开导之法。盖由阴虚火盛。经络郁滞。不得通畅而设。其处有五。谓迎香。内睥。上星。耳
际左右。两太阳穴也。内睥。正队之冲锋也。其功虽迟。渐收而平顺。两太阳。击其左右翼也。
其功次之。上星穴。绝其饷道也。内迎香。抵贼之巢穴也。成功虽速。乘险而征。耳际。击其游
骑耳。道远功卑。智者不取。此实极危之良术。挫敌之要机。与其闭门捕贼。不若开门
逐之为良法也。若病浅而邪不胜正者。固内治而邪自退矣。倘或六阳炎炽。不若开导通之。纵使
其虚。虽有所伤。以药内治。而补其所亏。庶免瘀滞至极。而有溃烂枯凸之患。
病有内外。治各不同。内疾已成。外证若无。点之何益。外有红丝赤脉。若初发乃微邪。退
后乃余贼。点亦可消。服之犹愈。内病始盛而不内治。只泥外点者。不惟徒点无功。且有激发之
患。内病既成。外病已见。必须内外夹攻。点服并行。奈何人多愚拗。有喜服而畏点者。有喜点
而畏服者。不知内证既发。非服不除。外疾既成。非点不退。外障服而不点者。病初发。浮嫩未
定者亦退。既已结成者。服虽不发不长。所结不除。当内外夹攻。方尽其妙。
钩割针烙四者。犹斩刈之刑。剪戮凶顽之法也。如钩。先须识定何处。皮肉筋脉浮浅。而手
力亦随病轻重行之。如针。先须识定内障证候可针。岁月已足。气血宁定者。方与之针。庶无差
误。针后当照证内治其本。或补或泻。各随其证之所宜。若止治其标。不治其本。则气不定。不
久复为害矣。割。如在气血肉三轮者可割。而大 一块红肉。乃血之英。心之华也。若误割之。
则目盲。伤重者死。有割伤因而惹风。则为燥为溃烂。为漏为目枯。凡障若掩及风轮之重浓者可
割。如攀睛 肉。鸡冠蚬肉。鱼子石榴。赤脉虬筋。肉睥粘轮等证可割。凡钩割见血。及针犯血
络。须以绵渍墨水
之。余病及在风轮之浅者误割之。则珠破而目损矣。烙能治残风溃眩。疮烂湿热。久不愈者。轻
则不须烙而能自愈。若红障血分之病割去者。必须烙定。否则不久复生。在气分之白者。不须用
烙。凡针烙皆不可犯及乌珠。虽有恶障浓者。钩割亦宜轻轻浅浅。披去外边。其内边障底。只点
药缓伐。久自潜消。若镰割风毒流毒瘀血等证。当以活法审视。不可拘于一定。针瞳神发白。一
切内障。在心融手巧。轻重得宜。须口传目见。非笔下可形容也。
开导疗法。这是针对阴虚火旺、经络郁滞不通的情况而设立的。其操作部位有五个，分别是迎香穴、内眦（眼角）、上星穴、耳际左右两侧以及两太阳穴。内眦，是正面进攻的先锋，虽然见效较慢，但能逐渐收效且平稳；两太阳穴，是攻击敌人的左右侧翼，效果次之；上星穴，是切断敌人的粮道；内迎香，是直接抵近敌人的巢穴，虽然成功迅速，但属于冒险进军；耳际，则是打击敌人的游动骑兵，路途遥远且功效低下，明智的医者不会采用。这确实是治疗极危重症的良方，也是克制病邪的关键时机。与其闭门捉贼，不如开门逐寇更为高明。如果病情轻微，正气足以战胜邪气，那么通过内部调理，邪气自然消退。倘若六阳经火热炽盛，不如采用开导法使其通畅，即使因此造成一定损伤，再通过药物进行内部调理，补益亏损之处，这样可以避免瘀滞发展到极致而出现溃烂、干枯凸起等祸患。
疾病有内在和外在的区别，治疗方法各不相同。如果是内部疾病已经形成，而外部没有明显症状，点刺有什么益处呢？如果外部出现红丝赤脉，若是初起则是微邪，消退后则是余邪，点刺也可以消除，配合服药效果更好。如果内部病势正盛却不进行内部治疗，只拘泥于外部点刺，不仅徒劳无功，还有激发病邪的危害。如果内部疾病已经形成，外部病症也显现出来，必须内外夹攻，点刺与服药同时进行。无奈许多人愚昧固执，有的喜欢服药却害怕点刺，有的喜欢点刺却害怕服药。他们不知道内部证候既然发作，不服药无法根除；外部疾患既然形成，不点刺无法消退。对于外障，若仅服药而不点刺，在病初发、浮嫩未定时也能消退；但如果已经结成硬块，服药虽能防止其发展增大，却无法去除结块，此时应当内外夹攻，才能发挥最佳疗效。
钩、割、针、烙四种方法，如同斩刈的刑罚，是剪除凶顽的方法。如用钩法，必须先确定位置，看皮肉筋脉是否浮浅，手法力度也要随病情轻重而定。如用针法，必须先确认内障证候适合针刺，且病程已久，气血平稳时，才可以施针，这样才不会有差错。针刺之后，应当根据证候进行内部调理根本，或补或泻，各随证候适宜。如果只治标不治本，则气血不能安定，不久又会为害。如用割法，如果在气血肉三轮的部位可以切割，但有一大块红肉，那是血的精华，心的华彩，如果误割，会导致失明，重伤者会死亡。如果有因割伤而感染风邪，就会变成干燥、溃烂、瘘管或目枯。凡是翳膜遮蔽风轮（黑睛）深重浓密的可以切割，如攀睛胬肉、鸡冠蚬肉、鱼子石榴状翳、赤脉虬筋、肉睑粘轮等证候可以切割。凡是钩割见血，以及针刺触犯血络的，需要用棉花蘸墨汁擦拭止血。其他病变及位于风轮浅层的误割，会导致眼球破裂而损伤视力。烙法能治疗残存的风邪导致的溃烂眩晕、疮烂湿热久不愈者。轻症不需要烙法也能自愈。如果是红障属于血分的病，割去之后必须用烙法固定，否则不久会再生。属于气分的白色翳障，不需要使用烙法。凡是针刺和烙法都不可侵犯乌珠（黑睛）。虽然有恶障深重的，钩割也应轻轻浅浅地剥离外层，对于内侧底部的翳障，只需用药缓慢攻伐，久而久之自然会潜消。如果是镰割风毒、流毒、瘀血等证候，应当灵活审视处理，不可拘泥于固定模式。针刺瞳神导致发白，一切内障，关键在于心融手巧，轻重得当，必须口传身教、亲眼目睹才能掌握，不是笔头文字可以形容清楚的。
The method of opening and guiding (Kai Dao). This is established for conditions characterized by Yin deficiency with flourishing fire, and stagnation in the meridians preventing smooth flow. There are five operative sites: Yingxiang (LI20), the inner canthus (Nei Pi), Shangxing (GV23), the sides of the ears, and the two Taiyang acupoints. The inner canthus serves as the vanguard of a frontal assault; although its effect is slow, it gradually achieves results smoothly. The two Taiyang points attack the flanks of the enemy; their efficacy is secondary. Shangxing cuts off the enemy's supply lines. The inner Yingxiang strikes directly at the enemy's nest; while success is rapid, it involves a risky advance. The area around the ears targets the enemy's cavalry on the move; the distance is far and the merit is low, so wise practitioners do not adopt this. This is indeed an excellent technique for extremely critical conditions and a key mechanism to挫败 (defeat) the pathogen. Rather than closing the door to catch thieves, it is better to open the door to drive them out. If the disease is mild and the healthy Qi is sufficient to overcome the pathogen, internal treatment will naturally cause the pathogen to recede. However, if the heat of the six Yang channels is blazing, it is preferable to use the opening and guiding method to promote unobstructed flow. Even if some injury occurs, subsequent internal medication can tonify the deficiencies, thereby avoiding the risk of extreme stagnation leading to ulceration, dryness, or protrusion.
Diseases have internal and external aspects, and treatments differ accordingly. If an internal disease has formed but there are no external signs, what benefit is there in pricking? If red threads and crimson vessels appear externally, if they are newly emerged, they represent minor pathogens; after receding, they represent residual pathogens. Pricking can eliminate them, and taking medication yields even better results. If the internal pathology is flourishing but only external pricking is employed without internal treatment, not only will the pricking be futile, but it may also provoke the disease. When both internal diseases have formed and external symptoms are visible, simultaneous internal and external attacks—combining pricking and medication—are necessary. Unfortunately, many people are stubbornly foolish: some prefer medication but fear pricking, while others prefer pricking but fear medication. They fail to realize that once internal manifestations arise, they cannot be eliminated without medication; once external ailments form, they cannot recede without pricking. For external obstructions, if only medication is taken without pricking during the initial stage when the condition is floating, tender, and unstable, it may still recede. However, once nodules have formed, medication may prevent further growth but cannot remove the existing nodules; in such cases, internal and external combined therapy is required to achieve optimal efficacy.
The four methods of hooking, cutting, needling, and cauterizing are akin to execution by chopping and weeding, serving as methods to eliminate fierce and obstinate pathogens. For hooking, one must first identify the location, assessing whether the skin, flesh, sinews, and vessels are superficial, and adjusting manual force according to the severity of the disease. For needling, one must first confirm that the internal obstruction syndrome is suitable for needling, that the duration of the disease is sufficient, and that Qi and Blood are stable before proceeding, thus avoiding errors. After needling, the root cause should be treated internally according to the syndrome, either by tonifying or reducing, as appropriate. If only the branch symptoms are treated without addressing the root, Qi will remain unsettled, and harm will recur shortly. For cutting, incisions may be made in the three wheels of Qi, Blood, and Flesh. However, a large piece of red flesh represents the essence of blood and the brilliance of the Heart; accidental cutting here causes blindness, and severe injury leads to death. If wind pathogens invade due to cutting wounds, it may result in dryness, ulceration, fistulas, or ocular atrophy. Cutting is permissible when opacities heavily cover the Wind Wheel (cornea/pupil area), such as in pterygium, chicken-comb fleshy growths, fish-roe or pomegranate-like opacities, crimson veins like twisted tendons, and eyelid adhesion to the globe. Whenever hooking or cutting produces bleeding, or needling damages blood vessels, cotton soaked in ink should be used to stop the bleeding. Accidental cutting of other lesions or those shallow on the Wind Wheel will rupture the eyeball and damage vision. Cauterization treats residual wind causing ulceration and vertigo, as well as chronic ulcers and damp-heat. Mild cases heal spontaneously without cauterization. Red opacities belonging to the Blood level must be cauterized after excision, otherwise they will regrow quickly. White opacities belonging to the Qi level do not require cauterization. Neither needling nor cauterization should infringe upon the Black Pearl (pupil/cornea). Even with severe opacities, hooking and cutting should be gentle and shallow, removing only the outer layers; the base of the opacity on the inner side should be slowly dissipated using topical medications over time. For conditions involving wind-toxicity, flowing toxicity, or stasis requiring scissor-cutting, flexible assessment is necessary, and rigid adherence to fixed rules should be avoided. Needling the pupil resulting in whitening, and all internal obstructions, depend on mental integration and manual dexterity, with appropriate weight and pressure. These skills must be transmitted orally and demonstrated visually; they cannot be fully described in writing.