瘅之为言热也，或作疸，黄病必由热而成，故名黄胆。《肘后》以来，以黄胆、谷疸、酒疸、女劳疸、黄汗，
称为五疸。
然黄胆实其总名，非有别证，黄汗仲景隶之水气，而后世无有发明，是以今并不取也。盖伤寒发黄，既摘其要，
此编所举，多系内因病，而表湿证亦及之云。
病必因湿热 湿与热郁蒸于脾，面目肢体为之发黄，此即疸也。痘之名有五云云，五者虽不同，其为黄
则一，自本自根，未有非热非湿而能致病者也。湿也热也，又岂无轻重之别乎。湿气胜，则如熏黄而晦；热气胜，
则如橘黄而明。盖脾主肌肉，土色尚黄，湿热内蒸，或重或轻，不容 于外矣。（《直指》）
疸不用分其五，同是湿热，如 曲相似。（《丹溪》）
疸者，虽有酒、谷、黄汗、大饥、女劳五治之分，而《病源》所论不过湿热二字。古人云∶菽粟水火，不
可一日而去焉。盖水火即人身腐熟水谷之气也，得其平谓之水火，失其宜谓之湿热。凡为之病，或因脾胃受伤，
而中焦清气落陷，故使浊气浑然，以致湿热滋蔓，或饥中饮酒，或大渴饮泉，或汗出入水，或大醉当风，或劳伤
汗出衣里冷，或因雨湿而闭塞，或过食油面湿热之物，或内热而房劳，或病后失于调理，湿热游于经络，气不
荣行，渐积皮肤，身体面目俱黄，尿汗黄如柏。譬如造曲，用水拌面 之，不令气泄，黯成黄色。故人黄胆，亦
是因湿热而成者也。（《诸证辨疑》）
黄胆之证，皆湿热所成。湿气不能发泄，则郁蒸而生热，热气不能宣畅，则固结而生湿，湿得热而益深，热
因湿而愈炽，二者相助而相成，愈久而愈甚者也。然求其湿热之所由生，未有不由于大醉大饱，及醉饱后贪睡久
卧，与努力行房而得者。或醉饱后入水洗浴，寒气敛束，密其腠理，汗不得出，以致湿热相感而成此病焉。外不
得汗，内不得泻，熏熏濡染，流入皮肤，上达面目，下至足趺，中及手臂，前腹
后背皆如涂金，小便赤如姜黄，犹之罨盐罨酱，因湿热而变其色也。（《丹台玉案》）
夫脾为胃行其津液者也，津液行则小便利，何黄之有。惟湿生乎热，热滋乎湿，湿热相生，遂成滞满。由是
胃气潜衰，脾气孱弱，不能为胃行其津液，致上焦不行，故身不得汗，下脘不通，故复无小便，熏蒸日久，热气
成黄。（《苍生司命》）
黄胆一证，古人多言为湿热，及有五疸之分者，皆未足以尽之。而不知黄之大要有四∶曰阳黄，曰阴黄，曰
表邪发黄，曰胆黄也。知此四者，则黄胆之证无余义矣。丹溪曰∶疸不必分五种，同是湿热，如 曲相似。岂果
皆如 曲，悉可谓之湿热耶，弗足凭也。（《景岳》）（按∶此说失当。盖黄胆或有不因湿热者，然其正证则必
自湿热，《金匮》首条可征。至其别证，则有如寒湿发黄，有如女劳疸。今景岳以四证概之，而所谓阴黄，盖是
虚黄，既非寒湿，又非女劳。更举胆黄者，是希有之证，而列为其一。然则其说，亦未足以尽之，仍姑拈于此，以
辨其谬云。）
病由邪郁 巢氏黄病一论，未为该通，而诸家《伤寒论》中多从之。夫致黄之由非一，或误下，或火熏，
皆能成黄，非止寒热谷气而已。大抵寒邪中人，久不能去，变为热毒。假春风发动，表为可出之时，既动则不可
复回，而腠理不开，无由作汗而出，郁而在里，终不能散，淫邪泮衍，血脉传流。其毒之重者，遇血相搏不能胜，
为之变结，或如豚肝，或如墨色，此为邪气所败之血也，无以泄其邪，则血枯而人死。其轻者鼓血而上，随衄可出，
涩者因促滑气而下，随溺可去。既不能与血相搏，又不能开腠理而生汗，上不可出，下不可去，乃散于毛窍之际，
已失所舍而无可定止，进
退不能，郁为至黄之色，以待汗与溺而后通，此毒非不欲出也，犹人之行及门而无路也。医者疏通其道而指示
之，不为汗则为溺，未有不去之理。然毒在腠理之内，与正气争持，正邪相窒，毛孔亦不可开，是以不能作汗，
必从开窍利小便而出。此所以毒瓦斯在里不能出者，必成黄血二证，虽轻重上下不同，其理一也。有可汗而出者乎？
曰∶脉浮甚者，其表必疏，可汗而出之也。（《伤寒补亡论》）
五疸之外，有时行瘴疟风寒暑湿等证疸不同。（《三因》）
脉候 （互见次条及瘀血发黄、生死诀等。）湿热相郁而疸即成，脉洪而大，不弦，却带软而长，宜利其
小府。（《史载之方》）
疸脉缓大，顺；弦急而坚，逆。（《直指》）
五疸实热，脉必洪数，其或微涩，证属虚弱。（《崔氏脉诀》）
表里证总说 黄病者，一身尽疼，发热面色洞黄，七八日后，壮热在里有血，当下之，法如 肝状。
其人少腹内急，若其人眼睛涩疼，鼻骨疼，两膊及项强，腰背急，即是患黄。多大便涩，但令得小便快，即不
虑死，不用大便多，多即心腹胀（《圣惠》作不用大便多涩，涩即心腹胀）不存（存《外台》作好，《圣惠》作
安）。此由寒湿在表（《活人书》作在里），则热蓄于脾胃，腠理不开，瘀热与宿谷相搏，烦郁不得消，则大小
便不通，故身体面目，皆变黄色。（《病源论》）
黄胆之病，此由酒食过度，腑脏不和，水谷相并，积于脾胃，复为风湿所搏，瘀结不散，热气郁蒸，故食已
如饥，令身体面目及爪甲小便尽黄而欲安卧。若身体多赤黑多青皆
见者，必寒热身疼，面色微黄，齿垢黄，爪甲上黄，黄胆也。（同上）（按∶面色微黄以下，本出《脉经》。）
风黄候 凡人先患风湿，复遇冷气相搏，则举身疼痛，发热而体黄也。（同上）
阳气伏，阴气盛，热毒加之，故但身面色黄，头痛而不发热，名为阴黄。（同上）（按∶此犹里热之证，仍
列于此。）
色如熏黄，乃湿病也，一身尽痛。色如橘子黄，乃黄病也，一身不痛。干黄，燥也，小便自利，四肢不沉重，
渴而引饮者，栀子柏皮汤。湿黄，脾也，小便不利，四肢沉重，似渴不欲饮者，大茵陈汤。若大便自利而黄者，
茵陈栀子黄连三物汤。往来寒热，一身尽黄者，小柴胡加栀子。（《微义》引《难知》）
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。（《纲目》）（按∶此说欠
确，姑存之。）
表邪发黄，即伤寒证也，凡伤寒汗不能透而风湿在表者，有黄证。或表邪不解，自表传里而湿热郁于阳明者，
亦有黄证。表邪未解者，必发热身痛，脉浮少汗，宜从汗散。湿热内郁者，必烦热脉缓滑多汗，宜从分消清利。
若阳明实邪内郁而痞结胀满者，宜先下之，然后清其余热，则自无不愈。（《景岳》）
阳黄证，因湿多成热，热则生黄，此即所谓湿热证也。然其证必有身热，有烦渴，或躁扰不宁，或消谷善饥，
或小水热痛赤涩，或大便秘结，其脉必洪滑有力。此证不拘表
里，或风湿外感，或酒食内伤，皆能致之。但察其元气尚强，脾胃无损，而湿热果盛者，直宜清火邪，利小便，湿
热去而黄自退，治此者本无难也。（同上）
辨色 若面色微黄，身体或青赤黑色皆见者，与纯热之证不同，当于湿家求之。（《圣济》）
黄如橘而明者，热多脉必数，解热为主；黄如熏黄而暗，湿多脉必沉缓，渗湿为主。（《六要》）（按∶此说
本于《直指》，既见上。）
淡黄易愈，深黄者难愈，焦黄者不治。（《订补明医指掌》）
湿盛则但黄而不亮，热盛则鲜明如橘子，干黄则枯槁不润。盖色润者属水，色光者属火。若色如烟熏，黄黑晦滞，
枯槁无光，为危证。旧说湿胜如熏黄黑晦，存参。按∶黑晦即不亮也，然未必枯；若并不润，则是瘀败之死水，
难治矣。（《医碥》）（按∶《千金》茵陈栀子等七味汤方后有曰桃皮色，出后疏里方中，宜参。）
谷疸 谷疸者，食毕头旋，心怫郁不安而发黄，由失饥大食，胃气冲熏所致。（《肘后》）
谷疸，头眩心忡，怫郁不安，以小柴胡汤加谷芽、枳实、白术、山栀仁主之。（《原病集》）
酒疸 酒疸黄色，心下结热而烦。（《脉经》）
酒疸者，心懊痛，足胫满，小便黄，饮酒发赤斑黄黑，由大醉当风入水所致。（《肘后》）
五疸唯酒疸变证最多，盖酒之为物，随人性量不同，有盈石而不醉者，有濡吻而辄乱者，以酝酿而成，有大
热毒渗入百脉为病，则不特发黄，溢于皮肤，为黑为肿，流于清气道中，则眼黄鼻雍种种不同。故方论中，酒疸
外有肉疸黑疸
癖疸劳役乃至令人恍惚失常等数证不同。（《三因》）
酒疸脉若浮滑，腹满欲呕吐者，必先吐之；脉若沉滑，腹满大便秘者，必先下之。（《奇效》）
酒疸，心中懊 ，足胫满，尿黄面赤，酒过胃热，醉卧当风，水湿得之，以小柴胡汤加茵陈、白术、豆豉、
葛根、黄连、泽泻主之。（《原病集》）
酒疸，因饮酒过伤而黄，俗名为酒黄，宜干葛煎汤或栀子仁煎汤调五苓散，或生料五苓散加干葛一钱。有酒
疸后变成腹胀，渐至面足俱肿，或肿及遍身，宜藿香脾饮（按∶用浓朴、甘草、陈皮、半夏、藿香）加木香三钱，
或木香、麦柏各半钱。（《要诀》）
女劳疸 女劳疸者，身目皆黄，发热恶寒，小腹满急，小便难，由大劳大热交接，交接后入水所致。
（《肘后》）
夫交接输泻，必动三焦。上焦属心，中焦属脾，下焦属肾。动则热，热则欲火炽，因入水中。中焦热郁，故
能发黄。上焦气胜，故额黑。下焦走血，随瘀热行，大便溏黑。贵胜人有男女同室而浴者，多成此病，摄生之人，
不可不知。（《三因》）
女劳疸，乃是肾虚而成大不足之症，不可作湿热有余治之，必也四物知、柏以壮水之主，人参、白术以培
气之原，随症以加行湿热之剂，则标本同冶，或可以收全功矣。（《苍生司命》）
黑疸 夫黄胆、酒疸、女劳疸，久久多变为黑疸。（《病源论》）
酒瘅下之，久久为黑瘅者，栀子大黄汤去大黄，加犀角、地黄。（《医通》）
黄瘅证中，惟黑瘅最剧，良由酒后不禁，酒湿流入髓脏
所致，土败水崩之兆。始病神未槁者，尚有湿热可攻，为祛瘅之向导，若病久肌肉消烁，此真元告匮，不能回荣
于竭泽也。中翰汪先于病瘅，服茵陈五苓不应，八月间邀石顽诊之，弦大而芤，肾伤挟瘀，结积不散所致，急乘
元气尚可攻击时，用金匮消石矾石散兼桂苓丸之制以洗涤之，迟则难为力矣。汪氏有业医者，以为药力太峻，
不便轻用。旋值公郎乡荐，继以公车，未免萦心，不及调冶。迨至新正二日，复邀石顽相商，脉转弦劲而革，真
元竭尽无余，半月以来，日服人参数钱，如水投石，延至正月下 ，遣内使窃问。予谓之曰∶挨至今日，小主人场
事，可无碍矣。其后安公联捷，不及殿试而返，信予言之不谬也。同时有伶人黑瘅，投以消石矾石散作丸，晨夕各
进五丸，服至四日，少腹攻绞，小便先下瘀水，大便继下溏黑，至十一日瘀尽，次与桂、苓、归、芍之类，调理
半月而安。（同上）
急黄 脾胃有热，谷气郁蒸，因为热毒所加，故卒然发黄，心满气喘，命在顷刻，故云急黄也。有得病
即身体面目发黄者，有初不知是黄，死后乃身面黄者。其候，得病但发热心战者，是急黄也。（《病源论》）
许仁则疗急黄病。此病始得。与前天行病不多异。五六日但加身体黄。甚者 泪汗唾小便如柏色。眼白睛正
黄。其更重状。与天行病候最重者无别。（《外台》）（按∶《金鉴》曰∶天行疫疠发黄，名曰瘟黄，死人最暴也。
盖是急黄耳。又瘟黄之称，本出《明医杂着》。）
寒湿发黄 （宜参后温中诸方）阴瘅一证，仲景之方论已亡，千古之下，惟罗谦甫茵陈附子干姜甘草汤一方，
治用寒凉药过当，阳瘅变阴之证，有合往辙，此外无有也。今人但云阳瘅色明，阴瘅色晦，此不过气血之分，辨
之不清，转足
误人。如酒瘅变黑，女劳瘅额上黑，岂以其黑遂谓阴瘅，可用附子干姜乎。夫女劳瘅者，真阳为血所壅闭，尚未
大损，瘀血一行，阳气即通矣。阴瘅则真阳衰微不振，一任湿热与浊气败血团结不散，必复其阳，锢结始开，傥非
离照当空，幽隐胡繇毕达耶。（《法律》）（按∶阴黄之称，本出《巢源》，而其证自异，如寒湿发黄，名以阴
黄者，盖 于韩祗和。）
阴瘅无热恶寒，小便自利，脉迟而微，误开鬼门，则肌肤冷硬，自汗不止，误洁净府，则膀胱不约，小便如
奔，死期且在旦暮，况于吐下之大谬乎。即以平善之药迁延，亦为待毙之术耳。在半阴半阳之证，其始必先退阴复
阳，阴退乃从阳治。若以附子黄连合用，必且有害，奈何纯阴无阳辄用苦寒耶。（同上）
诸虚发黄 （面黄）（宜参“治有二端”条。）诸疸，口淡怔忡，耳鸣脚软，当作虚治（按，此《三因》养
“瘅”这个字的意思是热，有时也写作“疸”，黄病必定是由热邪形成的，所以称为黄胆。从《肘后备急方》以来，将黄胆、谷疸、酒疸、女劳疸、黄汗，称为五疸。
然而黄胆实际上是总称，并没有特殊的证候区别；黄汗被张仲景归入水气病（以水肿为主要表现的疾病）的范畴，后世对此没有进一步阐发，所以现在并不采纳这种分类。大概伤寒引起的发黄，已经摘取了其要点，本编所列举的，多属于内伤病因导致的疾病，同时也涉及表湿证。
疾病必定因为湿热而成。湿与热郁结蒸腾于脾脏，导致面目和肢体发黄，这就是疸病。疸病的名称虽有五种说法，但这五种虽然不同，其表现为黄色是一致的，它们根源相同，没有不是由热和湿致病的情况。湿和热，难道没有轻重之分吗？湿气胜则颜色像熏过的黄那样晦暗；热气胜则颜色像橘子黄那样鲜明。因为脾主肌肉，土的颜色尚黄，湿热在体内蒸腾，无论轻重，都会显露于体表。（出自《直指方》）
治疸不必区分五种，都是湿热，就像制曲发酵一样相似。（出自《丹溪心法》）
疸病，虽然有酒、谷、黄汗、大饥、女劳五种治疗上的区分，但《诸病源候论》所论述的不过就是“湿热”两个字。古人说：豆类和谷物如同水火，人不可一日离开。所谓水火即人体内腐熟水谷的气机，保持平衡称为水火，失去适宜状态就称为湿热。凡是因此生病，有的因为脾胃受伤，导致中焦清气下陷，使得浊气混沌，以致湿热蔓延；有的在饥饿时饮酒，或极度口渴时饮泉水，或出汗后进入水中，或醉酒时吹受风邪，或劳累出汗后衣服冷湿贴身，或因雨湿闭塞毛孔，或过食油腻面食等湿热之物，或内热时行房事过度，或病后调理不当，湿热游走于经络，气机不能正常荣养运行，逐渐积聚于皮肤，身体和面目都变黄，尿液和汗水像柏树汁一样黄。这就像制作酒曲，用水拌面并密封不让气泄出，慢慢变成黄色。所以人患黄胆，也是因湿热而形成的。（出自《诸证辨疑》）
黄胆这一证候，都是由湿热造成的。湿气不能发散，就会郁结蒸腾而生热；热气不能宣畅，就会固结而生湿，湿得到热而更深重，热因为湿而更炽盛，两者互相助长而成就，时间越久就越严重。然而探求湿热产生的原因，无不来自于大醉大饱，以及醉饱后贪睡久卧，还有努力行房事所致。或者醉饱后入水洗浴，寒气收敛束缚，使腠理密闭，汗液无法排出，以致湿热相互感应而形成此病。外不能出汗，内不能泻下，湿热熏蒸浸染，流入皮肤，上达面目，下至足背，中及手臂，前腹后背都像涂了金子一样，小便赤红如姜黄，就像腌盐酱菜，因湿热而改变颜色一样。（出自《丹台玉案》）
脾是帮助胃输送津液的器官，津液运行则小便通利，哪里有发黄的道理呢？只有湿生于热，热滋生于湿，湿热相生，于是形成痞满胀气。由此胃气暗中衰弱，脾气虚弱，不能为胃输送津液，导致上焦不通行，所以身体不能出汗，下脘不通畅，所以又没有小便，熏蒸日久，热气变成黄色。（出自《苍生司命》）
关于黄胆一证，古人多说它是湿热，以及有五疸之分的，都不足以完全概括它。却不知道黄病的大要有四种：叫阳黄，叫阴黄，叫表邪发黄，叫胆黄。知道这四种，那么黄胆的证候就没有遗漏了。丹溪说：疸不必分五种，都是湿热，就像制曲一样相似。难道真的都像制曲，都可以说是湿热吗？这是不足为凭的。（出自《景岳全书》）（按语：此说失当。大概黄胆或许有不因湿热者，但其正证必定自湿热，《金匮要略》首条可以证明。至于其别证，则有寒湿发黄，有女劳疸。现在景岳用四证来概括，而所谓的阴黄，其实是虚黄，既非寒湿，又非女劳。再举出胆黄，这是稀有的证候，却列为其中一种。然而他的说法，也不足以穷尽所有情况，暂且列出于此，以辨别其谬误。）
病由邪气郁结 巢元方的黄病论述，不够全面通达，而各家《伤寒论》中多遵循它。导致发黄的原因不止一种，有的误用下法，有的用火熏法，都能造成发黄，不仅仅是寒热谷气而已。大致寒邪侵入人体，久久不能去除，变为热毒。假借春风发动，表证可出的时机，既然动则不可复回，而腠理不开，无从作汗而出，郁结在里，最终不能消散，淫邪扩散，血脉传流。其中毒邪重的，遇到血液相搏不能战胜，发生变异凝结，有的像猪肝，有的像墨色，这是被邪气败坏的血液，无法排泄邪气，则血枯而死。毒邪轻的，鼓动血液向上，随鼻衄而出，脉涩的因促迫滑利的之气向下，随小便而去。既然不能与血相搏，又不能开腠理生汗，上不能出，下不能去，于是散于毛窍之间，已失去居所而无处安顿，进退两难，郁结成为至黄的颜色，等待汗与尿排出后才能通畅，这种毒邪并非不想排出，就像人走到门口却没有路一样。医生疏通其道并指示出来，不为汗则为尿，没有不痊愈的道理。然而毒邪在腠理之内，与正气争持，正邪相窒塞，毛孔也不能打开，所以不能作汗，必须通过开窍利小便排出。这就是毒瓦斯在里不能排出的，必定形成黄病和血证，虽然轻重上下不同，道理是一样的。有可以通过发汗排出的吗？回答说：脉浮甚的，其表必疏，可以通过发汗排出。（出自《伤寒补亡论》）
在五疸之外，还有时行瘴疟、风寒暑湿等证候，与疸病不同。（出自《三因极一病证方论》）
脉象 （互见次条及瘀血发黄、生死诀等。）湿热相郁结而疸即形成，脉洪大而大，不弦，却带软而长，宜通利小便。（出自《史载之方》）
疸病脉缓大，为顺；脉弦急而坚，为逆。（出自《直指方》）
五疸实热，脉必洪数，如果微涩，证属虚弱。（出自《崔氏脉诀》）
表里证总说 黄病患者，全身疼痛，发热面色洞黄，七八日后，壮热在里有瘀血，应当用下法，方法如大黄硝石汤状。其人少腹内急，如果其人眼睛涩疼，鼻骨疼，两膊及项强，腰背急，即是患黄病。大多大便涩滞，只要让小便痛快，就不必担心死亡，不需要大便多通，多通则心腹胀（《圣惠方》作不需要大便多涩，涩则心腹胀）不安（“存”字《外台秘要》作“好”，《圣惠方》作“安”）。这是由于寒湿在表（《活人书》作在里），则热蓄积于脾胃，腠理不开，瘀热与宿食相搏，烦闷郁结不得消解，则大小便不通，所以身体面目，都变黄色。（出自《诸病源候论》）
黄胆的病，这是由于酒食过度，脏腑不和，水谷混杂，积聚于脾胃，又为风湿所搏结，瘀结不散，热气郁蒸，所以吃完饭后像饥饿一样，令身体面目及爪甲小便尽黄而想安静躺卧。如果身体多现青赤黑色，皆可见到，必定寒热身疼，面色微黄，齿垢黄，爪甲上黄，这是黄胆。（同上）（按语：面色微黄以下，原本出自《脉经》。）
风黄候 凡人先患风湿，又遇冷气相搏，则全身疼痛，发热而体黄。（同上）
阳气伏匿，阴气盛，热毒加之，所以只身面色黄，头痛而不发热，名为阴黄。（同上）（按语：这仍然是里热之证，仍列于此。）
色如熏黄，乃是湿病，全身疼痛。色如橘子黄，乃是黄病，全身不痛。干黄，是燥，小便自利，四肢不沉重，渴而饮水的，用栀子柏皮汤。湿黄，属脾，小便不利，四肢沉重，似渴不欲饮的，用大茵陈汤。如果大便自利而黄的，用茵陈栀子黄连三物汤。往来寒热，全身尽黄的，用小柴胡加栀子。（出自《医学纲目》引《难知》）
其症状有三种：一是栀子柏皮汤，二是麻黄连翘赤小豆汤，都治疗身黄，小便利而身不痛的，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，《活人书》所说的中湿。（出自《本草纲目》）（按语：此说不确切，暂且保留。）
表邪发黄，就是伤寒证，凡伤寒汗不能透而风湿在表的，有黄证。或者表邪不解，自表传里而湿热郁于阳明经的，也有黄证。表邪未解的，必发热身痛，脉浮少汗，宜从汗散。湿热内郁的，必烦热脉缓滑多汗，宜从分消清利。若阳明实邪内郁而痞结胀满的，宜先下之，然后清其余热，则自然无有不愈。（出自《景岳全书》）
阳黄证，因湿多成热，热则生黄，这就是所谓的湿热证。然而此证必有身热，有烦渴，或躁扰不宁，或消谷善饥，或小溲热痛赤涩，或大便秘结，其脉必洪滑有力。此证不拘表里，或风湿外感，或酒食内伤，都能导致。只要察其元气尚强，脾胃无损，而湿热果盛的，直宜清火邪，利小便，湿热去而黄自退，治疗此证本来并不难。（同上）
辨色 如果面色微黄，身体或青赤黑色皆见的，与纯热之证不同，应当在湿家求治。（出自《圣济总录》）
黄如橘而明的，热多脉必数，以解热为主；黄如熏黄而暗的，湿多脉必沉缓，以渗湿为主。（出自《医宗必读》）（按语：此说本于《直指方》，已见于上文。）
淡黄易愈，深黄者难愈，焦黄者不治。（出自《订补明医指掌》）
湿盛则但黄而不亮，热盛则鲜明如橘子，干黄则枯槁不润。盖色润者属水，色光者属火。若色如烟熏，黄黑晦滞，枯槁无光，为危证。旧说湿胜如熏黄黑晦，存参。按：黑晦即不亮也，然未必枯；若并不润，则是瘀败之死水，难治矣。（出自《医碥》）（按语：《千金方》茵陈栀子等七味汤方后有曰桃皮色，出后疏里方中，宜参。）
谷疸 谷疸者，吃完饭头晕，心中郁结不安而发黄，由失饥暴食，胃气冲熏所致。（出自《肘后备急方》）
谷疸，头眩心慌，郁结不安，用小柴胡汤加谷芽、枳实、白术、山栀仁主治。（出自《原病集》）
酒疸者，心中懊恼痛，足胫胀满，小便黄，饮酒发赤斑黄黑，由大醉当风入水所致。（出自《肘后备急方》）
五疸中唯酒疸变证最多，大概酒这种东西，随人性量不同，有喝一石而不醉的，有沾唇就乱的，因酝酿而成，有大热毒渗入百脉为病，则不仅发黄，溢于皮肤，变黑变肿，流于清气道中，则眼黄鼻雍种种不同。所以方论中，酒疸外有肉疸、黑疸、癖疸、劳役乃至令人恍惚失常等数种不同。（出自《三因极一病证方论》）
酒疸脉若浮滑，腹满欲呕吐的，必须先吐之；脉若沉滑，腹满大便秘的，必须先下之。（出自《奇效良方》）
酒疸，心中懊恼，足胫胀满，尿黄面赤，酒过胃热，醉卧当风，水湿得之，用小柴胡汤加茵陈、白术、豆豉、葛根、黄连、泽泻主治。（出自《原病集》）
酒疸，因饮酒过伤而黄，俗名为酒黄，宜干葛煎汤或栀子仁煎汤调服五苓散，或生料五苓散加干葛一钱。有酒疸后变成腹胀，渐至面足俱肿，或肿及遍身，宜藿香脾饮（按：用浓朴、甘草、陈皮、半夏、藿香）加木香三钱，或木香、麦柏各半钱。（出自《医方摘要》）
女劳疸 女劳疸者，身目皆黄，发热恶寒，小腹满急，小便难，由大劳大热交接，交接后入水所致。（出自《肘后备急方》）
夫交接输泻，必动三焦。上焦属心，中焦属脾，下焦属肾。动则热，热则欲火炽，因入水中。中焦热郁，故能发黄。上焦气胜，故额黑。下焦走血，随瘀热行，大便溏黑。贵胜人有男女同室而浴者，多成此病，摄生之人，不可不知。（出自《三因极一病证方论》）
女劳疸，乃是肾虚而成大不足之症，不可作湿热有余治之，必也用四物知柏以壮水之主，人参、白术以培气之原，随症以加行湿热之剂，则标本同冶，或许可以收全功矣。（出自《苍生司命》）
黑疸 夫黄胆、酒疸、女劳疸，久久多变为黑疸。（出自《诸病源候论》）
酒瘅下之，久久为黑瘅者，栀子大黄汤去大黄，加犀角、地黄。（出自《医学入门》）
黄瘅证中，惟黑瘅最剧，良由酒后不禁，酒湿流入髓脏所致，土败水崩之兆。始病神未槁者，尚有湿热可攻，为祛瘅之向导，若病久肌肉消烁，此真元告匮，不能回荣于竭泽也。中翰汪先于病瘅，服茵陈五苓不应，八月间邀石顽诊之，脉弦大而芤，肾伤挟瘀，结积不散所致，急乘元气尚可攻击时，用金匮消石矾石散兼桂苓丸之制以洗涤之，迟则难为力矣。汪氏有业医者，以为药力太峻，不便轻用。旋值公郎乡荐，继以公车，未免萦心，不及调冶。迨至新正二日，复邀石顽相商，脉转弦劲而革，真元竭尽无余，半月以来，日服人参数钱，如水投石，延至正月下浃，遣内使窃问。予谓之曰：挨至今日，小主人场事，可无碍矣。其后安公联捷，不及殿试而返，信予言之不谬也。同时有伶人黑瘅，投以消石矾石散作丸，晨夕各进五丸，服至四日，少腹攻绞，小便先下瘀水，大便继下溏黑，至十一日瘀尽，次与桂、苓、归、芍之类，调理半月而安。（同上）
急黄 脾胃有热，谷气郁蒸，因为热毒所加，故卒然发黄，心满气喘，命在顷刻，故云急黄也。有得病即身体面目发黄者，有初不知是黄，死后乃身面黄者。其候，得病但发热心战者，是急黄也。（出自《诸病源候论》）
许仁则疗急黄病。此病始得。与前天行病不多异。五六日但加身体黄。甚者 泪汗唾小便如柏色。眼白睛正黄。其更重状。与天行病候最重者无别。（出自《外台秘要》）（按语：《医宗金鉴》曰：天行疫疠发黄，名曰瘟黄，死人最暴也。盖是急黄耳。又瘟黄之称，本出《明医杂著》。）
寒湿发黄 （宜参后温中诸方）阴瘅一证，仲景之方论已亡，千古之下，惟罗谦甫茵陈附子干姜甘草汤一方，治用寒凉药过当，阳瘅变阴之证，有合往辙，此外无有也。今人但云阳瘅色明，阴瘅色晦，此不过气血之分，辨之不清，转足误人。如酒瘅变黑，女劳瘅额上黑，岂以其黑遂谓阴瘅，可用附子干姜乎。夫女劳瘅者，真阳为血所壅闭，尚未大损，瘀血一行，阳气即通矣。阴瘅则真阳衰微不振，一任湿热与浊气败血团结不散，必复其阳，锢结始开，傥非离照当空，幽隐胡繇毕达耶。（出自《寓意草》）（按语：阴黄之称，本出《巢源》，而其证自异，如寒湿发黄，名以阴黄者，盖始于韩祗和。）
阴瘅无热恶寒，小便自利，脉迟而微，误开鬼门，则肌肤冷硬，自汗不止，误洁净府，则膀胱不约，小便如奔，死期且在旦暮，况于吐下之大谬乎。即以平善之药迁延，亦为待毙之术耳。在半阴半阳之证，其始必先退阴复阳，阴退乃从阳治。若以附子黄连合用，必且有害，奈何纯阴无阳辄用苦寒耶。（同上）
The term "dan" (fever-jaundice) refers to heat. It is sometimes written as "dan" (jaundice). Yellow disease must be formed by heat, hence it is called Huang Dan (Yellow Gallbladder/Jaundice). Since the *Zhou Hou Bei Ji Fang* (Emergency Prescriptions Kept Up My Sleeve), the five types of jaundice—Huang Dan (Yellow Gallbladder/Jaundice), Gu Dan (Grain Jaundice), Jiu Dan (Wine Jaundice), Nv Lao Dan (Female Labor Jaundice), and Huang Han (Yellow Sweat)—have been referred to as the "Five Dans."
However, Huang Dan is actually a general term and does not denote a distinct syndrome with specific symptoms; Huang Han was classified by Zhang Zhongjing under Shui Qi (Water Qi/Edeema, diseases characterized primarily by edema), and later generations have not elaborated on it, so this classification is not adopted today. Generally speaking, jaundice caused by Shang Han (Cold Damage) has had its essentials extracted; the cases presented in this compilation mostly relate to internal injury diseases, while also covering exterior dampness syndromes.
Disease necessarily arises from Damp-Heat. When Dampness and Heat stagnate and steaming within the Spleen, the face, eyes, and limbs turn yellow; this is Dan (Jaundice). Although there are five names for Dan, while they differ, their manifestation as yellow is consistent. They share the same root, and none can cause disease without Heat and Dampness. Are there no differences in severity between Dampness and Heat? When Dampness prevails, the color is like smoked yellow, dull and dark; when Heat prevails, the color is like orange yellow, bright and clear. Because the Spleen governs the muscles, and the color of Earth is yellow, when Damp-Heat steams internally, whether severe or mild, it inevitably manifests externally. (*Zhi Zhi Fang*)
Treating Dan need not distinguish among the five types; all are Damp-Heat, similar to the fermentation process of making Qu (yeast starter). (*Dan Xi Xin Fa*)
Regarding Dan, although there are distinctions in treatment for Wine, Grain, Yellow Sweat, Starvation, and Female Labor types, the *Zhu Bing Yuan Hou Lun* (Master of Diseases' Catalogue of All Causes and Manifestations) discusses nothing more than the two characters: Damp-Heat. The ancients said: Grains and beans are like water and fire; one cannot live a day without them. Water and Fire refer to the Qi that ripens and digests food and drink in the body. When balanced, it is called Water and Fire; when imbalanced, it is called Damp-Heat. Illnesses arising from this may be due to damage to the Spleen and Stomach, causing the Clear Qi of the Middle Jiao to sink, leading to chaotic Turbid Qi and the spread of Damp-Heat. Or, drinking alcohol while hungry, drinking spring water when extremely thirsty, entering water after sweating, exposure to wind while drunk, cold wet clothes after exertion and sweating, blockage due to rain and dampness, overconsumption of greasy noodles and other Damp-Heat producing foods, sexual indulgence amidst internal heat, or improper care after illness. Damp-Heat wanders through the meridians, Qi fails to nourish and circulate properly, gradually accumulating in the skin, causing the body and face to turn yellow, urine and sweat turning yellow like camphor tree sap. This is like making Qu: mixing flour with water and sealing it to prevent gas escape, slowly turning yellow. Thus, human Huang Dan is also caused by Damp-Heat. (*Zhu Zheng Bian Yi*)
The syndrome of Huang Dan is entirely formed by Damp-Heat. If Dampness cannot dissipate, it stagnates and steams to generate Heat; if Heat cannot circulate freely, it consolidates to generate Dampness. Dampness becomes deeper with Heat, and Heat becomes fiercer with Dampness; the two assist and complete each other, worsening over time. However, investigating the origin of Damp-Heat, it invariably stems from excessive drunkenness and overeating, followed by sleeping late or lying down for long periods, or strenuous sexual activity. Or, bathing in water after drunkenness and overeating, where Cold Qi constricts and closes the Cou Li (pores/skin texture), preventing sweat excretion, causing Damp-Heat to interact and form this disease. Externally unable to sweat, internally unable to purge, the steaming and soaking infiltrate the skin, reaching up to the face and eyes, down to the dorsum of the feet, and mid-way to the arms. The front abdomen and back are like gold-plated, and urine is red like turmeric, just as pickling salt or soy sauce changes color due to Damp-Heat. (*Dan Tai Yu An*)
The Spleen transports and transforms fluids for the Stomach. If fluids circulate, urination is smooth, so why would yellowing occur? Only when Dampness generates from Heat, and Heat nourishes Dampness, creating a cycle of Damp-Heat, does stagnation and fullness result. Consequently, Stomach Qi secretly declines, and Spleen Qi becomes weak, unable to transport fluids for the Stomach. This leads to obstruction in the Upper Jiao, preventing sweating, and blockage in the Lower Wan (lower epigastrium), preventing urination. After prolonged steaming, Heat transforms into yellowing. (*Cang Sheng Si Ming*)
Regarding Huang Dan, the ancients often spoke of Damp-Heat and the five types of Dan, but these are insufficient to cover everything. One should know that the main categories of yellowing are four: Yang Huang (Yang Jaundice), Yin Huang (Yin Jaundice), Biao Xie Fa Huang (Exterior Pathogen Induced Yellowing), and Dan Huang (Gallbladder Jaundice). Understanding these four leaves no hidden meanings in Huang Dan. Dan Xi said: Dan need not be divided into five types; all are Damp-Heat, similar to making Qu. Can it really be said that all are like Qu and thus all are Damp-Heat? This is unreliable. (*Jing Yue Quan Shu*) [Note: This view is inappropriate. Perhaps some Huang Dan cases do not arise from Damp-Heat, but the typical syndrome certainly does, as evidenced by the first line of *Jin Gui Yao Lue*. As for atypical cases, there are Cold-Damp yellowing and Nv Lao Dan. Jing Yue summarizes with four types, but his so-called Yin Huang is actually Xu Huang (Deficiency Jaundice), which is neither Cold-Damp nor Nv Lao. He further lists Dan Huang, a rare syndrome, as one category. Thus, his theory is still insufficient. It is listed here merely to refute its errors.]
Disease caused by pathogenic stagnation: Chao Yuanfang's discussion on yellow disease is not comprehensive, yet many schools of *Shang Han Lun* follow it. The causes of yellowing are not singular; misapplication of purgatives or moxibustion/fire therapy can all cause yellowing, not just cold-heat or grain qi issues. Generally, Cold pathogens invading the body, if not expelled for a long time, transform into Heat Toxin. Borrowing the movement of Spring Wind, when the exterior is open for release, once activated, it cannot return. With Cou Li closed and no sweat produced, the pathogen remains stagnant inside, unable to disperse. The evil spreads, circulating through the blood vessels. In severe cases, the toxin clashes with blood, overwhelming it, causing coagulation. The blood may resemble pig liver or ink; this is blood defeated by pathogenic Qi. Without a way to vent the pathogen, blood dries up and death ensues. In milder cases, blood is driven upward and exits via epistaxis (nosebleed); if the pulse is choppy, the constrained slippery Qi drives it downward, exiting via urination. If it cannot clash with blood, nor open Cou Li to produce sweat, and cannot exit up or down, it scatters among the hair follicles, losing its residence and having nowhere to settle. Advancing or retreating is impossible, stagnating to become the color of extreme yellow, waiting for sweat and urine to clear the blockage. This toxin does not wish to stay out; it is like a person reaching a gate but finding no path. The physician clears the pathway and guides it; it will exit either as sweat or urine, and there is no reason it will not leave. However, since the toxin is within the Cou Li, contending with Healthy Qi, and the pathogen and healthy Qi obstruct each other, pores cannot open, so sweat cannot be produced. It must exit through opening orifices and promoting urination. This is why toxins trapped inside that cannot exit inevitably form Huang (Jaundice) and Blood syndromes. Although severity and location differ, the principle is the same. Is there a case where it can be released by sweating? Answer: If the pulse is very floating, the exterior is loose, and it can be released by sweating. (*Shang Han Bu Wang Lun*)
Outside the Five Dans, there are seasonal epidemic malaria, wind-cold, summer-heat, and dampness syndromes that differ from Dan. (*San Yin Fang*)
Pulse Diagnosis (See also next item, Blood Stasis Jaundice, and Life/Death Decisions.) When Damp-Heat stagnates and Dan forms, the pulse is Hong (Surging) and Da (Large), not Xian (Wiry), but soft and long. Promote urination. (*Shi Zai Zhi Fang*)
For Dan, a Huan (Slow) and Da (Large) pulse is favorable (Shun); a Xian (Wiry), Ji (Rapid/Tight), and Jian (Firm) pulse is unfavorable (Ni). (*Zhi Zhi Fang*)
For the Five Dans with Excess-Heat, the pulse must be Hong (Surging) and Shuo (Rapid). If it is Wei (Fine) and Se (Choppy), the syndrome belongs to Deficiency. (*Cui Shi Mai Jue*)
General Discussion of Exterior and Interior Syndromes: Patients with yellow disease suffer from whole-body pain, fever, and a piercing yellow complexion. After seven or eight days, intense heat resides inside with blood stasis; purgation is indicated, using a method similar to Da Huang Xiao Shi Tang (Rhubarb and Alumen Pill). The patient feels urgency in the lower abdomen. If the eyes are sore and painful, nasal bones hurt, both shoulders and neck are stiff, and the lower back is tight, it is yellow disease. Bowel movements are often difficult. As long as urination is smooth, death need not be feared. There is no need for frequent bowel movements; too many lead to abdominal distension and discomfort (*Sheng Hui Fang* states: no need for difficult bowel movements; difficulty leads to abdominal distension). *Cun* (Existence/Comfort) is written as *Hao* (Good) in *Wai Tai Mi Yao* and *An* (Peaceful) in *Sheng Hui Fang*. This is due to Cold-Damp on the exterior (*Huo Ren Shu* says interior), causing Heat to accumulate in the Spleen and Stomach. Cou Li closes, Stagnant Heat clashes with retained food, causing vexation and stagnation that cannot resolve, leading to obstruction of both urination and defecation. Thus, the body and face turn yellow. (*Zhu Bing Yuan Hou Lun*)
The disease of Huang Dan arises from excessive wine and food, disharmony of the Fu and Zang organs, mixing of water and grain accumulating in the Spleen and Stomach, combined with Wind-Damp clashing. Stagnation and knotting do not disperse, Heat steams and stagnates, causing hunger shortly after eating. The body, face, nails, and urine turn completely yellow, and the patient desires to lie quietly. If the body shows much blue, red, black, or mixed colors, accompanied by alternating chills and fever, body pain, slightly yellow complexion, yellow dental plaque, and yellow nails, it is Huang Dan. (Same source) [Note: From "slightly yellow complexion" onwards, originally from *Mai Jing*.]
Wind-Yellow Syndrome: If a person first suffers from Wind-Damp, then encounters Cold Qi clashing, the whole body aches, fever occurs, and the body turns yellow. (Same source)
When Yang Qi is latent and Yin Qi is abundant, plus Heat Toxin, only the body and face turn yellow, with headache but no fever; this is named Yin Huang (Yin Jaundice). (Same source) [Note: This is still an interior Heat syndrome, listed here nonetheless.]
Color like smoked yellow indicates Dampness disease, with whole-body pain. Color like orange yellow indicates Yellow Disease, with no whole-body pain. Dry Yellow indicates Dryness: urination is normal, limbs are not heavy, thirst with desire to drink; use Zhi Zi Bai Pi Tang (Gardenia and Bark Decoction). Wet Yellow indicates Spleen involvement: urination is difficult, limbs are heavy, apparent thirst but no desire to drink; use Da Yin Chen Tang (Major Coptis Decoction). If stool is normal but yellow, use Yin Chen Zhi Zi Huang Lian San Wu Tang (Three-Ingredient Decoction of Coptis, Gardenia, and Rhizoma Coptidis). Alternating chills and fever with whole-body yellowing: use Xiao Chai Hu Tang plus Zhi Zi (Gardenia). (*Wei Yi* citing *Nan Zhi*)
There are three manifestations: First, Zhi Zi Bai Pi Tang; second, Ma Huang Lian Qiao Chi Xiao Dou Tang (Ephedra, Forsythia, and Red Bean Decoction). Both treat body yellowing with normal urination and no body pain, what Hai Zang calls Dry Yellow. Third, Gui Zhi Fu Zi Tang minus Gui Zhi plus Bai Zhu Tang (Atractylodes Macrocephala Decoction). Both treat body yellowing with normal urination and whole-body pain, what *Huo Ren Shu* calls Zhong Shi (Midstening by Dampness). (*Ben Cao Gang Mu*) [Note: This statement is inaccurate; preserved tentatively.]
Exterior Pathogen Induced Yellowing is a Shang Han syndrome. In any Shang Han case where sweat cannot penetrate and Wind-Damp remains on the exterior, yellowing may occur. Or, if exterior pathogens remain unresolved and transmit from exterior to interior, causing Damp-Heat to stagnate in the Yangming channel, yellowing may also occur. If exterior pathogens are unresolved, there must be fever, body pain, floating pulse, and little sweat; dispersal via sweating is appropriate. If Damp-Heat stagnates internally, there must be vexing heat, slow and slippery pulse, and profuse sweating; resolution via separation, clearing, and draining is appropriate. If Yangming Excess pathogens stagnate internally causing palpitations, knots, and distension, purgation should be used first, then clearing residual heat, ensuring recovery. (*Jing Yue Quan Shu*)
Yang Huang Syndrome: When Dampness predominates, it forms Heat; Heat generates yellowing. This is the so-called Damp-Heat syndrome. However, this syndrome must present with body heat, vexing thirst, restlessness, rapid digestion/hunger, hot/painful/red/scanty urination, or constipation. The pulse must be Hong (Surging), Hua (Slippery), and You Li (Forceful). This syndrome applies regardless of exterior or interior; whether Wind-Damp external contraction or wine/food internal injury, all can cause it. As long as Yuan Qi (Primal Qi) is strong, Spleen and Stomach are undamaged, and Damp-Heat is indeed prevalent, directly clearing Fire Evil and promoting urination is suitable. Once Damp-Heat is removed, yellowing recedes naturally; treating this is not difficult. (Same source)
Differentiating Color: If the complexion is slightly yellow, and the body shows blue, red, or black hues, it differs from pure Heat syndromes; seek treatment among Dampness patterns. (*Sheng Ji Zong Lu*)
If yellow is like orange and bright, Heat predominates, pulse is likely Rapid; focus on resolving Heat. If yellow is like smoked yellow and dark, Dampness predominates, pulse is likely Deep and Slow; focus on leaching out Dampness. (*Liu Yao*) [Note: This view originates from *Zhi Zhi Fang*, seen above.]
Pale yellow heals easily; deep yellow is hard to heal; scorched yellow is untreatable. (*Ding Bu Ming Yi Zhi Zhang*)
When Dampness is abundant, yellowing is dull and not bright; when Heat is abundant, it is bright like an orange; Dry Yellow is withered and unmoistened. Moist color belongs to Water; shiny color belongs to Fire. If the color is like smoke, yellow-black, dull, withered, and lacking luster, it is a critical syndrome. Old theories state Dampness excess resembles smoked yellow-black and dullness; consider this. Note: Black-dull means not bright, but not necessarily withered; if it is also unmoistened, it is stagnant, ruined dead water, difficult to treat. (*Yi Que*) [Note: *Qian Jin Fang*'s Seven-Ingredient Decoction of Yin Chen and Zhi Zi mentions "peach bark color" after the formula, found in subsequent interior-releasing formulas; consult this.]
Gu Dan (Grain Jaundice): After eating, the head spins, the heart feels郁结 (depressed/stagnant) and uneasy, leading to yellowing. Caused by irregular fasting and overeating, with Stomach Qi rushing and steaming. (*Zhou Hou Bei Ji Fang*)
Gu Dan presents with dizziness, palpitations, and depression/unease. Treat with Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Gu Ya (Sprouted Grain), Zhi Shi (Immature Bitter Orange), Bai Zhu (Atractylodes Macrocephala), and Shan Zhi Ren (Gardenia Seed). (*Yuan Bing Ji*)
Jiu Dan (Wine Jaundice): Yellow complexion, heat knotting below the heart with vexation. (*Mai Jing*)
Jiu Dan presents with mental anguish and pain, fullness in calves and shins, yellow urine, red spots and yellow-black discoloration after drinking. Caused by drunkenness exposed to wind and entering water. (*Zhou Hou Bei Ji Fang*)
Among the Five Dans, Jiu Dan has the most variable transformations. Alcohol varies by individual tolerance; some drink a dan (unit of volume) without getting drunk, others get confused after a sip. Fermented, it contains great Heat Toxin penetrating the hundred vessels. Illness arises not only with yellowing, but overflow into skin causing blackness or swelling, flowing into clear Qi pathways causing yellow eyes and nasal congestion, etc. Thus, besides Jiu Dan, formulas discuss Rou Dan (Meat Jaundice), Hei Dan (Black Jaundice), Pi Dan (Mass Jaundice), Lao Yi (Overwork Jaundice), and even conditions causing恍惚 (trance/confusion). (*San Yin Fang*)
If the pulse for Jiu Dan is Floating and Slippery, with abdominal fullness and desire to vomit, induce vomiting first. If the pulse is Deep and Slippery, with abdominal fullness and constipation, purge first. (*Qi Xiao Liang Fang*)
Jiu Dan presents with mental anguish, calf/shin fullness, yellow urine, red face, stomach heat from alcohol, sleeping in wind while drunk, contracting water-dampness. Treat with Xiao Chai Hu Tang plus Yin Chen (Artemisia Capillaris), Bai Zhu, Dou Chi (Fermented Soybean), Ge Gen (Kudzu Root), Huang Lian (Coptis), and Ze Xie (Alisma). (*Yuan Bing Ji*)
Jiu Dan, yellowing due to excessive alcohol consumption, commonly called Jiu Huang (Wine Yellow). Use Gan Ge (Kudzu Root) decoction or Zhi Zi Ren (Gardenia Seed) decoction to mix with Wu Ling San (Five-Ingredient Powder with Poria), or raw material Wu Ling San plus one qian of Gan Ge. If Jiu Dan later transforms into abdominal distension, gradually swelling face and feet, or entire body, use Huo Xiang Pi Yin (Agastache Spleen Decoction) [Note: Uses Hou Po, Gan Cao, Chen Pi, Ban Xia, Huo Xiang] plus three qian of Mu Xiang (Aucklandia), or half qian each of Mu Xiang and Mai Bai (Lily Bulb/Mugwort seed - context implies specific herb, likely typo for something else, kept as transliterated). (*Yao Jue*)
Nv Lao Dan (Female Labor Jaundice): Body and eyes yellow, fever with aversion to cold, fullness and urgency in lower abdomen, difficult urination. Caused by strenuous labor and high heat during intercourse, followed by entering water. (*Zhou Hou Bei Ji Fang*)
Intercourse and ejaculation necessarily move the San Jiao (Triple Burner). Upper Jiao belongs to Heart, Middle Jiao to Spleen, Lower Jiao to Kidney. Movement generates Heat; Heat ignites desire. Entering water afterwards causes Middle Jiao Heat stagnation, leading to yellowing. Upper Jiao Qi dominance causes black forehead. Lower Jiao moves blood; following Stagnant Heat, stool becomes loose and black. Noble people bathing together often contract this disease; those caring for health must know this. (*San Yin Fang*)
Nv Lao Dan is a deficiency syndrome caused by Kidney Deficiency. It must not be treated as Excess Damp-Heat. Use Si Wu Tang plus Zhi Mu and Huang Bai to strengthen the Master of Water (Kidney Yin), and Ren Shen and Bai Zhu to cultivate the Source of Qi. Add herbs to move Damp-Heat according to symptoms, treating both root and branch simultaneously, potentially achieving full recovery. (*Cang Sheng Si Ming*)
Hei Dan (Black Jaundice): Huang Dan, Jiu Dan, and Nv Lao Dan, if lingering, often transform into Hei Dan. (*Zhu Bing Yuan Hou Lun*)
If Jiu Dan is purged and later becomes Hei Dan, use Zhi Zi Da Huang Tang (Gardenia and Rhubarb Decoction) minus Da Huang, adding Xi Jiao (Rhinoceros Horn - substitute with Buffalo Horn in modern practice) and Di Huang (Rehmannia). (*Yi Tong*)
Among Huang Dan syndromes, Hei Dan is the most severe, largely due to lack of restraint after drinking, allowing alcohol-dampness to flow into the Marrow and Viscera, signaling failure of Earth (Spleen) and collapse of Water (Kidney). If spirit is not exhausted at onset, Damp-Heat can still be attacked, serving as a guide to dispel Dan. If the disease lingers, muscles waste away, indicating depletion of True Yuan (Primal Essence), unable to restore prosperity to a dried-up pool. Official Wang suffered from Dan; Yin Chen Wu Ling San failed. In August, Shi Wen diagnosed him: Pulse was Xian (Wiry), Da (Large), and Kou (Hollow), indicating Kidney injury with Blood Stasis, knotting and not dispersing. Urgently, while Yuan Qi could still withstand attack, use Jin Gui Xiao Shi Fan Shi San (Alum and Nitre Powder) combined with Gui Ling Wan (Cinnamon and Poria Pill) to cleanse it; delaying makes it difficult. Wang's family physician thought the medicine too harsh for light use. Soon after, Wang's son passed provincial exams and prepared for metropolitan exams, worrying him, neglecting treatment. On the second day of the new year, Wang invited Shi Wen again. Pulse turned Xian (Wiry), Jin (Tough), and Ge (Leather-like), indicating True Yuan completely exhausted. For half a month, he took several qian of Ren Shen daily, like water thrown on stone. By the third decade of the first lunar month, he sent a messenger to ask secretly. I said: Enduring until today, the young master's examination matters are safe. Later, Lord An succeeded in consecutive exams, returned before the palace exam, confirming my words were not wrong. Simultaneously, a performer had Hei Dan. Given Xiao Shi Fan Shi San made into pills, five taken morning and evening. After four days, lower abdomen cramping, urinating stagnant water first, then loose black stool. By the eleventh day, stasis cleared. Then given Gui (Cinnamon), Ling (Poria), Gui (Angelica), Shao (Peony) type herbs, regulated for half a month, and recovered. (Same source)
Ji Huang (Acute Jaundice): Heat in Spleen and Stomach, grain Qi stagnating and steaming, plus Heat Toxin, causes sudden yellowing. Fullness in heart, panting, life in imminent danger, hence called Ji Huang. Some have immediate body and face yellowing upon illness onset; others do not know they have yellowing until death, when body and face turn yellow. Symptom: Only fever and heart tremors upon illness onset indicate Ji Huang. (*Zhu Bing Yuan Hou Lun*)
Xu Renze treats Ji Huang. At onset, this disease is not much different from epidemic diseases. After five or six days, only body yellowing adds. In severe cases, tears, sweat, saliva, and urine are yellow like camphor tree sap. Whites of eyes are truly yellow. Its heaviest state is indistinguishable from the heaviest epidemic symptoms. (*Wai Tai Mi Yao*) [Note: *Yi Zong Jin Jian* says: Epidemic pestilence yellowing is named Wen Huang (Plague Jaundice), killing people most violently. This is essentially Ji Huang. Also, the term Wen Huang originates from *Ming Yi Za Zhuo*.]
Han Shi Fa Huang (Cold-Damp Induced Yellowing) (Consult warming formulas below): Yin Dan syndrome, Zhang Zhongjing's formulas and discussions are lost. Through millennia, only Luo Qianfu's Yin Chen Fu Zi Gan Jiang Gan Cao Tang (Artemisia, Aconite, Ginger, and Licorice Decoction) remains. It treats cases where Cold-Cooling medicines were overused, transforming Yang Dan into Yin. This aligns with past precedents; nothing else exists. Today, people simply say Yang Dan is bright colored, Yin Dan is dull colored. This is merely a distinction of Qi and Blood, unclear differentiation leads to misleading people. For example, Jiu Dan turning black, Nv Lao Dan having black forehead; can we call them Yin Dan and use Fu Zi and Gan Jiang because of blackness? Nv Lao Dan involves True Yang blocked by Blood, not yet severely damaged; once Blood Stasis moves, Yang Qi flows. Yin Dan involves True Yang decline and weakness,任由 (allowing) Damp-Heat, Turbid Qi, and Ruined Blood to knot and not disperse. Must restore Yang; only then will knots open. Unless the sun shines brightly in the sky, how can darkness be illuminated? (*Yu Yi Cao*) [Note: The term Yin Huang originates from *Chao Yuan*, but the syndrome differs. Cold-Damp yellowing named Yin Huang likely started with Han Zhihe.]
Yin Dan presents with no heat but aversion to cold, normal urination, slow and fine pulse. Mistakenly opening the Ghost Gate (sweating) leads to cold, hard skin and continuous spontaneous sweating. Mistakenly purifying the Clean Mansion (urination/bladder) leads to bladder incontinence, urine running like a rush. Death is imminent. How much more erroneous are emesis and purgation! Even delaying with mild medicines is a way to await death. In Half-Yin Half-Yang syndromes, initially must retreat Yin and restore Yang; only after Yin retreats treat according to Yang. Combining Fu Zi and Huang Lian will surely cause harm. Why use Bitter-Cold on pure Yin without Yang? (Same source)
Zhu Xu Fa Huang (Various Deficiencies Inducing Yellowing) (Face Yellow) (Consult "Treatment Has Two Ends" section.) Various Dans presenting with bland taste, palpitations, tinnitus, and weak legs should be treated as Deficiency. (Note: This is from *San Yin*...)