王××，年三十二岁，于季秋得黄胆证。
病因 出外行军，夜宿帐中，勤苦兼受寒凉，如此月余，遂得黄胆证。
证候 周身黄色甚暗似兼灰色，饮食减少，肢体酸懒无力，大便一日恒两次似完谷不化，
脉象沉细，左部更沉细欲无。
诊断 此脾胃肝胆两伤之病也，为勤苦寒凉过度，以致伤其脾胃，是以饮食减少完谷不化；伤其
肝胆，是以胆汁凝结于胆
管之中，不能输肠以化食，转由胆囊渗出，随血流行于周身
而发黄。此宜用《金匮》硝石矾石散以化其胆管之凝结，而以健脾胃补肝胆之药煎汤送服。
处方 用硝石矾石散所制丸药，每服二钱，一日服两次，用后汤药送服。
汤药 生箭 （六钱） 白术（四钱炒） 桂枝尖（三钱） 生鸡内金（二钱黄色的捣） 甘草（二钱）
共煎汤一大盅，送服丸药一次，至第二次服丸药时，仍煎此汤药之渣送之。
复诊 将药连服五剂，饮食增加，消化亦颇佳良，体力稍振，周身
黄退弱半，脉象亦大有起色。俾仍服丸药一次服一钱五分，日两次，所送服之汤药宜略有加减。
汤药 生箭 （六钱） 白术（三钱炒） 当归（三钱） 生麦芽（三钱）
生鸡内金（二钱黄色的捣） 甘草（二钱）
共煎汤一大盅，送服丸药一次。至第二次服丸药时，仍煎此汤药之渣送服。
效果 将药连服六剂，周身之黄已退十分之七，身形亦渐强壮，脉象已复其常。俾将丸药减去一
次，将汤药中去白术加生怀山药五钱，再服数剂以善其后。
Wang XX, aged thirty-two, contracted jaundice (Huangdan) in late autumn.
Etiology He was on a military expedition and camped overnight in tents. Enduring hard labor and exposure to cold for over a month, he subsequently developed jaundice.
Symptoms The skin of the whole body appeared dark yellow, almost grayish. Appetite was diminished, limbs felt sore, lazy, and weak. Bowel movements occurred twice daily, often containing undigested food particles (Wan Gu Bu Hua). The pulse was deep and fine (Chen Xi), with the left radial pulse being even deeper and finer, nearly imperceptible.
Diagnosis This is a disease involving injury to both the Spleen-Stomach and the Liver-Gallbladder. Excessive hard labor and cold exposure injured the Spleen-Stomach, leading to reduced appetite and undigested food in stools; it also injured the Liver-Gallbladder, causing bile to coagulate within the bile ducts. Unable to flow into the intestines to aid digestion, the bile leaked from the gallbladder, circulated with the blood throughout the body, and caused yellowing. It is appropriate to use Xiao Shi Fan Shi San (Niter and Alum Powder) from *Jin Gui Yao Lue* to resolve the coagulation in the bile ducts, accompanied by a decoction of herbs that strengthen the Spleen-Stomach and nourish the Liver-Gallbladder to administer the pills.
Prescription Use pills prepared from Xiao Shi Fan Shi San (Niter and Alum Powder). Take two qian per dose, twice daily, administered with the following decoction.
Decoction Raw Qian Huangqi (Astragali Radix, six qian) Chao Baizhu (Atractylodis Macrocephalae Rhizoma, four qian, stir-fried) Guizhi Jian (Cinnamomi Ramulus acumen, three qian) Sheng Jineijin (Galli Gigerii Endothelium Corneum, two qian, yellow variety, crushed) Gancao (Glycyrrhizae Radix et Rhizoma, two qian)
Decoct together to make one large cup of liquid. Administer once with the pills. For the second pill dose, still decoct the dregs of this herbal mixture to administer.
Follow-up Visit After taking five doses consecutively, appetite increased, digestion became quite good, physical strength slightly recovered, and the yellow discoloration of the body faded by half. The pulse showed significant improvement. Continue taking the pills, reducing the dose to one and a half qian per time, twice daily. The accompanying decoction should be slightly modified.
Decoction Raw Qian Huangqi (Astragali Radix, six qian) Chao Baizhu (Atractylodis Macrocephalae Rhizoma, three qian, stir-fried) Danggui (Angelicae Sinensis Radix, three qian) Sheng Maiya (Hordei Fructus Germinatus, three qian) Sheng Jineijin (Galli Gigerii Endothelium Corneum, two qian, yellow variety, crushed) Gancao (Glycyrrhizae Radix et Rhizoma, two qian)
Decoct together to make one large cup of liquid. Administer once with the pills. For the second pill dose, still decoct the dregs of this herbal mixture to administer.
Outcome After taking six doses consecutively, the yellow discoloration of the body had faded by seventy percent, physical constitution gradually strengthened, and the pulse returned to normal. Reduce the pill dosage to once daily. In the decoction, remove Baizhu and add Sheng Huai Shanyao (Dioscoreae Hypoglaucae Rhizoma, five qian). Take several more doses to consolidate the therapeutic effect.