  • Scattered and mild bloodshot in the white part indicates virtual fire in lung meridian.
  • Slightly red and turbid changes in the white part with extreme itching indicate damp-heat in lung and spleen.
  • Green-blue color appearing in the white part indicates qi deficiency and blood stasis, also indicates painful condition in certain body region.  
  • Dryness and lusterless of the white part indicates lung yin insufficiency. 
  • Yellowish change in the white part should first consider jaundice. Individuals with jaundice also have yellowish skin and urine, in TCM understanding, it is due to dampness accumulated in spleen and stomach. 
  • Pale gray change in the white part often appear in indigestion cases. 

 
  • Tiny turbid spots gradually appear on the cornea tends to indicate external wind evils irritating.
  • Tender or ulcerous patches on the cornea tends to indicate toxic fire flaming in liver. 
  • Corneal opacity, or with blood vessels growing tend to indicate damp-heat in liver and gallbladder, in combination with blood stasis.
  • Corneal opacity that appears intermittently or last for a long time tend to indicate liver yin insufficiency, or deficiency of blood and qi.        
 
 
  • Constricted pupils with a sense of falling pain at the eyeballs tend to indicate wind-heat in liver meridian, or excess fire in liver and gallbladder. 
  • Light-green and dilated pupil, and accompany with severe distending pain and hard eyeball, headache and vomiting tend to indicate toxic fire in liver and gallbladder. 
  • Gradual developing enlarged pupil with distending and itchy feelings of the eye, intermittent vomiting, indicate yin deficiency and yang hyperactivity, or liver qi stagnation.    
  • Irregular shape in the pupils may indicate kidney and liver deficiency, or yin deficiency with virtual fire.
  • Color change in the pupils may indicate deficiency of kidney and liver, or heart and spleen dysfunction.
 
Anatomical structures of eye in modern medicine
Anatomical structures of eye in modern medicine


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TCM Five Wheel Principles

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