温热在里不能散。蓄积脾中成此患。头面有汗至颈还。渴饮水浆曾莫闲。茵陈五
苓汤
最奇。渗湿除黄功有赞。瘀血之症亦相类。大便必黑此其异。下焦有热或加狂。桃仁须加入
承气。
脾胃有湿热则发黄。黄者、脾胃之色也。此即伤寒瘀热、发黄之症。瘀热即阳黄
也。经曰。阳明病发热汗出。此为热。越则不发黄。若但头汗。身无汗。小便不利。渴饮
水浆。此为痰热在里。必发黄。宜以茵陈蒿汤主之。如初起发者。则以茵陈五苓散主之。亦
有太阳瘀热在里发黄者。此亦为阳黄。宜以麻黄连翘赤小豆汤主之。若身如橘色。小便不利
。腹微满者。亦宜茵陈蒿汤主之。若身黄发热者。则热外出而不内入矣。宜以栀子柏皮汤主
之。亦有寒湿发黄者。身熏黄而色暗。此为阴黄。宜茵陈附子汤主之。亦有瘀血发黄者。小
便利。大便黑。此蓄血症也。宜桃仁承气汤及犀角地黄汤主之。大抵伤寒发黄。与杂症不同。
宜参症治之。经曰。中湿与发黄。不利小便非其治也。
茵陈蒿汤用大黄。浓煎去疸善殴黄。栀子柏皮兼可用。五苓加上又为良。桃仁承气五般
奇。
甘草硝黄并桂枝。血症发黄瘀内结。狂言妄语总相宜。渗湿汤中苍白术。陈皮泽泻猪苓茯。
浓朴香砂甘草同。灯心姜引水煎服。犀角地黄芍药汤。血升胃热火邪干。斑黄汤毒皆堪治。
或益柴苓总伐肝。
湿热之邪蕴结于体内，无法向外发散。湿邪积聚在脾脏中，从而引发此病。患者表现为头面部出汗，但汗止于颈部以下，身体无汗；口渴想喝水浆，却因小便不利而难以缓解。茵陈五苓汤对此症疗效奇特，具有渗利湿气、消除黄疸的显著功效。
瘀血导致的发黄症状与此类似，但其区别在于大便颜色必定发黑。若下焦有热邪，患者可能出现神志狂乱的症状，此时需在方剂中加入桃仁，配合承气汤使用。
脾胃若有湿热蕴结，就会导致发黄。黄色是脾胃的本色。这就是伤寒中瘀热内蕴导致发黄的病症。“瘀热”即指“阳黄”。《内经》记载：阳明病出现发热、汗出，这是热邪外越的表现，因此不会发黄。如果只有头部出汗，身上无汗，且小便不通利，口渴想喝水浆，这是痰热蕴结在里的表现，必然会导致发黄，适宜用茵陈蒿汤主治。如果是疾病初起时出现的发黄，则适宜用茵陈五苓散主治。也有太阳经瘀热蕴结在里导致发黄的，这也属于阳黄，适宜用麻黄连翘赤小豆汤主治。如果全身皮肤像橘子皮一样颜色鲜黄，伴有小便不利、腹部轻微胀满，也适宜用茵陈蒿汤主治。如果身体发黄且伴有发热，说明热邪向外发散而不向内深入，适宜用栀子柏皮汤主治。也有因寒湿导致的发黄，肤色熏黄且色泽晦暗，这属于“阴黄”，适宜用茵陈附子汤主治。也有因瘀血导致的发黄，表现为小便通利、大便发黑，这是蓄血证，适宜用桃仁承气汤及犀角地黄汤主治。大抵而言，伤寒引起的发黄与杂病引起的发黄不同，应当结合具体症状进行治疗。《内经》说：治疗中湿和发黄，如果不通过利小便来祛湿，就不是正确的治法。
茵陈蒿汤中含有大黄，浓煎服用能有效祛除黄疸并止呕。栀子柏皮汤也可兼用。在五苓散基础上加上茵陈，效果更佳。桃仁承气汤由五种药材组成，极为奇妙，包含甘草、芒硝、大黄和桂枝。对于因血症瘀血内结导致的发黄，以及出现胡言乱语等症状，都非常适宜。渗湿汤（此处指茵陈五苓散或相关化裁方）中含有苍术、白术、陈皮、泽泻、猪苓、茯苓、厚朴、香附、砂仁、甘草等，以灯心草和生姜为引，水煎服。犀角地黄汤含有芍药，适用于血热上冲、胃火炽盛、热邪干扰的情况，斑疹和黄痘等热毒病症皆可治疗，有时也可加入柴胡和五苓散以疏肝泄热。
Heat and dampness pathogens accumulate internally and cannot dissipate. Accumulation in the Spleen gives rise to this affliction. Sweat appears on the head and face but stops at the neck; thirst for fluids exists, yet relief is hindered by urinary difficulty. Yinchen Wuling Tang (Coptis and Atractylodes Macrocephala Decoction with Five Ingredients) is most remarkable, assisting in promoting diuresis to remove dampness and jaundice.
The manifestation of jaundice caused by blood stasis is similar, but the distinguishing feature is that the stool must be black. If there is heat in the Lower Jiao, madness may occur; in such cases, Tao Ren (Peach Kernel) should be added to Chengqi Tang (Major Order the Qi Decoction).
When damp-heat accumulates in the Spleen and Stomach, jaundice ensues. Yellow is the color of the Spleen and Stomach. This is the syndrome of jaundice caused by stagnant heat in Shaoyang diseases. "Stagnant heat" refers to Yang Jaundice. The Classics state: In Yangming disease, if there is fever and sweating, this indicates heat escaping outward, so jaundice will not develop. However, if there is only sweat on the head, no sweat on the body, urinary difficulty, and thirst for drinking, this indicates phlegm-heat accumulating internally, which inevitably leads to jaundice. It is appropriate to treat with Yinchen Hao Tang (Artemisiae Scopariae Decoction). If jaundice appears at the onset, Yichen Wuling San (Coptis and Atractylodes Macrocephala Powder with Five Ingredients) is appropriate. There are also cases where stagnant heat from the Taiyang channel accumulates internally causing jaundice; this is also Yang Jaundice, treated with Mahuang Lianqiao Chixiaodou Tang (Ephedra, Forsythia, and Red Bean Decoction). If the body resembles the color of an orange, accompanied by urinary difficulty and slight abdominal fullness, Yinchen Hao Tang is also appropriate. If the body is yellow with fever, it indicates heat moving outward rather than inward; Zhizi Bopi Tang (Gardenia and Phellodendron Bark Decoction) is appropriate. There are also cases of jaundice due to cold-dampness, where the skin is smoked-yellow and dark in color; this is Yin Jaundice, treated with Yinchen Fuzi Tang (Coptis and Aconite Decoction). There are also cases of jaundice due to blood stasis, characterized by free urination and black stools; this is Blood Accumulation Syndrome, treated with Tao Ren Chengqi Tang (Peach Kernel and Major Order the Qi Decoction) and Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction). Generally, jaundice in Shaoyang diseases differs from miscellaneous disorders; treatment should be based on specific symptoms. The Classics state: For treating dampness and jaundice, failing to promote urination is not the correct method.
Yinchen Hao Tang uses Dahuang (Rhubarb); decocting it thickly effectively removes jaundice and stops vomiting. Zhizi Bipi Tang can also be used concurrently. Adding Yinchen to Wuling San improves efficacy. Tao Ren Chengqi Tang consists of five unique ingredients: Gancao (Licorice), Xiaoshuang (Mirabilite), Dahuang (Rhubarb), and Guizhi (Cinnamon Twig). For jaundice caused by blood stasis accumulation, or accompanied by delirious speech, this formula is suitable. Shen Shi Tang (Dampness Percolating Decoction) contains Cangzhu (Atractylodes Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), Chenpi (Tangerine Peel), Zexie (Alisma), Zhuling (Polyporus), Fuling (Poria), Houpo (Magnolia Bark), Xiangfu (Cyperus Rhizome), Sharen (Amomum Fruit), and Gancao (Licorice); decoct with Dengxincao (Juncus Effusus) and Shengjiang (Fresh Ginger) as guides. Xijiao Dihuang Shaoyao Tang contains Shaoyao (Peony Root); it treats conditions where blood rises due to stomach fire and heat pathogens interfering, including macules, jaundice, and toxin accumulation. Sometimes, Chaihu (Bupleurum) and Wuling San are added to regulate the Liver.