阳明病。无汗。小便不利。心中懊 者。身必发黄。
阳明病。被火。额上微汗出。小便不利者。必发黄。
邪入阳明。寒已变热。若更被火。则邪不得去。而热反内增矣。且无汗。则热不外越。小便不
利。则热不下泄。蕴蓄不解。集于心下而聚于脾间。必恶热。为懊 不安。脾以湿应。与热相合。
势必蒸郁为黄矣。额上虽微汗。被火气劫。从炎上之化也。岂能解其火邪哉。
阳明病。发热汗出。此为热越。不能发黄也。但头汗出。身无汗。剂颈而还。小便不利。渴饮
水浆者。此为瘀热在里。身必发黄。茵陈蒿汤主之。
热越、热随汗而外越也。热越则邪不蓄而散。安能发黄哉。若但头汗出而身无汗。剂颈而还。
则热不得外达。小便不利。则热不得下泄。而又渴饮水浆。则其热之蓄于内者方炽。而湿之引于外
者无已。湿与热得。瘀郁不解。则必蒸发为黄矣。茵陈蒿汤苦寒通泄。使病从小便出也。
茵陈蒿汤方
茵陈蒿（六两） 栀子（十四枚擘） 大黄（二两去皮）
上三味。以水一斗二升。先煎茵陈减六升。纳二味。煮取三升。去滓。分温三服。小盒饭利。
尿如皂角汁状。色正赤。一宿腹减。黄从小便去也。
伤寒发汗已。身目为黄。所以然者。以寒湿在里。不解故也。以为不可下也。于寒湿中求之。
伤寒发汗已。热与汗越。不能发黄。而反身目为黄者。以寒湿深入在里。汗虽出。而寒湿不与俱
出也。寒
湿在里。必伤于脾。脾伤而色外见。则身目为黄。是不可比于瘀热在里之例。而辄用下法也。云于
寒湿中求之者。意非温脾燥湿不可耳。
伤寒七八日。身黄如橘子色。小便不利。腹微满者。茵陈蒿汤主之。
此则热结在里之证也。身黄如橘子色者。色黄而明。为热黄也。若湿黄则色黄而晦。所谓身黄
如薰黄也。热结在里。为小便不利。腹微满。故宜茵陈蒿汤下热通瘀为主也。
伤寒身黄发热者。栀子柏皮汤主之
此热瘀而未实之证。热瘀。故身黄。热未实。故发热而腹不满。栀子彻热于上。柏皮清热于下。
而中未及实。故须甘草以和之耳。
栀子柏皮汤方
栀子（十五枚擘） 甘草（一两炙） 柏皮（二两）
上三味。以水四升。煮取一升半。去滓。分温再服。
伤寒瘀热在里。身必发黄。麻黄连轺赤小豆汤主之。
此亦热瘀而未实之证。瘀热在里者。汗不得出而热瘀于里也。故与麻黄、杏仁、生姜之辛温。
以发越其表。赤小豆、连轺、梓白皮之苦寒甘。以清热于里。大枣、甘草。甘温悦脾。以为散湿驱邪
之用。用潦水者。取其味薄。不助水气也。合而言之。茵陈蒿汤是下热之剂。栀子柏皮汤是清热之
剂。麻黄连轺赤小豆汤
是散热之剂也。
麻黄连轺赤小豆汤方
麻黄（二两） 生姜（二两切） 生梓白皮（一升） 连轺（二两） 甘草（二两炙） 大
枣（十二枚擘） 赤小豆（一升） 杏仁（四十粒去皮尖）
上八味。以潦水一斗。先煮麻黄再沸。去上沫。纳诸药。煮取三升。分温三服。半日服尽。
Yangming disease. Absence of sweating, difficulty in urination, and restlessness in the heart (restlessness in the chest/epigastrium) indicate that jaundice will inevitably develop.
In Yangming disease, if fire therapy is applied, resulting in slight sweating only on the forehead and difficulty in urination, jaundice will inevitably develop.
When pathogenic factors enter the Yangming channel, cold has transformed into heat. If fire therapy is further applied, the pathogen cannot be expelled, and internal heat increases instead. Furthermore, absence of sweating prevents heat from dissipating outward; difficulty in urination prevents heat from draining downward. The accumulated and stagnant heat fails to resolve, gathering in the epigastrium and stagnating in the Spleen region. This causes aversion to heat and restlessness (An Nao). Since the Spleen corresponds to Dampness, when Dampness combines with Heat, steaming and stagnation inevitably lead to jaundice. Although slight sweating occurs on the forehead, it is coerced by the fire qi, following the upward-flaring nature of fire. How can this resolve the fire pathogen?
In Yangming disease, fever with sweating indicates that heat is venting outward (Re Yue), so jaundice will not develop. However, if there is sweating only on the head, no sweating on the body, stopping at the neck, along with difficulty in urination and thirst for fluids, this indicates Stagnant Heat in the interior (Yu Re Zai Li), and jaundice will inevitably develop. Yinchen Hao Tang (Mugwort Seed and Rhubarb Decoction) is the primary treatment.
"Venting heat" means heat dissipates outward with sweat. When heat vents, pathogens do not accumulate but disperse, so how can jaundice develop? If there is only head sweating without body sweating, stopping at the neck, heat cannot reach the exterior. Difficulty in urination prevents heat from draining downward. Thirst for fluids indicates that internal heat accumulation is intense, while external dampness attraction is unceasing. When Dampness and Heat combine, stagnation and郁结 fail to resolve, inevitably steaming into jaundice. Yinchen Hao Tang is bitter and cold, promoting unblocking and purging, allowing the pathogen to exit via urination.
Formula: Yinchen Hao Tang (Mugwort Seed and Rhubarb Decoction)
Yin Chen Hao (Artemisiae Scopariae Herba, 6 liang), Zhi Zi (Gardeniae Fructus, 14 fruits, split), Da Huang (Rhei Radix et Rhizoma, 2 liang, bark removed).
These three ingredients are decocted in 12 sheng of water. First, boil Yin Chen Hao until the volume reduces by 6 sheng. Then add the other two ingredients, boil to obtain 3 sheng of liquid, remove dregs, and divide into three warm doses. After administration, urination should become smooth, urine resembling soapberry juice with a reddish color. Abdominal fullness decreases overnight, and jaundice exits via urination.
After treating Cold Damage (Shang Han) with sweating methods, if the body and eyes turn yellow, it is because Cold-Dampness remains unresolved in the interior. This condition contraindicates purgative therapy; treatment should seek resolution within the context of Cold-Dampness.
If after sweating therapy for Cold Damage, heat vents with sweat and jaundice does not occur, but the body and eyes nevertheless turn yellow, it is because Cold-Dampness has penetrated deeply into the interior. Although sweat is produced, Cold-Dampness does not exit with it. Cold-Dampness in the interior inevitably damages the Spleen. Spleen damage manifests externally as its color, causing yellowing of the body and eyes. This cannot be compared to cases of Stagnant Heat in the interior where purgatives are used. "Seeking resolution in Cold-Dampness" implies that warming the Spleen and drying Dampness are indispensable.
In Cold Damage, after seven or eight days, if the body is yellow like an orange peel, with difficulty in urination and mild abdominal fullness, Yinchen Hao Tang (Mugwort Seed and Rhubarb Decoction) is the primary treatment.
This is a pattern of Heat knotting in the interior. Yellowing like an orange peel indicates bright yellow, characteristic of Heat Jaundice. In contrast, Damp-Jaundice presents as dull yellow, described as "yellow like smoked tobacco." Heat knotting in the interior causes difficulty in urination and mild abdominal fullness. Therefore, Yinchen Hao Tang is appropriate, primarily focusing on purging Heat and unblocking stagnation.
In Cold Damage, if the body is yellow with fever, Zhizi Bopi Tang (Gardenia and Phellodendron Decoction) is the primary treatment.
This is a pattern of Heat stagnation without excess (fullness). Heat stagnation causes jaundice; lack of excess explains fever without abdominal fullness. Zhi Zi (Gardeniae Fructus) clears Heat from above, Bopi (Phellodendri Cortex) clears Heat from below, and since the middle Jiao is not yet excessive, Gan Cao (Glycyrrhizae Radix et Rhizoma) is required to harmonize.
Formula: Zhizi Bopi Tang (Gardenia and Phellodendron Decoction)
Zhi Zi (Gardeniae Fructus, 15 fruits, split), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried), Bo Pi (Phellodendri Cortex, 2 liang).
These three ingredients are decocted in 4 sheng of water to obtain 1.5 sheng of liquid. Remove dregs and divide into two warm doses.
In Cold Damage, if Stagnant Heat is in the interior, jaundice will inevitably develop. Mahuang Lianqiao Chixiaodou Tang (Ephedra, Forsythia, and Red Bean Decoction) is the primary treatment.
This is also a pattern of Heat stagnation without excess. Stagnant Heat in the interior means sweat cannot emerge, trapping Heat inside. Therefore, the acrid-warm properties of Mahuang (Ephedrae Herba), Xing Ren (Armeniacae Semen Amarum), and Sheng Jiang (Zingiberis Rhizoma Recens) are used to vent the exterior. The bitter-cold and sweet properties of Chixiaodou (Phaseoli Semen Rubrum), Lian Qiao (Forsythiae Fructus), and Zi Bai Pi (Cedri Cortex) clear Heat in the interior. Da Zao (Jujubae Fructus) and Gan Cao (Glycyrrhizae Radix et Rhizoma) use their sweet-warm nature to benefit the Spleen, assisting in dispersing Dampness and expelling pathogens. Liao Shui (rainwater) is used for its thin flavor, which does not aggravate fluid retention. In summary, Yinchen Hao Tang is a formula for purging Heat, Zhizi Bopi Tang is for clearing Heat, and Mahuang Lianqiao Chixiaodou Tang is for venting Heat.
Formula: Mahuang Lianqiao Chixiaodou Tang (Ephedra, Forsythia, and Red Bean Decoction)
Mahuang (Ephedrae Herba, 2 liang), Sheng Jiang (Zingiberis Rhizoma Recens, 2 liang, sliced), Sheng Zi Bai Pi (Cedri Cortex, 1 sheng), Lian Qiao (Forsythiae Fructus, 2 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 liang, honey-fried), Da Zao (Jujubae Fructus, 12 fruits, split), Chixiaodou (Phaseoli Semen Rubrum, 1 sheng), Xing Ren (Armeniacae Semen Amarum, 40 grains, skin and tips removed).
These eight ingredients are decocted in 10 sheng of rainwater. First, boil Mahuang until boiling, then remove the foam on the surface. Add the remaining herbs, boil to obtain 3 sheng of liquid, and divide into three warm doses. Take all doses within half a day.