太阳病，关节疼痛而烦，脉沉而细者，此名湿痹。其候小便不利，大便反快，但当利其小便。
沈尧封曰∶伤寒既以头痛、胃实等项分六经，即以汗字判
风寒，渴字认燥热，小便不利认湿气，纵横辨别，邪无遁形矣。学人当于此等处，着实留心。
湿家之为病，一身尽疼，发热，身色如熏黄。
倪冲之曰∶此湿家为病之总纲也。前条湿在关节而疼，故曰痹。此则一身尽疼而表有热，故成氏谓之在经
。熏黄与橘子黄，同是湿热；彼以热胜者黄而明，此以湿胜者黄而晦，宜茵陈五苓散。王海藏以熏黄为阴黄，
盖既湿胜，则次传寒中，小便自利者有之（王梦隐按∶此由治病者，但清其热，不治其湿所致），宜术附汤。
沈尧封曰∶丹溪云∶如造麴然，湿热郁久则发黄也。
王梦隐曰∶湿热发黄，名曰黄瘅，皆是暴病，故仲景以十八日为期。其余所因甚多∶有谷疸，酒疸，女劳
疸，黄胆，黄汗，及冷汗、便溏、气虚之阴黄，身面浮肿、睛白能餐、劳倦之弱黄，神志不足、猝受恐吓、胆
气外泄之惊黄，肝木横肆、脾胃伤残、土败而黄色外越之痿黄；皆与暴病不同，不可概目为湿热病。
湿家，其人但头汗出，背强，欲得被复向火。若下之早则哕，胸满，小便不利；舌上如苔者，以丹田有热，
胸中有寒，渴欲得水而不能饮，则口燥烦也。
王梦隐曰∶胸中有寒之寒字，当作痰字解。胸中有痰，故舌上如苔。其津液为痰所阻，故口燥烦。而痰饮
乃水之所凝结，故虽渴而不能饮也。
尤在泾曰∶寒湿在表，阳气不得外通，而但上越，故头汗背强，欲得被复向火也。是宜用温药以通阳，不
可用攻药以逐湿。乃反下之，则阳更被抑，而哕乃作矣。或上焦之阳不布而胸中满，或下焦之阳不化而小便不
利，随所伤之上下而为病
也。舌上如苔者，本非胃热，而舌上津液燥聚如苔之状，实非苔也。盖下后阳气陷于下，而寒湿聚于上，于是
丹田有热而渴欲得水，胸中有寒而复不能饮，则口舌燥烦而津液乃聚耳。
湿家下之，额上汗出，微喘，小便利者死；若下利不止者，亦死。
尤在泾曰∶湿病在表者宜汗，在里者宜利小便。苟非湿热蕴积成实，未可遽用下法。额汗出微喘，阳已离
而上行；小便利，下利不止，阴复决而下走∶阴阳离决，故死。一作小便不利者死，谓阳上浮而阴不下济也，
亦通。
王梦隐曰∶张石顽云，由此推之，虽额汗微喘，若大小便不利，则阴气未脱而阳之根犹在也。虽大小便利
，而无额汗微喘，则阳气不越，阴之根犹在也。阴阳不至离决，尚可随其虚实而救之。至于下利不止，虽无喘
汗阳脱之候亦死。又小便反闭，而额上汗出者谓之关。经云∶关格不通，头无汗者可活。有汗者死。
问曰∶风湿相搏，一身尽疼痛，法当汗出而解。值天阴雨不止，医云此可发汗，汗之病不愈者，何也？答
曰∶发其汗，汗大出者，但风气去，湿气在，是故不愈也。若治风湿者。发其汗，但微微似欲汗出者，风湿俱
去也。
汪谢城云∶古人即表汗，亦有节度如此；奈何今人动发其汗，且逼令其多耶？此与伤寒论桂枝汤后注，可
以互参。
湿家病身疼痛，发热，面黄而喘，头晕鼻塞而烦，其脉大，自能饮食，腹中和无病，病在头中寒湿，故鼻
塞，内药鼻中则愈。
章虚谷曰∶此所谓雾露清邪，中于上也。三阳经脉，上头而行于身之表∶头中寒湿，则表气不宣，故身疼
发热。肺开窍于鼻，而行气于皮毛；邪从鼻入，湿遏其阳而上蒸则面黄，气闭则喘，气壅则头痛鼻塞而烦，皆
肺气窒塞，不得下降，故脉反大，与湿中于下而在阴之脉沉细者，迥不同也。肺通喉，胃通咽；邪在肺，不在
胃；故腹无病而自能饮食。头中寒湿故鼻塞，当用辛香苦泄之药纳鼻中，如近世之痧药（王梦隐用古法瓜蒂散
嗅鼻出黄水），使肺气通达，其湿邪化水，从鼻中出则愈。
伤寒瘀热在里，身必发黄，麻黄连轺赤小豆汤主之。
章虚谷曰∶表邪未解，湿热内瘀则发黄。用麻黄解表，连轺、赤豆利肺气以清湿热。此以邪在经络，故从
表解之。
王梦隐曰∶夏月湿热发黄，表有风寒者，采用本方，以香薷易麻黄辄效（杨素园曰∶香薷乃夏月之麻黄，
换得恰当）。
伤寒身黄发热者，栀子柏皮汤主之。
尤在泾曰∶此热瘀而未实之证，热瘀故身黄，热未实，故发热而腹不满。栀子撤热于上，柏皮清热于下，
而中未及实，故用甘草以和之。
沈尧封曰∶栀柏汤清热利水，治湿热之主方也。程扶生以麻黄小豆汤为主方，不知麻黄小豆乃发汗之方，
惟外兼风寒者宜之，栀柏汤为利小便之方，乃治湿热之正法。观论中但当利其小便句，则此理自明矣。
伤寒七八日，身黄如橘子色，小便不利，腹微满者，茵陈蒿汤主之。
尤在泾曰∶此热结在里之证也。黄如橘子色者，色黄而明，为热黄也，若阴黄，则色黄而晦矣。热结在里
，则小便不利而腹满，故宜茵陈蒿汤，以下热通瘀为主也。
阳明病，发热汗出，为热越不能发黄也。但头汗出，身无汗，剂颈而还，小便不利，渴饮水浆者，此为瘀
热在里，身必发黄。茵陈蒿汤主之。
尤在泾曰∶热越，热随汗而外越也。热越则邪不蓄而散，安能发黄？若但头汗出，剂颈而还，则热不外达
；小便不利，则热不下泄∶而又渴饮水浆，则热之蓄于内者方炽，而湿之引于外者无已∶湿与热合，瘀郁不解
，则必蒸发为黄矣。茵陈蒿汤苦寒通泄，使病从小便出也。
阳明病，面合赤色，不可攻之；攻之必发热色黄，小便不利也。
沈尧封曰∶此寒邪外束之湿温证也，麻黄小豆汤是其主方。除却恶寒，即是栀柏汤证。更加腹微满，即是
茵陈蒿证。
章虚谷曰∶面赤者，热郁在经也，当以汗解。若攻之，伤其腑气，则经热反从内走，与水谷之气郁蒸发黄
，三焦闭塞，小便不利也。
阳明病，无汗，小便不利，心中懊 者，身必发黄。
章虚谷曰∶此条虽未误下，而无汗小便不利，其邪热闭结而无出路，与胃中水液郁蒸，则必发黄矣。
阳明病，被火，额上微汗出，小便不利者，必发黄。
喻嘉言曰∶湿停热郁而误火之，则热邪愈炽，津液上奔，额有微汗，而周身之汗与小便，均不可得矣∶发
黄之变，安能免乎。
太阳病，出现关节疼痛且伴有烦扰感，脉象沉而细的，这叫做湿痹。其症状表现为小便不通畅，大便反而稀溏，治疗时应当采用利小便的方法。
沈尧封说：伤寒既然以头痛、胃实等症状来划分六经，就以“汗”字来判断风寒，以“渴”字来识别燥热，以“小便不利”来认定湿气，纵横交错地辨别，邪气就无法隐藏了。学习的人应当在这些地方切实留心。
患有湿病的人，全身都疼痛，发热，面色像被烟熏过的黄色（晦暗发黄）。
倪冲之说：这是湿病患者疾病的总纲。前一条讲湿邪在关节导致疼痛，所以称为痹证。这一条则是全身疼痛且体表有热，所以成无己称之为邪在经络。熏黄与橘子色黄，都是湿热所致；前者因热邪偏胜，黄色鲜明；后者因湿邪偏胜，黄色晦暗，适宜用茵陈五苓散。王海藏认为熏黄属于阴黄，因为既然湿邪偏胜，随后会传变为寒中，若小便通利的则有此情况（王梦隐按语：这是由于治病者只清热而不治湿所导致的），适宜用术附汤。
沈尧封说：丹溪曾说：就像制作酒曲一样，湿热郁积久了就会发黄。
王梦隐说：湿热发黄，名叫黄瘅，都是急性病，所以张仲景以十八天为期限。其余成因很多：有谷疸、酒疸、女劳疸、黄胆、黄汗，以及冷汗、便溏、气虚引起的阴黄；身面浮肿、眼睛白、能进食、因劳倦导致的弱黄；神志不足、突然受惊吓、胆气外泄导致的惊黄；肝木横逆、脾胃受损、土败而黄色外越导致的痿黄；这些都与急性病不同，不能一概视为湿热病。
患湿病的人，只有头部出汗，背部僵硬，想要盖被子靠近火源取暖。如果过早使用攻下法，就会出现呃逆、胸满、小便不利；舌面上好像有苔状物，这是因为丹田有热，胸中有寒，想喝水却喝不下去，从而导致口燥烦渴。
王梦隐说：胸中有寒的“寒”字，应当解释为“痰”。胸中有痰，所以舌面上像有苔。津液被痰阻滞，所以口燥烦渴。而痰饮是水液凝结而成的，所以虽然口渴却不能饮水。
尤在泾说：寒湿在体表，阳气不能向外通达，只能向上浮越，所以头汗出、背强，想要盖被子靠近火源。这时适宜用温药来通阳，不可用攻下药来逐湿。反而误用下法，则阳气更受抑制，于是产生呃逆。或者上焦阳气不布散导致胸中胀满，或者下焦阳气不化导致小便不利，根据受伤部位的上或下而产生相应的病症。舌面上像有苔，本来不是胃热，而是舌上津液干燥聚集像苔的样子，实际上并不是苔。因为下法之后，阳气陷于下部，而寒湿聚于上部，于是丹田有热而想喝水，胸中有寒而不能喝水，导致口舌燥烦而津液聚集。
湿病患者被误用下法后，额头出汗，轻微气喘，小便通利的，预后不良（死）；如果腹泻不止的，也预后不良（死）。
尤在泾说：湿病在表适宜发汗，在里适宜利小便。如果不是湿热蕴结形成实证，不可以轻易使用下法。额头出汗、轻微气喘，说明阳气已脱离本体而上行；小便通利、腹泻不止，说明阴气也决裂而下走：阴阳离决，所以死亡。另一种说法是“小便不利者死”，意思是阳气上浮而阴气不能下行济助，也讲得通。
王梦隐说：张石顽说，由此推断，即使是额头出汗、轻微气喘，如果大小便不通利，那么阴气未脱，阳气的根本还在。即使大小便利，但没有额头出汗、轻微气喘，那么阳气没有外越，阴的根本还在。只要阴阳不至离决，还可以根据虚实情况进行救治。至于腹泻不止，即使没有气喘、汗出等阳气脱失的症状，也会死亡。另外，小便反而闭塞，而额头出汗的叫做“关”。医经说：关格不通，头上无汗的可以存活；有汗的死亡。
问：风湿相互搏结，全身都疼痛，按照法则应当通过发汗来解除。正值天下阴雨不停，医生说这可以发汗，但发汗后病没好，为什么呢？答：发汗时，如果汗出太多，只是风气去了，湿气还在，所以病不好。如果治疗风湿病，发汗时，只要微微似要出汗的样子，风湿就能一起去除。
汪谢城说：古人即使是发汗解表，也有这样的节度；为什么现在的人动不动就发汗，而且逼迫使其多汗呢？这与《伤寒论》桂枝汤后的注脚，可以互相参考。
患湿病的人身体疼痛，发热，面色黄且气喘，头晕、鼻塞且烦闷，脉象大，自己能饮食，腹部和缓无病，这是病在头部感受寒湿，所以鼻塞，将药物纳入鼻中即可痊愈。
章虚谷说：这就是所说的雾露清邪，侵犯上部。三阳经脉，上行头部并运行于体表；头部感受寒湿，则表气不宣通，所以身体疼痛、发热。肺开窍于鼻，并运行气于皮毛；邪气从鼻进入，湿邪遏制阳气而上蒸则面色黄，气机闭塞则气喘，气机壅滞则头痛、鼻塞且烦闷，这都是肺气窒塞，不能下降，所以脉象反而大，与湿邪中于下部而在阴分的脉象沉细截然不同。肺通喉，胃通咽；邪气在肺，不在胃；所以腹部无病且能自行饮食。头部感受寒湿所以鼻塞，应当用辛香苦泄的药物纳入鼻中，如近世的痧药（王梦隐用古法瓜蒂散嗅鼻引出黄水），使肺气通达，湿邪化为水液，从鼻中排出即可痊愈。
伤寒瘀热在体内，身体一定会发黄，用麻黄连轺赤小豆汤主治。
章虚谷说：表邪未解，湿热内郁则发黄。用麻黄解表，连轺、赤豆利肺气以清湿热。这是因为邪气在经络，所以从表解除。
王梦隐说：夏季湿热发黄，表有风寒的，采用本方，用香薷代替麻黄往往有效（杨素园说：香薷是夏季的麻黄，替换得当）。
伤寒身体发黄、发热的，用栀子柏皮汤主治。
尤在泾说：这是热郁但未成实的证候，热郁故身体发黄，热未成实，故发热而腹部不胀满。栀子清除上部的热，黄柏清除下部的热，而中部尚未成实，所以用甘草来调和。
沈尧封说：栀柏汤清热利水，是治疗湿热的主要方剂。程扶生以麻黄连轺赤小豆汤为主方，不知道麻黄连轺赤小豆汤是发汗的方子，只有兼有外感风寒的才适宜，栀柏汤是利小便的方子，才是治疗湿热的正法。看《伤寒论》中说“但当利其小便”这句话，那么这个道理自然就明白了。
伤寒七八天，身体黄得像橘子色，小便不通利，腹部轻微胀满的，用茵陈蒿汤主治。
尤在泾说：这是热结在里的证候。黄得像橘子色，黄色鲜明，是热黄；如果是阴黄，则黄色晦暗。热结在里，则小便不利且腹部胀满，所以适宜用茵陈蒿汤，以下热通瘀为主。
阳明病，发热汗出，说明热随汗外越，不会发黄。如果只是头部出汗，身上无汗，汗止于颈部，小便不通利，口渴想喝水浆的，这是瘀热在体内，身体一定会发黄，用茵陈蒿汤主治。
尤在泾说：热越，指热随汗向外发散。热越则邪气不蓄积而消散，怎么能发黄？如果只是头部出汗，止于颈部，则热不能向外达；小便不利，则热不能向下泄；再加上口渴想喝水浆，则内部蓄积的热正炽盛，而外部引动的湿无止境：湿与热结合，瘀郁不解，则必然蒸发为黄疸。茵陈蒿汤苦寒通泄，使病邪从小便排出。
阳明病，面色整体发红，不可用攻下法；攻下必导致发热、面色黄、小便不利。
沈尧封说：这是寒邪外束的湿温证，麻黄连轺赤小豆汤是其主方。除去恶寒症状，就是栀子柏皮汤的证候。再加上腹部轻微胀满，就是茵陈蒿汤的证候。
章虚谷说：面赤，是热郁在经络，应当用汗法解除。如果攻下，损伤腑气，则经络之热反而从内部走窜，与水谷之气郁积蒸发发黄，三焦闭塞，小便不利。
阳明病，无汗，小便不利，心中烦闷懊恼的，身体一定会发黄。
章虚谷说：这条虽然没有误用下法，但无汗且小便不利，邪热闭结而没有出路，与胃中水液郁积蒸发，则一定会发黄。
阳明病，被误用火疗，额头微汗出，小便不利的，一定会发黄。
喻嘉言说：湿停热郁而误用火疗，则热邪更加炽盛，津液向上奔涌，额头有微汗，而周身之汗与小便，都无法得到：发黄的变证，怎么能避免呢。
Taiyang disease, characterized by joint pain accompanied by restlessness and a deep, fine pulse, is named Shibi (Dampness Bi). Its manifestations include impaired urination and loose stools; treatment should focus on promoting diuresis.
Shen Yaofeng stated: Since Shanghan (Cold Damage) differentiates the six meridians based on symptoms such as headache and gastric excess, it uses "sweating" to identify Wind-Cold, "thirst" to recognize Dryness-Heat, and "impaired urination" to ascertain Dampness. Through this longitudinal and horizontal differentiation, pathogenic factors cannot hide. Students should pay close attention to these aspects.
Patients suffering from Dampness diseases experience generalized body pain, fever, and a sallow complexion resembling smoke-stained yellow (dull yellow).
Ni Chongzhi remarked: This serves as the general outline for Dampness diseases. The previous clause described dampness in the joints causing pain, hence termed Bi syndrome. Here, generalized body pain with exterior heat leads Cheng Wuji to classify it as pathogen residing in the meridians. Both smoke-stained yellow and orange-yellow result from Damp-Heat; the former, where Heat predominates, presents as bright yellow, while the latter, where Dampness predominates, presents as dull yellow, making Yinchen Wuling San appropriate. Wang Haicang considered smoke-stained yellow to be Yin-Jaundice (Yin Huang); since Dampness predominates, it may subsequently transmit to Cold in the Middle Jiao. If urination is free, this condition applies (Wang Mengyin noted: This results from physicians clearing Heat without treating Dampness), making Zhufu Tang appropriate.
Shen Yaofeng cited Danxi: Just like fermenting Qu (yeast starter), prolonged stagnation of Damp-Heat leads to jaundice.
Wang Mengyin explained: Jaundice caused by Damp-Heat is called Huangdan, typically an acute illness, which is why Zhang Zhongjing sets an eighteen-day prognosis. Other causes are numerous: there is Grain Jaundice (Gu Dan), Wine Jaundice (Jiu Dan), Sexual Exhaustion Jaundice (Nv Lao Dan), Yellow Gallbladder (Huang Dan), Sweat Jaundice (Huang Han), and Yin-Jaundice due to Cold sweat, loose stools, and Qi deficiency; Weak Jaundice due to fatigue, characterized by facial edema, white sclera, and ability to eat; Shock Jaundice due to fright and leakage of Gallbladder Qi; and Wei-Yellow (atrophy-related yellowing) due to Liver Wood overacting on Spleen/Stomach, leading to Earth failure and outward projection of yellow color. These differ from acute illnesses and should not all be categorized as Damp-Heat diseases.
In Dampness patients, sweating occurs only on the head, accompanied by neck stiffness and a desire to cover up and face fire. Premature use of purgatives leads to hiccups, chest fullness, and impaired urination. A coating-like appearance on the tongue indicates Heat in the Lower Abdomen (Dantian) and Cold in the Chest; thirst exists but drinking is impossible, resulting in dry mouth and irritability.
Wang Mengyin interpreted "Cold in the Chest" as "Phlegm." Phlegm in the chest causes the tongue coating appearance. Fluids are obstructed by Phlegm, causing dry mouth and irritability. Since Phlegm-Drush is congealed water, one feels thirsty but cannot drink.
You Zaijing explained: Cold-Dampness at the exterior prevents Yang Qi from circulating outward, causing it to float upward, leading to head sweating, neck stiffness, and a desire for warmth. Warm herbs should be used to unblock Yang, not purgatives to expel Dampness. Incorrect purgation suppresses Yang further, causing hiccups. Upper Jiao Yang may fail to distribute, causing chest fullness; Lower Jiao Yang may fail to transform, causing impaired urination. The tongue coating is not Stomach Heat but dried fluids gathering like a coating. After purgation, Yang sinks downward while Cold-Damp gathers upward, creating Heat in the Lower Abdomen (thirst) and Cold in the Chest (inability to drink), leading to oral dryness and fluid aggregation.
If Dampness patients are incorrectly purged, resulting in forehead sweating, slight wheezing, and free urination, the prognosis is fatal. Similarly, unceasing diarrhea is fatal.
You Zaijing stated: Exterior Dampness requires sweating; Interior Dampness requires diuresis. Unless Damp-Heat has consolidated into excess, purgation should not be used hastily. Forehead sweating and wheezing indicate Yang detaching and rising; free urination and diarrhea indicate Yin rupturing and descending. This separation of Yin and Yang is fatal. Alternatively, "impaired urination is fatal" implies Yang floats up while Yin fails to nourish downwards, which is also valid.
Wang Mengyin cited Zhang Shiweng: Even with forehead sweating and wheezing, if urine and stool are retained, Yin is not depleted and Yang's root remains. Even if urine and stool are free, without forehead sweating or wheezing, Yang does not escape, and Yin's root remains. As long as Yin and Yang do not separate, rescue is possible based on deficiency or excess. However, unceasing diarrhea is fatal even without signs of Yang collapse. Additionally, urinary retention with forehead sweating is called Guan (Closure). Classics state: In Guan-Ge (Obstruction and Reversal) blockage, survival is possible if no forehead sweat; death if sweat is present.
Q: Wind-Dampness binding causes generalized pain, usually resolved by sweating. Why does illness persist despite sweating during rainy weather?
A: Excessive sweating expels Wind but leaves Dampness behind, hence no cure. Treatment of Wind-Dampness requires mild, continuous perspiration so that both Wind and Dampness are expelled.
Wang Xiecheng noted: Ancient methods of inducing sweating had proper moderation; modern practitioners often force excessive sweating. This parallels the notes following Guizhi Tang in Shanghan Lun.
Dampness patients presenting with body pain, fever, sallow complexion, wheezing, dizziness, nasal congestion, irritability, and a large pulse, yet able to eat with a harmonious abdomen, suffer from Cold-Dampness in the head causing nasal congestion. Medication inserted into the nose will cure it.
Zhang Xuguxia explained: This refers to misty/dewy clear pathogens attacking the upper jiao. The three Yang meridians ascend to the head and run on the exterior. Cold-Dampness in the head blocks exterior Qi, causing pain and fever. The Lung opens into the nose and governs skin/hair. Pathogens entering via the nose cause Dampness to restrain Yang, steaming upwards to cause sallow complexion; Qi closure causes wheezing; Qi stagnation causes headache, nasal congestion, and irritability. All stem from Lung Qi obstruction failing to descend, resulting in a large pulse, distinct from the deep-fine pulse of lower-body Dampness. Since pathogens are in the Lung, not the Stomach, digestion remains normal. Cold-Dampness in the head causes nasal congestion; pungent-aromatic and bitter-draining herbs (such as Sandao or ancient Genti Powder insufflated) should be used to open Lung Qi, transforming Dampness into water expelled through the nose.
In Shanghan, stagnant Heat in the interior causes jaundice; Mahuang Lianqiao Chixiaodou Decoction is indicated.
Zhang Xuguxia stated: Unresolved exterior pathogens with internal Damp-Heat stagnation cause jaundice. Mahuang releases the exterior; Lianqiao and Chixiaodou benefit Lung Qi to clear Damp-Heat. Since pathogens are in the meridians, resolution is sought from the exterior.
Wang Mengyin noted: For summer Damp-Heat jaundice with exterior Wind-Cold, replacing Mahuang with Xiangru (Mosla Herb) in this formula is effective (Yang Suyuan noted: Xiangru is the summer equivalent of Mahuang).
For Shanghan presenting with jaundice and fever, Zhizi Bopi Tang is indicated.
You Zaijing explained: This represents Heat stagnation without consolidation. Heat causes jaundice; lack of consolidation explains fever without abdominal fullness. Zhizi clears upper Heat, Bupi (Phellodendron Bark) clears lower Heat, and Gancao harmonizes the middle where no excess has formed.
Shen Yaofeng stated: Zhizi Bopi Tang clears Heat and promotes urination, serving as the primary formula for Damp-Heat. Cheng Fusheng prioritized Mahuang Lianqiao Chixiaodou Decoction, unaware it is a sweating formula suitable only for cases with concurrent Wind-Cold. Zhizi Bopi Tang promotes urination, representing the correct method for treating Damp-Heat. The principle is clarified by the statement "one should merely promote urination."
After seven to eight days of Shanghan, if the body turns yellow like an orange peel, with impaired uritation and slight abdominal fullness, Yinchenshao Tang is indicated.
You Zaijing explained: This is Heat consolidation in the interior. Bright yellow resembles an orange, indicating Heat-Jaundice; Yin-Jaundice is dull. Heat consolidation causes impaired urination and abdominal fullness, necessitating Yinchenshao Tang to purge Heat and resolve stasis.
In Yangming disease, fever and sweating indicate Heat venting outward, preventing jaundice. However, if only the head sweats, sweating stops at the neck, urination is impaired, and thirst for fluids exists, this indicates stagnant Heat in the interior, inevitably leading to jaundice. Yinchenshao Tang is indicated.
You Zaijing explained: "Heat venting" means Heat escapes with sweat, dispersing pathogens and preventing jaundice. Head-only sweating prevents external release; impaired urination prevents downward excretion. Thirst indicates intense internal Heat accumulation and endless external Dampness attraction. Damp-Heat combine and stagnate, evaporating into jaundice. Yinchenshao Tang, being bitter-cold and draining, expels pathogens via urination.
In Yangming disease, a ruddy complexion contraindicates purgation. Purgation will cause fever, yellowing, and impaired urination.
Shen Yaofeng stated: This is a Wet-Warm pattern constrained by exterior Cold, primarily treated with Mahuang Lianqiao Chixiaodou Decoction. Without chills, it becomes Zhizi Bopi Tang pattern. With slight abdominal fullness, it becomes Yinchenshao Tang pattern.
Zhang Xuguxia explained: Facial redness indicates Heat stagnation in the meridians, requiring sweating. Purgation damages Fu organ Qi, causing meridian Heat to move inward, combining with food/water Qi to evaporate into jaundice, blocking the Triple Burner and impairing urination.
In Yangming disease, absence of sweating and impaired urination, accompanied by inner restlessness (Ao Nao), inevitably leads to jaundice.
Zhang Xuguxia explained: Although purgation was not misused, the combination of no sweating and impaired urination traps Heat pathogens without an exit. Combined with郁蒸 (stagnant steaming) of stomach fluids, jaundice ensues.
In Yangming disease, incorrect application of Fire therapy, resulting in slight forehead sweating and impaired urination, inevitably leads to jaundice.
Yu Jiayan explained: Stagnant Dampness and郁 Heat aggravated by Fire therapy intensify Heat, forcing fluids upward. Only forehead sweats appear, while body sweat and urination cease. Jaundice complications are unavoidable.