严氏济生。枳术汤。治饮癖气分。心下坚硬如杯。水饮不下。
即本方。加肉桂。附子。细辛。桔梗。槟榔。甘草。生姜。
李氏辨惑论。易水张先生枳术丸。治痞消食强胃。
枳实（麸炒黄色去穣一两） 白术（二两）
上同为极细末。荷叶裹烧饭为丸。如桐子大。每服五十丸。多用白汤下无时。
附方
外台防己黄 汤。治风水脉浮为在表。其人或头汗出。表无他病。病者但下重。从腰以上为和。腰以
下当肿及阴。难以屈伸。（方见风湿中。○脉经。其人下有能食二字。无或字。但下。有言字。外
台引深师。作木防己汤云。此本仲景伤寒论方。）
〔沈〕此乃湿从下受。湿多风少。故用黄 实表。使水不
得上溢。以防己驱除风湿。术草健脾。姜枣以俾营卫和。而湿自除矣。
寸口脉浮而缓。浮则为风。缓则为痹。痹非中风。四肢苦烦。脾色必黄。
瘀热以行。（苦。徐本。脉经。作若。）
〔程〕脉得浮缓者。必发黄。故伤寒脉浮而缓者。系在太阴。太阴者。必发身黄。今浮为风。缓为痹。
非外证之中风。乃风热蓄于脾土。脾主四肢。故四肢苦烦。瘀热行于外。则发
黄也。
〔沈〕风湿郁结。邪正为痹。痹者。闭也。因风拒闭。营卫为痹。非内经风寒湿三气之痹。
案痹非中风。文义不属。恐有脱误。
趺阳脉紧而数。数则为热。热则消谷。紧则为寒。食即为满。尺脉浮。为伤肾。趺阳脉紧。为伤脾。
风寒相搏。食谷即眩。谷气不消。胃中苦浊。浊气下流。小便不通。阴被其寒。热流膀胱。身体尽黄。名曰谷
疸。额上黑。微汗出。手足中热。薄暮即发。膀胱急。小便自利。名曰女劳疸。腹如水状不治。心中懊 而
热。不能食。时欲吐。名曰酒疸。（脉经。女劳疸酒疸。各为别条。徐沈魏尤并同。疸。沈尤。作瘅。）
〔程〕趺阳。胃脉也。数为热。紧为寒。此胃中阴阳不分。清浊相干。寒热混杂。虽消谷不能传导。故
食即满也。尺脉以候肾。浮为风。则伤肾。趺阳以候胃。紧则寒不伤胃。而伤于脾。风寒相搏。邪不消谷。
得谷气则熏蒸头目。故作眩也。谷不消。则胃中之浊气下流。而小便又不通利。正以
肾为胃关。脾寒被于少阴。则不能行宣泄之令。胃热流于膀
胱。则热瘀蓄而不行。一身尽黄。因作谷疸也。
〔尤〕肾劳而热。黑色上出。犹脾病而黄外见也。额于部为
庭。灵枢云。庭者。颜也。又云。肾病者。颧与颜黑。微汗出者。肾热上行。而气通于心也。手足心热。薄暮
即发者。病在里在阴也。膀胱急者。肾热所逼也。小便自利。病不在腑也。此得之房劳过度。热从肾出。
故名曰女劳瘅。若腹如水状。则不特阴伤。阳亦伤矣。故曰不治。懊 。郁闷不宁之意。热内蓄。
则不能食。热上冲。则时欲吐。酒气熏心。而味归脾胃也。此得之饮酒过多所致。故名酒瘅。
巢源云。黄胆之病。此由酒食过度。腑脏未和。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。黄胆也。谷疸之状。食毕头眩。心忪怫
郁不安。而发黄。由失饥大食。胃气冲熏所致也。女劳疸之状。身目皆黄。发热恶寒。少腹满急。小便难。
由大劳大热而交接。交接竟入水所致也。案本经云。小便自利。可疑。
阳明病脉迟者。食难用饱。饱则发烦头眩。小便必难。
此欲作谷疸。虽下之。腹满如故。所以然者。脉迟故也。（发。阳明篇。作微。）
〔鉴〕谷疸属胃热。脉当数。今脉迟。脾脏寒也。寒不化谷。所以虽饥欲食。食难用饱。饱则烦闷。胃
中填塞。健运失常也。清者阻于上升。故头眩。浊者阻于下降。故小便难也。此皆欲作谷疸之征。其证原从
太阴寒湿郁黩而生。若误以为阳明热湿发黄下之。虽腹满暂减。顷复如故。所以然
者。脉迟寒故也。此发明欲作谷疸属脾阴寒化。而不可下者也。
张氏伤寒心印云。按金匮谷疸有二证。此则虚寒而冷HT
者也。伤寒缵论云。脉迟胃虚。下之无益。则发汗利小便之
法。用之无益。惟当用和法。如甘草干姜汤。先温其中。然后少与调胃。微和胃气是也。
夫病酒黄胆。必小便不利。其候心中热。足下热。是其证也。
〔程〕夫小便利则湿热行。不利则热留于胃。胃脉贯膈。下足跗。上熏胃脘。则心中热。下注足跗。则
足下热也。
酒黄胆者。或无热。靖言了。腹满欲吐。鼻燥。其脉浮者先吐之。沉弦者先下之。（赵本。了。作小。
程本。金鉴同。脉经。千金。徐沈魏。并作靖言了了。徐沈云。靖。恐是清字。外台同千金。作静。尤同。
程本。金鉴。作谵。案了。作小。靖。作谵。并系于后人改定。故今仍脉经等。作靖言了了。吐。赵本
作呕。非。）
〔尤〕酒黄瘅者。心中必热。或亦有不热。静言了了者。则其热不聚于心中。而或从下积为腹满。或从
上冲为欲吐鼻燥也。腹满者。可下之。欲吐者。可因其势而越之。既腹满且欲吐。则可下。亦可吐。然必审
其脉。浮者邪近上。宜先吐。脉沉弦者。则邪近下。宜先下也。
〔沈〕详先字。要知吐
下之后。再以清解余热。不待言矣。（案靖。本作 。静同。见后汉崔 传注。）
千金云。夫人病酒疸者。或无热。靖言了了。腹满欲吐呕者。宜吐之方苦参散七味者是。
苦参散 治人无渐忽然振寒发黄。皮肤黄曲尘出。小便赤少。大便时秘。气力无异。食饮不妨。已
服诸汤散。余热不除。久黄者。宜吐下方。
苦参 黄连 瓜蒂 黄柏 大黄 黄芩（各一两○千金缺今据翼方补之） 葶苈（二两）
上六味。治下筛。饮服方寸匕。当大吐。吐者日一服。
不吐日再亦得下。服五日知。可消息。不觉退更服之。
酒疸。心中热欲吐者。吐之愈。（赵。吐。作呕。非。）
〔程〕前证热深。则懊 欲吐。今热微则心中热。亦欲吐。病属上焦。故一吐之可愈。
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。（巢源。外台。无虽黑微黄四字。程。爪。作抓。）
〔尤〕酒疸。虽有可下之例。然必审其腹满脉沉弦者。而后下之。不然。湿热乘虚。陷入血中。则变为
黑疸。目青面黑。皮肤不仁。皆血变而瘀之征也。然虽曰黑疸。而其原则仍是酒家。故心中热气熏灼。如啖
蒜状。一如懊 之无奈也。且其脉当浮弱。其色虽黑当微黄。必不如女劳疸之色纯黑。而脉必沉也。
〔鉴〕赵良曰。便如黑漆。其目青与脉浮弱。皆血病也。
〔魏〕黄变为黑。如物之初被火灼则黄。久被火熏则黑也。
巢源云。黑疸之状。苦小腹满。身体尽黄。额上反黑。足下热。大便黑是也。夫黄胆。酒疸。女劳疸。
久久多变为黑疸。千金。茵陈大黄等七味方云。夫黄发已久。变作桃皮色。心下有坚。呕逆不下饮食。小便
极赤色少。四肢逆冷。脉深沉极微细迟者。不宜服此方。得下必变 也。案桃皮色。
盖谓带黑不明润。故附记备考。案汪氏医学原理云。虽黑微黄者。难治。未知何据。
师曰。病黄胆。发热烦喘。胸满口燥者。以病发时。火劫其汗。两热所得。然黄家所得。从湿得之。一
身尽发热。面黄肚热。热在里当下之。（两热所得之所字。程金鉴作相。面黄。赵本。脉
经。作而黄。徐程沈魏尤并同。案面当作而。）
〔魏〕此病发时。乃风寒外感之病发也。
〔尤〕烦满燥渴。
病发于热。而复以火劫之。以热遇热。相得不解。则发黄胆。然非内兼湿邪。则热与热相攻。而反相散矣。
何瘅病之有哉。故曰黄家所得。从湿得之。明其病之不独因于热也。而治此病者。必先审其在表在里。而施
或汗或下之法。若一身尽热。而腹热尤甚。则其热为在里。里不可从表散。故曰
当下。
〔鉴〕但扪其肚热。其热在里。当下之。
〔沈〕即栀子大黄汤之意也。
脉沉。渴欲饮水。小便不利者。皆发黄。
〔鉴〕脉沉。主里也。渴欲饮水。热瘀也。小便不利。湿郁也。热瘀湿郁于里。故发黄也。首条谓脉浮
缓紧数。皆令发黄。是得之于外因也。此条脉沉。亦令发黄。是得之于内因也。故治黄有汗下二法也。
李曰。脉沉而渴。渴欲饮水。小便不利。则湿热内蓄。无从分消。故发黄也。
腹满舌痿黄。躁不得睡。属黄家。（〔原注〕舌痿。疑作身痿。○案舌痿。诸注并云。作身痿。但尤
仍原文释之非。魏云。痿当作委。舌苔色正黄。无间色。亦非。躁。赵徐沈作燥。非。）
〔徐〕腹满。里证也。乃有腹满。而如身痿黄。躁不得睡。
瘀热外行。此发黄之渐也。故曰属黄家。见当图治于将成。不得俟既成。而后药之也。
案痿黄。即萎黄。谓身黄不明润。沈云。湿热郁蒸。则腹满身痿。津血枯燥。土色外越。故黄躁不得眠。
此以痿为痿弱之义。且黄躁连读。谬亦太甚。
黄胆之病。当以十八日为期。治之十日以上瘥。反剧为难治。（剧。赵本作极。）
〔鉴〕高世 曰。十八日。乃脾土寄旺于四季之期。十日。土之成数也。黄胆之病。在于脾土。故
当以十八日为期。然治之宜先。故治之十日以上。即当瘥。至十日以上不瘥。
而疸病反剧者。是谓难治。谓土气虚败。不可治也。
疸而渴者。其疸难治。疸而不渴者。其疸可治。发于阴部。其人必呕。阳部。其人振寒而发热也。（
阳部上。脉经。千金。程本。金鉴。有发于二字。是发热之发。巢源千金作微。）
〔沈〕此言表病易治。里病难治也。胃中湿热。蒸越皮肤。则一身尽黄。虽发于外。当以表里阴阳辨证。
则知可治与难治。若疸而渴者。邪虽外越。胃中湿热。半居于内。耗竭津液。则渴。津枯血燥。阳火亢极。
表里皆邪。故曰难治。不渴者。热邪一发。尽越于表。里无余蕴。一解表而即散。故曰可治。然邪在胸膈
胃腑之里。为发阴部。内逆上冲。其人必呕。其邪尽发皮壳之表为阳部。乃太阳所主。故振寒而发热也。
案疸。本作瘅。瘅热也。故有消瘅瘅疟等之称。而热郁发黄。谓之黄胆。疸乃非黄病之谓。字书。注
疸字云。黄病也。误。然如本条单言疸者。盖省黄字也。亦不必拘耳。
谷疸之为病。寒热不食。食即头眩。心胸不安。久久发黄。为谷疸。茵陈
蒿汤主之。（黄下。肘后。有失饥大食胃气冲熏所致十字。）
〔程〕湿热与宿谷相搏。留于胃中。因作谷疸。
〔尤〕谷疸为阳明湿热瘀郁之证。阳明既郁。荣卫
之源。壅而不利。则作寒热。健运之机。窒而不用。则为不食。食入则适以助湿热。而增逆满。为头眩心胸不
安而已。
〔徐〕头眩。为谷疸第一的据也。观方下注云。一宿腹减。此亦必小便不快。而腹微胀可知。
茵陈蒿汤方
茵陈蒿（六两） 大黄（二两） 栀子（十四枚○阳明篇有擘字）
上三味。以水一斗。先煮茵陈。减六升。内二味。煮取
三升。去滓分温三服。小盒饭利。尿如皂角汁状。色正赤。一宿腹减。黄从小便去也。
〔程〕茵栀以导之。则湿热行矣。大黄以下之。则宿谷去矣。苦以泄之之剂也。
徐氏伤寒类方云。先煮茵陈。则大黄从小便出。此秘法也。
千金茵陈汤。伤寒七八日。内实瘀热结。身黄如橘。小
便不利。腹微胀满。宜下之方。（即本方○与阳明篇文少异。故附载之。）
外台范汪疗谷疸。茵陈汤。（即本方。）
又短剧三物茵陈蒿汤。疗黄胆身目皆黄。皮肤曲尘出。
茵陈蒿（一把） 栀子（二十四枚） 石膏（一斤） ○千金加大黄（二两）
上三味。以水八升。煮取二升半。去滓。以猛火烧石膏。
令正赤。投汤中。沸定取清汁。适寒温服一升。自覆令汗出。
又广济。茵陈丸。疗黄胆遍身面悉黄。小便如浓栀子汁。
于本方。去栀子。加黄芩枳实。蜜丸。
又必效茵陈汤。及丸。疗一切黄。蒋九处得其父远使得黄。服此极效。
于本方加黄芩。
千金茵陈汤。主黄胆酒疸酒癖。身体面目尽黄方。（按外台云。太医校尉史脱处。）
于本方。加黄芩黄连人参甘草。
又治发黄。身面目悉黄如金色。小便如浓煮柏汁。
于本方。加黄芩柴胡升麻龙胆。
又治发黄方。
于本方。加黄柏黄连。丸方更加黄芩。
黄家日晡所发热。而反恶寒。此为女劳得之。膀胱急少腹满。身尽黄。额上黑。足下热。因作黑疸。
其腹胀如水状。
大便必黑。时溏。此女劳之病非水也。腹满者难治。硝石矾石散主之。（之病。千金。作疸一字。）
〔鉴〕此详申女劳疸之为病。黄胆日晡所发热。乃阳明热症。当不恶寒也。而反恶寒者。非阳明热症。
此或为女劳得之也。女劳得之疸证。虽膀胱急少腹满。而小便自利。身虽尽黄。而额上则黑。虽发热惟足下
甚。此少阴热。因作黑疸也。故腹胀如水状。而大便必黑时溏。知非水胀病。乃为女劳得之疸胀病也。时溏
严氏《济生方》中的枳术汤，用于治疗饮邪停聚形成的癖块（气分病），症状表现为心下部位坚硬如杯状，水饮无法下行。
即在本方基础上，加入肉桂、附子、细辛、桔梗、槟榔、甘草、生姜。
李氏《辨惑论》中记载的易水张先生所制的枳术丸，用于治疗痞满、消除食积、强健胃气。
药材及剂量：枳实（麸炒至黄色，去除瓤，一两）、白术（二两）。
以上药物共同研磨成极细粉末。用荷叶包裹烧饭制成丸剂，大小如梧桐子大。每次服用五十丸，多用温水送服，不拘时间。
附方：
《外台秘要》防己黄芪汤，治疗风水病，脉象浮表示病在表。患者可能头部出汗，体表无其他病症，病人仅感到身体下部沉重，腰部以上正常，腰部以下应当出现浮肿甚至阴部肿胀，难以屈伸。（该方见风湿病篇中。○《脉经》中，“其人”后有“能食”二字，无“或”字。“但下”，有“言”字。《外台秘要》引用《深师方》，作木防己汤，称这原本是张仲景《伤寒论》中的方剂。）
〔沈〕这是湿气从下部受邪，湿多风少，所以用黄芪固护肌表，使水液不得上溢；以防己驱除风湿；用白术、甘草健脾；用生姜、大枣调和营卫，这样湿气自然就能除去。
寸口脉浮而缓，浮脉主风，缓脉主痹证。此痹证并非中风，四肢苦于烦扰不适，脾的颜色必然发黄，瘀滞的热邪随之运行。（“苦”字，徐本、《脉经》作“若”。）
〔程〕脉象得浮缓者，必定发黄，所以伤寒脉浮而缓者，病系在太阴。太阴病，必定发身黄。现在浮脉为风，缓脉为痹，这不是外证的中风，而是风热蓄积于脾土。脾主四肢，所以四肢苦于烦扰。瘀滞的热邪行于体表，就会发黄。
〔沈〕风湿郁结，邪气与正气相搏形成痹证。痹，就是闭塞的意思。因风邪拒闭，导致营卫之气闭塞，这不是《内经》中风寒湿三气杂至之痹。
按语：文中说“痹非中风”，文义不连贯，恐怕有脱漏或错误。
趺阳脉紧而数，数脉主热，热则消谷善饥；紧脉主寒，寒则进食后腹部胀满。尺脉浮，表示伤肾；趺阳脉紧，表示伤脾。风寒相互搏结，进食后即感头晕，谷气不能消化，胃中苦于浊气内停，浊气向下流注，小便不通。阴分被寒邪所困，热邪流入膀胱，全身尽黄，名叫谷疸。如果额头上色黑，微汗出，手足心发热，傍晚时分发作，膀胱急迫，小便自利，名叫女劳疸。如果腹部像有水状（腹胀大），属于不治之症。心中懊恼且热，不能进食，时常想吐，名叫酒疸。（《脉经》将女劳疸和酒疸各列为单独条目，徐、沈、魏、尤各家观点相同。疸，沈、尤两家作“瘅”。）
〔程〕趺阳脉是胃脉。数脉为热，紧脉为寒，这是胃中阴阳不分，清浊相干，寒热混杂，虽然能消谷但不能传导，所以进食即感胀满。尺脉用来候肾，浮脉为风，则伤肾。趺阳脉用来候胃，紧脉为寒，不伤胃而伤脾。风寒相搏，邪气不能消谷，得到谷气则熏蒸头目，所以发生眩晕。谷气不消，则胃中的浊气下流，而小便又不通利。正因为肾是胃的关隘，脾寒波及少阴，则不能行使宣泄的职能；胃热流入膀胱，则热邪瘀滞蓄积而不行。全身尽黄，因此作成谷疸。
〔尤〕肾劳而生热，黑色上现于面部，犹如脾病而黄色外见于皮肤一样。额头部位称为庭，《灵枢》说：“庭者，颜也。”又说：“肾病者，颧与颜黑。”微汗出，是肾热上行，气通于心。手足心发热，傍晚即发，说明病在里、在阴。膀胱急迫，是肾热逼迫所致。小便自利，说明病不在腑。这是由于房劳过度，热从肾出，所以名叫女劳瘅。如果腹部像有水状，则不仅阴伤，阳也伤了，所以说是不治之症。懊恼，是郁闷不宁的意思。热邪内蓄，则不能进食；热邪上冲，则时常想吐。酒气熏心，味道归于脾胃，这是由于饮酒过多所致，所以名叫酒瘅。
巢元方说：黄疸病，这是由于酒食过度，脏腑不和，水谷相并，积聚于脾胃，又为风湿所搏，瘀结不散，热气郁蒸，所以食后如饥，令身体面目及爪甲、小便尽黄，而想安卧，这是黄疸。谷疸的症状，食毕头眩，心中悸动怫郁不安，而发黄，是由于失饥大食，胃气冲熏所致。女劳疸的症状，身目皆黄，发热恶寒，少腹满急，小便难，是由于大劳大热而行房事，行房事后入水所致。按语：本经云“小便自利”，令人可疑。
阳明病脉迟者，饮食难以吃饱，饱则发烦、头眩，小便必难。
这是将要作成谷疸，即使使用下法，腹部胀满依旧。之所以如此，是因为脉迟的缘故。（“发”字，阳明篇作“微”。）
〔鉴〕谷疸属胃热，脉应当数，现在脉迟，是脾脏寒。寒不能化谷，所以虽然饥饿想吃，但难以吃饱，饱则烦闷，胃中填塞，健运功能失常。清气阻于上升，所以头眩；浊气阻于下降，所以小便难。这都是将要作成谷疸的征象。其证原从太阴寒湿郁滞而生，如果误以为是阳明热湿发黄而下之，虽然腹部胀满暂时减轻，片刻后又恢复原状。之所以如此，是因为脉迟代表寒的缘故。此处阐明了欲作谷疸属脾阴寒化，而不可用下法。
张氏《伤寒心印》说：按《金匮》谷疸有二证，此则是虚寒而冷的那种。《伤寒缵论》说：脉迟胃虚，下之无益，那么发汗利小便的方法，使用也无益，只应当用和法，如甘草干姜汤，先温其中焦，然后少量给予调理胃气，微微调和胃气就是了。
凡是患酒黄疸病，必定小便不利，其症状是心中热，足下热，这就是它的证候。
〔程〕小便利则湿热行散，不利则热留于胃。胃脉贯穿膈肌，下行至足背，上熏胃脘，则心中热；下注足背，则足下热。
酒黄疸，有的没有热象，神情安静，言语清晰，腹部胀满，想吐，鼻燥。其脉浮的先用吐法，脉沉弦的先用下法。（赵本，“了”作“小”。程本、《金鉴》同。《脉经》、《千金》、徐、沈、魏各家，都作“靖言了了”。徐、沈说：“靖”，恐怕是“清”字。《外台》同《千金》，作“静”。尤家同。程本、《金鉴》作“谵”。按语：“了”作“小”，“靖”作“谵”，都是后人改定的，所以现在仍依《脉经》等书，作“靖言了了”。吐，赵本作“呕”，不对。）
〔尤〕酒黄瘅，心中必定热，或者也有不热的。“靖言了了”，则是热不聚于心中，或者从下积聚为腹满，或者从上冲逆为欲吐、鼻燥。腹满的，可以下之；欲吐的，可以因其势而越之（催吐）。既腹满且欲吐，则可以下，也可以吐。然而必须审察其脉，脉浮者邪气近上，宜先用吐法；脉沉弦者，邪气近下，宜先用下法。
〔沈〕详究“先”字，要知道吐下之后，再以清解余热，是不言而喻的了。（按语：“靖”，本作“ ”，静同，见后汉崔 传注。）
《千金方》说：凡是人患酒疸病，有的没有热象，神情安静，言语清晰，腹部胀满想吐呕的，宜用吐法，方用苦参散七味药。
苦参散：治疗人无渐进忽然振寒发黄，皮肤黄曲尘出，小便赤少，大便时常秘结，气力无异，饮食不妨，已服诸汤散，余热不除，久黄者，宜用吐下方。
药材：苦参、黄连、瓜蒂、黄柏、大黄、黄芩（各一两○《千金》缺，今据《翼方》补之）、葶苈（二两）。
以上六味药，捣碎过筛。用饮服方寸匕的量，应当大吐。吐的人每日一服。
不吐的人每日再服一次也可以。服药五日见效，可酌情调整，不觉退去更服之。
酒疸，心中热想吐的，吐之即愈。（赵本，“吐”作“呕”，不对。）
〔程〕前证热深，则懊恼欲吐；现在热微则心中热，也欲吐。病属上焦，所以一吐之可愈。
酒疸，下之久久变为黑疸，目青面黑，心中如吃蒜泥状，大便正黑，皮肤抓之不仁，其脉浮弱，虽然黑微黄，故可知之。（《巢源》、《外台》，无“虽黑微黄”四字。程本，“爪”作“抓”。）
〔尤〕酒疸，虽有可下的例子，但必须审察其腹满脉沉弦者，而后下之。不然，湿热乘虚，陷入血中，则变为黑疸。目青面黑，皮肤不仁，都是血变而瘀的征象。然而虽曰黑疸，而其原则仍是酒家，所以心中热气熏灼，如吃蒜状，一如懊恼之无奈。且其脉当浮弱，其色虽黑当微黄，必不如女劳疸之色纯黑，而脉必沉。
〔鉴〕赵良说：便如黑漆，其目青与脉浮弱，都是血病。
〔魏〕黄变为黑，如同物体初被火灼则黄，久被火熏则黑。
巢元方说：黑疸的症状，苦小腹满，身体尽黄，额头反黑，足下热，大便黑是也。夫黄疸、酒疸、女劳疸，久久多变为黑疸。《千金方》茵陈大黄等七味方说：夫黄发已久，变作桃皮色，心下有坚块，呕逆不下饮食，小便极赤色少，四肢逆冷，脉深沉极微细迟者，不宜服此方，得下必变 。按语：桃皮色，大概谓带黑不明润，故附记备考。按语：汪氏《医学原理》说：虽黑微黄者，难治，不知何依据。
老师说：患黄疸病，发热烦喘，胸满口燥的，因为病发时，用火劫取汗，两热相合。然而黄家所得，从湿得之，一身尽发热，面黄肚热，热在里当下之。（“两热所得”的“所”字，程、《金鉴》作“相”。面黄，赵本、《脉经》作“而黄”，徐、程、沈、魏、尤各家同。按语：面当作“而”。）
〔魏〕此病发时，乃风寒外感之病发。
〔尤〕烦满燥渴，病发于热，而复以火劫之，以热遇热，相得不解，则发黄胆。然而非内兼湿邪，则热与热相攻，而反相散矣，何瘅病之有哉。所以说黄家所得，从湿得之，明确其病之不独因于热也。而治此病者，必先审其在表在里，而施或汗或下之法。若一身尽热，而腹热尤甚，则其热为在里，里不可从表散，所以说当下。
〔鉴〕只要摸其肚子热，其热在里，当下之。
〔沈〕即栀子大黄汤之意。
脉沉，渴欲饮水，小便不利者，皆发黄。
〔鉴〕脉沉，主里也。渴欲饮水，热瘀也。小便不利，湿郁也。热瘀湿郁于里，故发黄也。首条谓脉浮缓紧数，皆令发黄，是得之于外因也。此条脉沉，亦令发黄，是得之于内因也。故治黄有汗下二法也。
李氏说：脉沉而渴，渴欲饮水，小便不利，则湿热内蓄，无从分消，故发黄也。
腹部胀满，舌痿黄（或身痿黄），躁不得睡，属黄家。（〔原注〕舌痿，疑作身痿。○按语：舌痿，诸注并云，作身痿，但尤家仍原文释之非。魏说：痿当作委，舌苔色正黄，无间色，亦非。躁，赵、徐、沈作“燥”，不对。）
〔徐〕腹满，里证也。乃有腹满，而如身痿黄，躁不得睡，瘀热外行，此发黄之渐也。故曰属黄家，见当图治于将成，不得俟既成，而后药之也。
按语：痿黄，即萎黄，谓身黄不明润。沈说：湿热郁蒸，则腹满身痿，津血枯燥，土色外越，故黄躁不得眠。此以痿为痿弱之义，且黄躁连读，谬亦太甚。
黄疸病，当以十八日为期，治之十日以上瘥，反剧为难治。（剧，赵本作“极”。）
〔鉴〕高世栻说：十八日，乃脾土寄旺于四季之期。十日，土之成数也。黄疸病，在于脾土，故当以十八日为期。然治之宜先，故治之十日以上，即当瘥。至十日以上不瘥，而疸病反剧者，是谓难治，谓土气虚败，不可治也。
疸而渴者，其疸难治；疸而不渴者，其疸可治。发于阴部，其人必呕；阳部，其人振寒而发热也。（“阳部”上，《脉经》、《千金》、程本、《金鉴》，有“发于”二字，是“发热”之“发”。《巢源》、《千金》作“微”。）
〔沈〕此言表病易治，里病难治也。胃中湿热，蒸越皮肤，则一身尽黄，虽发于外，当以表里阴阳辨证，则知可治与难治。若疸而渴者，邪虽外越，胃中湿热，半居于内，耗竭津液，则渴。津枯血燥，阳火亢极，表里皆邪，故曰难治。不渴者，热邪一发，尽越于表，里无余蕴，一解表而即散，故曰可治。然邪在胸膈胃腑之里，为发阴部，内逆上冲，其人必呕。其邪尽发皮壳之表为阳部，乃太阳所主，故振寒而发热也。
按语：疸，本作“瘅”，瘅热也，故有消瘅、瘅疟等之称，而热郁发黄，谓之黄疸，疸乃非黄病之谓。字书注疸字云：黄病也，误。然而如本条单言疸者，盖省黄字也，亦不必拘耳。
谷疸之为病，寒热不食，食即头眩，心胸不安，久久发黄，为谷疸，茵陈蒿汤主之。（“黄”下，《肘后方》，有“失饥大食胃气冲熏所致”十字。）
〔程〕湿热与宿谷相搏，留于胃中，因作谷疸。
〔尤〕谷疸为阳明湿热瘀郁之证，阳明既郁，荣卫之源，壅而不利，则作寒热；健运之机，窒而不用，则为不食。食入则适以助湿热，而增逆满，为头眩心胸不安而已。
〔徐〕头眩，为谷疸第一的据也。观方下注云：一宿腹减，此亦必小便不快，而腹微胀可知。
茵陈蒿汤方：
茵陈蒿（六两）、大黄（二两）、栀子（十四枚○阳明篇有“擘”字）。
以上三味药，用水一斗，先煮茵陈，减六升，内二味，煮取三升，去滓，分温三服。小盒饭利（小便通利），尿如皂角汁状，色正赤，一宿腹减，黄从小便去也。
〔程〕茵栀以导之，则湿热行矣；大黄以下之，则宿谷去矣。苦以泄之之剂也。
徐氏《伤寒类方》说：先煮茵陈，则大黄从小便出，此秘法也。
《千金方》茵陈汤：伤寒七八日，内实瘀热结，身黄如橘，小便不利，腹微胀满，宜下之方。（即本方○与阳明篇文少异，故附载之。）
《外台秘要》范汪疗谷疸，茵陈汤。（即本方。）
又短剧三物茵陈蒿汤，疗黄疸身目皆黄，皮肤曲尘出。
茵陈蒿（一把）、栀子（二十四枚）、石膏（一斤）○《千金》加大黄（二两）。
以上三味药，用水八升，煮取二升半，去滓，以猛火烧石膏，令正赤，投汤中，沸定取清汁，适寒温服一升，自覆令汗出。
又《广济方》茵陈丸，疗黄疸遍身面悉黄，小便如浓栀子汁。
于本方，去栀子，加黄芩、枳实，蜜丸。
又《必效方》茵陈汤，及丸，疗一切黄。蒋九处得其父远使得黄，服此极效。
于本方加黄芩。
《千金方》茵陈汤，主黄疸、酒疸、酒癖，身体面目尽黄方。（按《外台》云：太医校尉史脱处。）
于本方，加黄芩、黄连、人参、甘草。
又治发黄，身面目悉黄如金色，小便如浓煮柏汁。
于本方，加黄芩、柴胡、升麻、龙胆。
又治发黄方。
于本方，加黄柏、黄连。丸方更加黄芩。
黄家日晡所发热，而反恶寒，此为女劳得之。膀胱急少腹满，身尽黄，额上黑，足下热，因作黑疸。其腹胀如水状，大便必黑，时溏，此女劳之病非水也。腹满者难治，硝石矾石散主之。（“之病”，《千金》作“疸”一字。）
〔鉴〕此详申女劳疸之为病。黄疸日晡所发热，乃阳明热症，当不恶寒也。而反恶寒者，非阳明热症，此或为女劳得之也。女劳得之疸证，虽膀胱急少腹满，而小便自利，身虽尽黄，而额上则黑，虽发热惟足下甚，此少阴热，因作黑疸也。故腹胀如水状，而大便必黑时溏，知非水胀病，乃为女劳得之疸胀病也。时溏
Yan's *Jisheng Fang* (Prescriptions for Saving the Born) contains the Zhizhu Tang (Bitter Orange and Atractylodes Decoction), which treats Yin Pi (accumulation of fluid retention affecting Qi distribution). Symptoms include hardness in the epigastrium resembling a cup, and inability to swallow fluids.
This formula is modified by adding Rougui (Cinnamon Bark), Fuzi (Aconite Lateral Root), Xixin (Asarum), Jiegeng (Platycodon Root), Binglang (Areca Seed), Gancao (Licorice Root), and Shengjiang (Fresh Ginger).
Li's *Bianhuo Lun* (Treatise on Distinguishing Doubts) records the Zhizhu Wan (Bitter Orange and Atractylodes Pill) created by Master Zhang from Yishui. It treats Pi (fullness/stagnation), eliminates food stagnation, and strengthens the stomach.
Ingredients: Zhishi (Immature Bitter Orange, stir-fried with bran until yellow, core removed, 1 liang); Baizhu (White Atractylodes Rhizome, 2 liang).
Grind the above into an extremely fine powder. Wrap in lotus leaves and roast rice to form pills, sized like paulownia seeds. Take 50 pills each time, preferably with warm water, at any time.
Supplementary Formulas:
Waitai Fangji Huangqi Tang (Pueraria and Astragalus Decoction from *Waitai Mi Yao*), treats Fengshui (Wind-Water edema). A floating pulse indicates the pathogen is in the exterior. The patient may have sweating only on the head, with no other exterior symptoms. The patient feels heaviness only in the lower body; the upper waist is normal, while the lower waist should exhibit edema extending to the genitals, with difficulty in flexion and extension. (See the Rheumatism section for the formula. ○ In *Mai Jing*, "the person" is followed by "can eat," and the character "huo" (or) is absent. "Dan xia" includes the character "yan." *Waitai Mi Yao* cites *Shenshi Fang*, calling it Mufangji Tang, stating this was originally a formula from Zhang Zhongjing's *Shanghan Lun*.)
[Shen] This indicates dampness entering from below, where dampness predominates over wind. Thus, Huangqi (Astragalus Root) is used to consolidate the exterior, preventing water from overflowing upward; Fangji (Stephania Root) expels wind-damp; Baizhu (White Atractylodes Rhizome) and Gancao (Licorice Root) strengthen the spleen; Shengjiang (Fresh Ginger) and Dazao (Jujube) harmonize Ying and Wei (Nutritive and Defensive Qi), allowing dampness to be eliminated naturally.
The Cun Kou (Radial Artery at the wrist) pulse is floating and slow. Floating indicates wind; slow indicates Bi syndrome (obstruction). This Bi is not Wind-Stroke. The four limbs suffer from vexation. The color of the Spleen must be yellow; stagnant heat circulates. ("Ku" [suffer], Xu edition and *Mai Jing* read "ruo".)
[Cheng] A floating and slow pulse inevitably leads to jaundice. Therefore, in Shanghan, a floating and slow pulse indicates involvement of the Taiyin. Taiyin disease inevitably causes whole-body jaundice. Now, floating is wind, and slow is Bi. This is not external Wind-Strike, but wind-heat accumulating in the Spleen Earth. The Spleen governs the four limbs, hence the limbs suffer vexation. Stagnant heat circulating externally causes jaundice.
[Shen] Wind-dampness knots together; pathogens and righteous Qi engage in Bi. Bi means closure. Due to wind rejection and closure, Ying and Wei become obstructed. This is not the Bi of cold-wind-dampness described in *Neijing*.
Note: The phrase "Bi is not Wind-Strike" does not fit the context logically, suggesting possible textual loss or error.
The Fu Yang pulse is tight and rapid. Rapid indicates heat; heat digests grain. Tight indicates cold; cold causes fullness after eating. The Chi (distal radial) pulse floating indicates Kidney injury. The Fu Yang pulse tight indicates Spleen injury. Wind and cold contend; eating causes dizziness. Grain qi is not digested; the stomach suffers from turbid qi. Turbid qi flows downward; urination is blocked. Yin is affected by cold; heat flows into the Bladder. The whole body turns yellow, named Gu Dan (Grain Jaundice). If the forehead is black, with slight sweating, heat in hands and feet, occurring at dusk, Bladder urgency, and spontaneous urination, it is named Nulao Dan (Female Labor Jaundice). If the abdomen is distended like water, it is incurable. Vexation and heat in the heart, inability to eat, occasional desire to vomit, is named Jiu Dan (Alcohol Jaundice). (*Mai Jing* lists Nulao Dan and Jiu Dan as separate entries; Xu, Shen, Wei, You agree. Dan, Shen and You read as "Dan" [febrile disease].)
[Cheng] Fu Yang is the Stomach pulse. Rapid is heat, tight is cold. This indicates confusion of Yin and Yang in the Stomach, mixing of clear and turbid, and chaos of cold and heat. Although it digests grain, it cannot transmit, causing fullness after eating. The Chi pulse assesses the Kidney; floating is wind, injuring the Kidney. Fu Yang assesses the Stomach; tight is cold, injuring the Spleen rather than the Stomach. Wind and cold contend, failing to digest grain. Grain qi steams the head and eyes, causing dizziness. Undigested grain causes stomach turbidity to flow down, and urination becomes difficult. Since the Kidney is the gate of the Stomach, Spleen cold affects Shaoyin, preventing excretion. Stomach heat flows to the Bladder, causing heat stagnation. Whole-body jaundice results, forming Gu Dan.
[You] Kidney labor generates heat, black color emerges upwards, similar to Spleen disease showing yellow externally. The forehead is called Ting. *Ling Shu* states: "Ting is the face." Also: "Kidney disease shows black on the cheekbones and forehead." Slight sweating indicates Kidney heat rising and connecting to the Heart. Heat in palms and soles, occurring at dusk, indicates interior and Yin pathology. Bladder urgency is forced by Kidney heat. Spontaneous urination indicates the disease is not in the Fu organs. This results from excessive sexual exertion, with heat originating from the Kidney, hence named Nulao Dan. If the abdomen is distended like water, both Yin and Yang are injured, hence incurable. Aoyi denotes depression and restlessness. Internal heat accumulation prevents eating; heat rushing up causes occasional vomiting. Alcohol fumes affect the Heart, flavors return to Spleen and Stomach, caused by excessive drinking, hence named Jiu Dan.
Chao Yuanfang states: Jaundice arises from excessive alcohol and food, disharmony of Zang-Fu, mixing of water and grain accumulating in Spleen and Stomach, combined with wind-damp, knotting and not dispersing, heat郁蒸 (stifling-steaming). Thus, hunger after eating, yellow body/face/nails/urine, and desire to lie down characterize Jaundice. Gu Dan presents with dizziness after eating, palpitations, depression, and jaundice, caused by irregular eating and Stomach Qi steaming. Nulao Dan presents with yellow body/eyes, fever/chills, lower abdominal fullness/urgency, difficult urination, caused by severe labor/heat and intercourse followed by water exposure. Note: The classic mentions "spontaneous urination," which is questionable.
Yangming disease with a slow pulse: Difficulty eating to fullness; fullness causes vexation and dizziness; urination will be difficult.
This is about to become Gu Dan. Even if purged, abdominal fullness remains. The reason is the slow pulse. ("Fa" [develop], Yangming chapter reads "wei" [slight].)
[Jian] Gu Dan belongs to Stomach heat, pulse should be rapid. Now the pulse is slow, indicating Spleen cold. Cold cannot transform grain, so although hungry, one cannot eat much. Fullness causes vexation, filling the Stomach, impairing transportation. Clear Qi is blocked from ascending, causing dizziness; turbid Qi is blocked from descending, causing difficult urination. These are signs of impending Gu Dan. The condition originates from Taiyin cold-damp stagnation. Mistaking it for Yangming heat-damp jaundice and purging it may temporarily reduce fullness, but it returns quickly. The reason is the slow pulse indicating cold. This clarifies that impending Gu Dan due to Spleen Yin cold transformation cannot be treated with purgatives.
Zhang's *Shanghan Xin Yin* states: According to *Jinkui*, there are two types of Gu Dan; this is the deficiency-cold type. *Shanghan Zuanchun* states: Slow pulse indicates Stomach deficiency; purging is useless. Sweating and promoting urination are also useless. One should use harmonizing methods, such as Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction), to first warm the middle, then gently regulate Stomach Qi.
Patients with Alcohol Jaundice invariably have difficult urination. Symptoms include heat in the heart and heat under the feet.
[Cheng] If urination is free, damp-heat dissipates; if not, heat stays in the Stomach. The Stomach meridian passes through the diaphragm, descends to the dorsum of the foot, and ascends to steam the Stomach cavity, causing heart heat; descending to the foot dorsum causes foot heat.
Alcohol Jaundice may present without heat, with quiet demeanor and clear speech, abdominal fullness, desire to vomit, and dry nose. If the pulse is floating, induce vomiting first; if deep and wiry, purge first. (Zhao edition reads "xiao" for "liao"; Cheng edition and *Jinjian* agree. *Mai Jing*, *Qianjin*, Xu, Shen, Wei read "jing yan liao liao". Xu/Shen suggest "jing" might be "qing" [clear]. *Waitai* agrees with *Qianjin*, reading "jing" [quiet]. You agrees. Cheng/Jinjian read "chan" [delirious]. Note: "liao" as "xiao" and "jing" as "chan" are later alterations; we retain "jing yan liao liao" per *Mai Jing*. "Tu" [vomit], Zhao reads "ou", incorrect.)
[You] Alcohol Jaundice involves heat in the heart, though sometimes absent. "Jing yan liao liao" means heat is not concentrated in the heart, but accumulates below causing abdominal fullness, or rushes up causing desire to vomit and dry nose. Abdominal fullness can be purged; desire to vomit can be resolved by inducing vomiting. If both exist, either method works, but pulse diagnosis is crucial. Floating pulse indicates pathogen near the upper part, favoring emesis; deep/wiry pulse indicates pathogen near the lower part, favoring purgation.
[Shen] The word "first" implies that after emesis or purgation, clearing residual heat follows naturally. (Note: "Jing" originally written as " ", same as "jing", see Han Dynasty Cui biography note.)
*Qianjin* states: For Alcohol Jaundice without heat, quiet demeanor, clear speech, abdominal fullness, and vomiting, induce vomiting using Kushen San (7 ingredients).
Kushen San: Treats sudden chills and jaundice without gradual onset, yellow dusty skin, scanty dark urine, constipation, preserved strength, normal appetite, residual heat after other treatments, chronic jaundice. Induce vomiting.
Ingredients: Kushen (Sophora Root), Huanglian (Coptis Rhizome), Gudi (Melon Twig), Huangbai (Phellodendron Bark), Dahuang (Rhubarb Root), Huangqin (Scutellaria Root, 1 liang each ○ missing in *Qianjin*, supplemented from *Yifang*), Tingli (Descurainia Seed, 2 liang).
Grind the six herbs, sieve. Take one cun-bi with water. Expect heavy vomiting. Once daily if vomiting occurs.
If no vomiting, take twice daily. Effect seen in five days; adjust dosage. If no improvement, continue.
Alcohol Jaundice with heart heat and desire to vomit: Vomiting cures it. (Zhao reads "ou", incorrect.)
[Cheng] Previous severe heat caused Aoyi and vomiting; now mild heat causes heart heat and vomiting. Disease is in the Upper Jiao, so vomiting cures it.
Alcohol Jaundice, if purged long-term, becomes Hei Dan (Black Jaundice): Blue-black eyes, black face, sensation of eating garlic paste in the heart, black stool, insensate skin, floating/weak pulse. Although black, slight yellow remains, thus identifiable. (*Chaoyuan*, *Waitai* omit "although black, slight yellow". Cheng reads "zhua" [scratch] for "zhao".)
[You] Alcohol Jaundice has indications for purgation, but only if abdominal fullness and deep/wiry pulse are confirmed. Otherwise, damp-heat enters blood vessels due to deficiency, transforming into Black Jaundice. Blue-black eyes, insensate skin indicate blood stasis. However, the root remains alcohol-related, so heart heat burns like garlic, akin to Aoyi. Pulse should be floating/weak; color black but slightly yellow, unlike pure black of Nulao Dan with deep pulse.
[Jian] Zhao Liang says: Stool like black lacquer, blue eyes, floating/weak pulse all indicate blood disease.
[Wei] Yellow turning black is like objects first scorched yellow, then smoked black.
Chao Yuanfang states: Black Jaundice features lower abdominal fullness, whole-body yellow, black forehead, foot heat, black stool. Jaundice, Alcohol Jaundice, Nulao Jaundice often transform into Black Jaundice over time. *Qianjin* Yinchen Dahuang 7-ingredient formula states: Long-standing jaundice turning peach-skin color, hard mass in epigastrium, vomiting/inability to eat, scanty dark urine, cold limbs, deep/slow/fine pulse contraindicates this formula; purging causes transformation. Note: Peach-skin color implies dull blackness; recorded for reference. Wang's *Medical Principles* states "black with slight yellow" is difficult to treat; basis unknown.
Master said: Jaundice with fever, vexation, panting, chest fullness, and dry mouth results from fire-coercion of sweat during disease onset, combining two heats. However, Jaundice arises from dampness. Whole-body fever, yellow face, hot abdomen indicate heat in the interior; purge it. ("Suo" in "Liang Re Suo De", Cheng/*Jinjian* read "xiang" [mutual]. "Mian Huang" [yellow face], Zhao/*Mai Jing* read "er huang" [and yellow]; Xu/Cheng/Shen/Wei/You agree. Note: "Mian" should be "er".)
[Wei] Disease onset refers to external Wind-Cold infection.
[You] Vexation, fullness, dryness, thirst arise from heat. Fire-coercion adds heat to heat. Without internal dampness, heat would disperse mutually, not causing Jaundice. Thus, Jaundice comes from dampness, proving heat alone is insufficient. Treatment must determine exterior/interior status for sweating or purging. Whole-body heat with severe abdominal heat indicates interior heat; interior heat cannot be dispersed via exterior, hence "must purge".
[Jian] Touching abdominal heat confirms interior heat; purge it.
[Shen] This aligns with Zhizi Dahuang Tang (Gardenia and Rhubarb Decoction).
Deep pulse, thirst with desire to drink, difficult urination: All lead to jaundice.
[Jian] Deep pulse indicates interior. Thirst indicates heat stagnation. Difficult urination indicates dampness obstruction. Interior heat-damp stagnation causes jaundice. The first article (floating/slow/tight/rapid pulses) indicates external cause. This deep pulse indicates internal cause. Thus, treating jaundice involves sweating and purging.
Li states: Deep pulse/thirst/difficult urination indicates internal damp-heat accumulation without dispersion, causing jaundice.
Abdominal fullness, tongue/body withered yellow, restlessness, insomnia: Belongs to Jaundice family. ([Original Note] "She wei" [withered tongue], suspected to be "Shen wei" [withered body]. ○ Note: Annotations suggest "Shen wei", but You retains original text incorrectly. Wei suggests "wei" should be "wei" [depressed], tongue coating bright yellow without mixed colors, also incorrect. "Zao" [restless], Zhao/Xu/Shen read "zao" [dry], incorrect.)
[Xu] Abdominal fullness is an interior sign. With abdominal fullness, withered yellow body, restlessness, insomnia, stagnant heat circulates externally. This is the precursor to jaundice. Hence "belongs to Jaundice family," indicating treatment should begin before formation, not after.
Note: "Wei Huang" is "Withered Yellow," meaning dull yellow skin. Shen states: Damp-heat steaming causes abdominal fullness and withered body; fluid/blood dryness allows Earth color to emerge externally, causing yellow/restlessness/insomnia. Interpreting "wei" as weakness and linking "huang zao" is erroneous.
Jaundice prognosis: Period is 18 days. Healing within 10+ days is good; worsening is difficult. (Ju, Zhao reads "ji" [extreme].)
[Jian] Gao Shishi states: 18 days is the period when Spleen Earth thrives in the four seasons. 10 days is the completion number of Earth. Jaundice involves Spleen Earth, hence 18-day period. Early treatment is key; healing within 10 days is expected. Worsening after 10 days indicates difficult treatment due to Spleen Qi deficiency/collapse.
Jaundice with thirst is difficult to treat; without thirst is curable. Emission from Yin parts causes vomiting; emission from Yang parts causes chills and fever. ("Fa Yu" [emerge from] before "Yang Bu", present in *Mai Jing*, *Qianjin*, Cheng, *Jinjian*; "Fa" is "fa re" [fever]. *Chaoyuan*, *Qianjin* read "wei" [slight].)
[Shen] Exterior diseases are easy to treat; interior diseases are difficult. Stomach damp-heat steaming skin causes whole-body jaundice. Differentiate exterior/interior/Yin/Yang to determine curability. Thirst indicates damp-heat half-staying inside, consuming fluids, leading to thirst. Dry fluids/blood, hyperactive Yang fire, exterior/interior pathogens make it difficult. Non-thirst indicates heat fully venting to exterior, leaving interior empty; resolving exterior disperses it, making it curable. Pathogens in Chest/Diaphragm/Stomach (Interior/Yin) rush up, causing vomiting. Pathogens fully venting to Skin/Surface (Exterior/Yang), governed by Taiyang, cause chills and fever.
Note: "Dan" originally "Dan" [febrile], hence Xiao Dan, Dan Nue. Heat-damp jaundice is called Huang Dan. "Dan" does not mean yellow disease. Dictionaries defining "Dan" as yellow disease are wrong. However, single "Dan" here omits "Huang"; do not be rigid.
Gu Dan disease: Chills/fever, anorexia, dizziness after eating, chest/mind unrest, long-term jaundice. Treated with Yinchen Hao Tang (Artemisiae Scopariae, Rhubarb, and Gardenia Decoction). (*Ehou Fang* adds "caused by irregular eating and Stomach Qi steaming" after "Huang".)
[Cheng] Damp-heat contends with retained grain, staying in Stomach, causing Gu Dan.
[You] Gu Dan is Yangming damp-heat stagnation. Yangming stagnation blocks Ying/Wei source, causing chills/fever. Obstructs transportation mechanism, causing anorexia. Eating aids damp-heat, increasing fullness, dizziness, and unrest.
[Xu] Dizziness is the primary evidence of Gu Dan. Formula note "abdomen reduced overnight" implies poor urination and slight abdominal distension.
Yinchen Hao Tang Formula:
Yinchen Hao (Artemisiae Scopariae Herba, 6 liang), Dahuang (Rhubarb Radix, 2 liang), Zhizi (Gardeniae Fructus, 14 pieces ○ Yangming chapter adds "break").
Boil three herbs in 10 dou water. First boil Yinchen, reduce by 6 sheng. Add remaining two, boil to 3 sheng. Strain, divide into 3 warm doses. Urine becomes smooth, dark like soapberry juice, red. Abdomen reduces overnight; yellow exits via urine.
[Cheng] Yinchen/Zhizi guide damp-heat out; Dahuang purges retained grain. Bitter drains heat.
Xu's *Shanghan Leifang* states: Boiling Yinchen first ensures Dahuang exits via urine; this is a secret method.
*Qianjin* Yinchen Tang: Shanghan 7-8 days, interior excess heat-knot, orange-yellow skin, difficult urination, slight abdominal fullness. Purge. (Same formula ○ slightly different from Yangming chapter, attached here.)
*Waitai* Fan Wang treats Gu Dan, Yinchen Tang. (Same formula.)
Also Short-Ji Three-Ingredient Yinchen Hao Tang: Treats jaundice yellow body/eyes, dusty skin.
Yinchen Hao (1 bundle), Zhizi (24 pieces), Shigao (Gypsum Fibrosum, 1 jin) ○ *Qianjin* adds Dahuang (2 liang).
Boil three in 8 sheng water to 2.5 sheng. Strain. Roast Shigao until red-hot, add to decoction. Boil, take clear liquid, 1 sheng warm. Cover to sweat.
Also *Guangji* Yinchen Wan: Treats whole-body/face jaundice, urine like strong Gardenia juice.
Remove Zhizi from base formula, add Huangqin (Scutellaria Root), Zhishi (Immature Bitter Orange), honey pills.
Also *Bixiao* Yinchen Tang/Wan: Treats all jaundice. Jiang Jiu obtained from father Yuan Shi for jaundice; highly effective.
Add Huangqin to base formula.
*Qianjin* Yinchen Tang: Treats Jaundice, Alcohol Jaundice, Alcohol Pi, whole-body/face jaundice. (According to *Waitai*: Ta Yi Xiao Wei Shi Tuo.)
Add Huangqin, Huanglian, Renshen (Ginseng Radix), Gancao to base formula.
Also treats yellowing, golden-yellow body/face, urine like boiled Phellodendron juice.
Add Huangqin, Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma), Longdan (Gentianae Radix) to base formula.
Also treat yellowing formula.
Add Huangbai, Huanglian to base formula. Wan formula adds Huangqin.
Jaundice patients fever at Ding-Shi (5-7 PM) with aversion to cold: Caused by Female Labor. Bladder urgency, lower abdominal fullness, whole-body yellow, black forehead, foot heat, transforming into Black Jaundice. Abdominal distension like water, black stool, loose stools. This Female Labor disease is not Water Distension. Abdominal fullness is difficult to treat. Treated with Xiaoshi Fanshi San (Niter and Alum Powder). ("Zhi Bing", *Qianjin* reads "Dan" [jaundice] as one character.)
[Jian] Clarifying Female Labor Jaundice. Jaundice fever at Ding-Shi is Yangming heat, should not have aversion to cold. Aversion to cold indicates Female Labor etiology. Female Labor Jaundice has bladder urgency/lower fullness but spontaneous urination. Whole-body yellow but black forehead. Fever mainly in feet, indicating Shaoyin heat, causing Black Jaundice. Abdominal distension like water, black/loose stool indicates not Water Distension, but Female Labor Jaundice Distension. Loose stools...