【谷疸之症】食谷头眩,心中怫郁,胃中苦浊,小便不通,遍身俱黄,此谷疸之症也。
【谷疸之因】脾胃有伤,不能运化水谷,谷气不消,胃中苦浊,浊气下流,小便不利,
湿热内甚,则身体发黄,而谷疸成矣。
【谷疸之脉】趺阳紧数,数则为热,紧即为寒。阳明脉迟,食难用饱,滑大者易治,弦
【谷疸之治】脉迟者不可下,茵陈汤治之。胃热血燥者,用猪膏发煎。润燥下利,能
泄阳明之阴,以泄谷气之实。今推展茵陈平胃散,泄阳明之阳,以泄谷气之实。
茵陈汤
茵陈蒿 栀子 大黄
上三味去滓,温作三服,小便利如皂角汁,色黄从小便出也。
猪膏发煎 泄阳明之阴。
猪膏 乱发(鸡子大,三块)
上二味,煎至发消药成膏,病从小便出,以上《金匮》治法。
茵陈平胃散 泄阳明之阳。
熟苍术 浓朴 广皮 山栀 茵陈 淡豆豉
【酒疸之症】身目俱黄,心热足热,懊 时时欲吐,小便赤,腹满,鼻燥,胸中热痛,
下之,久久为黑疸,目青面黑,心中如啖蒜状,大便黑,皮肤不仁,此皆酒疸之症。
【酒疸之因】其人以酒为事,或饥时浩饮,大醉当风、入水,兼以膏粱积热,互相蒸酿
,则酒疸之症成矣。
【酒疸之脉】其脉浮弱,或见洪大,或见浮数,或见沉数。
【酒疸之治】心中热,欲呕者,吐之。或无热,神清腹满,欲吐,先吐之。脉沉者,
酒疸,心懊 ,或热痛,《金匮》栀子大黄汤。今推展身发热口渴者,葛根汤治之。作呕
,合平胃散。小便涩,加减五苓散。
《金匮》栀子大黄汤 治酒疸,心中懊 ,发热。
栀子 大黄 枳实 豆豉
推展干葛汤
干葛 山栀 豆豉 枳实 甘草
平胃散 见前。
加减五苓散
猪苓 泽泻 白茯苓 白术 茵陈
【谷疸的症状】进食后出现头晕目眩,心中烦闷郁结,胃中感觉秽浊不适,小便不通畅,全身皮肤发黄,这就是谷疸的症状。
【谷疸的成因】脾胃受损,不能正常运化水谷精微,谷气停滞不消,导致胃中秽浊之气内蕴,浊气向下流注,引起小便不利;若湿热在体内炽盛,则身体发黄,从而形成谷疸。
【谷疸的脉象】趺阳脉(足背动脉)紧而数,数脉主热,紧脉主寒。阳明脉迟,饮食难以吃饱;脉象滑大者容易治疗;脉象弦……(原文此处中断)。
【谷疸的治疗】脉象迟缓者不可使用攻下法,应用茵陈汤治疗。若是胃热且血燥者,使用猪膏发煎。此方能润燥通便,能够泄除阳明经的阴分邪热,以消除谷气的实滞。如今推广使用茵陈平胃散,以泄除阳明经的阳分邪热,同样可以消除谷气的实滞。
茵陈汤
茵陈蒿、栀子、大黄
以上三味药,去渣,分三次温服。服药后小便通畅,颜色如皂角汁一样黄,说明湿热从小便排出。
猪膏发煎:泄除阳明经的阴分邪热。
猪膏(猪油)、乱发(如鸡蛋大小,三块)
以上两味药,煎煮至头发溶解、药成膏状。病邪随小便排出。以上为《金匮要略》中的治法。
茵陈平胃散:泄除阳明经的阳分邪热。
熟苍术、浓朴、广皮(陈皮)、山栀(栀子)、茵陈、淡豆豉
【酒疸的症状】眼睛和身体都发黄,心中发热,脚心发热,心中懊恼烦闷,时时想要呕吐,小便色赤,腹部胀满,鼻干燥,胸中热痛。若误用攻下法,日久会转为黑疸,表现为眼睛周围青黑,面色黑,心中感觉像吃了大蒜一样的辛辣灼痛感,大便黑色,皮肤麻木不仁。这些都是酒疸的症状。
【酒疸的成因】此人以饮酒为生,或在饥饿时豪饮,大醉后受风或入水沐浴,再加上平时食用肥甘厚味积热,内外热邪互相蒸酿,从而形成酒疸。
【酒疸的脉象】脉象浮弱,或者见洪大脉,或者见浮数脉,或者见沉数脉。
【酒疸的治疗】心中发热,想要呕吐的,采用涌吐法。如果无发热,神志清醒但腹部胀满,想要呕吐的,先采用涌吐法。脉象沉实的酒疸,心中懊恼烦闷,或有热痛,参考《金匮要略》使用栀子大黄汤。如今推广使用:若伴有身体发热、口渴者,用葛根汤治疗;伴有作呕者,合用平胃散;小便涩滞不畅者,用加减五苓散。
《金匮要略》栀子大黄汤:治疗酒疸,心中懊恼烦闷,发热。
栀子、大黄、枳实、豆豉
平胃散:见前文。
[Symptoms of Gu Dan (Grain Jaundice)] Dizziness after eating, mental depression and irritability, a sensation of turbidity in the stomach, obstruction of urination, and yellowing of the whole body. These are the symptoms of Gu Dan (Grain Jaundice).
[Etiology of Gu Dan (Grain Jaundice)] Damage to the Spleen and Stomach impairs their ability to transform and transport food and fluids. Grain Qi fails to digest, leading to turbid Qi accumulating in the Stomach. This turbid Qi flows downward, causing difficult urination. When Damp-Heat becomes severe internally, the body turns yellow, resulting in Gu Dan (Grain Jaundice).
[Pulse of Gu Dan (Grain Jaundice)] The Fuyang pulse (pulse at the dorsum pedis) is tight and rapid; rapid indicates Heat, while tight indicates Cold. The Yangming pulse is slow, making it difficult to eat until full; a slippery and large pulse indicates ease of treatment; a wiry [text incomplete].
[Treatment of Gu Dan (Grain Jaundice)] If the pulse is slow, purgatives should not be used; Yinchen Tang (Artemisiae Scopariae Decoction) should be administered. For cases with Stomach Heat and Blood dryness, Zhigao Fa Jian (Pig Fat and Hair Decoction) is used. This formula moistens dryness and promotes bowel movement, clearing the Yin aspect of the Yangming channel to resolve the excess of Grain Qi. Currently, Yichen Pingwei San (Artemisiae Scopariae and Pingwei Powder) is extended to clear the Yang aspect of the Yangming channel to resolve the excess of Grain Qi.
Yinchen Tang (Artemisiae Scopariae Decoction)
Yin Chen Hao (Artemisiae Scopariae Herba), Zhi Zi (Gardeniae Fructus), Da Huang (Rhei Radix et Rhizoma).
The above three ingredients are decocted, strained, and taken warm in three doses. Urine will become clear and flow freely, appearing dark yellow like soapberry juice, indicating the expulsion of pathogenic factors through urination.
Zhigao Fa Jian (Pig Fat and Hair Decoction): Clears the Yin aspect of the Yangming channel.
Zhu Gao (Porci Medulla / Pig Fat), Luan Fa (Capilli Humani / Human Hair, size of a chicken egg, three pieces).
The above two ingredients are decocted until the hair dissolves and the medicine forms a paste. The disease is expelled through urination. This is the treatment method from *Jinkui Yaolue* (Essential Prescriptions of the Golden Cabinet).
Yichen Pingwei San (Artemisiae Scopariae and Pingwei Powder): Clears the Yang aspect of the Yangming channel.
Shu Cang Zhu (Atractylodis Rhizoma Preparatum), Nong Po (Magnoliae Officinalis Cortex), Guang Pi (Citri Reticulatae Pericarpium), Shan Zhi (Gardeniae Fructus), Yin Chen (Artemisiae Scopariae Herba), Dan Dou Chi (Sojae Semen Preparatum).
[Symptoms of Jiu Dan (Wine Jaundice)] Yellowing of the eyes and body, heat in the heart and feet, mental restlessness and irritability (Ao Nu), frequent desire to vomit, red urine, abdominal fullness, dry nose, heat and pain in the chest. If purged improperly, it may eventually turn into Hei Dan (Black Jaundice), characterized by blue-black around the eyes, black complexion, a sensation in the heart as if eating garlic, black stool, and insensitivity of the skin. These are all symptoms of Jiu Dan (Wine Jaundice).
[Etiology of Jiu Dan (Wine Jaundice)] The person relies on alcohol, drinking heavily when hungry, or getting drunk and exposed to wind or entering water. Combined with accumulated heat from rich and greasy food, these factors steam and ferment each other, forming Jiu Dan (Wine Jaundice).
[Pulse of Jiu Dan (Wine Jaundice)] The pulse may be floating and weak, or large and surging, or floating and rapid, or deep and rapid.
[Treatment of Jiu Dan (Wine Jaundice)] For heat in the heart and desire to vomit, induce vomiting. If there is no heat, consciousness is clear, but there is abdominal fullness and desire to vomit, induce vomiting first. For Jiu Dan with a deep pulse, mental restlessness (Ao Nu), or heat and pain, refer to *Jinkui Yaolue* for Zhizi Dahuang Tang (Gardeniae and Rheum Decoction). Currently, it is extended that for those with fever and thirst, Gegen Tang (Puerariae Decoction) is used; for vomiting, combine with Pingwei San (Pingwei Powder); for astringent and difficult urination, use Jiawu Wuling San (Modified Wuling Powder).
*Jinkui Yaolue* Zhizi Dahuang Tang (Gardeniae and Rheum Decoction): Treats Jiu Dan (Wine Jaundice) with mental restlessness (Ao Nu) and fever.
Zhi Zi (Gardeniae Fructus), Da Huang (Rhei Radix et Rhizoma), Zhi Shi (Aurantii Fructus Immaturus), Dou Chi (Sojae Semen Preparatum).
Extended Formula: Gan Ge Tang (Puerariae Decoction)
Gan Ge (Puerariae Radix), Shan Zhi (Gardeniae Fructus), Dou Chi (Sojae Semen Preparatum), Zhi Shi (Aurantii Fructus Immaturus), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Pingwei San (Pingwei Powder): See previous section.
Jiawu Wuling San (Modified Wuling Powder)
Zhu Ling (Polypori Parabolica), Ze Xie (Alismatis Rhizoma), Bai Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Yin Chen (Artemisiae Scopariae Herba).