伤寒发黄。惟阳明太阴两经有之。阳明病。应遍身有汗。今但头汗出。小便不利。
心中懊 。身必发黄者。瘀热在里。内外无从发泄也。发汗已。身目皆黄者。大发湿家汗。风去湿不去也。
发汗已。太阴病。身当发黄。因小便不利。湿土为热所蒸。而黄色外现也。若小便自利。
小腹硬满者。瘀血发黄也。
邵评∶以小便利不利。分发黄蓄血。是已。惟胆汁入血为胆黄。其症治尚须补入。治法。阳明发黄。
乃胃家移热于脾。必二便俱秘。茵陈蒿汤。太阴发黄。是脾家湿热。必小便不利。大便反快。茵陈五苓散。
邵评∶发黄有太阴阳明湿热虚实之不同。若发黄而二便俱秘者。乃阳明胃实。
移热于脾。故宜用下。若发黄而小便不利。大便反快。乃太阴脾湿蒸热。故宜清利。
若发黄。汗出身冷。
脉沉迟者。阴黄也。茵陈五苓加干姜（参准绳）
邵评∶寒湿留滞而成阴黄。故宜温通。若更阳虚。可用茵陈四逆汤。
金鉴云。表实无汗发黄者。宜麻黄连翘赤小豆汤汗之。里实不便者。宜茵陈蒿汤下之。无表里症
而热甚者。宜栀子柏皮汤清之。大便溏。小便不利。发黄者。宜茵陈五苓散利之。阴证发黄者。宜茵陈四
逆汤温之。环口黧黑。冷汗者。阴黄死症也。身体枯燥如烟煤者。阳黄死症也。
邵评∶发黄有汗下清利温五种治法。治黄之法。不外是矣。阴黄阳绝。阳黄阴涸。均是死症。
Jaundice in Shanghan (Cold Damage) occurs only in the Yangming and Taiyin meridians. In Yangming disease, sweating should be generalized over the whole body; however, now there is only sweating on the head, and urination is difficult. With vexation and irritability in the chest and epigastrium (Xin Zhong Ao Nao), jaundice will inevitably develop because heat and blood stasis are trapped inside, with no outlet for release from within or without. After inducing sweating, if the body and eyes become yellow, it is due to excessive sweating of a dampness-pattern patient; the wind pathogen has left, but the dampness remains. After inducing sweating, if the condition shifts to Taiyin disease, jaundice should appear because of difficulty in urination; dampness and earth qi are steamed by heat, causing the yellow color to manifest externally. If urination is spontaneous and normal, but the lower abdomen is hard and full, this is jaundice caused by blood stasis.
Shao's Commentary: Distinguishing between jaundice caused by blood stasis and that caused by damp-heat based on whether urination is free or obstructed is correct. However, jaundice caused by bile entering the blood (Dan Huang) requires additional discussion regarding its symptoms and treatment. Regarding treatment methods: Yangming jaundice results from heat transferring from the Stomach to the Spleen; both stool and urine must be constipated/obstructed, so Yinchen Hao Tang (Artemisiae Scopariae Decoction) is indicated. Taiyin jaundice results from damp-heat in the Spleen; urination must be difficult, while stool tends to be loose, so Yinchen Wuling San (Artemisiae Scopariae and Five-Ingredient Poria Powder) is indicated.
Shao's Commentary: Jaundice varies in terms of damp-heat affecting the Taiyin and Yangming meridians, presenting as excess or deficiency patterns. If jaundice presents with obstruction of both stool and urine, it indicates Yangming Stomach excess, where heat transfers to the Spleen; thus, purgative therapy is appropriate. If jaundice presents with difficult urination and loose stool, it indicates Taiyin Spleen dampness steaming into heat; thus, clearing and draining therapy is appropriate.
If jaundice presents with sweating followed by cold limbs and a deep, slow pulse, it is Yin Jaundice (Yin Huang); Yinchen Wuling San plus Ganjiang (Dried Ginger) is indicated (referencing *Zhun Sheng*).
Shao's Commentary: Cold-damp stagnation leads to Yin Jaundice, so warming and unblocking therapy is appropriate. If accompanied by Yang deficiency, Yinchen Sini Tang (Artemisiae Scopariae and Four-Ingredient Reversal Decoction) can be used.
*Yizong Jinjian* states: For exterior excess with no sweating and jaundice, Mahuang Lianqiao Chixiaodou Tang (Ephedra, Forsythia, and Red Bean Decoction) should be used to induce sweating. For interior excess with constipation, Yinchen Hao Tang should be used to purge. For severe heat without exterior or interior signs, Zhizi Bopi Tang (Gardeniae and Phellodendri Bark Decoction) should be used to clear heat. For loose stool, difficult urination, and jaundice, Yinchen Wuling San should be used to promote diuresis. For Yin syndrome jaundice, Yinchen Sini Tang should be used to warm. Blackening around the mouth with cold sweat indicates a fatal case of Yin Jaundice. A dry, rough body resembling soot indicates a fatal case of Yang Jaundice.
Shao's Commentary: There are five treatment methods for jaundice: sweating, purging, clearing, draining, and warming. The methods for treating jaundice do not exceed these principles. Yin Jaundice leading to the exhaustion of Yang, and Yang Jaundice leading to the depletion of Yin, are both fatal conditions.