四肢不沉重也。○案治阴黄。医学纲目。用理中加茯苓汤。喻氏治女劳疸属虚者。用八味肾气丸。圣惠治房黄。
用鹿茸散（鹿茸。熟地。山茱。五味。黄 。牡蛎。）之类。皆不用茵陈。然如韩氏小茵陈汤。（附子。甘草。
茵陈。）茵陈四逆汤。茵陈附子汤。茵陈茱萸汤。罗氏茯苓栀子茵陈汤之类。皆附子茵陈并用。盖本于千金
翼。治黄胆小便赤黄方（前胡。茯苓。椒目。附子。茵陈。）之意。寒热错杂者。亦宜随证而选用。不必执拘矣。
附方
瓜蒂汤。治诸黄。（方见 病中。）
〔沈〕瓜蒂汤。吐药也。若邪冲于胸膈。或心烦懊 。欲
吐而无他病者。当用此汤。吐去黄水。因其高而越之也。
外台。删繁。疗天行毒热。通贯脏腑。沉鼓骨髓之间。或为黄胆黑疸赤疸白疸谷疸马黄等疾。喘急须臾而绝方。
瓜蒂（二七枚）
上一味。以水一升。煮取五合。作一服。○案此方。与 病所载同。北史麦铁杖传。瓜蒂喷鼻。疗黄不瘥。
考千金外台。用瓜蒂等二三味者。凡八方。多系于吹两鼻中出黄水。正是别法。故此不录出。当考原书。
千金。麻黄醇酒汤。治黄胆。（外台。引仲景伤寒论云。短剧。古今录
验。张文仲。经心录同。千金云。治伤寒热出表。发黄胆方。外台煮法后。引古今方。文同。）
麻黄（三两○外台作一大把去节肘后同）
上一味。以美清酒五升。煮取二升半。顿服尽。冬月用酒。春月用水煮之。
〔沈〕外感风寒。湿热在表。郁 成黄。或脉自浮。当以
汗解者。用此一味。煮酒使其彻上彻下。行阳开腠。而驱营分之邪。则黄从表解矣。
四肢并不感觉沉重。○按语：治疗阴黄，在《医学纲目》中采用理中汤加茯苓方。喻嘉言治疗属于虚证的女劳疸，使用八味肾气丸。《圣惠方》治疗房黄，使用鹿茸散（由鹿茸、熟地黄、山茱萸、五味子、黄芪、牡蛎组成）之类的方剂，这些方子都不使用茵陈。然而像韩氏小茵陈汤（附子、甘草、茵陈）、茵陈四逆汤、茵陈附子汤、茵陈茱萸汤、罗氏茯苓栀子茵陈汤等方剂，都是附子和茵陈并用。这大概是源于《千金翼方》中治疗黄疸小便赤黄的方子（前胡、茯苓、椒目、附子、茵陈）的意旨。对于寒热错杂的情况，也应当根据证候随宜选用，不必拘泥固执。
附方
〔沈明宗〕瓜蒂汤是催吐药。如果邪气冲击胸膈，或者心中烦闷懊恼，想要呕吐却没有其他病症的，应当使用此汤。通过呕吐排出黄水，这是顺应病位在上而使其向上涌出的治法。
《外台秘要》和《删繁》记载治疗天行毒热，邪气贯通脏腑，深入骨髓之间，导致黄疸、黑疸、赤疸、白疸、谷疸、马黄等疾病，喘促急迫片刻即断气的方子。
瓜蒂（十四枚）
以上一味药，用水一升，煮取五合，一次服下。○按语：此方与《金匮要略》疾病篇所载相同。《北史·麦铁杖传》记载用瓜蒂喷鼻治疗黄疸不愈。考证《千金方》和《外台秘要》，使用瓜蒂等二至三味药的方子共有八个，大多是将药末吹入两鼻孔中流出黄水，这正是另一种方法。因此此处不收录，应当考证原书。
《千金方》麻黄醇酒汤。治疗黄疸。（《外台秘要》引用张仲景《伤寒论》云，《短剧方》、《古今录验》、《张文仲方》、《经心录》内容相同。《千金方》称：治疗伤寒热邪外出体表，发为黄疸的方子。《外台秘要》煮法之后，引用《古今方》，文字相同。）
麻黄（三两○《外台秘要》作一大把，去节；《肘后备急方》同）
以上一味药，用优质清酒五升，煮取二升半，一次性服完。冬季用酒煮，春季用水煮。
〔沈明宗〕外感风寒，湿热郁结在表，郁蒸而成黄疸，或者脉象自浮，应当以发汗解表的，使用这一味药，煮酒使其彻上彻下，通行阳气，开泄腠理，从而驱除营分中的邪气，那么黄疸就会从表解除。
The four limbs do not feel heavy. ○ Commentary: To treat Yin Jaundice (Yin Huang), *Medical Outline* (*Yixue Gangmu*) uses Lizhong Decoction with added Poria (*Lizhong Jia Fuling Tang*). Yu Jiayan treated Female Labor Jaundice (*Nulao Dan*) of the deficiency type using Eight-Ingredient Rehmannia Pill (*Bawei Shenqi Wan*). *Shenghui Fang* treated "Room Yellow" (*Fanghuang*) using Deer Antler Powder (*Lurong San*, composed of Deer Antler, Prepared Rehmannia Root, Cornus Fruit, Schisandra Berry, Astragalus Root, and Oyster Shell) and similar formulas; none of these use Yin Chen Hao. However, formulas such as Han's Minor Yinchen Decoction (Aconite, Licorice, Yin Chen Hao), Yinchen Sini Decoction, Yinchen Fuzi Decoction, Yinchen Zhuyu Decoction, and Luo's Poria Gardenia Yinchen Decoction all combine Aconite and Yin Chen Hao. This is likely derived from the intent of the formula in *Qianjin Yifang* for treating Jaundice with red-yellow urine (Peucedani Radix, Poria, Pepper Seed, Aconite, Yin Chen Hao). For cases of mixed cold and heat, one should also select treatments according to the syndrome without being rigid or dogmatic.
Supplementary Formulas
Gua Di Tang. Treats various types of Jaundice. (Formula seen in the Disease section.)
[Shen Mingzong] Gua Di Tang is an emetic. If pathogenic factors attack the chest and diaphragm, or if there is mental restlessness and oppression with a desire to vomit but no other disease, this decoction should be used. It induces vomiting to expel yellow fluid, following the principle of evacuating pathogens located high by causing them to ascend and exit.
*Waitai Miyao* and *Shanfan* record a formula for treating epidemic toxic heat that penetrates the zang-fu organs and sinks into the marrow, leading to conditions such as Jaundice, Black Jaundice, Red Jaundice, White Jaundice, Grain Jaundice, or Horse Yellow, characterized by sudden suffocation and impending death.
Gua Dai (14 seeds)
Take the above single herb, boil in one sheng of water until five he remain, and take as a single dose. ○ Commentary: This formula is identical to that recorded in the Disease section of *Jingui Yaolue*. The *History of the Northern Dynasties* (*Beishi*), Biography of Mai Tiezhang, records using Gua Dai insufflated into the nose to treat persistent jaundice. Examining *Qianjin Fang* and *Waitai Miyao*, there are eight formulas using two or three herbs including Gua Dai, mostly involving blowing powder into both nostrils to discharge yellow fluid; this is indeed another method. Therefore, it is not recorded here, and the original texts should be consulted.
*Qianjin Fang* Mahuang Chunjiu Tang. Treats Jaundice. (*Waitai Miyao* cites Zhang Zhongjing's *Shanghan Lun*, stating that *Duanju Fang*, *Gujin Luyian*, *Zhang Wenzhong Fang*, and *Jingxin Lu* have the same content. *Qianjin Fang* states: Formula for treating Jaundice caused by heat from Taiyang Shaoyang transforming outward after Cold Damage. After the boiling instructions in *Waitai Miyao*, it cites *Gujin Fang*, with identical text.)
Mahuang (3 liang ○ *Waitai Miyao* specifies one large handful, removing joints; *Zhouhou Beiji Fang* agrees)
Take the above single herb, boil in five sheng of clear fine wine until two and a half sheng remain, and consume entirely in one dose. In winter, use wine for boiling; in spring, use water for boiling.
[Shen Mingzong] When external contraction of Wind-Cold causes Damp-Heat to stagnate at the exterior, steaming and transforming into Jaundice, or when the pulse is naturally floating and sweating is indicated for resolution, this single herb boiled in wine is used. It acts thoroughly from top to bottom, circulating Yang Qi, opening the Couli (pores/skin interstices), and driving out pathogens from the Ying (Nutritive) level, thereby resolving the Jaundice through the exterior.