治阴证身黄。脉沉细迟。发热手足冷。喘呕。烦躁。不渴者。服之。
茵陈（一钱） 橘皮（一钱半） 生姜（五片） 白术（三钱） 半夏 茯苓（各一钱半） 干姜（一钱炮）
上用水二钟。煎至一钟。通口服。
治阴黄脉沉迟。肢体逆冷。腰以下自汗。
附子（一个炮切作八片） 茵陈（二钱） 干姜（炮一钱半）
上煎法同前
治阴黄。脉伏不出者。
吴茱萸（一钱） 当归（一钱半） 附子（制如前一个） 木通 干姜（炮） 茵陈（各一钱） 人参（二钱）
上煎法如前
琥按上三方。皆自伤寒蕴要中集入者。发黄虽系太阴经中寒湿。然亦侵及少阴厥阴二经。如上橘皮汤走太阴。四逆
汤走少阴。吴茱萸汤走厥阴也。外如第一茵陈茯苓汤。已不可考。据准绳云。发黄。小便不利。烦躁而渴。茵陈汤。加
茯苓。猪苓。滑石。当归。官桂主之。韩氏云茵陈茯苓汤是也。又如第三茵陈附子汤。准绳云发黄。四肢遍身冷者。茵
陈汤。加附子甘草主之是也。又如第五茵陈姜附汤。准绳云发黄。肢体逆冷。腰上自汗。茵陈汤。加附子干姜甘草主之
是也。观乎此。而阴黄用药之义。概可知矣。
薛氏医按所载敖氏伤寒金镜录。相传为杜碧清学士所着。前后共三十六图。其十一图。曰。厥阴舌十二图。曰死现
舌。皆真阴寒证之征。厥阴舌。纯红色。内有黑竖纹者。乃阴毒厥于肝经。肝主筋。故舌见如丝形也。用理中。合四逆
汤温之。死现舌。满舌皆见黑色。水克火明矣。患此者。百无一治。治者审之。立斋云。余在留都时。地官主事。郑汝
东妹婿。患伤寒。得此舌。院内医士曾禧。谓当用附子理中汤。人咸惊骇。遂止。亦莫能疗。困甚。治棺。曾与之邻。
往视之。谓用前药。犹有生理。其家既待以死。KT 从之。数剂而愈。大抵舌黑之证。有火极似水者。即杜学士所谓薪
为黑炭之意也。宜凉膈散之类。以泻其阳。有水来克火者。即曾医士所疗之人是也。宜理中汤。以消阴翳。又须以老生
姜切平。擦其舌。色稍退者。可治。坚不退者。不可治。
弘治辛酉。金台姜梦辉。患伤寒。亦得此舌。手足厥冷。吃逆不止。众医犹作火治。几致危殆。判院吴仁斋用附子
理中汤而愈。夫医之为道。有是病。必用是药。附子疗寒。其效可数。奈何世皆以为必不可用之药。宁视人之死而不救。
不亦哀哉。至于火极似水之证。用药得宜。效应不异。不可便谓为百无一治而弃之也。
琥按舌苔虽黑。必冷滑无芒刺。斯为阴证无疑。
或问仲景论中。如三承气汤。及麻仁丸等。皆治肠胃实热。不大便之药。至三阴寒证。但云下利。而无不大便之条。
岂肠胃虚寒。无便秘之证邪。余答云。肠胃虚。则气馁而不通。寒则凝滞而隔绝。虚寒便秘。焉得无之。有如霹雳煎。
用大盐与蜜等分。熬可捻。如蜜煎导法。海藏云。蜜导用盐相合。亦可。如用草乌头末相合亦可。盐则软坚润燥。草乌
末则化寒消结。可随证阴阳。所宜用之。此可见阴寒秘结。宜用辛温以开之也。又局方半硫丸。本治年高冷秘虚秘。及
癖冷气。愚谓中寒便秘。宜借用之。
治疗阴证身黄。脉象沉细迟。发热但手足冰冷。气喘呕吐。烦躁不安。口不渴者。服用此方。
茵陈（一钱） 橘皮（一钱半） 生姜（五片） 白术（三钱） 半夏 茯苓（各一钱半） 干姜（一钱，炮制）
以上药材用水二钟，煎煮至一钟。一次性温服。
治疗阴黄，脉象沉迟。四肢逆冷。腰部以下自汗。
附子（一个，炮制后切为八片） 茵陈（二钱） 干姜（炮制一钱半）
以上煎煮方法同前。
治疗阴黄，脉象伏匿不出者。
吴茱萸（一钱） 当归（一钱半） 附子（按前述方法炮制的一个） 木通 干姜（炮制） 茵陈（各一钱） 人参（二钱）
以上煎煮方法如前。
琥按：上述三方，皆是从《伤寒蕴要》中收集而来的。发黄虽然属于太阴经的中寒湿邪，但也侵及少阴和厥阴两经。如上方的橘皮汤主要作用于太阴经，四逆汤主要作用于少阴经，吴茱萸汤主要作用于厥阴经。另外如第一方茵陈茯苓汤，已不可考证。据《准绳》记载：发黄，小便不利，烦躁且口渴，用茵陈汤加茯苓、猪苓、滑石、当归、官桂主治。韩氏认为这就是茵陈茯苓汤。又如第三方茵陈附子汤，《准绳》记载：发黄，四肢遍身寒冷，用茵陈汤加附子、甘草主治。又如第五方茵陈姜附汤，《准绳》记载：发黄，肢体逆冷，腰部以上自汗，用茵陈汤加附子、干姜、甘草主治。由此观之，阴黄的用药原理，大概可以知道了。
薛氏医按所载的敖氏《伤寒金镜录》，相传为杜碧清学士所著。前后共三十六图。其中第十一图，名为“厥阴舌”；第十二图，名为“死现舌”。这些都是真阴寒证的征象。“厥阴舌”，舌色纯红，内有黑色竖纹，这是阴毒厥逆于肝经所致。肝主筋，所以舌面出现如丝状的形态。用理中汤合四逆汤温补治疗。“死现舌”，满舌皆见黑色，是水克火之象明显。患此症者，百无一治。医者需谨慎判断。立斋说：我留在留都时，担任地官主事，郑汝东妹婿患伤寒，得了这种舌象。院内医士曾禧说应当用附子理中汤。大家都感到惊骇，于是停止不用，最终也没能治愈。病情危重，家人准备棺材。曾禧与他相邻，前去探望，说使用前面的药，还有生机。家属既然已经把他当作死人对待，勉强听从了建议。服用几剂后痊愈。大抵舌黑之证，有火极似水的情况，即杜学士所说的柴薪烧成黑炭的意思。宜用凉膈散之类，以泻其阳热。有水来克火的情况，即曾医士所治疗的那位患者。宜用理中汤，以消除阴寒阴影。又需用老生姜切片平铺，擦拭其舌，颜色稍退者，可治；坚硬不退者，不可治。
弘治辛酉年，金台的姜梦辉患伤寒，也得了这种舌象。手足厥冷，呃逆不止。众医仍按火热证治疗，几乎导致危殆。判院吴仁斋用附子理中汤而治愈。医学之道，有病必有相应的药。附子治疗寒证，其疗效显著。为何世人却认为它必不可用的药物，宁愿看着人死去也不去救治，不也很悲哀吗？至于火极似水的证候，用药得当，效应并不不同，不可以便说是百无一治而放弃治疗。
有人问：仲景论中，如三承气汤及麻仁丸等，都是治疗肠胃实热、不大便的药物。到了三阴寒证，只说下利，而没有不大便的条文。难道肠胃虚寒，没有便秘的证候吗？我回答说：肠胃虚弱，则气衰而不通；受寒则凝滞而隔绝。虚寒便秘，怎么会没有呢？如有霹雳煎，用大盐与蜜等分，熬至可捏成团，如蜜煎导法。海藏说，蜜导用盐相合也可以。如果用草乌头末相合也可以。盐能软坚润燥，草乌头末能化寒消结。可根据证候的阴阳适宜选用。这可见阴寒秘结，宜用辛温药以开通之。又局方半硫丸，本用于治疗年老冷秘、虚秘及癖冷气。我认为中寒便秘，宜借用此方。
To treat Yin syndrome with yellowing of the body. The pulse is deep, fine, and slow. There is fever but cold hands and feet, wheezing and vomiting, irritability, and no thirst. Take this prescription.
Yinchen (Artemisiae Scopariae Herba) (1 qian), Jupi (Citri Reticulatae Pericarpium) (1.5 qian), Shengjiang (Zingiberis Rhizoma Recens) (5 slices), Baizhu (Atractylodis Macrocephalae Rhizoma) (3 qian), Banxia (Pinelliae Rhizoma), Fuling (Poria) (each 1.5 qian), Ganjiang (Zingiberis Rhizoma) (1 qian, processed).
Take the above herbs, add two zhong of water, decoct to one zhong. Drink all at once.
To treat Yin Huang (Yin-type jaundice) with a deep and slow pulse. Cold extremities. Spontaneous sweating below the waist.
Fuzi (Aconiti Lateralis Radix Praeparata) (one piece, processed and cut into eight slices), Yinchen (Artemisiae Scopariae Herba) (2 qian), Ganjiang (Zingiberis Rhizoma) (processed, 1.5 qian).
Decoct in the same manner as above.
To treat Yin Huang (Yin-type jaundice) with a hidden or imperceptible pulse.
Wuzhuyu (Evodiae Fructus) (1 qian), Danggui (Angelicae Sinensis Radix) (1.5 qian), Fuzi (Aconiti Lateralis Radix Praeparata) (one piece, processed as before), Mutong (Akebiae Caulis), Ganjiang (Zingiberis Rhizoma) (processed), Yinchen (Artemisiae Scopariae Herba) (each 1 qian), Renshen (Ginseng Radix) (2 qian).
Decoct in the same manner as above.
Hu notes: The above three prescriptions were all collected from *Shanghan Wenyao* (Essentials of Cold Damage). Yellowing although belonging to Cold-Dampness in the Taiyin meridian, also invades the Shaoyin and Jueyin meridians. As mentioned, Jupi Tang (Tangerine Peel Decoction) acts on the Taiyin meridian, Sini Tang (Recovery from Extremity-Cold Decoction) acts on the Shaoyin meridian, and Wuzhuyu Tang (Evodia Decoction) acts on the Jueyin meridian. Regarding the first prescription, Yichen Fuling Tang (Artemisia and Poria Decoction), it cannot be verified now. According to *Zhunsheng*, for yellowing with difficult urination, irritability, and thirst, use Yinchen Tang (Artemisia Decoction) plus Fuling (Poria), Zhuling (Polyporus), Huashi (Talcum), Danggui (Angelicae Sinensis Radix), and Guigui (Cinnamomi Cortex). Han Shi considered this to be Yichen Fuling Tang. Similarly, for the third prescription, Yichen Fuzi Tang (Artemisia and Aconite Decoction), *Zhunsheng* states that for yellowing with cold limbs and whole body, use Yinchen Tang (Artemisia Decoction) plus Fuzi (Aconiti Lateralis Radix Praeparata) and Gancao (Glycyrrhizae Radix et Rhizoma). Similarly, for the fifth prescription, Yichen Jiangfu Tang (Artemisia, Ginger, and Aconite Decoction), *Zhunsheng* states that for yellowing with cold limbs and spontaneous sweating above the waist, use Yinchen Tang (Artemisia Decoction) plus Fuzi (Aconiti Lateralis Radix Praeparata), Ganjiang (Zingiberis Rhizoma), and Gancao (Glycyrrhizae Radix et Rhizoma). Observing this, the principle of medication for Yin Huang (Yin-type jaundice) can be generally understood.
The *Xueshi Yi'an* (Medical Records of Xue) records Ao's *Shanghan Jinjinglu* (Golden Mirror Record of Cold Damage), which is traditionally attributed to Scholar Du Biqing. There are thirty-six diagrams in total. The eleventh diagram is titled "Jueyin Tongue," and the twelfth is titled "Death Manifestation Tongue." Both are signs of true Yin-Cold syndrome. "Jueyin Tongue" is purely red with black vertical lines inside; this is caused by Yin-Toxin counterflow affecting the Liver meridian. Since the Liver governs sinews, the tongue appears thread-like. Treat with Lizhong Tang (Regulate the Middle Decoction) combined with Sini Tang (Recovery from Extremity-Cold Decoction) to warm. "Death Manifestation Tongue" shows black covering the entire tongue, indicating Water overcoming Fire clearly. Those suffering from this have virtually no chance of cure. Physicians must examine carefully. Lizhai said: When I was stationed in Liudu serving as Diguan Zhushi, the brother-in-law of Zheng Rudong suffered from cold damage and developed this tongue appearance. The hospital physician Zeng Xi stated that Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) should be used. Everyone was shocked, so treatment was stopped, and ultimately, he could not be cured. His condition became critical, and his family prepared a coffin. Zeng Xi, who lived next door, visited him and said that using the aforementioned medicine still offered a chance of life. Since the family had already treated him as dead, they reluctantly agreed. After several doses, he recovered. Generally speaking, black tongue coating cases include those where extreme Heat resembles Water, which is what Scholar Du meant by firewood turning into black charcoal. Use Liao Ge San (Cool the Diaphragm Powder) etc., to drain Yang-Heat. There are also cases where Water overcomes Fire, such as the patient treated by Physician Zeng. Use Lizhong Tang (Regulate the Middle Decoction) to dispel Yin-Cold shadows. Additionally, rub the tongue with sliced old fresh ginger; if the color fades slightly, it is treatable; if it remains hard and does not fade, it is untreatable.
In the Xin You year of the Hongzhi era, Jiang Menghui from Jintai suffered from cold damage and also developed this tongue appearance. His hands and feet were cold, and hiccups persisted. Most physicians still treated it as a Heat syndrome, nearly causing death. Vice President Wu Renzhai cured him with Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction). The way of medicine dictates that for every disease, there is a corresponding medicine. Fuzi (Aconiti Lateralis Radix Praeparata) treats Cold syndromes, and its efficacy is remarkable. Why do people nowadays consider it a drug that must never be used, preferring to watch people die rather than save them? Is this not tragic? As for syndromes where extreme Heat resembles Water, if the medication is appropriate, the effect is no different. One cannot simply say it is incurable and abandon treatment.
Hu notes: Although the tongue coating is black, if it is cold, slippery, and lacks prickles, it is undoubtedly a Yin syndrome.
Someone asked: In Zhang Zhongjing's discussions, formulas like the Three Chengqi Decoctions and Mahuang Wan (Hemp Seed Pill) etc., are all used to treat excess Heat in the intestines and stomach causing constipation. However, in the discussion of Three Yin Cold syndromes, only diarrhea is mentioned, with no clauses regarding constipation. Does this mean there are no constipation syndromes due to deficiency-cold of the intestines and stomach? I answered: If the intestines and stomach are deficient, Qi becomes weak and fails to circulate; if cold, stagnation occurs leading to blockage. How could deficiency-cold constipation not exist? For example, Pilei Jian (Thunderbolt Decoction) uses equal parts of large salt and honey, boiled until moldable, similar to the method of Honey Suppository. Haizang said that combining salt with honey suppositories is also effective. Combining with Caowutou powder (Aconiti Kusnezoffii Radix) is also possible. Salt softens hardness and moistens dryness; Caowutou powder transforms cold and dissolves accumulation. Choose according to the Yin-Yang suitability of the syndrome. This shows that for Yin-Cold constipation, acrid-warm herbs should be used to open the blockage. Also, Banshu Wan (Half-Sulfur Pill) from the Bureau Formulary is originally used to treat elderly cold constipation, deficiency constipation, and phlegm-fluid cold qi. I believe it can be borrowed for middle-cold constipation.