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Wu Dan (Five Types of Jaundice) belongs to the excess-heat syndrome, and the pulse must be surging (Hong) and rapid (Shuo). If the pulse is choppy (Se) and faint (Wei), it indicates a deficiency syndrome; thirst is strictly contraindicated.

Dan refers to Huang Dan (Jaundice), which includes Shi Dan (Dampness Jaundice), Gu Dan (Grain Jaundice), Nü Lao Dan (Female Exhaustion Jaundice), Jiu Dan (Alcohol Jaundice), and Huang Han (Yellow Sweat). Although named as five types, in reality, the Spleen and Stomach are the general managers, and Damp-Heat is the origin. The Spleen and Stomach belong to Earth, combine with muscles, and govern the four limbs. Their transformation governs dampness, their nature is sticky and adherent, their color is yellow, and their pulse is slow (Chi) and moderate (Huan). They fear Wood (Wind), yet prefer the dryness of Wind. They can be controlled by Water (Cold), yet dislike the dampness of Water. When humans fall ill, if there is no internal stagnation of the Spleen and Stomach, and no external confrontation of Wind and Dampness, even if external pathogens invade, the Qi mechanism remains smooth, heat does not steam, and how could jaundice form? Therefore, *Jin Gui Yao Lue* discusses Shi Dan saying: The Cun Kou pulse is floating (Fu) and slow (Huan). Floating indicates Wind, slow indicates Bi obstruction. This Bi is not Zhong Feng (Wind Stroke); the four limbs suffer from vexation, the color of the Spleen must be yellow, and stagnant heat circulates. This means that when Wind moves alone, it is called Zhong Feng. Zhong Feng causes the Cou Li (pores) to be loose, the skin and hair follicles to open, sweat to flow, and heat to dissipate, preventing jaundice. Now, however, the pulse is floating and slow; floating is indeed Wind, but slow is Earth-Dampness. Dampness causes Bi obstruction, unlike Wind which is dispersing; it must stagnate and become heat. The four limbs governed by Spleen-Earth also suffer from vexation, and the yellow color steams and spreads on the surface.

Regarding Gu Dan, it says: The Fu Yang pulse is tight (Jin) and rapid (Shuo). Rapid indicates Heat, Heat digests grain. Tight indicates Cold, food intake leads to fullness. The Chi pulse floating indicates Kidney injury. The tight Fu Yang pulse indicates Spleen injury. Wind and Cold contend, dizziness occurs after eating grain. Grain Qi fails to digest, the Stomach suffers from turbid Qi. Turbid Qi flows downward, urination is blocked. Yin is affected by Cold, Heat flows into the Bladder, the whole body turns yellow, named Gu Dan. When food enters the Stomach, the Stomach governs digestion and reception, the Spleen governs transportation. When Spleen and Stomach are warm and mild, they perform their duties. Now, if Stomach Heat is excessive, it only digests but cannot transform; if Spleen Cold is weak, it cannot transport. Being both cold and weak, Liver-Wood takes advantage to invade. Wood corresponds to Wind. Wind contending with Cold makes the Spleen even less functional. Adding food makes Qi even less digestible. Contending with Cold causes middle-fullness; contending with Wind causes upper dizziness. Since Qi does not digest, the Stomach becomes turbid. Turbidity cannot ascend clearly but flows downward. Downward flow allows Spleen's tight Cold to attack the Kidney, and Stomach's rapid Heat to attack the Bladder. (*Shang Shu Hong Fan* states: Earth's nature is planting and harvesting. Planting and harvesting produce sweetness. All things rely on Earth to grow, humans rely on grains for nourishment. Planting and harvesting refer to grain. Grain Qi flowing downward returns to the Kidney and Bladder, which is the meaning of Earth overcoming Water. *Nan Jing* Chapter 37 states: Spleen Qi connects to the mouth; when the mouth is harmonious, one knows the taste of grain. The Spleen governs the five flavors; countless food flavors return to the Spleen, yet only one grain flavor is mentioned, reflecting the meaning of planting and harvesting producing sweetness.) The Bladder is the official of the reservoir, mainly storing fluids. The Kidney is the Water organ, governing the two yin openings. Heat flowing into the Bladder, while urination is difficult, causes water and heat to stagnate, inevitably steaming into yellow. Since the Bladder Tai Yang governs the exterior, the yellow covers the whole body. (Sometimes accompanied by chills, fever, anorexia, dizziness after eating, chest discomfort, turning yellow over time into Gu Dan. Yin Chen Tang with modifications is indicated.)

Regarding Nü Lao Dan, it says: The forehead is black, slight sweating, heat in the hands and feet, onset at dusk, bladder urgency, spontaneous urination, named Nü Lao Dan. Abdomen looks like it contains water, untreatable. This implies that jaundice caused by sexual exhaustion results in yellowing, which is self-evident. Carefully examining Zhang Zhongjing's text, this is also a variation of stagnant grain Qi steaming. Generally, excessive sexual activity injures Essence; essence injury leads to Kidney deficiency; Kidney deficiency leads to insufficiency of True Water; insufficiency of True Water leads to blazing Minister Fire. Thus, turbid heat Qi in the Stomach does not flow to the Bladder but returns to the Kidney. It attacks the deficient Water and joins the blazing Fire. Blazing Fire agitates Lord Fire. Moreover, Zi and Wu share the same Qi, Heart and Kidney communicate, so not only is the sole of the foot hot (Kidney meridian), but the palm is also hot (Heart meridian). At dusk, Qi descends and belongs to Yin, attacking the already deficient Yin and aiding its downward trend, hence the disease manifests at dusk. Although the bladder is urgently deficient, heat does not accumulate internally, so urination is spontaneous. If Damp-Heat and Minister Fire are severely stagnant and chronic, Spleen Qi accumulates without transporting, Kidney Qi scatters without storing, leading to abdominal distension as if containing water; this is failure of both Spleen and Kidney, hence untreatable. *Jin Gui* further states: Jaundice patients have fever at dusk (You Shi) but paradoxically feel aversion to cold; this is caused by Nü Lao. Bladder urgency, lower abdomen fullness, whole body yellow, black forehead, hot soles, thus forming Hei Dan (Black Jaundice). Abdominal distension like water, stool must be black, sometimes loose. This is a disease of Nü Lao, not Water Qi. Abdominal fullness is difficult to treat; Xiao Fan San is indicated.

Regarding Jiu Dan, it says: Vexation (Ao Nao) and heat in the heart, inability to eat, frequent desire to vomit, named Jiu Dan. Jiu Dan is jaundice caused by excessive drinking, also a variation of stagnant grain Qi steaming. *Ling Shu: Lun Yong* states: Wine is the essence of water and grain, the fluid of cooked grain. After fermentation, extracting the subtle essence and shedding the dregs, it is a substance with pure Yang Qi prevailing. Its nature is fierce, rising more than descending. (The fact that modern people's faces turn red after drinking small amounts of wine is clear evidence of rising more than descending.) It differs from the unfermented grain Qi mentioned above. Thus, Damp-Heat does not flow downward but accumulates in the Middle Jiao, stagnating and steaming the Stomach and Heart, causing external yellowing and internal vexation, inability to eat, and frequent desire to vomit. It also states: Symptoms of Jiu Dan include difficult urination, heat in the heart, heat in the soles, or no heat, delirium, lower abdomen fullness, desire to vomit, dry nose. If the pulse is floating, induce vomiting first. If sinking and string-taut, induce purgation first. If heat in the heart and desire to vomit, vomiting cures it. If Jiu Dan is treated with purgatives, it eventually becomes Hei Dan, with blue-black eyes, black face, sensation of eating minced garlic in the heart, black stool, insensate skin upon scratching, floating-weak pulse; although black, slightly yellow, thus recognizable. For Jiu Dan with heart vexation or painful heat, Zhi Zi Da Huang Tang is indicated.

Huang Han (Yellow Sweat) is included in the Water Qi disease chapter of *Jin Gui Yao Lue*; its treatment is distinct from jaundice. Later authors classified it as one of the Five Dans due to yellow sweat, but it is not truly Dan. Since this text mentions Five Dans, Huang Han is included here and should not be removed; we follow it tentatively, but the treatment discussion follows *Yao Lue*. Those with flexible understanding will distinguish them. *Yao Lue* states: Huang Han disease presents with heavy body, fever, sweating, and thirst, resembling Feng Shui disease. Sweat stains clothes yellow like cypress sap, pulse is naturally sunken. How is it acquired? The Master says: Bathing in water while sweating, water enters through the pores. Huang Qi Shao Gui Jiu Tang is indicated. This is the etiology of Huang Han. Generally, labor causes sweating, Yang Qi moves and expands, Yin fluids leak recklessly. At this time, Xuan Fu (pores) are not closed, Ying and Wei are both deficient; bathing in water allows cold-damp pathogens to enter via deficiency. Water-damp invades internally, floating Yang repels externally, stagnating and contending between muscles. Muscles combine with Spleen-Earth, so the body feels hot, and sweat appears yellow. Originally, deficiency of Ying and Wei invites pathogens; pathogen entry increases deficiency, Yang remains insecure, Yin fluids continue to leak. This aligns with Zhongjing's principle: floating Yang causes spontaneous heat, weak Yin causes spontaneous sweat. Excessive sweat causes thirst. Water Qi on the exterior resembles Feng Shui. Water tends downward, so the pulse is sunken. Treatment with Huang Qi Shao Gui Jiu Tang harmonizes Ying and Wei, secures Wei, supports the interior, and establishes the center; thus yellow reduces via sweat, water dissipates via sweat. This cannot be compared to treating jaundice with diaphoresis and diuresis.

It also states: Huang Han disease presents with cold calves. If feverish, it belongs to Li Jie (Joint Bi). Sweating after eating, and night sweats in the evening, relate to Ying Qi. If fever persists after sweating, eventually the body becomes Jia Cuo (rough, scaly skin). Continuous fever generates evil sores. If heavy body, lightening after sweat, eventually muscle twitching (Shun) and chest pain. Sweating above the waist, no sweat below, flaccid pain in loins and hips, sensation of foreign body in skin, severe cases anorexia, body ache/heaviness, irritability, difficult urination; this is Huang Han, Gui Zhi Jia Huang Qi Tang is indicated. This is a variant of Huang Han. Huang Han involves both Yin and Yang deficiency; Yang floats outward, Yin detaches downward. Cold calves are normal. Now, instead of cold, there is fever; heat is formed by damp stagnation, attacking deficient Yin, flowing to the Lower Jiao and calves. Joints above the calves become painful throughout, which is self-evident. This is how Huang Han transmits to Li Jie. Wei Qi is Yang Qi. Labor moves Yang, Yang movement expands Wei Qi. Suddenly eating raises Stomach Yang rapidly. Expanded deficient Yang cannot restrain the fierce Grain Qi, so they exit together as sweat. Dusk is when Yang declines; labor depletes declining Yang, making it weaker at dusk. Weakness fails to secure the exterior, causing night sweats. This is Huang Han accompanying labor Qi. Normally, heat resolves with sweat. Now, fever persists after sweat; over time, fluids perish, skin becomes dry and rough, leading to Jia Cuo. Persistent heat beyond skin affects flesh layers, inevitably generating evil sores (such as abscesses). Heavy body is damp-wind pathogen. Lightening after sweat seems like pathogen resolution, but "over time" implies alternating lightness and heaviness. Loss of Wei Yang and depletion of fluids occur repeatedly. Pathogen remains, transforming into muscle twitching and chest pain. *Ling Shu: Ben Cang* states: Harmonious Wei Qi makes intermuscular spaces smooth, skin soft, Cou Li dense. Wei Qi warms muscles, fills skin, thickens Cou Li, controls opening/closing. *Su Wen: Bi Lun* states: Wei Qi circulates in skin and muscles, steams Huo membranes, scatters in chest/abdomen. *Tiao Jing Lun* states: Yang receives Qi from Upper Jiao to warm skin and muscles. From these texts, intermuscular spaces and Cou Li are filled by Wei Qi. Upper Jiao chest/abdomen are distributed by Wei Yang. Now, Wei Qi scatters, Cou Li becomes loose and empty, moving vacuously. Upper Jiao lacks warming distribution, becoming vacuous pain (relieved by pressure). Ying is deficient, Wei is insecure. Waist-up is Yang, Yang opens, so sweating. Waist-down is Yin, Yin closes; Ying-Wei deficiency and pathogen stagnation cause no sweat. No sweat means pathogen doesn't resolve, feeling like a foreign body in skin, causing flaccid loin/hip pain. Severe cases, Three Jiao has no defense, Ying-Wei cannot support each other. Qi failing to ascend causes anorexia; failing to mid-level causes irritability; failing to descend causes difficult urination. Gui Zhi Jia Huang Qi Tang shares the meaning of Huang Qi Shao Gui Jiu Tang. But this clause mentions post-prandial sweating, night sweats, persistent fever after sweat, partial sweating, suggesting pathology at the sweat site; thus adding Ginger, Jujube, Licorice to assist Spleen/Stomach in distributing fluids and obtain proper sweat via Pungent-Sweet synergy.

All jaundice patients should promote urination. If pulse is floating, use diaphoresis; Gui Zhi Jia Huang Qi Tang is indicated. (Promoting urination is fixed for jaundice, but floating pulse indicates exterior stagnation, requiring diaphoresis.) All jaundice may be treated with Zhu Gao Fa Jian. Jaundice disease may be treated with Yin Chen Wu Ling San. (Both are general formulas.) Jaundice with abdominal fullness, difficult/cherry-red urination, spontaneous sweating indicates Exterior Harmonious and Interior Excess; purge with Da Huang Xiao Shi Tang. (Sweating indicates Exterior Harmony; fullness/hard stool indicates Interior Excess requiring purgation.) Jaundice with unchanged urine color, desire for loose stools, abdominal fullness/wheezing should not have heat cleared; clearing heat causes hiccups. Hiccups are treated with Xiao Ban Xia Tang. (Unchanged urine/desire for loose stools indicates no Interior Heat; wheezing/fullness is deficiency. Clearing heat wrongly causes Stomach Cold hiccups.) Jaundice with abdominal pain and vomiting should use Chai Hu Tang. (Pain/vomiting indicates Half-Exterior/Half-Interior; Chai Hu Tang is Xiao Chai Hu Tang.) Male jaundice with spontaneous urination should receive Xu Lao Xiao Jian Zhong Tang. (Jaundice with spontaneous urination indicates not damp-stagnation, but Spleen injury from labor; Spleen injury reveals Earth color.) Jaundice with fever, vexation/wheezing, chest fullness/dry mouth results from fire-coercing sweat during onset, combining two heats. However, jaundice originates from dampness. Whole-body fever/yellowing, abdominal heat indicates Interior Heat requiring purgation. (Abdominal heat indicates Interior heat, palpable.) Sunken pulse, thirst with desire to drink, difficult urination all lead to yellowing. (Sunken indicates Interior, thirst indicates Interior Heat; heat causes drinking, difficult urination causes stagnation into yellow.) Abdominal fullness, tongue withered/yellow/dry, insomnia belong to Huang Jia. (Stomach Earth stagnation prevents fluid distribution, causing fullness/dry tongue. Classics state: Disharmonious Stomach leads to restless sleep; these are precursors of jaundice.)

Jaundice disease has an 18-day prognosis. Healing within 10+ days is good; worsening is difficult. (Earth prospers for 18 days in each season; damp diseases follow this. After 10 days, prosperous Qi declines, pathogen should retreat. Worsening means righteous Qi cannot overcome pathogen.) Jaundice with thirst is difficult; without thirst is treatable. Manifesting in Yin parts causes vomiting; manifesting in Yang parts causes chills and fever. (Damp-Earth stagnation affecting Spleen/Stomach. Manifesting in Spleen Yin causes vomiting; manifesting in Stomach Yang causes chills/fever; both are meridian activation diseases.) Text states: Five Dans are Excess Heat because damp and heat stagnate, unable to vent externally or drain internally, steaming into yellow. Deficient/loose conditions with drainage prevent yellowing, hence Excess Heat implies surging-rapid pulse. Choppy-faint pulses indicate Deficient Yellow. Thirst indicates Interior Heat, yellow indicates Exterior Steaming. Excess Exterior-Interior Heat overwhelms Yin. With damp stagnation blocking sweat/urine, adding fluids (drinking) is forbidden. Thirst leads to drinking, hence strictly contraindicated. (Danxi stated: Jaundice need not be divided into five; it is always Damp-Heat indistinguishable. His view was too simple. Chao Yuanfang expanded to Nine Dans, too complex. Only *Jin Gui* arguments and prescriptions hit the mark. Students following it avoid excess/deficiency biases.)