古人论内障有大圆翳小圆翳，人秉父母胎元，瞳人大小不一，瞳人大者其翳大，
瞳人小者其翳小，脑脂流下，经年凝结而成翳也。医者用针，自有浅深，翳大针浅，
翳不能落，翳小针深，岂不损睛，误治者可不慎乎！
凡镰洗，查逐日人神所在其经，忌用刀针。
翳障复起，宜平肝顺气，其障自落，如不能落，复针亦可。
凡针后忌用川芎，恐行血作痛。如痛用熟地、当归、白芍之类。
瞳人清，白珠红，用桑白皮、防风、柴胡、赤芍。
瞳人内有油气不清，当平肝气，用柴胡、枳壳。
若作恶心，用藿香、浓朴、半夏、淡豆豉。
头痛、太阳痛，用防风、白芷、羌活、石膏。
太阳痛甚，用炒盐熨之。
白珠赤，用柴胡、红花、赤芍、归尾、桃仁、桑白皮。
瞳人散大，用白芍、茯神、人参、麦冬、当归、枣仁、北五味。
凡受热致瞳人小者，用当归、川芎、黄连、麦冬、茺蔚子、柴胡、山栀。
大圆翳 按此证先由肾水亏损，后由恼怒伤肝。盖眼属脏腑而以肝肾为本，肾
为水之源，眼为水之精，色欲过度，肾水衰弱，不能生养肝木，亦不能荣养眼珠，加
以七情暴怒，心胸热气上冲入脑，脑脂不固，下注于目，凝滞遮盖于瞳人前，结成
内障。起时眼前常见垂 飞蝇，薄雾轻烟，不疼不痛，渐渐失明，先从一眼，久后相
传。其脂青白色，所禀父母胎元，瞳人大者，其翳即大，故曰大圆翳。阴看则大，阳
看则小，初觉宜服冲和养胃汤、（柴胡、当归、白芍、甘草、葛根、人参、黄 、白术、五味子、羌活、
防风、白茯苓，口干加黄连、黄芩。）石斛夜光丸。（人参、山药、牛膝、菟丝子、五味子、麦门冬、羚
羊角、肉苁蓉、川芎、生地、天门冬、白蒺藜、枸杞子、青葙子、草决明、杏仁、石斛、枳壳、犀角、白
茯苓、甘草、防风、黄连。）年久宜用金针拨之。
小圆翳 按此证与大圆翳受病相同。俱因欲怒致伤肝肾，热气上冲，脑脂下注，
结成青白翳，遮盖瞳仁。夫瞳仁神水通注于胆，脏腑平和，气血循环，胆汁通流于
上，则能鉴照万物；肝肾既伤，热气上冲不散，胆汁不能流通，是以脂凝成障。名
曰小圆翳者，所禀父母胎元，瞳仁小者，脂即小故也。虽见三光，不辨人物。初起宜
服冲和养胃汤、石斛夜光丸。年久宜鼠尾金针拨之。
浮翳内障 按此证初起由色欲过度，耗竭肾水，水亏火旺，攻翳于目，视物即
昏昧如雾露中，全不疼痛；渐因七情郁结，纵欲伤肝，以致热气上冲于脑，脑脂灌注
睛内，结成一块光亮如银箔色，浮在瞳人上。先从一眼，久后相传，不见三光。金
针难拨，初起宜补肾平肝。（治同上）
沉翳内障 按此证皆因肾经亏损，肝
心火盛，致目视昏昧，眼前常见黑花，脑中恶气渐渐侵瞳；二三年外，凝结成翳青
白色，如沉水中，若见三光，宜针拨之。（治同上）
涩翳内障 按此证皆因淫欲伤肾，纵怒伤肝，肝肾两伤，以失生化之源，致令
气血虚弱，不能荣养双眸。日久邪热炎上，脑脂下流，结成一块，遮盖瞳人，黄色而
大，凝滞无收吸，故曰涩翳。初患同前治，久后不宜针拨。
滑翳内障 按此证皆因肝肾并虚，致使脑脂灌注珠内，形如水银珠子，流动吸
收不定，不疼不痒，只因昏花而起，日久相传，渐渐失明，虽见三光，不辨人物。治
同前。如年久用莲子金针拨之。
散翳内障 按此证皆由五脏虚劳，酒色过度，加之忧思暴怒，肝气上冲，脑中
恶气流下，凝滞瞳人之前，结而成翳，或浓或淡，浓薄不一，其色黄白，散大而无
收吸，虽见三光，不宜针拨，不能治也。
冰翳内障 按此证皆因肝肾亏损，风火上炎，攻冲痰动，以致头旋连脸，眉骨
额骨偏痛，眼中赤涩，或黄、白、黑色不定，或夜见烟火，久则结成内障，其脂如
欲解之冰，又如碎磁之状，故曰冰翳。初起宜驱风痰，服半夏白术天麻汤，（人参、白术、
半夏、天麻、干姜、陈皮、神曲、泽泻、苍术、麦冬、黄 、黄柏、黄芩。）神效补肝散，
（夏枯草、香附各二两，甘草四钱为末，每服三钱、茶下。）不宜针拨。
金星内障 按此证初患头痛，脸觉微肿，目中赤色，常见黑花撩乱，瞳人渐昏
渐小，内有脑脂如金箔色，不宜针拨，亦不能治；皆因水衰火盛所致，水本克火，水
衰不能克火，反受火制，故火愈炽而水愈竭矣。初觉以养血凉血，补肾清火为主，大
抵此证，最为难治。
横剑翳内障 按此证皆因肝肾亏败，房劳不节，以致昏暗，不痛不痒，先从一
眼，久后相传，两目俱损。如剑横于瞳人之上，虽见三光，不宜针拨。初起宜石斛
夜光丸。
枣花翳内障 按此证皆因肝肾不足，水衰火盛，头痛脑旋，见花飞黄黑不定，瞳
人周遭如锯齿，故曰枣花翳。初起微觉昏暗，皆能视物，宜服冲和养胃汤、石斛夜
光丸，俱去五味子，加茺蔚子为君，服之可保。如久后内有一点蓝星，则不能治，亦不能拨。
偃月翳内障 按此证乃肝亏肾损，虚火上炎，致使脑脂流下，遮蔽瞳人，渐成
白色，如初十夜之月，半薄半浓，半明半偃。先从一眼，久后相传，瞳人俱损，不宜针拨。
惊振翳内障 按此证皆因肝肾二经虚劳，偶遇打撞，惊动脑脂流下，渐渐昏朦
成翳，久则白色。亦有自下而入肝经者，亦有随惊随散者。瞳人无收吸，虽见三光，不
宜针拨，治同圆翳。
雷头风内障 按此证初患头痛足冷，恶心呕吐，脑内如雷鸣，致使瞳人散大，渐
渐失明，不睹三光。皆因暴怒伤肝，体气虚弱，风寒之气所侵，逆于三焦，攻冲于
头。因头为诸阳之所会，邪正相传，伏而不散，故发痛如雷鸣；胃为寒气所冲，故
恶心呕吐；瞳人神水，乃气之聚也，气为怒伤，故散而不聚。初起急服附子猪苓汤、
（人参、白芍、白茯苓、羌活、熟地、猪苓、熟附子。）香芎散、（川芎、石膏、香
附、薄荷、白芷、川乌 甘草为末，每服二钱。）石斛夜光丸（倍加五味子。）以收散
大，痛极不止，用乳香定痛散吹鼻。（乳香、没药、雄黄、石膏、川芎各五钱，焰硝一分五厘，研细，噙
水吹少许入鼻内，痛即止。）久则不治。
绿风内障 按此证初患头额痛急，兼半边头痛，鼻内如烟，恶心呕逆，足冷，眼
内见红黑，皆因肝肾俱虚，气血亏损，瞳人渐渐散大，神水淡绿色。大抵受病与雷
头风相同，但因头痛暴怒过极，热气上冲，脑中恶气流于珠内，与神水搅混而变成绿
色，故谓绿风内障。久则不睹三光则不能治。初起先止头痛，服附子猪苓汤，候痛
止，服冲和汤，加减夜光丸去肉苁蓉，俱倍加五味子。
黄风内障 按此证初患之时头痛，乃是肝肾亏虚，风毒相侵，又兼脾肺壅热，白
睛黄色，先患绿风内障，呕吐伤胃，久则变为黄色，此乃不治之证也。
乌风内障 按此证皆因色欲过度，以伤元气。元气一虚，心火亢盛，致眼前常
见黑花，眼眶鼻梁眉骨俱酸疼，白睛高起数粒，色青如豆，瞳人渐渐紧小，视物不
明。瞳人属肾水，水本克火，反受火制，故昏暗紧小；火克肺金，白睛属肺，火克则
护睛水滞结隐起，高低不平，飞花酸痛等证，乃火气拂郁，血虚挟风故也。初起宜
服神效补肝散、选奇汤（陈皮、半夏、甘草、羌活、白茯苓、黄芩、防己、姜一片同煎。）散风补血，后
服补中益气汤、石斛夜光丸益气滋阴。不见三光，不能治也。
黑风内障 按此证皆因气体虚弱，肝肾不足，兼以七情郁结，邪火上盛，逆冲
于头目，以致头旋脑痛，眼中昏涩，常见黑花，渐至瞳人散大失明，瞳人实气聚而
成。火盛气散，故失明矣，此不治之证也。
五风变化内障 按此证皆因气血两虚，脏腑俱劳，毒风上攻，脑热相侵，头
旋脑痛呕吐，故此失明，不可治也。
瞳人散大内障 按此证皆因肝肾亏损，况怒伤肝，恐伤肾，肝肾受伤则瞳人
散大；盖瞳人属肾，乃气之所聚也，怒伤则气散。初起昏如雾露中行，渐空中有黑
花，睹一成二，久则不收。遂为废疾。盖神水渐散，终至尽散。初宜冲和汤、夜光
丸去肉苁蓉，倍加五味子收之；俟少有光，兼服千金磁朱丸。（先以磁石置火中醋粹七次晒干，
另研极细末二两，辰砂细末二两，生神曲三两，外以一两水调作饼，煮浮为度，搜入前药和炼蜜为丸如桐子大，
每服十丸，加至三十丸，空心米汤吞下。凡服此药后俯视不见，仰视渐睹三光，此其效也。空心服此，午后服
石斛夜光丸。）此乃虚证镇坠之药，不宜服早，恐坠元气。若气为怒伤，散而不聚者，服
益阴肾气丸。（熟地、山药、山萸肉、生地、白茯苓、
牡丹皮、泽泻、五味子、当归、柴胡，炼蜜为丸，辰砂为衣，每服五七丸，空心淡盐汤徐送下。此壮水之主以
镇阳光，气为怒伤，散而不聚之故也。然必兼磁朱丸服之，庶几为易效。）又为物击，神水遂散，此不治之证也。
瞳人紧小内障 按此证因肾水亏弱，相火强盛，水弱火盛则水受火制，故瞳人
渐渐紧小。瞳人者，肾水也，初起无痛痒眵泪之证，但觉羞涩 ，瞳人毛缺，肝
水青黄，宜服还阴救苦汤，（川芎、甘草、黄柏、桔梗、柴胡、防风、羌活、黄连、知母、黄芩 红花、生
地、龙胆草、当归尾、连翘、升麻、细辛、苍术、 本，白水煎服。）御抑相火。夜光丸补肾壮水。（去五
味子，加茺蔚子。畏其酸有收之意。）若日久不节色欲，不避劳苦，忽加眉骨酸痛，必致小如
菜子，内凝脑脂，或黄或白，永不能治。
小儿胎元内障 按此证皆因母怀孕时有暴怒惊恐，兼饮食乖违，将息失度，母
食面食五辛炙 之物，并服诸毒丹药，积热在腹，内攻小儿损目，及生二三岁后，不
言不哭，都无盼视，父母始觉；及长成方知内障，内有翳青白色遮盖瞳人，若辨三
光，有用金针可拨者。大抵小儿内障多难治疗。
经曰∶目者五脏六腑之华，荣卫魂魄之精常荣也。又曰∶诸脉者皆属于目，目
得血而能视，故脏腑精气皆上注于目而为之睛。白睛属肺，黑睛属肝，瞳人属肾，上
下胞属脾，两 属心而内 又属胆与三焦，上纲属太阳膀胱小肠，下纲属阳明大肠。五
脏五色，各有所司，心主赤，赤甚者心实热也，赤微者心虚热；肝主青，青甚者肝
热也，淡青者肝虚也；脾主黄，黄甚者脾热也，淡黄者脾虚也；目无睛光及白睛多
而黑睛少者，肝肾俱不足也。昼视通明，夜视罔见者，禀受阳气衰弱，遇夜阴盛则阳
愈衰，故不能视也。赤脉从上而下者属足太阳经，从下而上者，属足阳明经。若上
眼皮而下出黑白翳者，属太阳寒水；从外至内者属少阳风热；从下至上而绿色者，属
足阳明及肺肾合病。然翳膜者风热内蕴也，
邪气未定谓之热翳而浮于外，邪气既定谓之冰翳而沉于内，邪气若深谓之陷翳，此
宜升发以消之。更有疳眼者。因肝火湿热上冲，脾气有亏，不能上升清气，故生白
翳，睫闭不开，眵泪糊久而脓流，遂致损目。雀目者，上午能视，临晚失明，此因
肝气衰弱也。盖木生于子，旺于卯，绝于申，所以上午而能视，至申西而失明；况
目得血而能视，午后肝气渐衰，且阴虚则火必盛，弱阴不能以胜强火，故夜转剧；天
明以阳用事，阳主动，浊阴暂消故稍明。大要治肝养血，兼理脾胃为主。更有目闭而
不能开者，有因过服寒凉之剂，致使阳气下陷不能升举而然；有因胃气亏损，眼睫
无力而然，并宜升阳益胃。更有暴赤肿痛，风火炽盛者，有因多泪羞明，肝心积热者，
一宜疏风散火，一宜凉血清肝。若风沿烂眼者，是膈有热也；若时时作痒者，是脓
溃生虫也；若眼睫连扎者，是肝经风热也；若初生目黄壮热，二便秘结，面赤眼闭者，
此胎热也；更有痘后精血既亏，余毒上侵及斑疮入眼者，有视物不明，不肿不痛，但
见黑花而无精光者，此皆肝肾并虚也。若外无翳膜，内障如云，视物不见，俗名青
盲者，若非肾水枯涸，则必久病成疳。脉洪大者养血为先，脉沉细者补阳为主。盖
天无日色，虽有火镜，何能使晶光相射乎？若吐泻后而始生膜障，不能开举及无精光
者，此精滋泻脱，无神已亡也，难治。更有热毒眼小，积毒眼小者，更有时气流行
而肿赤者，然治法总忌寒凉及单行发散，盖寒则凝，热则散而风则燥耳。况目病虽由
火热，然多因初感风寒，腠理闭密，火热不得外泄，上走空窍而为病。若散其外感，
则火热泄而痛自止，兼之养血凉血退翳诸剂，必兼风药，始能上达头目。且火郁则
发之，以减其盛势；若概用寒凉则邪愈凝滞；亦不可发汗，汗则津液耗而血亦燥，燥
则其疾愈甚矣。更有目疾血瘀血热，而投以破血凉血之剂者，或投以寒凉损脾之剂
者，皆为不可。盖脾为至阴，归明于目，况目得血而能视，血少则热火愈动而目愈昏。
夫血者木之精脉也，精光者木之华叶也，脾胃者木之根本也，故莫若以上病治下之法，
古人论述内障眼病时，提到有大圆翳和小圆翳两种。人禀受父母的先天胎元之气，瞳孔的大小各不相同；瞳孔大的人，其形成的翳障也大；瞳孔小的人，其形成的翳障也小。这是由于脑部的脂液流下，经过多年凝结而形成的翳障。医生使用金针拨障手术时，进针的深浅自有定法：如果翳障大但进针浅，翳障不能脱落；如果翳障小但进针深，岂不是会损伤眼球？误治的情况难道可以不谨慎吗！
凡是进行镰洗（一种眼科外治法）时，必须查阅每日“人神”所在的经络，忌讳在该经络上使用刀针。
如果翳障消退后又复发，应当平抑肝气、顺调气机，翳障自然会脱落；如果不能脱落，再次进行针刺拨障也是可以的。
凡是针刺之后，忌讳使用川芎，因为川芎行血作用强，可能会引起疼痛。如果出现疼痛，可以使用熟地黄、当归、白芍等药物。
如果瞳孔清澈，但眼白（白珠）发红，可以使用桑白皮、防风、柴胡、赤芍。
如果瞳孔内有油雾样的浑浊不清，应当平抑肝气，使用柴胡、枳壳。
如果太阳经疼痛剧烈，可以用炒热的盐熨敷患处。
如果眼白发红，可以使用柴胡、红花、赤芍、当归尾、桃仁、桑白皮。
如果瞳孔散大，可以使用白芍、茯神、人参、麦冬、当归、酸枣仁、北五味子。
凡是因受热导致瞳孔缩小的，可以使用当归、川芎、黄连、麦冬、茺蔚子、柴胡、山栀。
【大圆翳】按此证候，起初是由于肾水亏损，后来因恼怒伤及肝脏。眼睛与脏腑相关，而以肝肾为本。肾为水的源头，眼睛是水的精华。如果房事过度，肾水衰弱，就不能滋养肝木，也不能荣养眼珠。再加上七情中的暴怒，心胸的热气上冲入脑，导致脑部脂液不固，向下灌注到眼睛，凝滞并遮盖在瞳孔前面，结成内障。发病时眼前常看到有垂下的飞蝇状黑影，像薄雾轻烟一样，不疼不痛，渐渐失明，先从一只眼睛开始，久了后传给另一只眼睛。这种脂液呈青白色，禀受父母胎元，瞳孔大的人，其翳障就大，所以叫做大圆翳。阴看时显得大，阳看时显得小，初起时适宜服用冲和养胃汤（组成：柴胡、当归、白芍、甘草、葛根、人参、黄芩、白术、五味子、羌活、防风、白茯苓，口干加黄连、黄芩）和石斛夜光丸（组成：人参、山药、牛膝、菟丝子、五味子、麦门冬、羚羊角、肉苁蓉、川芎、生地、天门冬、白蒺藜、枸杞子、青葙子、草决明、杏仁、石斛、枳壳、犀角、白茯苓、甘草、防风、黄连）。病程长久者，适宜用金针拨除。
【小圆翳】按此证候与大圆翳致病原因相同。都是因为欲望和愤怒导致肝肾受伤，热气上冲，脑部脂液下注，结成青白色的翳障，遮盖瞳孔。瞳孔的神水通注于胆腑，脏腑平和，气血循环通畅，胆汁流通向上，就能鉴照万物；现在肝肾既已受伤，热气上冲不散，胆汁不能流通，因此脂液凝结形成翳障。名叫小圆翳，是因为禀受父母胎元，瞳孔小的人，脂液形成的翳障也就小。虽然能看到日月光辉（三光），但不能分辨人物。初起时适宜服用冲和养胃汤、石斛夜光丸。病程长久者，适宜用鼠尾状的金针拨除。
【浮翳内障】按此证候初起是由房事过度，耗竭肾水，水亏火旺，攻冲于目，视物昏昧如同在雾露之中，完全不疼痛；逐渐因七情郁结，纵欲伤肝，以致热气上冲于脑，脑部脂液灌注睛内，结成一团光亮如银箔颜色的翳，浮在瞳孔上面。先从一只眼睛开始，久了后传给另一只眼睛，看不见三光。金针难以拨动，初起时适宜补肾平肝。（治疗方法同上）
【沉翳内障】按此证候都是因为肾经亏损，肝心火盛，导致视力昏昧，眼前常见黑花，脑中恶气渐渐侵扰瞳孔；两三年后，凝结成青白色的翳，如同沉在水中，如果还能看见三光，适宜针刺拨除。（治疗方法同上）
【涩翳内障】按此证候都是因为淫欲伤肾，纵怒伤肝，肝肾两伤，失去了生化之源，导致气血虚弱，不能荣养双眼。日久邪热炎上，脑部脂液下流，结成一团，遮盖瞳孔，颜色黄色且大，凝滞没有收吸之力，所以叫做涩翳。初患时同前面的治法，久后不宜针刺拨除。
【滑翳内障】按此证候都是因为肝肾俱虚，致使脑部脂液灌注眼球内，形状像水银珠子，流动吸收不定，不疼不痒，只因视力昏花而起，日久相传，渐渐失明，虽然能看到三光，但不能分辨人物。治疗同前法。如果病程长久，用莲子状的金针拨除。
【散翳内障】按此证候都是由五脏虚劳，酒色过度，加上忧思暴怒，肝气上冲，脑中恶气流下，凝滞在瞳孔之前，结而成翳，或浓或淡，浓薄不一，颜色黄白，散大而没有收吸之力，虽然能看到三光，但不宜针刺拨除，无法治愈。
【冰翳内障】按此证候都是因为肝肾亏损，风火上炎，攻冲痰动，以致头晕连及面部，眉骨额骨偏侧疼痛，眼中赤涩，颜色或黄、白、黑色不定，或者夜间看见烟火，久了则结成内障，其脂液像要融化的冰，又像碎瓷片的样子，所以叫做冰翳。初起时适宜驱除风痰，服用半夏白术天麻汤（组成：人参、白术、半夏、天麻、干姜、陈皮、神曲、泽泻、苍术、麦冬、黄芩、黄柏、黄芩）、神效补肝散（组成：夏枯草、香附各二两，甘草四钱研为末，每次服三钱，茶送下），不宜针刺拨除。
【金星内障】按此证候初患时头痛，脸部感觉微肿，眼中红色，常见黑花撩乱，瞳孔渐渐昏花渐小，里面有脑部脂液像金箔颜色，不宜针刺拨除，也不能治愈；这都是因为水衰火盛所致，水本来克火，水衰不能克火，反而受火制约，所以火越炽盛而水越枯竭。初觉时以养血凉血、补肾清火为主，大抵此证最为难治。
【横剑翳内障】按此证候都是因为肝肾亏败，房劳不节，以致昏暗，不痛不痒，先从一只眼睛开始，久了后传给另一只眼睛，两眼都受损。像剑横在瞳孔上面，虽然能看到三光，不宜针刺拨除。初起时适宜服用石斛夜光丸。
【枣花翳内障】按此证候都是因为肝肾不足，水衰火盛，头痛头晕，看见花朵飞舞，颜色黄黑不定，瞳孔周围像锯齿一样，所以叫做枣花翳。初起时微微觉得昏暗，都能视物，适宜服用冲和养胃汤、石斛夜光丸，都要去掉五味子，加入茺蔚子作为主药，服用后可以保全视力。如果久后内部有一点蓝星，则不能治愈，也不能拨除。
【偃月翳内障】按此证候乃是肝亏肾损，虚火上炎，致使脑部脂液流下，遮蔽瞳孔，渐渐变成白色，像初十夜晚的月亮，半薄半浓，半明半暗。先从一只眼睛开始，久了后传给另一只眼睛，瞳孔都受损，不宜针刺拨除。
【惊振翳内障】按此证候都是因为肝肾二经虚劳，偶遇打撞，惊动脑部脂液流下，渐渐昏朦成翳，久了则变白。也有从下面进入肝经的，也有随着惊吓随即消散的。瞳孔没有收吸之力，虽然能看到三光，不宜针刺拨除，治疗同圆翳内障。
【雷头风内障】按此证候初患时头痛脚冷，恶心呕吐，脑内如雷鸣声，致使瞳孔散大，渐渐失明，看不见三光。都是因为暴怒伤肝，体质虚弱，风寒之气所侵，逆乱于三焦，攻冲于头部。因为头是诸阳经汇聚的地方，邪正相争，伏留而不散，所以发作疼痛如雷鸣；胃被寒气冲犯，所以恶心呕吐；瞳孔的神水，是气的聚集，气被怒伤，所以散开而不能聚合。初起时急服附子猪苓汤（组成：人参、白芍、白茯苓、羌活、熟地、猪苓、熟附子）、香芎散（组成：川芎、石膏、香附、薄荷、白芷、川乌、甘草研为末，每次服二钱）、石斛夜光丸（加倍五味子）以收敛散大的瞳孔；疼痛极度不止时，用乳香定痛散吹入鼻中（组成：乳香、没药、雄黄、石膏、川芎各五钱，焰硝一分五厘，研细，含水噙着吹少许入鼻内，疼痛即止）。久了则无法治疗。
【绿风内障】按此证候初患时头额部疼痛急促，兼半边头痛，鼻内如烟熏感，恶心呕吐，脚冷，眼内看见红黑色，都是因为肝肾俱虚，气血亏损，瞳孔渐渐散大，神水呈淡绿色。大抵受病与雷头风相同，但因为头痛暴怒过极，热气上冲，脑中恶气流于眼球内，与神水搅混而变成绿色，所以谓之为绿风内障。久了后看不见三光则不能治愈。初起先止头痛，服用附子猪苓汤，等疼痛停止后，服用冲和汤，加减夜光丸去掉肉苁蓉，都要加倍五味子。
【黄风内障】按此证候初患时头痛，乃是肝肾亏虚，风毒相侵，又兼脾肺壅热，白睛黄色，先前患有绿风内障，呕吐伤胃，久了则变为黄色，这是不治之证。
【乌风内障】按此证候都是因为房事过度，损伤元气。元气一虚，心火亢盛，致眼前常见黑花，眼眶鼻梁眉骨都酸疼，白睛高起几粒，颜色青如豆子，瞳孔渐渐紧小，视物不明。瞳孔属肾水，水本来克火，反受火制约，所以昏暗紧小；火克肺金，白睛属肺，火克则护睛之水滞结隐起，高低不平，飞花酸痛等症状，乃是火气拂郁，血虚挟风所致。初起时适宜服用神效补肝散、选奇汤（组成：陈皮、半夏、甘草、羌活、白茯苓、黄芩、防己、姜一片同煎）以散风补血，后来服用补中益气汤、石斛夜光丸以益气滋阴。看不见三光，不能治愈。
【黑风内障】按此证候都是因为气体虚弱，肝肾不足，兼以七情郁结，邪火上盛，逆冲于头目，以致头晕脑痛，眼中昏涩，常见黑花，渐渐至瞳孔散大失明，瞳孔实为气聚而成。火盛气散，所以失明了，这是不治之证。
【五风变化内障】按此证候都是因为气血两虚，脏腑俱劳，毒风上攻，脑热相侵，头晕脑痛呕吐，所以失明，不可治愈。
【瞳人散大内障】按此证候都是因为肝肾亏损，况且怒伤肝，恐伤肾，肝肾受伤则瞳孔散大；盖瞳孔属肾，乃气之所聚，怒伤则气散。初起时昏蒙如在雾露中行走，渐渐空中有黑花，看一个看成两个，久了则不能收回。遂成为废疾。盖神水渐渐散开，终至完全散尽。初起适宜冲和汤、夜光丸去掉肉苁蓉，加倍五味子以收敛；等到稍有光线，兼服千金磁朱丸（先将磁石放在火中醋淬七次晒干，另研极细末二两，辰砂细末二两，生神曲三两，外面用一两水调成饼，煮至浮起为度，揉入前药和炼蜜制成梧桐子大小的丸药，每次服十丸，加至三十丸，空腹米汤吞下。凡是服用此药后俯视不见，仰视渐渐能看见三光，这就是它的疗效。空腹服此药，午后服石斛夜光丸。）这是虚证用的镇坠药物，不宜过早服用，恐怕损伤元气。如果气被怒伤，散开而不能聚合的，服用益阴肾气丸（组成：熟地、山药、山萸肉、生地、白茯苓、牡丹皮、泽泻、五味子、当归、柴胡，炼蜜为丸，辰砂为衣，每次服五七丸，空腹淡盐汤徐徐送下。这是壮水之主以镇阳光，解决气被怒伤、散而不聚的缘故。然而必须兼服磁朱丸，才容易见效。）又如果是被物体击打，神水遂散，这是不治之证。
【瞳人紧小内障】按此证候因肾水亏弱，相火强盛，水弱火盛则水受火制约，所以瞳孔渐渐紧小。瞳孔者，是肾水，初起时无痛痒眵泪的症状，只觉得羞涩，瞳孔边缘毛缺，肝水青黄，适宜服用还阴救苦汤（组成：川芎、甘草、黄柏、桔梗、柴胡、防风、羌活、黄连、知母、黄芩、红花、生地、龙胆草、当归尾、连翘、升麻、细辛、苍术、藁本，白水煎服）以御抑相火。夜光丸补肾壮水（去掉五味子，加茺蔚子。担心其酸味有收敛之意）。如果日久不节制色欲，不躲避劳苦，忽然加上眉骨酸痛，必定致瞳孔小如菜籽，内部凝结脑部脂液，或黄或白，永远不能治愈。
【小儿胎元内障】按此证候都是因为母亲怀孕时有暴怒惊恐，兼饮食违和，调养失度，母亲食用面食、五辛、炙烤之物，并服用各种毒丹药，积热在腹，内攻小儿损伤眼睛，以及出生后二三岁后，不言不哭，都没有盼视的眼神，父母才开始察觉；等到长成才知道是内障，里面有青白色的翳遮盖瞳孔，如果能辨别三光，有用金针可以拨除的。大抵小儿内障大多难治疗。
医经说：眼睛是五脏六腑的精华，营卫魂魄的精气常常在此荣华。又说：所有脉络都属于眼睛，眼睛得到血液滋养才能视物，所以脏腑的精气都上注于眼睛而形成视觉。白睛属肺，黑睛属肝，瞳孔属肾，上下眼睑属脾，内外眼角属心而内眼角又属胆与三焦，上纲属足太阳膀胱小肠，下纲属足阳明大肠。五脏对应五色，各有主管，心主赤色，赤色甚者是心实热，赤色微者是心虚热；肝主青色，青色甚者是肝热，淡青色者是肝虚；脾主黄色，黄色甚者是脾热，淡黄色者是脾虚；眼睛没有精光及白睛多而黑睛少的，是肝肾都不足。白天视物清晰，晚上视物不见的，是禀受阳气衰弱，遇到夜晚阴盛则阳更衰，所以不能视物。赤脉从上往下的属于足太阳经，从下往上的属于足阳明经。如果上眼皮而下出黑白翳的，属于太阳寒水；从外向内的属于少阳风热；从下至上而绿色的，属于足阳明及肺肾合病。然而翳膜是风热内蕴，邪气未定叫做热翳而浮于外，邪气既定叫做冰翳而沉于内，邪气若深叫做陷翳，这适宜升发以消除它。更有疳眼，是因为肝火湿热上冲，脾气有亏，不能上升清气，所以生白翳，睫毛闭合不开，眵泪糊久而脓流，遂致损害眼睛。雀目，上午能视物，傍晚失明，这是因为肝气衰弱。盖木生于子时，旺于卯时，绝于申时，所以上午能视物，到了申酉时失明；况且眼睛得到血液才能视物，午后肝气渐衰，且阴虚则火必盛，弱阴不能胜强火，所以夜里加重；天明阳气当令，阳气主动，浊阴暂时消减所以稍明。大抵治疗以养肝养血，兼理脾胃为主。更有眼睛闭合不能开的，有因为过服寒凉药剂，致使阳气下陷不能升举而这样的；有因为胃气亏损，眼睫无力而这样的，都适宜升阳益胃。更有暴赤肿痛，风火炽盛的，有因为多泪羞明，肝心积热的，一种适宜疏风散火，一种适宜凉血清肝。如果是风沿烂眼，是膈有热；如果是时时作痒，是脓溃生虫；如果是眼睫粘连，是肝经风热；如果是初生婴儿目黄壮热，二便秘结，面赤眼闭的，这是胎热；更有痘疹后精血既亏，余毒上侵及斑疮入眼的，有视物不明，不肿不痛，只见黑花而无精光的，这都是肝肾俱虚。如果外无翳膜，内障如云，视物不见，俗名青盲的，如果不是肾水枯涸，则必是久病成疳。脉洪大的以养血为先，脉沉细的以补阳为主。盖天没有日光，虽然有火镜，怎么能使晶光相射呢？如果在吐泻后才生膜障，不能开举及无精光的，这是精滋泻脱，无神已亡，难治。更有热毒眼小，积毒眼小的，更有因时气流行而肿赤的，然而治法总忌寒凉及单行发散，盖寒则凝滞，热则散发而风则干燥。况且眼病虽由火热引起，然而多因初感风寒，腠理闭密，火热不得外泄，上走空窍而为病。如果疏散其外感，则火热泄而痛自止，兼之养血凉血退翳诸剂，必须兼用风药，始能上达头目。且火郁则发之，以减其盛势；如果一概用寒凉则邪气愈凝滞；也不可发汗，汗则津液耗而血亦燥，燥则其病愈甚了。更有眼疾血瘀血热，而投以破血凉血药剂的，或投以寒凉损脾药剂的，都是不可以的。盖脾为至阴，归明于目，况且眼睛得到血液才能视物，血少则热火愈动而眼睛愈昏。夫血是木之精脉，精光是木之华叶，脾胃是木的根本，所以不如以上病治下的方法，
Ancient texts discuss internal cataracts, mentioning large round cataracts (Da Yuan Yi) and small round cataracts (Xiao Yuan Yi). Humans inherit the prenatal essence from their parents, resulting in variations in pupil size. Those with larger pupils tend to develop larger cataracts, while those with smaller pupils develop smaller ones. This condition arises when brain lipid flows downward and condenses over years to form an opacity. When physicians use acupuncture needles for treatment, the depth must be appropriate: if the cataract is large but the needle insertion is shallow, the opacity will not detach; if the cataract is small but the needle insertion is too deep, it may damage the eyeball. Physicians must exercise extreme caution to avoid misdiagnosis and mistreatment!
When performing "Lian Xi" (a traditional ophthalmic external therapy), one must consult the daily location of the "Ren Shen" (vital spirit) in the meridians and avoid using knives or needles on those specific meridians.
If the cataract recurs after subsiding, one should soothe the Liver Qi and regulate the flow of Qi, which will naturally cause the opacity to detach. If it does not detach, re-acupuncture may be performed.
After needling, Chuanxiong Rhizome (Chuanxiong) should be avoided as its blood-invigorating properties may induce pain. If pain occurs, prepared Rehmannia Root (Shu Di Huang), Angelica Sinensis Radix (Dang Gui), and White Peony Root (Bai Shao) may be used.
If the pupil is clear but the sclera (white part of the eye) is red, use Mulberry Cortex (Sang Bai Pi), Saposhnikovia Root (Fang Feng), Bupleurum Root (Chai Hu), and Red Peony Root (Chi Shao).
If there is oily turbidity within the pupil, soothe the Liver Qi using Bupleurum Root (Chai Hu) and Aurantium Fructus (Zhi Ke).
For nausea, use Agastache Herba (Huo Xiang), Magnolia Bark (Hou Po), Pinellia Tuber (Ban Xia), and Fermented Soybean (Dan Dou Chi).
For headache or Taiyang meridian pain, use Saposhnikovia Root (Fang Feng), Angelica Dahurica Root (Bai Zhi), Notopterygium Rhizome (Qiang Huo), and Gypsum Fibrosum (Shi Gao).
For severe Taiyang pain, apply hot stir-fried salt as a compress.
For red sclera, use Bupleurum Root (Chai Hu), Carthamus Flower (Hong Hua), Red Peony Root (Chi Shao), Angelica Sinensis Tail (Gui Wei), Peach Kernel (Tao Ren), and Mulberry Cortex (Sang Bai Pi).
For dilated pupils, use White Peony Root (Bai Shao), Poria Sclerotium (Fu Shen), Ginseng Radix (Ren Shen), Ophiopogon Tuber (Mai Dong), Angelica Sinensis Radix (Dang Gui), Ziziphus Seed (Suan Zao Ren), and Schisandra Fruit (Wu Wei Zi).
For cases where heat causes pupil constriction, use Angelica Sinensis Radix (Dang Gui), Chuanxiong Rhizome (Chuanxiong), Coptis Rhizome (Huang Lian), Ophiopogon Tuber (Mai Dong), Leonurus Fruit (Chong Wei Zi), Bupleurum Root (Chai Hu), and Gardenia Fruit (Shan Zhi).
[Large Round Cataract] This syndrome initially stems from Kidney Water deficiency, followed by Liver injury due to anger. The eyes are related to the Zang-Fu organs, with the Liver and Kidneys as the root. The Kidney is the source of water, and the eyes are the essence of water. Excessive sexual activity weakens Kidney Water, failing to nourish Liver Wood and the eyeballs. Additionally, violent anger causes heat from the heart and chest to rush upward into the brain, destabilizing brain lipids, which then flow down to the eyes, condensing and covering the pupil to form an internal cataract. Initially, patients see floating spots like flies or thin mist/smoke, without pain, gradually losing vision, starting in one eye and potentially spreading to the other. The lipid appears blue-white. Inherited from parental essence, those with larger pupils develop larger opacities, hence the name "Large Round Cataract." It appears larger when viewed in shade and smaller in sunlight. Early treatment should involve Chonghe Yangwei Decoction (Chai Hu, Dang Gui, Bai Shao, Gan Cao, Ge Gen, Ren Shen, Huang Qin, Bai Zhu, Wu Wei Zi, Qiang Huo, Fang Feng, Fu Ling; add Huang Lian and Huang Qin if thirsty) and Shihu Yeguang Pill (Ren Shen, Shan Yao, Niu Xi, Tu Si Zi, Wu Wei Zi, Mai Men Dong, Ling Yang Jiao, Rou Cong Rong, Chuan Xiong, Sheng Di, Tian Men Dong, Bai Ji Li, Gou Qi Zi, Qing Xiang Zi, Jue Ming Zi, Xing Ren, Shi Hu, Zhi Ke, Xi Jiao, Fu Ling, Gan Cao, Fang Feng, Huang Lian). For long-standing cases, gold needle extraction is indicated.
[Small Round Cataract] This syndrome shares the same etiology as the Large Round Cataract. Both result from desire and anger injuring the Liver and Kidneys, causing heat to rush upward and brain lipids to flow down, forming a blue-white opacity covering the pupil. The pupil's divine water connects to the Gallbladder. When Zang-Fu organs are harmonious and Qi and Blood circulate smoothly, bile flows upward, enabling clear vision. However, Liver and Kidney injury prevents this flow, causing lipid condensation. Named "Small Round Cataract" because inherited smaller pupils result in smaller opacities. Patients may see light sources (Three Lights) but cannot distinguish objects. Early treatment involves Chonghe Yangwei Decoction and Shihu Yeguang Pill. Long-standing cases require mouse-tail shaped gold needle extraction.
[Floating Internal Cataract] Initially caused by excessive sexual activity depleting Kidney Water, leading to Water deficiency and Fire hyperactivity attacking the eyes. Vision becomes blurry like looking through fog/mist, without pain. Gradually, emotional stagnation and liver injury from lust cause heat to rush to the brain, infusing brain lipids into the eye, forming a bright, silver-foil-like opacity floating on the pupil. Starts in one eye, spreads later, blocking the Three Lights. Difficult to extract with gold needle. Early treatment: Tonify Kidney and soothe Liver (same as above).
[Sinking Internal Cataract] Caused by Kidney Meridian deficiency and excess Fire in Liver and Heart, leading to blurry vision and frequent black spots. Malignant Qi from the brain gradually invades the pupil. After 2-3 years, a blue-white opacity forms, appearing as if sinking in water. If the Three Lights are still visible, needle extraction is suitable (treatment same as above).
[Astringent Internal Cataract] Caused by lust injuring the Kidney and anger injuring the Liver, damaging both and depleting the source of Qi and Blood production. Qi and Blood become weak, failing to nourish the eyes. Over time, pathogenic heat rises, and brain lipids flow down, forming a large, yellow, stagnant opacity without contraction ability, hence "Astringent Cataract." Early treatment is similar; long-term cases should not undergo needle extraction.
[Slippery Internal Cataract] Caused by dual deficiency of Liver and Kidney, allowing brain lipids to infuse the eyeball, resembling mercury beads that move and absorb unpredictably. No pain or itch, only blurry vision. Spreads over time, causing gradual blindness. Though Three Lights may be seen, objects cannot be distinguished. Treatment is the same. For long-standing cases, lotus-seed shaped gold needle extraction is used.
[Scattered Internal Cataract] Caused by five Zang organs' deficiency and exhaustion, excessive alcohol and sex, plus worry and anger causing Liver Qi to rush upward. Malignant brain Qi flows down, condensing before the pupil into an opacity of varying density and yellow-white color, scattered and lacking contraction. Though Three Lights may be seen, needle extraction is contraindicated as it is incurable.
[Ice Internal Cataract] Caused by Liver and Kidney deficiency, with Wind and Fire rising, stirring phlegm. Symptoms include dizziness, facial pain, temporal/forehead pain, red and gritty eyes, variable colors (yellow, white, black), or seeing fireflies at night. Eventually, an internal cataract forms, with lipids resembling melting ice or broken porcelain. Early treatment: Dispel Wind and Phlegm using Banxia Baizhu Tianma Decoction (Ren Shen, Bai Zhu, Ban Xia, Tian Ma, Gan Jiang, Chen Pi, Shen Qu, Ze Xie, Cang Zhu, Mai Dong, Huang Qin, Huang Bo, Huang Qin) and Shenxiao Bugan Powder (Xiakucao, Xiangfu each 2 liang, Gan Cao 4 qian, powdered; take 3 qian with tea). Needle extraction is contraindicated.
[Venus Star Internal Cataract] Initial symptoms include headache, slight facial swelling, red eyes, chaotic black spots, and gradually dimming/constricting pupils containing gold-foil-like brain lipids. Contraindicated for needle extraction and incurable. Caused by Water deficiency and Fire excess. Normally Water controls Fire, but Water deficiency allows Fire to dominate, intensifying Fire and depleting Water. Early treatment focuses on nourishing and cooling Blood, tonifying Kidney, and clearing Fire. This is considered very difficult to treat.
[Horizontal Sword Internal Cataract] Caused by Liver and Kidney depletion and unregulated sexual activity, leading to dimness without pain or itch. Starts in one eye, spreads to both. Resembles a sword across the pupil. Though Three Lights are visible, needle extraction is contraindicated. Early treatment: Shihu Yeguang Pill.
[Jujube Flower Internal Cataract] Caused by Liver and Kidney insufficiency, Water deficiency, and Fire excess. Symptoms include headache, dizziness, flying flowers of varying colors, and serrated pupil margins. Early mild dimness allows vision. Treatment: Chonghe Yangwei Decoction and Shihu Yeguang Pill, removing Wu Wei Zi and adding Chong Wei Zi as the chief herb. If a blue star appears internally after a long time, it is incurable and cannot be extracted.
[Crescent Moon Internal Cataract] Caused by Liver deficiency and Kidney damage, with deficient Fire rising, causing brain lipids to flow down and cover the pupil, turning white like the crescent moon (half thin/thick, half bright/dark). Starts in one eye, spreads, damaging both pupils. Needle extraction is contraindicated.
[Startle/Vibration Internal Cataract] Caused by Liver and Kidney deficiency/exhaustion, combined with physical trauma startling brain lipids downward, causing gradual blurring and whitening. May enter the Liver Meridian from below or dissipate with the startle. Pupils lack contraction; though Three Lights are visible, needle extraction is contraindicated. Treatment follows Round Cataract protocols.
[Thunder Head Wind Internal Cataract] Initial symptoms: headache, cold feet, nausea/vomiting, thunderous sensation in the head, dilated pupils, gradual blindness, loss of Three Lights. Caused by violent anger injuring the Liver, weak constitution, invasion of Wind-Cold, rebellion in San Jiao, and attacking the head. As the head is the meeting point of all Yang meridians, evil and righteous Qi struggle, remaining trapped, causing thunder-like pain. Stomach invaded by cold causes nausea/vomiting. Pupil's divine water is gathered Qi; anger scatters Qi, preventing gathering. Early urgent treatment: Fuzi Zhuling Decoction (Ren Shen, Bai Shao, Bai Fu Ling, Qiang Huo, Shu Di, Zhu Ling, Shu Fu Zi), Xiangxiong Powder (Chuan Xiong, Shi Gao, Xiang Fu, Bo He, Bai Zhi, Chuan Wu, Gan Cao, powdered; take 2 qian), and Shihu Yeguang Pill (double Wu Wei Zi) to gather dilated pupils. For extreme pain, blow Rushing Ding Tong San (Ru Xiang, Mo Yao, Xiong Huang, Shi Gao, Chuan Xiong each 5 qian, Yan Xiao 1.5 fen, finely powdered; sniff with water) into the nose. Long-term cases are incurable.
[Green Wind Internal Cataract] Initial symptoms: urgent forehead/hemicranial pain, smoky sensation in nose, nausea/vomiting, cold feet, red-black vision, gradually dilated pupils, pale green divine water. Etiology resembles Thunder Head Wind but is triggered by extreme anger/headache causing heat to rush up, mixing malignant brain Qi with divine water to turn green. Long-term loss of Three Lights is incurable. Early treatment: Stop pain with Fuzi Zhuling Decoction, then Chonghe Decoction, and modified Yeguang Pill (remove Rou Cong Rong, double Wu Wei Zi).
[Yellow Wind Internal Cataract] Initial headache due to Liver/Kidney deficiency, Wind-Toxin invasion, and Spleen/Lung heat accumulation. Sclera turns yellow. Often evolves from Green Wind Internal Cataract where vomiting damages the Stomach. Long-term yellowing is incurable.
[Black Wind Internal Cataract] Caused by excessive lust damaging Yuan Qi. Qi deficiency leads to Hyperactive Heart Fire, causing frequent black spots, soreness in eye sockets/nose/eyebrows, raised green bean-like spots on sclera, and gradually constricting pupils with unclear vision. Pupil belongs to Kidney Water; normally Water controls Fire, but here Fire dominates, causing dimness and constriction. Fire insults Lung Metal (sclera), causing stagnant protective fluid, uneven sclera, flying flowers, and soreness due to stifled Fire and Blood deficiency with Wind. Early treatment: Shenxiao Bugan Powder and Xuanqi Tang (Chen Pi, Ban Xia, Gan Cao, Qiang Huo, Bai Fu Ling, Huang Qin, Fang Ji, Ginger; decoct) to scatter Wind and nourish Blood. Later: Buzhong Yiqi Decoction and Shihu Yeguang Pill to tonify Qi and Yin. Loss of Three Lights is incurable.
[Black Wind Internal Cataract - Variant] Caused by weak Qi, Liver/Kidney insufficiency, emotional stagnation, and excess Evil Fire rushing to head/eyes. Symptoms: dizziness, headache, gritty eyes, black spots, gradually dilating pupils leading to blindness. Pupil is formed by gathered Qi; Fire excess scatters Qi, causing blindness. Incurable.
[Five Winds Changing Internal Cataract] Caused by dual Qi/Blood deficiency, Zang-Fu exhaustion, toxic Wind attacking upward, and brain heat invasion. Symptoms: dizziness, headache, vomiting, leading to blindness. Incurable.
[Dilated Pupil Internal Cataract] Caused by Liver/Kidney deficiency; anger injures Liver, fear injures Kidney. Pupil belongs to Kidney and gathers Qi; anger scatters Qi. Early symptoms: blurry vision like walking in fog, black spots in air, diplopia, eventually irretractable, becoming a disability. Divine water gradually disperses completely. Early treatment: Chonghe Decoction, Yeguang Pill (remove Rou Cong Rong, double Wu Wei Zi) to gather. Once slight light returns, combine with Qianjin Cizhu Wan (Magnetite treated with vinegar 7 times, dried, powdered 2 liang; Cinnabar powder 2 liang; raw Shen Qu 3 liang; mix with water to make cakes, boil until floating; mix with previous powders and honey into pill size of paulownia seeds; take 10-30 pills empty stomach with rice soup. Effect: looks down unseen, looks up sees Three Lights. Take empty stomach, then Shihu Yeguang Pill at noon). This is a sedative for deficiency; do not take early to avoid damaging Yuan Qi. For Qi scattered by anger: Yiyin Shenqi Wan (Shu Di, Shan Yao, Shan Yu Rou, Sheng Di, Bai Fu Ling, Mu Dan Pi, Ze Xie, Wu Wei Zi, Dang Gui, Chai Hu, honey pills, Cinnabar coating; take 5-7 pills empty stomach with light salt water). This strengthens Water to control Fire. Must combine with Cizhu Wan for efficacy. Trauma causing divine water dispersion is incurable.
[Tightly Constricted Pupil Internal Cataract] Caused by weak Kidney Water and strong Minister Fire. Water weakness allows Fire dominance, causing gradual pupil constriction. Pupil is Kidney Water. Early stage has no pain/itch/discharge, only a sense of tightness, irregular pupil margin, and green-yellow Liver water. Treatment: Huan Yin Jiu Ku Tang (Chuan Xiong, Gan Cao, Huang Bo, Jie Geng, Chai Hu, Fang Feng, Qiang Huo, Huang Lian, Zhi Mu, Huang Qin, Hong Hua, Sheng Di, Long Dan Cao, Dang Gui Wei, Lian Qiao, Sheng Ma, Xi Xin, Cang Zhu, Cao Ben; decoct in water) to suppress Minister Fire. Yeguang Pill tonifies Kidney and strengthens Water (remove Wu Wei Zi, add Chong Wei Zi to avoid excessive astringency). If unregulated diet/lifestyle continues, sudden brow bone pain may lead to pupil shrinking to seed size with internal lipid condensation (yellow/white), permanently incurable.
[Pediatric Prenatal Internal Cataract] Caused by maternal anger/fear during pregnancy, improper diet/care, consumption of wheat, five pungents, roasted foods, and toxic elixirs, accumulating heat in abdomen, attacking fetal eyes. Infants aged 2-3 show no speech/crying/gaze. Parents notice later; diagnosed as internal cataract with blue-white opacity covering pupil. If Three Lights can be distinguished, gold needle extraction may work. Generally, pediatric internal cataracts are difficult to treat.
The Classics state: The eyes are the brilliance of the five Zang and six Fu organs, the essence of Ying-Wei, Hun, and Po. All meridians connect to the eyes; eyes see when nourished by Blood. Thus, Zang-Fu essence ascends to the eyes. Sclera belongs to Lung, cornea to Liver, pupil to Kidney, eyelids to Spleen, inner/outer canthi to Heart, inner canthus to Gallbladder/San Jiao. Upper lid relates to Taiyang Bladder/Small Intestine, lower lid to Yangming Large Intestine. Five Zang correspond to five colors: Heart governs Red (excess=real heat, slight=deficient heat); Liver governs Green (excess=heat, slight=deficiency); Spleen governs Yellow (excess=heat, slight=deficiency). Lack of luster, excessive sclera, scant cornea indicates Liver/Kidney insufficiency. Clear day vision but night blindness indicates weak congenital Yang; Yin dominance at night further weakens Yang. Red veins descending belong to Foot Taiyang; ascending to Foot Yangming. Eyelid opacity with black/white cataract indicates Taiyang Cold-Water; outer-to-inner indicates Shaoyang Wind-Heat; bottom-to-top green indicates Foot Yangming/Lung-Kidney combined disease. Membranous cataracts stem from internal Wind-Heat. Undetermined evil is "Heat Cataract" (floating exterior); settled evil is "Ice Cataract" (sinking interior); deep evil is "Sunken Cataract," requiring ascending methods to resolve. Malnutrition eye (Gan Eye) results from Liver Fire/Damp-Heat rushing up and Spleen deficiency failing to ascend clear Qi, causing white cataract, closed eyelids, purulent discharge, and eye damage. Night blindness (Que Mu) allows morning vision but evening blindness due to weak Liver Qi. Wood grows at Zi hour, peaks at Mao, ends at Shen; thus morning vision, evening blindness. Eyes need Blood to see; Liver Qi declines post-noon, Yin deficiency leads to Fire excess, weak Yin cannot overcome strong Fire, worsening at night. Dawn brings Yang activity, clearing turbid Yin, improving vision. Main treatment: Nourish Liver, tonify Blood, regulate Spleen/Stomach. Closed eyes may result from excessive cold herbs trapping Yang downward, or Stomach Qi deficiency causing weak eyelids; both require raising Yang and benefiting Stomach. Acute red/swollen/painful eyes with intense Wind-Fire or tearing/light sensitivity due to Liver/Heart heat require either dispersing Wind/Fire or cooling Blood/clearing Liver. Erosive eye margin indicates Diaphragm Heat; itching indicates pus/worms; adherent eyelids indicate Liver Wind-Heat. Infant jaundice/high fever/constipation/red face/closed eyes indicates Fetal Heat. Post-measles Blood/Yin deficiency with residual toxins invading eyes causes unclear vision without swelling/pain, only black spots/lack of luster, indicating Liver/Kidney deficiency. External membrane absence but internal cloud-like cataract ("Blue Blindness") indicates either Kidney Water exhaustion or chronic malnutrition. Surging pulse requires Blood tonification; deep/thin pulse requires Yang tonification. Without Sunlight, even mirrors cannot reflect light. Post-vomit/diarrhea membrane formation with inability to open/lack of luster indicates depleted essence/spirit, difficult to treat. Heat/toxin-induced small eyes, accumulated toxin small eyes, or epidemic red/swollen eyes all share treatments avoiding cold/herbs and single dispersal agents. Cold causes stagnation; heat disperses; Wind dries. Although eye diseases stem from Fire/Heat, they often begin with Wind-Cold closing pores, trapping Fire/Heat which rises to orifices. Dispersing exterior pathogens releases Fire/Heat and stops pain. Blood-nourishing/cooling/astringent formulas must include Wind-dispelling herbs to reach the head. Stifled Fire requires venting to reduce intensity; indiscriminate cold herbs cause stagnation. Sweating consumes fluids/blood, worsening dryness/disease. Blood stasis/heat conditions treated with blood-breaking/cooling herbs, or spleen-damaging cold herbs, are inadvisable. Spleen is supreme Yin, illuminating the eyes. Eyes need Blood to see; low Blood increases Fire/Heat and blurs vision. Blood is the essence of Wood's vessels; luster is Wood's leaves; Spleen/Stomach are Wood's roots. Therefore, treating upper body diseases via the lower body is preferred.