色如熏黄，一身尽痛，乃湿病也。色如橘子黄，身不痛，乃疸病也。疸分为五∶
黄汗、黄胆、谷疸、酒疸、女劳疸。
【黄汗】汗出染衣，黄如柏汁是也。问曰∶黄汗之为病，身体肿，（一作强）。发热汗出而渴，
状如风水，汗沾衣，色正黄如柏汁，脉自沉，何从得之？师曰∶以汗出入水中浴，水从汗孔入得之。
宜芍桂酒汤主之。黄汗之病，两胫自冷，假令发热，此属历节。食已汗出，又身常暮盗汗出者，此
劳气也。若汗出已，反发热者，久久其身必甲错。若发热不止者，必生恶疮。若身重，汗出已辄轻者，
久久必身 ，又胸前痛，腰上有汗，腰下无汗，腰髋弛痛，如有物在皮中状，剧者不能食，身疼重，
烦躁，小便不利者，此为黄汗，桂枝加黄 汤主之。按汗出浴水，亦是仲景举一隅耳。多由脾胃有热，
汗出逢闭遏，湿与热 而成者，宜黄 汤。（治阴黄汗染衣，涕唾黄，用蔓菁子捣末，平旦以井花水
服一匙，日再，加至两匙，以知为度。每夜小便中浸少许帛子，各书记日，色渐退白则瘥，不过服五
升而愈。）
【黄胆】食已即饥，遍身俱黄，卧时身体带青带赤，憎寒壮热，此饮食过度，脏腑热，水谷并积
于脾胃，风湿相搏，热气熏蒸而得之。师曰∶病黄胆，发热烦喘，
胸满口燥者，以病发时火劫其汗，两热所得，然黄皆从湿得之，一身发热而黄，肚热，热在里，当下
之。黄胆脉浮而腹中和者，宜汗之，桂枝加黄 汤热服，须臾饮热粥以助药力，取微汗为度，未汗更
服。若腹满欲呕吐，懊 而不和者，宜吐之，不宜汗。黄胆腹满，小便不利而赤，自汗出，此为表和
里实，当下之，宜大黄硝石汤。黄胆病，小便色不变，欲自利，腹满而喘，不可除热，热除必哕，哕
者，小半夏汤主之。黄胆病，茵陈五苓散主之。
【谷疸】食毕即头眩，心中怫郁不安，遍身发黄。趺阳脉紧而数，数则为热，热则消谷；紧则
为寒，食即为满。尺脉浮为伤肾，趺阳脉紧为伤脾。风寒相搏，食谷则眩，谷气不消，胃中苦浊，浊
气下流，小便不通，阴被其寒，热流膀胱，身体尽黄，名曰谷疸。阳明病脉迟者，食难用饱，饱则发
烦，头眩，小便难，此欲作谷疸，虽下之腹满如故，所以然者，脉迟故也。谷疸之为病，寒热不食，
食即头眩，心胸不安，久久发黄为谷疸，茵陈汤主之。续法，谷疸丸、《宝鉴》茵陈栀子汤、红丸子。
【酒疸】身目发黄，则心下懊 而热，不能食，时时欲吐。（足胫满，小便黄，面发赤斑，此因
饥中饮酒，大醉当风入水所致）。夫病酒黄胆者，必小便不利，其候心中热，足下热，是其证也。酒
黄胆者，或无热，静言了了，腹满欲吐，鼻燥，其脉浮者，先吐之；沉弦者，先下之。酒疸，心中热，
欲呕者，吐之即愈。酒疸下之，久久为黑疸，目青面黑，心中如啖蒜韭状，大便正黑，皮肤、爪之不
仁，其脉浮弱，虽黑微黄，故知之。（《三因》白术汤）。酒黄胆，心中懊 ，或热痛，栀子大黄汤
主之。续法，葛根汤、小柴胡加茵陈、豆豉、大黄、黄连、葛根汤。戴云∶饮酒即睡，酒毒熏肺，脾
土生肺金，肺为脾之子，子移病而克于母，故黄。又肺主身之皮肤，肺为酒毒熏蒸，故外发于皮而黄。
法宜合脾肺而治，宜藿枇饮。葛根煎汤，或栀子仁煎汤，调五苓散。或生料五苓散加干葛一钱，或葛
花解酲汤。酒疸发黄，心胸坚满，不进饮食，小便黄赤，其脉弦涩，当归白术汤。酒疸后变成腹胀，
渐至面足俱肿，或肿及遍身，宜藿香脾饮加木香、麦 各半钱。
【女劳疸】额上黑，微汗出，手足中热，薄暮即发，膀胱急，小便自利，（或云小便不利，发热
恶寒，此因过于劳伤，极于房室之后，入水所致）。腹如水状不治。黄家，日晡时发热而反恶寒，此
为女劳得之。膀胱急，少腹满，一身尽黄，额上黑，足下热，因作黑疸。其腹胀如水状，大便黑，或
时溏，此女劳之病，非水也，腹满者难治，硝石散主之。续法，加味四君子汤，（脾气不健，大便不
实者用之）。滑石散，（小便不利者用之）。东垣肾疸汤。
【通治】丹溪云∶五疸不要分，同是湿热，如 曲相似，轻者小温中丸，重者大温中丸。按∶丹
溪之言，已得大意，其用药则未备也。考之《内经》，病有上、中、下之分，有谓目黄曰黄胆者，有
谓黄胆暴病，久逆之所生者，及少阴、厥阴司天之政，四之气，溽暑，皆发黄胆者，悉是上焦湿热病
也。有谓食已如饥曰胃疸者，与脾风发瘅，腹中热出黄者，又脾脉搏坚而长，其色黄者，《灵枢》谓
脾所生病黄瘅，皆中焦湿热病也。有谓溺黄赤，安卧者，黄胆，及肾脉搏坚而长，其色黄者，《灵枢》
谓肾所生病，皆下焦湿热也。独张仲景妙得其旨，推之于伤寒证中，或以邪热入里，与脾湿相交则发
黄。或由内热已盛，复被火者，两阳熏灼，其身亦黄。或
阳明热盛，无汗，小便不利，湿热不得泄亦发黄。或发汗已，身目俱黄者，为寒湿在里不解而黄也。
或食难用饱，饱则头眩，必小便难，欲作谷疸。疸者、单也，单阳而无阴也。成无己释诸黄，皆由湿
热二者相争则黄。湿家之黄，黄而色暗不明；热盛之黄，其黄如橘子色。大抵黄家属太阴，太阴者，
脾之经也。脾属土，黄色，脾经为湿热蒸之，则色见于外。或脉沉小腹不利者，乃血在下焦之黄也。
凡此，必须当其病用其药，直造病所，庶无诛伐无过，夭枉之失也。大法宜利小便，除湿热。脉浮，
腹中和，宜汗。脉浮，心中热，腹满欲吐者，宜吐。脉沉，心中懊 ，或热痛，腹满，小便不利而赤，
自汗出，宜下。脉不浮不沉微弦，腹痛而呕，宜和解。脉沉细无力，身冷而黄，或自汗泄利，小便清
白，为阴黄，宜温。男子黄，大便自利，宜补。饥饱劳役，内伤中州，变寒病生黄，非外感而得，宜
补。治疸须分新久。新病初起，即当消导攻渗，如茵陈五苓散、胃苓饮、茯苓渗湿汤之类，无不效者。
久病又当变法也，脾胃受伤日久，则气血虚弱，必用补剂，如参术健脾汤、当归秦艽散，使正气盛则邪
气退，庶可收功。若口淡怔忡，耳鸣脚软，或微寒热，小便赤白浊，又当作虚治。宜养荣汤或四君子
汤吞八味丸，五味子、附子者，皆可用。不
可过用凉剂强通小便，恐肾水枯竭，久而面黑黄色，不可治矣。然有元气素弱，避渗利之害，过服滋
补，以致湿热愈增者，则又不可拘于久病调补之例也。发汗，桂枝加黄 汤，麻黄醇酒汤。吐，瓜蒂
散、藜芦散、二陈汤探吐。下，栀子大黄汤、大黄硝石汤、黄连散。利小便，五苓散、益元散。除湿
热，茵陈五苓散、茯苓渗湿汤。和解，小柴胡汤。搐鼻，瓜蒂散。温，茵陈附子干姜汤。补，养荣汤、
补中汤、大小建中汤、理中汤。干黄、燥也，小便自利，四肢不沉重，渴而引饮，栀子柏皮汤。湿黄、
脾也，小便不利，四肢沉重，似渴不欲饮者，大茵陈汤。大便自利而黄，有实热者，茵陈栀子黄连三
物汤。无实热者，小建中汤。往来寒热，一身尽黄者，小柴胡加栀子汤。腹痛而呕者，小柴胡汤。诸
疸，小便不利为里实，宜利小便，或下之。无汗为表实，宜发汗，或吐之，吐中有汗。诸疸，小便黄
赤色者为湿热，可服利小便清热渗湿之药。若小便色白，是无热也，不可除热。若有虚寒证者，当作虚
劳治之。故仲景云∶男子黄，小便自利，当与虚劳小建中汤。若欲自利，腹满而喘，不可除热，而除
之必哕，小半夏汤主之。要当详审，勿令误也。海藏云∶内感伤寒，劳役形体，饮食失节，中州变寒病
生黄，非外感而得，只用理中、大、小建中足矣。
不必用茵陈。戴复庵云∶诸失血后，多令面黄。盖血为荣，面色红润者，血荣之也。血去则面见黄色，
譬之竹木，春夏叶绿，遇秋叶黄，润与燥之别也。宜养荣汤、枳归汤、十全大补汤。妨食者，四君子
汤加黄 、扁豆各一钱，即黄 四君子汤。加陈皮名异功散。亦有遍身黄者，但不及耳目。病疟后多
黄，盖脾受病，故色见于面。宜理脾为先，异功散加黄 、扁豆各一钱。诸病后黄者皆宜。黑疸已前
见酒疸、女劳疸二条，此证多死。宜急治，用土瓜根一斤，捣碎绞汁六合，顿服，当有黄水随小便出，
更服之。
【食劳疳黄】（一名黄胖。夫黄胆者，暴病也。故仲景以十八日为期。食劳黄者，宿病也，至有久不
愈者，故另为此条。）大温中丸、小温中丸、暖中丸、枣矾丸。上前三方，以针砂、醋之类伐肝，以术、米之类助脾。
后一方，以矾、醋之酸泻肝，以枣肉之甘补脾。实人及田家作苦之人宜之。若虚人与豢养柔脆者，宜
佐以补剂。
目黄（经云∶目黄者曰黄胆，亦有目黄而身不黄者，故另为条。）
经云∶风气自阳明入胃，循脉而上至目 ，其人肥，风气不得外泄，则为热中而目黄。（烦渴引
饮）。河间青龙散主之。黄胆目黄不除，以瓜蒂散搐鼻取黄水。
【诊】脉沉，渴欲饮水，小便不利者，皆发黄。腹胀满，面痿黄，躁不得睡，属黄家。黄胆之
病，当以十八日为期，治之十日以上宜瘥，反剧为难治。疸病，渴者难治。不渴者，可治。脉洪大，
大便利而渴者死。脉微小，小便利，不渴者生。发于阴部，其人必呕。发于阳部，其人必振寒而发热。
凡黄家，候其寸口脉近掌无脉，口鼻并冷不可治。疸毒入腹喘满者危。凡年壮气实，脉来洪大者易愈。
年衰气虚，脉来微涩者难瘥。年过五十，因房劳饮酒，七情不遂而得，额黑呕哕，大便自利，手足寒
冷，饮食不进，肢体倦怠，服建中、理中、渗湿诸药不效者，不可为也。
The complexion is yellow like that of being smoked, with pain throughout the body; this is a dampness disease (Shi Bing). The complexion is yellow like an orange peel, without body pain; this is jaundice (Dan Bing). Jaundice is divided into five types: Huang Han (Yellow Sweat), Huang Dan (Jaundice), Gu Dan (Grain Jaundice), Jiu Dan (Wine Jaundice), and Nü Lao Dan (Sexual Exhaustion Jaundice).
【Huang Han (Yellow Sweat)】Sweat stains clothes yellow, resembling the juice of Phellodendron bark. Question: In the disease of Huang Han, the body swells (or feels stiff), there is fever, sweating, and thirst; the condition resembles Feng Shui (Wind-Water edema), sweat stains clothes yellow like Phellodendron juice, and the pulse is naturally deep. How is it contracted? The Master said: It is contracted because one bathes in water while sweating, allowing water to enter through the pores. It should be primarily treated with Shaoyao Guiji Tang (Peony and Cinnamon Twig Decoction). Patients with Huang Han disease have naturally cold lower legs; if they feel feverish, this belongs to Li Jie (Migratory Joint Bi). Sweating after eating, along with frequent night sweats in the evening, indicates Lao Qi (Consumptive Qi deficiency). If fever persists after sweating, the skin will eventually become rough and scaly (Jia Cuo). If fever continues indefinitely, malignant sores will surely develop. If the body feels heavy but lightens after sweating, over time the body will... [text missing/variant], accompanied by chest pain, sweating above the waist but none below, flaccid pain in the loins and hips, and a sensation as if something is in the skin. In severe cases, inability to eat, body pain and heaviness, irritability, and difficult urination indicate Huang Han, which should be treated with Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction plus Astragalus). Note: Bathing in water while sweating is merely an example cited by Zhang Zhongjing to illustrate other scenarios. Most cases arise from heat in the Spleen and Stomach, where sweating is blocked by wind-cold, causing dampness and heat to combine. Huangqi Tang (Astragalus Decoction) is suitable. (For Yin Huang Han staining clothes, with yellow nasal discharge and saliva, use crushed Verbenaceae seeds taken with well water at dawn, starting with one spoon twice daily, increasing to two spoons until effective. Soak a cloth piece in urine nightly, recording dates; when the color fades to white, recovery occurs, usually within five sheng.)
【Huang Dan (Jaundice)】Feeling hungry immediately after eating, with yellowing of the entire body, bluish or reddish discoloration during sleep, aversion to cold, and high fever. This results from excessive diet causing internal organ heat, accumulation of food and fluids in the Spleen and Stomach, and the struggle between Wind-Dampness, leading to steaming heat. The Master said: In Jaundice with fever, irritability, panting, chest fullness, and dry mouth, it is caused by using fire therapy to force sweating during onset, combining external and internal heat. However, jaundice generally stems from dampness. With whole-body fever and yellowing, abdominal heat, and interior heat, purgation is indicated. If the pulse is floating and the abdomen is harmonious, diaphoresis is indicated; treat with Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction plus Astragalus) hot, followed by warm millet porridge to assist the medicinal power, aiming for slight sweating. Repeat if no sweat. If there is abdominal fullness, desire to vomit, and mental restlessness, emesis is indicated, not diaphoresis. In Jaundice with abdominal fullness, difficult and dark urination, and spontaneous sweating, the exterior is resolved and the interior is excess; purgation is indicated, preferably Dahuang Xiaoshi Tang (Rhubarb and Nitro Stone Decoction). If the urine color remains unchanged, there is a desire for diarrhea, abdominal fullness, and panting, clearing heat is contraindicated; clearing heat will cause hiccups, which should be treated with Xiaobanxia Tang (Minor Pinellia Decoction). Yinyin Wuling San (Yinchen and Five-Ingredient Poria Decoction) is also indicated for Jaundice.
【Gu Dan (Grain Jaundice)】Dizziness immediately after eating, mental depression and unease, and generalized yellowing. The Fuyang pulse is tight and rapid; rapidity indicates heat, which digests food quickly; tightness indicates cold, causing fullness after eating. A floating Chi pulse indicates Kidney injury; a tight Fuyang pulse indicates Spleen injury. Wind-Cold struggles, causing dizziness upon eating; grain qi fails to digest, causing turbidity in the Stomach. Turbid qi flows downward, blocking urination. Cold affects the Yin, while heat flows to the Bladder, causing whole-body yellowing, named Grain Jaundice. In Yangming disease with a slow pulse, one cannot eat to satiety; fullness causes irritability, dizziness, and difficult urination, indicating impending Grain Jaundice. Even if purged, abdominal fullness remains due to the slow pulse. For Grain Jaundice with alternating chills and fever, anorexia, dizziness after eating, and chest discomfort, prolonged yellowing confirms the diagnosis; Yinyin Tang (Yinchen Decoction) is indicated. Subsequent methods include Gu Dan Wan (Grain Jaundice Pill), Baojian Yinzhi Zizi Tang (Treasure Mirror Yinchen, Gardenia, and Phellodendron Decoction), and Hong Wanzi (Red Pills).
【Jiu Dan (Wine Jaundice)】Yellowing of the body and eyes, mental restlessness and heat in the epigastrium, anorexia, and frequent desire to vomit. (Swollen calves, yellow urine, and red facial spots result from drinking on an empty stomach, getting drunk, and exposing oneself to wind and water.) Patients with Wine Jaundice invariably have difficult urination; their signs include heat in the heart and heat under the feet. Some cases present without heat, with clear consciousness, abdominal fullness, desire to vomit, and dry nose; if the pulse is floating, induce vomiting first; if deep and wiry, purge first. For Wine Jaundice with heart heat and desire to vomit, vomiting leads to cure. Purging Wine Jaundice may lead to Hei Dan (Black Jaundice) over time, characterized by blue-black eyes, black face, a sensation of having eaten garlic and leeks in the heart, black stool, numbness of skin and nails, and a floating-weak pulse; though black, the faint yellow hue identifies its origin. (Baizhu Tang from San Yin Fang). For Wine Jaundice with mental restlessness or painful heat, Zhizi Dahuang Tang (Gardenia and Rhubarb Decoction) is indicated. Subsequent methods include Gegen Tang (Kudzu Decoction), Xiao Chaihu Tang modified with Yinchen, Douchi, Dahuang, Huanglian, and Gegen. Dai Yun stated: Sleeping immediately after drinking allows wine toxin to fumigate the Lung. Since Spleen Earth generates Lung Metal, and the Lung is the child of the Spleen, the child's disease attacks the mother, causing yellowing. As the Lung governs the skin, wine toxin fumigation manifests externally as yellowing. Treatment should address both Spleen and Lung; Huopi Yin (Litsea and Loquat Drink) is suitable. Gegen decoction or Zhiren decoction can be used to mix with Wuling San. Or Shengliao Wuling San plus Gan Ge (Dried Kudzu Root) 1 qian, or Gehua Jie Cheng Tang (Kudzu Flower Relieving Intoxication Decoction). For Wine Jaundice with hard, full chest, anorexia, yellow-red urine, and wiry-choppy pulse, Danggui Baizhu Tang (Angelica and Atractylodes Macrocephala Decoction) is indicated. If Wine Jaundice progresses to abdominal distension, swelling of face and feet, or generalized edema, Huoxiang Pi Yin (Agastache and Spleen Harmonizing Drink) plus Muxiang and Maidong 0.5 qian each is suitable.
【Nü Lao Dan (Sexual Exhaustion Jaundice)】Black forehead, slight sweating, heat in hands and feet occurring at dusk, urgency of the Bladder, and free urination (some say difficult urination, fever, and aversion to cold, resulting from excessive sexual exertion followed by water exposure). Abdominal distension resembling fluid retention is incurable. Jaundice patients who feel feverish in the late afternoon but are averse to cold contract this from sexual exhaustion. Urgency of the Bladder, fullness of the lower abdomen, whole-body yellowing, black forehead, and heat under the feet constitute Black Jaundice. Abdominal distension like water, black stool, or occasional loose stools indicate this is Nü Lao disease, not fluid retention. Abdominal fullness is difficult to treat; Xiaoshi San (Nitro Stone Powder) is indicated. Subsequent methods: Jiawei Sijunzi Tang (Modified Four Gentlemen Decoction) for weak Spleen Qi and loose stools; Huashi San (Talcum Powder) for difficult urination; Dongyuan Shendan Tang (Dongyuan Kidney Jaundice Decoction).
【General Treatment】Zhu Danxi said: Do not distinguish among the five jaundices; they are all Damp-Heat, similar to fermentation. Mild cases use Xiaowenzhong Wan (Minor Warm Middle Pill); severe cases use Dawenzhong Wan (Major Warm Middle Pill). Note: Danxi grasped the general principle, but his medication was incomplete. Examining the Neijing, diseases are divided into Upper, Middle, and Lower. Yellow eyes are called Huang Dan. Sudden Huang Dan arises from long-standing rebellion of Qi. During the governance of Shaoyin and Jueyin, in the fourth Qi period of humid summer, Huang Dan occurs; these are all Upper Jiao Damp-Heat diseases. Feeling hungry after eating is called Wei Dan. Spleen Wind causing Dan, heat in the abdomen with yellow excretion, and a firm-long Spleen pulse with yellow complexion described in Ling Shu as Spleen diseases causing Huang Dan, are all Middle Jiao Damp-Heat diseases. Yellow-red urine and lethargy indicate Huang Dan; a firm-long Kidney pulse with yellow complexion described in Ling Shu as Kidney diseases, are all Lower Jiao Damp-Heat. Only Zhang Zhongjing perfectly understood this, applying it to Taiyang diseases: Heat entering the interior interacting with Spleen Dampness causes yellowing; or intense internal heat combined with fire therapy causes double yang scorching and yellowing; or Yangming heat excess with no sweat and difficult urination prevents Damp-Heat drainage, causing yellowing; or post-sweating whole-body yellowing indicates unresolved Cold-Damp in the interior; or inability to eat to satiety, dizziness, and difficult urination indicate impending Grain Jaundice. "Dan" means single, implying Yang alone without Yin. Cheng Wuji explained that all yellows result from the struggle between Dampness and Heat. Dampness-type yellow is dull and obscure; Heat-excess yellow is bright like an orange. Generally, Jaundice belongs to Taiyin, the Spleen meridian. Spleen corresponds to Earth and the color Yellow; steamed by Damp-Heat, the color appears externally. Deep pulse with lower abdominal difficulty indicates Blood stasis in the Lower Jiao causing yellowing. One must match medicine to disease to reach the pathology directly, avoiding unjustified attack and premature death. The general method favors promoting urination to remove Damp-Heat. Floating pulse with harmonious abdomen: Diaphoresis. Floating pulse with heart heat and abdominal fullness/desire to vomit: Emesis. Deep pulse with mental restlessness/painful heat, abdominal fullness, difficult dark urination, and spontaneous sweating: Purging. Non-floating, non-deep, slightly wiry pulse with abdominal pain and vomiting: Harmonizing. Deep-thin-weak pulse with cold body and yellowing, or spontaneous sweating/diarrhea with clear urine: Yin Jaundice, requires warming. Male Jaundice with free stool: Tonification. Injury from hunger/fullness/labor damaging the Middle Jiao, transforming into Cold disease causing Jaundice (not external contraction): Tonification. Differentiate new vs. old Jaundice. New onset: Resolve and drain, e.g., Yinyin Wuling San, Weiling Yin, Fuling Shen Shi Tang. Old disease: Change method. Long-term Spleen/Stomach injury leads to Qi/Blood deficiency; tonics like Shenbai Jianpi Tang or Danggui Qinjiao San are needed to strengthen Zheng Qi and retreat Xie Qi. If mouth bland, palpitations, tinnitus, weak legs, mild chills/fever, or turbid urine, treat as Deficiency: Yangrong Tang or Sijunzi Tang swallowing Bawei Wan, Wuzi, or Fuzi are usable. Do not overuse cold herbs to force urination, lest Kidney Water dry up, leading to incurable black-yellow complexion. However, those with weak Yuan Qi avoiding draining harm but overusing tonics, increasing Damp-Heat, do not strictly follow the "tonify old disease" rule. Diaphoresis: Guizhi Jia Huangqi Tang, Mahuang Chunjiu Tang. Emesis: Goudi San, Lili San, Erchen Tan inducing emesis. Purging: Zhizi Dahuang Tang, Dahuang Xiaoshi Tang, Huanglian San. Promoting urination: Wuling San, Yiyuan San. Removing Damp-Heat: Yinyin Wuling San, Fuling Shen Shi Tang. Harmonizing: Xiao Chaihu Tang. Nasal insufflation: Goudi San. Warming: Yinyin Fuzi Ganjiang Tang. Tonifying: Yangrong Tang, Buzhong Tang, Da/Xiao Jianzhong Tang, Lizhong Tang. Dry Jaundice (Dryness): Free urination, limbs not heavy, thirst with desire to drink; Zhibi Bapi Tang (Gardenia, Phellodendron, and Licorice Decoction). Damp Jaundice (Spleen): Difficult urination, heavy limbs, apparent thirst without desire to drink; Dayin Chen Tang (Major Yinchen Decoction). Free stool with yellowing and Excess Heat: Yinzhi Huanglian Sanwu Tang (Yinchen, Gardenia, Coptis Three-Ingredient Decoction). No Excess Heat: Xiao Jianzhong Tang. Alternating chills/fever with whole-body yellowing: Xiao Chaihu Tang plus Zhizi. Abdominal pain and vomiting: Xiao Chaihu Tang. All Jaundices with difficult urination indicate Interior Excess; promote urination or purge. No sweat indicates Exterior Excess; diaphoresis or emesis (which induces sweat). Yellow-red urine indicates Damp-Heat; take diuretics clearing heat and draining dampness. White urine indicates no Heat; do not clear heat. Deficient-Cold signs require treating as Xu Lao (Deficiency Consumption). Thus, Zhongjing said: Male Jaundice with free urination should receive Xu Lao Xiao Jianzhong Tang. Desire for diarrhea with abdominal fullness/panting: Do not clear heat; clearing causes hiccups, treated with Xiaobanxia Tang. Examine carefully to avoid error. Haizang said: Internal contraction of Shanghan, physical labor, irregular diet damaging Middle Jiao, transforming into Cold causing Jaundice (not external): Lizhong, Da/Xiao Jianzhong are sufficient; no need for Yinchen. Dai Funan said: Post-hemorrhage often causes yellow face. Blood nourishes the complexion; loss of blood reveals yellow, like leaves turning yellow in autumn compared to green in spring (moisture vs. dryness). Use Yangrong Tang, Zhi Gui Tang, Shiquan Dabu Tang. If appetite is poor, Sijunzi Tang plus Huangqi and Bian Dou 1 qian each (Huangqi Sijunzi Tang). Add Chenpi for Yigong San. Generalized yellowing sparing eyes/ears: Treat Spleen first, Yigong San plus Huangqi and Bian Dou 1 qian each. Suitable for post-malaria yellowing too. Black Jaundice: See Wine and Nü Lao sections; prognosis is poor. Treat urgently with Tugua Gen (Trichosanthes Kirilovii Root) 1 jin, crushed and juiced, taken at once; yellow fluid should pass via urine, repeat dosing.
【Shi Lao Gan Huang (Food/Labor Malnutrition Jaundice)】(Also known as Huang Pang/Yellow Puffiness. Huang Dan is acute, limited to 18 days by Zhongjing. Shi Lao Huang is chronic, sometimes lingering, hence this separate section.) Dawenzhong Wan, Xiaowenzhong Wan, Nuanchong Wan, Zaofan Wan. The first three use Zhen Sha (Needle Sand) and Vinegar to subdue Liver, and Zhu (Atractylodes) and Rice to assist Spleen. The last uses Alum/Vinegar acid to drain Liver and Jujube flesh sweetness to tonify Spleen. Suitable for robust individuals and manual laborers. For deficient or delicate individuals, add tonics.
【Mu Huang (Eye Jaundice)】(Classic says: Eye yellow is Huang Dan. Some have yellow eyes but no body yellow, hence separate section.) Classic: Wind-Qi enters Stomach via Yangming, travels up to the eye corner. In obese individuals, Wind-Qi cannot escape, causing Heat-Zhong and eye yellowing (with irritability/thirst). Hejian Qinglong San (Green Dragon Powder) is indicated. For persistent Jaundice eye yellowing, use Goudi San (Melon Tip Powder) nasal insufflation to extract yellow fluid.
【Diagnosis】Deep pulse, thirst with desire to drink, and difficult urination all indicate yellowing. Abdominal fullness, sallow face, irritability preventing sleep belong to Huang Jia (Jaundice Family). Huang Dan has an 18-day course; curing within 10 days is good, worsening is difficult. Thirsty Jaundice is difficult; non-thirsty is curable. Large pulse, free stool, and thirst indicate death. Tiny pulse, free urination, and non-thirst indicate survival. Manifesting in Yin parts causes vomiting; manifesting in Yang parts causes chills and fever. If Cun Kou pulse near palm is absent and nose/mouth are cold, it is incurable. Jaundice toxin entering abdomen with panting/fullness is critical. Robust youth with large pulse recovers easily. Elderly with weak Qi and thin-choppy pulse heals slowly. Over 50 years old, contracting from sexual fatigue/alcohol/emotional stagnation, with black forehead, vomiting/hiccups, free stool, cold limbs, anorexia, fatigue, unresponsive to Jianzhong, Lizhong, or damp-draining drugs, is incurable.