原夫钩割针烙之法，肇自华佗，今人效之，不识病症之轻重，不辨部位之当否。盲医瞎
治，妄加痛楚于人，此等乱为，贻误病患罪莫大焉。今予将部位病症之当否，钩割针烙之所
宜者，请备言之，以为后学规矩准绳，庶无妄治之愆，或于临症，谅有小补云。夫钩，钩起
也，割，割去也，针非砭针之针，乃针拨瞳神之针，烙即熨烙之烙。此四者，犹夫刑之杀戮
凶强，剪除横逆之法也，要在审察明而详夺定，然后加刑，先灭巨魁，以及从恶，则情真罪
当，而良善无枉屈侵扰之害，强暴无激变作乱之祸。若论治法，实开泄郁滞，涤除瘀积之一
法也。惟要症候明而部分当，始可施治，先伐标而后治本，则气血宁，而精膏无耗涩枯伤之患
轮廓无误失损害之过。如钩先须认定何处皮肉，筋脉浮浅，可钩不可钩，酌量治之，即手
力，亦随病之轻重行之。如针，必须内障，即症候可针，必俟年月已足，血气已定者，方可
针之，庶无差谬，不可妄为，使病患受无辜之痛楚，致同道之耻笑。针后当照病用药，内治
其本，或补或泻，或温或凉，各随症之所宜。若只治其标，不治其本，则气不定，不久复为
患矣。如割，在气血肉三轮者可割，而大 一块红肉，乃血之英，心之华，决不可割，误割
则目盲，若神在此而伤之，必死，有割伤因而惹风，及元气虚弱之人，烦燥湿盛者，必为溃
烂，为漏，为目枯。凡障如攀睛 肉、鸡冠蚬肉、鱼子石榴、赤脉虬筋、胞肉粘轮等症，可
割。若在风轮之浅者，误割之，则珠破而目损。至于烙，只能治残风溃眩，疮烂湿热，重而
久不愈者，轻者亦不必烙，服药自愈。若红障血分之病，割之必用烙以断之，否则不久复生
若在气分白珠，不可用烙。若在乌珠，针烙皆不可犯，不惟珠破，亦且甚痛。凡乌珠有恶
障浓蔽者，钩割亦宜浅，浅割外边赤丝瘀肉，其内贴珠翳障，只宜缓缓点药服药，耐心治之
久而自消，不可性急而取快也。若镰割风毒流毒瘀血等症，当以活法审视，不可拘于
一定，必须口传亲授，临症亲见，非笔下之可形容。大抵钩割针烙之治，功效最速，虽有拨
乱反正之功，乃乘险救危之法，亦不得已而用之，全在心细而胆大，必症候明而部分当。又
兼服药内治，方为两尽其美，若只治外症而不治内，虽有今日之功，恐为后日之害也。业斯
道者，甚无忽焉。
钩、割、针、烙这四种疗法，起源于华佗。如今人们效仿这些方法，却不识别病症的轻重，也不辨别治疗部位是否恰当。庸医盲目施治，随意给患者增加痛苦，这种胡乱作为，贻误病患，罪过极大。现在我打算详细说明部位与病症是否适宜使用钩、割、针、烙的方法，以此作为后学者的规矩准绳，希望避免妄加治疗的过失，或许对临床诊疗能有一点补益。
所谓“钩”，是指钩起组织；“割”，是指割除病变；“针”并非砭石之针，而是用于针拨瞳神的针具；“烙”即熨烫烙灼之法。这四种方法，犹如刑罚中杀戮凶顽、剪除暴逆的手段，关键在于审查清楚并详细决断，然后才施加手段。先消灭主要病灶，再处理从属问题，这样就能做到情罪相当，使良善之人不受冤枉侵扰之害，使强暴之患不致激变作乱。若论其治疗原理，实际上是开通泄导郁滞、涤除瘀积的一种方法。只有症状明确且部位恰当，才可以实施治疗。先治标而后治本，气血才能安宁，精膏（眼内精华物质）就不会出现耗损、干涩、枯伤的危害，眼睑轮廓也不会出现失误损害。
至于钩法，必须先认定哪里的皮肉、筋脉浮浅，判断是否可以钩治，酌情进行治疗。即使手法力度，也要随着病情的轻重而调整。至于针法，必须针对内障，即症状适合用针的情况，必须等到病程年月已足，血气已经稳定时，才可以施针，这样才能避免差错谬误，不可妄为，使患者遭受无辜的痛苦，招致同行的耻笑。针后应当根据病情用药，内治其根本，或补或泻，或温或凉，各随症状的适宜情况而定。如果只治标不治本，气机就不稳定，不久又会复发为患。
至于割法，在气轮、血轮、肉轮（指眼部不同层次的组织）上可以切割，但有一块大红色的肉，那是血的精华，心的外华，绝对不可切割，误割会导致失明。如果神气所在之处受伤，必死无疑。如果有割伤因而感染风邪，以及元气虚弱、烦躁湿盛的人，必然导致溃烂、形成瘘管、眼球干枯萎缩。凡是像攀睛（翼状胬肉）、肉、鸡冠蚬肉、鱼子石榴、赤脉虬筋、胞肉粘轮等症状，可以切割。如果在风轮（黑睛）浅层，误割的话，会导致眼球破裂而目损。
至于烙法，只能治疗残存的风邪导致的溃眩、疮烂湿热，病情重且久治不愈者。轻症也不必烙，服药即可自愈。如果是红障属于血分的病，切割时必须配合烙法以断绝病根，否则不久会再生。如果在气分白珠（白睛），不可使用烙法。如果在乌珠（黑睛），针法和烙法都不可侵犯，不仅会导致眼球破裂，而且疼痛剧烈。凡是乌珠有恶障浓密遮蔽者，钩割也宜浅，仅浅割外边的赤丝瘀肉，对于内部贴近眼球的翳障，只宜缓缓点药、服药，耐心治疗，久而久之自然消散，不可性急求快。
如果是镰割风毒、流毒、瘀血等症，应当灵活审视，不可拘泥于一定之规，必须口传亲授，临症亲见，不是笔头文字所能形容的。大抵钩、割、针、烙的治疗，功效最快，虽然有拨乱反正之功，但这乃是乘险救危的方法，也是不得已而用的手段，全凭心细胆大，必须症状明确且部位恰当。再加上服药内治，才算两全其美。如果只治外症而不治内，虽然今天有功，恐怕会成为日后的祸害。从事这一行的人，千万不要忽视啊。
The methods of hooking, cutting, needling, and cauterization originated with Hua Tuo. Nowadays, people imitate these methods without recognizing the severity of the disease or distinguishing whether the treatment site is appropriate. Quack doctors treat blindly, arbitrarily inflicting pain on patients. Such reckless actions cause great harm by delaying proper treatment for patients, which is a grave sin. I now intend to elaborate in detail on the appropriateness of sites and conditions for using hooking, cutting, needling, and cauterization, to serve as rules and standards for future learners, hoping to avoid errors from arbitrary treatment, and perhaps offering some minor assistance in clinical practice.
"Hooking" refers to lifting tissue; "cutting" refers to excising lesions; "needling" here does not refer to Bian stones (stone needles), but to needles used for displacing the pupil (Zhenbo Tongshen); "cauterization" refers to the method of hot iron application. These four methods are akin to the penal measures of executing the violent and eliminating rebellion. The key lies in thorough examination and decisive judgment before applying the technique. By first eliminating the major culprit and then addressing accomplices, one ensures that justice is served, preventing innocent people from suffering unjust harassment and stopping violent elements from causing chaos. In terms of therapeutic principles, this is actually a method to open up and drain stagnation, and cleanse away accumulated blood stasis. Only when symptoms are clear and the anatomical part is appropriate can treatment be administered. Treating the branch (symptoms) first and then the root (cause) allows Qi and Blood to settle, preventing the depletion, dryness, and damage of Jing Gao (ocular essence), and avoiding defects or damage to the ocular contours.
Regarding hooking, one must first identify where the skin, flesh, tendons, and vessels are superficial, determining whether hooking is feasible, and treating accordingly. Even the manual force applied should vary according to the severity of the disease. Regarding needling, it must be used for internal cataracts (Nei Zhang), i.e., conditions suitable for needling. One must wait until the duration of the illness is sufficient and the Qi and Blood have stabilized before needling, to avoid errors. One must not act recklessly, causing patients unnecessary pain and inviting ridicule from peers. After needling, medication should be administered based on the condition to treat the root internally, whether tonifying or purging, warming or cooling, according to the specific symptoms. If only the branch is treated without addressing the root, Qi will remain unstable, and the disease will likely recur soon.
Regarding cutting, it can be performed on the Qi Wheel, Blood Wheel, and Flesh Wheel (layers of the eye). However, a large piece of red meat, which is the essence of blood and the manifestation of the Heart, must absolutely not be cut. Mistaken cutting leads to blindness. Injury to the seat of Shen (Spirit) is fatal. For those with wounds prone to wind invasion, or those with deficient Yuan Qi, irritability, and dampness, cutting may lead to ulceration, fistula formation, or ocular atrophy. Conditions such as Panning (Pterygium), Rou Li (Caruncle hypertrophy), Ji Guan Xian Rou (Chicken-comb-like growths), Yu Zi Shi Liu (Fish-egg/Pomegranate-like nodules), Chi Mai Qiu Jin (Red coiled vessels), and Bao Rou Zhan Lun (Palpebral adhesion) are suitable for cutting. If the Wind Wheel (Cornea) is superficial, mistaken cutting will rupture the eyeball and damage vision.
Regarding cauterization, it is only suitable for residual wind causing ulcerative vertigo, sores, damp-heat, and severe, chronic cases that do not heal. Mild cases do not require cauterization and will heal with medication alone. If a red opacity is due to blood-level pathology, cutting must be followed by cauterization to sever the root; otherwise, it will regrow soon. Cauterization should not be used on the Qi-level White Pearl (Sclera/Conjunctiva). On the Black Pearl (Cornea/Iris), both needling and cauterization are contraindicated, as they not only risk rupturing the eyeball but also cause severe pain. For malignant opacities densely covering the Black Pearl, hooking and cutting should be shallow, removing only the superficial red filaments and stasis. For opacities adhering closely to the globe internally, one should slowly apply drops and oral medications, treating patiently until they gradually dissipate. One must not be impatient for quick results.
For conditions like wind-toxicity, flowing toxicity, and blood stasis requiring scissor-cutting, one must examine flexibly, not adhering rigidly to fixed rules. This knowledge must be transmitted orally and taught personally, observed clinically, and cannot be fully described in writing. Generally, the treatments of hooking, cutting, needling, and cauterization yield the fastest results. Although they have the power to restore order from chaos, they are methods of rescuing danger amidst peril, used only as a last resort. They require meticulous care and boldness, ensuring symptoms are clear and sites are appropriate. Combined with internal medication, this achieves the best outcome. If only external symptoms are treated without internal regulation, although there may be immediate benefit, it may become a detriment later. Practitioners of this art must not neglect this warning.