何谓凝脂翳？肥而带黄色，血停神膏伤，气壅经络塞，热向脑中摧，窟从睛上得，亡明指顾间，入命谁与易。
此症初起，目亦痛，多虬脉，畏光紧闭，强开则泪涌出。风轮上有点如星，色白，中有孔如锥刺伤，后渐渐
长大，变为黄色，孔亦渐大，变为窟。有初起翳色便黄，大且浓。治根据下法∶四围裂开一缝，若可施钳，或竟镊
去，下得一窝，窝底皮膜如芦竹之纸，风吹欲破，见辄令人吃惊。又初起现浓大白障，继则于障内裒出黄翳，状
类鹅脂，为疾益急。再头痛便秘，则为窟、为漏、为蟹睛、为凹凸、为眇、为瞽、不日而致。治之，不问孔窟浅
深，但见翳色肥黄浮脆，善变速长，亟以小承气下利中丸净其内，随磨羚羊角，调清肝散彻其外，俾表里邪行，
头风不即止，大便必通。大便通，目赤痛与泪合减，乃用消风活血汤或防风散结汤、犀角地黄汤。服过，势少退，
照下星月翳蚀定方。其眼药对症点洗，妥适便好，不须琐赘。愈后必有白障，若鱼鳞、玛瑙等形，终身不能脱。
然亦不幸中之幸也。揆因，盖木火自焚，殃及金土，一水不胜四火，是以焦瘁神膏。良医遇兹，也须昼夜监守，
假徒茶毕一揖，揖后一函，放心他往，一时症变如上，救得睛完，亦带疾耳。学人虚心敬听，进德良多。
原案友人艾秀瞻，初夏暴得此症，服驱风散热之剂反剧。或谓城中林挂苑素知名，曷请治之。既至，视其形
弱，其色枯白，审其脉细数，其家素封，意必斫丧过度，精血不能经营，因而外感。故辛凉之药不投，乃主补
中、四物、六味地黄等汤，未数日翳满而失明，加之烦躁不安，林
辞去，遣书招余。余当与艾子同学，信而专，遂以大承气下三黄丸五钱，一服无附应，再服略下，痛稍减，明旦
微开，则右目已能辨黑白矣。复如前药日进二剂，至大利乃止。止则头目痛攻顿除，然后散以八正、逍遥，丸以
退云、既济，月余，能出溪桥以纳凉，秋中全愈。桂苑问故，曰∶目痛自下而上，头痛重太阳穴，阳明胜厥阴也，
故承气以通之。大小便秘，脏移热于腑也，故三黄以降之。气轮簇火，八正实泻其子。震廓凝脂，逍遥直解其郁。
退云、既济，特以靖余孽耳。林退而叹曰∶法之妙，神验如此！可见法不远人，人自远法。智圆胆大，触类而长
之，则术在我矣。虽然秀瞻形脉怯弱，用重方屡通，幸获戴人邪实急攻之效，而仲景忌下之教不几违乎。是案徒
以伐功，不可为训。
什么是凝脂翳？其形态肥厚且带有黄色，血液停滞导致神膏（晶状体及眼内组织）受损，气机壅滞致使经络阻塞，热邪向脑部冲击，黑睛上出现如窟窿般的病变，失明往往在顷刻间发生，此时谁能挽救生命呢？
此症初起时，眼睛也会疼痛，多伴有扭曲的赤脉，畏光并紧闭双眼，强行睁开则泪水涌出。黑睛（风轮）上出现如星星般的白点，中间有孔洞如同锥子刺伤，随后逐渐长大，变为黄色，孔洞也逐渐扩大，变成窟窿。有的初起时翳色便呈黄色，且大而浓重。治疗依据以下方法：四周裂开一道缝隙，如果可以用钳子操作，或者直接用镊子去除，下面会露出一个窝，窝底的皮膜像芦竹纸一样薄，风吹欲破，见到的人都会吃惊。还有的初起现出浓重的白色大障，继而在障内生出黄色翳膜，形状类似鹅脂，病情更加危急。如果再出现头痛、便秘，那么就会迅速演变为窟漏、蟹睛、凹凸不平、单目失明或双目失明，不久即可导致。治疗时，不论孔窟深浅，只要见到翳色肥黄、浮脆、善变且生长迅速，就急需用小承气汤合下利中丸通利大便以清除内部邪气，同时研磨羚羊角粉，调服清肝散以清除外部邪气，使表里之邪得以运行，头风不立即停止，但大便必须通畅。大便通畅后，眼睛红肿疼痛和流泪会随之减少，这时再用消风活血汤，或者防风散结汤、犀角地黄汤。服用过后，病势稍退，再按照“下星月翳蚀定方”进行治疗。眼药如果对证点洗，妥善适宜就好了，不必琐碎赘述。痊愈后必然留有白色翳障，形状如鱼鳞、玛瑙等，终身不能脱落。但这也不幸中的万幸了。推究病因，大概是木火自焚，殃及金土，肾水（一水）不胜心肝之火（四火），因此烧焦了神膏。良医遇到这种情况，也必须昼夜监护，如果只是喝完茶作个揖，揖后再写封信，就放心去别处，一旦病情变化如上所述，即使救得眼球完整，也带着残疾罢了。学习者应虚心恭敬地听取，进德修业良多。
原案中友人艾秀瞻，初夏突然得了此症，服用驱风散热的药剂反而加重。有人说城中的林挂苑向来有名望，何不请他治疗。林医生到了之后，观察患者形体虚弱，面色枯白，诊察其脉象细数，考虑到他家境富裕，心想必定是房事过度，精血耗损不能滋养身体，因而外感邪气。所以辛凉的药物不适用，于是主张用补中益气汤、四物汤、六味地黄汤等方剂，没过几天翳膜布满眼球而失明，加上烦躁不安，林医生便告辞离去，写信招我前去。我与艾秀瞻曾是同学，他信任我且专心求治，于是我给他服用大承气汤合三黄丸五钱，第一次服药没有反应，第二次服药略有大便排出，疼痛稍减，第二天早晨微微睁开眼，右眼已经能辨别黑白。接着像之前那样每天进服两剂药，直到大便极度通畅才停止。停止用药后，头部和眼睛的攻冲疼痛顿时消除，然后散剂用八正散、逍遥散，丸剂用退云丹、既济丸，一个多月后，他能走出溪桥去纳凉，秋天完全痊愈。林挂苑询问原因，我说：眼睛疼痛从下往上，头痛集中在太阳穴部位，这是阳明经胜过了厥阴经，所以用承气汤来通泄。大小便不通畅，是脏器的热邪移注于腑，所以用三黄丸来降泄。气轮（白睛）簇拥着火邪，用八正散实泻其子（肺金之子为肾水，此处指通过利小便导热下行，或依五行相生相克理论调整）。震廓（黑睛）凝结脂膜，用逍遥散直接解除郁结。退云丹、既济丸，特意用来平定残余的病邪罢了。林医生回去后感叹道：医术的精妙，竟然神验到如此程度！可见法度并不远离人，是人自己远离了法度。智慧圆融胆识宏大，触类旁通加以推广，那么医术就在自己手中了。虽然如此，秀瞻形脉怯弱，却用重方多次通下，幸好获得了戴元礼（朱丹溪弟子，号戴人者常指张从正，此处可能借指攻邪派风格或特定语境下的名医）邪实急攻的效果，但张仲景忌讳攻下的教诲岂不是违背了吗？这个案例仅仅凭借攻伐立功，不可以作为典范。
What is called "Ningzhi Yi" (Corneal Ulcer with Greasy Film)? Its morphology is thick and yellowish; blood stagnation damages the Shengao (lens and intraocular tissues); qi stagnation blocks the meridians; heat attacks the brain; a cavity forms on the eyeball; blindness occurs in an instant; who can save life then?
At the onset, the eyes are painful, accompanied by many tortuous red vessels, photophobia, and tight closure of the eyelids. Forcing them open causes tears to gush out. On the Fenglun (cornea), star-like white spots appear, with holes in the center resembling puncture wounds from an awl. Gradually, these enlarge and turn yellow, and the holes expand into cavities. In some cases, the opacity appears yellow from the beginning, large and dense. Treatment follows the following methods: If a gap opens around the periphery, and forceps can be applied, or if it can be completely removed with tweezers, a pit is revealed at the bottom. The membrane at the bottom of this pit is as thin as reed-paper, fragile enough to break with wind, shocking anyone who sees it. In other cases, a dense, large white opacity appears initially, followed by the emergence of a yellow film within the opacity, resembling goose fat, indicating a more urgent condition. If headache and constipation also occur, it will rapidly evolve into a perforated ulcer (Kulou), crab-eye (Xiejing), irregular surface (Aotu), monocular blindness (Miao), or total blindness (Gu), leading to disaster within days. Regardless of the depth of the hole or cavity, as long as the opacity is thick, yellow, floating, brittle, and changes rapidly, one must urgently use Xiao Chengqi Tang combined with Xializhong Wan to purge the interior via bowel movement. Simultaneously, grind Antelope Horn (Lingyangjiao) and mix with Qinggan San to clear the exterior, ensuring the pathogenic factors in both interior and exterior are expelled. Even if the cephalic wind does not stop immediately, the bowels must become unobstructed. Once the bowels are unobstructed, eye redness, pain, and tearing will decrease. Then, use Xiaofeng Huoxue Tang, or Fangfeng Sanjie Tang, or Xijiao Dihuang Tang. After administration, if the condition slightly recedes, proceed according to the fixed prescription for "Lowering Star-Moon Opacity Erosion." Apply appropriate eye drops and washes; if suitable, recovery ensues without need for further elaboration. After healing, a white opacity will inevitably remain, shaped like fish scales or agate, which cannot detach throughout life. However, this is a fortunate outcome amidst misfortune. Investigating the etiology, it is likely due to Wood and Fire consuming themselves, damaging Metal and Earth; Kidney Water (one water) fails to overcome Heart and Liver Fire (four fires), thereby scorching the Shengao. A skilled physician encountering such a case must monitor day and night. If one merely drinks tea, bows, writes a letter, and leaves confidently, when symptoms change as described above, even if the eyeball is saved, it will remain disabled. Students should listen with humility and reverence, greatly advancing their virtue.
In the original case, my friend Ai Xiuzhan suddenly contracted this disease in early summer. Taking wind-dispelling and heat-clearing agents aggravated his condition. Someone suggested inviting Lin Guayuan, who was well-known in the city, for treatment. Upon arrival, Lin observed that the patient's physique was weak and complexion withered and pale. His pulse was fine and rapid. Considering his family was wealthy, Lin suspected excessive sexual indulgence had depleted essence and blood, leaving the body vulnerable to external pathogens. Therefore, acrid-cool herbs were inappropriate. He prescribed Buzhong Yiqi Tang, Siwu Tang, and Liuwei Dihuang Tang. Within a few days, the cornea became fully opaque, causing blindness, accompanied by restlessness. Lin resigned and sent a letter summoning me. I had studied with Ai Xiuzhan; he trusted me and sought my help exclusively. I administered Dachengqi Tang combined with Sanhuang Wan, 5 qian. The first dose yielded no response; the second dose produced slight bowel evacuation, and pain decreased slightly. The next morning, upon opening his eye slightly, his right eye could distinguish black and white. I continued administering two doses daily as before, until severe diarrhea occurred, at which point I stopped. After stopping, the pounding pain in the head and eyes was instantly relieved. Then, I used Bazheng San and Xiaoyao San as powders, and Tuiyun Dan and Jiji Wan as pills. Over a month later, he could walk out to the creek bridge to enjoy the cool air, and by autumn, he had fully recovered. When Lin Guayuan asked for the rationale, I said: Eye pain rising from below and heavy headache at the Taiyang acupoints indicate Yangming meridian overcoming Jueyin meridian; thus, Chengqi decoction is used to unblock. Constipation indicates heat transferring from Zang to Fu organs; thus, Sanhuang Wan is used to descend. Fire clustering in the Qi Lun (sclera/conjunctiva) requires Bazheng San to purge the child organ (via draining damp-heat through urination). Greasy film condensing in the Zhen Kuo (cornea) requires Xiaoyao San to directly resolve stagnation. Tuiyun Dan and Jiji Wan are specifically used to pacify residual pathogens. Lin returned and sighed, saying: The subtlety of medical methods is so divinely effective! It shows that principles do not distance themselves from people; rather, people distance themselves from principles. With round wisdom and bold courage, applying knowledge analogously, one masters the art. Nevertheless, Xiuzhan presented with a weak constitution and pulse, yet received heavy purgatives repeatedly. Fortunately, the effect of aggressive attack on excess pathogens (as advocated by Zhang Congzheng/Dairen) was achieved, but did this not violate Zhang Zhongjing's teaching against purging? This case succeeds only through attacking methods and should not serve as a model.