脉
五疸实热，脉必洪数，其或微涩，证属虚弱。脉沉，渴欲饮水，小便不利者，必发黄也。
病
夫疸者，黄病也，其证有五∶曰黄汗，曰黄胆，曰酒疸，曰谷疸，曰女劳疸。须有五者之分，
而病原不过湿与热郁蒸于脾，使面目肢体发黄，如栀子水染也。
治
治法但利小便为先，溺白，黄自退矣。若食积黄者，量其虚实下之。
一、外有伤寒病，阳明内实，当下而不得下，当汗而不得汗，当利而不得利，故使湿热怫郁内甚，皆
能令人发黄病也，先哲制茵
陈五苓散、茵陈汤、茯苓渗湿汤之类以治之。
一、又有时气、伤寒、伤风、伏暑解散未尽，亦令人发黄。如
有其状，口淡怔忡，耳鸣脚弱，微寒微热，小便白浊，此为虚证，不可妄用凉药，愈伤气血。
一、疸病面黑黄色，而作渴腹胀者，难治。
方
肾疸汤〔批〕（按此方治肾疸，用风药以胜湿也） 治肾疸，目黄，甚至浑身黄，小便赤涩。
羌活 防风 本 独活 柴胡（各五分） 白术（五分） 白茯苓（二分）
泽泻（三分） 猪苓（四分） 苍术（一钱） 黄柏（二分） 人参（三分） 葛根（五分） 神
曲（六分） 升麻（五分） 甘草（三分）
上锉，作二剂，水煎，稍热食前服。
茯苓渗湿汤 治湿热发黄，汗黄尿赤。
猪苓 泽泻 苍术 茯苓 陈皮 枳实 黄连（炒） 黄芩 栀子 防己 茵陈 木通
如不思饮食，加砂仁、神曲炒、麦芽炒各等分。
上锉，生姜煎服。
加减胃苓汤〔批〕（按此方治黄胆渗湿利水之剂） 治黄胖，饮食无味，四肢无力，行步倦怠，脉涩而濡。
苍术（米泔制，一钱半） 陈皮（去白，一钱） 浓朴（姜炒，八分） 甘草（炙，三分）
猪苓（八分） 泽泻（一钱） 白术（去芦，一钱） 赤茯苓（去皮，一钱） 神曲（炒，八
分） 山楂（去核，七分） 砂仁（炒，七分） 香附（姜汁炒，六分） 槟榔（八分） 木瓜
（一钱） 大腹皮（六分） 藿香 半夏 萝卜子 三棱 莪术 青皮（各七分）
上锉一剂，水煎服。
牛黄散子〔批〕（按此方治五疸实热之剂） 治酒疸、食黄，及水气蛊证。
酒疸，饮酒太过；食黄，宿食积久，以此面目甚黄，遍身浮肿；蛊证，肚大如盆。
黑牵牛（春八分，夏九分，秋七分，冬一钱） 大黄（春八分，夏九分，秋七分，
冬一钱） 槟榔（春八分，夏九分，秋七分，冬四分） 甘草（春八分，夏九分，秋七分，
冬四分）
上为细末，每服五钱，五更时面朝东南，用井花水调服，疾随下；而不动，面朝太阳，吸气三口，疾速
下，蛊症全消，酒疸、宿食俱愈。忌生冷发物。后服乌药顺气散一二帖，再服十全大补汤数帖。
酒煮茵陈汤（蒋云山传） 治酒疸，遍身眼目发黄如金黄色者。
茵陈（一两） 好陈酒一钟半，煎至八分，食远温服，不数剂而愈。
五疸神丹（孔柳塘传）〔批〕（按此方治黄胆专攻之剂） 治五疸黄肿。
绿矾（不拘多少，炒至白色为度，入瓶中，火 白尤佳）
上为细末，煮枣肉为丸，如樱桃大。每服五丸，早晨、午间、
晚上各一服，用冷陈酒送下。忌醋生冷发物，若有蛊，服之亦吐出，神效。
退金丸（鄢陵蹇太尹传） 治黄肿及癖疾发热。
砂罐一个，装青矾令八分满，外以盐泥固济，炭火 令通红，去泥埋土中，以彻去火毒，将砂罐及矾
俱为末，水打面糊丸，如梧桐子大。每服二三十丸，肉汤送下，日进三服，滚汤亦可。忌鱼腥面筋等发物。
铁砂丸（思恒传） 治黄胆腹内有块。
苍术（三两，米泔制炒） 香附（三两，醋炒） 白术（一两） 猪苓（一两） 泽泻（一
两） 茯苓（一两） 茵陈（一两五钱） 牛膝（一两） 槟榔（一两） 木瓜（一两） 草果（一
两） 砂仁（一两） 枳壳（一两五钱，麸炒） 青皮（一两） 陈皮（一两五钱） 三棱（一两，
醋炒） 莪术（一两，醋炒） 当归（一两） 神曲（二两） 青矾（三两，麸炒黑）
上为末，醋糊丸，如梧桐大。每服九十丸，温酒送下，醋汤亦可。
脉象
五疸（五种黄疸病）属于实热证，脉象必定洪大且数；如果脉象微细或涩滞，则证候属于虚弱。脉象沉取，伴有口渴想喝水、小便不利的症状，一定会出现发黄。
病症
所谓疸病，就是黄病，其证候有五种：分别是黄汗、黄胆、酒疸、谷疸、女劳疸。必须区分这五种情况，但病因不过是因为湿邪与热邪郁结蒸腾于脾脏，导致面目和肢体发黄，就像用栀子水染色一样。
治法
治疗原则以通利小便为先，尿液变清后，黄色自然消退。如果是食积导致的发黄，需根据患者体质的虚实情况，酌情使用攻下法。
第一类，外感伤寒病，阳明经内里实热，应当用攻下法却未能下行，应当发汗却未能出汗，应当利小便却未能通利，因此导致湿热怫郁在内严重化热，都能使人患上发黄病。先贤制定了茵陈五苓散、茵陈汤、茯苓渗湿汤等方剂来治疗。
第二类，有时因时气、伤寒、伤风、伏暑等病邪解散未尽，也会使人发黄。如果出现口淡、心悸怔忡、耳鸣、脚弱、轻微恶寒发热、小便白浊等症状，这属于虚证，不可妄用寒凉药物，否则会进一步损伤气血。
第三类，疸病患者面色黑黄，并伴有口渴、腹胀的，难以治愈。
方剂
肾疸汤 [批注]（按：此方治疗肾疸，使用风药以胜除湿邪） 治疗肾疸，眼睛发黄，甚至全身发黄，小便赤红涩痛。
羌活、防风、藁本、独活、柴胡（各五分）、白术（五分）、白茯苓（二分）、泽泻（三分）、猪苓（四分）、苍术（一钱）、黄柏（二分）、人参（三分）、葛根（五分）、神曲（六分）、升麻（五分）、甘草（三分）。
以上药材切碎，分为两剂，加水煎煮，在饭前稍热时服用。
茯苓渗湿汤 治疗湿热引起的发黄，汗液发黄，尿色赤红。
猪苓、泽泻、苍术、茯苓、陈皮、枳实、黄连（炒制）、黄芩、栀子、防己、茵陈、木通。
如果食欲不振，加入砂仁、炒神曲、炒麦芽各等分。
以上药材切碎，加生姜煎服。
加减胃苓汤 [批注]（按：此方是治疗黄胖病渗湿利水的方剂） 治疗黄胖病，饮食无味，四肢无力，行走倦怠，脉象涩而濡软。
苍术（米泔水制，一钱半）、陈皮（去白，一钱）、厚朴（姜汁炒，八分）、甘草（炙，三分）、猪苓（八分）、泽泻（一钱）、白术（去芦头，一钱）、赤茯苓（去皮，一钱）、神曲（炒，八分）、山楂（去核，七分）、砂仁（炒，七分）、香附（姜汁炒，六分）、槟榔（八分）、木瓜（一钱）、大腹皮（六分）、藿香、半夏、萝卜子、三棱、莪术、青皮（各七分）。
以上药材切碎为一剂，加水煎服。
牛黄散子 [批注]（按：此方是治疗五疸实热的方剂） 治疗酒疸、食黄，以及水气蛊胀证。
酒疸，因饮酒过多所致；食黄，因宿食积久所致，表现为面目非常黄，全身浮肿；蛊胀证，腹部大如盆。
黑牵牛（春八分，夏九分，秋七分，冬一钱）、大黄（春八分，夏九分，秋七分，冬一钱）、槟榔（春八分，夏九分，秋七分，冬四分）、甘草（春八分，夏九分，秋七分，冬四分）。
以上研为细末，每次服用五钱，在五更天面向东南方向，用井花水调服，病邪随即排出；如果未排出，面向太阳，吸气三口，迅速排出，蛊胀症全消，酒疸、宿食均痊愈。忌食生冷及发物。之后服用乌药顺气散一二帖，再服用十全大补汤数帖。
酒煮茵陈汤（蒋云山传授） 治疗酒疸，全身及眼目发黄如金黄色者。
茵陈（一两），好陈酒一钟半，煎至八分，饭后温服，不需多剂即可痊愈。
五疸神丹（孔柳塘传授） [批注]（按：此方是治疗黄胆专攻的方剂） 治疗五疸黄肿。
绿矾（不拘多少，炒至白色为止，放入瓶中，火煅尤佳）。
以上研为细末，用煮熟的枣肉制成丸药，大小如樱桃。每次服用五丸，早晨、中午、晚上各一次，用冷陈酒送服。忌醋、生冷及发物，如果有蛊胀，服用后也能吐出，效果神奇。
退金丸（鄢陵蹇太尹传授） 治疗黄肿及癖疾发热。
取一个砂罐，装入青矾令其八分满，外部用盐泥密封加固，用炭火煅烧至通红，取出泥土埋入土中，以彻底去除火毒，将砂罐及青矾一起研为细末，用水调和面糊制成丸药，大小如梧桐子。每次服用二三十丸，用肉汤送服，每日三次，滚开水亦可。忌鱼腥、面筋等发物。
铁砂丸（思恒传授） 治疗黄胆腹内有肿块。
苍术（三两，米泔水制后炒）、香附（三两，醋炒）、白术（一两）、猪苓（一两）、泽泻（一两）、茯苓（一两）、茵陈（一两五钱）、牛膝（一两）、槟榔（一两）、木瓜（一两）、草果（一两）、砂仁（一两）、枳壳（一两五钱，麸炒）、青皮（一两）、陈皮（一两五钱）、三棱（一两，醋炒）、莪术（一两，醋炒）、当归（一两）、神曲（二两）、青矾（三两，麸炒黑）。
以上研为细末，用醋糊制成丸药，大小如梧桐子。每次服用九十丸，用温酒送服，醋汤亦可。
Pulse
For the five jaundices (five types of jaundice diseases) presenting as excess-heat syndromes, the pulse must be surging and rapid. If the pulse is faint or choppy, the syndrome belongs to deficiency. A deep pulse accompanied by thirst with desire to drink water and difficult urination indicates that jaundice will definitely develop.
Disease
The term "jaundice" refers to yellow disease. Its manifestations are categorized into five types: Huanghan (Yellow Sweat), Huangdan (Yellow Gallbladder/Jaundice), Jiudan (Wine Jaundice), Gu dan (Grain Jaundice), and Nülaodan (Female Exhaustion Jaundice). It is necessary to distinguish among these five types. However, the etiology essentially involves dampness and heat stagnating and steaming within the Spleen, causing the face, eyes, and limbs to turn yellow, resembling dyeing with Gardenia water.
Treatment Principles
The primary treatment principle is to promote diuresis; once urine becomes clear, the yellow discoloration will naturally recede. For jaundice caused by food accumulation, purgative methods should be applied according to the patient's constitution regarding excess or deficiency.
First category: In cases of external Cold Damage (Shanghan) with interior excess in the Yangming channel, where purgation is indicated but fails to descend, sweating is indicated but fails to occur, and diuresis is indicated but fails to flow, damp-heat becomes constrained and severe internally, leading to jaundice. Ancient physicians formulated formulas such as Yinchen Wuling San (Cinnamon Twig and Atractylodes Macrocephala Decoction with Coix Seed), Yinchen Tang (Artemisia Capillaris Decoction), and Fuling Shenshi Tang (Poria Damp-Draining Decoction) to treat this.
Second category: Sometimes, residual pathogens from seasonal diseases, Cold Damage, Wind Strike, or latent summerheat that have not been fully resolved can also cause jaundice. If symptoms include a bland taste in the mouth, palpitations, tinnitus, weak legs, slight aversion to cold and fever, and turbid white urine, this constitutes a deficiency syndrome. Cool/cold-natured medicines should not be used recklessly, as they will further damage Qi and Blood.
Third category: Jaundice patients presenting with a dark-yellow complexion, thirst, and abdominal distension are difficult to treat.
Formulas
Shendan Tang (Kidney Jaundice Decoction) [Commentary: This formula treats Kidney Jaundice using wind-dispelling herbs to overcome dampness.] Treats Kidney Jaundice, characterized by yellow eyes, potentially progressing to whole-body yellowing, and red, scanty, painful urination.
Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Bencao (Ligustici Rhizoma), Duhuo (Angelicae Pubescentis Radix), Chaihu (Bupleuri Radix) (each 5 fen), Baizhu (Atractylodis Macrocephalae Rhizoma) (5 fen), Baifuling (Poria cum Ligno) (2 fen), Zexie (Alismatis Rhizoma) (3 fen), Zhuling (Polyporus) (4 fen), Cangzhu (Atractylodis Rhizoma) (1 qian), Huangbai (Phellodendri Cortex) (2 fen), Renshen (Ginseng Radix) (3 fen), Gegen (Puerariae Lobatae Radix) (5 fen), Shenqu (Massa Medicata Fermentata) (6 fen), Shengma (Cimicifugae Rhizoma) (5 fen), Gancao (Glycyrrhizae Radix et Rhizoma) (3 fen).
Crush the ingredients, divide into two doses, decoct with water, and take warm before meals.
Fuling Shenshi Tang (Poria Damp-Draining Decoction) Treats jaundice caused by damp-heat, characterized by yellow sweat and red urine.
Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Cangzhu (Atractylodis Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Zhishi (Aurantii Fructus Immaturus), Huanglian (Coptidis Rhizoma) (stir-fried), Huangqin (Scutellariae Radix), Zhizi (Geniposide/Gardeniae Fructus), Fangji (Stephaniae Tetrandrae Radix), Yinchen (Artemisiae Scopariae Herba), Mutong (Akebiae Caulis).
If appetite is poor, add Renkou (Amomi Fructus Rotundus), stir-fried Shenqu (Massa Medicata Fermentata), and stir-fried Maiya (Hordei Fructus Germinatus) in equal parts.
Crush the ingredients, decoct with fresh ginger, and take.
Jiajian Weiling Tang (Modified Weiling Decoction) [Commentary: This is a formula for draining dampness and promoting diuresis in treating Huangpan (Yellow Puffiness).] Treats Huangpan (yellow puffiness/edema), loss of taste, weakness in the four limbs, fatigue upon walking, and a choppy, soggy pulse.
Cangzhu (Atractylodis Rhizoma) (prepared with rice wash water, 1.5 qian), Chenpi (Citri Reticulatae Pericarpium) (peel removed, 1 qian), Houpo (Magnoliae Officinalis Cortex) (stir-fried with ginger juice, 8 fen), Gancao (Glycyrrhizae Radix et Rhizoma) (honey-roasted, 3 fen), Zhuling (Polyporus) (8 fen), Zexie (Alismatis Rhizoma) (1 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (rhizome tip removed, 1 qian), Chifuling (Poria with Red Sandalwood) (peel removed, 1 qian), Shenqu (Massa Medicata Fermentata) (stir-fried, 8 fen), Shanzha (Crataegi Fructus) (pits removed, 7 fen), Sharen (Amomi Fructus Rotundus) (stir-fried, 7 fen), Xiangfu (Cyperi Rhizoma) (stir-fried with ginger juice, 6 fen), Binglang (Arecae Semen) (8 fen), Mugua (Chaenomelis Fructus) (1 qian), Dafupi (Pericarpium Arecae) (6 fen), Huoxiang (Agastaches Herba), Banxia (Pinelliae Rhizoma), Luobozhongzi (Brassicae Semenicum), Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Longae Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride) (each 7 fen).
Crush one dose, decoct with water, and take.
Niuhuang Sanzi (Ox Bezoar Powder/Pills) [Commentary: This is a formula for clearing excess heat in the five jaundices.] Treats Jiudan (Wine Jaundice), Shi Huang (Food Jaundice), and Guzheng (Gu Abdominal Distension/Water Qi Syndrome).
Jiudan results from excessive alcohol consumption; Shi Huang results from long-standing food retention, manifesting as very yellow face and eyes, generalized edema; Guzhen manifests as an abdomen large as a basin.
Heiqianniu (Pharbitidis Semen), Dahuang (Rhei Radix et Rhizoma), Binglang (Arecae Semen), Gancao (Glycyrrhizae Radix et Rhizoma). Dosages vary by season: Spring (Qianniu 8 fen, Dahuang 8 fen, Binglang 8 fen, Gancao 8 fen); Summer (Qianniu 9 fen, Dahuang 9 fen, Binglang 9 fen, Gancao 9 fen); Autumn (Qianniu 7 fen, Dahuang 7 fen, Binglang 7 fen, Gancao 7 fen); Winter (Qianniu 1 qian, Dahuang 1 qian, Binglang 4 fen, Gancao 4 fen).
Grind into fine powder. Take 5 qian each time at dawn (wugeng hour), facing southeast, mixed well-water. The pathogen will discharge immediately. If it does not move, face the sun, inhale three times, and the pathogen will discharge rapidly. Guzhen will completely resolve, and Jiudan and food retention will heal. Avoid raw, cold, and stimulating foods. Afterwards, take Wuyao Shunqi San (Aucklandia and Cyperi Powder) for 1-2 doses, followed by Shiquan Dabu Tang (Decoction for Tenfold Tonification) for several doses.
Jiu Zhu Yinchen Tang (Wine-Boiled Artemisia Capillaris Decoction) (Transmitted by Jiang Yunshan) Treats Jiudan (Wine Jaundice) where the whole body and eyes turn yellow like gold.
Yinchen (Artemisiae Scopariae Herba) (1 liang), good aged wine 1.5 zhong. Decoct until 0.8 remains. Take warm after meals. Cure usually occurs within a few doses.
Wu Dan Shendan (Divine Elixir for Five Jaundices) (Transmitted by Kong Liutang) [Commentary: This is a specialized attacking formula for treating Yellow Gallbladder/Jaundice.] Treats the five jaundices with yellow swelling.
Lvfan (Chalcanthite) (any amount, stir-fry until white, place in a jar, calcination is best).
Grind into fine powder. Mix with paste from boiled jujube flesh to form pills the size of cherries. Take 5 pills each time in the morning, noon, and evening, washed down with cold aged wine. Avoid vinegar, raw/cold foods, and stimulating foods. If Gu distension is present, it may induce vomiting. Extremely effective.
Tuijin Wan (Gold-Removing Pills) (Transmitted by Jian Taiyin of Yanling) Treats yellow swelling and fever due to Xi Ji (accumulated masses).
Take one clay pot, fill it 80% full with Qingfan (Green Chalcanthite). Seal externally with salt mud. Calcine with charcoal fire until red hot. Bury in soil to remove fire toxicity. Grind the pot and mineral together into powder. Mix with wheat flour paste to form pills the size of Sophora seeds. Take 20-30 pills each time, washed down with meat broth. Three times daily. Boiled water is also acceptable. Avoid fishy odors, gluten, and other stimulating foods.
Tiesha Wan (Iron Sand Pills) (Transmitted by Si Heng) Treats Huangdan (Yellow Gallbladder/Jaundice) with abdominal masses.
Cangzhu (Atractylodis Rhizoma) (3 liang, prepared with rice wash water and stir-fried), Xiangfu (Cyperi Rhizoma) (3 liang, stir-fried with vinegar), Baizhu (Atractylodis Macrocephalae Rhizoma) (1 liang), Zhuling (Polyporus) (1 liang), Zexie (Alismatis Rhizoma) (1 liang), Fuling (Poria) (1 liang), Yinchen (Artemisiae Scopariae Herba) (1.5 liang), Niuxi (Achyranthis Bidentatae Radix) (1 liang), Binglang (Arecae Semen) (1 liang), Mugua (Chaenomelis Fructus) (1 liang), Caoguo (Tsaoko Fructus) (1 liang), Sharen (Amomi Fructus Rotundus) (1 liang), Zhiqiao (Aurantii Fructus) (1.5 liang, stir-fried with bran), Qingpi (Citri Reticulatae Pericarpium Viride) (1 liang), Chenpi (Citri Reticulatae Pericarpium) (1.5 liang), Sanleng (Sparganii Rhizoma) (1 liang, stir-fried with vinegar), Ezhu (Curcumae Longae Rhizoma) (1 liang, stir-fried with vinegar), Danggui (Angelicae Sinensis Radix) (1 liang), Shenqu (Massa Medicata Fermentata) (2 liang), Qingfan (Green Chalcanthite) (3 liang, stir-fried with bran until black).
Grind into powder. Mix with vinegar paste to form pills the size of Sophora seeds. Take 90 pills each time, washed down with warm wine. Vinegar water is also acceptable.