黑色者。亦脏病及血之征也。血病者颜必变。岂有色黑而血不病者乎。女劳疸腹满者。为难治。以其脾胃两
败也。以硝石入血消坚。矾石入气胜湿。然此方治标固宜。非图本之治。世久书讹。姑辨其理也。
〔尤〕黄家
日晡所。本当发热。乃不发热。而反恶寒者。此为女劳。肾热所致。与酒疸谷疸不同。酒疸谷疸。热在胃。女
劳疸热在肾。胃浅而肾深。热深则外反恶寒也。膀胱急。额上黑。足下热。大便黑。皆肾热之征。虽少腹
满胀。有如水状。而实为肾热。而气内蓄。非脾湿而水不行也。
硝石矾石散方（外台。引仲景伤寒论云。肘后。短剧。崔氏。文仲。千金。范汪深师并同。）
硝石 矾石（烧等分○硝石下外台尤本有熬黄二字）
上二味。为散。以大麦粥汁。和服方寸匕。日三服。病随大小便去。小便正黄。大便正黑。是
黑色的面色，也是脏腑病变及血分受邪的征象。凡是血分有病的人，面部颜色必然发生变化，哪里有面色发黑而血分没有病的呢？女劳疸（因房劳过度导致的黄疸）如果伴有腹部胀满的症状，属于难治之证，这是因为脾胃功能都已败坏所致。方中用硝石入血分以消除瘀结坚积，用矾石入气分以燥湿胜湿。然而此方仅适用于治疗标症，并非治本之法。由于年代久远，书籍流传中出现讹误，此处姑且辨析其医理。
〔尤在泾按语〕：黄家（指黄疸病患者）通常在日晡时（下午3-5点）应当发热，如果不发热反而恶寒，这是女劳疸，由肾热所致。这与酒疸、谷疸不同。酒疸和谷疸的热邪在胃，女劳疸的热邪在肾。胃位浅而肾位深，热邪深入则体表反而出现恶寒症状。膀胱拘急不适、额头色黑、足心发热、大便色黑，都是肾热的征象。虽然小腹胀满，看起来像有水饮停聚，但实际上是肾热导致气机在内蓄积，并非脾虚湿盛导致水液运行不畅。
硝石矾石散方（《外台秘要》引用张仲景《伤寒论》云，《肘后备急方》、《短剧方》、崔氏方、文仲方、《千金方》、范汪《深师方》均与此相同。）
硝石、矾石（烧制，等分○注：硝石下《外台》尤本有“熬黄”二字）
以上两味药，研为散剂。用大麦粥汁调和，每次服用一方寸匕，每日三次。病邪随大小便排出，小便颜色正黄，大便颜色正黑，这是……
Black complexion is also a sign of zang-organ pathology and blood disease. In cases of blood disease, the facial complexion must change; how can there be black complexion without blood disease? For female labor jaundice (jaundice caused by sexual exhaustion) accompanied by abdominal fullness, it is difficult to treat because both the spleen and stomach are failing. Niter (Xiaoshi) enters the blood level to dissolve stasis and hardness, while Alum (Fanshi) enters the qi level to overcome dampness. However, this formula is suitable for treating the branch symptoms but not for addressing the root cause. Due to the passage of time, errors have occurred in the transmitted texts; here, the rationale is tentatively clarified.
[You Zaijing's Commentary]: Patients with jaundice typically experience fever during the Shen hour (3-5 PM). If they do not feel feverish but instead feel aversion to cold, this indicates female labor jaundice caused by kidney heat. This differs from wine jaundice and grain jaundice. In wine and grain jaundice, the heat resides in the stomach; in female labor jaundice, the heat resides in the kidney. The stomach is superficial while the kidney is deep; when heat is deep-seated, it manifests externally as aversion to cold. Urgency in the bladder, blackness on the forehead, heat under the feet, and black stool are all signs of kidney heat. Although there is fullness and distension in the lower abdomen resembling fluid retention, it is actually due to kidney heat causing internal accumulation of qi, rather than spleen deficiency with dampness obstructing water metabolism.
Niter and Alum Powder Formula (The *Wai Tai Mi Yao* cites Zhang Zhongjing's *Shanghan Lun*, stating that *Zhou Hou Bei Ji Fang*, *Duan Ju Fang*, Cui Shi's formula, Wen Zhong's formula, *Qian Jin Fang*, and Fan Wang's *Shen Shi Fang* are all consistent with this.)
Niter (Xiaoshi), Alum (Fanshi) [calcined, equal parts] (Note: The You edition of *Wai Tai Mi Yao* adds "roasted until yellow" after Niter.)
Grind the above two ingredients into a powder. Mix with barley gruel juice and administer one fangcun bi (a square-inch measure) per dose, three times daily. The pathogen will exit via the large or small intestines; when the urine turns properly yellow and the stool turns properly black, this indicates...