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The bladder feels tense, the lower abdomen is full, the whole body turns yellow, the forehead is black, and the soles of the feet are hot; thus, Black Jaundice (Hei Dan) develops. The abdominal distension resembles water accumulation, the stool must be black, and occasionally loose. This is a disease of Female Labor Jaundice (Nü Lao Dan), not Water Disease (Shui Bing). If the abdomen is full, it is difficult to treat. Xiao Shi Fan Shi San (Mineral Stone and Alum Powder) is the primary prescription. No one has ever explained the meaning of using Xiao Shi (Niter); medical texts have all changed it to Hua Shi Fan Shi San (Talcum Stone and Alum Powder), and erroneously stated under the formula that "the degree is reached when yellow water is discharged via urine." Furthermore, they changed Da Huang Xiao Shi Tang (Rhubarb and Niter Decoction) to Da Huang Hua Shi Tang (Rhubarb and Talcum Stone Decoction). How low has the state of medicine fallen! In men, blood transforms into essence (Jing). When essence moves, the blood of the entire body moves. Due to excessive sexual activity depleting the essence, the blood follows suit. Therefore, those who experience hematuria due to female labor still have flowing blood, which is relatively easy to treat. However, jaundice resulting from female labor involves stagnant blood that does not flow, making it difficult to treat. In severe cases, long-standing blood stasis causes the entire abdomen to become full, forming Blood Gu (Xue Gu), which is extremely severe and difficult to treat. Those who fail to understand Zhang Zhongjing’s original text and instead contradict the intent of the prescription will find no path to survival for Female Labor Jaundice unless they urgently remove the blood stasis in the bladder and lower abdomen. In cases of Heat Stasis in the Bladder from Cold Damage (Shang Han), the patient recovers after bleeding. If blood does not descend, Di Dang Tang (Ephedra, Persimmon Seed, Silkworm, and Earthworm Decoction) is used to purge it, because the blood is temporarily congealed and can be aggressively attacked. However, the accumulated blood in Female Labor Jaundice has gathered over days or months, not overnight; aggressive purging is useless. One must rely on the fierce nature of mineral drugs to rapidly reach the disease site. Xiao Shi (Niter) is salty and cold, enters the blood level, and can eliminate and expel heat-stagnant blood, thus serving as the sovereign drug. Fan Shi (Alum) is recorded in herbal classics as capable of removing entrenched heat in the bone marrow; it is used to clear heat in the Kidney and Bladder organs and establish the function of eliminating stasis and turbidity. This is the most exquisite aspect of this formula worth emulating. Chen Wuyue, though virtuous, was ambiguous in his theory, stating that this decoction should be used only if there is no fever, aversion to cold, or slippery pulse. If there is fever and aversion to cold with a floating-tight pulse, Hua Shi (Talcum Stone) and Shi Gao (Gypsum) should be used. This is merely mumbling dream talk in broad daylight, let alone other errors! Is there any case in the world where blood accumulates in the Lower Jiao but presents with a floating, slippery, and tight pulse? Absurd! Absurd!

In summer, the heat of the weather and the dampness of the earth steam together. Humans receive these two qi, which remain internally stagnant and unresolved, leading to Yellow Jaundice (Huang Dan), indistinguishable from fermented sauce. Treatment must follow the methods of sweating, purging, or vomiting for exterior patterns to eliminate damp-heat. However, in summer, yang qi is external and yin qi is internal, unlike winter Cold Damage where pathogenic qi lies dormant and hard to move. I have clarified Zhang Zhongjing’s intention to use these three methods cautiously. As for Grain Jaundice (Gu Dan), Wine Jaundice (Jiu Dan), and Female Labor Jaundice (Nü Lao Dan), these diseases arise from internal injury and are unrelated to exterior contraction. Zhang Zhongjing supplemented the gaps in *Nei Jing* (The Inner Canon) and exhaustively revealed its subtleties, which I have also elucidated. Regarding Yin Jaundice (Yin Dan), Zhang Zhongjing’s formulas and discussions have been lost. Since ancient times, only Luo Qianfu’s Yin Chen Fu Zi Gan Jiang Gan Cao Tang (Artemisia Capillaris, Aconite, Ginger, and Licorice Decoction) exists. It treats conditions where excessive use of cold-cooling medicines caused Yang Jaundice to transform into Yin Jaundice, aligning with past precedents; there are no others. Modern practitioners merely say that Yang Jaundice has a bright color and Yin Jaundice has a dull color. This distinction based on qi and blood is unclear and leads to misleading patients. For instance, Wine Jaundice turning black or Female Labor Jaundice presenting with a black forehead—does their black color imply Yin Jaundice, warranting the use of Fu Zi (Aconite Root) and Gan Jiang (Dried Ginger)? In Female Labor Jaundice, True Yang is obstructed by blood stasis but not yet severely damaged; once the stasis moves, Yang Qi flows freely. In Yin Jaundice, however, True Yang is weak and failing, allowing damp-heat, turbid qi, and ruined blood to knot together without dispersing. One must restore Yang Qi for the entrenched knots to open. Without the sun shining brightly in the sky, how could hidden darkness be illuminated? Students should study the formulas and theories in the previous volume carefully, and their understanding will be more than half complete.

[Three Laws]
1. For Yellow Jaundice acquired from exterior contraction, mistakenly using tonification methods constitutes "reinforcing excess" (Shi Shi), which is the physician's fault.
2. For Yellow Jaundice acquired from internal injury, mistakenly using purgative methods constitutes "depleting deficiency" (Xu Xu), which is the physician's fault.
3. For Yin Jaundice, mistakenly treating it according to Yang patterns and blindly applying bitter-cold herbs, acting against nature, leading to an irreversible critical state, results in the physician killing the patient. Yin Jaundice presents with no fever but aversion to cold, free urination, and a slow, faint pulse. Mistakenly using Kai Gui Men (opening the ghost gate/sweating) causes cold skin and incessant spontaneous sweating; mistakenly using Jing Ji Fu (cleaning the water reservoir/diuresis) causes bladder incontinence and urinary urgency like rushing water, with death imminent within day or night. How much worse are the gross errors of vomiting and purging! Even delaying with mild medicines is merely a method of waiting for death. In semi-yin semi-yang patterns, one must first retreat yin and restore yang; only after yin retreats should treatment follow yang patterns. Combining Fu Zi (Aconite Root) and Huang Lian (Coptis Rhizome) will surely cause harm. Why, then, resort to bitter-cold medicines when the pattern is purely yin without yang?