仲景曰。脉浮而动数。医反下之。动数变迟。阳气内陷。心下因
硬。则为结胸。若不结胸。但头汗出。余处无汗。剂颈而还。小便不
利。身必发黄。常氏云。发黄者。与茵陈煎浓汁。调五苓散亦可。雍
曰。凡黄皆用二药。重者茵陈蒿汤。轻者五苓散。
又曰。伤寒脉浮而缓。手足自温者。是为系在太阴。太阴者身当
发黄。若小便自利者。不能发黄。治在阳明证中。
又曰。阳明病。无汗。小便不利。心中懊 者。身必发黄。
又曰。阳明病。被火。额上微汗出。而小便不利者。必发黄。常氏
云。可与茵陈汤、五苓散。
又曰。阳明病。发热汗出者。此为热越。不能发黄。但头汗出。身
无汗。剂颈而还。小便不利。渴饮水浆者。此为瘀热在里。身必发黄。
宜下之。茵陈汤主之。
又曰。伤寒六七日。身黄如橘子色。小便不利。腹微满者。茵陈
汤主之。
又曰。伤寒身黄发热。栀子柏皮汤主之。
又曰。伤寒瘀热在里。身必发黄。麻黄连翘赤小豆汤主之。
又曰。伤寒发汗已。身目为黄。所以然者。以寒湿在里故也。以
为不可下也。于寒湿中求之。常氏云。可五苓散。
又曰。伤寒头痛。翕翕发热。形象中风。下之。益烦心。发汗。则
致。熏之。则发黄。雍曰。治在不可汗证中。发黄。则茵陈蒿汤也。
又曰。阳明病。脉迟。食难用饱。饱则微烦。头眩。必小便难。此
欲作谷疸。虽下之。腹满如故。所以然者。脉迟故也。常氏云。可茯苓
汤、五苓散。雍曰。宜千金方谷疸丸。
又曰。太阳中风。以火劫发汗。两阳相熏灼。其身发黄。阳盛则
欲衄。阴虚则小便难。阴阳俱虚竭。身体则枯燥。但头汗出。剂颈而
还。小便利者。其人可治。雍曰。治法在不可火证中。身黄者。茵陈
汤。小便难者。五苓散。
又曰。寸口脉。阳浮而阴濡弱。阳浮则为风。阴濡弱为少血。浮
虚受风。少血发热。医以火熏熨令汗出。恶寒遂甚。客热因火而发。
身因为黄。小便难。鼻中出血。复下之。热瘀在膀胱。蓄结成积聚。状
如肝。当下不下。心乱狂走赴水。蓄血若去。目明心了。此皆医所
为。轻者得愈。剧者不治。雍曰。详治在不可火证中。先下积血。次身
黄。小便难。治如前证。
又曰。阳明中风。脉弦浮大而短气。腹都满。胁下及心痛。久按
之气不通。鼻干不得汗。嗜卧。一身及面目悉黄。小便难。雍曰。治在
阳明证中。身目黄。茵陈蒿汤。小便难者。五苓散。
又曰。伤寒发热。口中勃勃气出。头痛目黄。衄不可制。雍曰。治
在不可下证中。目黄。如前法治。
又曰。得病六七日。脉迟浮弱。恶风寒。手足温。医二三下之。不
能食而胁下满痛。面目及身黄。颈项强。小便难。雍曰。治在吐下后
证中。身黄小便难。治如前法。
千金方曰。诸病黄胆。宜利其小便。假令脉浮。当以汗解。宜桂
枝黄 汤。
又曰。伤寒。热出表。发黄胆。麻黄醇酒汤。冬用宜酒。春用宜水。
又曰。治黄胆。鼻中取黄汁。宜瓜蒂、赤小豆、秫米末。名瓜丁散。
又曰。时行病。急黄。并瘴疠疫气 疟。宜茵陈丸。余见千金十
卷。（今千金三十四卷）
巢氏曰。伤寒阳明病。无汗。小便不利。心中懊 。必发黄。被
火。额上微汗出而小便不利。亦发黄。其人黄如橘色。或如桃枝色。
腹微满。此由寒湿气不散。瘀热在脾胃也。又时气发黄候曰。湿气
盛。蓄于脾胃。脾胃有湿。则新谷郁蒸。不能消化。大小便结涩。故发
黄。又温病候曰。发汗不解。温毒瓦斯瘀结在内。小便为之不利。故发
黄。雍曰。巢氏所论。即仲景阳明懊 被火二证。及寒湿一证而已。
亦甚略也。言简多不尽意。大抵瘀热在里不解。必为黄。热在膀胱。
亦为黄也。桃枝色者。孙真人云。久则变作桃皮色也。
又巢氏黄病论曰。黄病一身尽痛。发热。面色深黄。七八日后。
热结在里。有血当下。如豚肝状。（庞氏云。有血。抵当汤。狂者。血下
必自愈。）其人少腹满急。若眼睛涩痛。鼻骨疼。两膊及项强。腰背
急。则是黄候。大便涩。但得小便利。则不虑死矣。不用大便多。多则
心腹胀不住。此由寒湿在里。则热蓄于脾胃。腠理不开。瘀热与宿谷
相搏。郁蒸不得消散。则大小便不通。故身体面背变黄色。凡黄候。
其寸口近掌无脉。鼻口气冷。并死不治。
活人书曰。病患寒湿在里不散。热蓄于脾胃。腠理不开。瘀热与
宿谷相搏。郁蒸不消化。故发黄。此皆巢氏之言。惟改一表里字。
又曰。发黄与瘀血。外证及脉俱相似。但小便不利为黄。小便自
利为瘀血。要之发黄之人。心脾蕴积。发热引饮。脉必浮滑而紧数。
若瘀血证发狂。大便必黑。此为异耳。凡病患身体发热。头面汗出。
身无汗。剂颈而止。渴引水浆。小便不利。如此必发黄。茵陈蒿汤、五
苓散加茵陈主之。
又曰。茵陈蒿汤十分。五苓散五分。二药拌匀。每服三钱。温酒
调服。日三服。即以茵陈蒿汤调五苓散服之最良。病患服汤。得小便
利如皂角色赤。一宿腹减。则黄从小便中出也。栀子柏皮汤、麻黄连
翘赤小豆汤。皆可选用。
又曰。伤寒欲发黄者。急用瓜蒂末。口含水。搐一字许入鼻中。
出黄水。甚验。
又曰。太阳病。一身尽痛。发热。身如熏黄者。何也。太阳中湿
也。雍曰。宜五苓散。（太阳下宜有一病字。中湿原本是温字。）
又曰。白虎证与发黄相近。遍身汗出。此为热越。白虎证也。头
面汗出。
颈以下都无汗。发黄证也。雍曰。白虎证遍身汗出。安能发
黄。故仲景言阳明热越。不得发黄也。
雍曰。巢氏黄病一论。未为该通。而诸家伤寒论中多从之。夫致
黄之由非一。或误下。或火熏。皆能成黄。非止寒热谷气而已。大抵寒
邪中人。久不能去。变为热毒。假春风发动表为可出之时。既动则不
可复回。而腠理不开。无由作汗而出。郁而在里。终不能散。淫邪泮
衍。血脉传流。其毒之重者。遇血相搏不能胜。为之变结。或如豚肝。
或如墨色。此为邪气所败之血也。无以泄其邪。则血枯而人死。其轻
者鼓血而上。随衄可出。涩者因促滑气而下。随溺可去。既不能与血
相搏。又不能开腠理而生汗。上不可出。下不可去。乃散于毛窍之际。
已失所舍。而无可定止。进退不能。郁为至黄之色。以待汗与溺而后
通。此毒非不欲出也。犹人之行及门而无路也。医者疏通其道而指示
之。不为汗。则为溺。未有不去之理。然毒在腠理之内。与正气争持。
正邪相窒。毛孔亦不可开。是以不能作汗。必从开窍利小便而出。此
所以毒瓦斯在里不能出者。必成黄血二证。虽轻重上下不同。其理一
也。有可汗而出者乎。曰。脉浮甚者。其表必疏。可汗而出之也。
庞氏曰。孙真人云。凡遇天行热病。多内热发黄。但用瓜丁散纳
鼻中。黄水出乃愈。即后不复病患黄矣。常须谨候病患。四肢身面。
微似有黄气。即速行瓜丁散。不可令散漫失候。必大危矣。特忌酒面
色欲。犯者不治。（瓜丁细辛含水搐一字许千金方三味不同）
张仲景说：脉象浮而动数，医生反而使用攻下法。动数之脉变为迟脉，阳气内陷，心下因此变硬，这就形成了结胸证。如果不形成结胸，只是头部出汗，身体其他部位无汗，汗水仅到颈部为止，小便不通利，身体一定会发黄。常氏说：治疗发黄，可以用茵陈煎煮成浓汁，调服五苓散也可以。郭雍说：凡是黄疸都可用这两种药，病情重的用茵陈蒿汤，病情轻的用五苓散。
又说：伤寒病脉象浮而缓，手足自然温暖，这是病系于太阴经。太阴经受邪的人身体应当发黄，如果小便自利通畅，就不会发黄。治疗应参照阳明病的证候进行。
又说：阳明病，无汗，小便不利，心中烦闷懊恼的，身体一定会发黄。
又说：阳明病，被火疗法治疗后，额头微微出汗，而小便不利的，必定发黄。常氏说：可以给予茵陈汤、五苓散。
又说：阳明病，发热汗出的，这叫热邪向外发散，不会发黄。如果只是头部出汗，身体无汗，汗水仅到颈部为止，小便不利，口渴想喝水浆的，这叫瘀热郁结在体内，身体一定会发黄，适宜用攻下法，以茵陈汤为主治方剂。
又说：伤寒病六七天，身体黄色像橘子色一样，小便不利，腹部轻微胀满的，以茵陈汤为主治方剂。
又说：伤寒病瘀热郁结在体内，身体一定会发黄，以麻黄连翘赤小豆汤为主治方剂。
又说：伤寒病发汗后，身体和眼睛发黄，之所以这样，是因为寒湿在体内的缘故。认为这种情况不可用攻下法，应当在治疗寒湿的方法中寻求对策。常氏说：可用五苓散。
又说：伤寒头痛，发热如羽毛覆盖般温和，形象像中风，误用攻下法，会使心烦加重；误用发汗法，则会导致……（原文缺字）；误用火熏法，则会发黄。郭雍说：治疗应参照不可发汗的证候处理。若已发黄，则用茵陈蒿汤。
又说：阳明病，脉象迟，饮食难以吃饱，饱食后则轻微心烦，头晕目眩，必定小便困难，这是将要发生谷疸。即使使用攻下法，腹部胀满依然如故，之所以这样，是因为脉迟的缘故。常氏说：可用茯苓汤、五苓散。郭雍说：适宜用《千金方》中的谷疸丸。
又说：太阳中风病，用火劫法强行发汗，两阳（风与火）相互熏灼，身体发黄。阳盛则想要鼻衄，阴虚则小便困难，阴阳俱虚竭，身体就会干枯粗糙。只是头部出汗，仅到颈部为止。如果小便通利，这个人还可以治愈。郭雍说：治疗方法参照不可用火疗的证候。身体黄的，用茵陈汤；小便困难的，用五苓散。
又说：寸口脉，阳部浮而阴部濡弱。阳浮则为风邪，阴濡弱为血少。因浮虚受风，血少发热，医生用火熏熨法令其出汗，恶寒于是加重，客热因火而发作，身体因此发黄，小便困难，鼻中出血，医生又误用攻下法，导致热邪瘀结在膀胱，蓄积结成积聚，形状像肝脏。应当攻下而未攻下，导致心神混乱，狂跑甚至投水自尽。如果瘀血得以去除，眼睛明亮，心神安宁。这都是医生造成的失误。病情轻的可以痊愈，病情重的无法治愈。郭雍说：详细的治疗参照不可用火疗的证候。先攻下积血，再治疗身黄和小便困难，治疗方法如同前证。
又说：阳明中风，脉象弦、浮、大且短气，腹部全面胀满，胁下及心痛，久按之气不通畅，鼻干不得汗，嗜睡，全身及面目全部发黄，小便困难。郭雍说：治疗参照阳明病证候。身目黄的，用茵陈蒿汤；小便困难的，用五苓散。
又说：伤寒发热，口中热气勃勃外冒，头痛目黄，鼻衄不止。郭雍说：治疗参照不可攻下的证候。目黄的，按照前面的方法治疗。
又说：得病六七天，脉象迟浮弱，恶风寒，手足温，医生反复二三次的攻下，导致不能进食且胁下满痛，面目及身体发黄，颈项强直，小便困难。郭雍说：治疗参照吐下后的证候。身黄小便难，治疗方法同前法。
《千金方》说：各种黄疸病，适宜通利小便。假如脉浮，应当用汗法解表，适宜用桂枝加黄芪汤。
又说：伤寒病，热邪出于体表，发为黄疸，用麻黄醇酒汤。冬天宜用酒煎，春天宜用水煎。
又说：治疗黄疸，从鼻中取出黄汁，适宜用瓜蒂、赤小豆、秫米研末，名为瓜丁散。
又说：时行病，急黄，以及瘴疠疫气疟疾，适宜用茵陈丸。其余内容见《千金方》第十卷。（现今《千金方》为第三十四卷）
巢元方说：伤寒阳明病，无汗，小便不利，心中懊恼，必定发黄。被火疗后，额头微汗出而小便不利，也发黄。其人黄色像橘子色，或像桃枝色，腹部轻微胀满。这是由于寒湿气不散，瘀热在脾胃所致。又有时气发黄候曰：湿气盛，蓄积于脾胃，脾胃有湿，则新入的水谷郁蒸，不能消化，大小便结涩，所以发黄。又有温病候曰：发汗后病不解，温毒瓦斯瘀结在内，小便因此不利，所以发黄。郭雍说：巢元方所论述的，就是张仲景阳明病懊恼和被火疗两个证候，以及寒湿一个证候罢了。也非常简略。言辞简单多有未尽之意。大抵瘀热在体内不解，必定发黄；热在膀胱，也会发黄。桃枝色，孙真人说：时间久了会变成桃皮色。
又巢元方论黄疸病说：黄疸病一身尽痛，发热，面色深黄，七八日后，热结在体内，有瘀血应当下行，状如猪肝。（庞安常说：有瘀血，用抵当汤；发狂的，瘀血下去必定自愈。）其人小腹满急，如果眼睛涩痛，鼻骨疼，两膊及项强，腰背拘急，这就是黄疸的征候。大便涩滞，只要小便通利，就不用担心死亡了。不需要大便多，多了则心腹胀满不停止。这是由于寒湿在体内，热蓄积于脾胃，腠理不开，瘀热与宿食相搏，郁蒸不得消散，所以大小便不通，因此身体面背变成黄色。凡是黄疸征候，如果寸口近掌处无脉，鼻孔气息冷，都是死证，无法治愈。
《活人书》说：病患寒湿在体内不散，热蓄积于脾胃，腠理不开，瘀热与宿食相搏，郁蒸不消化，所以发黄。这些都是巢元方的言论，只改了一个“表里”字。
又说：发黄与瘀血，外在证候及脉象都相似，但小便不利的是发黄，小便自利的是瘀血。总之，发黄之人，心脾蕴积湿热，发热引饮，脉象必定浮滑而紧数。如果是瘀血证发狂，大便必定黑，这是不同之处。凡是病患身体发热，头面出汗，身体无汗，仅到颈部停止，口渴引饮水浆，小便不利，如此必定发黄，用茵陈蒿汤、五苓散加茵陈主治。
又说：茵陈蒿汤十分，五苓散五分，两种药拌匀，每次服用三钱，用温酒调服，每日三次。即以茵陈蒿汤调服五苓散效果最好。病患服药后，得到的小便颜色像皂角染色的红色，一夜之间腹部减轻，则黄色从小便中排出。栀子柏皮汤、麻黄连翘赤小豆汤，都可以选用。
又说：伤寒病想要发黄的，急忙用瓜蒂末，口含水，搐一字许进入鼻中，流出黄水，非常有效。
又说：太阳病，一身尽痛，发热，身体像熏黄那样，为什么呢？是太阳中湿。郭雍说：适宜用五苓散。（太阳篇下应该有一个“病”字，“中湿”原本是“温”字。）
又说：白虎证与发黄相近，遍身汗出，这叫热邪发散，是白虎证。头面汗出，颈部以下都没有汗，是发黄证。郭雍说：白虎证遍身汗出，怎么能发黄呢？所以张仲景说阳明热越，不得发黄。
郭雍说：巢元方的黄疸病论述，不够全面通达，而各家伤寒论中大多遵从它。导致发黄的原因不止一种，或误用攻下，或火熏，都能造成发黄，不仅仅是寒热谷气而已。大抵寒邪中人，久久不能去除，变为热毒，假借春风发动，表证为可出的时机，既然动了就不能再回去，而腠理不开，没有途径通过汗液排出，郁结在体内，最终不能消散，淫邪蔓延，血脉传流，其中毒性重的，遇到血液相搏不能战胜，为之变结，或像猪肝，或像墨色，这是被邪气败坏的血液。无法排泄邪气，则血枯而死。轻的鼓动血液向上，随鼻衄而出；涩的因促滑之气向下，随尿液而去。既然不能与血相搏，又不能开腠理生汗，上不能出，下不能去，于是散于毛窍之际，已经失去所舍之处，而无可定止，进退不能，郁结成为至黄的颜色，等待汗与尿来疏通。这种毒并非不想出去，就像人走到门口却没有路一样。医生疏通其道并指示出来，不为汗，则为尿，没有不出去的道理。然而毒在腠理之内，与正气争持，正邪相窒，毛孔也不可开，所以不能作汗，必须从开窍利小便而出。这就是毒瓦斯在体内不能出的，必定形成黄、血两种证候。虽然轻重上下不同，道理是一样的。有可以通过汗法排出的吗？回答说：脉浮甚的，其表必疏，可以通过汗法排出。
庞安常说：孙真人说：凡是遇到天行热病，多内热发黄，只用瓜丁散纳入鼻中，黄水出乃愈，之后不再患黄疸。必须经常谨慎观察病患，四肢身面，微似有黄气，就迅速施行瓜丁散，不可令其散漫失掉时机，否则必大危矣。特别忌酒、面食、色欲，犯者不治。（瓜丁散细辛含水搐一字许，《千金方》三味药不同）
Zhang Zhongjing said: The pulse is floating, dynamic, and rapid. If the physician erroneously applies purgation, the dynamic and rapid pulse changes to a slow one. Yang qi sinks inward, causing hardness in the epigastrium, resulting in Jie Xiong (Chest Binding). If Jie Xiong does not form, but there is sweating only on the head with no sweat elsewhere, stopping at the neck, and urination is difficult, jaundice will inevitably occur. Chang Shi stated: For treating jaundice, decoct Yin Chen (Artemisiae Scopariae Herba) into a thick juice and mix it with Wu Ling San (Five-Ingredient Powder with Poria). Guo Yong stated: For all cases of jaundice, both remedies may be used; for severe cases, use Yin Chen Hao Tang (Artemisia Scoparia Decoction); for mild cases, use Wu Ling San.
He also said: In Shang Han (Cold Damage), if the pulse is floating and slow, and the hands and feet are naturally warm, this indicates the disease is related to the Tai Yin (Greater Yin) channel. Patients affected by Tai Yin should develop jaundice; however, if urination is free and easy, jaundice will not occur. Treatment should follow the patterns of Yang Ming (Bright Yang) syndrome.
He also said: In Yang Ming disease, if there is no sweat, urination is difficult, and the patient experiences mental restlessness and distress (Ao Nao), jaundice will inevitably occur.
He also said: In Yang Ming disease, if treated with fire therapy, leading to slight sweating on the forehead but difficulty in urination, jaundice will certainly occur. Chang Shi stated: Yin Chen Tang (Artemisia Decoction) or Wu Ling San may be given.
He also said: In Yang Ming disease, fever accompanied by sweating indicates that heat is venting outward, so jaundice will not occur. However, if there is only sweating on the head, no sweat on the body, stopping at the neck, difficulty in urination, and thirst for fluids, this indicates stagnant heat trapped inside. Jaundice will inevitably occur, and purgation is indicated, primarily using Yin Chen Tang.
He also said: In Shang Han, after six or seven days, if the body is yellow like an orange peel, urination is difficult, and the abdomen is slightly full, treat primarily with Yin Chen Tang.
He also said: For Shang Han presenting with jaundice and fever, treat primarily with Zhi Zi Bai Pi Tang (Gardenia and Phellodendron Bark Decoction).
He also said: For Shang Han with stagnant heat trapped inside, where jaundice inevitably occurs, treat primarily with Ma Huang Lian Qiao Chi Xiao Dou Tang (Ephedra, Forsythia, and Red Bean Decoction).
He also said: After treating Shang Han with diaphoresis, if the body and eyes turn yellow, it is because cold-dampness resides in the interior. This condition should not be treated with purgation; instead, seek treatment within the methods for cold-dampness. Chang Shi stated: Wu Ling San may be used.
He also said: In Shang Han with headache, mild fever resembling wind-stroke, erroneous purgation increases mental distress; erroneous diaphoresis leads to [text missing]; erroneous fire fumigation causes jaundice. Guo Yong stated: Treatment should follow protocols for conditions where diaphoresis is contraindicated. If jaundice has already occurred, use Yin Chen Hao Tang.
He also said: In Yang Ming disease, if the pulse is slow, the patient cannot eat to fullness, feeling slight mental distress and dizziness after eating, and experiencing difficulty in urination, this is about to become Gu Dan (Grain Jaundice). Even if purged, abdominal fullness remains because of the slow pulse. Chang Shi stated: Fu Ling Tang (Poria Decoction) or Wu Ling San may be used. Guo Yong stated: Gu Dan Wan (Grain Jaundice Pill) from *Qian Jin Fang* is appropriate.
He also said: In Tai Yang Wind Strike, if fire coercion is used to induce sweating, the combination of wind and fire scorches the body, causing jaundice. Excess Yang leads to epistaxis; Yin deficiency leads to difficult urination. With both Yin and Yang exhausted, the body becomes dry and rough. There is only head sweating stopping at the neck. If urination is free, the patient can be cured. Guo Yong stated: Treatment follows protocols for conditions where fire therapy is contraindicated. For jaundice, use Yin Chen Tang; for difficult urination, use Wu Ling San.
He also said: At the Cun Kou (inch position) pulse, the Yang aspect is floating and the Yin aspect is soggy and weak. Floating Yang indicates wind; soggy-weak Yin indicates blood deficiency. Due to floating deficiency contracting wind and blood-deficiency fever, if the physician uses fire fumigation to induce sweating, aversion to cold worsens, and pathogenic heat ignites due to fire, causing jaundice, difficult urination, and epistaxis. If the physician then erroneously purges, heat stagnates in the Bladder, forming accumulations resembling the liver. Failure to purge when necessary leads to mental confusion, mania, and running toward water. If blood stasis is removed, vision clears and the mind settles. These errors are caused by physicians. Mild cases recover; severe cases are incurable. Guo Yong stated: Detailed treatment follows protocols for conditions where fire therapy is contraindicated. First purge blood stasis, then treat jaundice and difficult urination as previously described.
He also said: In Yang Ming Wind Strike, if the pulse is wiry, floating, large, accompanied by shortness of breath, generalized abdominal fullness, pain in the hypochondrium and chest, obstruction of Qi upon prolonged pressure, dry nose without sweat, lethargy, generalized jaundice of the body and face, and difficult urination: Guo Yong stated: Treatment follows Yang Ming patterns. For jaundice of the body and eyes, use Yin Chen Hao Tang; for difficult urination, use Wu Ling San.
He also said: In Shang Han with fever, hot air rushing from the mouth, headache, yellow eyes, and uncontrollable epistaxis: Guo Yong stated: Treatment follows protocols for conditions where purgation is contraindicated. For yellow eyes, treat as previously described.
He also said: On the sixth or seventh day of illness, if the pulse is slow, floating, and weak, with aversion to wind and cold, and warm hands and feet, but the physician purges two or three times, leading to inability to eat, fullness and pain in the hypochondrium, jaundice of the face, eyes, and body, stiff neck, and difficult urination: Guo Yong stated: Treatment follows protocols for post-emesis/purgation conditions. For jaundice and difficult urination, treat as previously described.
*Qian Jin Fang* states: For various jaundice diseases, promoting urination is suitable. If the pulse is floating, release via sweating is indicated, preferably Gui Zhi Jia Huang Qi Tang (Astragalus Added to Cinnamon Twig Decoction).
He also said: For Shang Han where heat exits the exterior causing jaundice, use Ma Huang Chun Jiu Tang (Ephedra in Malt Wine Decoction). Use wine in winter and water in spring.
He also said: To treat jaundice, extract yellow fluid from the nose using powder of Gua Di (Thladianthae Fructus), Chi Xiao Dou (Adzuki Bean), and Shu Mi (Broomcorn Millet), named Gua Ding San.
He also said: For epidemic diseases, acute jaundice, and miasma/malaria, use Yin Chen Wan (Artemisia Pill). See Volume 10 of *Qian Jin Fang* (currently Volume 34).
Chao Yuan-fang stated: In Shang Han Yang Ming disease, lack of sweat and difficult urination with mental distress lead to jaundice. Fire therapy causing slight forehead sweating and difficult urination also leads to jaundice. The skin color may be like an orange or peach branch, with slight abdominal fullness. This is due to unresolved cold-dampness and stagnant heat in the Spleen and Stomach. Regarding "Qi Jaundice": excessive dampness accumulates in the Spleen and Stomach; dampness hinders digestion of new food, causing constipation in stool and urine, leading to jaundice. Regarding "Warm Disease": failure to resolve after sweating causes warm toxins to stagnate internally, hindering urination and causing jaundice. Guo Yong stated: Chao’s discussion covers Zhang Zhongjing’s Yang Ming distress/fire therapy patterns and the cold-damp pattern, which is quite brief. Generally, unresolved internal stagnant heat causes jaundice; heat in the Bladder also causes jaundice. Sun Simiao noted that peach-branch color turns into peach-skin color over time.
Chao Yuan-fang further discussed jaundice: Generalized pain, fever, and deep yellow complexion indicate jaundice. After seven or eight days, heat knots internally, requiring blood evacuation resembling pig liver. Pang An-chang noted: For blood stasis, use Di Dang Tang (Water Bug Decoction); for mania, evacuation of blood leads to self-healing. Fullness and urgency in the lower abdomen, sore eyes, nasal bone pain, stiffness in shoulders/neck/back indicate jaundice signs. Constipation is present, but if urination is free, death is avoidable. Excessive stool causes abdominal distension. This is due to internal cold-dampness heating the Spleen/Stomach, closing pores, and stagnant heat clashing with old food, blocking stool and urine, turning the body yellow. If the pulse disappears near the palm and breath from the nose is cold, it is fatal.
*Huo Ren Shu* stated: Unresolved internal cold-dampness heats the Spleen/Stomach, closing pores, clashing with old food, causing jaundice. This echoes Chao Yuan-fang, merely changing "exterior-interior." It also stated: Jaundice and blood stasis have similar external signs and pulses; difficult urination indicates jaundice, while free urination indicates blood stasis. Jaundice patients have accumulated heat in Heart/Spleen, fever, thirst, and a floating-slippery-tight-rapid pulse. Blood stasis mania presents with black stool. For fever, head sweating only, thirst, and difficult urination, use Yin Chen Hao Tang or Wu Ling San added with Yin Chen.
It also stated: Mix Yin Chen Hao Tang (10 parts) and Wu Ling San (5 parts). Take 3 qian with warm wine, three times daily. Mixing Yin Chen Hao Tang with Wu Ling San is best. Effective urination resembling soap-color red reduces abdominal fullness overnight, expelling jaundice via urine. Zhi Zi Bai Pi Tang and Ma Huang Lian Qiao Chi Xiao Dou Tang are also options.
It also stated: For impending jaundice in Shang Han, quickly use Gua Ding powder. Hold water in mouth, insufflate a character's amount into the nose to discharge yellow fluid; this is very effective.
It also stated: Tai Yang disease with generalized pain, fever, and smoky-yellow body indicates Tai Yang Dampness. Guo Yong stated: Use Wu Ling San. ("Zhong Shi" was originally "Wen").
It also stated: Bai Hu (White Tiger) syndrome resembles jaundice. Generalized sweating indicates heat venting (Bai Hu). Head/face sweating only, with no sweat below the neck, indicates jaundice. Guo Yong stated: Bai Hu involves generalized sweating, so jaundice cannot occur. Zhang Zhongjing stated Yang Ming heat venting prevents jaundice.
Guo Yong stated: Chao Yuan-fang’s theory is incomplete, yet widely followed. Jaundice arises from various causes: erroneous purgation or fire fumigation, not just cold-heat/grain issues. Cold pathogens lingering transform into toxic heat. When spring winds move the exterior, if pores do not open, heat cannot sweat out, stagnating internally. Pathogens spread through vessels. Severe toxicity clashes with blood, forming clots like pig liver or ink (defeated blood). Without excretion, blood dries and death ensues. Mild cases vent via epistaxis; sluggish cases exit via urine. Unable to clash with blood or sweat, pathogens scatter in hair follicles, stagnating into yellow color, waiting for sweat/urine to clear. Doctors must guide this path. Internal toxins competing with healthy Qi block pores, preventing sweat, thus exiting via urine/openings. This explains why internal toxins cause jaundice or blood syndromes. For floating pulses indicating loose exterior, sweating is possible.
Pang An-chang stated: Sun Simiao said: Epidemic febrile diseases often cause internal heat jaundice. Use Gua Ding San nasally; discharge of yellow fluid cures it, preventing recurrence. Monitor for slight yellow hue on limbs/face immediately. Avoid alcohol, wheat products, and sexual desire; violation is incurable. (Note: Gua Ding San composition differs in *Qian Jin Fang*).