不必分五种,同是湿热,如 面相似。渴者,难治;不渴者,易治。脉浮宜吐,脉沉宜下。轻者小温中丸,重
者大温中丸,脾虚者以白术等药作汤使。脾胃不和,黄胆,倦怠,少食,胃苓汤。小便赤加滑石。湿热黄胆小便
赤涩,茵陈五苓散。湿寒黄胆,脾胃不和,不食,脉沉细,小便清利者,理中汤。甚者加附子,所谓阴黄胆也。脾
湿积黄心腹疼痛,胃苓汤。湿热因倒胃气,服药而大便下利者,参、术等加茵陈、山栀、甘草。热多,温中丸加黄
连。湿多,茵陈五苓散加食积药。面色黄,肢体倦,小便清,谓之木胜于中,土走于外故也,黄 建中汤。用茵
陈之药过剂,乃成阴证,身目俱黄,皮肤冷,心下疼,眼涩不开,自利,茵陈附子干姜汤。谷疸为病,寒热不能食,食
则头眩,心胸不安,久则发黄,用茵陈、栀子、大黄亦治伤
寒发黄。气实人,心痛,发黄,抚芎散吐之。疸发寒热、呕吐、渴欲饮冷、身体面目俱黄、小便不利,全不思
食,夜间不卧,茯苓渗湿汤。以茵陈四苓散内加芩、连、栀子、防己、苍术、青皮、陈皮,一方加枳实,用长流水煎
服。黄胆方∶黄连(炒) 黄芩(炒) 山栀(炒) 猪苓 泽泻 苍术 茵陈 青皮 龙胆草(各一钱) 劳食疸加
三棱、蓬术(各一钱),砂仁、陈皮、神曲(各五分)。茵陈附子干姜汤∶附子(炮) 干姜(炮) 茵陈 白茯
苓草豆蔻 枳实 半夏 泽泻 白术 陈皮 上姜煎凉服。小温中丸治黄胆与食积∶苍术(炒) 神曲(炒)
针砂(醋 ) 半夏(各二两) 川芎 栀子(各一两) 香附(四两) 春加川芎,夏加苦参或黄连,冬加茱萸或
干姜,上末醋糊丸。大温中丸即暖中丸,治食积黄胆肿,又可借为制肝燥脾之用∶陈皮 苍术(米泔浸炒) 浓朴(姜
制) 三棱(醋炒) 蓬术(醋炒) 青皮(各五两) 甘草(二两) 香附(一斤醋炒) 针砂(十两醋 ) 上
为末醋糊丸,空心姜汤下,午饭、晚饭前酒下。脾虚者,以白术、人参、芍药、陈皮、甘草等药作汤使,忌大肉果菜。
又方小温中丸,治脾胃停湿,水谷不分,面色痿黄∶针砂(八两醋炒) 香附 神曲(八两炒) 白术(五两炒) 半
夏(五两洗) 甘草(二两) 陈皮(五两和白) 黄连(二两) 苦参(三两) 上为末,醋糊丸,每服五十丸,白
术、陈皮汤下,冬去黄连加浓朴。
不必区分五种黄疸,它们本质上都是湿热所致,就像人的面貌相似一样。口渴的,难治;不口渴的,易治。脉象浮的适宜用吐法,脉象沉的适宜用下法。病情轻的用小温中丸,病情重的用大温中丸,脾虚的患者用白术等药物煎汤服用。脾胃不和导致的黄疸,伴有倦怠、食欲减退,用胃苓汤治疗。小便颜色深红的,加滑石。湿热导致的黄疸,小便赤涩,用茵陈五苓散治疗。湿寒导致的黄疸,脾胃不和,不能进食,脉象沉细,小便清利通畅的,用理中汤治疗。病情严重的加附子,这就是所谓的阴黄。脾湿积聚导致的黄疸伴有心腹疼痛,用胃苓汤治疗。因湿热导致胃气上逆,服药后出现大便泄泻的,用人参、白术等药加上茵陈、山栀、甘草。热邪偏盛的,在温中丸基础上加黄连。湿邪偏盛的,在茵陈五苓散基础上加消食积的药物。面色发黄,肢体疲倦,小便清亮,这叫做木气胜于中焦,土气外散所致,用黄芪建中汤治疗。使用茵陈类药物过量,导致变成阴证,身体和眼睛都发黄,皮肤发冷,心下部疼痛,眼睛干涩睁不开,自行腹泻,用茵陈附子干姜汤治疗。谷疸这种病,表现为寒热往来,不能进食,进食后头晕目眩,心胸不安,时间久了就会发黄,用茵陈、栀子、大黄也能治疗伤寒发黄。体质壮实的人,心痛,发黄,用抚芎散催吐。黄疸发作时伴有寒热、呕吐、想喝冷水、身体面目都发黄、小便不利,完全不想吃东西,夜间无法安睡,用茯苓渗湿汤治疗。在茵陈四苓散中加入黄芩、黄连、栀子、防己、苍术、青皮、陈皮,其中一方加入枳实,用长流水煎服。黄疸方:黄连(炒)、黄芩(炒)、山栀(炒)、猪苓、泽泻、苍术、茵陈、青皮、龙胆草(各一钱)。因劳倦饮食积滞导致的黄疸加三棱、蓬术(各一钱),砂仁、陈皮、神曲(各五分)。茵陈附子干姜汤:附子(炮制)、干姜(炮制)、茵陈、白茯苓、草豆蔻、枳实、半夏、泽泻、白术、陈皮。以上药物用生姜煎煮,凉服。小温中丸治疗黄疸与食积:苍术(炒)、神曲(炒)、针砂(醋淬)、半夏(各二两)、川芎、栀子(各一两)、香附(四两)。春季加川芎,夏季加苦参或黄连,冬季加茱萸或干姜,以上药物研末,用醋糊制成丸剂。大温中丸即暖中丸,治疗食积引起的黄疸肿胀,也可以借用来制约肝燥脾湿:陈皮、苍术(米泔水浸泡炒制)、浓朴(姜汁制)、三棱(醋炒)、蓬术(醋炒)、青皮(各五两)、甘草(二两)、香附(一斤醋炒)、针砂(十两醋淬)。以上药物研末,用醋糊制成丸剂,空腹时用姜汤送服,午饭、晚饭前用酒送服。脾虚的患者,用白术、人参、芍药、陈皮、甘草等药物煎汤服用,忌食肥甘厚味及生冷蔬菜。又一方小温中丸,治疗脾胃停聚湿气,水谷不分,面色萎黄:针砂(八两醋炒)、香附、神曲(八两炒)、白术(五两炒)、半夏(五两洗净)、甘草(二两)、陈皮(五两和白)、黄连(二两)、苦参(三两)。以上药物研末,用醋糊制成丸剂,每次服用五十丸,用白术、陈皮汤送服,冬季去掉黄连加入浓朴。
There is no need to distinguish between the five types of jaundice; they are all essentially caused by damp-heat, similar to how human faces resemble each other. Those with thirst are difficult to treat; those without thirst are easy to treat. A floating pulse indicates the suitability of emesis (inducing vomiting), while a deep pulse indicates the suitability of purgation (inducing bowel movement). For mild cases, Xiao Wen Zhong Wan (Minor Warming the Middle Pill) is used; for severe cases, Da Wen Zhong Wan (Major Warming the Middle Pill) is used. For patients with Spleen deficiency (deficiency of the Spleen organ's function), decoctions containing Bai Zhu (Atractylodis Rhizoma) and other herbs should be administered. For jaundice due to Disharmony of the Spleen and Stomach (impaired digestive function), accompanied by fatigue and poor appetite, Wei Ling Tang (Stomach-Ling Decoction) is prescribed. If urine is dark red, Hua Shi (Talcum) is added. For damp-heat jaundice with dark and painful urination, Yin Chen Wu Ling San (Artemisiae Scopariae Five-Ingredient Powder) is used. For cold-damp jaundice characterized by Spleen-Stomach disharmony, anorexia, a deep and fine pulse, and clear, free urination, Li Zhong Tang (Regulate the Middle Decoction) is used. In severe cases, Fu Zi (Prepared Aconiti Lateralis Radix) is added; this is referred to as Yin Jaundice (Cold-Damp Jaundice). For jaundice caused by Spleen dampness accumulation with abdominal pain, Wei Ling Tang is used. If damp-heat causes rebellious Stomach Qi, leading to diarrhea after taking medication, Ren Shen (Ginseng Radix et Rhizoma) and Bai Zhu (Atractylodis Rhizoma) are combined with Yin Chen (Artemisiae Scopariae Herba), Shan Zhi (Gardeniae Fructus), and Gan Cao (Licorice Radix et Rhizoma). If heat predominates, Huang Lian (Coptidis Rhizoma) is added to Wen Zhong Wan. If dampness predominates, food-resolving herbs are added to Yin Chen Wu Ling San. Yellow complexion, limb fatigue, and clear urine indicate Wood overacting on the Middle Jiao (Middle Burner), causing Earth Qi to scatter outward; Huang Qi Jian Zhong Tang (Astragali Decoction to Establish the Middle) is used. Overuse of Yin Chen (Artemisiae Scopariae Herba) can lead to a Yin syndrome (cold-deficiency pattern), manifesting as yellowing of the body and eyes, cold skin, epigastric pain, dry and unopenable eyes, and spontaneous diarrhea; Yin Chen Fu Zi Gan Jiang Tang (Artemisiae Scopariae, Aconite, and Dried Ginger Decoction) is used. Gu Dan (Grain Jaundice) presents with alternating chills and fever, inability to eat, dizziness after eating, mental restlessness, and eventual yellowing of the skin; Yin Chen (Artemisiae Scopariae Herba), Zhi Zi (Gardeniae Fructus), and Da Huang (Rhei Radix et Rhizoma) are also effective for jaundice resulting from Shang Han (Cold Damage). For robust individuals with chest pain and jaundice, Fu Xiong San (Chuanxiong Powder) is used to induce emesis. For jaundice presenting with chills and fever, vomiting, thirst for cold drinks, generalized yellowing of the body and face, difficulty in urination, complete loss of appetite, and insomnia at night, Fu Ling Shen Shi Tang (Poria Damp-Draining Decoction) is prescribed. This formula consists of Yin Chen Si Ling San (Artemisiae Scopariae Four-Ingredient Powder) supplemented with Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Zhi Zi (Gardeniae Fructus), Fang Ji (Stephaniae Tetrandrae Radix), Cang Zhu (Atractylodis Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride), and Chen Pi (Citri Reticulatae Pericarpium); one variation includes Zhi Shi (Aurantii Fructus Immaturus). It is decocted with long-flowing water.
Jaundice Formula: Huang Lian (Coptidis Rhizoma, stir-fried), Huang Qin (Scutellariae Radix, stir-fried), Shan Zhi (Gardeniae Fructus, stir-fried), Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), Cang Zhu (Atractylodis Rhizoma), Yin Chen (Artemisiae Scopariae Herba), Qing Pi (Citri Reticulatae Pericarpium Viride), Long Dan Cao (Gentianae Radix et Rhizoma) — each 1 qian. For jaundice due to labor and food stagnation, add San Leng (Sparganii Rhizoma) and Peng Ze (Curcumae Radix) — each 1 qian; Sha Ren (Amomi Fructus Rotundus), Chen Pi (Citri Reticulatae Pericarpium), and Shen Qu (Massa Medicata Fermentata) — each 0.5 qian.
Yin Chen Fu Zi Gan Jiang Tang (Artemisiae Scopariae, Aconite, and Dried Ginger Decoction): Fu Zi (Prepared Aconiti Lateralis Radix, processed), Gan Jiang (Zingiberis Rhizoma, processed), Yin Chen (Artemisiae Scopariae Herba), Bai Fu Ling (Poria cum Risu), Cao Dou Kou (Cardamomi Fructus), Zhi Shi (Aurantii Fructus Immaturus), Ban Xia (Pinelliae Rhizoma), Ze Xie (Alismatis Rhizoma), Bai Zhu (Atractylodis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium). Decoct with fresh ginger and take cool.
Xiao Wen Zhong Wan (Minor Warming the Middle Pill) treats jaundice and food stagnation: Cang Zhu (Atractylodis Rhizoma, stir-fried), Shen Qu (Massa Medicata Fermentata, stir-fried), Zhen Sha (Hematitum, vinegar-quenched), Ban Xia (Pinelliae Rhizoma) — each 2 liang; Chuan Xiong (Ligustici Chuanxiong Rhizoma), Zhi Zi (Gardeniae Fructus) — each 1 liang; Xiang Fu (Cyperi Rhizoma) — 4 liang. Add Chuan Xiong in spring, Ku Shen (Sophorae Flavescentis Radix) or Huang Lian (Coptidis Rhizoma) in summer, and Yu Zhu (Corni Fructus) or Gan Jiang (Zingiberis Rhizoma) in winter. Grind into powder, make pills with vinegar paste.
Da Wen Zhong Wan (Major Warming the Middle Pill), also known as Nuan Zhong Wan, treats jaundice and swelling due to food stagnation, and can also be used to regulate Liver dryness and Spleen dampness: Chen Pi (Citri Reticulatae Pericarpium), Cang Zhu (Atractylodis Rhizoma, stir-fried after soaking in rice wash water), Nong Po (Magnoliae Officinalis Cortex, ginger-processed), San Leng (Sparganii Rhizoma, vinegar-stir-fried), Peng Ze (Curcumae Radix, vinegar-stir-fried), Qing Pi (Citri Reticulatae Pericarpium Viride) — each 5 liang; Gan Cao (Licorice Radix et Rhizoma) — 2 liang; Xiang Fu (Cyperi Rhizoma, vinegar-stir-fried) — 1 jin; Zhen Sha (Hematitum, vinegar-quenched) — 10 liang. Grind into powder, make pills with vinegar paste. Take on an empty stomach with ginger decoction, or with wine before lunch and dinner.
For Spleen deficiency, administer decoctions of Bai Zhu (Atractylodis Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Shao Yao (Paeoniae Radix Alba), Chen Pi (Citri Reticulatae Pericarpium), and Gan Cao (Licorice Radix et Rhizoma). Avoid heavy meats and raw vegetables.
Another variation of Xiao Wen Zhong Wan treats Spleen-Stomach dampness retention, indistinct differentiation of water and grain, and sallow complexion: Zhen Sha (Hematitum, vinegar-stir-fried) — 8 liang; Xiang Fu (Cyperi Rhizoma), Shen Qu (Massa Medicata Fermentata, stir-fried) — 8 liang; Bai Zhu (Atractylodis Rhizoma, stir-fried) — 5 liang; Ban Xia (Pinelliae Rhizoma, washed) — 5 liang; Gan Cao (Licorice Radix et Rhizoma) — 2 liang; Chen Pi (Citri Reticulatae Pericarpium, mixed with white variety) — 5 liang; Huang Lian (Coptidis Rhizoma) — 2 liang; Ku Shen (Sophorae Flavescentis Radix) — 3 liang. Grind into powder, make pills with vinegar paste. Take 50 pills per dose with Bai Zhu and Chen Pi decoction. Remove Huang Lian and add Nong Po (Magnoliae Officinalis Cortex) in winter.