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This text discusses the etiology, symptoms, and treatment of pediatric cataracts, divided into two parts: "Congenital Cataract" (Tai Huan Nei Zhang) and "Five Winds Transforming into Internal Cataract" (Wu Feng Bian Nei Zhang).

**Part 1: Congenital Cataract (Tai Huan Nei Zhang)**

When this eye disease first manifests, it is mostly due to the wet nurse's improper diet and inadequate care. If she indulges in eating damp wheat noodles, five pungent spices (Wu Xin, referring to five types of pungent vegetables such as garlic, chives, etc.), and various toxic elixirs, heat accumulates in the abdomen. This subsequently affects the fetus, causing the infant to suffer from eye disease while still in the womb. From birth until the age of five or six, the child does not speak or smile, and their gaze lacks spirit or focus. Parents only realize the abnormality at this stage. It is urgent to administer herbal medicine for regulation; one should avoid applying corrosive substances to the eyes or using cauterization and moxibustion on the head and face, which would merely damage the appearance without benefit. Only when the child reaches the age of fifteen can the shape of the intraocular opacity be clearly distinguished. The opacity appears bluish-white and fixes over the pupil, yet the patient may still distinguish the three lights (San Guang, referring to sunlight, moonlight, and lamplight). At this point, gold-needle cataract surgery (Jin Zhen Bo Zhi) can be performed. Most cases of pediatric internal cataract are difficult to cure; therefore, careful examination must precede any medical intervention. It is advisable to administer Hu Jing Wan (Eye-Protecting Pill), which will prevent further damage to the eyes.

The poem states:
Why do internal cataracts occur in children?
It is caused by heat in the fetus leading to the descent of brain fat.
Not noticeable at birth, within three years, the eye movements become sluggish.
At four or five years old, speech is faint, the pupil turns white, and vision becomes confused.
If one trusts and accepts the physician's advice,
And reads the subsequent poems of former sages.

Another poem states:
Pediatric internal cataracts should not be treated hastily;
Careful nursing is difficult to determine with certainty.
If parents wait until the child is eighteen,
Gold-needle manipulation yields results swift as flying clouds.
Foolishly applying cauterization and burning to the head and face,
Or licking and rubbing the eyes, depletes the Black Water (Hei Shui, referring to the pupil/kidney essence).
Damaged before proper treatment can begin,
Incapable of needle manipulation, only sorrow remains.

**Hu Jing Wan (Eye-Protecting Pill):**
Muxiang (Aucklandiae Radix), Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Heishen (Ginseng Radix Nigra, each 1 liang); Shegan (Belamcandae Rhizoma), Xixin (Asari Radix, each 0.5 liang).
Grind all ingredients into fine powder. Mix with refined honey to form pills the size of tung tree seeds. Take ten pills orally on an empty stomach with tea water.

**Part 2: Five Winds Transforming into Internal Cataract (Wu Feng Bian Nei Zhang)**

When this eye disease first occurs, it is accompanied by dizziness and unilateral headache. The root cause lies in deficiency and exhaustion of the zang-fu organs and internal wind generated by the liver. It may affect one eye initially, or both eyes may become dim due to vomiting, allowing toxic wind to invade the eyes, compounded by heat invading from the brain, resulting in blindness. Immediate treatment is required upon initial detection. It is suitable to administer Chu Feng Tang (Wind-Expelling Decoction) and Tong Ming Bu Shen Wan (Brightening Kidney-Nourishing Pill) for immediate effect.

The poem states:
Wu Wind, Lü Wind, Qing Wind, Hei Wind, and Huang Wind;
Alas, these are calamities from past lives.
The pupil's color resembles the bright moon,
Yet when asked if the three lights are visible, no light is seen.
Later, brain fat condenses like white frost,
Truly resembling the frosty hue of internal cataracts.
If physicians fail to recognize the condition and blindly use needles,
Although the opacity falls, the eye suffers injury.

**Chu Feng Tang (Wind-Expelling Decoction):**
Lingyangjiao (Saiga Tataricae Cornu), Cheqianzi (Plantaginis Semen, each 2 liang); Shaoyao (Paeoniae Radix), Renshen (Ginseng Radix), Fuling (Poria), Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Mangxiao (Natrii Sulfas, each 1 liang).
Grind all ingredients into fine powder. Take one qian of the powder with one cup of water, decoct until half remains. Strain and take warm after meals.

**Tong Ming Bu Shen Wan (Brightening Kidney-Nourishing Pill):**
Cheqianzi (Plantaginis Semen), Shijueming (Haliotidis Concha), Jiegeng (Platycodonis Radix), Shaoyao (Paeoniae Radix, each 1 liang); Xixin (Asari Radix, 2 liang); Dahuang (Rhei Radix et Rhizoma, 1 fen); Chongweizi (Leonuri Fructus), Gan Dihuang (Rehmanniae Radix Praeparata, each 2 liang).
Grind all ingredients into fine powder. Mix with refined honey to form pills the size of tung tree seeds. Take ten pills orally on an empty stomach with tea water.