此眼初患之时。皆因乳母多有吃食乖违。将息失度。爱食湿面五辛诸毒丹药。积热在腹。后此令胎中患眼。生后五
六岁以来，不言不笑。睹无盼视。父母始觉。急须服药调理。不宜点诸毒药。烧炙头面。枉害形容直至年长十五以来方
始辨眼内翳状如青白色。盖定瞳人。犹辨三光。可令金针拨之。小儿内障。多有不堪疗者。宜仔细看之。方可医疗。宜
服护睛丸。即不损眼也。
诗曰∶
内障因何及小儿 胎中受热脑脂垂 初生不觉三年内 流盼还应眼转迟
四五岁时言近看 瞳人结白始如迷 若能信受医家语 更读前贤后首诗
又诗曰∶
小儿内障未容医 将息难为定不疑 父母解留年十八 金针一拨若云飞
痴心炙烙烧头面 舌舐揩摩黑水亏 年几得医先损了 不堪针拨只堪悲
护睛丸
木香 大黄 黄芩 黑参（各一两） 射干 细辛（各半两）
上为末。炼蜜为丸如桐子大。空心茶下十丸。
此眼初患之时。头旋偏痛。亦是脏腑虚劳肝风为本。或一眼先患。或因呕吐双暗，毒风入眼。兼脑热相侵。致令眼
目失明。初觉即须急疗。宜服除风汤、通明补肾丸立效。
诗曰∶
乌绿青风及黑黄 堪嗟宿世有灾殃 瞳人颜色如明月 问睹三光不见光
后有脑脂如结白 真如内障色如霜 医人不识将针拨 翳落非明目却伤
除风汤
羚羊角 车前子（各二两） 芍药 人参 茯苓 大黄 黄芩 芒硝（各一两）
上为末。以水一盏。散一钱。煎至五分。食后去渣温服。
通明补肾丸
车前子 石决明 桔梗 芍药（各一两） 细辛（二两） 大黄（一分） 茺蔚子 干地黄（各二两）
上为末。炼蜜为丸如桐子大。空心茶下十丸。
这段文字主要论述了小儿内障的病因、症状及治疗，分为“胎患内障”和“五风变内障”两部分。
**第一部分：胎患内障**
这种眼病在初发时，大多是因为乳母饮食不当，调养失度，喜爱食用湿面、五辛（葱、蒜、韭、薤、兴渠等五种辛辣蔬菜）以及各种有毒丹药，导致体内积热蕴结于腹部，进而影响胎儿，使胎儿在母体内就患上眼疾。患儿出生后到五六岁时，表现为不说话、不笑，眼神呆滞无神，父母这时才发觉异常。此时急需服药调理，不宜使用各种腐蚀性药物点眼，也不宜用火烧或艾灸头面部，以免白白损害容貌。直到孩子长到十五岁左右，才能看清眼内翳障的形状，呈现青白色，固定遮蔽瞳仁，但尚能分辨三光（日光、月光、灯光）。此时可以用金针拨障术进行治疗。小儿内障患者，大多属于难以治愈的类型，必须仔细诊察后，方可进行医疗。适宜服用护睛丸，这样就不会损伤眼睛。
诗云：
内障为何会发生在小儿身上？是因为胎中受热，脑脂下垂所致。
初生时并不察觉，三年之内眼神流转迟缓。
到了四五岁，说话声音近听，瞳孔结白，开始显得迷茫。
若能相信并听从医生的话，再研读前代贤人后面的诗句。
又诗云：
小儿内障尚未允许轻易医治，调养护理很难确定是否无疑。
如果父母能留待孩子长到十八岁，再用金针拨障，效果若云飞般迅速。
若是痴心妄用炙烙烧灼头面，或用舌头舔舐、手揩摩眼部，会导致黑水（瞳仁/肾精）亏损。
年纪轻轻就因误治而受损，无法接受针拨治疗，只令人悲伤。
**护睛丸方：**
木香、大黄、黄芩、黑参（各一两），射干、细辛（各半两）。
以上药材研为细末，用炼蜜制成如梧桐子大小的药丸。空腹时用茶送服十丸。
**第二部分：五风变内障**
这种眼病初发时，伴有头晕、偏头痛等症状，其根本原因是脏腑虚劳、肝风内动。可能是一只眼睛先患病，也可能是因为呕吐导致双眼昏暗，毒风侵入眼中，兼有脑部热邪相侵，致使眼睛失明。刚发觉时就须紧急治疗，适宜服用除风汤、通明补肾丸，立竿见影。
诗云：
乌风、绿风、青风及黑风、黄风，可叹是前世造下的灾殃。
瞳仁颜色如同明月，询问能否看见三光，却看不见光亮。
后来脑脂凝结如白色，真像内障色如霜雪。
医生如果不认识此病而盲目用针拨，虽然翳障落下，眼睛反而受伤。
**除风汤方：**
羚羊角、车前子（各二两），芍药、人参、茯苓、大黄、黄芩、芒硝（各一两）。
以上药材研为细末，用水一盏，取药散一钱，煎至五分，饭后去渣温服。
**通明补肾丸方：**
车前子、石决明、桔梗、芍药（各一两），细辛（二两），大黄（一分），茺蔚子、干地黄（各二两）。
以上药材研为细末，用炼蜜制成如梧桐子大小的药丸。空腹时用茶送服十丸。
This text discusses the etiology, symptoms, and treatment of pediatric cataracts, divided into two parts: "Congenital Cataract" (Tai Huan Nei Zhang) and "Five Winds Transforming into Internal Cataract" (Wu Feng Bian Nei Zhang).
**Part 1: Congenital Cataract (Tai Huan Nei Zhang)**
When this eye disease first manifests, it is mostly due to the wet nurse's improper diet and inadequate care. If she indulges in eating damp wheat noodles, five pungent spices (Wu Xin, referring to five types of pungent vegetables such as garlic, chives, etc.), and various toxic elixirs, heat accumulates in the abdomen. This subsequently affects the fetus, causing the infant to suffer from eye disease while still in the womb. From birth until the age of five or six, the child does not speak or smile, and their gaze lacks spirit or focus. Parents only realize the abnormality at this stage. It is urgent to administer herbal medicine for regulation; one should avoid applying corrosive substances to the eyes or using cauterization and moxibustion on the head and face, which would merely damage the appearance without benefit. Only when the child reaches the age of fifteen can the shape of the intraocular opacity be clearly distinguished. The opacity appears bluish-white and fixes over the pupil, yet the patient may still distinguish the three lights (San Guang, referring to sunlight, moonlight, and lamplight). At this point, gold-needle cataract surgery (Jin Zhen Bo Zhi) can be performed. Most cases of pediatric internal cataract are difficult to cure; therefore, careful examination must precede any medical intervention. It is advisable to administer Hu Jing Wan (Eye-Protecting Pill), which will prevent further damage to the eyes.
The poem states:
Why do internal cataracts occur in children?
It is caused by heat in the fetus leading to the descent of brain fat.
Not noticeable at birth, within three years, the eye movements become sluggish.
At four or five years old, speech is faint, the pupil turns white, and vision becomes confused.
If one trusts and accepts the physician's advice,
And reads the subsequent poems of former sages.
Another poem states:
Pediatric internal cataracts should not be treated hastily;
Careful nursing is difficult to determine with certainty.
If parents wait until the child is eighteen,
Gold-needle manipulation yields results swift as flying clouds.
Foolishly applying cauterization and burning to the head and face,
Or licking and rubbing the eyes, depletes the Black Water (Hei Shui, referring to the pupil/kidney essence).
Damaged before proper treatment can begin,
Incapable of needle manipulation, only sorrow remains.
**Hu Jing Wan (Eye-Protecting Pill):**
Muxiang (Aucklandiae Radix), Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Heishen (Ginseng Radix Nigra, each 1 liang); Shegan (Belamcandae Rhizoma), Xixin (Asari Radix, each 0.5 liang).
Grind all ingredients into fine powder. Mix with refined honey to form pills the size of tung tree seeds. Take ten pills orally on an empty stomach with tea water.
**Part 2: Five Winds Transforming into Internal Cataract (Wu Feng Bian Nei Zhang)**
When this eye disease first occurs, it is accompanied by dizziness and unilateral headache. The root cause lies in deficiency and exhaustion of the zang-fu organs and internal wind generated by the liver. It may affect one eye initially, or both eyes may become dim due to vomiting, allowing toxic wind to invade the eyes, compounded by heat invading from the brain, resulting in blindness. Immediate treatment is required upon initial detection. It is suitable to administer Chu Feng Tang (Wind-Expelling Decoction) and Tong Ming Bu Shen Wan (Brightening Kidney-Nourishing Pill) for immediate effect.
The poem states:
Wu Wind, Lü Wind, Qing Wind, Hei Wind, and Huang Wind;
Alas, these are calamities from past lives.
The pupil's color resembles the bright moon,
Yet when asked if the three lights are visible, no light is seen.
Later, brain fat condenses like white frost,
Truly resembling the frosty hue of internal cataracts.
If physicians fail to recognize the condition and blindly use needles,
Although the opacity falls, the eye suffers injury.
**Chu Feng Tang (Wind-Expelling Decoction):**
Lingyangjiao (Saiga Tataricae Cornu), Cheqianzi (Plantaginis Semen, each 2 liang); Shaoyao (Paeoniae Radix), Renshen (Ginseng Radix), Fuling (Poria), Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Mangxiao (Natrii Sulfas, each 1 liang).
Grind all ingredients into fine powder. Take one qian of the powder with one cup of water, decoct until half remains. Strain and take warm after meals.
**Tong Ming Bu Shen Wan (Brightening Kidney-Nourishing Pill):**
Cheqianzi (Plantaginis Semen), Shijueming (Haliotidis Concha), Jiegeng (Platycodonis Radix), Shaoyao (Paeoniae Radix, each 1 liang); Xixin (Asari Radix, 2 liang); Dahuang (Rhei Radix et Rhizoma, 1 fen); Chongweizi (Leonuri Fructus), Gan Dihuang (Rehmanniae Radix Praeparata, each 2 liang).
Grind all ingredients into fine powder. Mix with refined honey to form pills the size of tung tree seeds. Take ten pills orally on an empty stomach with tea water.