论曰 肉攀睛淫肤垂睑之类，皆为外障，审其轻重，则有服食点洗之剂，钩割熨烙之法
，以外去者，盖其势微浅，所以除治在皮肤之表尔，内障之证异于是，有不痛不痒者，虚实
特未定也，有冰涩浮沉枣花偃月之翳，浅深固不一也，亦有清明无翳，若未尝萦疾苦者，则
患与未患又相似也，是以论内障者，每重于医疗，必俟之岁月，其翳成熟，乃用针拨，或一
之而愈，或再三而愈，若披云雾睹青天白日之快，方且封闭绵密以待安宁，而又服药以攻其
内，所以扫除荡涤，绝其本根，复其自然而已，世之专治者甚多，载在方册，不可概举。大
抵以龙木为师法，龙木内障二十有三，可以针者，一十有二，皆言针后用某汤某丸，则知内
障非针无以取效，且治眼至于针，诚出于不得已，岂可轻用妄投耶，针法具载别叙，今姑以
针后用药先后次第，列之于左。
治内障圆翳，状如冰水团圆，一点不散，针后羚羊角饮方
羚羊角（镑三两） 防风（去叉二两） 车前子 细辛（去苗叶） 人参 知母（焙） 黄
芩（
去黑心各一两）
上七味，粗捣筛，每服三钱匕，水一盏，煎至六分，去滓食后临卧温服。
治内障圆翳眼，针后及涩翳，针后防风汤方
防风（去叉） 茺蔚子 五味子 知母（焙） 桔梗（炒） 玄参 车前子 大黄（锉
焙） 细
辛（去苗叶） 黄芩（去黑心各一两）
上一十味，粗捣筛，每服三钱匕，水一盏，煎至六分，去滓温服，食后临卧，日二。
治内障冰翳，如水冻坚结睛上，拨之不下，针后及横关翳，针后还睛丸方
车前子 防风（去叉） 茺蔚子 知母（焙各二两） 人参 桔梗（炒） 黄芩（去黑
心各一
两） 五味子 细辛（去苗叶各一两半） 生干地黄（焙） 玄参（各半两）
上一十一味，捣罗为末，炼蜜和丸，如梧桐子大，空心茶清下十丸，至十五丸。
治内障滑翳，状似水银珠子，针拨之时，闭之不牢，针后及散翳，针后补肝汤方
人参 白茯苓（去黑皮） 玄参 黄芩（去黑心各一两） 防风（去叉） 知母 桔梗
（炒）
茺蔚子（各二两）
上八味，粗捣筛，每服三钱匕，水一盏，煎至六分，去滓温服，食后临卧。
治内障滑翳眼，针后石决明丸方
石决明 车前子 防风 知母（焙各二两） 茺蔚子 细辛（去苗叶） 五味子 黄芩
（去
黑心） 人参 白茯苓（去黑皮） 大黄（锉炒各一两）
上一十一味，捣罗为末，炼蜜和丸，如梧桐子大，每服十五丸，食前茶汤下。
治内障冰翳，如水冻坚结睛上，用针拨收之后，及散翳，七宝丸方
石决明（捣研二两） 人参 茺蔚子（各一两） 琥珀（捣研三分） 真珠（捣研半两）
龙脑
（研一分） 熊胆（半两）
上七味，捣研为末，炼蜜和丸，如梧桐子大，每服十五丸，食前茶清下，加至二十丸。
治内障散翳，状如酥点溃烂，以针拨如涎散乱，针后，及惊振内障眼，针后还睛汤方
人参 白茯苓（去黑皮） 细辛（去苗叶） 五味子 桔梗（炒各一两） 车前子 防
风（去
叉各二两）
上七味，粗捣筛，每服五钱匕，水一盏半，煎至八分，去滓夜卧温服。
治内障浮翳，或如枣花，或若银钉浮浅透外，针后决明散方
石决明（刮洗） 细辛（去苗叶） 防风（去叉） 车前子 人参 白茯苓（去黑皮） 大
黄（
锉炒） 茺蔚子（各一两） 桔梗（炒半两）
上九味，捣罗为散，每服二钱匕，粥饮调下，食后临卧服。
治内障浮翳针后及枣花翳，针后堕翳丸方
石决明（刮洗） 人参 知母（焙各一两） 细辛（去苗叶半两） 防风（去叉） 生
干地黄（
焙各二两） 五味子（一两半） 兔肝（一具炙干）
上八味，捣研为末，炼蜜和丸，如梧桐子大，每服二十丸，空心茶汤下，渐加至三十丸
治内障沉翳，隐隐伏藏，黑睛向日即见，针后服羚羊角汤方
羚羊角（镑） 防风（去叉） 茺蔚子（各二两） 车前子 黄芩（去黑心） 玄参（各
一两） 大
上七味，粗捣筛，每服三钱匕，水一盏，煎至六分，去滓温服，食前临卧。
治内障沉翳，针后空青丸方
空青（研如粉） 五味子 细辛（去苗叶） 石决明（刮洗捣研） 车前子（各一两） 生
干地
黄（焙） 防风（去叉） 知母（焙各二两）
上八味，捣研为末，炼蜜和丸，如梧桐子大，每服二十丸，空心茶汤下。
治内障横翳，横着瞳仁，中心起如剑脊，针后七宝汤方
羚羊角（镑） 犀角（镑） 丹砂（研各一两） 胡黄连 石决明（刮洗捣研） 车前
子甘草
（炙锉各半两）
上七味，除丹砂决明外，粗捣筛，每服三钱匕，水一盏，煎至七分，去滓入丹砂末半钱
匕，决明末一字匕，再煎两沸，温服食后。
治内障，偃月翳如凝脂，一边浓，一边薄，状如偃月，针后及内障枣花翳，针后四胆丸
方
象胆（半两） 鲤鱼胆（七枚） 熊胆（一分） 牛胆（半两） 石决明（捣研一两） 麝
香（研
一钱）
上六味，捣研为末，面糊和丸，如梧桐子大，每服空心茶清下十丸。
治惊振内障眼，针后镇肝丸方
山芋 茺蔚子（各二两） 防风（去叉一两半） 石决明（别捣研） 车前子 细辛（去
苗叶）
人参 白茯苓（去黑皮） 柏子仁（捣研一两）
上九味，捣研为末，炼蜜和丸，如梧桐子大，每服二十丸，食前茶清下。
治内障，黑水凝结青白色成翳，针后芦荟丸方
芦荟 人参（各半两） 柏子仁（捣研一两） 羚羊角（镑二两） 细辛（去苗叶一两）
甘草
（炙锉） 牛胆（干者别研入各一分）
上七味，除胆外，捣研为末，入研胆再和匀，炼蜜为丸，如梧桐子大，每服二十丸，空
心茶清下。
治内障黑水凝翳，针后通明汤方
柏子仁（捣研二两） 防风（去叉） 茺蔚子（各一两） 车前子 桔梗（炒各二两） 人
参
白茯苓（去黑皮） 玄参（各一两）
上八味，粗捣筛，每服三钱匕，水一盏，煎至六分，去滓温服，食后临卧。
治内障白翳，病久毒瓦斯不散，中心变黄色，针后决明车前散方
石决明（刮洗） 茺蔚子 防风（去叉各二两） 甘菊花 车前子 人参（各一两）
上六味，捣研为散，再同和匀，每服二钱匕，以粥饮调下，食后临卧服。
Discussion states: Conditions such as pterygium (fleshy growth climbing the cornea), excessive skin, and drooping eyelids all belong to external cataracts (external eye obstructions). After carefully assessing their severity, there are preparations for internal administration, eye drops, and washing, as well as methods of hooking, cutting, cauterizing, and branding. Since the pathogenic factor is minor and superficial, treatment focuses on the surface of the skin. The manifestations of internal cataracts (internal eye obstructions) differ from this; some present with no pain or itching, leaving the deficiency-excess pattern undetermined; others exhibit opacities described as ice-cold stiffness, floating/sinking, date-blossom, or crescent-moon shapes, varying in depth. There are also cases where vision remains clear without opacity, resembling a state of health free from distress, making the distinction between diseased and healthy states similar. Therefore, when discussing internal cataracts, medical intervention is emphasized, requiring time to wait for the opacity to mature before employing needle puncture (needle manipulation). Some recover after one session, while others require two or three sessions. The relief felt upon clearing the clouds to see the bright blue sky and sun is followed by strict protection to await stability, along with taking medications to treat internally. This serves to sweep away turbidity, eradicate the root cause, and restore natural function. Many specialists in treating eye diseases exist in the world, and their records in medical texts cannot be exhaustively listed. Generally, the *Longmu Treatise* (Dragon Wood Treatise) serves as the standard model. In the *Longmu Treatise*, twenty-three types of internal cataracts are recorded, twelve of which can be treated with needles. All mention using specific decoctions or pills after needling, indicating that internal cataracts cannot achieve efficacy without needling. Moreover, resorting to needles in eye treatment is truly a last resort; how can one casually use or recklessly administer them? Needling techniques are detailed elsewhere; here, we briefly list the sequence of medication usage following needling below.
Formula for Lingyang Jiao Yin (Antelope Horn Decoction) used after needling for round opacity (round cataract):
Lingyang Jiao (Antelope Horn, 3 liang, sliced), Fangfeng (Saposhnikovia Root, 2 liang, processed), Cheqianzi (Plantago Seed), Xixin (Asarum Root, processed), Renshen (Ginseng Root), Zhimu (Anemarrhena Rhizome, roasted), Huangqin (Scutellaria Root, 1 liang each, cleaned).
The above seven herbs are coarsely crushed and sifted. Take 3 qianbi per dose, add one zhan of water, boil until reduced to six parts, remove dregs, and take warm after meals and before bedtime.
Formula for Fangfeng Tang (Saposhnikovia Decoction) used after needling for round opacity eyes and涩 opacity (astringent opacity):
Fangfeng (Saposhnikovia Root, processed), Chongweizi (Chuanxiong Herb Seed), Wuweizi (Schisandra Fruit), Zhimu (Anemarrhena Rhizome, roasted), Jiegeng (Platycodon Root, stir-fried), Xuanshen (Scrophularia Root), Cheqianzi (Plantago Seed), Dahuang (Rhubarb Root, cut and roasted), Xixin (Asarum Root, processed), Huangqin (Scutellaria Root, 1 liang each, cleaned).
The above ten herbs are coarsely crushed and sifted. Take 3 qianbi per dose, add one zhan of water, boil until reduced to six parts, remove dregs, and take warm after meals and before bedtime, twice daily.
Formula for Huanjing Wan (Restore Vision Pill) used after needling for ice opacity (ice-like cataract) and horizontal barrier opacity:
Cheqianzi (Plantago Seed), Fangfeng (Saposhnikovia Root, processed), Chongweizi (Chuanxiong Herb Seed), Zhimu (Anemarrhena Rhizome, roasted, 2 liang each), Renshen (Ginseng Root), Jiegeng (Platycodon Root, stir-fried), Huangqin (Scutellaria Root, 1 liang each, cleaned), Wuweizi (Schisandra Fruit), Xixin (Asarum Root, processed, 1.5 liang each), Sheng Gan Dihuang (Rehmannia Root, dried/roasted), Xuanshen (Scrophularia Root, 0.5 liang each).
The above eleven herbs are pulverized into powder, mixed with refined honey to form pills the size of paulownia seeds. Take 10-15 pills on an empty stomach with tea infusion.
Formula for Bugan Tang (Tonify Liver Decoction) used after needling for slippery opacity (slippery cataract) and scattered opacity:
Renshen (Ginseng Root), Baifuling (Poria Sclerotium, peeled), Xuanshen (Scrophularia Root), Huangqin (Scutellaria Root, 1 liang each, cleaned), Fangfeng (Saposhnikovia Root, processed), Zhimu (Anemarrhena Rhizome), Jiegeng (Platycodon Root, stir-fried), Chongweizi (Chuanxiong Herb Seed, 2 liang each).
The above eight herbs are coarsely crushed and sifted. Take 3 qianbi per dose, add one zhan of water, boil until reduced to six parts, remove dregs, and take warm after meals and before bedtime.
Formula for Shijueming Wan (Hawk Eye Shell Pill) used after needling for slippery opacity eyes:
Shijueming (Hawk Eye Shell), Cheqianzi (Plantago Seed), Fangfeng (Saposhnikovia Root), Zhimu (Anemarrhena Rhizome, roasted, 2 liang each), Chongweizi (Chuanxiong Herb Seed), Xixin (Asarum Root, processed), Wuweizi (Schisandra Fruit), Huangqin (Scutellaria Root, cleaned), Renshen (Ginseng Root), Baifuling (Poria Sclerotium, peeled), Dahuang (Rhubarb Root, cut and stir-fried, 1 liang each).
The above eleven herbs are pulverized into powder, mixed with refined honey to form pills the size of paulownia seeds. Take 15 pills before meals with tea infusion.
Formula for Qibao Wan (Seven Treasures Pill) used after needling for ice opacity and scattered opacity:
Shijueming (Hawk Eye Shell, pounded and ground, 2 liang), Renshen (Ginseng Root), Chongweizi (Chuanxiong Herb Seed, 1 liang each), Hupo (Amber, pounded and ground, 3 fen), Zhenzhu (Pearl, pounded and ground, 0.5 liang), Longnao (Borneol, ground, 1 fen), Xiongdan (Bear Bile, 0.5 liang).
The above seven herbs are pounded and ground into powder, mixed with refined honey to form pills the size of paulownia seeds. Take 15 pills before meals with tea infusion, increasing to 20 pills.
Formula for Huanjing Tang (Restore Vision Decoction) used after needling for scattered opacity and startled internal cataract:
Renshen (Ginseng Root), Baifuling (Poria Sclerotium, peeled), Xixin (Asarum Root, processed), Wuweizi (Schisandra Fruit), Jiegeng (Platycodon Root, stir-fried, 1 liang each), Cheqianzi (Plantago Seed), Fangfeng (Saposhnikovia Root, processed, 2 liang each).
The above seven herbs are coarsely crushed and sifted. Take 5 qianbi per dose, add 1.5 zhan of water, boil until reduced to eight parts, remove dregs, and take warm before sleep.
Formula for Jueming San (Clear Vision Powder) used after needling for floating opacity (floating cataract) and date-blossom opacity:
Shijueming (Hawk Eye Shell, scraped and washed), Xixin (Asarum Root, processed), Fangfeng (Saposhnikovia Root, processed), Cheqianzi (Plantago Seed), Renshen (Ginseng Root), Baifuling (Poria Sclerotium, peeled), Dahuang (Rhubarb Root, cut and stir-fried), Chongweizi (Chuanxiong Herb Seed, 1 liang each), Jiegeng (Platycodon Root, stir-fried, 0.5 liang).
The above nine herbs are pulverized into powder. Take 2 qianbi per dose, mix with porridge drink, and take after meals and before bedtime.
Formula for Duoyi Wan (Fallen Opacity Pill) used after needling for floating opacity and date-blossom opacity:
Shijueming (Hawk Eye Shell, scraped and washed), Renshen (Ginseng Root), Zhimu (Anemarrhena Rhizome, roasted, 1 liang each), Xixin (Asarum Root, processed, 0.5 liang), Fangfeng (Saposhnikovia Root, processed), Sheng Gan Dihuang (Rehmannia Root, dried/roasted, 2 liang each), Wuweizi (Schisandra Fruit, 1.5 liang), Tugan (Rabbit Liver, roasted and dried, one piece).
The above eight herbs are pounded and ground into powder, mixed with refined honey to form pills the size of paulownia seeds. Take 20 pills on an empty stomach with tea infusion, gradually increasing to 30 pills.
Formula for Lingyang Jiao Tang (Antelope Horn Decoction) taken after needling for sinking opacity (sinking cataract):
Lingyang Jiao (Antelope Horn, sliced), Fangfeng (Saposhnikovia Root, processed), Chongweizi (Chuanxiong Herb Seed, 2 liang each), Cheqianzi (Plantago Seed), Huangqin (Scutellaria Root, cleaned), Xuanshen (Scrophularia Root, 1 liang each).
The above seven herbs are coarsely crushed and sifted. Take 3 qianbi per dose, add one zhan of water, boil until reduced to six parts, remove dregs, and take warm before meals and before bedtime.
Formula for Kongqing Wan (Azurite Pill) used after needling for sinking opacity:
Kongqing (Azurite, ground to powder), Wuweizi (Schisandra Fruit), Xixin (Asarum Root, processed), Shijueming (Hawk Eye Shell, scraped, washed, pounded and ground), Cheqianzi (Plantago Seed, 1 liang each), Sheng Gan Dihuang (Rehmannia Root, dried/roasted), Fangfeng (Saposhnikovia Root, processed), Zhimu (Anemarrhena Rhizome, roasted, 2 liang each).
The above eight herbs are pounded and ground into powder, mixed with refined honey to form pills the size of paulownia seeds. Take 20 pills on an empty stomach with tea infusion.
Formula for Qibao Tang (Seven Treasures Decoction) used after needling for horizontal opacity (horizontal cataract):
Lingyang Jiao (Antelope Horn, sliced), Xijiao (Rhinoceros Horn, sliced), Dansha (Cinnabar, ground, 1 liang each), Huhuanglian (Picrorhiza Rhizome), Shijueming (Hawk Eye Shell, scraped, washed, pounded and ground), Cheqianzi (Plantago Seed), Gancao (Licorice Root, roasted and cut, 0.5 liang each).
Except for Dansha and Shijueming, the above seven herbs are coarsely crushed and sifted. Take 3 qianbi per dose, add one zhan of water, boil until reduced to seven parts, remove dregs, add half a qianbi of Dansha powder and one zi of Shijueming powder, boil for two more boils, and take warm after meals.
Formula for Sidan Wan (Four Gall Pills) used after needling for crescent-moon opacity and date-blossom opacity:
Xiangdan (Elephant Gall), Liyu Dan (Carp Gall, seven pieces), Xiongdan (Bear Bile, 1 fen), Niudan (Ox Gall, 0.5 liang), Shijueming (Hawk Eye Shell, pounded and ground, 1 liang), Shexiang (Musk, ground, 1 qian).
The above six herbs are pounded and ground into powder, mixed with flour paste to form pills the size of paulownia seeds. Take 10 pills on an empty stomach with tea infusion.
Formula for Zhen Gan Wan (Settle Liver Pill) used after needling for startled internal cataract:
Shanyu (Dioscorea Rhizome), Chongweizi (Chuanxiong Herb Seed, 2 liang each), Fangfeng (Saposhnikovia Root, processed, 1.5 liang), Shijueming (Hawk Eye Shell, separately pounded and ground), Cheqianzi (Plantago Seed), Xixin (Asarum Root, processed), Renshen (Ginseng Root), Baifuling (Poria Sclerotium, peeled), Baiziren (Biota Seed, pounded and ground, 1 liang).
The above nine herbs are pounded and ground into powder, mixed with refined honey to form pills the size of paulownia seeds. Take 20 pills before meals with tea infusion.
Formula for Lushui Wan (Aloe Pill) used after needling for black water condensation forming green-white opacity:
Lushui (Aloe), Renshen (Ginseng Root, 0.5 liang each), Baiziren (Biota Seed, pounded and ground, 1 liang), Lingyang Jiao (Antelope Horn, sliced, 2 liang), Xixin (Asarum Root, processed, 1 liang), Gancao (Licorice Root, roasted and cut), Niudan (Ox Gall, dried, separately ground, 1 fen each).
Except for the gallbladders, the above seven herbs are pounded and ground into powder, mixed with the ground gallbladders, then formed into pills with refined honey the size of paulownia seeds. Take 20 pills on an empty stomach with tea infusion.
Formula for Tongming Tang (Clear Vision Decoction) used after needling for black water condensation opacity:
Baiziren (Biota Seed, pounded and ground, 2 liang), Fangfeng (Saposhnikovia Root, processed), Chongweizi (Chuanxiong Herb Seed, 1 liang each), Cheqianzi (Plantago Seed), Jiegeng (Platycodon Root, stir-fried, 2 liang each), Renshen (Ginseng Root), Baifuling (Poria Sclerotium, peeled), Xuanshen (Scrophularia Root, 1 liang each).
The above eight herbs are coarsely crushed and sifted. Take 3 qianbi per dose, add one zhan of water, boil until reduced to six parts, remove dregs, and take warm after meals and before bedtime.
Formula for Jueming Cheqian San (Clear Vision Plantago Powder) used after needling for white opacity:
Shijueming (Hawk Eye Shell, scraped and washed), Chongweizi (Chuanxiong Herb Seed), Fangfeng (Saposhnikovia Root, processed, 2 liang each), Gan Juhua (Chrysanthemum Flower), Cheqianzi (Plantago Seed), Renshen (Ginseng Root, 1 liang each).
The above six herbs are pounded and ground into powder, mixed evenly. Take 2 qianbi per dose, mix with porridge drink, and take after meals and before bedtime.