栀子十四枚 大黄一两 枳实五枚 豉一升
右四味，以水六升，煮取三升，分温二服。
【集解】
魏荔彤曰：酒黄疸，心中懊□或热甚而痛，栀子大黄汤主之，盖为实热之邪立法也。
酒家积郁成热，非此不除也。
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酒疸下之，久久为黑疸，目青面黑，心中如啖蒜齑状，大便正黑，皮肤抓之不仁，其
脉浮弱，虽黑微黄，故知之。
【注】
酒疸，心中懊□，或心中热痛，脉沉实者，当下之。若心中热欲吐，脉浮弱者，当吐
之，而反下之则为逆也。若其人素有劳倦，下之则热入于脾，顷时腹满如故，则成谷
疸也。若其人素有女劳，下之则热入于肾，虽黄微黑，久久必变为黑疸也。目青者精
伤也，面黑者肾伤也，心中如啖蒜齑状胃伤也，大便黑色血伤也，皮肤不仁血痹也，
此等证皆因酒疸，脉浮弱者，应吐而反下之之误使然也。
【集注】
赵良曰：酒疸之黑，非女劳疸之黑也，盖女劳之黑，肾气所发也；酒疸之黑，败血之
黑也。因酒之湿热伤脾胃，脾胃不和，阳气不化，阴气不运，若更下之，久久则运化
之用愈耗矣。气耗血积故腐瘀，浊色越出面为黑，味变于心咽作嘈杂，心辣如啖蒜齑
状。荣血衰而不行于皮肤，抓之不仁，输于大肠，便如黑漆，其目青与脉浮弦，皆血
病也。
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诸黄，猪膏发煎主之。
【按】
诸黄，谓一切黄也。皆主猪膏发煎，恐未必尽然。医者审之，此必有脱简也。
【集注】
程林曰：扁鹊有『黄经』、『明堂』有烙三十六黄法，皆后人所未见，唯『圣济总录
』载三十六黄，方论详明，治法始备。今猪膏发煎，能治诸黄，当是黄之轻者，可从
小便而去，至若阴黄、急黄、女劳之属，岂猪膏发煎所能治乎？医者审之。
栀子十四枚，大黄一两，枳实五枚，豆豉一升。
以上四味药，用水六升，煎煮至三升，分两次温服。
【集解】
魏荔彤说：酒黄疸（因饮酒过度导致的黄疸），心中烦闷不适或热盛而疼痛，用栀子大黄汤主治，这是针对实热之邪设立的治法。
嗜酒之人积郁化热，不用此方不能消除。
@@@
酒疸若误用攻下法治疗，日久会变成黑疸，表现为眼睛周围发青、面色发黑，心中感觉像吃了蒜泥一样辛辣难受，大便颜色正黑，皮肤麻木抓之不痛，脉象浮而弱，虽然肤色黑但隐约可见黄色，因此可以据此判断。
【注】
酒疸，心中烦闷不适，或心中热痛，脉象沉实的，应当用攻下法。如果心中热且想呕吐，脉象浮弱的，应当用催吐法，反而使用攻下法就是逆治错误。如果其人素来有劳倦内伤，误用攻下法则热邪陷入脾脏，片刻后腹部依然胀满，就会形成谷疸（因饮食不节导致的黄疸）。如果其人素来有房劳过度，误用攻下法则热邪陷入肾脏，虽然黄色中微带黑色，日久必定变成黑疸。眼睛发青是精气受伤的表现，面色发黑是肾脏受伤的表现，心中感觉像吃了蒜泥是胃受伤的表现，大便黑色是血液受伤的表现，皮肤麻木不仁是血痹的表现，这些证候都是因为酒疸脉象浮弱时，本应催吐却反而误用攻下法造成的错误所致。
【集注】
赵良说：酒疸的黑，不同于女劳疸（因房劳过度导致的黄疸）的黑。大概女劳疸的黑，是肾气病变发出的；酒疸的黑，是败坏瘀血的黑。因为酒的湿热损伤脾胃，导致脾胃不和，阳气不能运化，阴气不能运行，如果再误用攻下法，日久则运化功能更加耗损。气耗血积故而生腐瘀，浊色外现面部则发黑，气味变化于心咽部产生嘈杂感，心中火辣辣的感觉像吃了蒜泥一样。营血衰少而不能运行于皮肤，所以抓之不痛，流注于大肠，大便如黑漆一般，眼睛发青和脉象浮弦，都是血病的表现。
【按】
“诸黄”，指一切类型的黄疸。都说用猪膏发煎主治，恐怕未必完全正确。医生们需谨慎审察，这里一定有脱漏的简文。
【集注】
程林说：扁鹊有《黄经》，《明堂》中有烙治三十六黄的疗法，都是后人未能见到的，只有《圣济总录》记载了三十六黄，方论详细明确，治疗方法才完备。如今猪膏发煎能治疗各种黄疸，应当是指病情较轻的黄疸，可以通过小便排出；至于阴黄、急黄、女劳疸等类型，难道是猪膏发煎所能治疗的吗？医生们需谨慎审察。
Zhi Zi (Fructus Gardeniae) fourteen pieces, Da Huang (Radix et Rhizoma Rhei), one tael, Zhi Shi (Fructus Aurantii Immaturus), five pieces, Chi Xiao Dou (Faber Semen Preparatum), one sheng.
The above four ingredients are boiled in six sheng of water until three sheng remain; divide into two warm doses.
[Collected Explanations]
Wei Litong states: For Jiu Huang Dan (Alcohol-induced Jaundice), characterized by Xin Zhong Ao Nao (mental restlessness and discomfort) or severe heat with pain, Zhi Zi Da Huang Tang (Gardenia and Rhubarb Decoction) is the primary treatment. This formula is established to address pathogenic excess-heat.
For individuals habitually consuming alcohol, accumulation and stagnation transform into heat; without this formula, it cannot be eliminated.
@@@
If Jiu Huang Dan is incorrectly treated with purgation, over time it may transform into Hei Dan (Black Jaundice). Symptoms include bluish eyes, black complexion, a sensation in the heart as if eating minced garlic, normal black stool, skin numbness where scratching does not elicit pain, a floating and weak pulse, and although the complexion is black, a faint yellow hue remains, allowing for identification.
[Annotation]
In Jiu Huang Dan, if there is mental restlessness or heat-pain in the heart with a deep and solid pulse, purgation should be employed. If there is heat in the heart accompanied by the desire to vomit, with a floating and weak pulse, emesis should be employed; conversely using purgation constitutes an erroneous counter-treatment. If the patient has a history of physical exhaustion, purgation causes heat to enter the Spleen; shortly thereafter, abdominal fullness persists, resulting in Gu Huang Dan (Grain-induced Jaundice). If the patient has a history of sexual exhaustion, purgation causes heat to enter the Kidney; although the yellowing is slightly black, over time it will inevitably transform into Hei Dan (Black Jaundice). Bluish eyes indicate injury to essence; black complexion indicates injury to the Kidney; the sensation of eating minced garlic indicates injury to the Stomach; black stool indicates injury to blood; skin numbness indicates Blood Bi (Blood Stasis obstruction); these syndromes are all caused by the error of applying purgation instead of emesis when the pulse of Jiu Huang Dan is floating and weak.
[Collected Notes]
Zhao Liang states: The blackness of Jiu Huang Dan differs from that of Nu Lao Dan (Sexual Exhaustion Jaundice). The blackness of Nu Lao Dan originates from Kidney Qi pathology; the blackness of Jiu Huang Dan stems from corrupted and stagnant blood. Alcohol-damp-heat injures the Spleen and Stomach, causing disharmony where Yang Qi fails to transform and Yin Qi fails to circulate. Further incorrect purgation depletes transformation and transportation functions. Qi depletion and blood stasis lead to corruption and瘀 (stasis); turbid colors manifest on the face as black; flavors change in the heart and throat causing zao za (discomfort and hunger pangs), with a burning sensation in the heart like eating minced garlic. Ying Blood (Nutritive Blood) declines and fails to circulate to the skin, causing numbness upon scratching; it flows into the Large Intestine, making stool black as lacquer. Bluish eyes and a floating, wiry pulse are both manifestations of Blood pathology.
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For various types of jaundice, Zhu Gao Fa Jian (Pig Fat and Hair Decoction) is indicated.
[Commentary]
"Various jaundices" refers to all types of jaundice. To claim that Zhu Gao Fa Jian treats all cases is likely not entirely accurate. Physicians must examine this carefully; there must be missing text here.
[Collected Notes]
Cheng Lin states: Bian Que had the "Huang Jing" (Classic of Jaundice), and the "Ming Tang" contains methods for cauterizing thirty-six types of jaundice, which are unseen by later generations. Only the "Sheng Ji Zong Lu" records thirty-six jaundices, with detailed formulas and theories, making treatments complete. That Zhu Gao Fa Jian can treat various jaundices likely applies only to mild cases, which can be expelled via urination. As for Yin Huang (Yin-type Jaundice), Ji Huang (Acute Jaundice), and Nu Lao Dan, can they truly be treated by Zhu Gao Fa Jian? Physicians must examine this carefully.