（王叔和原入阳明篇）
伤寒脉浮而缓，手足自温者，是为系在太阴，当发身黄。小便自利者，不能发黄。至七八日，虽暴烦，下
利日十余行，必自止，以脾家实，腑秽当去故也。
〔海〕色如烟熏黄，乃湿病也，一身尽痛。色如橘子黄，乃黄病也，一身不痛。
〔成〕湿家之黄也，身黄似熏黄，虽黄而色暗不明也。热家之黄也，身黄似橘子色，甚者勃勃出，染着衣，
正黄如黄柏，是其正黄色也。色如熏黄，一身尽痛，发热者为湿痹，若脉沉缓，小便不利者，甘草附子汤、五
苓散。若脉大头痛鼻塞者，纳药鼻中则愈矣。（论见体痛。）
〔许〕一人病身体痛，面黄，喘满，头痛，自能饮食，大小便如常。予诊之脉大而虚，鼻塞而烦。予曰∶
非湿热宿谷相搏，此乃头中寒湿，非茵陈五苓不可行也。仲景云∶湿家病身疼痛发热，面黄而喘，头痛鼻塞而
烦，其脉大，自能饮食，腹中初无病，病在头中，寒湿攻鼻故塞，纳药鼻中则愈。仲景无药方，此方见《外台》。
《删繁》症云∶治天行热病，盖通贯脏腑，寒湿沉于骨髓之间，或为黄胆，宜瓜蒂散，即此方也。（瓜蒂散方
见后黄续条。）
又有一舟梢，病伤寒发黄，鼻酸痛，身与目如金色，小便赤而数，大便如常。或者欲用茵陈五苓。
予曰∶非其治也，小便利，大便如常，则知病不在脏。今眼睛鼻 痛，是病在清道中。清道者，华盖肺之经也，
若下大黄，则必腹胀为逆。亦用瓜蒂散，先含水，次搐之，鼻中黄水尽乃愈。伤寒七八日，身黄如橘子色，小
便不利，腹微满者，茵陈汤主之。阳明胃家实，身无汗，但头汗出，小便不利，饮水浆发黄，亦茵陈蒿汤主之。
茵陈蒿（嫩者，一两） 大黄（半两） 山栀（二钱）
上 咀，用水三大盏，先煎茵陈减半，纳二味，煎熟温服，日三服，小盒饭利，如皂荚汁状，色正赤。过
一宿，腹满减，黄从小便中去也。
身黄胁痛，小便难，未下者宜柴胡，下后者忌柴胡。（二法俱见胸胁痛门。）
伤寒发汗后而身目俱黄，所以然者，以寒湿在里不解故也。法不可下，当于寒湿中求之。（与熏法同。）
太阳病，脉浮数，为表未解，医反下之，若不结胸，但头汗出，余无汗，剂颈而还，小便不利，身必发黄。
（论见结胸。《活人》云∶茵陈汤主之。）阳明病，面赤，攻之必发热身黄，小便不利。（论见胃实。）阳明病，
黄而腹满，脉迟，饱则头眩，小便难者，虽下之，腹满如故。（论见腹满。）下后不能食，胁下满痛，
颈项强，小便难而身黄者，与柴胡汤必下重。
阳明病，被火，额上微汗出，小便不利者，身必发黄。风温脉浮汗出，身重多眠，若被火则微发黄色，剧
则如惊痫，时螈 。（论见风温。）太阳病中风，以火劫发汗，邪风被火热，血气流溢，失其常度，两阳相熏，灼其身
发黄。（论见头汗。）
身黄，脉沉结，少腹硬而小便自利，其人发狂，大便黑者，为蓄血，宜抵当汤。（论见蓄血。）
伤寒身黄发热者，栀子黄柏皮汤主之。
栀子（十五枚） 甘草（一两） 黄柏（二两）
上 咀，每服五钱，水煎温服。
伤寒瘀热在里，身必发黄，麻黄连翘汤主之。
麻黄（泡，去节） 连翘根 生姜 甘草（各一两） 赤小豆 梓白皮（生。各半升） 杏仁（二十粒）
大枣（六枚）
上 咀，每服五钱，用潦水一盏半煎，温服。（麻黄、杏仁、生姜、甘草、大枣五味甘辛发散表邪，为
阳也。赤小豆、连翘、梓皮酸苦泄里为阴也，潦水味薄不助阴气也。）
上身黄小便自利，小腹硬而狂，大便黑者，为蓄血，则宜抵当汤下之。若小腹不硬，其人不狂，大便
不黑者，虽小便利，非蓄血也。其为症有三。一者栀子柏皮汤，二者麻黄连翘赤小豆汤，皆治身黄小便利
而身不疼者，海藏所谓干黄是也。三者桂枝附子汤、去桂加白术汤，皆治身黄小便利，而一身尽痛者，《活
人》所谓中湿是也。
汗下烧针后，心下痞而胸烦者，面色青，肤 ，难治。色微黄，手足温者，易治。（论见痞。）身黄
禁忌。（见前汗后身黄、下后身黄条。）
（王叔和原将其归入阳明篇）
伤寒脉象浮而缓，手足自然温暖者，这是病邪关联太阴脾经，应当出现身体发黄。若小便通畅自利，则不会发黄。到了七八天，虽然突然感到烦闷，每天腹泻十几次，必定会自行停止，这是因为脾家正气恢复（脾家实），肠道内的秽浊之物应当排出的缘故。
〔海藏〕面色如烟熏般的黄，属于湿病，全身都疼痛。面色如橘子般的黄，属于黄疸病，全身不痛。
〔成无己〕这是湿家所致的黄疸，身黄类似熏黄，虽然发黄但色泽晦暗不明。热家所致的黄疸，身黄类似橘子色，严重的甚至颜色鲜艳欲滴，沾染衣物，正黄如同黄柏，这才是纯正的黄色。面色如烟熏黄，全身尽痛，发热的属于湿痹；如果脉象沉缓，小便不利，可用甘草附子汤、五苓散治疗。如果脉大、头痛、鼻塞，将药物纳入鼻中即可痊愈。（此论述见“体痛”条。）
〔许叔微〕有一人患病，身体疼痛，面色黄，气喘胸闷，头痛，但能正常饮食，大小便如常。我诊察其脉象大而虚，鼻塞且烦躁。我说：这不是湿热与宿食相互搏结，而是头中寒湿，非茵陈五苓散不可用。张仲景说：湿家患病，身体疼痛发热，面黄而喘，头痛鼻塞且烦躁，脉象大，能正常饮食，腹部起初没有病，病位在头部，寒湿侵袭鼻子导致鼻塞，将药物纳入鼻中即可痊愈。张仲景没有给出药方，此方见于《外台秘要》。《删繁》症候记载：治疗天行热病，大概通贯脏腑，寒湿沉伏于骨髓之间，或形成黄疸，宜用瓜蒂散，就是此方。（瓜蒂散方剂见后文“黄续”条。）
又有一位船夫，患伤寒发黄，鼻部酸痛，身体和眼睛像金色一样，小便赤红且频数，大便如常。有人想用茵陈五苓散。
我说：这不是正确的治法。小便利，大便如常，就知道病不在脏腑。现在眼睛和鼻子疼痛，说明病在清道之中。清道，是华盖肺经所属的路径，如果使用大黄攻下，必然会导致腹胀，这是逆证。也使用瓜蒂散，先含一口水，然后搐鼻给药，直到鼻中流出黄水才痊愈。伤寒七八日，身黄如橘子色，小便不利，腹部轻微胀满的，茵陈汤主治。阳明胃家实证，身上无汗，仅头部出汗，小便不利，饮水浆后发黄，也用茵陈蒿汤主治。
茵陈蒿（嫩者，一两） 大黄（半两） 山栀（二钱）
以上切碎，用水三大盏，先煎茵陈至减半，加入另外两味药，煎熟后温服，每日三次，小便应当通利，排出物如皂荚汁状，颜色正赤。过了一夜，腹部胀满减轻，黄色从小便中去除。
身黄伴胁痛，小便困难，未使用泻下法的适宜用柴胡剂，已使用泻下法的忌用柴胡。（这两种方法均见“胸胁痛”门。）
伤寒发汗后，身体和眼睛都发黄，之所以这样，是因为寒湿在体内未能解除的缘故。法度上不可使用泻下法，应当在寒湿中寻求治疗方法。（与熏蒸法相同。）
太阳病，脉象浮数，表示表证未解，医生反而使用泻下法，如果不形成结胸，只是头部出汗，其余部位无汗，汗水只到颈部即止，小便不利，身体必定发黄。（此论述见“结胸”。《活人书》云：茵陈汤主治。）阳明病，面色红赤，攻下必致发热身黄，小便不利。（此论述见“胃实”。）阳明病，身黄且腹部胀满，脉迟，饱食后头晕目眩，小便困难的，即使使用泻下法，腹部胀满依然如故。（此论述见“腹满”。）泻下后不能进食，胁下胀满疼痛，颈项强直，小便困难且身黄的，给予柴胡汤必定会导致下重感。
阳明病，被火疗，额头微微出汗，小便不利的，身体必定发黄。风温病，脉浮汗出，身体沉重多眠，如果被火疗则微微发黄，严重时如同惊痫，不时抽搐。（此论述见“风温”。）太阳病中风，用火劫迫发汗，邪风被火热所伤，血气流溢，失去常态，两阳相熏灼，身体发黄。（此论述见“头汗”。）
身黄，脉象沉结，少腹硬满而小便自利，其人发狂，大便黑色的，为蓄血证，适宜抵当汤。（此论述见“蓄血”。）
伤寒身黄发热的，栀子柏皮汤主治。
栀子（十五枚） 甘草（一两） 黄柏（二两）
以上切碎，每服五钱，水煎温服。
伤寒瘀热在里，身体必定发黄，麻黄连翘赤小豆汤主治。
麻黄（泡，去节） 连翘根 生姜 甘草（各一两） 赤小豆 梓白皮（生。各半升） 杏仁（二十粒） 大枣（六枚）
以上切碎，每服五钱，用潦水一盏半煎煮，温服。（麻黄、杏仁、生姜、甘草、大枣五味甘辛发散表邪，属阳。赤小豆、连翘、梓皮酸苦泄里，属阴，潦水味薄不助阴气。）
上身黄，小便自利，小腹硬满且狂躁，大便黑色的，为蓄血，则适宜抵当汤攻下。如果小腹不硬，人不狂躁，大便不黑的，虽然小便利，也不是蓄血。此类症状有三种情况。一是栀子柏皮汤，二是麻黄连翘赤小豆汤，都治疗身黄、小便利而身不疼的，这是海藏所说的干黄。三是桂枝附子汤、去桂加白术汤，都治疗身黄、小便利，而全身尽痛的，这是《活人书》所说的中湿。
汗法、下法、烧针治疗后，心下痞塞且胸中烦闷的，面色青，皮肤涩滞，难治。面色微黄，手足温暖的，易治。（此论述见“痞”。）身黄的禁忌。（见前文“汗后身黄”、“下后身黄”条。）
(Wang Shuhe originally included this in the Yangming chapter.)
In cold damage (Shanghan), if the pulse is floating and slow, and the hands and feet are naturally warm, this indicates the pathogen is associated with the Taiyin Spleen channel. The patient should develop jaundice. If urination is free and unobstructed, jaundice will not occur. By the seventh or eighth day, although there may be sudden irritability and diarrhea occurring more than ten times a day, it will certainly stop on its own. This is because the Spleen's healthy qi has become substantial (Pi Jia Shi), and the turbid waste in the fu organs is about to be expelled.
[Hai Zang] A yellow complexion resembling soot-smoke indicates dampness disease, accompanied by pain throughout the body. A yellow complexion resembling an orange indicates jaundice disease, without pain throughout the body.
[Cheng Wuji] This is jaundice caused by dampness in the "damp person" (Shi Jia). The body is yellow like soot-smoke yellow; although yellow, the color is dark and unclear. Jaundice caused by heat in the "heat person" (Re Jia) resembles the color of an orange. In severe cases, the color is vibrant and bright, staining clothes, truly yellow like Phellodendri Cortex (Huangbai), which is the pure yellow color. If the face is like soot-smoke yellow and the whole body hurts, with fever, it is damp bi syndrome. If the pulse is deep and slow, and urination is difficult, Gancao Fuzi Tang (Licorice and Aconite Decoction) or Wuling San (Five-Ingredient Powder with Poria) can be used. If the pulse is large, with headache and nasal congestion, inserting medicine into the nose will cure it. (This discussion is found under the section "Body Pain".)
[Xu Shumi] One patient suffered from body pain, yellow face, wheezing and chest fullness, headache, but could eat normally, and bowel and bladder movements were normal. I diagnosed his pulse as large and deficient, with nasal congestion and irritability. I said: This is not a struggle between damp-heat and retained food, but rather cold-dampness in the head. Yinchen Wuling San (Artemisiae Scopariae and Five-Ingredient Powder with Poria Decoction) must be used. Zhang Zhongjing said: When a damp person suffers from body pain, fever, yellow face, wheezing, headache, nasal congestion, and irritability, with a large pulse and normal appetite, while the abdomen initially has no pathology, the disease is located in the head. Cold-dampness attacking the nose causes congestion; inserting medicine into the nose will cure it. Zhang Zhongjing did not provide a prescription for this; this formula is seen in *Waitai Miyao* (Essential Prescriptions from the Imperial Library). *Shanfan* symptomatology states: To treat epidemic febrile diseases, which generally penetrate the zang-fu organs, if cold-dampness sinks into the marrow, it may form jaundice. It is appropriate to use Gouti San (Melon Seed Powder), which is this formula. (The formula for Gouti San is seen later in the "Continued Jaundice" section.)
Another case involved a boatman who contracted cold damage with jaundice, soreness and pain in the nose, body and eyes appearing golden-yellow, red and frequent urination, but normal bowel movements. Someone suggested using Yinchen Wuling San.
I said: This is not the correct treatment. Since urination is free and bowel movements are normal, we know the disease is not in the zang-fu organs. Now, with eye and nose pain, the disease is in the "clear pathways" (Qing Dao). The clear pathway belongs to the Lung meridian, known as Huagai (Canopy). If Da Huang (Rhubarb) is used to purge, abdominal distension will inevitably result, which is a contraindication. Use Gouti San instead. First, hold water in the mouth, then insufflate the powder into the nose. Recovery occurs only when all yellow fluid flows out of the nose. In cold damage, by the seventh or eighth day, if the body is yellow like an orange, urination is obstructed, and there is slight abdominal fullness, Yinchen Tang (Artemisiae Scopariae Decoction) is indicated. In Yangming Stomach excess patterns, if there is no sweat on the body, only sweating on the head, obstructed urination, and yellowing after drinking fluids, Yinchenshao Tang (Artemisiae Scopariae, Rhubarb, and Gardenia Decoction) is indicated.
Yinchen Hao (Tender Artemisiae Scopariae Herba, 1 liang), Dahuang (Rhei Radix et Rhizoma, 0.5 liang), Shanzhi (Gardeniae Fructus, 2 qian).
Crush the ingredients. Use three large bowls of water. First decoct Yinchen Hao until reduced by half, then add the other two herbs. Decoct until ready, take warm. Take three times daily. Urination should become free, and the urine will resemble soap pod juice, with a bright red color. After one night, abdominal fullness decreases, and the yellow pigment is eliminated through urination.
For body yellow with hypochondriac pain and difficult urination, Chaihu (Bupleuri Radix) is suitable if purgatives have not been used, and contraindicated if they have. (Both methods are discussed under the section "Hypochondriac Pain".)
After cold damage is treated with sweating, if the body and eyes both turn yellow, it is because cold-dampness remains unresolved inside. Purging is contraindicated; one should seek treatment within the context of cold-dampness. (Same as moxibustion fumigation method.)
In Taiyang disease, if the pulse is floating and rapid, the exterior pattern is unresolved. If the physician erroneously uses purging, and if chest binding (Jie Xiong) does not form, but there is only sweating on the head, no sweat elsewhere, stopping at the neck, and obstructed urination, the body will certainly develop jaundice. (This discussion is found under "Chest Binding." *Ren Jian Shu* says: Yinchen Tang is indicated.) In Yangming disease, if the face is red, purging will necessarily cause fever and jaundice with obstructed urination. (This discussion is found under "Stomach Excess.") In Yangming disease, if there is jaundice and abdominal fullness, a slow pulse, dizziness after eating, and difficult urination, even if purged, the abdominal fullness will remain unchanged. (This discussion is found under "Abdominal Fullness.") After purging, if the patient cannot eat, has fullness and pain in the hypochondrium, stiff neck, difficult urination, and jaundice, giving Chaihu Tang will necessarily cause a sensation of heaviness in defecation.
In Yangming disease, if fire therapy is applied, causing slight sweating on the forehead and obstructed urination, the body will certainly develop jaundice. In Wind-Warmth disease, with a floating pulse, sweating, heavy body, and excessive sleepiness, if fire therapy is applied, slight yellowing occurs; in severe cases, it resembles convulsive epilepsy with occasional spasms. (This discussion is found under "Wind-Warmth".) In Taiyang disease with Wind Strike, if fire coercion is used to induce sweating, the evil wind is damaged by fire heat. Blood and qi flow excessively, losing their normal rhythm. The two yangs scorch each other, causing the body to develop jaundice. (This discussion is found under "Head Sweating".)
If there is body yellow, a deep and knotted pulse, hardness in the lower abdomen, free urination, mania, and black stools, this is blood retention (Xu Xue). Didang Tang (Efficacious Rescue Decoction) is indicated. (This discussion is found under "Blood Retention".)
For cold damage with body yellow and fever, Zhizi Bopi Tang (Gardenia and Phellodendron Bark Decoction) is indicated.
Zhizi (Gardeniae Fructus, 15 pieces), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang), Huangbai (Phellodendri Cortex, 2 liang).
Crush the ingredients. Take 5 qian per dose, decoct in water, and take warm.
For cold damage with stagnant heat in the interior, leading to body yellow, Mahlianqiao Chi Xiaodou Tang (Ephedra, Forsythia, and Adzuki Bean Decoction) is indicated.
Mahuang (Ephedrae Herba, soaked, nodes removed), Lianqiao Gen (Forsythiae Radix), Shengjiang (Zingiberis Rhizoma Recens), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 liang), Chixiaodou (Adzuki Bean), Zibai Pi (Catalpae Cortex, raw, each half sheng), Xingren (Prunus Armeniacae Semen Amarum, 20 grains), Dazao (Jujubae Fructus, 6 pieces).
Crush the ingredients. Take 5 qian per dose, decoct in 1.5 bowls of rainwater (Liao Shui), and take warm. (Mahuang, Xingren, Shengjiang, Gancao, and Dazao are five sweet and pungent herbs that disperse exterior pathogens, belonging to Yang. Chixiaodou, Lianqiao, and Zibi are sour and bitter herbs that drain the interior, belonging to Yin. Liao Shui has a thin taste and does not assist yin qi.)
If there is upper body yellow, free urination, hardness and mania in the lower abdomen, and black stools, this is blood retention, and Didang Tang should be used to purge. If the lower abdomen is not hard, the patient is not manic, and stools are not black, even with free urination, it is not blood retention. There are three types of such symptoms. First, Zhizi Bopi Tang; second, Mahlianqiao Chi Xiaodou Tang. Both treat body yellow with free urination and no body pain, which Haizang refers to as "Dry Jaundice." Third, Guizhi Fuzi Tang and Gui Zhi Fu Zi Yi Zhu Tang (Guizhi Fuzi Decoction minus Cinnamon Twig plus Atractylodes Macrocephala Decoction). Both treat body yellow with free urination and pain throughout the body, which *Ren Jian Shu* refers to as "Dampness Strike."
After sweating, purging, or burning needle treatments, if there is epigastric stuffiness and chest irritability, with a blue-green face and rough skin, the prognosis is poor. If the face is slightly yellow and hands and feet are warm, the prognosis is good. (This discussion is found under "Stuffiness".) Contraindications for body yellow. (See previous sections on "Jaundice after Sweating" and "Jaundice after Purging".)