（黄胆之病，以十八日为期，治十日已上宜瘥，反剧为难治。）
窦材治一人，遍身皆黄，小便赤色而涩，灸食窦穴五十壮，服姜附汤、全真丹而愈。
沈以潜、葛可久，俱神医也。一日，有老妪患黄胆，诣沈求治，曰∶吾固未之能。荐于葛，葛延沈饮，以
针针其左右乳下，而与沈饮者倾刻时，出启左针，而左半身肉色莹然，启右针，而右半身肉如左。（《漱石闲谈》。）
张子和治一男子作赘，偶病疸，善食而瘦，四肢不举，面黄无力。其妇翁欲弃之，其女子不肯，曰∶我已
生二子矣，更他适乎？翁本农者，召婿意欲作劳，见其病甚，每日辱诟，人教之饵胆矾丸、三棱丸，了不关涉，
针灸祈禳，百无一济。张见之，不诊而疗，使服涌剂，去积痰宿水一斗。又以泻水丸、通经散，下四五十行，
不止，命以冰水一钟，饮之立止。服平胃散等，间服槟榔丸，五七日，黄退力生。盖脾疸之症，湿热与宿谷相
搏故也，俗谓之金劳黄。
周、黄、刘三家，各有仆病黄胆。张曰∶仆役之职，饮食寒热，风暑湿气，寻常触冒，恐难调摄，虚费治
功。其二家留仆于张所，从其余饵。一仆不离主人执役，三人同服苦散以涌之，又服三花神佑丸下之。五日之
间，果二仆愈，一仆不愈，如其言。
一女子病黄，遍身浮肿，面如金色，困乏无力，不思饮饵，惟喜食生物泥煤之属。先以苦剂蒸为饼丸，涌
痰一碗。又以舟车丸、通经散，下五七行如墨汁。更以导饮丸、磨气散，数日肌肉如初。
赵君玉病遍身发黄，往问医者。医云∶君乃阳明症。公等与麻知几，皆受训于张戴人，是商议吃大黄者，
难与论病。君玉不悦，归自揣无别病，乃取三花神 丸八十粒服之，不效。乃悟曰∶予之湿热盛矣，此药尚不
能动，以舟车丸、浚川散作剂，大下一斗，粪多结者，一夕黄退。君玉由此益信戴人之言。
孙文垣治王文川子，原伤饮食，又伤冷菱等物，遍身黄如金色，夜发热，天明则退，腹痛，手不可近。医
拟进草药。孙曰∶此症乃食积酿成，而黄为湿热所致，法当健脾，用温暖之剂下之，草药性寒，是损脾土而益
其疾也。用保和丸一钱，入备急丸五分，作数次服之。少顷，泻一次，又少顷，连下三次，积物甚多，腹痛尽
止。再与调中丸，服一月病愈，而轻健如常。
孙竹 途次受暑，又为酒曲所伤，因作吐，胸膈痞闷。医以消导之剂，燥动脾火，口渴嘈杂，躁乱不安，
目珠如金，一身尽黄，已成疸症，右寸脉滑大有力。用温胆汤，倍加香薷、滑石、葛根，解暑止吐为君，黄连、
麦冬，清热止渴为臣，使湿热散而黄自瘳也。服三帖，吐止食进。再与五苓散加青蒿、葛根、滑石、黄连、枳
实，八剂而黄尽退。
张仲文治一妇人，年六十岁。病振寒战栗，足太阳寒水也。呵欠喷嚏，足少阳胆也；口亡津液，足阳明不
足也；心下急痛而痞，手太阴受寒，足太阴血滞也；身热又欲近火，热在皮肤，寒在骨髓也；脐下恶寒，丹田
有寒，浑身黄及睛黄，皆寒湿也；余症验之，知其为寒湿，溺黄赤而黑，又频数，乃寒湿盛也；病来身重如山，
便着床枕者，阴湿盛也。其脉右手关尺命门弦细，按之洪而弦，弦急为寒，加之细者，北方寒水，杂以缓者，
湿盛出黄色也；脉洪大者，心火受制也；左手又按之至骨，举手来实者，壬癸肾旺也；六脉按之但空虚者，下
焦无阳也。用药法先宜以轻剂去其寒湿，兼退其洪大之脉，以理中加茯苓汤投之。
朱丹溪治一妇人，年二十八岁，发黄脉涩，经水自来不行，身体倦怠，未曾生子。用陈皮、白术、木通各
一两，黄芩、归头、丹皮半两，甘草一钱，分作十二帖，水煎，食前热服。
一人年二十岁，因劳又冒雨，得疸症，脚酸心悸，口苦力弱，尿黄，脉浮而数。病在表，宜解外，黄 三
钱，白术、苍术各一钱，陈皮、苏叶、木通各五分，山栀炒二钱，甘草稍五分，白水煎服，下保和十五丸，与
点抑青各十丸，温中二十丸而愈。
一妇人年三十，面黄脚酸弱，口苦喜茶，月经不匀，且多倦怠。用黄 、甘草各三钱，人参、当归、白芍
各一钱，木通、陈皮各五分，白术一分，炒柏、秦艽各二分。
一妇人年六十，面黄倦甚，足酸口苦，脉散而大，此湿伤气也。白术半两，陈皮四钱，苍术、木通、黄芩
各三钱，人参、川芎各二钱，黄柏炒一钱，甘草炙五分，分六帖，水煎，食前服。
王官人痞后面黄，脚酸弱，倦怠，食饱气急头旋。黄 、甘草、木通各二分，白术一钱，半夏、浓朴、陈
皮、苍术各一钱，黄柏炒三分，水煎服。
成庚五官面黄，脚酸无力，食不化，脚虚而少力，口苦肚胀，宜补之。人参、木通各三分，白术一钱五
分，当归、白芍、川芎、陈皮、苍术各五分，甘草二分，水煎，下保和丸四十丸。
孙文垣治一人，因冒雨劳力汗出，又以冷水澡浴，因发热口渴，心与背胀痛，小水长而赤，舌苔黄，不眠，
目黄如金，皮肤尽黄。或谓年高，不敢与治。诊得左脉浮数，（热。）右濡弱，（湿。）皆七至。（湿热相并。）
此湿热发黄症也，病虽重，年虽高，犹可为。以柴胡三钱，（太重否？）酒芩、葛根、青蒿、香薷、花粉各
一钱，人参七分，甘草五分，连进二剂，得微汗，次早即热退其半，舌稍淡润。身黄未退，胸膈余热作烦，以竹
茹、青蒿、葛根各一钱，人参、麦冬、花粉、知母各八分，白芍六分，二帖，热退食进，精神陡长。后与补
中益气汤，加青蒿、麦冬、花粉，十帖，黄尽退，顿痊。
一人患酒疸，遍身皆黄，尿如柏汁，目如金，汗出沾衣如染，胸膈痞闷，口不知味，四肢酸软，脉濡而数，
以四苓散加浓朴、陈皮、山楂、麦芽、葛根，倍青蒿，水煎，临服加萱草根自然汁一小杯，四帖顿愈。
一人病后，身面俱黄，吐血成盆，（热郁阳明。）诸药不效。用螺十个，水漂去泥，捣烂，露一夜，五更
取清汁服二三次，血止黄愈。（《小山怪症方》、《本草纲目》。）
《外台秘要》治三十大黄急救方∶用鸡子一颗，连壳烧灰，研酢一合和之，温服，鼻中虫出为效。身体极黄
者，不过三枚，神效。
柴屿青治觉罗玛德夫人，病疽。医投茵陈五苓散未效，又合末药服之，肌肤白眼皆如金色，转致不思饮
食，右关缓弱特甚。柴曰∶胃为水谷之海，脾为仓廪之官，腑脏失职，湿热滋甚。今惟有调其土，使能健运，
湿热自去，不必治疸，而疸自愈矣。用六君子汤加浓朴、炮姜以温中，神曲、麦芽以助戊己之化，不数剂而全愈。
东垣曰∶戊申春，一妇人六十岁，病振寒战栗，（太阳寒水客也。）呵欠喷嚏，（足少阳溢。）口亡津液，
（足阳明不足也。）心下急痛而痞，（手足太阴受寒也，故急痛。太阴血滞为痞。）身热近火，（热在皮表，
寒在骨髓，故振寒战栗也。）脐下恶寒，（丹田有寒。）浑身黄而白睛黄，（寒湿也，以余症推之，知其寒也。）
溺黄赤而黑，频数。（寒湿盛也。）自病来身重如山，便着床枕。（至阴湿盛也。）其
诊脉，得左右关并尺命门中得弦而急极细，杂之以洪而极缓，（弦急为寒，加之以细者，北方寒水。杂以又洪
大者，心火受制也。缓甚者，湿盛出黄色也。）左手按之至骨，举止来实者，（壬癸俱旺也。）六脉按之俱空
虚者，下焦无阳也。先以轻剂去其中焦寒湿，兼退其洪大脉，理中汤加茯苓是也。水煎冰之，令寒服之。谓
之热因寒用，假寒以对足太阳之假热也。以干姜之辛热，以泻真寒也。故曰∶真对真，假对假。若不愈，当以
术附汤，冰之令寒，以补下焦元气也。（《试效方》、《医说续编》。）
陆祖愚治潘巨源，食量颇高，恣肆大嚼，因劳役失饥伤饱，每患脾胃之症，或呕或泻，恬不介意，后成黄
疸，用茵陈五苓散治之，而症仍前。饮食不节，疸症复作。人传一方，以苦药葫芦煮，服之即效。试之果然。
仍力疾生理，后试之至再，至周身熏黄，肚腹如鼓而卒。
薛立斋治大司徒李浦汀，南吏部少宰时，患黄胆。当用淡渗之剂，公尚无嗣，犹预不决。曰∶有是病，而
用是药。以茵陈五苓散加芩、连、山栀，二剂而愈。至辛卯得子。
应天王治中，遍身发黄，妄言如狂，苦于胸痛，手不可近。此中焦蓄血为患，用桃仁承气汤，一剂下瘀血
而愈。又太守朱阳山弟，下部蓄血发狂，用抵当汤而愈。
马元仪治沈玉格患疸症，一身及面目悉黄，微见黑滞，烦渴腹满。脉之，左弦数，右空大，此内伤发黄，
为厥阴肝木，太阴脾土，二脏交伤之候也。夫肝郁则生热，脾郁则生湿，湿热交争，而烦渴腹满，发黄之症生
矣。至黑色兼见于面，则并伤其肾，汗之下之，非其治也。宜平肝之亢，扶土之虚，兼解郁热以清气道，除湿
蒸而和中气。用人参三钱，白术二钱，白芍一钱，黄连、山栀七分，归身、丹皮、茵陈、秦艽各一钱，柴胡
七分，炙草五分，半夏曲一钱，服三十剂愈。
顾奉常务远目黄，脾气弱，仲淳疏方用茵陈三钱，人参三钱，薏仁三钱，莲肉三钱，木通八分，黄连酒炒
一钱，山栀炒八分，白术土炒一钱，石斛酒蒸三钱，皆治疸之剂。以事冗未服，既而身目皆黄，小便亦赤，乃
服仲淳先见，饮前药稍愈。一按摩者，投以草汁药酒，脾败，遂不起。临殁，下瘀血数升，亦蓄血症也，以其
年迈不绝欲故耳。前方尚有茯苓二钱。
施灵修乃兄，七年前曾患疸症，服草药，愈后复发。坐多气多劳，故草药不效。服田螺汁，服一日夜，大
作寒热，因发渴，小便如油，眼目黄且赤，手足黄紫。仲淳以瘀血发黄，服药后，大小便通，黄及渴俱减。橘
红一钱五分，红曲炒研二钱，山楂五钱，郁金汁十五匙，薏苡六钱，木瓜三钱，牛膝五分，麦冬五钱，车前二
钱五分，赤茯三钱，通草五分，白芍酒炒四钱，竹茹二钱，河水二钟，煎八分，饥时服。三日后，加人参三钱。
（《广笔记》。）
魏玉横曰∶徐环薇，年二十余，病疸，服山栀茵陈五苓、六一之剂将两月，不效。脉之，弦细而驶，面目
爪甲俱淡黄，语言迟倦。谓之曰∶君以黄胆求治，此其余症耳，今病成劳损矣。乃竦然曰∶诚有之，近来夜卧
不宁，晚即发热，黎明始退，咳嗽痰稀，腰膝疼痛。然治之当奈何？曰∶病缘阴虚火盛，肝热久郁，移其所胜，
故食少便溏，发为黄症。与酒谷诸疸为湿热熏蒸者不同，乃服苦寒渗利，重伤其阴，致成劳损。今宜峻养肝肾，
俾嗽止热退，食进便调，而黄自消矣。与集灵膏加减十余剂，诸症渐退，黄亦愈矣。
金鲁胆，年四十余，馆于时医汤静公宅，病疸，诸治不效。已历数医，最后一人与草头方四味，中有六月
雪，余忘之矣，服之增剧。脉之，软无神，略数。外症目黄如橘，面额则黄而黑暗，腹大脐凸，便溏食少，动
则气促，知为脾肾两亏，近乎女劳一症，乃疸中最难治者也。与熟地、山药各一两，杞子、枣仁、米仁各五钱。
彼疑太补，持以问汤。汤老医也，谓曰∶方极是，第吾辈素不用此，姑试之。一剂减，二剂又减。再诊，脉渐
起，仍前方八剂全愈。
朱天一年二十余，喜食糖及燥炙诸饼，忽病黄，面目如金。脉之，两关数实有力，尺滑。大便六七日不行，
小便黄涩。此敦阜太过燥热，如以素瓷覆火，其色必黄，非湿症也。与小承气汤加当归、白芍，一剂便行而瘥。
治黄胆方，苍耳子、薄荷、木通、茵陈谷三钱。用好陈酒一斤，煎一碗，冲砂仁末三钱服。若小便赤若血水
者，加川连一钱同煎。
裴兆期曰∶凡泻病、痢病、虫病、疳病、水病、酒病、疸病，于初愈时，断不可骤服滋补之药。盖此数症，
以湿为本，滋补之药，乃助湿热之尤者，骤服之，少不致害。昔当湖一孝廉，余通家世好也，为人偏滞多思，
无事而恒戚戚，偶于甲午秋病疸，后虽治愈，而饮食未能撤消，则脾尚虚而湿未清也。值公车北上，一医以天
王保心丹数斤为赆，一往舟中，饵无虚日，渐觉胸膈窒碍，饮食日减，入春而疸病复作。迨归而形容枯槁，仅
存皮骨，其腹庞然，按之如石。此余往视，则真气已衰败无余，无可措手矣，越旬而殁。此亦误投滋补之一验也。
(Jaundice disease has an eighteen-day course. If treated for ten days, it should resolve; if it worsens instead, it is difficult to treat.)
Dou Cai treated a patient with generalized jaundice and dark red, dysuric urine. He moxibusted the Shidong (ST15) acupoint fifty moxa cones and administered Jiang Fu Tang (Ginger and Aconite Decoction) and Quan Zhen Dan (Complete True Pill), resulting in recovery.
Shen Yiqian and Ge Kejiu were both divine physicians. One day, an elderly woman suffering from jaundice sought treatment from Shen Yiqian. Shen said, "I indeed cannot treat this," and recommended her to Ge Kejiu. Ge invited Shen to drink together. While Shen was drinking, Ge inserted needles into points below the left and right breasts of the patient. In the brief moment it took Shen to finish his drink, upon removing the needle on the left side, the flesh color of the left half of the body became crystal clear; upon removing the needle on the right side, the right half of the body's flesh color became identical to the left. (From *Shushi Xiantan*.)
Zhang Zihe treated a man who had become a matrilocal son-in-law and accidentally contracted jaundice. He had a good appetite but was emaciated, unable to lift his limbs, with a sallow complexion and lack of strength. His father-in-law wished to discard him, but his daughter refused, saying, "I have already borne two sons; shall I remarry?" The father-in-law was originally a farmer and summoned his son-in-law to perform labor. Seeing the severity of his illness, he abused him daily. Someone advised him to take Dan Fan Wan (Alum Pill) and San Leng Wan (Burreed Rhizome Pill), but these were ineffective. Acupuncture and prayers yielded no results. Zhang Zihe saw him and treated him without pulse diagnosis, prescribing a vomiting agent that expelled one dou of accumulated phlegm and old water. He then used Xie Shui Wan (Water-Draining Pill) and Tong Jing San (Meridian-Unblocking Powder), causing forty to fifty bowel movements. When this did not stop, he ordered the patient to drink a cup of ice water, which immediately stopped the diarrhea. Subsequently, he administered Ping Wei San (Calm the Stomach Powder) and other formulas, taking Bing Lang Wan (Betel Nut Pill) intermittently. Within five to seven days, the jaundice receded and strength returned. This is likely Spleen Jaundice, caused by the struggle between damp-heat and retained food, commonly known as Jin Lao Huang (Metal Labor Yellow).
The servants of the Zhou, Huang, and Liu families all suffered from jaundice. Zhang Zihe said, "Servants' duties involve irregular diet and frequent exposure to wind, heat, dampness, and cold, making regulation difficult and treatment efforts futile." Two of the servants stayed with Zhang Zihe to follow his remaining prescriptions. One servant remained with his master performing duties. All three took Ku San (Bitter Powder) to induce vomiting and San Hua Shen You Wan (Three Flowers Divine Protection Pill) to purge. Within five days, indeed, two servants recovered and one did not, just as he predicted.
A young woman suffered from jaundice with generalized edema, a golden-yellow face, fatigue, lack of appetite, and a craving for raw mud or coal-like substances. First, a bitter agent steamed into pill cakes induced the vomiting of one bowl of phlegm. Then, Zhou Che Wan (Boat and Cart Pill) and Tong Jing San were used to cause five to seven bowel movements resembling ink juice. Subsequently, Dao Yin Wan (Guiding Drink Away Pill) and Mo Qi San were administered, and within several days, her muscles returned to normal.
Zhao Junyu had generalized yellowing of the skin and consulted a physician. The doctor said, "You have Yangming Syndrome." Zhao Junyu and Ma Zhiji were both disciples of Zhang Dairen (Zhang Zihe) and advocated the use of Da Huang (Rhubarb); thus, they found it difficult to discuss pathology with them. Dissatisfied, Zhao went home, reasoned he had no other illness, and took eighty pills of San Hua Shen You Wan, but to no effect. He then realized, "My damp-heat is too abundant; this medicine cannot move it. I will use Zhou Che Wan and Jun Chuan San as a dosage to purge heavily." He passed over one dou of stool containing many clumps, and overnight, the jaundice receded. From this, Zhao trusted Zhang Dairen's words even more.
Sun Wenyuan treated the son of Wang Wenchuan, who had initially injured himself with diet and subsequently with cold water chestnuts. His whole body was yellow like gold, he had nighttime fever that subsided at dawn, abdominal pain sensitive to touch. Physicians intended to prescribe herbal remedies. Sun said, "This condition arises from food stagnation, and the yellowing is due to damp-heat. The method should be to strengthen the spleen and use warm agents to purge. Herbal medicines are cold-natured; using them damages the spleen earth and exacerbates the disease." He used Bao He Wan (Preserve Harmony Pill) one qian mixed with Bei Ji Wan (Emergency Aid Pill) five fen, taken in divided doses. Shortly after, he had one bowel movement, and soon after, three consecutive ones, expelling much stagnant matter, and the abdominal pain ceased completely. He then gave Tiao Zhong Wan (Regulate the Middle Pill), taken for one month until recovery, leaving the patient light and healthy as usual.
Sun Zhu caught summerheat during travel and was injured by yeast/fermentation, leading to vomiting and chest oppression. Physicians used digestion-promoting agents, which dried out and stirred up spleen fire, causing thirst, epigastric discomfort, restlessness, eyes yellow like gold, and generalized jaundice. The right Cun pulse was slippery, large, and forceful. He used Wen Dan Tang (Warm the Gallbladder Decoction), doubling Xiang Ru (Mosla Herb), Hua Shi (Talcum), and Ge Gen (Kudzu Root) to resolve summerheat and stop vomiting as the sovereign herbs, and Huang Lian (Coptis Rhizome) and Mai Dong (Ophiopogon Tuber) to clear heat and stop thirst as the minister herbs, so that damp-heat would scatter and jaundice heal. After three doses, vomiting stopped and appetite improved. He then prescribed Wu Ling San (Five-Ling Powder) added with Qing Hao (Artemisia Annua), Ge Gen, Hua Shi, Huang Lian, and Zhi Shi (Immature Bitter Orange). After eight doses, the jaundice completely receded.
Zhang Zhongwen treated a sixty-year-old woman. Her symptoms included aversion to cold and shivering (Foot-Taiyang Cold Water pathogen), yawning and sneezing (Foot-Shaoyang Gallbladder overflow), dry mouth and lack of fluids (Foot-Yangming insufficiency), urgent pain and fullness in the heart region (Hand-Taiyin Cold invasion, Foot-Taiyin blood stasis), body heat yet desire to stay near fire (heat in skin, cold in marrow), cold sensation below the navel (cold in Dantian), generalized jaundice including scleral yellowing (all due to cold-dampness). Other symptoms confirmed cold-dampness: dark yellow-red, frequent urination indicates severe cold-dampness. The body felt heavy as a mountain, requiring bed support, indicating extreme Yin dampness. Her pulse at the Guan and Chi positions on the right hand, corresponding to Mingmen, was wiry, fine, and rapid; pressing revealed it to be surging and wiry. Wiry and rapid indicates cold; combined with fine, it suggests Northern Cold Water mixed with slow, indicating dampness producing yellow color. Surging pulse indicates Heart Fire being constrained. Pressing the left hand to the bone, the pulse felt solid when lifted, indicating strong Ren and Gui (Kidney) qi. The six pulses felt empty when pressed, indicating lack of Yang in the Lower Jiao. Treatment first required mild agents to remove middle-jiao cold-dampness and reduce the surging pulse, using Li Zhong Jia Fu Ling Tang (Regulate the Middle Plus Poria Decoction).
Zhu Danxi treated a twenty-eight-year-old woman with jaundice, choppy pulse, amenorrhea, fatigue, and nulliparity. He used Chen Pi (Tangerine Peel), Bai Zhu (Atractylodes Macrocephala Rhizome), and Mu Tong (Akebia Stem) each one liang, Huang Qin (Scutellaria Root), Gui Tou (Angelica Sinensis Head), and Dan Pi (Moutan Cortex) half liang, and Gan Cao (Licorice Root) one qian. Divided into twelve doses, decocted in water, taken hot before meals.
A twenty-year-old man contracted jaundice due to exertion and rain exposure. Symptoms included sore legs, palpitations, bitter taste, weakness, yellow urine, and floating, rapid pulse. The disease was in the exterior, suitable for releasing the exterior. He used Yin Chen (Artemisia Capillaris) three qian, Bai Zhu and Cang Zhu (Atractylodes Lancea Rhizome) each one qian, Chen Pi, Su Ye (Perilla Leaf), and Mu Tong each five fen, Chao Shan Zhi (Stir-fried Gardenia Fruit) two qian, and Gan Cao Shao (Licorice Tip) five fen, decocted in plain water. He also took fifteen pills of Bao He Wan, ten pills of Dian Yi Qing, and twenty pills of Wen Zhong, resulting in recovery.
A thirty-year-old woman had a sallow face, weak and sore legs, bitter taste, preference for tea, irregular menstruation, and fatigue. She used Yin Chen and Gan Cao each three qian, Ren Shen (Ginseng), Dang Gui (Angelica Sinensis), and Bai Shao (White Peony Root) each one qian, Mu Tong and Chen Pi each five fen, Bai Zhu one fen, Chao Bai (Stir-fried Phellodendron Bark) and Qin Jiao (Gentiana Macrophylla Rhizome) each two fen.
A sixty-year-old woman had a sallow face, severe fatigue, sore legs, bitter taste, and a scattered, large pulse. This indicated dampness injuring Qi. She used Bai Zhu half liang, Chen Pi four qian, Cang Zhu, Mu Tong, and Huang Qin each three qian, Ren Shen and Chuan Xiong (Sichuan Lovage Rhizome) each two qian, Chao Huang Bo (Stir-fried Phellodendron Bark) one qian, and Zhi Gan Cao (Honey-fried Licorice Root) five fen. Divided into six doses, decocted in water, taken before meals.
Wuanren had jaundice following epigastric fullness, with weak and sore legs, fatigue, shortness of breath, and dizziness after eating. He used Yin Chen, Gan Cao, and Mu Tong each two fen, Bai Zhu one qian, Ban Xia (Pinellia Tuber), Hou Po (Magnolia Bark), Chen Pi, and Cang Zhu each one qian, and Chao Huang Bo three fen, decocted in water.
Cheng Geng had facial jaundice, leg weakness, indigestion, weak legs, bitter taste, and abdominal distension. Tonification was needed. He used Ren Shen and Mu Tong each three fen, Bai Zhu one qian five fen, Dang Gui, Bai Shao, Chuan Xiong, Chen Pi, and Cang Zhu each five fen, and Gan Cao two fen, decocted in water, followed by forty pills of Bao He Wan.
Sun Wenyuan treated a man who sweated from exertion in the rain and then bathed in cold water. He developed fever, thirst, chest and back distending pain, prolonged dark red urination, yellow tongue coating, insomnia, eyes yellow like gold, and generalized skin yellowing. Some said he was too old to treat. Pulse diagnosis revealed left floating and rapid (Heat), right soggy and weak (Dampness), both at seven beats per breath (Damp-Heat combining). This is Damp-Heat Jaundice. Although serious and the patient aged, it could still be treated. He used Chai Hu (Bupleurum Root) three qian (Is this too heavy?), Jiu Huang Qin (Wine-processed Scutellaria), Ge Gen, Qing Hao, Xiang Ru, and Hua Fen (Trichosanthes Root) each one qian, Ren Shen seven fen, and Gan Cao five fen. After two consecutive doses, slight sweating occurred, and by the next morning, fever reduced by half, tongue slightly pale and moist. Jaundice remained, with residual heat in chest/diaphragm causing irritability. He used Zhu Ru (Bamboo Shavings), Qing Hao, and Ge Gen each one qian, Ren Shen, Mai Dong, Hua Fen, and Zhi Mu (Anemarrhena Rhizome) each eight fen, and Bai Shao six fen. After two doses, fever receded, appetite improved, and spirit suddenly increased. Later, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Qing Hao, Mai Dong, and Hua Fen was given for ten doses, completely resolving jaundice and achieving sudden recovery.
Another patient had Wine Jaundice with generalized yellowing, urine like cypress sap, eyes like gold, sweat staining clothes, chest oppression, loss of taste, limb soreness, and soggy, rapid pulse. He was treated with Si Ling San (Four-Poria Powder) added with Hou Po, Chen Pi, Shan Zha (Hawthorn Fruit), Mai Ya (Barley Sprout), and Ge Gen, with doubled Qing Hao. Decocted in water, with a small cup of fresh juice from Xuannan Gen (Daylily Root) added before administration. Four doses resulted in complete cure.
Another patient, after illness, had generalized jaundice and massive hematemesis (Heat stagnating in Yangming). Various medicines failed. Ten snails were washed clean of mud, pounded, exposed overnight, and the clear juice taken at dawn twice or thrice. Bleeding stopped and jaundice healed. (From *Xiaoshan Guaizheng Fang*, *Bencao Gangmu*.)
*Waitai Miyao* treats severe jaundice with a Great Rhubarb Emergency Formula: One egg, shell and all, burned to ash, mixed with one he of vinegar, taken warm. Effect indicated by worms emerging from the nose. For extremely yellow bodies, no more than three eggs are needed; highly effective.
Chai Yuqing treated Lady Jueluo Made, who had carbuncles. Physicians used Yin Chen Wu Ling San without effect, then powdered medicines, causing skin and whites of eyes to turn golden, loss of appetite, and particularly weak and slow Guan pulse on the right. Chai said, "The Stomach is the sea of water and grain; the Spleen is the official of granaries. When organs fail, damp-heat proliferates. Now we must only regulate Earth, enabling robust transportation, so damp-heat leaves naturally. No need to treat jaundice specifically; jaundice will heal itself." He used Liu Jun Zi Tang (Six-Gentlemen Decoction) added with Hou Po and Pao Jiang (Roasted Ginger) to warm the middle, and Shen Qu (Medicated Leaven) and Mai Ya to assist the transformation of Wu and Ji (Stomach and Spleen). Not many doses were needed for full recovery.
Dong Yuan said: In the spring of Wushen year, a sixty-year-old woman suffered from chills and shivering (Taiyang Cold Water pathogen), yawning and sneezing (Shaoyang overflow), dry mouth (Yangming insufficiency), urgent pain and fullness in the heart region (Cold invading Hand and Foot Taiyin, causing pain and stasis-induced fullness), body heat seeking fire (Heat in skin, cold in marrow, causing shivering), cold below navel (Cold in Dantian), generalized jaundice with white sclera yellowing (Cold-dampness, inferred from other symptoms), dark yellow-red frequent urination (Severe cold-dampness). Body heavy as a mountain, lying on bed/pillow (Extreme Yin dampness). Pulse at Guan and Chi/Mingmen was wiry, rapid, extremely fine, mixed with surging and extremely slow. Wiry/rapid/fine indicates Northern Cold Water; surging indicates constrained Heart Fire; slow indicates dampness producing yellow. Left hand pulse firm to bone indicates strong Kidney Qi. Six pulses empty indicate lack of Yang in Lower Jiao. First, mild agents to remove middle-jiao cold-dampness and reduce surging pulse, using Li Zhong Tang plus Poria. Decocted in water, cooled, and taken cold. This is called "treating heat with cold," using false cold to counter false heat of Taiyang. Using pungent-hot Gan Jiang (Dry Ginger) to drain true cold. Thus, "True counters True, False counters False." If not cured, Shu Fu Tang (Atractylodes and Aconite Decoction) cooled and taken cold should be used to tonify Lower Jiao Yuan Qi. (From *Shixiao Fang*, *Yishuo Xubian*.)
Lu Zuyu treated Pan Juyuan, who had a large appetite, ate greedily, and suffered from irregular meals due to labor. He frequently had Spleen/Stomach issues like vomiting or diarrhea, ignoring them, eventually developing jaundice. Yin Chen Wu Ling San was used but symptoms persisted. Irregular diet caused recurrence. A folk remedy of boiling bitter gourd was tried and effective. However, he continued working hard, tried it again, and died with generalized yellowing and drum-like abdomen.
Xue Lizhai treated Grand Commandant Li Puting, while Vice Minister of Ministry of Personnel, who suffered from jaundice. Light-draining agents were appropriate, but he had no heirs and hesitated. He said, "If there is the disease, use the medicine." He used Yin Chen Wu Ling San added with Huang Qin, Huang Lian, and Shan Zhi. Two doses cured him. He had a son in Xinmao year.
Yingtian Wang Zhizhong had generalized jaundice, delirious speech like madness, severe chest pain insensitive to touch. This was Blood Stagnation in Middle Jiao. Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Order the Qi) was used; one dose purged blood stasis and cured him. Also, younger brother of Prefect Zhu Yangshan had lower-body blood stagnation causing madness, cured by Di Dang Tang (Breakthrough Pill).
Ma Yuanyi treated Shen Yuge with jaundice, generalized and facial yellowing, slight blackish stagnation, irritability, thirst, and abdominal fullness. Pulse: left wiry-rapid, right empty-large. This is Internal Injury Jaundice, indicating simultaneous injury to Jueyin Liver Wood and Taiyin Spleen Earth. Liver stagnation generates heat; Spleen stagnation generates dampness. Heat and dampness contend, causing irritability, thirst, fullness, and jaundice. Blackish hue on face indicates Kidney injury. Sweating or purging is incorrect treatment. One should calm Liver hyperactivity, support Spleen deficiency, resolve stagnant heat to clear airways, remove damp-steam to harmonize Qi. He used Ren Shen three qian, Bai Zhu two qian, Bai Shao one qian, Huang Lian and Shan Zhi seven fen, Dang Gui Shen (Angelica Body), Dan Pi, Yin Chen, Qin Jiao each one qian, Chai Hu seven fen, Zhi Gan Cao five fen, Ban Xia Qu (Pinellia Fermented) one qian. Thirty doses cured him.
Gu Fengchang had distant vision yellowing, weak Spleen Qi. Zhongchun prescribed Yin Chen three qian, Ren Shen three qian, Yi Yi Ren (Coix Seed) three qian, Lian Rou (Lotus Seed) three qian, Mu Tong eight fen, Jiu Chao Huang Lian (Wine-stirred Coptis) one qian, Chao Shan Zhi eight fen, Tu Chao Bai Zhu (Earth-stirred Atractylodes) one qian, Jiu Zheng Shi Hu (Wine-steamed Dendrobium) three qian, all jaundice-treating agents. Due to busy affairs, he didn't take them. Soon, body and eyes turned yellow, urine red. He then took Zhongchun's earlier prescription and improved slightly. A masseur used grass-juice medicinal wine, causing Spleen failure and death. Before death, he passed several sheng of blood stasis, also a Blood Stagnation case, due to advanced age and failure to abstain from sexual activity. The previous formula also contained Er Ling Qian (Two-Qian Poria).
Shi Lingxiu's elder brother had jaundice seven years ago, treated with herbal medicine, recovered but relapsed. Sitting too much, excessive Qi usage and labor made herbal medicine ineffective. He drank River Snail Juice for a day and night, causing severe chills and fever, thirst, oily urine, yellow-red eyes, and yellow-purple hands/feet. Zhongchun attributed this to Jaundice from Blood Stagnation. After medication, urination and defecation通畅, jaundice and thirst decreased. Ju Hong (Tangerine Peel) one qian five fen, Chao Hong Qu (Stir-fried Red Yeast Rice) two qian, Shan Zha five qian, Yu Jin Zhi (Curcuma Juice) fifteen spoons, Yi Yi six qian, Mu Gua (Chaenomeles) three qian, Niu Xi (Achyranthes) five fen, Mai Dong five qian, Che Qian (Plantago Seed) two qian five fen, Chi Fu (Red Poria) three qian, Tong Cao (Tetrapanax Pith) five fen, Jiu Chao Bai Shao (Wine-stirred White Peony) four qian, Zhu Ru two qian. Decocted in river water, concentrated to eight parts, taken when hungry. After three days, add Ren Shen three qian. (From *Guang Biji*.)
Wei Yuheng said: Xu Huanwei, over twenty years old, had jaundice. He took Shan Zhi Yin Chen Wu Ling and Liu Yi agents for nearly two months without effect. Pulse: wiry, fine, and rapid. Face, eyes, nails pale yellow, speech slow and fatigued. I told him, "You seek treatment for jaundice, but this is a residual symptom; now the disease has become Consumption/Lao Sun." He startled and said, "Indeed. Recently, restless sleep, evening fever subsiding at dawn, cough with thin phlegm, waist/knee pain. How to treat?" I said, "The disease originates from Yin deficiency with Fire hyperactivity, long-standing Liver Heat stagnation transferring to its conquered element, causing poor appetite and loose stools, manifesting as yellow syndrome. Unlike Wine/Food Jaundice caused by damp-heat steaming, he took bitter-cold draining agents, severely injuring Yin, leading to Consumption. Now, vigorously nourish Liver and Kidney, so cough stops, heat recedes, appetite improves, stools normalize, and jaundice disappears." He took modified Ji Ling Gao (Collect Spirit Paste) for over ten doses. Symptoms gradually receded, jaundice healed.
Jin Luban, over forty, lodged at Physician Tang Jinggong's house, had jaundice, various treatments failed. Seen by several doctors; the last gave a four-herb folk prescription including June Snow (Lysimachia), forgotten the rest. Taking it worsened condition. Pulse: soft, spiritless, slightly rapid. External symptoms: eyes yellow like orange, face/forehead yellow and dark, large abdomen with protruding umbilicus, loose stools, poor appetite, shortness of breath on exertion. Known as Spleen-Kidney Dual Deficiency, close to Nu Lao (Female Labor) syndrome, the most difficult type of jaundice. He was given Shu Di (Rehmannia Prepared) and Shan Yao (Dioscorea Rhizome) each one liang, Gou Qi (Goji Berry), Suan Zao Ren (Ziziphus Seed), Mi Ren (Coix Seed) each five qian. He suspected it was too tonifying and asked Tang. Tang, an old doctor, said, "The formula is excellent, but we usually don't use this. Try it tentatively." One dose reduced symptoms, two doses reduced further. Re-pulse, pulse gradually rose. Continued original formula for eight doses, fully recovered.
Zhu Tianyi, over twenty, liked sweets and dry-roasted pastries, suddenly developed jaundice, face/eyes like gold. Pulse: Guan positions surging, solid, forceful; Chi slippery. Bowel movement absent for 6-7 days, yellow-dry urination. This is Dun Fu (Excessive Accumulation) too much dry-heat. Like white porcelain covering fire, color must be yellow; not a dampness syndrome. He was given Xiao Cheng Qi Tang (Minor Order the Qi Decoction) added with Dang Gui and Bai Shao. One dose led to bowel movement and recovery.
Formula for treating Jaundice: Cang Er Zi (Xanthium Fruit), Bo He (Mint), Mu Tong, Yin Chen Gu three qian. Use one jin of good aged wine, decoct to one wan, mix with three qian Sha Ren (Amomum Cardamom) powder to take. If urine is red like blood water, add Chuan Lian (Coptis) one qian to decoct together.
Pei Zhaoqi said: For diarrhea, dysentery, parasites, malnutrition, edema, alcoholism, and jaundice, once initially cured, one must absolutely not abruptly take tonifying medicines. These syndromes have dampness as the root; tonifying medicines greatly aid damp-heat. Abrupt use causes harm. Once, a Xiaolian from Danghu, a family friend, was rigid and overthinking, often sad without reason. In autumn of Jiawu year, he got jaundice. Though cured, diet couldn't return to normal, meaning Spleen still weak and dampness not cleared. When traveling north for exams, a physician gave him several jin of Tian Wang Bao Xin Dan (Heavenly King Heart-Preserving Pills) as gifts. On the boat, he took them daily without fail. Gradually felt chest oppression, appetite decreased. Entering spring, jaundice relapsed. Upon return, emaciated, skin and bones remaining, abdomen large and stone-hard. When I visited, True Qi was exhausted, nothing could be done. He died ten days later. This is another verification of error in misusing tonics.