发黄之症,是邪热伏于阳明,郁塞熏蒸而现于外,必大便结小便闭,热结于中,而
不得泄也。治宜可下下之,次以清热和解为要。其症有三,凡两目或黄或赤,六脉洪大
有力燥渴者,为阳毒发黄,直下之。若小水不利或赤,小腹胀满不痛,脉来沉细有力,
渴而大便实者,为湿热发黄,宜清利小水。若环口黧黑,柔汗发黄者,此是脾绝,盖脾
主唇口,脾失精华,则黧黑见,脾气绝,则柔汗形,故真脏色见也,脾为精液之本,阳
气之宗,脾绝者,必死之候也。并发黄而寸口无脉,鼻气冷者,兼下痢而心腹满,脉沉细者,俱死。
衄者,是肺经热,其肺气受伤,不能卫血也。故凡脉浮紧鼻燥音哑无汗者,即宜汗
之自解,否则邪无由泄,入于里攻于肺,迫于血而衄斯作矣。然衄后而热退,精神爽
者,是邪从衄解,即大热而精神亦爽者,是内热亦泄,因邪气还表,故身大热,皆愈之
兆,俗名红汗。若在五六日间而衄者,此余热未清,错经妄行所致,可与导血归经,亦
必即愈。如衄后而反大热,烦渴而躁,诸症并作者,此血损气伤,邪乘虚而纵横于中,
为邪胜正也,难治。然衄虽多属于肺,若在二日间者,系阳明热在经中、迫血妄行,阳
明脉起于鼻,络于口,其候必欲漱冷水而不欲咽,不欲咽者是里无热,可见其在于阳,
而未入于阴也。若在三日间者,是邪热乘肝,肝不藏血也。若在四日间者,是太阴脉
布胃中,胃气攻冲,脾不能为之统血也。更有以火炙劫汗,以致助其里热,迫血上行,
轻则从鼻而出,重则从口而来。自腰以下,重而必痹,痹者,痛也,即名火逆,乃治之
不得其法,而人自致之病也。
The symptom of jaundice (Huang) arises when pathogenic heat lurks in the Yangming channel, becoming stagnant and steaming outward. It is characterized by constipation and urinary retention, with heat binding in the middle jiao and unable to vent. Treatment should employ purgation (Xia), followed by clearing heat and harmonizing as the key principle. There are three types of this condition: If both eyes appear yellow or red, the six pulses are surging, large, forceful, accompanied by dryness and thirst, it is classified as Yang toxicity jaundice (Yang Du Huang), which requires direct purgation. If urination is difficult or dark, the lower abdomen is distended but not painful, the pulse is deep, fine, and forceful, with thirst and solid stools, it is damp-heat jaundice (Shi Re Huang), for which promoting diuresis to clear dampness is appropriate. If the area around the mouth turns dark black, accompanied by soft sweat (soft sweating) and jaundice, this indicates the exhaustion of the Spleen. The Spleen governs the lips and mouth; when the Spleen loses its essence, darkness appears; when Spleen Qi perishes, soft sweat manifests, revealing the color of the True Zang organs. The Spleen is the root of fluids and the master of Yang Qi; exhaustion of the Spleen is a sign of inevitable death. Concurrent jaundice with no pulse at the Cun Kou position and cold breath from the nose, combined with dysentery and fullness in the heart and abdomen, with a deep and fine pulse, are all fatal conditions.
Nasal bleeding (Nu) results from heat in the Lung channel, where Lung Qi is injured and fails to secure the blood. Therefore, if the pulse is floating and tight, the nose is dry, the voice is hoarse, and there is no sweating, one should induce sweating to resolve the condition spontaneously; otherwise, the pathogen has no outlet to vent, enters the interior to attack the Lungs, forces the blood to move recklessly, and causes nasal bleeding. However, if the fever subsides and spirit becomes refreshed after nasal bleeding, it signifies that the pathogen is resolved through bleeding. Even with high fever, if the spirit remains refreshed, it indicates that internal heat has also been vented because the pathogen returns to the exterior; thus, despite high body temperature, these are signs of recovery, commonly known as "red sweat." If nasal bleeding occurs between the fifth and sixth days, it is due to residual heat not yet cleared, causing blood to flow erratically; administering herbs to guide blood back to its vessels will likely lead to immediate recovery. If, however, after nasal bleeding, there is instead severe fever, irritability, thirst, and restlessness with various symptoms appearing together, this indicates damage to blood and Qi, allowing the pathogen to rampage within due to deficiency, representing a state where pathogen overcomes healthy Qi, making it difficult to treat. Although nasal bleeding mostly pertains to the Lungs, if it occurs within two days, it is due to Yangming heat in the channels forcing blood to move recklessly; the Yangming channel originates at the nose and connects to the mouth, so the symptom must be a desire to rinse with cold water without swallowing. Not wanting to swallow indicates no heat in the interior, showing the pathogen is in the Yang aspect and has not entered the Yin. If it occurs on the third day, it is due to pathogenic heat invading the Liver, causing the Liver to fail to store blood. If it occurs on the fourth day, it is because the Taiyin channel spreads into the stomach, Stomach Qi attacks upward, and the Spleen fails to control the blood. Furthermore, using fire moxibustion to forcibly induce sweating may exacerbate interior heat, forcing blood upward; mildly, it flows from the nose, and severely, from the mouth. Heavy numbness and pain below the waist, where "bi" refers to pain, is named Huo Ni (Fire Adverse Reaction). This is a disease caused by improper treatment methods and self-inflicted harm.