论
《内经》曰∶中央黄色，入通于脾。又曰∶诸湿肿满，皆属脾土。夫黄胆为病，肌肉必虚肿而色黄，盖湿热郁积于
脾胃之中，久而不散，故其土色形于面与肌肤也。盖脾主肌肉，肺主皮毛，母能令子虚，母病子亦病矣。是故有诸中者，
必形诸外耳。其证有五∶曰黄汗，曰黄胆，曰酒疸，曰谷疸，曰女劳疸。虽有五者之分，终无寒热之异。丹溪曰∶不必
分五种，同是湿热，如 曲相似。正经所谓知其要者，一言而终是也。外有伤寒热病，阳明内实，当下而不得下，当汗
而不得汗，当分利而不得分利，故使湿热怫郁内甚，皆能令人发黄病也。先哲制茵 五苓散、茵 汤、茯苓渗湿汤之类，
无不应手获效。故曰治湿不利小便，非其治也。又曰湿在上宜发汗，湿在下宜利小便，或二法并用，使上下分消其湿，
则病无有不安者也，学人详之。
脉法
《脉经》曰∶凡黄候，寸口脉近掌无脉，口鼻冷，并不可治。
脉沉，渴欲饮水，小便不利者，必发黄也。
酒疸者，或无热，靖言了了，腹满欲吐，鼻燥，其脉浮者先吐之，沉弦者先下之。
酒疸下之，久久为黑疸，目青面黑，心头如 蒜韭之状，大便正黑，皮肤四肢不仁，其脉浮弱，颜黑微黄，故知难
治。
谷疸，寸口脉微而弱，微则恶寒，弱则发热，当发不发，骨节疼痛，当烦不烦，而黄汗出。趺阳脉缓而迟，胃气反
强，饱则烦满，满则发热，客热消谷，食已则饥，谷强肌瘦，名曰谷疸。
阳明病脉迟者，食难用饱，饱则发烦头眩者，必小便难，此欲作谷疸，虽下之，腹满如故。
趺阳脉紧而数，数则为热，热则消谷，紧则为寒，食则满也。
尺脉浮为伤肾，趺阳脉紧为伤脾，风寒相搏，食已则眩，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。
方法
丹溪曰∶不必分五，同是湿热，和 曲相似，轻者小温中丸，重者大温中丸，热多加黄连，湿多者茵 五苓散加食
积药。
戴氏曰∶食积者，量其虚实下之，其余但利小便，小便清利，则黄自退。或曰∶黄胆宜用倒仓法。又曰∶黄胆倦怠，
脾胃不和，食少，胃苓汤。小便赤，加滑石。
一方 治黄胆。
黄芩 黄连 栀子 茵 猪苓 泽泻 苍术 青皮 草龙胆（各五分）
谷疸，加三棱、莪术、缩砂、陈皮、神曲。
上细切，作一服，水煎服之。
又方 治气实伤湿，浑身发黄，宜吐法。
抚芎 栀子 桔梗（各二钱）
上细切，作一服，加姜煎，入韭汁服，探吐之。
小温中丸 治黄胆与食积，又可制肝燥脾。脾虚者，须以白术作汤使下。
针砂（十两，醋炒七次令通红，另研） 苦参（夏加冬减） 山楂（各二两） 吴茱萸（一两，冬加夏减） 苍术
（半斤） 白术（五两） 川芎（夏减） 神曲（各半斤）香附米（一斤，童便浸一宿）
上为细末，醋糊为丸，如梧桐子大，每服七、八十丸，食前盐汤下。一方，无白术、山楂、苦参、吴茱萸，有栀子。
大温中丸
针砂（十两，如前制） 陈皮 苍术 青皮 浓朴（姜汁制） 三棱 （醋煮一时） 莪术（同上制） 黄连 苦
参白术（各五两） 生甘草（二两） 香附（一斤，童便浸一宿）
上为细末，醋糊为丸。（一方无黄连、苦参、白术，一方又无甘草，名温中丸。）
调胃承气汤（活人，方见伤寒门。）
王叔和曰∶腹满舌痿，烦躁不得睡，属黄家。又曰∶病黄胆，发热烦喘，胸满口燥者，以发病时火劫其汗，两热相
搏。然黄家所得从湿，故一身尽发热而黄。如肚热者，热在里也，当下之安，用调胃承气汤。
又曰∶黄胆之病，当以十八日为期治之，十日以上为瘥，又剧者为难治。又曰∶病疸而渴者，其病难治；疸而不渴
者，其病易治。发于阴部，其人必呕；发于阳部，其人振寒而发热也。师曰∶诸黄家病，但宜利小便。假令脉浮，当以
汗解之，宜桂枝加 汤，又名黄 建中汤。（方见伤寒门。）
又曰∶男子黄，小便自利，当与小建中汤。又曰∶黄胆腹满，小便不利而赤，自汗出，此为表和里实，当下之，用
大黄黄柏栀子芒硝汤。
大黄黄柏栀子芒硝汤（叔和）
黄柏 芒硝 大黄（各四钱） 栀子（三枚）
上细切，作一服，水一盏半；煎至一盏，温服。
又曰∶黄胆病，小便色不变，欲自利，腹满而喘，不可除热，热除必哕，哕者宜服小半夏汤。（方见伤寒门。）
又曰∶夫病酒发黄胆，必小便不利，其候心中热，足下热，是其证也。又心中懊 而热，不能食，时欲吐，名曰酒
疸。又曰∶酒疸，心中热欲呕者，吐之即愈。又曰∶酒疸黄色，心中实热而烦。
又曰∶额上黑，微汗出，手足心热，薄暮则发，膀胱急，小便自利，名曰女劳疸。腹如水状，不治。
又曰∶黄家，日晡所当发热，而反恶寒，此为女劳得之。膀胱急，小腹满，一身尽黄，额上黑，足下热。因作黑疸，
其腹胀如水状，大便必黑，时溏，此女劳之病，非水也，腹满者难治，硝石矾石散主之。
硝石矾石散（叔和）
上以二石各等分，烧 为末，每服二钱，以大麦粥汤和服，日三
服，取汗愈。若小腹满急，小便不利，用滑石、石膏各二钱，入粳米一撮，同煎服之。
治酒疸，用小柴胡汤加茵 、豆豉、大黄、黄连、葛根，煎服效。（叔和）
茯苓汤（河间） 治胃疸，消谷善饥，面色痿黄，心中烦热，胸胁胀满，小便赤涩。（方见淋秘门。）
一方（丹溪） 治谷疸。
以柴胡、谷芽、枳实、浓朴、栀子、大黄等分，水煎服效。
胃苓汤（局方） 治脾胃不和黄肿。如小便赤涩，加滑石。
五苓散合平胃散是也。
肾疸汤（东垣） 治肾疸目黄，或浑身黄，小便赤涩。
升麻 羌活 防风 本 独活 柴胡（各五分） 苍术（一钱） 猪苓（四分） 葛根（五分） 泽泻（三分） 黄
芩（二分） 甘草（三分） 神曲（炒，三分） 黄柏（二分） 白术（五分） 人参（三分）
上细切，作一服，水一盏半，煎至一盏，去渣温服。
茵 五苓散（活人） 治伤寒或伏暑发黄，小便不利，烦渴等证。
本方倍加茵 ，入姜枣煎服之。
茵 茯苓汤（活人） 治发黄，脉沉细数，四肢冷，小便涩，烦躁而渴。
茯苓 桂枝 猪苓（各一钱） 滑石（一钱五分） 茵 （二钱）
上细切，作一服，水一盏半，煎至一盏服。如脉未出，加当归一钱五分。
栀子大黄汤（活人） 治酒疸，心中懊 ，或热而痛。
栀子（十四枚） 大黄（一两） 枳实（五枚） 豆豉（一升）
上作一服，用水五升，煎至二升，分三服。
半温半热汤（活人） 治酒疸，身黄无热，靖言了了，腹满欲呕，心烦足热，或有 瘕，心中懊 ，其脉沉弦
紧细。
半夏 茯苓 白术（各七分） 前胡 枳壳（麸炒黄色） 甘草（炙） 大戟（各五分） 黄芩 茵 当归（各
三分）
上细切，作一服，入生姜三片，水二盏，煎至一盏，温服。
茵 蒿汤（活人） 治身热鼻干汗出，阳气上奔，小便赤涩不利，湿热发黄。
茵 蒿（一两） 大栀子（三枚） 大黄（三钱五分）
上细切，作一服，水三盏，煎盏半，温服。
茵 大黄汤（活人） 治伤寒大热发黄，面目俱黄，小便赤涩。
茵 蒿 栀子 柴胡 黄柏 黄芩 升麻 大黄（各七分） 草龙胆（三分半）
上细切，作一服，水一盏半，煎至一盏，温服。
栀子柏皮汤（活人） 治身热不去，大便利而烦热身黄。
栀子 黄柏 黄连（各三钱五分）
上细切，作一服，水一盏半，煎至一盏，温服。
茯苓渗湿汤（活人） 治黄胆寒热，呕吐而渴，欲饮冷水，身目俱黄，小便不利，不思饮食。（方见湿证门。）
小茵 汤（活人） 治发黄，脉沉细而迟，遍身冷。
附子（一枚，作八片炮） 甘草（炙，一两） 茵 （二两）
上细切，作三服，每服用水二盏，煎至一盏，温服。
茵 四逆汤（活人） 治发黄，脉沉细而迟，肢体逆冷，腰以上自汗。
甘草（炙，一两） 干姜（炮，一两五钱） 附子（一枚，作八片炮） 茵 （二两）
上细切，分作四服，水煎服。
葶苈苦参散（活人） 治湿热内甚，小便赤涩，大便时秘，饮食少进，诸药不效，因为久黄。
苦参 黄连 瓜蒂 黄柏 大黄（各一两） 葶苈子（二两）
上为细末，每服一钱匕，清米饮调下，以吐利为度，随时看虚实消息加减。
当归白术汤（活人） 治酒疸发黄，心下有 癖坚满，身体沉重，妨害饮食，小便赤黄，此因内虚，饮食生冷，
脾胃痰结所致。
白术 茯苓（各一钱） 当归 黄芩 茵 （各三分半） 前胡 枳实 甘草（炙） 杏仁（各六分） 半夏（八
分，泡透）
上细切，作一服，加姜三片，水一盏半，煎至一盏，温服。
抵当汤（活人） 治伤寒热郁，瘀血内结，身黄脉沉细，狂言谵语，小便自利，大便黑。（方见伤寒门。）
针砂丸（集验方） 治谷疸、酒疸、湿热发黄等证。
针砂（半斤，醋炒红） 苍术（四两，米泔浸） 香附（四两，童便浸） 神曲（炒微黄） 茵 （姜汁炒） 麦
（麸炒，各二两） 芍药 当归（酒洗，去头） 生地黄 川芎 青皮（去穣炒，各一两五钱） 陈皮（去白） 莪术
（醋
煮） 三棱（醋煮，各二两） 栀子（去壳炒） 姜黄 升麻 干漆（各五钱，炒烟尽）
上为细末，醋糊为丸，如梧桐子大，每服六、七十丸，姜汤送下。
绿矾丸（集验） 治黄肿病最捷。
五倍子（半斤，炒黑） 绿矾（四两，姜汁炒白） 针砂（四两，醋炒红色） 神曲（半斤，炒微黄色）
上为细末，生姜汁煮红枣肉为丸，如梧桐子大，每服六、七十丸，温酒下。不能饮酒，米汤亦可。终身忌食荞麦面，
犯之再发难治。
枣矾丸（宝鉴） 治食劳，身目俱黄者。
绿矾（半斤，火 通红）
上研细，红枣肉为丸，如梧桐子大，每服五十丸，或酒或姜汤下。
（祖传方）
褪金丸 治黄肿，绝妙。
苍术（米泔浸） 白术（各二两五钱） 甘草（炙，五钱） 浓朴（姜汁拌炒，一两） 陈皮（去白，一两五钱） 针
砂（醋炒红色） 香附（童便浸，各六两） 神曲（炒黄色） 麦 面（炒微黄，各一两半）
有块加三棱（醋煮） 莪术（醋煮，各一两半）
上为细末，面糊为丸服，忌鱼腥、湿面、生冷、水果等物。
（医案）
一男子年三十余，得谷疸症，求予治。以胃苓汤去桂加茵 ，数十帖黄退，自以为安，不服药。十数日后，至晚目
盲不见物。予曰∶此名雀目，盖湿痰盛而肝火有余也。用 猪肝煮熟和夜明砂作丸服之，目遂明如故，来谢。予曰∶未
也，不早服制肝补脾消痰之剂，必成蛊胀。伊芳不信，半月后腹渐胀痞满，复来治。予仍以胃苓汤倍二术，加木通、麦门
冬，煎汤下褪金丸，一月平安。
论
《黄帝内经》说：中央方位对应黄色，与脾脏相通。又说：各种湿邪导致的肿胀和腹满，都归属于脾土。黄疸这种病，肌肉必然虚肿且颜色发黄，这是因为湿热郁结积聚在脾胃之中，时间久了不能消散，所以脾的土色显现于面部和肌肤上。因为脾主管肌肉，肺主管皮毛，母脏（脾）能使子脏（肺）虚弱，母脏生病，子脏也会受累。因此，内部有病变，必然会表现在外部。其症状主要有五种：称为黄汗、黄疸、酒疸、谷疸、女劳疸。虽然分为这五类，但最终都没有寒证或热证的本质区别。朱丹溪说：不必非要区分这五种，它们都是湿热，就像发酵的酒曲一样相似。经典所谓“知道关键的人，一句话就能终结道理”正是这个意思。此外还有伤寒热病，阳明腑实，该用下法却不能用下法，该发汗却不能用发汗法，该分利小便却不能用分利法，从而导致湿热郁闭内盛，都能使人患上发黄病。先贤制定了茵陈五苓散、茵陈汤、茯苓渗湿汤等方剂，没有不随手见效的。所以说治疗湿邪如果不通利小便，就不是正确的治法。又说湿邪在上适宜发汗，湿邪在下适宜利小便，或者两种方法并用，使上下分消湿邪，那么病就没有不安愈的，学习的人要详细研究。
脉法
《脉经》说：凡是黄疸的征候，如果寸口脉搏动微弱至手掌处无脉，口鼻冰冷，都属于不可治愈的绝症。
脉象沉，口渴想喝水，小便不通利的，一定会发黄。
酒疸患者，有的没有发热，神志清醒安静，腹部胀满想呕吐，鼻干燥，脉象浮的先采用催吐法，脉象沉弦的先采用泻下法。
酒疸如果用泻下法治疗，久而久之会变成黑疸，眼睛青黑，面色黑，心胸感觉像吃了蒜韭后的辛辣不适状，大便完全变黑，皮肤四肢麻木不仁，脉象浮弱，面色黑而微黄，所以知道难以治疗。
谷疸，寸口脉微而弱，脉微则怕冷，脉弱则发热，应当发汗却没有发汗，骨节疼痛，应当烦躁却没有烦躁，而出黄汗。趺阳脉缓而迟，胃气反而强盛，吃饱了就烦闷腹胀，腹胀就发热，客热消耗谷物，吃完就饿，谷物强盛而肌肉消瘦，名叫谷疸。
阳明病脉象迟缓的，吃饭难以吃饱，吃饱了就心烦头晕的，一定小便困难，这是将要发作谷疸，即使使用下法，腹部胀满依然如故。
趺阳脉紧而数，数代表热，热则消化食物快；紧代表寒，进食后就胀满。
尺脉浮是伤肾，趺阳脉紧是伤脾，风寒相互搏结，吃完东西就头晕，谷气不能消化，胃中苦于浊气，浊气向下流注，小便不通，阴经受寒，热气流入膀胱，身体全部发黄，名叫谷疸。
方法
朱丹溪说：不必区分五种，都是湿热，就像酒曲一样相似，轻症用小温中丸，重症用大温中丸，热重的加黄连，湿重的用茵陈五苓散加消食积的药。
戴氏说：食积的，根据虚实情况用泻下法，其余的只要利小便，小便清利通畅，黄色自然消退。有人说：黄疸应该用倒仓法。又说：黄疸倦怠，脾胃不和，吃得少，用胃苓汤。小便赤红，加滑石。
一方 治疗黄疸。
黄芩、黄连、栀子、茵陈、猪苓、泽泻、苍术、青皮、草龙胆（各五分）
以上细切，作一服，水煎服用。
又一方 治疗气实伤湿，浑身发黄，适宜用吐法。
以上细切，作一服，加生姜煎煮，加入韭菜汁服用，探吐之。
小温中丸 治疗黄疸与食积，又可以制约肝燥脾虚。脾虚者，必须用白术煮汤送服丸药。
针砂（十两，醋炒七次令通红，另研）、苦参（夏天加量冬天减量）、山楂（各二两）、吴茱萸（一两，冬天加量夏天减量）、苍术（半斤）、白术（五两）、川芎（夏天减量）、神曲（各半斤）、香附米（一斤，童便浸泡一夜）
以上为细末，醋糊做成丸，如梧桐子大小，每次服用七八十丸，饭前盐汤送下。另一方，没有白术、山楂、苦参、吴茱萸，有栀子。
针砂（十两，如前法制备）、陈皮、苍术、青皮、浓朴（姜汁制）、三棱（醋煮一时辰）、莪术（同上制）、黄连、苦参、白术（各五两）、生甘草（二两）、香附（一斤，童便浸泡一夜）
以上为细末，醋糊做成丸。（另一方没有黄连、苦参、白术，另一方又没有甘草，名叫温中丸。）
王叔和说：腹部胀满，舌体痿软，烦躁睡不着觉，属于黄家病。又说：患黄疸病，发热烦躁气喘，胸满口干的，是因为发病时用火劫迫出汗，两热相搏。然而黄家所得的病源于湿，所以全身都发热而发黄。如果肚脐周围热，说明热在里，应当用下法使其安宁，用调胃承气汤。
又说：黄疸病，应当以十八天为期来治疗，十天以上痊愈，再严重的就难治。又说：患疸病而口渴的，病难治；疸病而不口渴的，病易治。发于阴部的，其人必定呕吐；发于阳部的，其人恶寒而发热。老师说：所有黄家病，只适宜利小便。假如脉浮，应当用汗法解表，适宜用桂枝加黄芪汤，又名黄芪建中汤。（方见伤寒门。）
又说：男子发黄，小便自利，应当给予小建中汤。又说：黄疸腹部胀满，小便不利且赤，自汗出，这是表和解里实，应当用下法，用大黄黄柏栀子芒硝汤。
以上细切，作一服，水一盏半；煎至一盏，温服。
又说：黄疸病，小便颜色不变，想自行腹泻，腹部胀满而喘，不可以除热，热除必打嗝，打嗝的适宜服小半夏汤。（方见伤寒门。）
又说：患酒发黄疸病，一定小便不利，其征候心中热，足下热，这就是它的证候。又心中懊恼而热，不能吃东西，时常想吐，名叫酒疸。又说：酒疸，心中热想呕吐的，吐出来就好了。又说：酒疸黄色，心中实热而烦。
又说：额头黑，微汗出，手足心热，傍晚发作，膀胱急迫，小便自利，名叫女劳疸。腹部像有水状，不治。
又说：黄家，日晡时分应当发热，反而恶寒，这是女劳疸所致。膀胱急，小腹满，一身尽黄，额头黑，足下热。因而变成黑疸，其腹胀如水状，大便必黑，时而溏泄，这是女劳的病，不是水气病，腹部胀满的难治，用硝石矾石散主治。
硝石矾石散（王叔和）
以上两种石头各等分，烧成灰为末，每次服二钱，用大麦粥汤调和服用，每日三次，取汗即愈。如果小腹满急，小便不利，用滑石、石膏各二钱，入粳米一撮，同煎服用。
治疗酒疸，用小柴胡汤加茵陈、豆豉、大黄、黄连、葛根，煎服有效。（王叔和）
茯苓汤（刘河间） 治疗胃疸，消谷善饥，面色萎黄，心中烦热，胸胁胀满，小便赤涩。（方见淋秘门。）
胃苓汤（局方） 治疗脾胃不和引起的黄肿。如小便赤涩，加滑石。
升麻、羌活、防风、藁本、独活、柴胡（各五分）、苍术（一钱）、猪苓（四分）、葛根（五分）、泽泻（三分）、黄芩（二分）、甘草（三分）、神曲（炒，三分）、黄柏（二分）、白术（五分）、人参（三分）
以上细切，作一服，水一盏半，煎至一盏，去渣温服。
茵陈五苓散（《活人书》） 治疗伤寒或伏暑发黄，小便不利，烦渴等证。
茵陈茯苓汤（《活人书》） 治疗发黄，脉沉细数，四肢冷，小便涩，烦躁而渴。
以上细切，作一服，水一盏半，煎至一盏服。如果脉未出，加当归一钱五分。
以上作一服，用水五升，煎至二升，分三次服。
半温半热汤（《活人书》） 治疗酒疸，身黄无热，神志清醒安静，腹部胀满想呕，心烦足热，或有癥瘕，心中懊恼，其脉沉弦紧细。
半夏、茯苓、白术（各七分）、前胡、枳壳（麸炒黄色）、甘草（炙）、大戟（各五分）、黄芩、茵陈、当归（各三分）
以上细切，作一服，入生姜三片，水二盏，煎至一盏，温服。
茵陈蒿汤（《活人书》） 治疗身热鼻干汗出，阳气上奔，小便赤涩不利，湿热发黄。
以上细切，作一服，水三盏，煎盏半，温服。
茵陈大黄汤（《活人书》） 治疗伤寒大热发黄，面目俱黄，小便赤涩。
茵陈蒿、栀子、柴胡、黄柏、黄芩、升麻、大黄（各七分）、草龙胆（三分半）
以上细切，作一服，水一盏半，煎至一盏，温服。
栀子柏皮汤（《活人书》） 治疗身热不去，大便利而烦热身黄。
以上细切，作一服，水一盏半，煎至一盏，温服。
茯苓渗湿汤（《活人书》） 治疗黄疸寒热，呕吐而渴，欲饮冷水，身目俱黄，小便不利，不思饮食。（方见湿证门。）
小茵陈汤（《活人书》） 治疗发黄，脉沉细而迟，遍身冷。
以上细切，作三服，每服用水二盏，煎至一盏，温服。
茵陈四逆汤（《活人书》） 治疗发黄，脉沉细而迟，肢体逆冷，腰以上自汗。
甘草（炙，一两）、干姜（炮，一两五钱）、附子（一枚，作八片炮制）、茵陈（二两）
以上细切，分作四服，水煎服。
葶苈苦参散（《活人书》） 治疗湿热内甚，小便赤涩，大便时秘，饮食少进，诸药不效，因为久黄。
以上为细末，每次服一钱匕，清米饮调下，以吐利为度，随时看虚实消息加减。
当归白术汤（《活人书》） 治疗酒疸发黄，心下有癖坚满，身体沉重，妨害饮食，小便赤黄，此因内虚，饮食生冷，脾胃痰结所致。
白术、茯苓（各一钱）、当归、黄芩、茵陈（各三分半）、前胡、枳实、甘草（炙）、杏仁（各六分）、半夏（八分，泡透）
以上细切，作一服，加姜三片，水一盏半，煎至一盏，温服。
抵当汤（《活人书》） 治疗伤寒热郁，瘀血内结，身黄脉沉细，狂言谵语，小便自利，大便黑。（方见伤寒门。）
针砂（半斤，醋炒红）、苍术（四两，米泔浸）、香附（四两，童便浸）、神曲（炒微黄）、茵陈（姜汁炒）、麦芽（麸炒，各二两）、芍药、当归（酒洗，去头）、生地黄、川芎、青皮（去穣炒，各一两五钱）、陈皮（去白）、莪术（醋煮）、三棱（醋煮，各二两）、栀子（去壳炒）、姜黄、升麻、干漆（各五钱，炒烟尽）
以上为细末，醋糊做成丸，如梧桐子大小，每次服六、七十丸，姜汤送下。
五倍子（半斤，炒黑）、绿矾（四两，姜汁炒白）、针砂（四两，醋炒红色）、神曲（半斤，炒微黄色）
以上为细末，生姜汁煮红枣肉做成丸，如梧桐子大小，每次服六、七十丸，温酒送下。不能饮酒，米汤也可以。终身忌食荞麦面，犯了会复发且难治。
枣矾丸（《宝鉴》） 治疗食劳，身目俱黄者。
绿矾（半斤，火煅通红）
以上研细，红枣肉做成丸，如梧桐子大小，每次服五十丸，或酒或姜汤送下。
（祖传方）
苍术（米泔浸）、白术（各二两五钱）、甘草（炙，五钱）、浓朴（姜汁拌炒，一两）、陈皮（去白，一两五钱）、针砂（醋炒红色）、香附（童便浸，各六两）、神曲（炒黄色）、小麦面（炒微黄，各一两半）
以上为细末，面糊做成丸服用，忌鱼腥、湿面、生冷、水果等物。
（医案）
一个三十多岁的男子，得了谷疸症，求我治疗。我用胃苓汤去掉桂枝加上茵陈，几十帖后黄色退去，他自以为安好了，不服药。十几天后，到了晚上眼睛失明看不见东西。我说：这叫雀目（夜盲症），大概是湿痰盛而肝火有余。用猪肝煮熟和夜明砂做成丸服用，眼睛随即明亮如初，来道谢。我说：还没完，不早服制肝补脾消痰的药，必定发展成蛊胀。他不相信，半个月后腹部逐渐胀痞满，又来治疗。我还是用胃苓汤加倍白术和苍术，加木通、麦门冬，煎汤送服褪金丸，一个月平安。
Discussion
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The central direction corresponds to yellow and communicates with the Spleen. It also states: All dampness-induced swelling and fullness belong to Spleen Earth. In the disease of Jaundice (Huangdan), the muscles must be vacuously swollen and yellow in color, because Damp-Heat stagnates and accumulates within the Stomach and Spleen. Over time, it fails to dissipate, thus the Earth color of the Spleen manifests on the face and skin. Since the Spleen governs the muscles and the Lung governs the skin and hair, the Mother organ can cause deficiency in the Child organ; when the Mother is diseased, the Child is also affected. Therefore, internal pathology must manifest externally. There are five types of symptoms: Huanghan (Yellow Sweat), Huangdan (Jaundice), Jiudan (Wine Jaundice), Gu dan (Grain Jaundice), and Nü lao dan (Female Labor Jaundice). Although divided into these five categories, there is ultimately no difference between Cold and Heat patterns. Zhu Danxi said: There is no need to strictly distinguish the five types; they are all Damp-Heat, similar to fermenting Qu (yeast starter). As the classics say, "One who knows the essence needs only one word to conclude," which is precisely this meaning. Additionally, in Cold Damage and febrile diseases, if Yangming Fu-organ excess exists, but purgation cannot be used, sweating cannot be used, or diuresis cannot be used, leading to severe internal stagnation of Damp-Heat, all can cause jaundice. Ancient sages formulated formulas such as Yinchen Wuling San (Cinchona and Five-Ingredient Poria Decoction), Yinchen Tang (Cinchona Decoction), and Fuling Shen Shi Tang (Poria Damp-Draining Decoction), all of which yielded immediate effects. Thus it is said that treating dampness without promoting urination is not the correct treatment. It is also said that dampness in the upper body should be treated by sweating, while dampness in the lower body should be treated by diuresis; or both methods can be used simultaneously to drain dampness from above and below, ensuring recovery. Students should study this carefully.
Pulse Diagnosis
The *Mai Jing* (Pulse Classic) states: In any jaundice presentation, if the Cun Kou pulse is faint at the palm root and the mouth and nose are cold, it is incurable.
If the pulse is deep, thirst with desire to drink water, and urination is difficult, jaundice will definitely occur.
In Wine Jaundice, some patients may have no fever, appear calm and lucid, suffer from abdominal fullness and nausea, dry nose, and a floating pulse; in such cases, emesis should be induced first. If the pulse is deep and wiry, purgation should be induced first.
If Wine Jaundice is treated with purgation, it may eventually transform into Hei dan (Black Jaundice), characterized by blue-black eyes, black complexion, a sensation of burning discomfort in the heart like eating garlic or leeks, black stool, numbness of the skin and limbs, a floating and weak pulse, and a dark-yellowish complexion, indicating a difficult-to-treat condition.
In Grain Jaundice, the Cun Kou pulse is faint and weak. Faintness indicates aversion to cold, weakness indicates fever. If sweating should be induced but isn't, joint pain occurs. If irritability should arise but doesn't, yet yellow sweat appears. The Zu Yang pulse is slow and delayed; stomach Qi is excessively strong. After eating, there is irritability and fullness; fullness leads to fever. Exogenous heat consumes grain, causing hunger after eating. Strong grain intake leads to muscle wasting, named Grain Jaundice.
In Yangming disease, if the pulse is slow, one cannot eat until full; after eating, irritability and dizziness occur, accompanied by difficult urination. This indicates impending Grain Jaundice. Even if purged, abdominal fullness remains unchanged.
The Zu Yang pulse is tight and rapid. Rapid indicates heat, which digests food quickly. Tight indicates cold, causing fullness after eating.
A floating Chi pulse indicates Kidney injury; a tight Zu Yang pulse indicates Spleen injury. Wind-Cold combats each other, causing dizziness after eating, undigested grain, turbid Qi in the Stomach, downward flow of turbid Qi, blocked urination, Cold affecting the Yin channels, and Heat flowing into the Bladder, resulting in whole-body yellowing, named Grain Jaundice.
Methods
Zhu Danxi said: No need to distinguish the five types; they are all Damp-Heat, similar to Qu fermentation. For mild cases, use Xiao Wen Zhong Wan (Minor Warm the Middle Pill); for severe cases, Da Wen Zhong Wan (Major Warm the Middle Pill). Add Huanglian (Coptis Rhizome) for more heat; add Xiaoshiji (food stagnation-resolving herbs) to Yinchen Wuling San for more dampness.
Dai Shi said: For food stagnation, purge according to deficiency or excess; for others, simply promote urination. Once urine is clear and unobstructed, the yellow color recedes. Some say: Jaundice should be treated with Dao Cang Fa (Stomach Purging Method). Others say: For jaundice with fatigue, Spleen-Stomach disharmony, and poor appetite, use Weiling Tang (Gastrointestinal Decoction). Add Huashi (Talcum) for red urine.
Formula 1 for Treating Jaundice:
Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Zhizi (Gardenia Fruit), Yinchen (Artemisia Capillaris), Zhuling (Polyporus), Zexie (Alisma Rhizome), Cangzhu (Atractylodes Rhizome), Qingpi (Citrus Peel), Caolongdan (Gentiana Scabra Root) (each 0.5 fen).
For Grain Jaundice, add Sanleng (Sparganium Tuber), Ezhu (Curcuma Rhizome), Suosha (Amomum Fruit), Chenpi (Aged Tangerine Peel), Shenqu (Medicated Leaven).
Cut finely, take one dose, decoct in water and drink.
Another Formula for Treating Qi Excess with Damp Injury, Whole-Body Yellowing, Suitable for Emesis:
Fuxiong (Ligusticum Chuanxiong), Zhizi (Gardenia Fruit), Jiegeng (Platycodon Root) (each 2 qian).
Cut finely, take one dose, decoct with ginger, add chive juice, and induce vomiting.
Xiao Wen Zhong Wan treats Jaundice with Food Stagnation and restrains Liver Dryness and Spleen Deficiency. For Spleen deficiency, administer with Baizhu (Atractylodes Macrocephala Rhizome) decoction.
Zhensha (Needle Sand, prepared with vinegar), Kushen (Sophora Root, increased in summer, decreased in winter), Shanzha (Hawthorn Fruit) (each 2 liang), Wuzhuyu (Evodia Fruit, increased in winter, decreased in summer, 1 liang), Cangzhu (Atractylodes Rhizome, 8 liang), Baizhu (Atractylodes Macrocephala Rhizome, 5 liang), Chuanxiong (Ligusticum Chuanxiong Rhizome, decreased in summer), Shenqu (Medicated Leaven) (each 8 liang), Xiangfu (Cyperus Rhizome, soaked in child's urine overnight, 1 jin).
Grind into fine powder, make pills with vinegar paste, size of Sophora seeds. Take 70-80 pills before meals with salt water. Another version lacks Baizhu, Shanzha, Kushen, Wuzhuyu, but includes Zhizi.
Da Wen Zhong Wan:
Zhensha (Needle Sand, 10 liang, prepared as above), Chenpi (Aged Tangerine Peel), Cangzhu (Atractylodes Rhizome), Qingpi (Citrus Peel), Houpo (Magnolia Bark, processed with ginger juice), Sanleng (Sparganium Tuber, boiled in vinegar for one hour), Ezhu (Curcuma Rhizome, same preparation), Huanglian (Coptis Rhizome), Kushen (Sophora Root), Baizhu (Atractylodes Macrocephala Rhizome) (each 5 liang), Sheng Gancao (Raw Licorice Root, 2 liang), Xiangfu (Cyperus Rhizome, soaked in child's urine overnight, 1 jin).
Grind into fine powder, make pills with vinegar paste. (Another version lacks Huanglian, Kushen, Baizhu; another lacks Gancao, named Wen Zhong Wan.)
Tiaowei Chengqi Tang (from *Huoren Shu*, see Cold Damage section):
Wang Shuhe said: Abdominal fullness, flaccid tongue, irritability, and insomnia belong to the Jaundice category. Also: Jaundice with fever, irritability, panting, chest fullness, and dry mouth results from fire-forced sweating during onset, causing two heats to clash. However, Jaundice originates from dampness, so the whole body becomes hot and yellow. If the abdomen is hot, the heat is interior; purgation is required for relief using Tiaowei Chengqi Tang.
Also: Jaundice should be treated within 18 days. Recovery after 10 days is good; severe cases are difficult. Jaundice with thirst is difficult to treat; jaundice without thirst is easy to treat. Onset in Yin parts causes vomiting; onset in Yang parts causes chills and fever. The Master said: All Jaundice cases should primarily promote urination. If the pulse is floating, resolve via sweating using Guizhi Jia Huangqi Tang (Decocted Cinnamon Twig with Added Astragalus), also known as Huangqi Jianzhong Tang (Astragalus Decocted Middle-Jiao Decoction). (See Cold Damage section.)
Also: Male jaundice with spontaneous urination should receive Xiao Jianzhong Tang (Minor Decocted Middle-Jiao Decoction). Also: Jaundice with abdominal fullness, difficult and red urination, and spontaneous sweating indicates exterior harmony and interior excess; purge using Dahuang Huangbai Zhizi Mangxiao Tang (Rhubarb, Phellodendron, Gardenia, and Mirabilite Decoction).
Dahuang Huangbai Zhizi Mangxiao Tang (Wang Shuhe):
Huangbai (Phellodendron Bark), Mangxiao (Mirabilite), Dahuang (Rhubarb Root) (each 4 qian), Zhizi (Gardenia Fruit, 3 pieces).
Cut finely, take one dose, decoct in 1.5 cups of water until 1 cup remains, take warm.
Also: In jaundice, if urine color is unchanged, desire for spontaneous diarrhea, abdominal fullness, and panting, do not clear heat. Clearing heat will cause hiccups; for hiccups, use Xiaobanxia Tang (Minor Pinellia Decoction). (See Cold Damage section.)
Also: Wine-induced jaundice always involves difficult urination, with sensations of heat in the heart and soles of the feet. Heart palpitations with heat, inability to eat, and frequent urge to vomit constitute Wine Jaundice. Wine jaundice with heart heat and urge to vomit resolves upon vomiting. Wine jaundice presents with yellow color, real heat in the heart, and irritability.
Also: Black forehead, slight sweating, heat in palms and soles, evening exacerbation, bladder urgency, and spontaneous urination constitute Nü Lao Dan (Female Labor Jaundice). Abdominal distension resembling water accumulation is untreatable.
Also: Jaundice patients typically have afternoon fever but instead feel aversion to cold due to Female Labor Jaundice. Bladder urgency, lower abdominal fullness, whole-body yellowing, black forehead, and heat in soles lead to Black Jaundice. Abdominal distension like water, black tarry stools, and occasional loose stools indicate Female Labor Jaundice, not water retention. Abdominal fullness is difficult to treat; manage with Xiaoshi Fanshi San (Niter and Alum Powder).
Xiaoshi Fanshi San (Wang Shuhe):
Equal parts of Niter and Alum, calcined to ash. Take 2 qian per dose, mixed with Barley Porridge Soup, three times daily. Sweating indicates cure. If lower abdominal fullness/urgency and difficult urination occur, use Huashi (Talcum) and Shigao (Gypsum) (each 2 qian) with a pinch of Rice, decoct together.
For Wine Jaundice, use Xiaochaihu Tang (Minor Bupleurum Decoction) plus Yinchen, Douchi (Fermented Soybean), Dahuang, Huanglian, Gegen (Kudzu Root), decocted and taken. Effective. (Wang Shuhe)
Fuling Tang (Liu Hejian): Treats Wei Dan (Stomach Jaundice) with excessive hunger, sallow complexion, heart irritability, chest/hypochondriac fullness, and red/scanty urination. (See Lin Mi section.)
Formula 1 (Zhu Danxi) for Grain Jaundice:
Chaihu (Bupleurum Root), Guya (Sprouted Grain), Zhishi (Immature Bitter Orange), Houpo, Zhizi, Dahuang in equal parts, decocted and taken. Effective.
Weiling Tang (Jufang): Treats Spleen-Stomach disharmony causing yellow edema. Add Huashi for red/scanty urination.
This is Wuling San combined with Pingwei San.
Shen Dan Tang (Li Dongyuan): Treats Shen Dan (Kidney Jaundice) with yellow eyes or whole-body yellowing, red/scanty urination.
Shengma (Cimicifuga Rhizome), Qianghuo (Notopterygium Rhizome), Fangfeng (Saposhnikovia Root), Gaoben (Ligusticum Sinense Rhizome), Duhuo (Angelica Pubescens Root), Chaihu (each 0.5 fen), Cangzhu (1 qian), Zhuling (0.4 qian), Gegen (0.5 fen), Zexie (0.3 fen), Huangqin (0.2 fen), Gancao (0.3 fen), Shenqu (stir-fried, 0.3 fen), Huangbai (0.2 fen), Baizhu (0.5 fen), Renshen (0.3 fen).
Cut finely, take one dose, decoct in 1.5 cups of water until 1 cup remains, strain and take warm.
Yinchen Wuling San (*Huoren Shu*): Treats jaundice from Cold Damage or latent Summerheat, difficult urination, irritability/thirst.
Double the amount of Yinchen in this formula, add ginger and jujube, decoct and take.
Yinchen Fuling Tang (*Huoren Shu*): Treats jaundice with deep, thin, rapid pulse, cold limbs, scanty urination, irritability/thirst.
Fuling (Poria), Guizhi (Cinnamon Twig), Zhuling (Polyporus) (each 1 qian), Huashi (Talcum, 1.5 qian), Yinchen (2 qian).
Cut finely, take one dose, decoct in 1.5 cups of water until 1 cup remains. If pulse does not emerge, add Danggui (Angelica Sinensis Root) 1.5 qian.
Zhizi Dahuang Tang (*Huoren Shu*): Treats Wine Jaundice with heart palpitations/irritability or heat/pain.
Zhizi (Gardenia Fruit, 14 pieces), Dahuang (Rhubarb Root, 1 liang), Zhishi (Immature Bitter Orange, 5 pieces), Douchi (Fermented Soybean, 1 sheng).
Take one dose, decoct in 5 cups of water until 2 cups remain, divide into three doses.
Banwen Banre Tang (*Huoren Shu*): Treats Wine Jaundice with yellow body but no fever, calm demeanor, abdominal fullness/nausea, heart irritability/foot heat, possible masses, heart palpitations, deep/tight/wiry/thin pulse.
Banxia (Pinellia Tuber), Fuling (Poria), Baizhu (Atractylodes Macrocephala Rhizome) (each 0.7 fen), Qianhu (Peucedanum Root), Zhike (Bitter Orange Peel, stir-fried with bran until yellow), Gancao (Licorice Root, honey-fried), Daji (Euphorbia Lathyris Root) (each 0.5 fen), Huangqin (Scutellaria Root), Yinchen, Danggui (Angelica Sinensis Root) (each 0.3 fen).
Cut finely, take one dose, add 3 slices of ginger, 2 cups of water, decoct until 1 cup remains, take warm.
Yinchen Hao Tang (*Huoren Shu*): Treats body heat, dry nose, sweating, rising Yang Qi, red/scanty/unobstructed urination, Damp-Heat jaundice.
Yinchen Hao (Artemisia Capillaris Herb), Da Zhizi (Large Gardenia Fruit, 3 pieces), Dahuang (Rhubarb Root, 3.5 qian).
Cut finely, take one dose, decoct in 3 cups of water until 1.5 cups remain, take warm.
Yinchen Dahuang Tang (*Huoren Shu*): Treats severe heat jaundice from Cold Damage, yellow face/eyes, red/scanty urination.
Yinchen Hao, Zhizi, Chaihu, Huangbai, Huangqin, Shengma, Dahuang (each 0.7 fen), Caolongdan (Gentiana Scabra Root, 0.35 fen).
Cut finely, take one dose, decoct in 1.5 cups of water until 1 cup remains, take warm.
Zhizi Bo Pi Tang (*Huoren Shu*): Treats persistent body heat, loose stools, irritability, heat-induced yellowing.
Zhizi, Huangbai, Huanglian (each 3.5 qian).
Cut finely, take one dose, decoct in 1.5 cups of water until 1 cup remains, take warm.
Fuling Shen Shi Tang (*Huoren Shu*): Treats jaundice with alternating chills/fever, vomiting/thirst, desire for cold water, yellow eyes/body, difficult urination, anorexia. (See Dampness section.)
Xiao Yinchen Tang (*Huoren Shu*): Treats jaundice with deep, thin, slow pulse, whole-body coldness.
Fuzi (Aconite Root, 1 piece, sliced and processed), Gancao (Licorice Root, honey-fried, 1 liang), Yinchen (2 liang).
Cut finely, divide into three doses. Each dose decocted in 2 cups of water until 1 cup remains, take warm.
Yinchen Sini Tang (*Huoren Shu*): Treats jaundice with deep, thin, slow pulse, cold extremities, spontaneous sweating above waist.
Gancao (Licorice Root, honey-fried, 1 liang), Ganjiang (Dried Ginger, processed, 1.5 liang), Fuzi (Aconite Root, 1 piece, sliced and processed), Yinchen (2 liang).
Cut finely, divide into four doses, decoct in water and take.
Tingli Kushen San (*Huoren Shu*): Treats severe internal Damp-Heat, red/scanty urination, intermittent constipation, poor appetite, ineffectiveness of other drugs, chronic jaundice.
Kushen (Sophora Root), Huanglian, Gouti (Melon Seed), Huangbai, Dahuang (each 1 liang), Tinglizi (Descurainia Seed, 2 liang).
Grind into fine powder. Take 1 qian per dose, mixed with clear rice drink. Induce vomiting/diarrhea as needed, adjust based on deficiency/excess.
Danggui Baizhu Tang (*Huoren Shu*): Treats Wine Jaundice with hard/fullness under heart, heavy body, impaired digestion, red/yellow urine, caused by internal deficiency, raw/cold diet, and Phlegm-Stagnation in Spleen-Stomach.
Baizhu, Fuling (each 1 qian), Danggui, Huangqin, Yinchen (each 0.35 fen), Qianhu, Zhishi, Gancao (honey-fried), Xingren (Apricot Seed, each 0.6 fen), Banxia (Pinellia Tuber, 0.8 fen, well-soaked).
Cut finely, take one dose, add 3 slices of ginger, 1.5 cups of water, decoct until 1 cup remains, take warm.
Didang Tang (*Huoren Shu*): Treats Cold Damage with heat stagnation, intra-abdominal Blood Stasis, yellow body, deep/thin pulse, delirium, spontaneous urination, black stool. (See Cold Damage section.)
Zhensha Wan (Jiyan Fang): Treats Grain Jaundice, Wine Jaundice, Damp-Heat jaundice.
Zhensha (Needle Sand, 8 liang, stir-fried red with vinegar), Cangzhu (Atractylodes Rhizome, 4 liang, soaked in rice wash water), Xiangfu (Cyperus Rhizome, 4 liang, soaked in child's urine), Shenqu (Medicated Leaven, stir-fried light yellow), Yinchen (stir-fried with ginger juice), Maiya (Malt, bran-fried, each 2 liang), Shaoyao (Peony Root), Danggui (Angelica Sinensis Root, wine-washed, heads removed), Sheng Dihuang (Rehmannia Root), Chuanxiong, Qingpi (Citrus Peel, pith removed, stir-fried, each 1.5 liang), Chenpi (Aged Tangerine Peel, white pith removed), Ezhu (Curcuma Rhizome, vinegar-boiled), Sanleng (Sparganium Tuber, vinegar-boiled, each 2 liang), Zhizi (Gardenia Fruit, shell removed, stir-fried), Jianghuang (Turmeric Rhizome), Shengma, Ganqi (Drylac Resin, each 0.5 liang, stir-fried until smoke ceases).
Grind into fine powder, make pills with vinegar paste, size of Sophora seeds. Take 60-70 pills with ginger soup.
Lvfan Wan (Jiyan): Most effective for Yellow Edema.
Wubeizi (Chinese Gall, 8 liang, stir-fried black), Lvfan (Green Vitriol, 4 liang, stir-fried white with ginger juice), Zhensha (Needle Sand, 4 liang, stir-fried red with vinegar), Shenqu (Medicated Leaven, 8 liang, stir-fried light yellow).
Grind into fine powder, make pills with ginger juice and red jujube flesh, size of Sophora seeds. Take 60-70 pills with warm wine. Rice soup acceptable for non-drinkers. Avoid buckwheat noodles lifelong; recurrence is difficult to treat if consumed.
Zaofan Wan (*Baodian*): Treats dietary labor jaundice with yellow eyes/body.
Lvfan (Green Vitriol, 8 liang, calcined red hot).
Grind finely, make pills with red jujube flesh, size of Sophora seeds. Take 50 pills with wine or ginger soup.
(Ancestral Formula)
Tuijin Wan: Excellent for Yellow Edema.
Cangzhu (Atractylodes Rhizome, soaked in rice wash), Baizhu (Atractylodes Macrocephala Rhizome, each 2.5 liang), Gancao (Licorice Root, honey-fried, 0.5 liang), Houpo (Magnolia Bark, stir-fried with ginger juice, 1 liang), Chenpi (Aged Tangerine Peel, white pith removed, 1.5 liang), Zhensha (Needle Sand, stir-fried red with vinegar), Xiangfu (Cyperus Rhizome, soaked in child's urine, each 6 liang), Shenqu (Medicated Leaven, stir-fried yellow), Xiaomai Mian (Wheat Flour, stir-fried light yellow, each 1.5 liang).
Add masses: Sanleng (vinegar-boiled), Ezhu (vinegar-boiled, each 1.5 liang).
Grind into fine powder, make pills with flour paste. Avoid fishy smells, wet dough, raw/cold foods, fruits.
Medical Case
A man in his thirties suffered from Grain Jaundice and sought my treatment. I prescribed Weiling Tang minus Guizhi plus Yinchen. After dozens of doses, the yellow color subsided. Believing himself cured, he stopped medication. Ten days later, he went blind at night. I said: This is called Que Mu (Night Blindness), caused by abundant Damp-Phlegm and surplus Liver Fire. I prescribed cooked liver mixed with Yeming Sha (Cave Dirt/Feces) made into pills. His vision returned to normal, and he thanked me. I said: Not yet. Had you taken earlier herbs to restrain Liver, tonify Spleen, and resolve Phlegm, you would not have developed Gu Zhang (Abdominal Distension/Bloat). He did not believe me. Half a month later, his abdomen gradually became distended and full. He returned for treatment. I again prescribed Weiling Tang with doubled Baizhu and Cangzhu, plus Mutong (Akebia Stem) and Maidong (Ophiopogon Tuber), decocted to swallow Tuijin Wan. He recovered safely in one month.