Library

(Yellow is the color of the Earth in the center, thus it belongs to Yangming disease and Taiyin disease syndromes. When dampness and heat interact, body jaundice must occur, similar to how yellow mold grows due to damp-heat when fermenting Qu in summer. When dampness prevails, the whole body aches, and the complexion is like smoked yellow, dull and dark; when heat prevails, there is no whole-body pain, and the complexion is bright orange-yellow like an orange peel. Additionally, blood stasis can also cause jaundice, but it is accompanied by hardness and fullness in the lower abdomen, free urination, and a mental state resembling mania. Jaundice with cold air exhaled from the nose and absent pulse at the Cun position near the palm indicates death. Jaundice with fixed staring eyes and head shaking indicates Heart Qi exhaustion; jaundice with blackening around the mouth indicates Spleen Qi exhaustion. All these are due to stagnant heat trapped inside.)

Sweat only on the head, thirst, difficulty in urination, inability for sweat to escape outward, bright orange-yellow skin color. (If stool is constipated, use Yinchen Hao Tang [Artemisiae Scopariae Decoction]; if urination is difficult, use Wuling San [Polyporus Powder] added with Yinchen Hao [Artemisiae Scopariae Herba].) Jaundice caused by cold-dampness: body pain, fever, headache, nasal congestion, irritability, large pulse. Use Gouti San [Cucumis Trichosanthis Powder] insufflated into the nose to induce sneezing, or decoct Fangfeng [Saposhnikoviae Radix], Gegen [Puerariae Lobatae Radix], Cangzhu [Atractylodis Rhizoma], Yinchen Hao [Artemisiae Scopariae Herba], Jiegeng [Platycodonis Radix], Gancao [Glycyrrhizae Radix et Rhizoma], Chenpi [Citri Reticulatae Pericarpium], and Shengjiang [Zingiberis Rhizoma Recens] to induce mild sweating. Jaundice caused by Pi Qi [epigastric mass]: use Banxia Xiexin Tang [Pinellia Decoction to Drain the Epigastrium] added with Yinchen Hao [Artemisiae Scopariae Herba] and Zhishi [Aurantii Fructus Immaturus]; if urination is difficult, add Zhizi [Gardeniae Fructus]. Jaundice caused by Jie Xiong [chest binding]: use Xiaoxianxiong Tang [Minor Intra-thoracic Expelling Decoction] added with Yinchen Hao [Artemisiae Scopariae Herba]. Jaundice caused by Blood Stasis: fullness and pain in the lower abdomen, free urination, black stool, mental state resembling mania, deep pulse. Use Tao Ren Chengqi Tang [Prunus Persica Decoction to Order the Qi]. Jaundice caused by internal cold damage to the spleen/stomach: use Tiao Zhong Tang [Decoction to Regulate the Middle] added with Yinchen Hao [Artemisiae Scopariae Herba]; if limbs are cold, add Fuzi [Aconiti Lateralis Radix Preparata]. Yin syndrome jaundice: deep and slow pulse, cold limbs, shortness of breath, vomiting and chest oppression, or red face with cold feet, yin restlessness desiring to sit in a muddy well. (For mild cases, use Lizhong Tang [Regulate the Middle Decoction] added with Yinchen Hao [Artemisiae Scopariae Herba]; for severe cases, use Sini Tang [Reverse the Collapse Decoction] added with Yinchen Hao [Artemisiae Scopariae Herba].) When treating Yin Jaundice, warm with hot water compresses, or place the patient sitting over a basin of hot water, dipping cloth in hot water and applying it to the jaundiced area until recovery.

(When heat toxin resides in the Stomach and spreads to the Heart, mania occurs, which is the extreme of pathogenic heat. The onset of mania presents as little sleep, lack of appetite, delirious speech, laughter, aimless walking, singing while climbing high, discarding clothes and running, even killing people without avoiding fire or water, cursing without recognizing relatives or strangers, crying out in grief or anger, climbing walls and roofs. This is due to extreme hyperactivity of solitary Yang, which cannot be stopped without strong purgation. Delirious speech, upward rolling of eyes, recurrence of fever after sweating, continuous delirium, and inability to eat are all fatal signs. For uncontrollable manic jumping, pour good vinegar onto a hot charcoal brazier to let the vapor enter the patient's nose, then spray ginger juice [Zingiberis Rhizoma Recens] on the head, face, body, hands, and feet to calm them, then distinguish between Yang Mania and Yin Restlessness. Remove bed curtains and place dry grass before the patient.)

Great thirst, red eyes, cracked lips, dry tongue, dry teeth, excess pulse, madness. Use Dachengqi Tang [Major Order the Qi Decoction] for urgent purgation.) Floating pulse without sweat, physician used fire method to force sweating, resulting in fright and mania. Use Guizhi Tang removing Shaoyao [Paeoniae Radix Alba] plus Shujin [Asiasari Radix], Longgu [Fossilia Ossis Mastodi], and Muli [Concha Ostreae] for Rescue against Counterflow (Guizhi Qushaoyao Jienuo Tang).) A person prone to sweating who sweats heavily again will suffer from trance and mental confusion; after urination, genital pain occurs. Use Yuyuliang Wan [Metasideritum Pill].) Taiyang disease for six or seven days, exterior syndrome still present, pulse is faint and deep, but Chest Binding does not form. The patient becomes manic because heat is in the Lower Jiao. The lower abdomen should be hard and full, urination is free, and healing occurs upon bleeding. This is because Taiyang pathogen follows the channels into the interior, causing stagnant heat inside. Use Danggui Tang [Echinops Decoction - Note: Text says Didang Tang, usually Dandang Tang/Taohe Chengqi variant contextually implies Strong Blood Breaking, here strictly Didang Tang/Dredging Decoction].) Taiyang disease unresolved, heat binds to the Bladder, patient resembles mania. If blood discharges spontaneously, it heals. If exterior is not resolved, attack is forbidden; resolve exterior first. Once exterior is resolved, if only the lower abdomen feels tense and knotty, attack may proceed. Use Tao Ren Chengqi Tang [Prunus Persica Decoction to Order the Qi].) Body jaundice, deep and knotted pulse, hard lower abdomen, free urination, patient resembles mania. This is definitive Blood Stasis syndrome. Use Didang Tang [Dredging Decoction].) Yin syndrome restlessness, desiring to sit in a muddy well, red face, cold feet, deep pulse, inability to drink water. Use Pili San [Thunderbolt Powder] taken cold.) Slight fever, red face, cold feet, pulse rapid and large when lifted but weak when pressed. This is deficient Yang hidden within Yin causing restlessness. Use Renshen Sini Tang [Ginseng Reverse Collapse Decoction] taken cold.)

Analysis: Mania is mostly due to excess heat; without strong purgation using Dachengqi Tang [Major Order the Qi Decoction], how can it be stopped? If the pulse is weak, use Sanhuang Shigao Tang [Three-Yellow Gypsum Decoction] to clear heat. Regarding Blood Stasis syndrome, it is merely resembling mania, not true mania. This arises from failure to sweat when indicated, delayed sweating, excessive pulse with slight sweating, or inadequate covering leading to incomplete sweating. The Taiyang pathogen has no exit, so it follows the channels into the Fu organs, binding blood in the Bladder. Only after exterior symptoms resolve can purgation be used. As for Yin Restlessness, it is due to collapse of True Qi, floating of deficient Yang, and Yin excess repelling Yang. Unskilled physicians fail to observe the pulse's floating/sinking strength and the inability to drink; seeing a red face and hot body, they mistakenly administer cooling agents, leading to immediate death. Generally, although the skin surface feels hot, deep pressure reveals cold penetrating the hand. However, Yin Restfulness saves only two or three out of ten cases. It is lamentable that ignorant practitioners do not recognize it, while knowledgeable ones fear slander, leaving patients to wait for death with hands tied.)