小便不利,心中懊 而热,不能食,时时欲吐,面目黄,或发赤斑,由大醉当风入水所
致。盖酒湿之毒,为风水所遏,不得宣发,则蒸郁为黄也。
茵陈蒿汤 治酒疸,心中懊 ,小便黄赤。
茵陈蒿 葛根 赤苓(各五钱) 升麻 秦艽 栝蒌根(各三钱) 山栀(五分)
水煎三钱,温服,日二,以瘥为度。
小麦饮
生小麦二合,水煎取汁顿服,未瘥再服。
大黄汤 治酒疸,懊 ,胫肿溲黄,面发赤斑。
大黄(炒,二两) 山栀 枳实 豉(炒,三合)
水煎四钱,温服,日二。加茵陈亦得。
葛根汤(《济生》)
干葛(二钱) 栀子(二钱) 枳实 豆豉(各一钱) 炙草(五分)
水煎温服无时。
色欲伤肾得之。《金匮》云∶额上黑,微汗出,手足心热,薄暮即发,膀胱急,小便自
名曰女劳疸。盖黄胆热生于脾,女劳疸热生于肾,故黄胆一身尽黄,女劳疸身黄,额上黑
也。仁斋云∶脾与肾俱病为黑疸。
凡房劳黄病,体重不眠,眼赤如朱,心下块起若瘕,十死一生,宜灸心俞、关元二七壮
,及烙舌下,以妇人内衣烧灰,酒服二钱。
范汪亦云∶女劳疸气短气沉者,取妇女月经布和血烧灰,空腹酒服方寸匕,日
病本热而变为阴,非阴症能发黄也。韩祗和云∶病患三五日,服下药太过,虚其脾胃,
亡其
津液,渴饮水浆,脾土为阴湿所加,与热邪相会发黄,此阴黄也。当以温药治之,如两手脉
沉细迟,身体逆冷,皮肤粟起,或呕吐,舌上有苔,烦躁欲坐卧泥水中,遍身发黄,小便赤
少,皆阴候也。
茵陈橘皮汤(韩氏) 治身黄,脉沉细数,热而手足寒,喘呕烦躁,不渴者。
茵陈 橘红 生姜(各一两) 半夏 茯苓(各五钱) 白术(二钱五分)
水四升,煮取二升,分作四服。
小茵陈汤(韩氏) 治发黄脉沉细,四肢及遍身冷。
附子(一枚,炮,作八片) 炙草(一两) 茵陈(二两)
水四升 煮取二升,分三服。一方有干姜,无甘草,名茵陈附子汤。(韩氏)
茵陈理中汤 治身冷面黄,脉沉细无力,或泄,自汗,小便清白,名曰阴黄。
人参 白术 炮姜 炙草 茵陈
上 咀,每服五钱,水煎。
罗谦甫治真定韩君祥,暑月劳役过度,渴饮凉茶及食冷物,遂病头身肢节沉重疼痛,汗
下寒凉屡投不应。转变身目俱黄,背恶寒,皮肤冷,心下硬,按之痛,脉紧细,按之空虚,两寸
脉短,不及本位。此症得之因时热而多饮冷,加以寒凉过剂,助水乘心,反来侮土,先伤其
母,后及其子,经所谓薄所不胜,而乘所胜也。时值霖霪,湿寒相合,此为阴黄,以茵陈附
子干姜汤主之。《内经》云∶寒淫于内,治以甘热,佐以苦辛;湿淫所胜,平以苦热,以淡
渗之,以苦燥之,附子、干姜辛甘大热,散其中寒为君,半夏、草蔻辛热,白术、陈皮苦
甘
温,健脾燥湿为臣,生姜辛温以散之,泽泻甘平以渗之,枳实苦辛,泄其痞满,茵陈苦微寒
,其气轻浮,佐以姜、附,能去肤腠间寒湿,而退其黄为使也。煎服一两,前症减半,再服
悉愈。又与理中汤服之,数日得平复。
李思训谓发黄皆是阳症,凡云阴黄者,皆阳坏而成阴,非原有阴症也。茵陈干姜汤,是
治热
症坏而成寒者之药,学人要穷其源,盖即于本病主治药内,加热药一味以温之,如桂枝汤加
大黄之意。
小便排出不畅,心中烦闷且发热,无法进食,时常想要呕吐,面目发黄,或者出现红色斑点,这是由大醉后受风、涉水所致。因为酒湿的毒气,被风水之气所遏制,不能宣散发越,于是蒸腾郁结而发黄。
茵陈蒿汤 治疗酒疸,心中烦闷,小便黄赤。
茵陈蒿 葛根 赤茯苓(各五钱) 升麻 秦艽 栝蒌根(各三钱) 山栀(五分)
用水煎煮三钱药量,温服,每日两次,以病愈为度。
小麦饮
生小麦二合,用水煎取汁液一次性服用,如果未痊愈再服用。
大黄汤 治疗酒疸,心中烦闷,小腿肿胀,小便黄,面部出现红色斑点。
大黄(炒制,二两) 山栀 枳实 豆豉(炒制,三合)
用水煎煮四钱药量,温服,每日两次。加入茵陈也可以。
葛根汤(出自《济生方》)
干葛(二钱) 栀子(二钱) 枳实 豆豉(各一钱) 炙甘草(五分)
用水煎煮,随时温服。
因房事过度损伤肾脏而得此病。《金匮要略》说:额头颜色发黑,微微出汗,手心脚心发热,傍晚时分症状发作,膀胱拘急,小便自利,名叫女劳疸。大概黄疸的热邪生于脾脏,女劳疸的热邪生于肾脏,所以黄疸是一身尽黄,女劳疸则是身体发黄而额头发黑。仁斋说:脾与肾都生病就会变成黑疸。
凡是因房劳导致的黄病,身体沉重失眠,眼睛红得像朱砂一样,心下痞块突起像瘕聚一样,十死一生,适宜灸心俞穴、关元穴各十四壮,以及烙烫舌下,用妇女内衣烧成灰,用酒送服二钱。
范汪也说:女劳疸气息短促、气沉的,取妇女月经布和血烧成灰,空腹用酒送服一方寸匕,每天……(原文此处截断)
疾病本属热证而转变为阴证,并非阴证能导致发黄。韩祗和说:病患三五天,服用泻下药太过,使其脾胃虚弱,津液耗亡,口渴饮水浆,脾土受到阴湿侵袭,与热邪相会而发黄,这就是阴黄。应当用温药治疗,比如两手脉象沉细迟,身体逆冷,皮肤起粟粒状鸡皮疙瘩,或者呕吐,舌上有苔,烦躁想坐在泥水中,全身发黄,小便赤少,这些都是阴证的候象。
茵陈橘皮汤(韩氏) 治疗身体发黄,脉象沉细数,有热但手脚寒冷,气喘呕吐烦躁,不口渴的。
茵陈 橘红 生姜(各一两) 半夏 茯苓(各五钱) 白术(二钱五分)
用水四升,煮取二升,分作四次服用。
小茵陈汤(韩氏) 治疗发黄脉象沉细,四肢及全身寒冷。
附子(一枚,炮制,切成八片) 炙甘草(一两) 茵陈(二两)
用水四升,煮取二升,分三次服用。另一版本有干姜,无甘草,名叫茵陈附子汤。(韩氏)
茵陈理中汤 治疗身体寒冷面色黄,脉象沉细无力,或者腹泻,自汗,小便清白,名叫阴黄。
人参 白术 炮姜 炙甘草 茵陈
以上药物捣碎,每次服用五钱,用水煎煮。
罗谦甫治疗真定人韩君祥,暑月劳作过度,口渴喝凉茶并吃冷物,于是患上头身肢节沉重疼痛,发汗、攻下、寒凉药物多次投用都不见效。病情转变为身目俱黄,背部怕冷,皮肤寒冷,心下硬满,按压疼痛,脉紧细,按之空虚,两寸脉短,不及本位。这个病症是因为天气热而多饮冷水,加上寒凉药过量,助长水气乘袭心脏,反过来侮害脾土,先伤了母脏(心),后波及子脏(脾),正如经书所说:侵凌所不胜(克己者),而乘袭所胜(己克者)。当时正值连绵阴雨,湿寒相合,这是阴黄,用茵陈附子干姜汤为主治。《内经》说:寒邪淫盛于内,用甘热药治疗,辅以苦辛药;湿邪淫盛,用苦热药平抑它,用淡味药渗泄它,用苦味药燥湿它。附子、干姜辛甘大热,发散其中寒作为君药;半夏、草蔻辛热,白术、陈皮苦甘温,健脾燥湿作为臣药;生姜辛温以发散它,泽泻甘平以渗泄它,枳实苦辛,泄除痞满,茵陈苦微寒,其气轻浮,佐以姜、附,能去除肤腠间的寒湿,从而退黄作为使药。煎服一两,前面的症状减半,再服全部痊愈。又给予理中汤服用,几天后恢复健康。
李思训认为发黄都是阳证,凡是说阴黄的,都是阳证坏变而成阴证,并非原本就是阴证。茵陈干姜汤,是治疗热证坏变而成寒证的药物,学者要穷究其源头,大概就是在本病主治药内,加一味热药来温补它,就像桂枝汤加大黄的意思。
Urination is difficult, the heart feels stifled and hot, inability to eat, frequent desire to vomit, yellowing of the face and eyes, or eruption of red spots. This is caused by heavy drinking followed by exposure to wind and entering water. The toxicity of wine-dampness is suppressed by wind-water, preventing its dissemination and emission, thus steaming and stagnating to cause jaundice.
Yinchen Hao Tang (Artemisiae Scopariae Decoction) treats Jiudan (Wine Jaundice), characterized by a stifling sensation in the heart and yellow-red urine.
Yinchen Hao (Artemisiae Scopariae Herba), Gegen (Puerariae Lobatae Radix), Chiling (Polyporus with Hostwood, *Zhu Ling* variant often referring to Polyporus umbellatus but here specified as Chiling/Red Polyporus contextually linked to damp-heat drainage), Shengma (Cimicifugae Rhizoma), Qinjiao (Gentianae Macrophyllae Radix) each 5 qian; Gualou Gen (Trichosanthis Radix) each 3 qian; Shanzhi (Gardeniae Fructus) 5 fen.
Decoct with water, take 3 qian decoction, warm administration, twice daily, until recovery.
Xiaomai Yin (Wheat Drink)
Sheng Xiaomai (Tritici Levis Semen) 2 he, decoct with water to obtain juice, take in one dose. If not recovered, take again.
Dahuang Tang (Rhubarb Decoction) treats Jiudan (Wine Jaundice), stifling sensation, swelling of the shins, yellow urine, and red spots on the face.
Dahuang (Rhei Radix et Rhizoma, stir-fried) 2 liang; Shanzhi (Gardeniae Fructus), Zhishi (Aurantii Fructus), Chi (Zizyphi Fructus, stir-fried) 3 he.
Decoct with water, take 4 qian decoction, warm administration, twice daily. Adding Yinchen is also acceptable.
Gegen Tang (from *Jisheng Fang*)
Gegen (Puerariae Lobatae Radix) 2 qian; Zhizi (Gardeniae Fructus) 2 qian; Zhishi (Aurantii Fructus), Douchi (Sojae Semen Praeparatum) each 1 qian; Zhi Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) 5 fen.
Decoct with water, take warm at any time.
Acquired due to sexual excess damaging the Kidney. *Jinkui Yaolue* states: Blackening of the forehead, slight sweating, heat in the palms and soles, onset at dusk, urgency of the bladder, free urination, is called Nulaodan (Female Labor Jaundice). Generally, the heat of Huangdan (Jaundice) arises from the Spleen, while the heat of Nulaodan arises from the Kidney. Thus, Huangdan presents with full-body yellowing, whereas Nulaodan presents with body yellowing and blackening of the forehead. Renzhai stated: When both Spleen and Kidney are diseased, it becomes Heidan (Black Jaundice).
For all jaundice caused by sexual fatigue, accompanied by heavy body, insomnia, eyes red as cinnabar, and a mass rising in the epigastrium resembling a Jia (mass), which is ten deaths to one survival, moxa should be applied to Xinshu (BL-15) and Guanyuan (CV-4), fourteen moxa cones each. Also, cauterize under the tongue, and take two qian of powdered ashes from a woman's underwear mixed with wine.
Fan Wang also said: For Nulaodan with shortness of breath and sinking qi, take ashes of a woman's menstrual cloth mixed with blood, taken on an empty stomach with wine, one fangcun bi per day... [Text cuts off]
The disease originates as Heat transforming into Yin; it is not that Yin syndrome causes jaundice. Han Zhihe stated: After three to five days, if purgatives are used excessively, the Spleen and Stomach become deficient, and body fluids are depleted. Thirst leads to drinking liquids; the Spleen Earth is affected by Yin-dampness, meeting with Heat pathogen to cause jaundice; this is Yinhuang (Yin Jaundice). It should be treated with Warm medicines. For example, if the pulses in both hands are deep, fine, and slow, the body is cold from the extremities inward, skin has gooseflesh, or there is vomiting, coating on the tongue, restlessness desiring to sit in mud or water, full-body yellowing, and scanty dark urine, these are all signs of Yin syndrome.
Yinchen Jupi Tang (Han's Formula) treats full-body yellowing, deep-fine-rapid pulse, heat with cold hands and feet, wheezing, vomiting, restlessness, and no thirst.
Yinchen (Artemisiae Scopariae Herba), Juhong (Citri Reticulatae Pericarpium Rubrum), Shengjiang (Zingiberis Rhizoma Recens) each 1 liang; Banxia (Pinelliae Rhizoma), Fuling (Poria) each 5 qian; Baizhu (Atractylodis Macrocephalae Rhizoma) 2.5 qian.
Decoct with four sheng of water to obtain two sheng, divide into four doses.
Xiao Yinchen Tang (Han's Formula) treats jaundice with deep-fine pulse, cold limbs and whole body.
Fuzi (Aconiti Lateralis Radix Praeparata, one piece, processed, sliced into eight), Zhi Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) 1 liang, Yinchen (Artemisiae Scopariae Herba) 2 liang.
Decoct with four sheng of water to obtain two sheng, divide into three doses. Another version contains Ganjiang (Zingiberis Rhizoma) instead of Zhi Cao, named Yinchen Fuzi Tang (Han's Formula).
Yinchen Lizhong Tang treats cold body, yellow face, deep-fine-powerless pulse, or diarrhea, spontaneous sweating, clear and white urine, named Yinhuang (Yin Jaundice).
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Paojiang (Zingiberis Rhizoma Preparatum), Zhi Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Yinchen (Artemisiae Scopariae Herba).
Crush the above herbs, take 5 qian per dose, decoct with water.
Luo Qianfu treated Han Junxiang from Zhending. During summer, due to excessive labor, thirst led to drinking cold tea and eating cold food, resulting in heaviness and pain in the head, body, and joints. Sweating, purging, and cold medicines were administered repeatedly without effect. The condition transformed into yellowing of the body and eyes, aversion to cold on the back, cold skin, hardness and pain upon pressure in the epigastrium, tight-fine pulse that feels empty upon pressure, short pulses in both Cun positions failing to reach their standard location. This syndrome resulted from drinking cold liquids due to seasonal heat, compounded by excessive cold medicine, aiding Water to attack Heart, thereby insulting Spleen Earth. First the Mother (Heart) was injured, then the Child (Spleen), as stated in the classics: encroaching upon the unconquerable (one who overcomes oneself) and attacking the conquerable (one whom oneself overcomes). At that time, continuous rain combined dampness and cold; this is Yinhuang (Yin Jaundice), primarily treated with Yinchen Fuzi Ganjiang Tang. *Neijing* states: When Cold dominates internally, treat with Sweet-Hot, assisting with Bitter-Pungent; when Dampness dominates, level with Bitter-Hot, drain with Bland, dry with Bitter. Fuzi and Ganjiang are Pungent-Sweet Great Hot, dispersing middle Cold as Sovereign; Banxia and Caokou are Pungent-Hot; Baizhu and Chenpi are Bitter-Sweet-Warm, strengthening Spleen and drying Dampness as Ministers; Shengjiang is Pungent-Warm to disperse; Ze Xie is Bland-Sweet to drain; Zhishi is Bitter-Pungent to drain fullness; Yinchen is Bitter-Slightly Cold, its qi light and floating, assisted by Jiang and Fu, able to remove Cold-Damp from skin and pores to resolve jaundice as Envoys. Decoct and take 1 liang; previous symptoms halved, subsequent doses cured completely. Then given Lizhong Tang, recovered after several days.
Li Sixun stated that all jaundice is Yang syndrome; what is called Yinhuang is actually Yang syndrome deteriorating into Yin, not originally Yin syndrome. Yinchen Ganjiang Tang is for treating Heat syndrome deteriorating into Cold. Scholars must trace the source: essentially adding one Warm herb to the primary treatment formula to warm it, similar to the logic of Guizhi Tang adding Dahuang.