何 六旬外，脉数，消谷善饥，动则气喘。是脂液内涸，火亢烁金之候。经所谓壮火食气。固本丸加
生白芍、炒知母，效。
族女 频食易饥，手足 动，此消中症。经云∶瘅成为消中。以初病胃热，消谷而瘦，煎熬日久，胃
脂内消，水液不为宣布，下注直降，势必延为燥涸。局方甘露饮宜之。
朱 渴饮消水，日夜无度，自夏历冬，阅所服方，寒热互进，毫不一效。今饮一泄一，渴则饥嘈，明
系肾阴竭于下，虚阳灼于上，脉转沉迟。沉为脏阴受病，迟则热极反有寒象也。思壮火销铄肾阴，肾液既涸，
必饮水自救。症成下消，急滋化源，迟则难挽，仿易简地黄饮子加减，生地、熟地、人参、麦冬、石斛、花
粉、阿胶、甘草，服之效。又令服六味丸加猪脊髓、龟胶、女贞子、杞子、五味、去泽泻、茯苓，得安。
黄胆 谷疸 酒疸 女劳疸 黄汗 黄胖 脱力黄附
黄胆由脾胃湿热郁蒸，渐致身目如金，汗溺皆黄，经谓湿热相交，民病瘅也。丹溪云∶此如 曲酱相似，
湿热久罨，其黄乃成。此发黄胆所由。《伤寒论》发热，但头汗出，小便不利，渴饮，瘀热在里，必发黄。
又云∶伤寒汗已，身目为黄，以寒湿在里，不解，非但湿热发黄，寒湿亦发黄也。湿热发阳黄，寒湿发阴黄，
此发阳黄、阴黄所由。海藏云∶凡病当汗不汗，当利小便，不利，皆生黄。疸有五∶黄胆、谷疸、酒疸、女劳疸、
黄汗。身目悉黄，寒热体倦者，为黄胆。茵陈五苓散。食已如饥，头眩烦热身黄者，为谷疸。猪肚丸，实者
茵陈蒿汤，或龙胆苦参丸。经云∶食已如饥者，胃疸，即谷疸也。大醉当风入水，心中懊 ，不食欲呕，面黄
赤斑者，为酒疸。葛花解酲汤，加茵陈。房劳小腹满急，额上黑，手足心热，薄暮发者，为女劳疸。加味四
君子汤。经云∶溺黄赤，安卧者黄胆。《正理论》谓得之女劳也。汗出染衣，色如柏汁，因身热汗出澡浴，
水入毛孔而成者，为黄汗。黄 汤。既
分五疸，宜辨阴阳，阳黄多由瘀热，烦渴头汗，脉必滑数，阴黄多由寒湿，身冷汗出，脉必沉微。阳黄系胃
腑湿热熏蒸，与胆液泄越，上侵肺则发而为黄，其色明如橘子，治在胃、茵陈蒿汤。阴黄系脾脏寒湿不运，
与胆液浸淫，外渍肌肉，则发而为黄，其色晦如烟熏，治在脾。茵陈四逆汤。阴黄亦有体痛发热者，但身
如熏黄，终不似阳黄明如橘子色也。海藏治阴黄，小便不利，烦躁而渴，茵陈茯苓汤。发黄烦躁，喘呕不渴，
茵陈陈皮汤。发黄四肢遍身冷，茵陈附子汤。发黄肢体逆冷，腰自汗，茵陈四逆汤。冷汗不止，茵陈姜附汤。
发黄服姜附诸药未已，脉尚迟者，茵陈茱萸汤。伤冷中寒，脉弱气虚，理中汤加茵陈。挟表脉浮，桂枝加黄
汤。往来寒热，小柴胡汤加栀子。胸满呕吐，小半夏汤。小便利而色白者，仲景作虚劳治。小建中汤。
一种虚黄，口淡怔忡，耳鸣足软，神疲无力，人参养营汤。缪仲淳曰∶因劳发黄，用秦艽五钱，酒浸绞汁，
空心服，或利便止，屡用效。有风黄，其人肥，风不外泄，身不黄，独目黄者，青龙散。有瘀血发黄，身热，
小便自利，大便反黑，脉芤涩，当下尽黑物，桃仁承气汤。有疫疠发黄，杀人最急，茵陈泻黄汤、济生茵陈汤。
缪仲淳曰∶时行黄胆，用小麦汤。别有黑疸，因女劳伤肾，额色黑，膀胱急，腹胀如水，便黑多溏，硝矾散。
酒疸下之，久亦成黑疸，目青面黑，心中如啖蒜齑状，大便正黑，沈氏俱用黑疸汤。若黄变肿胀，必疏导腑
中湿热。茯苓渗湿汤去芩、连、艽、葛，加薏仁、大腹皮、鸡内金。若络脉瘀热发黄，金铃子散，加分消药。
疸久不愈则补脾，参术健脾丸，色疸久，加黄 、扁豆子。总之，黄而不渴易治，渴者难治。初起宜汗，有
食宜消，溺少宜利，小水利，黄自退。通用化疸汤、当归白术汤。久而虚，脉症宜温补者，养营汤、四君子汤、
肾气丸。酒疸多蕴热，先用清中，茵陈泻黄汤。加分利，加减五苓散。后必顾其脾阳，香砂六君子汤加枳 子。
女劳有秽浊，始用解毒，黑疸汤。继滑窍，二石散。终当峻补肾阴，六味汤。外有黄胖症，与黄胆异。黄胆目
黄，身不肿，黄胖多肿，其色黄中带白，目如故，疲倦少神，病源虽同属脾，然黄胆由湿热郁蒸而成，黄
胖则湿热未甚，多虫与食积所致，必吐黄
水，毛发皆直，或嗜食生米茶叶土炭，宜四宝丹。有食积则消导，保和丸加红曲。或健脾去湿药中，加
针砂重镇可效。盖疸属暴病，故仲景以十八日为期。黄胖为宿病，有久而不愈者。《正传》曰∶绿矾丸、褪
金丸，二方治黄胖病最捷。又劳力受伤，亦成黄胖，能食易饥，疲倦无力，沈氏双砂丸。俗名脱力黄，此
又在虫食黄病之外者。参《沈氏尊生书》。
He, over sixty years old, has a rapid pulse (Shu Mai), excessive hunger with good appetite (Xiao Gu Shan Ji), and shortness of breath upon exertion. This is a manifestation of internal depletion of essence fluids (Zhi Ye) and hyperactive fire scorching Metal (Lung). As the Classic states: "Vigorous fire consumes Qi" (Zhuang Huo Shi Qi). Gu Ben Wan (Solidify the Root Pill) added with raw Bai Shao (Radix Paeoniae Alba) and fried Zhi Mu (Rhizoma Anemarrhenae) was effective.
A female relative of the clan frequently eats and easily feels hungry, with twitching and tremors of hands and feet; this is Xiao Zhong Syndrome (Middle Jiao Diabetes). The Classic says: "Dan heat develops into Xiao Zhong." Because initially there is stomach heat, digesting food quickly leading to emaciation; after prolonged burning, the stomach's essence fluids are consumed internally, body fluids fail to distribute properly, flowing downward directly, inevitably extending to dryness and depletion. Ju Fang Gan Lu Yin (Purified Dew Decoction from the Bureau Formulary) is suitable.
Zhu, thirsty and drinking water excessively, day and night without limit, from summer to winter. Reviewing prescribed formulas, cold and hot herbs were alternated, yet no effect. Now, for every cup drunk, one cup is excreted; when thirsty, there is gastric discomfort (Ji Cao). Clearly, Kidney Yin is exhausted below, and deficient Yang scorches above. The pulse has turned deep and slow (Chen Chi). Deep indicates Zang Yin pathology; slow suggests extreme heat manifesting as cold signs. Considering vigorous fire has depleted Kidney Yin, once Kidney fluids are exhausted, the body must drink water to save itself. The syndrome has become Xia Xiao (Lower Diabetes); urgently nourish the source of transformation. Delay makes it difficult to salvage. Following Yi Jian Di Huang Yin (Easy-to-Use Rehmannia Decoction) modified: Sheng Di (Radix Rehmanniae Preparata), Shu Di (Radix Rehmanniae Preparata), Ren Shen (Radix Ginseng), Mai Dong (Radix Ophiopogonis), Shi Hu (Herba Dendrobii), Hua Fen (Radix Trichosanthis), E Jiao (Colla Corii Asini), Gan Cao (Radix Glycyrrhizae). Effective after taking. Also instructed to take Liu Wei Wan (Six-Ingredient Pill with Rehmannia) added with pig spinal cord, Gui Jiao (Colla Cornus Asini), Nu Zhen Zi (Fructus Ligustri Lucidi), Gou Qi Zi (Fructus Lycii), Wu Wei Zi (Fructus Schisandrae), removing Ze Xie (Rhizoma Alismatis) and Fu Ling (Sclerotium Poriae Cocos). Peace achieved.
Jaundice (Huang Dan): Grain Jaundice (Gu Dan), Wine Jaundice (Jiu Dan), Woman-Labor Jaundice (Nu Lao Dan), Yellow Sweat (Huang Han), Yellow Obesity (Huang Pang), Effort-Depletion Yellow (Tuo Li Huang).
Jaundice arises from damp-heat stagnating and steaming in the Spleen and Stomach, gradually causing the body and eyes to turn yellow like gold, with sweat and urine becoming yellow. The Classic states: "When damp-heat interacts, the people suffer from Dan disease." Danxi said: "This is similar to fermenting koji or soy sauce; only after damp-heat lingers long does the yellow color form." This explains the origin of jaundice. *Shanghan Lun* states: Fever, sweating only on the head, difficulty urinating, thirst, and stagnant heat in the interior will certainly cause jaundice. It also says: After treating Shanghan with sweating, if the body and eyes turn yellow, it is because cold-dampness remains in the interior unresolved. Not only damp-heat causes jaundice, but cold-dampness can also cause it. Damp-heat produces Yang Jaundice; cold-dampness produces Yin Jaundice. This explains the origins of Yang and Yin Jaundice. Haizang said: Any disease that should be treated by sweating but isn't, or should be treated by promoting urination but doesn't, will all generate jaundice. There are five types of Dan: Huang Dan, Gu Dan, Jiu Dan, Nu Lao Dan, Huang Han. Body and eyes completely yellow, with chills, fever, and body fatigue, is Huang Dan. Yin Chen Wu Ling San (Yin Chen and Five-Ingredient Powder with Poria). Feeling hungry after eating, dizziness, irritability, heat, and yellow skin is Gu Dan. Zhu Du Wan (Pig Stomach Pill); for excess patterns, Yin Chen Hao Tang (Yin Chen and Mugwort Decoction), or Long Dan Ku Shen Wan (Gentian and Sophora Pill). The Classic says: Feeling hungry after eating is Wei Dan, which is Gu Dan. Getting drunk and then exposed to wind or entering water, feeling mental restlessness (Ao Nao), anorexia with nausea, red spots on the face and yellow skin is Jiu Dan. Ge Hua Jie Cheng Tang (Kudzu Flower Decoction to Resolve Intoxication) added with Yin Chen. Sexual exhaustion with lower abdominal fullness and urgency, black forehead, heat in palms and soles, occurring at dusk is Nu Lao Dan. Jia Wei Si Jun Zi Tang (Modified Four Gentlemen Decoction). The Classic says: Yellow-red urine and lying still indicates Huang Dan. *Zheng Li Lun* attributes it to woman-labor. Sweat staining clothes, color like cypress juice, caused by bathing while sweaty from heat, allowing water to enter pores, is Huang Han.
Having distinguished the five Dans, one must differentiate Yin and Yang. Yang Jaundice mostly stems from stagnant heat, with irritability, thirst, head sweating, and a slippery-rapid pulse. Yin Jaundice mostly stems from cold-dampness, with cold body, sweating, and a deep-micro pulse. Yang Jaundice is due to damp-heat steaming in the Stomach Fu, mixing with bile leakage, invading the Lung upwards to cause yellowing; the color is bright like an orange peel. Treatment focuses on the Stomach, using Yin Chen Hao Tang. Yin Jaundice is due to cold-dampness failing to transform in the Spleen Zang, mixing with bile infiltration, soaking muscles externally to cause yellowing; the color is dull like smoke-stained. Treatment focuses on the Spleen. Yin Jaundice may also present with body pain and fever, but the body looks like smoked yellow, never as bright as the orange-peel color of Yang Jaundice. Haizang treated Yin Jaundice with difficulty urinating, irritability, and thirst using Yin Chen Fu Ling Tang (Yin Chen and Poria Decoction). For yellowing with irritability, wheezing, vomiting, and no thirst, use Yin Chen Chen Pi Tang (Yin Chen and Tangerine Peel Decoction). For yellowing with cold limbs and body, use Yin Chen Fu Zi Tang (Yin Chen and Aconite Decoction). For yellowing with reversed cold limbs and spontaneous lumbar sweating, use Yin Chen Si Ni Tang (Yin Chen and Counterflow Toxin Decoction). For unceasing cold sweat, use Yin Chen Jiang Fu Tang (Yin Chen, Ginger, and Aconite Decoction). For yellowing where Ginger/Aconite medicines failed and the pulse remains slow, use Yin Chen Zhu Yu Tang (Yin Chen and Dogwood Decoction). For cold injury and middle-jiao cold with weak pulse and Qi deficiency, use Li Zhong Tang (Regulate the Middle Decoction) added with Yin Chen. With exterior pattern and floating pulse, use Gui Zhi Jia Huang Qi Tang (Cinnamon Twig Decoction plus Astragalus). For alternating chills and fever, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Zhi Zi. For chest fullness and vomiting, use Xiao Ban Xia Tang (Minor Pinellia Decoction). If urination is free and clear/white, Zhongjing treats it as Deficiency Labor (Xu Lao) using Xiao Jian Zhong Tang (Minor Construct the Middle Decoction).
A type of Deficient Yellow presents with bland taste, palpitations, tinnitus, weak legs, spirit fatigue, and weakness, treated with Ren Shen Yang Ying Tang (Ginseng Nourishing Nutrient Decoction). Miao Zhongchun said: For jaundice due to labor, use Qin Jiao (Radix Gentianae Macrophyllae) 5 qian, soaked in wine and juiced, taken on an empty stomach; or until urination stops, repeatedly used effectively. There is Wind Yellow: the person is fat, wind cannot escape outward, body is not yellow, only eyes are yellow; treat with Qing Long San (Azure Dragon Powder). There is Blood Stasis Yellow: body heat, free urination, stool turns black, pulse is Kou and Se; purge thoroughly to expel black matter, using Tao Ren Cheng Qi Tang (Persimmon Seed and Major Downward Draining Decoction). There is Epidemic Jaundice, killing most urgently, using Yin Chen Xie Huang Tang (Yin Chen Draining Yellow Decoction) or Ji Sheng Yin Chen Tang (Life-Saving Yin Chen Decoction). Miao Zhongchun said: For seasonal jaundice, use Xiao Mai Tang (Wheat Decoction). There is distinct Black Dan: due to woman-labor injuring Kidney, forehead black, bladder urgency, abdominal distension like water, black loose stools, using Xiao Fan San (Alum and Saltpeter Powder). If Wine Dan is treated with purgatives improperly, it eventually becomes Black Dan: eyes blue, face black, heart feels like eating minced garlic, stool truly black; Shen's family uses Hei Dan Tang (Black Dan Decoction). If yellowing changes to swelling, one must guide out damp-heat from the Fu organs. Fu Ling Shen Shi Tang (Poria Damp-Draining Decoction) remove Huang Qin, Lian Qiao, Qiang Huo, Ge Gen, add Yi Yi Ren, Da Fu Pi, Ji Nei Jin. If collateral stagnant heat causes yellowing, use Jin Ling Zi San (Melia Melia Powder) added with dispersing-draining herbs.
If Dan persists, tonify the Spleen, using Shen Zhu Jian Pi Wan (Ginseng and Atractylodes Spleen-Strengthening Pill). For chronic color Dan, add Huang Qi, Bian Dou Zi. In summary, yellowing without thirst is easy to treat; with thirst is difficult. Early stage favors sweating; with food stagnation favors digestion; low urine volume favors diuresis. Once urination flows freely, yellow recedes naturally. General formulas include Hua Dan Tang (Transform Dan Decoction) and Dang Gui Bai Zhu Tang (Angelica and Atractylodes Decoction). For chronic deficiency where pulse/symptoms favor warming-tonifying, use Yang Ying Tang, Si Jun Zi Tang, or Shen Qi Wan. Wine Dan often harbors heat; first clear the center with Yin Chen Xie Huang Tang. Add diuretics, use Jia Jian Wu Ling San (Modified Five-Ingredient Powder with Poria). Later must protect Spleen Yang, using Xiang Sha Liu Jun Zi Tang (Fragrant Amomum Six Gentlemen Decoction) added with Zhi Shi. Nu Lao has turbid pathogens; initially detoxify with Hei Dan Tang. Then open orifices with Er Shi San (Two Stones Powder). Finally, vigorously tonify Kidney Yin with Liu Wei Tang (Six-Ingredient Decoction).
Externally, there is Huang Pang Syndrome, different from Jaundice. Jaundice has yellow eyes, body not swollen; Huang Pang is often swollen, color yellow mixed with white, eyes unchanged, fatigue and lack of spirit. Although both sources relate to Spleen, Jaundice forms from damp-heat stagnation; Huang Pang has less damp-heat, mostly caused by parasites and food stagnation. Must vomit yellow water, hair stands straight, or crave raw rice, tea leaves, soil, charcoal; treat with Si Bao Dan (Four Treasures Pill). With food stagnation, use digestion-promoting methods, Bao He Wan (Preserve Harmony Pill) added with Hong Qu. Or in Spleen-strengthening damp-draining herbs, add Zhen Sha (Cinnabar-like iron ore) for heavy settling efficacy. Dan belongs to acute illness, hence Zhongjing sets a period of eighteen days. Huang Pang is a chronic illness, sometimes persisting for years. *Zhuan* states: Lv Fan Wan (Green Alum Pill) and Tui Jin Wan (Remove Gold Pill) are fastest for Huang Pang. Also, labor injury can cause Huang Pang: good appetite, easy hunger, fatigue, weakness; Shen's family uses Shuang Sha Wan (Double Sand Pill). Commonly called Tuo Li Huang (Effort-Depletion Yellow), this lies outside parasite-induced yellow diseases. Refer to *Shen Shi Zun Sheng Shu*.