2.疸过十日而反剧, 色若烟熏目暗青, 喘满渴烦如啖蒜, 面黧汗冷
及天行.
【注】仲景曰: 黄疸之病, 当以十八日为期, 治之十日上宜瘥, 反剧
为难治也. 色若烟熏, 目神暗青, 阳黄死证也. 面色黧黑, 喘满渴烦
不己, 心胸如啖蒜刺痛, 黄毒入腹, 死证也. 面色黧黑, 冷汗????,
阴黄死证也. 天行疫疠发黄, 名曰瘟黄, 死人最暴也.
麻黄茵陈醇酒汤 茵陈蒿汤 栀子柏皮汤茵陈五苓散
3.表实麻黄茵陈酒, 里实茵陈栀大黄, 无证茵陈栀子柏, 尿少茵陈
五苓汤.
【注】诸疸表实无汗者, 以麻黄, 茵陈, 无灰好酒煎服汗之. 里实不
便,以茵陈, 栀子, 大黄下之. 无表里证, 以茵陈, 栀子, 柏皮清之
.小便短少, 以茵陈五苓散利之.
胃疸汤
4.谷疸热实宜乎下, 不实宜用胃疸汤, 茵陈胃苓减草朴, 连栀防己
葛秦方.
【注】胃疸汤, 即茵陈, 苍术, 陈皮, 白术, 茯苓, 猪苓, 泽泻, 黄
连,栀子, 防己, 葛根, 秦艽也.
茵陈解酲汤 栀子大黄汤 蔓菁散 加味玉屏风散
5.酒疸虚茵解酲汤, 实用栀鼓枳大黄, 黄汗一味蔓菁散, 石膏茵陈
耆术防.
【注】酒疸虚者, 用茵陈解酲汤, 即葛花解酲汤加茵陈也. 实者, 用
栀子大黄汤, 即栀子, 淡豆豉, 枳实, 大黄也. 黄汗宜用蔓菁子一味
,为细末, 每服二钱, 日三, 井华水调服, 小便白则愈. 或用加味玉
屏风散, 即石膏, 茵陈, 黄耆, 白术, 防风也.
石膏散 肾疸汤
6.女劳实者膏滑麦, 女劳虚者肾疸医, 升阳散火减去芍, 加芩柏麴
四苓俱.
【注】石膏散, 即?? 石膏, 飞滑石各等分, 每服二钱, 大麦汤调服.
肾疸汤, 即升阳散火汤减去芍药, 乃升麻, 苍术, 防风, 独活, 柴胡
,羌活, 葛根, 人参, 甘草, 加入黄芩, 黄柏, 神麴, 白术, 茯苓,
猪苓, 泽泻也.
2. 黄疸病超过十天反而加重,面色像烟熏一样晦暗,眼神昏暗发青,气喘胸满,口渴心烦,感觉心胸刺痛如同吃了大蒜一般,面色黧黑,冷汗淋漓,以及感受时行疫气发黄。
【注】张仲景说:黄疸病,应当以十八天为期限,治疗十天左右应该痊愈,如果反而加重,就难以治愈了。面色像烟熏一样,眼神昏暗发青,是阳黄的死证。面色黧黑,气喘胸满、口渴心烦不止,心胸像吃了大蒜一样刺痛,这是黄毒进入腹部,属于死证。面色黧黑,出冷汗,是阴黄的死证。感受时行疫气而发黄,称为瘟黄,死亡最为迅速猛烈。
麻黄茵陈醇酒汤 茵陈蒿汤 栀子柏皮汤 茵陈五苓散
3. 表实无汗用麻黄茵陈酒,里实便秘用茵陈栀大黄,无表里证用茵陈栀子柏皮,小便少用茵陈五苓汤。
【注】各种黄疸若表实无汗的,用麻黄、茵陈,用没有灰渣的好酒煎服,通过发汗来治疗。里实不便秘的,用茵陈、栀子、大黄通过泻下来治疗。没有表证和里证的,用茵陈、栀子、柏皮清热治疗。小便短少的,用茵陈五苓散利水渗湿治疗。
胃疸汤
4. 谷疸热实证适宜用下法,非实证适宜用胃疸汤,胃疸汤由茵陈、胃苓汤减去甘草、厚朴,加上黄连、栀子、防己、葛根、秦艽组成。
【注】胃疸汤,就是茵陈、苍术、陈皮、白术、茯苓、猪苓、泽泻、黄连、栀子、防己、葛根、秦艽。
茵陈解酲汤 栀子大黄汤 蔓菁散 加味玉屏风散
5. 酒疸虚证用茵陈解酲汤,实证用栀子大黄汤加枳实,黄汗单用一味蔓菁散,(黄汗)用石膏、茵陈、黄芪、白术、防风。
【注】酒疸虚证的,用茵陈解酲汤,也就是葛花解酲汤加入茵陈。实证的,用栀子大黄汤,也就是栀子、淡豆豉、枳实、大黄。黄汗适宜用蔓菁子一味药,研成细末,每次服用二钱,每天三次,用清晨第一次井水调服,小便变白就好了。或者使用加味玉屏风散,也就是石膏、茵陈、黄芪、白术、防风。
石膏散 肾疸汤
6. 女劳疸实证用石膏滑石大麦,女劳疸虚证用肾疸汤治疗,升阳散火汤减去芍药,加入黄芩、黄柏、神曲、四苓散全部药物。
【注】石膏散,就是石膏、飞滑石各等分,每次服用二钱,用大麦汤调服。肾疸汤,就是升阳散火汤减去芍药,乃升麻、苍术、防风、独活、柴胡、羌活、葛根、人参、甘草,加入黄芩、黄柏、神曲、白术、茯苓、猪苓、泽泻。
2. If jaundice persists for more than ten days and the condition worsens, with a complexion resembling smoke-stained darkness, dull and bluish eyes, wheezing and chest fullness, thirst, restlessness, and a sensation of heart pain as if consuming garlic, darkened complexion, and cold sweating, or if it is caused by epidemic pathogens causing yellowing, these are critical signs.
[Note] Zhang Zhongjing stated: For jaundice disease, eighteen days should be taken as the prognosis period; treatment within ten days should lead to recovery. If the condition worsens instead, it is difficult to treat. A complexion resembling smoke-stained darkness and dull, bluish eyes indicate a fatal syndrome of Yang Jaundice (Yang Huang). Darkened complexion, persistent wheezing, chest fullness, thirst, and restlessness, along with heart pain resembling the stinging sensation after eating garlic, indicate that the jaundice toxin has entered the abdomen, which is a fatal syndrome. Darkened complexion accompanied by cold sweating indicates a fatal syndrome of Yin Jaundice (Yin Huang). Yellowing caused by epidemic pathogens is called Plague Jaundice (Wen Huang), which causes death most rapidly and violently.
Mahuang Yinchen Chunjiu Tang (Ephedra and Artemisia Decoction in Mellow Wine) Yinchenshao Tang (Artemisia Decoction with Coptis and Rhubarb) Zhizi Bopi Tang (Gardenia and Phellodendron Bark Decoction) Yinchen Wuling San (Artemisia and Five-Ingredient Powder with Poria)
3. For exterior excess with no sweating, use Mahuang Yinchen Jiu (Ephedra and Artemisia in Wine); for interior excess with constipation, use Yinchen Zhi Dahuang (Artemisia, Gardenia, and Rhubarb); for cases without exterior or interior syndromes, use Yinchen Zhizi Bopi (Artemisia, Gardenia, and Phellodendron Bark); for scanty urination, use Yinchen Wuling Tang (Artemisia and Five-Ingredient Powder with Poria Decoction).
[Note] For various types of jaundice presenting with exterior excess and no sweating, decoct Ephedrae Herba (Mahuang, 麻黄) and Yinchen Hao (Artemisiae Scopariae Herba, 茵陈蒿) in good wine free of dregs, and administer to induce sweating. For interior excess with constipation, administer Artemisiae Scopariae Herba (Yinchen, 茵陈), Gardeniae Fructus (Zhizi, 栀子), and Rhei Radix et Rhizoma (Dahuang, 大黄) to purge downward. For cases lacking both exterior and interior syndromes, clear heat using Artemisiae Scopariae Herba (Yinchen, 茵陈), Gardeniae Fructus (Zhizi, 栀子), and Phellodendri Cortex (Bapi, 柏皮). For scanty urination, promote diuresis using Yinchen Wuling San (Artemisia and Five-Ingredient Powder with Poria).
Weidanz Tang (Stomach Jaundice Decoction)
4. For Grain Jaundice (Gu Dan) with heat-excess, purgation is appropriate; for non-excess patterns, Weidanz Tang (Stomach Jaundice Decoction) is indicated. This formula consists of Yinchen Wuling San (Artemisia and Five-Ingredient Powder with Poria) minus Gancao (Licorice Root) and Houpo (Magnolia Bark), plus Lianzuo (Coptidis Rhizoma, 黄连), Zhizi (Gardeniae Fructus, 栀子), Fangji (Stephaniae Tetrandrae Radix, 防己), Gegen (Puerariae Radix, 葛根), and Qinjiao (Gentianae Macrophyllae Radix, 秦艽).
[Note] Weidanz Tang (Stomach Jaundice Decoction) comprises Artemisiae Scopariae Herba (Yinchen, 茵陈), Atractylodis Rhizoma (Cangzhu, 苍术), Citri Reticulatae Pericarpium (Chenpi, 陈皮), Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), Poria (Fuling, 茯苓), Polyporus (Zuling, 猪苓), Alismatis Rhizoma (Zexie, 泽泻), Coptidis Rhizoma (Lianzuo, 黄连), Gardeniae Fructus (Zhizi, 栀子), Stephaniae Tetrandrae Radix (Fangji, 防己), Puerariae Radix (Gegen, 葛根), and Gentianae Macrophyllae Radix (Qinjiao, 秦艽).
Yinchen Jiecheng Tang (Artemisia Relieving Intoxication Decoction) Zhizi Dahuang Tang (Gardenia and Rhubarb Decoction) Manjing San (Brassica Seed Powder) Jiawei Yupingfeng San (Modified Jade Windscreen Powder)
5. For alcoholic jaundice with deficiency, use Yinchen Jiecheng Tang (Artemisia Relieving Intoxication Decoction); for excess, use Zhizi Dahuang Tang (Gardenia and Rhubarb Decoction) with Zhishi (Immature Bitter Orange). For Yellow Sweat, use a single herb, Manjingzi (Brassicae Semen, 蔓菁子), ground into fine powder, two qian per dose, three times daily, taken with well water drawn at dawn; recovery is indicated when urine turns white. Alternatively, use Jiawei Yupingfeng San (Modified Jade Windscreen Powder), consisting of Shigao (Gypsum Fibrosum, 石膏), Yinchen (Artemisiae Scopariae Herba, 茵陈), Huangqi (Astragali Radix, 黄芪), Baizhu (Atractylodis Macrocephalae Rhizoma, 白术), and Fangfeng (Saposhnikoviae Radix, 防风).
[Note] For alcoholic jaundice with deficiency, use Yinchen Jiecheng Tang (Artemisia Relieving Intoxication Decoction), which is Gehua Jiecheng Tang (Pueraria Flower Relieving Intoxication Decoction) plus Artemisiae Scopariae Herba (Yinchen, 茵陈). For excess patterns, use Zhizi Dahuang Tang (Gardenia and Rhubarb Decoction), comprising Gardeniae Fructus (Zhizi, 栀子), Sojae Preparata Semen (Danshi, 淡豆豉), Aurantii Immaturus Fructus (Zhishi, 枳实), and Rhei Radix et Rhizoma (Dahuang, 大黄). Yellow sweat is best treated with Brassicae Semen (Manjingzi, 蔓菁子) alone, ground into fine powder, administered two qian per dose, three times daily, mixed with well water drawn at dawn; healing occurs when urine becomes white. One may also use Jiawei Yupingfeng San (Modified Jade Windscreen Powder), composed of Gypsum Fibrosum (Shigao, 石膏), Artemisiae Scopariae Herba (Yinchen, 茵陈), Astragali Radix (Huangqi, 黄芪), Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), and Saposhnikoviae Radix (Fangfeng, 防风).
Shigao San (Gypsum Powder) Shendan Tang (Kidney Jaundice Decoction)
6. For Kidney Jaundice (Nü Lao Dan) with excess, use Shigao San (Gypsum Powder) with Huashi (Talcum) and Damai (Hordeum Vulgare); for Kidney Jaundice with deficiency, treat with Shendan Tang (Kidney Jaundice Decoction). The latter is derived from Shengyang Sanhuo Tang (Ascending Yang and Dispersing Fire Decoction) minus Shaoyao (Paeoniae Radix), adding Huangqin (Scutellariae Radix, 黄芩), Huangbai (Phellodendri Cortex, 黄柏), Shenqu (Medicated Leaven), and all components of Siling San (Four-Ingredient Powder with Poria).
[Note] Shigao San (Gypsum Powder) consists of equal parts Gypsum Fibrosum (Shigao, 石膏) and Talcum (Fei Huashi, 飞滑石), two qian per dose, taken with Hordeum Vulgare (Damai, 大麦) decoction. Shendan Tang (Kidney Jaundice Decoction) is Shengyang Sanhuo Tang (Ascending Yang and Dispersing Fire Decoction) minus Paeoniae Radix (Shaoyao, 芍药), comprising Cimicifugae Rhizoma (Shengma, 升麻), Atractylodis Rhizoma (Cangzhu, 苍术), Saposhnikoviae Radix (Fangfeng, 防风), Angelicae Dahuricae Radix (Duohuo, 独活), Bupleuri Radix (Chaihu, 柴胡), Notopterygii Rhizoma et Radix (Qianghuo, 羌活), Puerariae Radix (Gegen, 葛根), Ginseng Radix (Renshen, 人参), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), plus Scutellariae Radix (Huangqin, 黄芩), Phellodendri Cortex (Huangbai, 黄柏), Medicated Leaven (Shenqu, 神曲), Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), Poria (Fuling, 茯苓), Polyporus (Zuling, 猪苓), and Alismatis Rhizoma (Zexie, 泽泻).