夹时先翻转看上下胞睑，有瘀血处可 ， 至平，血尽方可夹上夹子，其夹不可高硕，只在重弦上，仔细看其睫毛，
转又要平正，方可着力扯紧，其夹肉处用小艾团灸三个，不可多灸，灸多恐溃夹决目，夹肉若未干，可再催用淡淡丹药，
去其余翳，此眼纵有浓翳，不可用重药。
用金针拨光了之时，将蓉花叶末调水护之，一日一换，宜服谨翳丸等方。
凡拨金针者，看人肥瘦，就手拨之，肥状者先宜服退气散血，和其五脏，后可拨之。
退气散血方
大黄（末，二钱五分） 当归（末，二钱五分） 穿山甲（一分二厘） 连翘（二分二厘） 白芷（一分二厘）
乳香（一分二厘） 没药（一分二厘）
凡开金针，须择吉日，静风日暖，须待日午之时，……然后方静坐片时，定自己之气息，令人取木凳一条，以绵被
贴软同患者坐于凳被上，骑马对坐面与我对平，勿使高低，缓缓用铜 脚于开缝处点计之，次看锋针口，与瞳仁三分之
下，要凭口诀使高低远近，方将锋针令其入眼，转看数遍足了，方按锋针三四下，看透了即取起，有些血出，用绵纸拭
干其血后，方用地方令针缓缓拈讯若透此针，取出，然后根据法，用天字针，再进取翳，其翳若好撒开裹针，缓缓收下，
停针毕方落在后去纸，举物与他看之，即见，不可与他人久视，即用湿纸重重封固，太阳用水膏涂之，至次早方开看，
再换湿纸再封，如此七日，斜卧不可凭他翻身转侧，七日后方开封与起无妨矣。……方取出金针，看其翳不浮起，即用
湿纸封片时，方去纸，举手动之。
使用夹法时，首先要翻转眼睑查看上下胞睑，若有瘀血之处，需先将其处理平整，待瘀血排尽后方可夹上夹子。夹子不可放置过高，只需夹在重弦（眼睑边缘）上，仔细检查睫毛是否转平正，然后方可用力扯紧。在夹住的肉处用小艾团灸三个，不可多灸，灸得过多恐怕导致溃烂、夹子脱落或伤及眼睛。若夹住的肉未干，可再用淡淡的丹药催干，以去除其余的翳膜。此眼即便有浓重的翳膜，也不可用重药。
用金针拨除翳膜完毕后，将蓉花叶末调水保护患处，每日更换一次，适宜服用谨翳丸等方剂。
凡是进行金针拨障手术者，需观察患者体型的肥瘦，顺势施术。体型肥胖者，应先宜服用退气散血方，调和五脏之气，之后方可进行拨治。
退气散血方：大黄（研末，二钱五分）、当归（研末，二钱五分）、穿山甲（一分二厘）、连翘（二分二厘）、白芷（一分二厘）、乳香（一分二厘）、没药（一分二厘）。
凡是施行金针开障，必须选择吉日，在风静日暖之时，须等到中午时分，……然后安静坐片刻，调整自己的呼吸气息。让人取一条木凳，铺上绵被使其柔软，让患者坐在凳上的棉被中，医者骑马与患者相对而坐，面部高度保持水平，不要有高低之差。缓缓用铜脚工具在开缝处点计定位，其次观察锋针入口，应在瞳孔下方三分处，要凭口诀掌握高低远近，然后将锋针刺入眼中。反复观察数遍确认无误后，才按压锋针三四下，看通透后即取出。若有少量出血，用绵纸拭干血迹后，方才用地方（此处疑为手法或特定工具描述，依原文直译）令针缓缓捻动。若透此针，取出，然后根据方法，使用天字针，再次进取翳膜。若翳膜较好剥离包裹针尖，则缓缓收回。停针完毕后，方取下后面的纸，举物给患者看，即能见物。不可与他人久视，即用湿纸重重封固，太阳穴部位用水膏涂抹，到第二天早上才打开查看，再换湿纸重新封好。如此七日，斜卧休息，不可任其翻身侧卧。七日后才开封取出，无妨了。……方才取出金针，看其翳膜不浮起，即用湿纸封片刻，方才去纸，举手示意活动。
When applying the clamp method, first flip the eyelids to inspect the upper and lower palpebrae. If there is blood stasis, it must be treated until flat; only after the blood is exhausted can the clamp be applied. The clamp should not be placed too high, but only on the *chongxian* (the marginal border of the eyelid). Carefully examine the eyelashes to ensure they are turned flat and straight before applying force to tighten the clamp. Apply three small moxa cones to the clamped flesh; do not apply excessive moxibustion, as too much may cause ulceration, clamp detachment, or eye injury. If the clamped flesh is not dry, use a mild mineral drug (*dansheng*) to promote drying and remove remaining nebulae. Even if the eye has thick nebulae, heavy medicines should not be used.
After clearing the nebula with the gold needle, apply water mixed with powder from *Ronghua* leaves to protect the area, changing it once daily. It is advisable to take *Jinyi Wan* (Astringent Nebula Pill) and other formulas.
For those undergoing gold needle cataract surgery, observe the patient's body type (fat or thin) and proceed accordingly. For obese patients, first administer *Tuiqi Sanxue Fang* (Qi-Reducing and Blood-Dispelling Decoction) to harmonize the five zang organs before proceeding with the extraction.
**Tuiqi Sanxue Fang (Qi-Reducing and Blood-Dispelling Decoction):**
*Dahuang* (Radix et Rhizoma Rhei, powdered, 2.5 qian), *Danggui* (Radix Angelicae Sinensis, powdered, 2.5 qian), *Chuanshanjia* (Squama Manis, 1.2 li), *Lianqiao* (Fructus Forsythiae, 2.2 li), *Baizhi* (Radix Angelicae Dahuricae, 1.2 li), *Ruxiang* (Resina Draconis, 1.2 li), *Moyao* (Resina Myrrhae, 1.2 li).
To perform the gold needle operation, one must select an auspicious day, preferably when the wind is calm and the sun is warm. Wait until noon... then sit quietly for a moment to regulate one's own breathing. Have someone prepare a wooden stool, pad it with soft cotton quilts, and have the patient sit on the padded stool. The practitioner should sit facing the patient (described as "riding horse" position, likely meaning straddling or sitting opposite), ensuring their faces are at the same level, neither higher nor lower. Gently mark the incision site using a copper tool. Next, identify the entry point for the *fengzhen* (sharp needle), which should be located three fen below the pupil. Use verbal instructions/mnemonics to determine the depth and distance, then insert the sharp needle into the eye. Observe multiple times to confirm accuracy. Press the needle three or four times; once visibility is clear, withdraw it. If any bleeding occurs, wipe it dry with cotton paper. Then, gently manipulate the needle using specific techniques. If the needle penetrates through, withdraw it. According to the method, use the *Tianzi Zhen* (Heaven Needle) to further extract the nebula. If the nebula peels away easily around the needle, slowly retract it. After stopping the needle manipulation, remove the backing paper. Hold up objects for the patient to see; vision should be restored. Advise against prolonged visual interaction with others. Seal the eye tightly with wet paper. Apply *Shui Gao* (Water Ointment) to the Taiyang region. Do not open until the next morning. Replace with fresh wet paper and reseal. Continue this for seven days. The patient should lie on their side and avoid rolling over. After seven days, the bandage can be removed without harm... Finally, withdraw the gold needle. Check if the nebula remains depressed. If so, seal with wet paper for a short while, then remove the paper and allow hand movement/exercise.