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[Pulse]
The pulse is mostly deep and rapid. Accompanied by thirst with desire to drink water and difficult urination, these conditions all lead to jaundice. If the pulse is floating and tight, it is due to sudden heat exposure followed by immersion in cold water, causing heat to stagnate in the chest. The whole body, face, and eyes appear golden yellow; this condition is named Jaundice (Huang Dan). If the pulse is tight and rapid, it is due to fever while hungry or stomach injury from overeating, leading to abdominal fullness after eating; this is named Grain Jaundice (Gu Dan). In Yangming disease, if the pulse is slow, it indicates difficulty in tolerating a full meal; feeling vexed and dizzy after eating, along with difficult urination, suggests impending Grain Jaundice. If the pulse is deep and wiry, or tight and fine, it is due to heat in the blood vessels from alcohol consumption, combined with wind invasion and contact with cold water, resulting in inner restlessness, mental irritability, and hot soles of the feet; this is named Wine Jaundice (Jiu Dan). For Wine Jaundice with a floating pulse, emesis should be induced first; for those with a deep and wiry pulse, purgation should be used first.

If the cun pulse (distal radial pulse) is faint and weak, a faint pulse indicates aversion to cold, while a weak pulse indicates fever. Failure to induce sweating when indicated leads to joint pain; failure to experience vexation when expected results in profuse sweating. The Yuyang pulse (dorsalis pedis artery) is slow and delayed, indicating excessive stomach qi. Fullness and vexation occur after eating; fullness generates heat. Exogenous heat consumes grain essence, causing hunger shortly after eating. Despite strong grain essence, muscles become emaciated; this is named Grain Jaundice. A tight chi pulse (proximal radial pulse) indicates kidney injury; a tight Yuyang pulse indicates spleen injury. Wind-cold pathogens combine, causing dizziness after eating. Grain qi fails to digest, turbid qi in the stomach flows downward obstructing urination. Yin is affected by cold, while heat flows into the bladder, causing the entire body to turn yellow; this is named Grain Jaundice. If the pulse is floating and tight, it is due to extreme heat immediately followed by water contact. Kidney qi is deficient, allowing dampness to flow to the spleen. The forehead turns black, there is afternoon fever (during Shen hour), lower abdominal urgency, hot soles, black stool that is occasionally loose; this is named Female Labor Jaundice (Nv Lao Dan). Abdominal distension resembling fluid accumulation is difficult to treat.

[Symptoms]
The *Neijing* states: "The central direction corresponds to yellow and connects to the Spleen." In Jaundice, the muscles are necessarily swollen and flaccid with yellowish discoloration. This is because damp-heat accumulates and stagnates within the Spleen and Stomach, persisting for a long time, thus manifesting the earth element's color externally. Since the Spleen governs muscles and the Lung governs skin and hair, the mother organ (Spleen) can cause deficiency in the child organ (Lung); when the mother is diseased, the child is also affected. Zhu Danxi stated: "There is no need to distinguish among the five types of jaundice; they are all caused by damp-heat, similar to fermentation in a starter culture." If there is exogenous Shaoyang/Taiyang heat, with excess pathology in the yang aspect internally, purgation is indicated but not performed, sweating is indicated but not performed, and diuresis is indicated but not performed. Consequently, damp-heat becomes severely constrained internally, all of which can cause yellowing of the body.

[Therapeutic Methods]
Although the disease has five classifications, they are essentially all damp-heat. Treatment should focus on promoting diuresis to drain dampness and clearing heat. Wuling San (Five-Ling Decoction) can be used, adding herbs such as Yinchen (Artemisiae Scopariae Herba) and Huanglian (Coptidis Rhizoma). For food stagnation, purge according to the patient's deficiency or excess. For other cases, simply promote urination; once urination is smooth, jaundice will naturally recede. For pathogenic factors located in the upper jiao, inducing sweating is particularly appropriate.

[Formulas]
Yinchen Wuling San (Artemisia Five-Ling Decoction): Treats jaundice caused by damp-heat.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma, 2 qian), Fuling (Poria, 1.5 qian), Zhuling (Polyporus, 1 qian), Zexie (Alismatis Rhizoma, 1 qian), Guizhi (Cinnamomi Ramulus, 0.8 qian), Yinchen (Artemisiae Scopariae Herba, 3 qian).
Preparation: Combine as one dose. Add three slices of Shengjiang (Zingiberis Rhizoma Recens), one Zao (Jujubae Fructus), and a small ball-sized amount of Dengxincao (Junci Medulla). Decoct and take orally.

Modifications:
For severe dampness: Add Cangzhu (Atractylodis Rhizoma, 2 qian), Houpo (Magnoliae Officinalis Cortex, 1 qian).
For severe heat: Add Huanglian (Coptidis Rhizoma, 1.5 qian), Shanzhi (Gardeniae Fructus, 1 qian).
For severe phlegm: Add Banxia (Pinelliae Rhizoma, 1.5 qian), Zhishi (Aurantii Fructus Immaturus, 1 qian), or use emetic therapy.
For food stagnation: Add Shanzha (Crataegi Fructus), Shenqu (Massa Medicata Fermentata), Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma) (each 1.5 qian), plus Zhen Sha (Ferrum Oxydatum Rubrum) and Zhishi (each 1 qian, processed into pills for better effect).
For Wine Jaundice: Add Gegen (Puerariae Lobatae Radix), Huanglian (each 1.5 qian), Yujin (Curcumae Longae Rhizoma), Shigao (Gypsum Fibrosum, each 1 qian).
For Grain Jaundice: Add Houpo (Magnoliae Officinalis Cortex), Zhishi (Aurantii Fructus Immaturus), Zhizi (Gardeniae Fructus) (each 1 qian), Dahuang (Rhei Radix et Rhizoma, 2.5 qian).
For Spleen-Stomach disharmony with yellow edema and red, scanty urine: Add Huashi (Talcum, 1.5 qian), Houpo (Magnoliae Officinalis Cortex), Cangzhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium) (each 1 qian).
For Kidney Jaundice with yellow eyes and red, scanty urine: Add Huangbai (Phellodendri Cortex), Cangzhu (Atractylodis Rhizoma) (each 1.5 qian), Guizhi (Cinnamomi Ramulus, 0.5 qian).
For Jaundice with deep, fine, and slow pulse, cold extremities, and cold sweat above the waist: Use this base formula, remove Zhuling (Polyporus) and Zexie (Alismatis Rhizoma), add Ganjiang (Zingiberis Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata) (each 1.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 qian).
For jaundice with wheezing: Add Sangbaipi (Mori Cortex), Huangqin (Scutellariae Radix) (each 1.5 qian), Tinglizi (Descurainiae Semen Lepidii et Lepidii Semen, fried, 1 qian).
For jaundice due to blood stasis: Add Danggui (Angelicae Sinensis Radix).
For various jaundices where urination is free and there is no thirst: Add Huangqi (Astragali Radix), Guizhi (Cinnamomi Ramulus), Baishaoyao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma) (reduce dosage of others to half, keep remaining ingredients in equal proportions), remove Zhuling (Polyporus) and Zexie (Alismatis Rhizoma).
For various jaundices with difficult urination and thirst: Add Maimendong (Ophiopogonis Radix), Shanzhi (Gardeniae Fructus), Mutong (Akebiae Caulis) (each 1.5 qian), Huashi (Talcum, 1 qian).
The treatment for women and children with various jaundices is the same; adults should modify dosages accordingly.