大意
中央黄色。入通于脾。（内经）故黄胆多属太阴湿土脾不能胜湿。复挟火热。则郁而生黄。（必读）
内因
发黄譬如 曲相似。多因饮食劳倦。致伤脾土。不能运化。湿热内蓄。无由发泄。流于脾肉。遍于四肢。凡郁
郁不得志之人。多生此病。（指掌）是脾虚为本。湿热为标。当于标本缓急审之。（三锡）
外候
湿热熏蒸。土气洋溢。面目爪甲身体俱黄。外则肌肉微肿。一身尽痛。内则胸腹满闷。嗳气不舒。日晡潮热。
四肢倦怠。大便去而不快。小便赤而短少。或溺出沾衣。犹如柏染。（汇补）
疸分干湿
干黄热胜。色黄而明。大便燥结。湿黄湿胜。色黄而晦。大便润利。（入门）
疸分阴阳
诸疸发于阴经。必呕恶。发于阳经。必寒热。（汇补）
疸分难易
疸症口渴。其病难治。疸而不渴。其病易治。又焦黄难治。淡黄易治。其壮年气盛。脉大。易治。老人气弱。脉微。
难治。（汇补）
黄汗
黄汗者。汗出染衣。色如熏黄。身肿且痛。虽发热而不渴。暮则烦躁不眠。因脾热汗出。入水澡浴。为风所闭。
热留皮肤所致。属表症。宜解热湿。和其荣。用丁香 鼻法。 去黄水。自愈。（汇补）
黄胆
黄胆者。小溺面目牙齿指甲肢体皆黄。食已善饥。安卧懒动。憎寒壮热。日晡转甚。因脏腑不和。水谷相并。
湿热蒸郁。邪留胃中。复为风热所搏。结滞不散。内蒸外郁。病属里症。便闭者。攻之。溺涩者。利之。二便利者。
清解之。（汇补）
谷疸
谷疸者。发寒热。不能食。食已头眩。腹胀不安。心烦怫郁。右关脉滑。因胃热大饥。因而过食。停滞中脘。病属
中焦。宜先去水谷之积滞。次解脾胃之郁热。（汇补）
酒疸
心胸懊 。欲吐不食。腹如水状。足心热。足胫满。小便黄。眼黄鼻燥。面发赤斑。因大醉当风。毒留清道。病属
上焦。脉浮洪者。当探吐。设或误下。邪陷肾中。变成黑疸。面黑目青。如啖蒜齑。大便黑。肤粗燥。其脉微弱者。
不治。（汇补）
女劳疸
女劳疸者。黄如灰色。额黑头汗。手足心热。薄暮不发热。日反恶寒。小腹急满。小便不利。大便时溏。腹胀如
水状。类黑疸。因过于劳伤。又于大热之中。犯房入水所致。病属下焦。非水气也。宜培脾肾。若腹满多渴者。
难治。（汇补）
虚黄
虚黄口淡怔忡。耳鸣脚软。怠惰无力。寒热微作。小便浊涩。皮肤虽黄。而爪甲如常。此劳倦太过。气血俱虚。
不可妄用凉药。宜调中培土。若面色青黄。小便自利。谓之木胜于土。中走于外。又宜培脾抑肝。（汇补）
阴黄
阴黄者。四肢清冷。自汗泄利。小便清白。身不发热。脉沉而迟。乃脾肾虚损所致。宜温补。亦有过服寒凉。变
成阴症。身目俱黄。肤冷胃疼。眼涩不开。大便自利者。茵陈附子干姜汤。（汇补）
疸兼杂症
黄胆初起。多兼杂症。如风症色黄带青。寒症色黄带黯。暑症色黄带赤。瘀血发黄。喜忘如狂。溺清便黑。食
积发黄。恶食噫气。胸满腹胀。又有瘀热入心发黄者。有痰火入肺发黄者。不拘外感内伤。怫郁不舒。皆能
成疸。（入门）
死症
凡疸以十八日为期。治之十日以上为瘥。如寸口近掌处无脉。口鼻皆冷。泄利呕哕。胃气已脱者死。环口
黧黑。汗出如油。脾气已绝者死。面见黑色。摇头直视者死。疸毒冲心。如狂喘满。腹胀气短者死。脉微小有
神。小便利而不渴者生。口渴者死。其云十八日为期者。此指真黄而言。若脾虚面黄。不在此例。（汇补）
脉法
五疸实热。脉必洪数。虚小微涩。症属虚弱。脉浮可吐。脉沉可下。脉洪泄利而渴者死。脉小泄利不渴者生。
入腹胀满。脉弦硬者凶。（汇补）
治法
疸病总以清热导湿为主。若病久脾胃衰薄者。当补中。（必读）
治禁苦寒
疸属脾胃。不可骤用凉药伤胃。必佐以甘温。君以淡渗。则湿易除。而热易解。若纯用苦寒。重伤脾肾。轻则
呕哕下利。重则喘满腹胀。（汇补）
久宜温补
疸属虚损。宜温补肾肝。真阳之气一升。而邪火自敛。若疸用茵陈。必利小便。枯竭肝津肾水。则强病幸痊。
而雀目肿胀又作。（入门）若面黄而黑。下有遗溺者。不治。（汇补）
用药
主以胃苓汤。茯苓渗湿汤。溺涩。加木通。食积。加山楂。属虚者。培脾。用四君子汤。补肾。八味丸。阴黄。理
中汤。平肝。建中汤。
验死生法
用二指重按病患胸前膻中穴。二指左右分开。中间有血色者。可治。无血色者。不治。
黄病选方
茯苓渗湿汤 治湿热发黄。口渴溺涩。少食少卧。
茵陈（七分） 茯苓（六分） 泽泻 猪苓 白术 苍术 陈皮 黄连 山栀 秦艽 防己 葛根（各四分） 灯
心草
水煎。
胃苓汤 治脾胃不和。倦怠食少。
苍术（中） 浓朴（中） 陈皮（上） 甘草（下） 泽泻（中） 茯苓（上）
猪苓（下）
加味五苓散 治寒湿发黄。
白术（上） 茯苓（上） 猪苓（下） 泽泻（中） 肉桂（下） 茵陈（中） 干姜（中） 浓朴
理中丸 治阴黄为病。（方见中寒）
黄 建中汤 治虚黄。（方见汗病）
加味四君子汤 治女劳疸。
即四君子加黄 、白芍、扁豆。水煎。
茵陈干姜附子汤（宝鉴） 治寒湿虚黄。
附子（三钱炮） 干姜（二钱炮） 茵陈（一钱二分） 茯苓（五分） 草豆蔻（一钱煨） 枳壳 半夏 泽泻（各
五分） 白术（四分） 陈皮（三分）
水煎。
补中益气汤 加茵陈、栀子、猪苓、泽泻、黄连、滑石、赤苓。
地黄丸 加苍术、白术、茵陈、酒炒黄柏。
汤丸二药。早晚兼进。又当服绿矾丸更效。二方皆治虚疸。
针砂丸（秘方） 治黄胆积块。久而不愈。
猪苓 泽泻 白术 赤苓（各五钱） 苍术 砂仁 香附 浓朴（各二两） 三棱 莪术 乌药 茵陈 草果 针
砂（醋炒七次各一两） 木香 青皮 陈皮（各七钱）
上为末。老酒打糊丸。梧子大。每服七十丸。忌食鸡、鱼。
硝石矾石散 治女劳疸。
硝石 矾石（各炒研等分）
为末。大麦粥汁调服二钱。一方。用滑石。不用硝石。
治方 用生姜二斤。捣烂煎汤。于无风处洗浴。令遍身汗出如雨。后用高良姜根捣汁服之。令其或吐或
下。行一二次即愈。又方。用大芫荽捣汁酒服。三朝即愈。又方。用绿矾不拘多少。炒至白色。为末。煮
枣肉丸。如樱桃大。每服七丸。早午晚各一服。黄酒送下。忌醋生冷发物。或有虫。即吐出。如神。
[General Principle]
Yellow corresponds to the Central direction, and its qi internally connects with the Spleen (Zang-organ). (From *Neijing*) Therefore, Jaundice (Huangdan) mostly belongs to the category of Taiyin Damp-Earth, where the Spleen fails to overcome dampness. If it is further complicated by Fire-Heat, stagnation occurs leading to jaundice. (From *Bidu*)
[Etiology: Internal Factors]
The yellowing of the body is similar to the fermentation of Qu (yeast starter). It is mostly caused by improper diet and overexertion, which damage the Spleen Earth, impairing transportation and transformation. Damp-Heat accumulates internally without an outlet, flowing into the muscles governed by the Spleen and spreading to the four limbs. Individuals who are often depressed or frustrated are prone to this disease. (From *Zhizhang*) This condition has Spleen Deficiency as the root and Damp-Heat as the branch; treatment should be based on prioritizing either the root or the branch according to urgency. (From *Sanxi*)
[External Manifestations]
Damp-Heat steaming and steaming causes the Qi of Earth to overflow, resulting in yellowing of the face, eyes, nails, and whole body. Externally, there is slight muscle swelling and generalized body pain; internally, there is chest and abdominal fullness, belching with discomfort, tidal fever in the late afternoon (Ribu), fatigue in the four limbs, incomplete defecation, and dark, scanty urine that may stain clothes like cypress dye. (From *Huibu*)
[Classification: Dry vs. Wet Jaundice]
Dry Jaundice is characterized by excess Heat, presenting with bright yellow skin and dry, constipated stool. Wet Jaundice is characterized by excess Dampness, presenting with dull yellow skin and loose, slippery stool. (From *Rumen*)
[Classification: Yin vs. Yang Jaundice]
Jaundice originating from Yin meridians must present with vomiting and nausea; jaundice originating from Yang meridians must present with aversion to cold and fever. (From *Huibu*)
[Prognosis: Difficulty vs. Ease]
Jaundice patients who feel thirsty have difficult-to-treat conditions; those without thirst have easy-to-treat conditions. Furthermore, scorched-yellow color is difficult to treat, while pale yellow is easy to treat. Young adults with robust Qi and large pulses are easy to treat; the elderly with weak Qi and faint pulses are difficult to treat. (From *Huibu*)
[Yellow Sweat]
Yellow Sweat syndrome involves sweat staining clothes yellow like smoked yellow, accompanied by body swelling and pain. Although there is fever, there is no thirst. In the evening, there is irritability and insomnia. This is caused by Spleen Heat inducing sweating, followed by bathing in water which closes the pores due to Wind, trapping Heat in the skin. This belongs to Exterior Syndromes. Treatment should focus on resolving Heat and expelling Dampness, harmonizing Ying and Wei. Use Dingxiang Bi Fa (Clove Nasal Therapy) to remove yellow fluid, and it will heal spontaneously. (From *Huibu*)
[Yellow Jaundice / Huangdan]
Huangdan involves scanty urination, and yellowing of the face, eyes, teeth, nails, and limbs. The patient feels hungry after eating but lies still and lacks energy, experiencing aversion to cold and high fever that worsens in the late afternoon. This is due to disharmony of the Zang-Fu organs, mixing of water and grain, steaming and stagnation of Damp-Heat, pathogenic factors remaining in the Stomach, and being combated by Wind-Heat, leading to stagnation. Internally steaming and externally stagnating, this belongs to Interior Syndromes. If stool is constipated, use purgation; if urination is obstructed, use diuresis; if both are free, use clearing and resolving methods. (From *Huibu*)
[Grain Jaundice / Gu Dan]
Gu Dan presents with chills and fever, inability to eat, dizziness after eating, abdominal distension and discomfort, mental restlessness and depression, and a slippery pulse at the right Guan position. It is caused by Stomach Heat leading to extreme hunger, followed by overeating, causing food stagnation in the Zhongwan area. This belongs to Middle Jiao pathology. Treatment should first eliminate food and fluid stagnation, then resolve Spleen and Stomach heat stagnation. (From *Huibu*)
[Wine Jaundice / Jiu Dan]
Jiu Dan presents with chest and heart oppression and distress, desire to vomit but unable to, abdominal distension resembling water accumulation, hot soles of feet, swollen calves, yellow urine, yellow eyes, dry nose, and red spots on the face. It is caused by drinking heavily in the wind, leaving toxins in the clear pathways. This belongs to Upper Jiao pathology. If the pulse is floating and surging, induce vomiting. If mistakenly treated with purgatives, pathogens sink into the Kidney, transforming into Black Jaundice (Hei Dan), presenting with black face, blue around eyes, appearance like eating minced garlic, black stool, rough dry skin, and faint pulse, which is incurable. (From *Huibu*)
[Sexual Exhaustion Jaundice / Nv Lao Dan]
Nv Lao Dan presents with grayish-yellow skin, black forehead, sweating only on the head, hot palms and soles, no fever in the evening but aversion to cold, urgent and full lower abdomen, difficult urination, loose stools, and abdominal distension resembling water accumulation, resembling Black Jaundice. It is caused by excessive sexual exertion and entering water during high heat. This belongs to Lower Jiao pathology, not Water-Qi disease. Treatment should tonify Spleen and Kidney. If abdominal fullness and severe thirst occur, it is difficult to treat. (From *Huibu*)
[Deficiency Yellow / Xu Huang]
Xu Huang presents with bland taste, palpitations, tinnitus, weak legs, lethargy, mild alternating chills and fever, turbid and obstructed urination. Although the skin is yellow, the nails remain normal. This is due to excessive labor and fatigue causing Qi and Blood deficiency. Do not recklessly use cooling herbs; instead, regulate the Middle and tonify Earth. If the complexion is greenish-yellow with free urination, it indicates Wood overcoming Earth, with dampness spreading outward; treat by tonifying Spleen and suppressing Liver. (From *Huibu*)
[Yin Jaundice / Yin Huang]
Yin Huang presents with cold extremities, spontaneous sweating, diarrhea, clear and white urine, no body fever, and deep, slow pulse. This is caused by Spleen and Kidney deficiency. Treatment should use warming and tonifying methods. Some cases result from overuse of cold/cool herbs turning into Yin Syndrome, presenting with yellow body and eyes, cold skin, stomach pain, dry eyes unable to open, and free stool. Treat with Yinchen Fuzi Ganjiang Tang. (From *Huibu*)
[Complicated Symptoms of Jaundice]
Early-stage jaundice often has complicated symptoms. Wind-induced jaundice has yellow color with green tint; Cold-induced has yellow with dark tint; Summerheat-induced has yellow with red tint. Blood stasis jaundice involves forgetfulness and mania-like behavior, clear urine, and black stool. Food stagnation jaundice involves food aversion, belching, chest/abdominal fullness. There are also cases of Heat entering the Heart causing jaundice, or Phlegm-Fire entering the Lung causing jaundice. Regardless of external contraction or internal injury, any frustration and stagnation can lead to jaundice. (From *Rumen*)
[Death Signs]
For all jaundice, 18 days is the critical period; healing within 10+ days of treatment is favorable. Death occurs if: pulse is absent near the Cun Kou (radial artery) close to the palm, mouth/nose are cold, with diarrhea/vomiting/hiccups indicating Stomach Qi exhaustion; black ring around the mouth with oily sweat indicating Spleen Qi exhaustion; black face with head shaking and fixed gaze; jaundice toxin rushing to the Heart with mania, panting, fullness, shortness of breath. Survival signs include: faint pulse with some spirit, free urination, no thirst. Thirst indicates death. The "18 days" rule applies to True Jaundice; Spleen Deficiency yellowing is excluded. (From *Huibu*)
[Pulse Diagnosis]
Five types of Jaundice with Excess-Heat show surging and rapid pulses. Deficient/mild cases show small, fine, choppy pulses. Floating pulse indicates suitability for emesis; sinking pulse indicates suitability for purgation. Surging pulse with diarrhea and thirst indicates death; small pulse with diarrhea and no thirst indicates survival. Abdominal fullness with wiry, hard pulse is ominous. (From *Huibu*)
[Treatment Principles]
Jaundice treatment primarily focuses on clearing Heat and guiding out Dampness. For long-term cases with weak Spleen/Stomach, tonify the Middle Jiao. (From *Bidu*)
[Contraindication: Bitter-Cold Herbs]
Jaundice involves Spleen/Stomach; do not abruptly use cooling herbs to damage Stomach Qi. Must assist with Sweet-Warm herbs and lead with Light-Diuretic herbs to easily remove Dampness and resolve Heat. Pure bitter-cold herbs severely damage Spleen/Kidney, causing mild vomiting/diarrhea or severe panting/abdominal distension. (From *Huibu*)
[Long-term Warming and Tonifying]
If Jaundice is due to deficiency, warm and tonify Kidney/Liver. Once True Yang rises, evil fire naturally subsides. Using only Yinchen (Artemisiae Scopariae Herba) causes excessive diuresis, depleting Liver fluids and Kidney water, potentially curing the illness temporarily but causing night blindness and swelling to recur. Black face with yellow hue and enuresis is incurable. (From *Rumen*, *Huibu*)
[Medication]
Main formulas: Weiling Tang, Fuling Shen Shi Tang. Add Mutong (Akebiae Caulis) for obstructed urination; add Shanzha (Crataegi Fructus) for food stagnation. For deficiency, tonify Spleen using Sijunzi Tang; tonify Kidney using Bawei Wan. For Yin Jaundice, use Lizhong Tang. To soothe Liver, use Jianzhong Tang.
[Method to Verify Life/Death]
Press firmly with two fingers on the Shanzhong acupoint (CV17) on the patient's chest, then separate fingers left and right. If blood color appears in the middle, it is treatable; if no blood color, it is untreatable.
[Selected Formulas for Jaundice Disease]
Fuling Shen Shi Tang: Treats Damp-Heat jaundice, thirst, obstructed urination, poor appetite, and sleep.
Ingredients: Yinchen (7 fen), Fuling (6 fen), Zexie, Zhuling, Baizhu, Cangzhu, Chenpi, Huanglian, Shanzhi, Qinjiao, Fangji, Gegen (4 fen each), Dengxincao.
Preparation: Decoct in water.
Weiling Tang: Treats Spleen-Stomach disharmony, fatigue, and poor appetite.
Ingredients: Cangzhu (Medium), Houpo (Medium), Chenpi (High), Gancao (Low), Zexie (Medium), Fuling (High), Zhuling (Low).
Jiawei Wuling San: Treats Cold-Damp jaundice.
Ingredients: Baizhu (High), Fuling (High), Zhuling (Low), Zexie (Medium), Rougui (Low), Yinchen (Medium), Ganjiang (Medium), Houpo.
Lizhong Wan: Treats Yin Jaundice. (See "Middle Cold" chapter for formula).
Huangqi Jianzhong Tang: Treats Deficiency Yellow. (See "Sweat Disease" chapter for formula).
Jiawei Sijunzi Tang: Treats Sexual Exhaustion Jaundice.
Composition: Sijunzi Tang plus Huangqi, Baishao, Bian Dou. Decoct in water.
Yinchen Ganjiang Fuzi Tang (From *Baojian*): Treats Cold-Damp Deficiency Jaundice.
Ingredients: Fuzi (3 qian, processed), Ganjiang (2 qian, processed), Yinchen (1.2 qian), Fuling (5 fen), Caodoukou (1 qian, roasted), Zhike, Banxia, Zexie (5 fen each), Baizhu (4 fen), Chenpi (3 fen).
Preparation: Decoct in water.
Buzhong Yiqi Tang: Add Yinchen, Zhizi, Zhuling, Zexie, Huanglian, Huashi, Chifuling.
Dihuang Wan: Add Cangzhu, Baizhu, Yinchen, Jiuchaohuangbai (Alcohol-fried Phellodendri Cortex).
Usage: Take decoction and pills morning and evening. Also take Lvfan Wan for better effect. Both treat Deficiency Jaundice.
Zhensha Wan (Secret Recipe): Treats Jaundice with masses, chronic and unhealed.
Ingredients: Zhuling, Zexie, Baizhu, Chifuling (5 qian each), Cangzhu, Sharen, Xiangfu, Houpo (2 liang each), Sanleng, Ezhu, Wuyao, Yinchen, Caoguo, Zhensha (vinegar-fried 7 times, 1 liang each), Muxiang, Qingpi, Chenpi (7 qian each).
Preparation: Powder, paste with old wine, form pills size of wutong seeds. Take 70 pills per dose. Avoid chicken and fish.
Xishi Fanshi San: Treats Sexual Exhaustion Jaundice.
Ingredients: Xishi, Fanshi (roasted, ground, equal parts).
Preparation: Powder, mix with barley porridge juice, take 2 qian. Alternative: use Huashi instead of Xishi.
Treatment Method 1: Use 2 jin of fresh ginger, crush and decoct in water. Bathe in a windless place until profuse sweating. Then drink juice of Gaoliangjiang root to induce vomiting or purgation. One or two doses cure.
Treatment Method 2: Crush Da Yuanxu, mix with wine, drink. Cured in 3 days.
Treatment Method 3: Use Lvfan (Green Vitriol), roast until white, powder, make pills with jujube meat size of cherries. Take 7 pills, 3 times daily, with yellow wine. Avoid vinegar, raw/cold, and stimulating foods. Parasites may be expelled. Effect is miraculous.