栀子（十四枚） 大黄（一两） 枳实（五枚） 豉（一升）
上四味，以水六升，煮取三升，分温二服。
【集解】魏荔彤曰∶酒黄胆，心中懊 或热甚而痛，栀子大黄汤主之，盖为实热之邪
立法也。酒家积郁成热，非此不除也。
酒疸下之，久久为黑疸，目青面黑，心中如啖蒜齑状，大便正黑，皮肤爪之不仁，
其脉浮弱，虽黑微黄，故知之。
【注】酒疸，心中懊 ，或心中热痛，脉沉实者，当下之。若心中热欲吐，脉浮弱者，
当吐之，而反下之则为逆也。若其人素有劳倦，下之则热入于脾，顷时腹满如故，则成
谷疸也。若其人素有女劳，下之则热入于肾，虽黄微黑，久久必变为黑疸也。目青者精伤
也，面黑者肾伤也，心中如啖蒜 状胃伤也，大便黑色血伤也，皮肤不仁血痹也。此等证
皆因酒疸脉浮弱者，应吐而反下之之误使然也。
【集注】赵良曰∶酒疸之黑，非女劳疸之黑也。盖女劳之黑，肾气所发也；酒疸之黑，败
血之黑也。因酒之湿热伤脾胃，脾胃不和，阳气不化，阴气不运，若更下之，久久则运化之
用愈耗矣。气耗血积故腐瘀，浊色越出面为黑，味变于心咽作嘈杂，心辣如啖蒜 状。荣
血衰而不行于皮肤，抓之不仁；输于大肠，便如黑漆。其目青与脉浮弦，皆血病也。
诸黄，猪膏发煎主之。
【按】诸黄，谓一切黄也。皆主猪膏发煎，恐未必尽然。医者审之，此必有脱简也。
【集注】程林曰∶扁鹊有《黄经》，《明堂》有烙三十六黄法，皆后人所未见，唯
《圣济总录》载三十六黄，方论详明，治法始备，今猪膏发煎，能治诸黄，当是黄之轻者，
可从小便而去，至若阴黄、急黄、女劳之属，岂猪膏发煎所能治乎？医者审之。
猪膏发前方
猪膏（半斤） 乱发（如鸡子大三枚）
上二味，和膏中煎之，发消药成，分再服，病从小便出。
诸黄，腹满而呕者，宜柴胡汤。
【注】呕而腹痛，胃实热也，然必有潮热便硬，始宜大柴胡汤两解之；若无潮热便软，
则当用小柴胡汤去黄芩加芍药和之可也。
【集注】程林曰∶呕而腹满，视其前后，知何部不利，利之则愈。今黄家腹痛而呕，应
内有实邪，当是大柴胡汤以下之。若小柴胡，则可止呕，未可疗腹痛也。
柴胡汤方（见寒疝呕吐中）
栀子（十四枚） 大黄（一两） 枳实（五枚） 豆豉（一升）
以上四味药，用水六升，煎煮至三升，分两次温服。
【集解】魏荔彤说：酒疸（因饮酒过度导致的黄疸），心中烦闷不安，或者热势严重而疼痛，用栀子大黄汤主治，这是针对实热邪气确立的治法。饮酒之人积郁化热，不用此方不能祛除病邪。
酒疸若误用攻下法，日久会变成黑疸（一种颜色发黑的重症黄疸），出现眼眶周围青黑、面色发黑，心中感觉像吃了蒜泥一样辛辣难受，大便完全变黑，皮肤麻木不仁，脉象浮而无力，虽然肤色发黑但隐约可见黄色，因此可以判断是黑疸。
【注】酒疸，如果心中烦闷不安，或者心中热痛，脉象沉实的，应当使用攻下法。如果心中热且想呕吐，脉象浮而无力的，应当使用涌吐法，反而误用攻下法就是逆治错误。如果其人平素有劳倦内伤，误用攻下法则热邪陷入脾脏，不久腹部依然胀满，就会形成谷疸（因饮食不节导致的黄疸）。如果其人平素有房劳过度，误用攻下法则热邪陷入肾脏，虽然黄色中微带黑色，日久必然转变为黑疸。眼眶青黑是肾精受损的表现，面色发黑是肾脏受损的表现，心中感觉像吃蒜泥一样是胃受损的表现，大便黑色是血液受损的表现，皮肤麻木不仁是血痹（血液运行不畅导致的肢体麻木）的表现。这些证候都是因为酒疸脉象浮弱时，本应涌吐却误用攻下法的错误所致。
【集注】赵良说：酒疸的黑，不同于女劳疸（因房劳过度导致的黄疸）的黑。女劳疸的黑，是肾气病变发出的；酒疸的黑，是败血瘀滞的黑。因为酒的湿热损伤脾胃，导致脾胃不和，阳气不能运化，阴气不能输布，如果再误用攻下法，日久则脾胃运化的功能更加耗损。气耗血积故而生腐瘀，浊色外现于面则面色发黑，气味变化于心咽部产生嘈杂感，心中辛辣如同吃蒜泥状。营血衰少而不能运行于皮肤，抓挠时感觉麻木不仁；流注于大肠，则大便如黑漆般黑。其目眶青黑与脉象浮弦，都是血病的表现。
各种黄疸，用猪膏发煎主治。
【按语】所谓“诸黄”，指一切类型的黄疸。都说主用猪膏发煎，恐怕未必完全如此。医生们需谨慎审察，这里必定有脱漏简文。
【集注】程林说：扁鹊有《黄经》，《明堂》中有烙治三十六黄的疗法，都是后人未曾见过的，只有《圣济总录》记载了三十六黄，方论详细明确，治疗方法才完备。如今猪膏发煎能治疗各种黄疸，应当是指较轻的黄疸，可以通过小便排出。至于阴黄（寒湿黄疸）、急黄（发病急骤危重的黄疸）、女劳疸等类型，难道是猪膏发煎所能治疗的吗？医生们需谨慎审察。
猪膏发煎前方
猪脂油（半斤） 乱发（如鸡蛋大三枚）
以上两味药，混合在猪脂油中煎煮，直到头发消融药成，分两次服用，病邪从小便排出。
【注】呕吐且腹痛，是胃中有实热的表现，但必须有潮热（定时发热）和大便干硬，才适宜用大柴胡汤表里双解；如果没有潮热且大便软，则应当用小柴胡汤去掉黄芩加入芍药来调和即可。
【集注】程林说：呕吐且腹部胀满，需观察前后二便，知道哪一部不通利，通利它就能痊愈。现在黄疸患者腹痛而呕吐，应当体内有实邪，应该用大柴胡汤来攻下。如果是小柴胡汤，只能止呕，还不能治疗腹痛。
Zhi Zi (Gardeniae Fructus, 14 pieces) Dahuang (Rhei Radix et Rhizoma, 1 liang) Zhishi (Aurantii Fructus Immaturus, 5 pieces) Chishao Douchi (Glycines Sojae Preparata, 1 sheng)
The above four herbs are boiled in 6 sheng of water until reduced to 3 sheng. Divide into two doses and take warm.
[Ji Jie] Wei Litong stated: For Jiu Dan (Alcohol-induced Jaundice), characterized by Ao Nu (mental restlessness and discomfort) or severe heat with pain, Zhi Zi Da Huang Tang (Gardenia and Rhubarb Decoction) is the primary formula. This establishes a treatment method for excess-heat pathogens. In individuals who consume alcohol, accumulated stagnation transforms into heat; without this formula, the pathogen cannot be eliminated.
If Jiu Dan is treated with purgatives (downward-draining methods), it may eventually transform into Hei Dan (Black Jaundice). Symptoms include bluish-black eyes, black complexion, a sensation in the heart as if eating minced garlic, completely black stool, skin numbness where scratching does not elicit sensation, a floating and weak pulse, and although the skin appears black, a faint yellow hue remains, allowing for diagnosis.
[Commentary] For Jiu Dan, if there is mental restlessness (Ao Nu) or heat-pain in the heart with a deep and solid pulse, downward-draining (purging) is indicated. If there is heat in the heart accompanied by the desire to vomit, with a floating and weak pulse, emetic therapy is indicated. Conversely, using purgatives in such cases constitutes an erroneous "reverse" treatment. If the patient has a history of labor fatigue, purging causes heat to enter the Spleen; shortly thereafter, abdominal fullness persists, leading to Gu Dan (Grain-induced Jaundice). If the patient has a history of sexual exhaustion (female labor), purging causes heat to enter the Kidney; although the yellowing is slightly mixed with black, it will eventually transform into Hei Dan. Bluish eyes indicate injury to Essence; black complexion indicates injury to the Kidney; the sensation of eating garlic indicates injury to the Stomach; black stool indicates injury to Blood; skin numbness indicates Blood Bi (Blood stasis obstruction). These syndromes result from the error of treating Jiu Dan with purgatives when the pulse was floating and weak, which should have been treated with emetics.
[Ji Zhu] Zhao Liang stated: The blackness of Jiu Dan differs from that of Nü Lao Dan (Sexual Exhaustion Jaundice). The blackness of Nü Lao Dan originates from Kidney Qi pathology; the blackness of Jiu Dan results from corrupted blood stasis. Alcohol's damp-heat injures the Spleen and Stomach, causing disharmony where Yang Qi fails to transform and Yin Qi fails to circulate. Further purging exhausts the transformative function over time. Qi depletion and blood accumulation lead to corruption and stasis; turbid colors manifest on the face as blackness, while flavors change causing clanging sensations in the heart and throat, with a burning sensation like eating garlic. Nutritive Blood declines and fails to circulate in the skin, causing numbness upon scratching; it flows into the Large Intestine, resulting in stools as black as lacquer. Bluish eyes and a floating-wiry pulse are all signs of Blood pathology.
For various types of Jaundice, Pig Fat and Hair Decoction (Zhu Gao Fa Jian) is indicated.
[Note] "Various types of Jaundice" refers to all forms of jaundice. Claiming that Zhu Gao Fa Jian is suitable for all is likely incorrect. Physicians must examine this carefully; there must be missing text in the bamboo slips.
[Ji Zhu] Cheng Lin stated: Bian Que had the *Huang Jing* (Classic of Jaundice), and *Ming Tang* contained methods for cauterizing thirty-six types of jaundice, which are unseen by later generations. Only the *Sheng Ji Zong Lu* records thirty-six types of jaundice with detailed formulas and clear treatments. Since Zhu Gao Fa Jian can treat various jaundices, it likely applies only to mild cases that can be expelled via urination. What about Yin Huang (Yin-type Jaundice), Ji Huang (Acute Jaundice), or Nü Lao Dan? Can Zhu Gao Fa Jian treat these? Physicians must examine this carefully.
Formula for Zhu Gao Fa Jian:
Zhu Gao (Pig Fat, half jin) Luan Fa (Tangled Human Hair, three pieces the size of a chicken egg)
Combine the two ingredients and boil in the pig fat until the hair dissolves and the medicine is ready. Divide into two doses. The disease will exit through urination.
For various types of Jaundice presenting with abdominal fullness and vomiting, Chai Hu Tang (Bupleurum Decoction) is appropriate.
[Commentary] Vomiting with abdominal pain indicates excess-heat in the Stomach. However, tidal fever (Chao Re) and hard stool must be present before Da Chai Hu Tang (Major Bupleurum Decoction) is used for simultaneous exterior-interior resolution. If there is no tidal fever and the stool is soft, Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Huang Qin removed and Shao Yao added should be used for harmonization.
[Ji Zhu] Cheng Lin stated: Vomiting with abdominal fullness requires observing the anterior and posterior orifices to determine which is obstructed; unblocking it leads to cure. Currently, jaundice patients with abdominal pain and vomiting likely have interior excess pathogens and should be treated with Da Chai Hu Tang for purging. Xiao Chai Hu Tang can stop vomiting but cannot treat abdominal pain.
Chai Hu Tang Formula (See section on Cold Cramps and Vomiting)