【歌】五疸多因湿热生，分消利水用茵陈。若因食积并瘀血，阴证虚黄另有形。
【论】夫五疸皆由湿热而成。黄胆，通身面目悉黄也。谷疸者，食已头眩，心中怫郁不安，饥饱所致，胃
气蒸冲而黄也。酒疸者，身目俱黄，心中懊 ，足胫满，尿赤面黄赤斑，因酒后胃热，醉卧当风，水湿得之也。
女劳疸者，额黑身黄，少腹满急，小便不利，因房事后为水湿所搏而得之也。黄汗者，汗如栀子水染衣黄，不
渴，因脾热汗出，入水澡浴所致。丹溪云∶疸病不须分五种，同是湿热，如 曲相似，宜利水为先，解毒次之。
亦有瘀血、食积，皆令发黄，又有阴黄、虚黄之证，各各不同。瘀血发黄，则发热，小便自利，大便反黑，脉
芤涩是也。饮食之积，留滞于胃，不得传化，熏蒸胃中湿气故也，必胸胁满闷，脉大是也。阴黄者，四肢冷，
自汗泄利，小便清白，脉沉迟是也。虚黄者，口淡怔忡，耳鸣脚软，怠惰无力，寒热溲白是也。学人遇此，必
审其因而疗之，勿忽略以误人也。
谨按∶黄胆之病，多起于饮食劳倦，致伤脾土，脾土不能运化，湿热内郁，无由发泄，流于皮肉，遍于四
肢，黄色如染。淡黄易愈，深黄者难愈，焦黄者不治。凡郁郁不得志
之人，多生此病。虽云湿热，不可纯用寒凉，必佐之以甘温，君之以渗泄，则湿易除，热易解，其病自愈。若
纯用凉药，重伤脾土，湿未必除，热未必去，反变为腹胀者矣。
【脉】五疸实热，脉必洪数。其或微涩，证属虚弱。
湿热黄
湿热发黄者，小便不利，大便反泄者，五苓散。（方见湿证。）虚者三因白术汤。实者大便不通，内热，
茵陈汤。
三因白术汤
桂心 白术（各一两） 豆豉 杏仁 甘草 干葛（各五钱） 枳实（炒，三钱）
上锉，每服四钱，水煎。
茵陈汤
治湿热发黄，身热鼻干，汗出，小便不利。
茵陈（六两） 栀子（十四个） 大黄（二两）
每服一两五钱，水煎。
阴黄
阴黄脉沉迟，四肢冷，自汗泄利，小便清白，茵陈四逆汤。（即四逆汤加茵陈也。）
虚黄
虚黄耳鸣口淡，怔忡微热，四肢无力，怠惰嗜卧，脚软脉沉细，四君子汤。（方见脾胃。）若兼食积发
黄者，小温中丸、大温中丸、或用六君子汤加茵陈、苍术、山药。
小温中丸
治黄胆与食积，又可制肝燥脾，脾虚者以白术作汤作使。
针砂（十两，炒红醋淬七次，再炒，另研） 苦参（夏加冬减） 山楂（各二两） 白术
（五两） 苍术 川芎（夏减） 神曲（各半斤） 香附（二斤，童便浸透） 吴茱萸（一两，冬加夏减）
上为末，醋糊丸，梧子大，食前盐汤送下。
大温中丸
制同前方。
针砂（十两，制） 陈皮 苍术 青皮 浓朴 三棱 蓬术 黄连 苦参 白术（各五两） 甘草
（二两，生） 香附（一斤）
六君子汤
即四君子加陈皮、半夏。
瘀血黄
瘀血黄者，大便黑，小便利，抵挡汤、桃仁承气汤，量人虚、实，下尽黑物则愈。
抵挡汤
水蛭（七个） 虻虫（八个） 桃仁（七个） 大黄（一两）
末之，分作四丸，水一钟，煎一丸，取七分温服。
桃仁承气汤
即小承气加桃仁一钱五分、硝六分，煎服。
五疸
谷疸，食已头眩，心中怫郁不安，济生谷疸丸，或小柴胡汤加谷芽、枳实、浓朴、山栀、大黄。
酒疸，身目俱黄，胫满，懊 ，尿黄，面黄赤斑，栀子大黄汤、茯苓渗湿汤。
女劳疸者，额黑身黄，少腹满急，小便不利，硝石矾石散。
黄汗者，汗出如栀子水，济生黄 散。
黄胆者，身目悉黄如金，茵陈五苓散。实者茵陈汤、搐鼻法。
济生谷疸丸
苦参（二两） 牛胆（一两） 龙胆草（一两）
上为末，用牛胆汁入炼蜜丸如梧桐子大，每服五十丸，空心，熟水或生姜甘草汤下。
小柴胡汤（方见疟疾。）
栀子大黄汤
治酒疸。
栀子（十五个） 大黄（一两） 枳实（五个） 豉（一升）
水煎服。
去大黄，加葛根，名葛根汤。
茯苓渗湿汤
治黄胆寒热呕吐而渴欲饮冷，身体、面、目俱黄，小便不利，不得安卧，不思食。
白茯（五分） 泽泻（三分） 茵陈（六分） 猪苓（二钱） 黄芩 黄连 栀子 防己 白术 苍术
陈皮 青皮 枳实（各二分）
上锉，水煎服。
硝石矾石散
治女劳疸身黄额黑，日进三服取汗。
硝石 矾石（各烧过，等分）
上为末，大麦粥汁调服二钱。
济生黄 散
治黄汗
黄 赤芍 茵陈（各二两） 石膏（四两） 麦冬（去心） 豆豉（各一两） 甘草（炙，半两）
每服五钱，生姜三片，水煎，食远服。
茵陈五苓散
即五苓散加茵陈是也。（方见二卷湿证条下。）
搐鼻法
治黄胆遍身如金色。
瓜蒂（二钱） 母丁香（二钱） 大黄（一两，醋炒） 黍米（半钱） 赤小豆（五分）
上为末，每夜两鼻搐药便睡，次日取下小便即愈。
[Verse] The five types of Jaundice (Huangdan) mostly arise from Damp-Heat (Shi-Re), and treatment should focus on separating and eliminating Dampness, promoting urination using Yinchen (Artemisiae Scopariae Herba). If caused by Food Retention (Shi Ji) and Blood Stasis (Yu Xue), Yin-type deficiency Jaundice presents with different manifestations.
[Discussion] All five types of Jaundice are formed by Damp-Heat. Huangdan (Generalized Jaundice) is characterized by yellowing of the entire body and face. Gu Dan (Grain Jaundice) involves dizziness after eating, mental restlessness and discomfort, caused by irregular meals; it results from stomach Qi steaming and rushing upward leading to yellowing. Jiu Dan (Wine Jaundice) features yellowing of the body and eyes, mental vexation (Ao Nu), fullness in the calves, red urine, and a yellow complexion with red spots; this occurs due to stomach heat after drinking wine, lying drunk in the wind, and contracting water-Dampness. Nü Lao Dan (Female Labor Jaundice) presents with a black forehead, yellow body, fullness and urgency in the lower abdomen, and difficult urination; it is contracted when water-Dampness attacks the body after sexual intercourse. Huang Han (Yellow Sweat) is characterized by sweat that stains clothes yellow like Gardenia water, without thirst; this is caused by spleen-heat sweating followed by bathing in water. Zhu Danxi said: There is no need to strictly divide Jaundice into five types; they are all Damp-Heat disorders, similar to fermentation by Qu (starter culture). Treatment should prioritize promoting urination, followed by detoxification. There are also cases of yellowing due to Blood Stasis and Food Retention, as well as Yin-Jaundice and Deficiency-Jaundice, each distinct. Yellowing due to Blood Stasis presents with fever, free urination, but black stools, and a Kou (Hollow) or Se (Choppy) pulse. Food retention stagnates in the stomach, failing to transmit and transform, steaming the dampness in the stomach; this inevitably causes chest and hypochondriac fullness and oppression, with a large pulse. Yin-Jaundice presents with cold limbs, spontaneous sweating, diarrhea, clear white urine, and a Chen (Deep) Chi (Slow) pulse. Deficiency-Jaundice presents with a bland taste, palpitations (Zheng Chong), tinnitus, weak legs, lethargy and weakness, alternating chills and fever, and clear white urine. Practitioners encountering these conditions must carefully examine the etiology and treat accordingly, avoiding negligence that could harm patients.
Note: Huangdan often originates from improper diet and overexertion, damaging Spleen Earth. When Spleen Earth fails to transport and transform, Damp-Heat accumulates internally with no outlet, flowing into the skin and flesh, spreading to the four limbs, resulting in a dyed-yellow appearance. Light yellow is easy to cure; deep yellow is difficult; scorched black is untreatable. People who are often depressed and frustrated are prone to this disease. Although it is Damp-Heat, one must not use purely cold/cooling herbs; one must assist with Sweet-Warm herbs and use Diaphoretic/Diuretic herbs as the sovereign agent. Thus, Dampness is easily removed, Heat is easily resolved, and the disease heals itself. If purely cooling herbs are used, Spleen Earth is severely damaged; Dampness may not be removed, Heat may not go away, and it may instead transform into abdominal distension.
[Pulse Diagnosis] For the five types of Jaundice presenting as Excess-Heat, the pulse must be Hong (Surging) and Shu (Rapid). If the pulse is Wei (Fine) or Se (Choppy), the syndrome belongs to Deficiency.
Damp-Heat Jaundice
For Damp-Heat causing yellowing, if urination is difficult and stool is loose, use Wuling San (Five-Ingredient Powder with Poria). For those with Deficiency, use Sanyin Baizhu Tang (Three Causes Atractylodes Decoction). For Excess cases with constipation and internal heat, use Yinchen Tang (Artemisia Decoction).
Sanyin Baizhu Tang
Guixin (Cinnamon Twig), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 1 liang), Douchi (Sojae Semen Praeparatum), Xingren (Armeniacae Semen Amarum), Gancao (Glycyrrhizae Radix et Rhizoma), Gange (Puerariae Radix) (each 5 qian), Zhishi (Immature Bitter Orange Fruit) (stir-fried, 3 qian).
Crush the herbs. Take 4 qian per dose, decoct in water.
Yinchen Tang
Treats Damp-Heat yellowing, body heat, dry nose, sweating, and difficult urination.
Yinchen (Artemisiae Scopariae Herba) (6 liang), Zhizi (Gardeniae Fructus) (14 pieces), Dahuang (Rhei Radix et Rhizoma) (2 liang).
Take 1.5 liang per dose, decoct in water.
Yin-Jaundice
For Yin-Jaundice with a Chen Chi pulse, cold limbs, spontaneous sweating, diarrhea, and clear white urine, use Yinchen Sini Tang (Artemisia Decoction combined with Sini Decoction). (This is Sini Tang added with Yinchen.)
Deficiency-Jaundice
For Deficiency-Jaundice with tinnitus, bland taste, palpitations with slight heat, limb weakness, lethargy and desire to lie down, weak legs, and a Chen Xi pulse, use Sijunzi Tang (Four Gentlemen Decoction). If accompanied by Food Retention causing yellowing, use Xiaowenzhong Wan (Minor Warm the Middle Pill), Dawenzhong Wan (Major Warm the Middle Pill), or Liujunzi Tang (Six Gentlemen Decoction) added with Yinchen, Cangzhu (Atractylodis Rhizoma), and Shanyao (Dioscoreae Rhizoma).
Xiaowenzhong Wan
Treats Jaundice and Food Retention; also controls Liver Dryness and Spleen. For Spleen Deficiency, use Baizhu decoction as a guiding vehicle.
Zhen Sha (Needle Sand, stir-fried red, quenched in vinegar seven times, then stir-fried and separately ground), Kushen (Sophorae Flavescentis Radix) (reduce in summer, increase in winter), Shanzha (Crataegi Fructus) (each 2 liang), Baizhu (5 liang), Cangzhu, Chuanxiong (Ligustici Chuanxiong Rhizoma) (reduce in summer), Shenqu (Massa Medicata Fermentata) (each half jin), Xiangfu (Cyperi Rhizoma) (2 jin, soaked thoroughly in child's urine), Wuzhuyu (Evodiae Fructus) (1 liang, increase in winter, reduce in summer).
Make into powder, form pills with vinegar paste, size of Sophora seeds. Take before meals with salt water.
Dawenzhong Wan
Preparation same as above.
Zhen Sha (prepared, 10 liang), Chenpi (Citri Reticulatae Pericarpium), Cangzhu, Qingpi (Citri Reticulatae Pericarpium Viride), Houpo (Magnoliae Officinalis Cortex), Sanleng (Sparganii Rhizoma), Pengze (Curcumae Zedoariae Rhizoma), Huanglian (Coptidis Rhizoma), Kushen, Baizhu (each 5 liang), Gancao (Licorice Root, raw, 2 liang), Xiangfu (1 jin).
Liujunzi Tang
This is Sijunzi Tang plus Chenpi and Banxia (Pinelliae Rhizoma).
Blood Stasis Jaundice
For Jaundice due to Blood Stasis, with black stool and free urination, use Didang Tang (Stare-to-the-Death Decoction) or Taoren Chengqi Tang (Peach Kernel Decoction to Order the Qi), depending on the patient's Excess or Deficiency status. Cure is achieved when black material is evacuated.
Didang Tang
Shuizhi (Hirudo) (7 pieces), Mengchong (Bombyx Batryticatus) (8 pieces), Taoren (Persicae Semen) (7 pieces), Dahuang (1 liang).
Grind into powder, divide into four pills. Decoct one pill in one zhong of water until reduced to 0.7 zhong; take warm.
Taoren Chengqi Tang
This is Xiao Chengqi Tang plus 1.5 qian of Taoren and 0.6 fen of Xiaoshi (Mirabilite). Decoct and take.
Five Types of Jaundice
Gu Dan (Grain Jaundice): Dizziness after eating, mental restlessness. Use Jisheng Gu Dan Wan (Jisheng Grain Jaundice Pill) or Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Guya (Sprouted Grain), Zhishi, Houpo, Zhizi, and Dahuang.
Jiu Dan (Wine Jaundice): Yellow body and eyes, calf fullness, mental vexation, yellow urine, yellow face with red spots. Use Zhizi Dahuang Tang (Gardenia and Rhubarb Decoction) or Fuling Shenshi Tang (Poria Damp-Draining Decoction).
Nü Lao Dan (Female Labor Jaundice): Black forehead, yellow body, lower abdominal fullness/urgency, difficult urination. Use Xiaoshi Fanshi San (Niter and Alum Powder).
Huang Han (Yellow Sweat): Sweat like Gardenia water. Use Jisheng Huang Han San (Jisheng Yellow Sweat Powder).
Huang Dan (Jaundice): Whole body and eyes yellow like gold. Use Yinchen Wuling San (Artemisia Five-Ingredient Powder). For Excess, use Yinchen Tang or Chu Bi Fa (Nasal Insufflation Method).
Jisheng Gu Dan Wan
Kushen (2 liang), Niudan (Ovis Gallbladder) (1 liang), Longdancao (Gentianae Radix) (1 liang).
Make into powder. Mix with Ovis Gallbladder juice and refined honey to form pills the size of Sophora seeds. Take 50 pills on an empty stomach with boiled water or Ginger-Gancao Decoction.
Xiao Chaihu Tang (See Malaria section for formula).
Zhizi Dahuang Tang
Treats Wine Jaundice.
Zhizi (15 pieces), Dahuang (1 liang), Zhishi (5 pieces), Chi (Fermented Soybean) (1 sheng).
Decoct in water and take.
Remove Dahuang and add Gegen (Puerariae Radix); this is named Gegen Tang.
Fuling Shenshi Tang
Treats Jaundice with chills, fever, vomiting, thirst for cold drinks, yellow body/face/eyes, difficult urination, inability to sleep peacefully, and loss of appetite.
Baifu (Poria) (0.5 fen), Zexie (Alismatis Rhizoma) (0.3 fen), Yinchen (0.6 fen), Zhuling (Polyporus) (2 qian), Huangqin (Scutellariae Radix), Huanglian, Zhizi, Fangji (Stephaniae Tetrandrae Radix), Baizhu, Cangzhu, Chenpi, Qingpi, Zhishi (each 0.2 fen).
Crush and decoct in water.
Xiaoshi Fanshi San
Treats Female Labor Jaundice with yellow body and black forehead. Take three doses daily to induce sweating.
Xiaoshi (Natrii Sulfas), Fanshi (Alumen) (both calcined, equal parts).
Make into powder. Take 2 qian mixed in barley gruel juice.
Jisheng Huang Han San
Treats Yellow Sweat.
Huangqi (Astragali Radix), Chishao (Paeoniae Radix Rubra), Yinchen (each 2 liang), Shigao (Gypsum Fibrosum) (4 liang), Maidong (Ophiopogonis Radix, heart removed), Douchi (each 1 liang), Gancao (Roasted, 0.5 liang).
Take 5 qian per dose with 3 slices of ginger, decoct in water, take long after meals.
Yinchen Wuling San
This is Wuling San added with Yinchen. (See Volume 2, Dampness Syndrome section).
Chu Bi Fa (Nasal Insufflation Method)
Treats Jaundice where the whole body is golden yellow.
Gua Di (Momordicae Fructus) (2 qian), Mu Dingxiang (Caryophylli Flos) (2 qian), Dahuang (1 liang, stir-fried with vinegar), Shumi (Millet) (0.5 qian), Chixiaodou (Vigna Angularis Seed) (0.5 fen).
Make into powder. Each night, insufflate into both nostrils then sleep. Remove discharge the next day; urination will normalize and the condition will heal.