王 两目身体皆黄，小便自利色清。此属脾虚，非湿热也，名曰虚黄。
黄 （一两） 白芍（三两） 伏苓（二两） 地肤子（二两）
酒浸服。
周 伏暑湿热为黄胆，腹微痛，小便利，身无汗。用麻黄连翘赤小豆汤表而汗之。
麻黄 连翘 杏仁 淡豆豉 茵 草 赤苓 川朴 枳壳 通草 六神曲（炒）
赤小豆一两，煎汤代水。
朱 湿热内走太阴，遍体发黄，肌肤粟起，小便黄赤。与茵 栀子柏皮汤。
茵 连翘 赤苓 大黄 泽泻 黑山栀 黄柏 淡芩 通草
曾 脉形乍大乍小，面色暗晦不泽，似有一团阴气阻遏于
中。苔黄而湿，腹满足肿，小便黄赤，又有湿遏热伏之形。色症
合参，是属女劳黑疸。变为腹满，在法难医。姑拟泄肾热以去脾湿，仿《金匮》法。
冬瓜皮 桑白皮 地骨皮 生姜皮 黄柏 川朴 茵
陈大麦柴煎汤代水。
施 三疟止而复作，腹满平而又发。今目黄脉细，面黑溺
少，防延黑疸。然疸而腹满者难治，姑与分消。
制附子 大腹皮 陈皮 麦芽 绵茵 赤苓 滑石 焦山栀 通草 栝蒌皮
渊按∶疸而腹满，前人未言其故。余谓肝脾脏气两伤，木土相克也，故难治。
又 面色黎黑，腹满足肿，脉沉而细。此脾肾之阳不化，水湿阻止于中，证势甚重。且与通阳燥湿。
四苓散加肉桂、川朴、陈皮、大腹皮、焦六曲、细辛、香橼皮、麦芽。
黄 面黄无力，能食气急，脱力伤脾之证也。用张鸡峰伐木丸。
皂矾（一两，泥土包固，置糠火中，煨一日夜，取出，候冷，矾色已红，去泥土净）
川朴（五钱） 茅术（一两，米泔浸，切，炒） 制半夏（一两） 陈皮（二两，盐水炒） 茯苓（一两） 炙甘草（五
钱）
共研细末，用大枣肉煮烂为丸。每服二钱，开水送。饮酒者酒下。此方颇效。
仁渊曰∶黄胆亦湿热郁遏之病，与伏暑、疟疾同一来路。古
人谓如 酱，湿热壅遏不泄所致。但有阴黄、阳黄、女劳、谷、
酒之分。同是湿热，阳黄则黄色鲜明，脉大口渴，其证多实，治
如茵 五苓、平胃、栀子柏皮等，甚则茵 大黄之类，开化中
宫，分泄湿热，从小便而出，其黄自退。阴黄则脾肾阳气素虚，
不能升化其邪，黄色暗晦，脉细皮寒，口不渴，分化湿热，宜佐
通阳理脾，如茵 五苓佐理中、真武之类。谷疸则食伤脾胃，酒
疸则酒伤肺脾，皆湿热阻而不化，各有所主。女劳黑疸，最为难
治，乃内伏湿邪，更伤女劳而得，肾精大伤，根本已坏，湿热之
邪深伏厥、少，正气不能胜任故也。又有虚黄一证，并非黄胆，
乃中虚木胜，土色发见于外，其黄色淡白，小便不变，脉弱口
淡，能食而无力，俗名懒黄，乃劳倦内伤之症，宜崇土疏木，调
补中气，如补中益气之类。诸黄证虽以分泄湿热为主，尤须察其阴阳虚实，有无兼证而调之，始为尽善。
Patient Wang: Both eyes and the whole body are yellow, urination is free and the urine is clear. This belongs to Spleen deficiency (Spleen Qi deficiency), not damp-heat, named "Deficiency Jaundice" (Xu Huang).
Prescription: Yinchen Hao (Artemisiae Scopariae Herba) (1 liang), Baishao (Paeoniae Radix Alba) (3 liang), Fuling (Poria) (2 liang), Difuzi (Kochiae Fructus) (2 liang).
Take after soaking in wine.
Patient Zhou: Jaundice caused by latent summerheat-dampness, slight abdominal pain, free urination, no sweating on the body. Use Mahlianqiao Chixiaodou Tang (Mahuang, Forsythia, and Red Bean Decoction) to release the exterior through sweating.
Prescription: Mahuang (Ephedrae Herba), Lianqiao (Forsythiae Fructus), Xingren (Armeniacae Semen Amarum), Danshichu (Fermented Soybean), Yinchenshao (Artemisiae Scopariae Herba), Gancao (Glycyrrhizae Radix et Rhizoma), Chiling (Poria cum Rhus), Chuanpu (Magnoliae Officinalis Cortex), Zhike (Aurantii Fructus Immaturus), Tongcao (Tetrapanacis Medulla), Liushenqu (Massa Medicata Fermentata, stir-fried).
Use 1 liang of Chixiaodou (Phaseoli Semen Rubrum), decocted as water substitute for boiling other herbs.
Patient Zhu: Damp-heat moves inward to the Taiyin channel, whole body turns yellow, skin presents with millet-like papules, urine is yellow and red. Administer Yinzhi Zige Bopi Tang (Yinchen, Gardenia, and Phellodendron Bark Decoction).
Prescription: Yinchenshao (Artemisiae Scopariae Herba), Lianqiao (Forsythiae Fructus), Chiling (Poria cum Rhus), Dahuang (Rhei Radix et Rhizoma), Zexie (Alismatis Rhizoma), Heishanzhi (Gardeniae Fructus), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), Tongcao (Tetrapanacis Medulla).
Patient Zeng: Pulse fluctuates between large and small, complexion is dark and dull, resembling a mass of Yin qi obstructing the middle jiao. Coating is yellow and moist, abdomen is full and swollen, urine is yellow and red, presenting signs of dampness suppressing heat. Combining inspection of color and pulse diagnosis, it is classified as Nulao Hei Dan (Black Jaundice due to sexual exhaustion). If it develops into abdominal fullness, it is difficult to treat according to standard methods. Tentatively prescribe to drain Kidney heat to remove Spleen dampness, imitating the method from *Jingui Yaolue*.
Prescription: Dongguapi (Benincasae Exocarpium), Sangbaipi (Mori Cortex), Digupi (Lycii Cortex), Shengjiangpi (Zingiberis Recens Cortex), Huangbai (Phellodendri Cortex), Chuanpu (Magnoliae Officinalis Cortex), Yinchenshao (Artemisiae Scopariae Herba), Damai Mai (Hordei Fructus Germinatus) decocted as water substitute.
Patient Shi: San Nu (Triennial Malaria) stops and recurs, abdominal fullness subsides and reappears. Now eyes are yellow, pulse is fine, face is black, urine volume is low, fear of progressing to Black Jaundice. However, jaundice with abdominal fullness is difficult to treat; tentatively use methods to separate and eliminate [pathogens].
Prescription: Zhi Fuzi (Aconiti Lateralis Radix Praeparata), Dafupi (Arecae Pericarpium), Chenpi (Citri Reticulatae Pericarpium), Maiya (Hordei Fructus Germinatus), Mian Yinchenshao (Artemisiae Scopariae Herba), Chiling (Poria cum Rhus), Huashi (Talcum), Jiaoshanzhi (Gardeniae Fructus, scorched), Tongcao (Tetrapanacis Medulla), Gualoupi (Trichosanthis Pericarpium).
Yu's Note: Jaundice with abdominal fullness, previous authors did not explain the cause. I believe it is due to injury of Liver and Spleen organ qi, where Wood overacts on Earth, hence difficult to treat.
Another Case: Complexion is dark black, abdomen is full and swollen, pulse is deep and fine. This is due to Spleen and Kidney Yang failing to transform, water-dampness obstructing the middle, the condition is severe. First apply methods to unblock Yang and dry dampness.
Prescription: Siling San (Four Poria Powder) plus Rougui (Cinnamomi Cortex), Chuanpu (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Dafupi (Arecae Pericarpium), Jia Liuqu (Massa Medicata Fermentata, scorched), Xixin (Asari Radix et Rhizoma), Xiangyuanpi (Citri Reticulatae Pericarpium Citranthae), Maiya (Hordei Fructus Germinatus).
Patient Huang: Face is sallow and weak, able to eat but short of breath, this is a syndrome of exhaustion injuring the Spleen. Use Zhang Jifeng's Famou Wan (Wood-Chopping Pill).
Prescription: Zaofan (Vitriolum Ferricum) (1 liang, wrapped in soil, roasted in chaff fire for one day and night, taken out when cool, when the color turns red, remove soil and clean), Chuanpu (Magnoliae Officinalis Cortex) (5 qian), Maoyu (Atractylodis Rhizoma) (1 liang, soaked in rice wash water, sliced, stir-fried), Zhi Banxia (Pinelliae Rhizoma Praeparatum) (1 liang), Chenpi (Citri Reticulatae Pericarpium) (2 liang, stir-fried with salt water), Fuling (Poria) (1 liang), Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparata) (5 qian).
Grind into fine powder, make pills using boiled and mashed Jujube flesh. Take 2 qian each time, washed down with warm water. Those who drink alcohol may take it after drinking. This prescription is quite effective.
Ren Yuan said: Jaundice is also a disease of damp-heat stagnation, sharing the same origin as latent summerheat and malaria. Ancients described its color like soy sauce paste, caused by damp-heat congestion and failure to vent. However, there are distinctions among Yin Jaundice, Yang Jaundice, Nulao Jaundice, Gu Dan (Grain Jaundice), and Jiu Dan (Wine Jaundice). Although all involve damp-heat, Yang Jaundice presents with bright yellow color, large pulse, and thirst, the syndrome is mostly excess; treatment uses formulas like Yinchen Wuling San, Pingwei San, or Zige Bipi Tang, and in severe cases, Yinchen Dahuang, to open the Middle Jiao, separate and drain damp-heat, which exits via urination, and the yellow color recedes. Yin Jaundice involves inherent deficiency of Spleen and Kidney Yang, unable to ascend and transform pathogens, presenting with dark yellow color, fine pulse, cold skin, and no thirst; when separating damp-heat, it is appropriate to assist with warming Yang and regulating Spleen, such as Yinchen Wuling San combined with Lizhong Tang or Zhenwu Tang. Gu Dan results from food damaging Spleen and Stomach, Jiu Dan results from alcohol damaging Lung and Spleen, both involve damp-heat obstruction without transformation, each having specific treatments. Nulao Hei Dan is the most difficult to treat, caused by latent internal dampness further injured by sexual exhaustion, great damage to Kidney essence, destruction of the root, with damp-heat pathogens deeply lodged in Jueyin and Shaoyin channels, and righteous Qi unable to cope. There is also Deficiency Jaundice, which is not true jaundice, but rather Middle deficiency with Liver Wood overacting, causing Spleen Earth color to manifest externally; the yellow color is pale white, urine color does not change, pulse is weak, mouth tastes bland, able to eat but lacks strength, commonly known as "Lazy Jaundice," belonging to fatigue-induced internal injury syndromes; treatment should strengthen Earth and soothe Wood, regulate and tonify Middle Qi, such as Buzhong Yiqi Tang. Although various jaundice syndromes focus mainly on separating and draining damp-heat, one must especially observe Yin-Yang and deficiency-excess, and any concurrent syndromes to adjust treatment, only then can it be perfect.