证治诸说 盖脾疸之证，湿热与宿谷相搏故也，俗谓之食劳黄。（《十形三疗》）
食劳疳黄，一名黄胖。夫黄胆者，暴病也，故仲景以十八日为期。食劳黄者，宿病也，至有久不愈者。（《纲
目》）
农民黄肿病，因饱作劳，脾气不舒，宜杨法师胜金丸。（《要诀》）（按∶此方不审，先教谕曰∶盖《本事
》紫金丹之类。）
黄肿者，或酒疸或谷疸（按∶疸字宜削），沉积顽痰，胶固郁结于其中，故或为 癖，或为积聚，是以积于
中而形于外，盖因土气外形而黄也。故宜以苍术、浓朴、香附、陈皮之类，以平其土气之敦阜；用铁粉、青皮之
类，以平其木气之有余；加以曲 ，助脾消积；退黄之后，仍用参、术等补脾之剂，以收十全之功，此标而本之之
治也。（《正传》）
黄肿病，即世俗所谓黄胖，起于食积湿郁而成，由脾湿不行积滞所致，丹溪用大小温中丸俱效。（《医统》）
黄肿者，皮肉色黄，四肢怠惰，头眩体倦，懒于作为，小便短而少，大便溏而频，食欲善进，不能生力，宜当健脾
为主治。（《绳墨》）
人有病黄肿者，不可误以为黄胆。盖黄胆者，遍身如金，眼目俱黄，而面无肿状；黄肿之黄，则其色带白，而
眼目如故。虽同出脾胃，而病形不同，医者当审而治之。黄胆之起，由于湿热蒸染。而黄肿之症，则湿染热未甚，
而多因虫积食积之为害也。或偶吞硬食过多，碍其脾家道路，经久不消，脾胃失运化之权，浊气上腾，故面部黄
而且浮，手足皆无血色（血字据《医镜》补）。有虫者，又吐黄水，毛发直指，肌肤不泽，且好食生米、茶叶之类
者是也。若肿及四肢者难治，肿及腹者不治，饮食减少者不治，以其无胃气也。（《玉案》）
食劳疳黄，或由食积，或由劳倦，或由疳积所致。或名黄胖，胖者肿也，湿热蒸而发胖，如馒头蒸而起发，
矾醋收敛，使之瘦缩，凡收敛即属伐肝。黄肿多有虫与食积，有虫必吐黄水，毛发皆直，或好食生米、茶叶之类，
用使君子、槟榔、川楝、雷丸之类，食积则用消食药，剂中不可无针砂，消积平肝，其功最速，治法亦与黄瘅有
别也。（《医碥》）（按∶食劳黄病，食积虫多，《施丸端效方》磨积食劳丸主治。）
力役人劳苦受伤，亦成黄胖病，俗名脱力黄，好食易饥，怠惰无力，宜沈氏双砂丸。（《尊生书》）
黄胖易治于黄胆。（《粹言》）
消积燥湿诸方 加减胃苓汤，治黄胖，饮食无味，四肢无力，行步倦怠，脉涩而濡，或腹有积块胀满。
苍术（米泔浸） 陈皮 浓朴（姜炒） 猪苓 泽泻 白术（去芦炒） 白茯苓 藿香 半夏（姜炒）
大腹皮 山楂 萝卜子 三棱 莪术 青皮 甘草
上锉，生姜三片，枣一枚，水煎温服。（《寿世保元》）
治男子妇人患食劳气劳，遍身黄肿，欲变成水肿，及久患 癖，小肠膀胱，面目悉黄，紫金丹。
胆矾（三两） 黄蜡（一两） 青州枣（五十个）
上于瓷合内，用头醋五升，先下矾、枣，慢火熬半日以来，取出枣去皮核，次下蜡一处，更煮半日如膏，入
好腊茶末二两同和，丸如梧子大，每服二三十丸，茶酒（《宝鉴》茶清）任下。如久患肠风痔漏，陈米饮下。宗
室赵彦才，下血，面如蜡，不进食，盖酒病也，授此方服之，终剂而血止，面色鲜润，食亦倍常。新安有一兵士亦
如是，与三百粒，作十服，亦愈。（《本事》）
枣矾丸，治食劳黄，目黄身黄者。
皂矾（不以多少，沙锅子木炭烧通赤，用米醋内点之赤红。）
上为末，枣肉丸如桐子大，每服二三十丸，食后生姜汤下。（《宝鉴》）《乾坤生意》以平胃散为衣。《医
鉴》名五疸神丹，曰∶有虫服之吐出，神效。《广笔记》曰∶凡服矾者，忌食荞麦、河豚，犯之即死。（按∶《丹
溪纂要》绿矾丸方后曰∶愈后宜忌食荞麦诸毒物，若犯之即死。余又尝见一人服此药下，后二年，因食所犯，
忽无故而死。）
紫金丸，治黄祛积。
荆三棱（三两煨） 蓬术（一两半炮） 枳壳（一两半麸炒） 干漆（一两半醋炒烟尽） 苍术（一两半米泔浸）
砂仁（一两半细研） 黑牵（头衣一两） 青皮（二两半） 针砂（三两酒炒） 白矾（五钱飞） 陈皮（二两半）
皂矾（五炒钱白）
上为细末，蒸饼为丸，如桐子大，每服五六十丸，白汤任下。（《修月鲁般经后录》）
大温中丸，治食积黄肿。
针砂（一十两，醋炒令红，醋浸七次再炒，另研。） 陈皮 苍术
青皮 浓朴 三棱 蓬术（六味各五两） 甘草（二两生用） 香附（一斤）
上九味末之，醋糊为丸，梧子大，每服五七十丸，空心姜盐汤下，午食前、晚食前，并温酒下。脾虚者，以
白米、人参作汤使下。（《新效方》）（按∶又有小温中丸，用针砂、苍术、神曲、川芎、栀子、香附。）
丹溪曰∶又可借为制肝燥脾之用。脾虚者，以参、术、陈皮、芍药、甘草为汤下。《纲目》丈夫黄胖，胃有宿积，
口淡脚酸气急，于本方去青皮、浓朴、蓬术、甘草，加黄连、茱萸、人参、茯苓。《准绳》举此方及枣矾丸曰∶
实人及田家作苦之人宜之，若虚人与素养柔脆者，宜佐以补剂。
治黄肿，用明亮绿矾一斤，锅内熔化，次下多年黄陈米四升，慢火煮炒，约一时许，烟尽为度（《卫生易简
方》莫炒枯了），取摊于地上出火毒，为末。另用苍术一斤二两，米泔水浸一昼夜，刮净锉晒干为末一斤，和前
药，以陈米醋（《易简方》打糊）为丸，如梧桐子大，每服七八十丸，空心临卧，温酒送下，陈米汤亦可，忌糯
米、面、生冷。（《乾坤生意》）《万应方》伐木丸，因脾土衰弱，只缘肝木气胜，能克脾土，故得此病，久服
能助土益元，于本方去陈米，加黄酒、麸曲。（《本草纲目》曰∶时珍常以此方，加平胃散，治一人中满腹胀，
果有效验。盖此矾色绿味酸，烧之则赤，既能入血分伐木，又能燥湿化涎，利小便，消食积，故胀满、黄肿、疟、
痢、疳疾方往往用之，其源则自张仲景用矾石、消石治女劳黄胆方中变化而来。）
脾劳黄病，针砂四两，醋炒七次，干漆烧存性二钱，香附三钱，平胃散五钱，为末，蒸饼丸梧子大，任汤使下。
（《本草纲目》引《摘玄方》）《寿世仙丹》皂矾丸，于平
胃散加皂矾、针砂，红枣捣烂丸。《广笔记》黄病有积神方，于平胃散加山楂、茯苓、麦芽、槟榔、绿矾，枣
肉丸，每服一钱，白汤吞，日三服。
退黄胖。
以平胃散料一分，香附一分，加神曲、麦芽、白术，丸服。（《医学集成》）
铁砂丸，治黄肿病。
针砂（半斤醋煮赤） 南木香（二两） 百草霜（四两） 人参（二两） 皂矾（一钱） 枣（三十枚去核）
上将枣肉同蒸饼汤浸一宿，和丸如梧桐子大，每服十五丸至三十丸，空心临卧各一服，温酒送下，二十日见效。
（《医林集要》）《沈氏》双砂丸，于本方去百草霜、人参，加砂仁、香附、大麦粉，胡桃肉生捣如泥，同黑枣
煮烂，去皮核为丸（皂矾白馒头包 红）。
《经验方》治食气，遍身黄肿，气喘食不得，心胸满闷。不 皂荚去皮及子，涂好醋炙令焦为末，一钱匕。
巴豆七枚，去油膜。二件以淡醋及研好墨为丸，如麻子大，每服三丸，食后陈橘皮汤下，日三服，隔一日增一丸，
以利为度。如常服，消酒食。（《本草》）
朱砂丸，治 食气，遍身黄肿，多年不瘥，及一切块积。
朱砂 砂 麝香（各一分） 雄黄 黄丹（各半两） 腻粉（三筒子） 巴豆（三十个，去皮出油后烂研，又用
醋半盏熬，成膏为度。）
上为细末，入巴豆膏内，用面（疑曲）尘和滴水丸，如绿豆大，每服五七丸，用水半盏煮一沸取出，临卧温
酒下，至晚但微泻二三行是效，并不搜搅人脏腑。（《鸡峰》）
【证治诸说】
脾疸这一病证，是由于湿热与体内停滞的食物相互搏结所致，民间称之为“食劳黄”。（出自《十形三疗》）
“食劳疳黄”，又名“黄胖”。黄疸属于急性发作的疾病，所以张仲景规定以十八天为预后期限。而食劳黄属于慢性宿疾，有的甚至长期不愈。（出自《本草纲目》）
农民患的黄肿病，是因为饱食后过度劳累，导致脾气郁滞不畅，适宜使用杨法师胜金丸治疗。（出自《医方要诀》）（按语：此方存疑，先前的教谕曾说：这大概是《本事方》中紫金丹之类的方子。）
所谓黄肿，可能是酒疸或谷疸演变而来（按语：“疸”字应当删去），由于沉积的顽痰胶结郁滞在体内，因此有时形成癖块，有时形成积聚。这是因为邪气积于体内而反映在体表，都是因土气（脾胃之气）异常外现而发黄。所以适宜用苍术、厚朴、香附、陈皮等药物，来平抑过盛的土气；使用铁粉、青皮等药物，来平抑肝木之气的有余；加上神曲，帮助脾胃消化积滞；退黄之后，仍用人参、白术等补脾的药物，以取得痊愈的效果，这是先治标后治本的治疗方法。（出自《医学正传》）
黄肿病，就是世俗所说的黄胖，起因是食物积滞和湿气郁结，由脾湿不能运化、积滞内停所致，朱丹溪使用大温中丸或小温中丸都有效。（出自《医统》）
黄肿的症状表现为皮肤肌肉颜色发黄，四肢倦怠无力，头晕体乏，懒得活动，小便短少，大便稀溏且次数频繁，食欲虽然好但无法转化为体力，治疗应当以健脾为主。（出自《医绳墨》）
有人患有黄肿病，不可误认为是黄疸。因为黄疸是全身皮肤像金子一样黄，眼睛和眼白也都发黄，但面部没有浮肿；而黄肿的黄，颜色偏白带白，眼睛和眼白如常。虽然两者都源于脾胃病变，但病症表现不同，医生应当仔细辨别后治疗。黄疸的起因，是由于湿热熏蒸染着。而黄肿的病状，则是湿邪染着而热邪不重，多因虫积和食积的危害所致。或者偶尔吞食过多坚硬食物，阻碍了脾胃的气机通道，经久不消，导致脾胃失去运化功能，浊气上腾，所以面部发黄且浮肿，手足都没有血色（“血”字据《医镜》补入）。如果有虫积的人，还会呕吐黄水，毛发竖立，肌肤没有光泽，并且喜欢吃生米、茶叶之类东西。如果肿胀波及四肢则难治，肿胀波及腹部则不治，饮食减少者也不治，因为这些情况表明胃气已绝。（出自《医宗必读·玉案》）
食劳疳黄，可能由食积引起，也可能由劳累过度引起，或由疳积所致。又称黄胖，“胖”即肿胀之意，湿热熏蒸导致身体浮肿，就像馒头蒸制时发酵膨胀一样。矾醋具有收敛作用，能使身体瘦缩，凡是收敛的方法都属于克制肝木。黄肿多伴有虫积和食积，有虫积必然呕吐黄水，毛发竖起，或喜欢吃生米、茶叶之类，可用使君子、槟榔、川楝子、雷丸等药物治疗；若是食积则用消食药，方剂中不可没有针砂，它能消积平肝，功效最快，治疗方法也与黄疸不同。（出自《医碥》）（按语：食劳黄病，多兼食积和虫积，《施丸端效方》中的磨积食劳丸主治此病。）
从事体力劳动的人因劳苦受伤，也会患上黄胖病，俗名“脱力黄”，表现为爱吃东西但容易饿，倦怠无力，适宜使用沈氏双砂丸治疗。（出自《尊生书》）
黄胖病比黄疸容易治疗。（出自《医学粹言》）
加减胃苓汤：治疗黄胖，饮食无味，四肢无力，行走倦怠，脉象涩而濡缓，或腹部有积块胀满。
处方：苍术（米泔水浸泡）、陈皮、厚朴（姜炒）、猪苓、泽泻、白术（去芦头并炒）、白茯苓、藿香、半夏（姜炒）、大腹皮、山楂、萝卜子（莱菔子）、三棱、莪术、青皮、甘草。
用法：以上药物切碎，加生姜三片、大枣一枚，用水煎煮，温服。（出自《寿世保元》）
紫金丹：治疗男子女人患食劳气劳，全身黄肿，想要变成水肿，以及长期患有癖块，小肠膀胱受累，面目全部发黄。
处方：胆矾（三两）、黄蜡（一两）、青州枣（五十个）。
用法：放在瓷盒内，用陈醋五升，先放入矾和枣，用慢火熬半天时间，取出枣去皮核，再放入蜡一起煮半天至成膏状，加入优质腊茶末二两混合均匀，制成梧桐子大小的丸药。每次服用二三十丸，用茶或酒送下（《宝鉴》建议用茶清）。如果是长期患有肠风痔漏，用陈米饮送下。宗室赵彦才，便血，面色如蜡，不进饮食，这是酒病所致，授以此方服用，服药结束后血止住，面色鲜润，进食量也加倍。新安有一个士兵也是这样，给他三百粒，分十次服用，也治愈了。（出自《本事方》）
枣矾丸：治疗食劳黄，眼睛黄、身体黄的病症。
处方：皂矾（用量不限，在沙锅中用木炭烧至通红，用米醋点淬使其呈赤红色）。
用法：研成粉末，用枣肉制作成梧桐子大小的丸药。每次服用二三十丸，饭后用生姜汤送下。（出自《普济本事方》）《乾坤生意》主张以平胃散为衣。《医鉴》称之为“五疸神丹”，说：有虫的患者服用后可吐出虫体，效果神奇。《广笔记》说：凡服用含矾药物的人，忌食荞麦、河豚，否则立即死亡。（按语：《丹溪纂要》绿矾丸方后记载：痊愈后宜忌食荞麦及其他毒物，若触犯就会死亡。我又曾见过一个人服用此药后，两年后因吃了禁忌食物，忽然无故死亡。）
紫金丸：治疗黄病，祛除积滞。
处方：荆三棱（三两煨制）、蓬术（莪术，一两半炮制）、枳壳（一两半麸炒）、干漆（一两半醋炒至烟尽）、苍术（一两半米泔水浸泡）、砂仁（一两半细研）、黑牵牛（头衣一两）、青皮（二两半）、针砂（三两酒炒）、白矾（五钱飞研）、陈皮（二两半）、皂矾（五钱炒）。
用法：以上药物研成细末，用蒸饼制作成梧桐子大小的丸药。每次服用五六十丸，白开水送下。（出自《修月鲁般经后录》）
大温中丸：治疗食积引起的黄肿。
处方：针砂（十两，醋炒至红，醋浸七次后再炒，另研）、陈皮、苍术、青皮、厚朴、三棱、蓬术（以上六味各五两）、甘草（二两生用）、香附（一斤）。
用法：以上九味药研末，用醋糊制作成梧桐子大小的丸药。每次服用五七十丸，空腹时用姜盐汤送下，午饭前、晚饭前，也可用温酒送下。脾虚者，用人参、白米煮汤送下。（出自《新效方》）（按语：还有小温中丸，使用针砂、苍术、神曲、川芎、栀子、香附。）
朱丹溪说：此方又可借用来制约肝木、燥湿健脾。脾虚者，用人参、白术、陈皮、芍药、甘草煮汤送服。《本草纲目》记载治疗男子黄胖，胃中有宿积，口淡脚酸气急，在本方中去掉青皮、厚朴、蓬术、甘草，加入黄连、吴茱萸、人参、茯苓。《医学准绳六要》引用此方及枣矾丸说：体质壮实及田间劳作辛苦之人适宜使用，若是体虚人和平时养尊处优体质柔脆的人，应配合补益药剂使用。
治疗黄肿，取明亮绿矾一斤，在锅内熔化，接着放入多年的黄陈米四升，用慢火煮炒，大约一小时左右，直到烟尽为止（《卫生易简方》注：不要炒枯了），取出摊在地上以去除火毒，研成粉末。另外取苍术一斤二两，米泔水浸泡一昼夜，刮净切碎晒干研成粉末一斤，与前药混合，用陈米醋（《易简方》注：打糊）制作成梧桐子大小的丸药。每次服用七八十丸，空腹及睡前，用温酒送下，陈米汤也可以，忌食糯米、面食、生冷食物。（出自《乾坤生意》）《万应方》中的伐木丸，认为因脾土衰弱，只缘肝木气盛，克制脾土，故得此病，久服能助土益元，在本方中去掉陈米，加入黄酒、麸曲。（《本草纲目》记载：李时珍常用此方，加入平胃散，治疗一人中满腹胀，果然有效。大概这种矾色绿味酸，烧之变红，既能入血分克制肝木，又能燥湿化痰，利小便，消食积，所以在治疗胀满、黄肿、疟疾、痢疾、疳疾的方剂中往往用到它，其源头则是从张仲景用矾石、消石治疗女劳黄疸方中变化而来。）
脾劳黄病：针砂四两，醋炒七次，干漆烧至存性二钱，香附三钱，平胃散五钱，研末，用蒸饼制作成梧桐子大小的丸药，任汤药送下。（《本草纲目》引《摘玄方》）《寿世仙丹》皂矾丸，在平胃散基础上加皂矾、针砂，红枣捣烂制作丸药。《广笔记》黄病有积神方，在平胃散基础上加山楂、茯苓、麦芽、槟榔、绿矾，枣肉制作丸药，每次服用一钱，白开水吞服，每日三次。
退黄胖方：
以平胃散料一份，香附一份，加入神曲、麦芽、白术，制作丸药服用。（出自《医学集成》）
铁砂丸：治疗黄肿病。
处方：针砂（半斤醋煮至红）、南木香（二两）、百草霜（四两）、人参（二两）、皂矾（一钱）、枣（三十枚去核）。
用法：以上将枣肉同蒸饼汤浸泡一夜，混合制作成梧桐子大小的丸药。每次服用十五丸至三十丸，空腹及睡前各服一次，温酒送下，二十天见效。（出自《医林集要》）《沈氏》双砂丸，在本方中去掉百草霜、人参，加入砂仁、香附、大麦粉，胡桃肉生捣如泥，同黑枣煮烂，去皮核制作丸药（皂矾白馒头包 红）。
《经验方》治疗食气，全身黄肿，气喘不能进食，心胸满闷。
处方：皂荚（去皮及子，涂好醋炙烤至焦黑研末，一钱匕）、巴豆（七枚，去油膜）。
用法：两件物品用淡醋及研好的墨汁制作成麻子大小的丸药。每次服用三丸，饭后用陈橘皮汤送下，每日三次，每隔一天增加一丸，以腹泻为度。如果经常服用，可消除酒食积滞。（出自《本草纲目》引《本草》）
朱砂丸：治疗食气，全身黄肿，多年不愈，以及一切块状积滞。
处方：朱砂、砂（此处疑为砒石或类似矿物药，原文缺字，依上下文推测可能指代某种矿物，保留原意或略过具体名称，此处依原文结构处理）、麝香（各一分）、雄黄、黄丹（各半两）、腻粉（三筒子）、巴豆（三十个，去皮出油后烂研，再用半盏醋熬，成膏状为度）。
用法：以上研成细末，加入巴豆膏内，用面（疑为曲尘）和滴水制作成绿豆大小的丸药。每次服用五七丸，用半盏水煮一沸后取出，临睡前用温酒送下，到了晚上只要轻微腹泻二三行即为有效，并不搜刮搅动人的脏腑。（出自《鸡峰普济方》）
[Theories and Treatments]
Spleen Jaundice (Pi Dan) is caused by the struggle between damp-heat (Shi Re) and retained food in the stomach, commonly known as "Food-Labor Yellow" (Shi Lao Huang) in folklore. (*Shi Xing San Liao*)
"Food-Labor Infantile Malnutrition Yellow" (Shi Lao Gan Huang), also named "Yellow Puffiness" (Huang Pang). Jaundice is an acute disease; therefore, Zhang Zhongjing set a prognosis period of eighteen days. Food-Labor Yellow is a chronic condition, and some cases may persist for a long time without healing. (*Ben Cao Gang Mu*)
The yellow swelling disease suffered by farmers is due to overeating followed by hard labor, causing the Spleen Qi to stagnate. Yang Fashi's Shengjin Pill is suitable. (*Yao Jue*) [Note: This prescription is questionable; the former Instructor stated that it is likely similar to Zijin Dan from *Ben Shi Fang*.]
Regarding yellow swelling, it may evolve from Wine Jaundice or Grain Jaundice [Note: The character 'Dan' should be omitted]. It results from accumulated stubborn phlegm (Tan) sticking and knotting within the body, thus forming either Pi masses (accumulations on the sides) or Ji Ju (masses in the center). This occurs because pathogens accumulate internally and manifest externally, specifically due to the abnormal expression of Earth Qi (Spleen/Stomach Qi) leading to yellowness. Therefore, it is appropriate to use herbs such as Cang Zhu (Atractylodis Rhizoma), Hou Po (Magnoliae Officinalis Cortex), Xiang Fu (Cyperus Rhizoma), and Chen Pi (Citri Reticulatae Pericarpium) to pacify the excessive Earth Qi; use Tie Fen (Iron Powder) and Qing Pi (Citri Reticulatae Pericarpium Viride) to pacify the excess Wood Qi (Liver); add Qu (Medicated Leaven) to assist the Spleen in digesting accumulations; after the yellowness recedes, continue using tonifying Spleen agents like Ren Shen (Ginseng Radix et Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) to achieve complete recovery. This is a treatment strategy addressing the branch first and then the root. (*Zheng Chuan*)
Yellow swelling disease, commonly known as Huang Pang in secular terms, arises from food retention and dampness stagnation, caused by Spleen dampness failing to transport and resolve accumulations. Zhu Danxi found both Da Wen Zhong Wan and Xiao Wen Zhong Wan effective. (*Yi Tong*)
Symptoms of yellow swelling include yellowish skin and flesh, lassitude of the four limbs, dizziness, bodily fatigue, reluctance to act, short and scanty urine, loose and frequent stools, good appetite but inability to generate strength. Treatment should primarily focus on invigorating the Spleen. (*Sheng Mo*)
Patients with yellow swelling must not be mistaken for having jaundice. Jaundice presents with the whole body yellow like gold, yellow eyes and sclera, but no facial swelling. In contrast, the yellowness of yellow swelling is pale white, and the eyes and sclera remain normal. Although both originate from the Spleen and Stomach, their manifestations differ; physicians must examine carefully before treating. Jaundice arises from damp-heat steaming and dyeing. Yellow swelling involves dampness with mild heat, often caused by parasitic accumulation or food retention. Occasionally, swallowing too much hard food obstructs the Spleen's pathways, remaining undigested for a long time. The Spleen and Stomach lose their transformative power, turbid Qi ascends, resulting in a yellow and swollen face, and colorless hands and feet ("Blood" character supplemented from *Yi Jing*). Those with parasites may vomit yellow water, have erect hair, lusterless skin, and crave raw rice or tea leaves. If swelling extends to the four limbs, it is difficult to treat; if it extends to the abdomen, it is untreatable; if food intake decreases, it is untreatable, indicating the absence of Stomach Qi. (*Yu An*)
Food-Labor Infantile Malnutrition Yellow may result from food retention, fatigue, or infantile malnutrition. Also called Huang Pang, "Pang" means swelling. Damp-heat steaming causes swelling, resembling the rising of steamed buns. Alum and vinegar have astringent properties that reduce swelling; any astringent method belongs to subduing the Liver. Yellow swelling often involves parasites and food retention. Parasitic cases feature vomiting of yellow water, erect hair, or cravings for raw rice/tea. Use Shi Jun Zi (Quisqualis Fructus), Bing Lang (Arecae Semen), Chuan Lian Zi (Toosendan Fructus), or Lei Wan (Omphalia Lapponica) for parasites; use digestive herbs for food retention. Zhen Sha (Magnetum Preparatum) must be included in the formula to dissipate accumulation and pacify the Liver, offering rapid efficacy. The treatment differs from Huang Dan (Jaundice). (*Yi Biao*) [Note: Food-Labor Yellow often involves food retention and parasites; *Mo Ji Shi Lao Wan* from *Shi Wan Duan Xiao Fang* treats this.]
Laborers suffering from hardship and injury may develop Huang Pang, commonly called "De Li Huang" (Effort-Depletion Yellow), characterized by increased appetite with easy hunger, lethargy, and weakness. Shen Shi's Shuang Sha Wan is suitable. (*Zun Sheng Shu*)
Huang Pang is easier to treat than Jaundice. (*Cui Yan*)
[Formulas for Dissipating Accumulation and Drying Dampness]
**Jia Jian Wei Ling Tang**: Treats Huang Pang with loss of taste, weakness in limbs, fatigue in walking, a choppy and soggy pulse, or abdominal masses with distension.
Ingredients: Cang Zhu (soaked in rice wash water), Chen Pi, Hou Po (stir-fried with ginger juice), Zhu Ling, Ze Xie, Bai Zhu (deprived of rhizome and stir-fried), Bai Fu Ling, Huo Xiang, Ban Xia (stir-fried with ginger juice), Da Fu Pi, Shan Zha, Luo Bo Zi (Radish Seed), San Leng, E Zhu, Qing Pi, Gan Cao.
Usage: Coarsely crush the ingredients, add three slices of fresh ginger and one jujube, decoct in water, and take warm. (*Shou Shi Bao Yuan*)
**Zijin Dan**: Treats men and women suffering from Food-Labor Qi Labor, presenting with generalized yellow swelling, impending edema, long-standing Pi masses, involvement of the Small Intestine and Bladder, and yellowing of the face and eyes.
Ingredients: Dan Fan (Alumen, 3 liang), Huang La (Yellow Beeswax, 1 liang), Qing Zhou Zao (Qingzhou Dates, 50 pieces).
Usage: Place in a porcelain container. Add five sheng of aged vinegar. First add alum and dates, simmer slowly over low heat for half a day. Remove dates, peel and pit them. Then add beeswax and cook for another half day until paste-like. Mix in two liang of fine aged tea powder. Form pills the size of wu zi (Chinese honeydew seeds). Take 20-30 pills per dose, washed down with tea or wine (use tea infusion according to *Bao Jian*). For chronic intestinal wind or hemorrhoids/fistulas, wash down with old rice drink. Zhao Yancai, a royal clan member, suffered from hematochezia, waxen complexion, and anorexia due to alcoholism. He was given this prescription; upon completion, bleeding stopped, complexion became rosy, and appetite doubled. A soldier in Xin'an presented similarly; given 300 pills in ten doses, he was also cured. (*Ben Shi Fang*)
**Zao Fan Wan**: Treats Food-Labor Yellow with yellow eyes and body.
Ingredients: Zao Fan (Vitriol, quantity unspecified). Roast in a clay pot over charcoal until red-hot, quench with rice vinegar until reddish.
Usage: Grind into powder. Form pills with jujube pulp, size of tung tree seeds. Take 20-30 pills per dose after meals, washed down with ginger soup. (*Pu Ji Ben Shi Fang*) *Qian Kun Sheng Yi* suggests coating with Ping Wei San. *Yi Jian* calls it "Five Jaundices Divine Pill," stating it expels parasites with miraculous effect. *Guang Bi Ji* warns: Avoid buckwheat and pufferfish when taking alum-containing drugs, or death will ensue. [Note: *Dan Xi Zuan Yao* post-script for Lv Fan Wan states: After cure, avoid buckwheat and other toxic foods; violation leads to death. I once witnessed a person who died suddenly two years after taking this drug due to dietary violation.]
**Zijin Wan**: Treats Yellow disease and removes accumulations.
Ingredients: Jing San Leng (San Leng, 3 liang, baked), Peng Zhu/E Zhu (Curcuma Longa Rhizoma, 1.5 liang, processed), Zhi Ke (Aurantii Fructus, 1.5 liang, bran-fried), Gan Qi (Dry Lacca, 1.5 liang, vinegar-fried until smoke ceases), Cang Zhu (1.5 liang, rice-wash soaked), Sha Ren (Amomi Fructus, 1.5 liang, finely ground), Hei Qian Niu (Black Morning Glory Seed, 1 liang, husk only), Qing Pi (2.5 liang), Zhen Sha (Prepared Magnetite, 3 liang, wine-fried), Bai Fan (White Alum, 5 qian, refined), Chen Pi (2.5 liang), Zao Fan (Green Vitriol, 5 qian, fried).
Usage: Grind into fine powder. Form pills with steamed bread dough, size of tung tree seeds. Take 50-60 pills per dose, washed down with plain boiled water. (*Xiu Yue Lu Ban Jing Hou Lu*)
**Da Wen Zhong Wan**: Treats food-retention-induced yellow swelling.
Ingredients: Zhen Sha (10 liang, vinegar-fried red, soaked in vinegar seven times, fried again, separately ground), Chen Pi, Cang Zhu, Qing Pi, Hou Po, San Leng, Peng Zhu (Each of these six: 5 liang), Gan Cao (Raw, 2 liang), Xiang Fu (1 jin).
Usage: Grind nine ingredients into powder. Form pills with vinegar paste, size of wu zi. Take 50-70 pills per dose. Empty stomach: wash down with ginger-salt soup. Before noon meal and before evening meal: wash down with warm wine. For Spleen deficiency: wash down with Ginseng and white rice decoction. (*Xin Xiao Fang*) [Note: There is also Xiao Wen Zhong Wan, using Zhen Sha, Cang Zhu, Shen Qu, Chuan Xiong, Zhi Zi, Xiang Fu.]
Zhu Danxi said: This formula can also be used to restrain the Liver and dry the Spleen. For Spleen deficiency, wash down with a decoction of Ren Shen, Bai Zhu, Chen Pi, Shao Yao, and Gan Cao. *Ben Cao Gang Mu* records for male Huang Pang with gastric retention, bland taste, sore legs, and急促 qi: Remove Qing Pi, Hou Po, Peng Zhu, Gan Cao from this formula; add Huang Lian, Zhu Yu, Ren Shen, Fu Ling. *Zhun Sheng* cites this formula and Zao Fan Wan, stating they are suitable for robust individuals and those engaged in hard farm labor. For deficient persons or those accustomed to fragility, combine with tonifying agents.
For treating yellow swelling: Melt 1 jin of bright Lv Fan (Green Vitriol) in a pot. Add 4 sheng of aged yellow rice. Simmer and stir-fry slowly for about one hour until smoke ceases (Do not burn dry, per *Wei Sheng Yi Jian Fang*). Spread on ground to remove fire toxicity. Grind into powder. Separately, take 1 jin 2 liang of Cang Zhu, soak in rice wash water for a day and night, scrape clean, cut, dry, and grind into 1 jin powder. Mix with the previous powder. Form pills with aged rice vinegar (paste, per *Yi Jian Fang*), size of wu zi. Take 70-80 pills per dose, empty stomach and before bed, with warm wine or old rice soup. Avoid glutinous rice, wheat products, and cold/raw foods. (*Qian Kun Sheng Yi*)
*Wan Ying Fang*'s Fa Mu Wan posits that Spleen Earth weakness allows Liver Wood to overact, causing this disease. Long-term use strengthens Earth and benefits Yuan Qi. Remove aged rice from this formula, add yellow wine and bran-qu. (*Ben Cao Gang Mu* notes: Li Shizhen often added Ping Wei San to this formula to treat a patient with fullness and abdominal distension, with successful results. Since this alum is green and sour, turns red when burned, it enters the Blood level to subdue Wood, dries dampness, transforms phlegm/fluid, promotes urination, and digests food. Thus, it is often used in formulas for distension, yellow swelling, malaria, dysentery, and infantile malnutrition. Its origin traces back to variations from Zhang Zhongjing's formula using Alum and Niter for Female-Labor Jaundice.)
Spleen-Labor Yellow Disease: Zhen Sha 4 liang (vinegar-fried 7 times), Gan Qi burnt to retain nature 2 qian, Xiang Fu 3 qian, Ping Wei San 5 qian. Grind into powder, form pills with steamed bread dough, size of wu zi. Wash down with any decoction. (*Ben Cao Gang Mu* citing *Zhai Xuan Fang*)
*Shou Shi Xian Dan* Zao Fan Wan: Add Zao Fan and Zhen Sha to Ping Wei San, form pills with mashed red dates.
*Guang Bi Ji* Yellow Disease with Accumulation Divine Formula: Add Shan Zha, Fu Ling, Mai Ya, Bing Lang, Lv Fan to Ping Wei San, form pills with jujube pulp. Take 1 qian per dose, swallow with plain water, three times daily.
**Formula for Reducing Huang Pang**:
Use Ping Wei San material (one part), Xiang Fu (one part), add Shen Qu, Mai Ya, Bai Zhu. Form pills. (*Yi Xue Ji Cheng*)
**Tie Sha Wan**: Treats yellow swelling disease.
Ingredients: Zhen Sha (half jin, vinegar-boiled red), Nan Mu Xiang (Inulae Radix, 2 liang), Bai Cao Shuang (Willow Soot, 4 liang), Ren Shen (2 liang), Zao Fan (1 qian), Zao (30 pieces, pitted).
Usage: Soak jujube pulp in steamed bread soup overnight. Mix and form pills size of wu zi. Take 15-30 pills per dose, empty stomach and before bed, with warm wine. Effective in 20 days. (*Yi Lin Ji Yao*)
*Shen Shi* Shuang Sha Wan: Remove Bai Cao Shuang and Ren Shen from this formula; add Sha Ren, Xiang Fu, Barley Flour. Crush raw walnuts into paste, boil with black dates until soft, remove skins/pits, form pills. (Zao Fan wrapped in white mantou, red exterior).
*Jing Yan Fang* treats Shi Qi (Food Qi), generalized yellow swelling, asthma, inability to eat, chest/heart fullness.
Ingredients: Zao Jia (Gleditsia Sinensis Fruit, peeled and seeded, roasted with good vinegar until charred, powdered, 1 qian bi), Ba Dou (Crotonis Fructus, 7 seeds, de-oiled).
Usage: Mix both ingredients with light vinegar and ground ink to form pills size of hemp seeds. Take 3 pills per dose after meals, washed down with aged tangerine peel soup, three times daily. Increase by one pill every other day, stopping at the onset of diarrhea. Regular use eliminates wine and food retention. (*Ben Cao*)
**Zhu Sha Wan**: Treats Shi Qi, generalized yellow swelling unhealed for years, and all types of mass accumulations.
Ingredients: Zhu Sha (Cinnabar), [Missing Character, likely Shi or similar mineral], She Xiang (Moschus, each 1 fen), Xiong Huang (Realgar), Huang Dan (Lead Tetroxide, each half liang), Ni Fen (Calomel, 3 tongzi), Ba Dou (30 seeds, peeled, de-oiled, pounded, then boiled with half cup vinegar to a paste).
Usage: Grind into fine powder. Mix with Ba Dou paste. Use flour (likely Qu dust) and drop-by-drop water to form pills size of mung beans. Take 5-7 pills per dose. Boil in half cup water for one boil, remove. Take before bed with warm wine. Mild diarrhea of 2-3 movements in the evening indicates efficacy. It does not scour and disturb the viscera. (*Ji Feng Pu Ji Fang*)