内障在睛里昏暗。与不患之眼相似。惟瞳神里有隐隐青白者。楼全善曰。内障先患一眼。次
第相引。两目俱损者。皆有翳在黑睛内遮瞳子而然。今详通黑睛之脉者目系也。目系属足厥阴足
太阴手少阴三经。盖此三经。脏腑中虚。则邪乘虚入。经中郁结。从目系入黑睛内为翳。龙木论
所谓脑脂流下作翳者。即足太阳之邪也。所谓肝气冲上成翳者。即足厥阴之邪也。治法。以针言
之。则当取三经之俞穴。以药言之。则当补中。疏通此三经郁结。使邪不入目系而愈。
倪仲贤云。心者五脏之专精。目者其窍也。又为肝之窍。肾主骨。骨之精为神水。故肝木不
平。内挟心火。乘势妄行。火
炎不制。神水受伤。上为内障。此五脏病也。膀胱小肠三焦胆脉。俱上循于目。四腑一衰。则精
气尽败。邪火乘之。上为内障。此六腑病也。初起时视觉微昏。常见空中有黑花。神水淡绿。次
则视歧。睹一成二。神水淡白。可与冲和养胃汤、益气聪明汤。有热。兼服黄连羊肝丸。久则不
睹。神水纯白。永为废疾也。
内障小 青白翳。大 亦微显白翳。脑痛。瞳子散大。上热恶热。大便涩难。遇热暖处。头
疼睛胀。日没后天阴暗则昏。六味丸加麦冬、五味。
石顽曰。内障诸证。其翳皆生于乌珠里面。故宜金针拨之。拨后用滋养之剂以助其光。如六
味丸、磁朱丸之类。气虚者佐以八珍汤、神效黄 汤。若翳嫩不可拨者。只与用药。治法纵各不
同。大意不出乎皂荚丸、生熟地黄丸。其间虚实寒热。轻重随证出入。活法在心。非笔可尽。有
肚肾阴虚。绝无翳膜者。惟宜滋养真阴。切勿误与消翳等药也。有偏正头风。久而生翳。以蛇蜕
炙脆为末。每服一钱。黑豆炒香淋酒一盏。入葱白三茎。同煎去葱。和滓日服效。
青风内障证 视瞳神内有气色昏蒙。如晴山笼淡烟也。然自视尚见。但比平时光华则昏蒙日
进。急宜治之。免变绿色。变绿色则病甚而光没矣。阴虚血少之人。及竭劳心思。忧郁忿恚。用
意太过者。每有此患。然无头风痰气夹攻者。则无此证。病至此危在旦夕。急用羚羊角汤。
绿风内障证 瞳神浊而不清。其色如黄云之笼翠岫。似蓝靛之合藤黄。乃青风变重之证。久
则变为黄风。虽曰头风所致。亦由痰湿所攻。火郁忧思忿怒之故。此病初患。则头旋两额角相牵。
瞳神连鼻内皆痛。或时红白花起。或先后而发。或两眼同发。肝受热则先左。肺受热则先右。肝
肺同病则齐发。羚羊角散。
黑风内障证 与绿风相似。但时时黑花起。乃肾受风邪。热攻于眼。宜先与去风热药三四剂。
如荆、防、羌活、木贼、蒺藜、甘菊之类。后用补肾磁石丸。
黄风内障证 瞳神已大。而色昏浊为黄也。病至此十无一人可救。
银风内障证 瞳神大成一片。雪白如银。其病头风痰火人偏于气忿怒郁不得舒而伤真气。此
乃痼疾。金丹不能返光也。
丝风内障证 视瞳神内隐隐然。若有一丝横经。或斜经于内。自视全物亦如有碎路者。乃络
为风攻。郁遏真气。故视亦光华有损。宜六味丸加细辛、白蒺藜。间与皂荚丸。延久变重。内证笃矣。
乌风内障证 色昏浊晕滞气。如暮雨中之浓烟重雾。风痰人嗜欲太多。败血伤精。肾络损而
胆汁亏。真气耗而神光坠矣。
偃月内障证 瞳神内上半边。有隐隐白气一湾。如新月覆垂而下。乃内障欲成之候。成则为
如银翳。脑漏人及脑有风寒。阴气怫郁者患之。先与芎辛汤。后与消内障丸剂。此与偃月侵睛。
在轮膜中来者不同。
仰月内障证 瞳神下半边。有白气隐隐一湾。如新月仰而从下向上也。久而变满。为如银内
障。乃水不足。木失培养。金反有余。故津液亏。乃火气郁滞于络而为病也。补肾丸、补肾磁石
丸等选用。
如银内障证 瞳神内白色如银。轻则一点白亮如星。重则瞳神皆白。一名圆翳。有仰月偃月
变重为圆者。有一点从中起而渐变大失明者。乃湿冷在脑。郁滞伤气。故阳光为其闭塞而不得发
现也。非银风内障已散大而不可
复收之比。血气未衰者拨治之。先服羚羊补肝散。次用补肾丸。庶有复明之理。
如金内障证 瞳神不大不小。只是黄而明莹。乃湿热伤元气。因而痰湿阴火攻激。故色变易。
非若黄风之散大不可治者。神消散、皂荚丸、羚羊角补肝散主之。
绿映瞳神证 瞳神乍看无异。久之专精熟视。乃见其深处隐隐绿色。自视亦渐觉昏眇。病甚
始觉深绿。盖痰火湿热害及清纯之气也。先服黄连羊肝丸。后与补肾磁石丸、皂荚丸之类。久而
不治。为如金青盲等证。其目映红光处。看瞳神有绿色。而彼自视不昏者。乃红光烁于瞳神。照
映之故。不可误认为绿风。此但觉昏眇而瞳神绿色。明处暗处。看之皆同。气浊不清者。是此证也。
云雾移睛证 自见如蝇飞花堕。旌旆条环。空中撩乱。或青黄黑白。仰视则上。俯则下也。
乃络间津液耗涩。郁滞清纯之气而然。其原皆属胆肾。黑者胆肾自病。补肾磁石丸。或白或黄者。
因痰火伤肺脾清纯之气也。皂荚丸。
圆翳内障证 黑睛上一点圆。初患之时。但见蝇飞蚁垂。薄烟轻雾。先患一眼。次第相牵。
若油点浮水中。日中看之差小。阴处看之则大。或明或暗。视物不明。医者不晓。以冷药治之。
转见黑花。此因肝肾俱虚而得。先与皂荚丸合生熟地黄丸。次与羚羊补肝散、补肾丸。
冰翳内障证 如冰冻坚实。傍观透于瞳神内。阴处及日中看之。其形一同。疼而泪出。此因
胆热攻脑而然也。皂荚丸合生熟地黄丸。
滑翳内障证 有如水银珠子。但微含黄色。不疼不痛无泪。遮绕瞳神。皂荚丸、生熟地黄丸。
涩翳内障证 微如赤色。或聚或开。而傍微光。瞳神上有凝脂色。时复涩痛而无泪出。皂荚
丸、生熟地黄丸。
散翳内障证 形如鳞点。乍青乍白。或睑下起粟子而烂。日夜痛楚。瞳神最疼。常下热泪。
或生散翳。形如烂绵。皂荚丸、生熟地黄丸。
浮翳内障证 上如冰光。白色环绕瞳神。初生目小 头至黑珠上细看方见。不痒不疼。无血
色相混。皂荚丸、生熟地黄丸。
沉翳内障证 白藏在黑水下。向日细视方见。或两眼相传疼痛。则早轻夜重。间或出泪。皂
荚丸、生熟地黄丸。右圆翳以下七证。虽有治法。然皆难于奏效。惟金针拨之为善。
偃月侵睛证 风轮上半。气轮交际。隐隐白片。薄薄盖下。其色粉青。从膜中而来。为害最迟。
每每忽之。乃脑有风湿郁滞。火激脑脂滴下而成。羚羊补肝散。
剑脊翳证 亦名横翳。色白或如糙米色者。或微带焦黄色者。但状如剑脊。中高边薄。有似
锋芒。横于风轮之外。浓薄不等。浓者虽露上下风轮。而瞳神被掩。视亦不见。薄者瞳神终是被
掩。视亦昏 。纵色嫩根浮者。亦有瘢痕。若微微红丝罩绊者。尤为难退。非需之岁月。必无功
耳。皂荚丸、生熟地黄丸。
枣花障证 薄甚而白。起于风轮。从白膜之内。四围环布而来。虽有枣花锯齿之说。实无正形。
初患时。微有头旋眼黑。时时痒痛。凡性躁急及患痰火伤酒湿热之人。多有此证。久则始有目急
干涩。昏花不爽之病。犯而不戒。则瞳神细小。火入血分。昏泪赤痛者。亦在变证例。宜皂荚丸、
生熟地黄丸。
白翳黄心证 四边皆白。中心一点黄。大小 头微赤。时下涩泪。团团在黑珠上。乃脾肺相
传。停留风热。皂荚丸合生熟地黄丸。
黑花翳证 又名黑水凝翳。初患时头旋眼涩见花黄黑不定。其翳凝结青色。大小 头涩。频
频下泪。口苦不喜饮食。盖肝受风寒所致。羚羊角散、皂荚丸、生熟地黄丸。
五风变成内障证 初患时。头旋偏肿。痛甚。或一目先患。或因呕吐双目并暗。瞳神结白如
霜。却无泪出。乃毒风脑热所致。先与除风汤。次用皂荚丸、生熟地黄丸。
内障是指眼球内部昏暗不清。外观与未患病的眼睛相似，唯有瞳孔内部隐约呈现青白色。楼全善说：内障通常先发作于一只眼，随后依次牵连另一只眼，最终双眼均受损的，都是因为黑睛内有翳障遮挡瞳神所致。详细分析贯通黑睛的脉络是目系，目系归属于足厥阴肝经、足太阴脾经和手少阴心经这三条经脉。大概是因为这三条经脉对应的脏腑虚弱，邪气便乘虚而入，在经脉中郁结，从目系进入黑睛内部形成翳障。《龙木论》所说的“脑脂流下形成翳障”，指的是足太阳膀胱经的邪气；所说的“肝气冲上形成翳障”，指的是足厥阴肝经的邪气。治疗方法，从针灸角度而言，应当选取这三条经脉的俞穴；从药物角度而言，应当补益中气，疏通这三条经脉的郁结，使邪气不侵入目系而痊愈。
倪仲贤说：心是五脏精气的神聚所在，眼睛是心的外窍，同时也是肝的外窍。肾主骨，骨的精华化为神水（指眼中清澈的液体）。因此，如果肝木不调平，内挟心火，顺着势头妄行，火势炎上无法制约，损伤了神水，向上导致内障，这是五脏的疾病。膀胱、小肠、三焦、胆的经脉，都上行环绕于眼睛。这四腑中任何一腑衰弱，精气就会败坏，邪火乘虚侵袭，向上导致内障，这是六腑的疾病。初起时视觉轻微昏花，常常见到空中有黑花飞舞，神水呈淡绿色；随后出现视物重影，看一个物体变成两个，神水呈淡白色。可以服用冲和养胃汤、益气聪明汤。如果有热象，兼服黄连羊肝丸。时间久了则完全看不见，神水纯白，永远成为废疾。
内障表现为小范围的青白翳，或大范围的也微显白翳。伴有脑痛，瞳孔散大，上部发热怕热，大便干涩困难。遇到炎热温暖的地方，头痛且眼睛胀痛，日落后天色阴暗时视力更昏花。可用六味丸加麦冬、五味子。
石顽说：内障的各种证候，其翳障都生在黑珠里面，所以适宜用金针拨法治疗。拨治后用滋养的药剂来辅助恢复视力，如六味丸、磁朱丸之类。气虚者辅以八珍汤、神效黄芪汤。如果翳障嫩软不可拨除的，只给予药物治疗。治疗方法虽然各不相同，但大意不出皂荚丸、生熟地黄丸的范围。其中的虚实寒热，轻重随证候加减变化，灵活变通在于医者心中，不是笔墨能完全尽述的。有的患者因肚腹肾脏阴虚，完全没有翳膜，只适宜滋养真阴，切勿误用消翳等药物。有的因偏正头风，日久生出翳障，可用蛇蜕炙脆研为末，每次服用一钱，黑豆炒香后淋酒一盏，加入葱白三根，同煎后去掉葱，连同药渣一起服用，有效。
青风内障证：观察瞳孔内部，有气色昏蒙，像晴天山峦笼罩着淡淡的烟雾一样。然而自己看东西还能看见，只是比平时的光华要昏蒙，且日渐加重。急需治疗，以免变为绿色。一旦变为绿色，病情严重且光明消失。阴虚血少的人，以及过度劳累心思、忧郁愤怒、用心太过的人，常有此患。然而如果没有头风痰气夹攻的情况，就不会有此证。病势至此危在旦夕，急用羚羊角汤。
绿风内障证：瞳孔浑浊不清，颜色像黄云笼罩翠绿的山峰，又像蓝靛混合藤黄。这是青风内障加重的证候。时间久了会变为黄风。虽然说是头风所致，也是由痰湿攻击，加上火郁、忧思、忿怒的缘故。此病初发时，头晕且两侧额角牵引疼痛，瞳孔连带鼻内都痛。有时红白花点升起，或先后发作，或双眼同时发作。肝受热则先发于左眼，肺受热则先发于右眼，肝肺同病则双眼齐发。用羚羊角散。
黑风内障证：与绿风内障相似，但时时出现黑花飞舞，这是肾受风邪，热气攻冲于眼睛。适宜先用祛风热药三四剂，如荆芥、防风、羌活、木贼、蒺藜、甘菊之类。之后用补肾磁石丸。
黄风内障证：瞳孔已经散大，且颜色昏浊呈黄色。病势至此十无一人可救。
银风内障证：瞳孔完全散大成一片，雪白如银。此病多见于头风痰火之人，偏于气忿怒抑郁不得舒展而损伤真气。这是顽固疾病，金丹也不能使目光复明。
丝风内障证：观察瞳孔内部，隐隐约约好像有一丝横贯其中，或斜贯其中。自己看完整物体也好像有破碎的路径一样。这是因为络脉被风邪攻击，郁遏真气，所以视物光华也有损害。适宜用六味丸加细辛、白蒺藜。间或服用皂荚丸。拖延久了病情加重，内证深重。
乌风内障证：颜色昏浊晕滞，像暮雨中的浓烟重雾。多见于风痰体质人嗜欲过多，败血伤精，肾络受损而胆汁亏虚，真气耗损而神光坠落。
偃月内障证：瞳孔内部上半边，有隐隐的一湾白气，像新月覆盖下垂而下。这是内障将要形成的征兆。形成后就像银翳。多见于脑漏患者及脑部有风寒、阴气郁结的人患病。先用芎辛汤，后用消内障丸剂。这与偃月侵睛（病变在轮膜中来）不同。
仰月内障证：瞳孔下半边，有隐隐的一湾白气，像新月仰起从下向上。时间久了变满，成为如银内障。这是由于水不足，木失培养，金反有余，导致津液亏损，火气郁滞在络脉而致病。选用补肾丸、补肾磁石丸等。
如银内障证：瞳孔内白色如银。轻则一点白亮如星，重则瞳孔皆白。又名圆翳。有仰月、偃月变重为圆的，有一点从中起始而逐渐变大致失明的。这是因为湿冷在脑，郁滞伤气，所以阳光被闭塞而不能显现。这不是银风内障已散大不可复收的情况。气血未衰者可拨治。先服羚羊补肝散，次用补肾丸，或许有复明的道理。
如金内障证：瞳孔不大不小，只是黄而明莹。这是因为湿热损伤元气，因而痰湿阴火攻激，导致颜色改变。不像黄风内障那样散大不可治。用神消散、皂荚丸、羚羊角补肝散主治。
绿映瞳神证：瞳孔乍看无异样，久而久之专注仔细看，才见其深处隐隐绿色。自己看也逐渐觉得昏花。病重时才觉深绿。这是因为痰火湿热伤害了清纯之气。先服黄连羊肝丸，后与补肾磁石丸、皂荚丸之类。时间久了不治疗，会成为如金、青盲等证。那些眼睛映照红光处，看瞳孔有绿色，而自己看并不昏花的，是红光闪烁于瞳神，照映的缘故。不可误认为绿风。这只是觉得昏花且瞳孔绿色，在明处暗处看都一样，气浊不清的，是这个证候。
云雾移睛证：自己看见像苍蝇飞、花堕、旌旗条环，空中撩乱，或青黄黑白，仰视则向上，俯视则向下。这是因为络间津液耗涩，郁滞清纯之气所致。其根源都属于胆肾。黑色的是胆肾自病，用补肾磁石丸。或白或黄的是因为痰火损伤肺脾清纯之气，用皂荚丸。
圆翳内障证：黑睛上有一点圆形。初患之时，只见蝇飞蚁垂、薄烟轻雾。先患一眼，依次牵连。像油点浮在水中，日中看较小，阴处看较大。或明或暗，视物不明。医者不懂，用冷药治疗，反而见到黑花。这是因为肝肾俱虚而得病。先用皂荚丸合生熟地黄丸，次用羚羊补肝散、补肾丸。
冰翳内障证：像冰冻坚实，旁观透见于瞳神内，阴处及日中看，形状一样。疼而流泪。这是因为胆热攻脑所致。皂荚丸合生熟地黄丸。
滑翳内障证：像水银珠子，仅微含黄色，不疼不痛无泪，遮绕瞳神。皂荚丸、生熟地黄丸。
涩翳内障证：微如赤色，或聚或开，旁边微光，瞳神上有凝脂色，时常涩痛而无泪出。皂荚丸、生熟地黄丸。
散翳内障证：形状如鳞点，乍青乍白，或眼睑下起粟米状而溃烂，日夜痛楚，瞳神最疼，常下热泪。或生散翳，形状如烂绵。皂荚丸、生熟地黄丸。
浮翳内障证：上面像冰光，白色环绕瞳神。初生时目小眦至黑珠上细看方见，不痒不疼，无血色相混。皂荚丸、生熟地黄丸。
沉翳内障证：白色藏在黑水下，向日细视方见。或两眼相传疼痛，则早轻夜重，间或出泪。皂荚丸、生熟地黄丸。以上圆翳以下的七证，虽然有治法，然而都难于奏效，只有金针拨法为好。
偃月侵睛证：风轮上半部，气轮交界处，隐隐白片，薄薄盖下，颜色粉青，从膜中而来，为害最迟，每每被人忽视。这是因为脑部有风湿郁滞，火激脑脂滴下而成。用羚羊补肝散。
剑脊翳证：又名横翳，颜色白或如糙米色，或微带焦黄色。但形状像剑脊，中高边薄，有似锋芒，横于风轮之外，浓薄不等。浓者虽露上下风轮，而瞳神被掩，视亦不见。薄者瞳神终是被掩，视亦昏花。即使色嫩根浮者，也有瘢痕。若微微红丝罩绊者，尤为难退，非需时日，必无功耳。皂荚丸、生熟地黄丸。
枣花障证：薄甚而白，起于风轮，从白膜之内，四围环布而来。虽有枣花锯齿之说，实无正形。初患时，微有头旋眼黑，时时痒痛。凡性躁急及患痰火伤酒湿热之人，多有此证。久则始有目急干涩、昏花不爽之病。犯而不戒，则瞳神细小，火入血分，昏泪赤痛者，也在变证例。宜皂荚丸、生熟地黄丸。
白翳黄心证：四边皆白，中心一点黄，大小头微赤，时下涩泪，团团在黑珠上。这是脾肺相传，停留风热。皂荚丸合生熟地黄丸。
黑花翳证：又名黑水凝翳。初患时头旋眼涩见花黄黑不定，其翳凝结青色，大小头涩，频频下泪，口苦不喜饮食。这是肝受风寒所致。羚羊角散、皂荚丸、生熟地黄丸。
五风变成内障证：初患时头旋偏肿，痛甚，或一目先患，或因呕吐双目并暗，瞳神结白如霜，却无泪出。这是毒风脑热所致。先用除风汤，次用皂荚丸、生熟地黄丸。
Internal cataract (Nei Zhang) refers to the dimness and cloudiness inside the eyeball. Its external appearance is similar to that of a healthy eye, except that there is a faint bluish-white opacity within the pupil (Tong Shen). Lou Quanshan stated: Internal cataract usually affects one eye first, then sequentially involves the other, leading to damage in both eyes. This occurs because an opacity (Yi) inside the cornea (Hei Jing) blocks the pupil. Detailed analysis indicates that the visual pathway (Mu Xi), which connects to the cornea, belongs to the Foot Jueyin Liver Meridian, Foot Taiyin Spleen Meridian, and Hand Shaoyin Heart Meridian. Generally, when the zang organs associated with these three meridians are deficient, pathogenic factors enter due to this deficiency, stagnate within the meridians, and enter the cornea via the visual pathway to form an opacity. The "Brain Fat Flowing Down" mentioned in the *Longmu Lun* refers to pathogenic factors from the Foot Taiyang Bladder Meridian; the "Liver Qi Rushing Upward" refers to pathogenic factors from the Foot Jueyin Liver Meridian. In terms of treatment, acupuncture should target the Shu points of these three meridians. Pharmacologically, one should tonify the middle jiao and unblock the stagnation in these three meridians, preventing pathogens from invading the visual pathway, thereby achieving cure.
Ni Zhongxian said: The Heart is the essence of the five zang organs, and the eyes are its orifice, as well as the orifice of the Liver. The Kidneys govern bones, and the essence of bones transforms into Divine Water (Shen Shui, referring to the clear fluid in the eye). Therefore, if Liver Wood is imbalanced and harbors internal Heart Fire, the fire acts recklessly. Unchecked flaming fire damages the Divine Water, rising upward to cause internal cataract; this is a disease of the five zang organs. The meridians of the Bladder, Small Intestine, Sanjiao, and Gallbladder all ascend around the eyes. If any of these six fu organs declines, the essential qi fails, and pathogenic fire attacks, causing internal cataract upward; this is a disease of the six fu organs. In the initial stage, vision is slightly blurred, often seeing black flowers floating in the air, and the Divine Water appears pale green. Subsequently, diplopia (seeing double) occurs, and the Divine Water becomes pale white. One may administer Chonghe Yangwei Tang (Harmonizing and Stomach-Nourishing Decoction) or Yiqi Congming Tang (Benefiting Qi and Brightening Eyes Decoction). If heat signs are present, combine with Huanglian Yanggan Wan (Coptis and Sheep Liver Pill). If left untreated for a long time, vision is lost completely, the Divine Water turns pure white, resulting in permanent disability.
Internal cataract presents as small bluish-white opacities or larger ones showing slight white opacity. Symptoms include headache, dilated pupils, upper body heat intolerance, dry and difficult defecation. In warm environments, headaches and eye distension worsen, and vision dims further after sunset or in dark places. Treat with Liuwei Wan (Six-Ingredient Rehmannia Pill) added with Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Berry).
Shiwan stated: For various syndromes of internal cataract, the opacities form inside the black cornea, so they are suitable for treatment by golden needle extraction. After extraction, use nourishing agents to assist vision recovery, such as Liuwei Wan or Cizhu Wan (Magnetite and Cinnabar Pill). For qi deficiency, supplement with Bazhen Tang (Eight-Treasure Decoction) or Shenxiao Huangqi Tang (Miraculous Astragalus Decoction). If the opacity is tender and unsuitable for extraction, only medication should be used. Although treatment methods vary, the general principle revolves around Zaojiao Wan (Gleditsia Sinensis Pill) and Shengshu Dihuang Wan (Raw and Cooked Rehmannia Pill). The differentiation of deficiency/excess and cold/heat, and adjustments for severity, depend on the clinician's flexibility and cannot be fully described in writing. For patients with Yin deficiency of the abdomen and kidneys without any membrane opacity, only true Yin nourishment is appropriate; never mistakenly use anti-opacity drugs. For those with chronic migraines developing opacities over time, use dried snake skin roasted until crisp and powdered, taken one qian per dose with wine infused with fried black beans and three stalks of scallion white, decocted together, removing the scallion before taking with the dregs.
Qingfeng Neizhang Syndrome (Green Wind Internal Cataract): Observation reveals a hazy color inside the pupil, resembling misty mountains on a clear day. Vision remains but is progressively dimmer than usual. Urgent treatment is required to prevent progression to green discoloration, which signifies severe disease and loss of light perception. This condition commonly affects individuals with Yin deficiency and blood insufficiency, or those who overwork mentally, suffer from depression, anger, or excessive mental exertion. It does not occur without the attack of wind-phlegm and head wind. At this critical stage, urgently use Lingyangjiao Tang (Antelope Horn Decoction).
Lvfeng Neizhang Syndrome (Green Wind Internal Cataract - Severe): The pupil is turbid and unclear, colored like yellow clouds covering green peaks or indigo mixed with gamboge. This is a worsening of Qingfeng syndrome. Over time, it may transform into Huangfeng (Yellow Wind). Although caused by head wind, it is also driven by phlegm-dampness attacking, combined with fire stagnation, worry, and anger. Initial symptoms include vertigo, pulling pain in the temples, and pain extending from the pupil to the nose. Red and white spots may appear intermittently, affecting one or both eyes. Heat in the Liver causes onset in the left eye first; heat in the Lung causes the right eye first; simultaneous Liver and Lung pathology causes bilateral onset. Use Lingyangjiao San (Antelope Horn Powder).
Heifeng Neizhang Syndrome (Black Wind Internal Cataract): Similar to Green Wind, but characterized by frequent black spots. This results from Kidney exposure to wind pathogens and heat attacking the eyes. Initially, use 3-4 doses of wind-heat dispelling herbs such as Jingjie (Schizonepeta), Fangfeng (Saposhnikovia), Qianghuo (Notopterygium), Muzei (Equisetum), Jili (Tribulus), and Ganju (Chrysanthemum). Follow up with Bushen Cishi Wan (Kidney-Nourishing Magnetite Pill).
Huangfeng Neizhang Syndrome (Yellow Wind Internal Cataract): The pupil is significantly dilated and turbid with a yellow hue. At this stage, the prognosis is fatal for almost all patients.
Yinfeng Neizhang Syndrome (Silver Wind Internal Cataract): The pupil is fully dilated into a single patch, white as silver. This condition typically affects individuals with head wind and phlegm-fire who suffer from suppressed anger and depression, damaging true qi. It is a stubborn disease; no elixir can restore vision.
Sifeng Neizhang Syndrome (Silk Wind Internal Cataract): Inside the pupil, a faint line is visible horizontally or diagonally. Objects appear fragmented. This is due to wind attacking the collaterals, obstructing true qi, and diminishing visual clarity. Use Liuwei Wan added with Xixin (Asarum) and Baijili (White Tribulus). Intermittently administer Zaojiao Wan. Delay leads to worsening and deep internal pathology.
Wufeng Neizhang Syndrome (Black/Dark Wind Internal Cataract): The color is turbid and stagnant, like thick smoke in evening rain. It affects individuals with wind-phlegm constitutions and excessive desires, leading to damaged blood and essence, injured Kidney collaterals, depleted bile, exhausted true qi, and fallen divine light.
Yanyue Neizhang Syndrome (Reclining Moon Internal Cataract): A faint bay of white gas appears in the upper half of the pupil, resembling a new moon hanging down. This is a precursor sign of internal cataract formation. Once formed, it resembles a silver opacity. It occurs in patients with nasal discharge (brain leakage) or brain wind-cold with Yin stagnation. First use Xiongxin Tang (Ligusticum and Asarum Decoction), then Xiao Neizhang Wan (Eliminate Internal Cataract Pill). Note: This differs from Yanyue Qinjing (Reclining Moon Invading Cornea), which originates from the sclera/cornea membrane.
Yangyue Neizhang Syndrome (Upright Moon Internal Cataract): A faint bay of white gas appears in the lower half of the pupil, resembling a new moon rising from below. Over time, it fills the pupil, becoming a silver-like internal cataract. This is due to water (Kidney Yin) insufficiency, failing to nourish wood (Liver), leading to excess metal (Lung Qi) and fluid depletion. Fire stagnates in the collaterals. Select Bushen Wan (Kidney-Nourishing Pill) or Bushen Cishi Wan.
Ruyin Neizhang Syndrome (Like-Silver Internal Cataract): The pupil is white as silver. Mild cases show a bright white spot like a star; severe cases involve total whiteness. Also known as Yuanyi (Round Opacity). Some evolve from Yangyue/Yanyue into round opacities, starting as a central point that enlarges causing blindness. This is caused by cold-dampness in the brain obstructing qi, blocking sunlight manifestation. Unlike Yinfeng where dilation is irreversible, if qi and blood are not yet exhausted, extraction may be attempted. First take Lingyang Bugan San (Antelope Horn Liver-Nourishing Powder), then Bushen Wan. There is hope for vision recovery.
Rujin Neizhang Syndrome (Like-Gold Internal Cataract): The pupil size is normal, but yellow and bright. This is caused by damp-heat damaging yuan qi, leading to phlegm-damp and yin-fire aggression changing the color. Unlike Huangfeng which is dilated and incurable, this is treatable. Use Shensan San, Zaojiao Wan, or Lingyang Bugan San.
Lvying Tongshen Syndrome (Green Reflection in Pupil): The pupil looks normal at first glance, but careful observation reveals a faint green hue deep inside. Self-perception gradually dims. Severe cases show deep green. This is due to phlegm-fire and damp-heat harming pure qi. First take Huanglian Yanggan Wan, then Bushen Cishi Wan or Zaojiao Wan. Untreated, it may become Rujin or Qingmang (Green Blindness). Note: If red light reflects on the pupil making it look green to others but the patient sees clearly, it is merely reflection, not Green Wind. True Lvying syndrome presents with dimness and green hue regardless of lighting conditions, indicating turbid qi.
Yunwu Yijing Syndrome (Clouds and Mist Moving in the Eye): Patients see flies, falling flowers, banners, or chaotic colors (blue, yellow, black, white) moving in the air, shifting direction with gaze. This is caused by depletion and stagnation of fluids in the collaterals, obstructing pure qi. The root lies in the Gallbladder and Kidneys. Black floaters indicate Gallbladder/Kidney pathology; treat with Bushen Cishi Wan. White or yellow floaters indicate phlegm-fire damaging Lung/Spleen pure qi; treat with Zaojiao Wan.
Yuanyi Neizhang Syndrome (Round Opacity Internal Cataract): A round opacity on the cornea. Early stages present as seeing flies, ants, thin smoke, or light fog. Starts in one eye, spreading to the other. Resembles oil droplets in water: appearing smaller in daylight and larger in shade. Vision fluctuates between clear and dim. Misdiagnosis as cold-pathogen and treatment with cold herbs may worsen symptoms (increased black spots). This is caused by dual deficiency of Liver and Kidney. First use Zaojiao Wan combined with Shengshu Dihuang Wan, followed by Lingyang Bugan San and Bushen Wan.
Bingyi Neizhang Syndrome (Ice Opacity Internal Cataract): Hard and solid like ice, visible through the pupil from the side. Shape remains constant in shade or sunlight. Accompanied by pain and tearing. Caused by Gallbladder heat attacking the brain. Use Zaojiao Wan combined with Shengshu Dihuang Wan.
Huayi Neizhang Syndrome (Slippery Opacity Internal Cataract): Resembles mercury beads, slightly yellowish. No pain or tearing. Surrounds the pupil. Use Zaojiao Wan and Shengshu Dihuang Wan.
Se Yi Neizhang Syndrome (Astringent Opacity Internal Cataract): Slightly reddish, aggregating or dispersing, with peripheral light. Coagulated fat-like color on the pupil. Intermittent aching pain without tearing. Use Zaojiao Wan and Shengshu Dihuang Wan.
Sanyi Neizhang Syndrome (Scattered Opacity Internal Cataract): Shape like scales, alternating blue and white. May have millet-like eruptions under eyelids. Day and night pain, severe pupil pain, hot tears. Or scattered opacity like rotting cotton. Use Zaojiao Wan and Shengshu Dihuang Wan.
Fuyi Neizhang Syndrome (Floating Opacity Internal Cataract): Upper part like ice sheen, white ring surrounding the pupil. Visible upon close inspection from the inner canthus to the cornea. No itching or pain, no blood mixing. Use Zaojiao Wan and Shengshu Dihuang Wan.
Chenyi Neizhang Syndrome (Sunken Opacity Internal Cataract): White hidden beneath the aqueous humor, visible only when looking closely at sunlight. Pain may alternate between eyes, worse at night. Occasional tearing. Use Zaojiao Wan and Shengshu Dihuang Wan. Of the seven syndromes below Yuanyi, although treatments exist, efficacy is low; golden needle extraction is superior.
Yanyue Qinjing Syndrome (Reclining Moon Invading Cornea): Faint white patches at the junction of the wind wheel (cornea) and qi wheel (sclera), thin and pinkish-blue, originating from the membrane. Harm develops slowly and is often ignored. Caused by wind-damp stagnation in the brain, with fire driving brain fat to drip down. Use Lingyang Bugan San.
Jianji Yi Syndrome (Sword Ridge Opacity): Also called Hengyi (Horizontal Opacity). Color white, rough rice-colored, or slightly scorched yellow. Shape like a sword ridge, high center, thin edges, sharp tip, horizontal across the cornea. Thickness varies. Thick opacities cover the pupil entirely, obscuring vision. Thin opacities also obscure vision, causing blurriness. Even if tender and superficial, scars remain. If covered by fine red vessels, removal is difficult and requires prolonged treatment. Use Zaojiao Wan and Shengshu Dihuang Wan.
Zaohua Zhang Syndrome (Date Blossom Obstruction): Very thin and white, arising from the cornea, spreading from the inner white membrane. Despite the name "date blossom sawtooth," it has no fixed shape. Early symptoms include mild vertigo, eye darkness, itching, and pain. Common in irritable individuals or those with phlegm-fire, alcohol injury, or damp-heat. Long-term effects include eye urgency, dryness, blurriness. Neglect leads to constricted pupil, fire entering blood level, dimness, tearing, and red pain. Consider a complication. Use Zaojiao Wan and Shengshu Dihuang Wan.
Baiyi Huangxin Syndrome (White Opacity Yellow Center): White edges with a yellow center, slightly red at the poles, intermittent astringent tearing, circular on the cornea. Caused by transmission between Spleen and Lung, retaining wind-heat. Use Zaojiao Wan combined with Shengshu Dihuang Wan.
Heihua Yi Syndrome (Black Flower Opacity): Also known as Heishui Ningyi (Black Water Coagulated Opacity). Early symptoms: vertigo, dry eyes, seeing yellow/black flowers. Opacity coagulates blue-green, painful poles, frequent tearing, bitter taste, poor appetite. Caused by Liver exposure to wind-cold. Use Lingyangjiao San, Zaojiao Wan, and Shengshu Dihuang Wan.
Wufeng Biancheng Neizhang Syndrome (Five Winds Transforming into Internal Cataract): Early symptoms: vertigo, swelling, severe pain. Starts in one eye or both eyes darken after vomiting. Pupil turns white like frost, no tearing. Caused by toxic wind and brain heat. First use Chufeng Tang (Dispel Wind Decoction), then Zaojiao Wan and Shengshu Dihuang Wan.