茵陈蒿末十分 五苓散五分（方见痰饮中）
右二味和，先食饮服方寸匕，日三服。
【集解】
尤怡曰：此正治湿热成疸者之法，茵陈散热郁，五苓利湿瘀也。
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黄疸病，小便色不变，欲自利，腹满而喘，不可除热，热除必哕，哕者小半夏汤主之
。
【注】
黄疸病小盒饭赤，今不赤而白，且欲自利，虽腹满而喘，是湿盛无热，阴黄证也。切
不可除热，若除热以凉药下之，则胃必寒而作哕。哕者主之以小半夏汤，以止哕也。
【集注】
李□曰：小便色不变欲自利，里无实可知，腹满而喘，脾气虚而肺气不利耳！用苦寒
药攻里除热，则胃寒而虚气上逆，故哕，宜小半夏汤散逆止哕。
高世栻曰：小便色不变，非赤也，欲自利，非下利也。若腹满而喘，虽似里实，不可
投寒剂以除热，如大黄硝石汤，不可用也。若投寒剂而除热，则必哕，哕，呃逆也。
半夏生姜辛温散寒，故哕者，当以小半夏汤主之也。
（见痰饮中）
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黄疸之病，当以十八日为期，治之十日以上差，反剧为难治。
【注】
疸病属脾，脾主土，土无定位，寄旺于四季之末，各十八日。期之十八日者，土旺之
日也，政治十日以上当差，而不逾十八日之外也。若逾十八日不差而反剧者，则土衰
矣。故曰：难治。
【集注】
高世栻曰：十八日，乃脾土寄旺于四季之期，十日土之成数也，黄疸之病在于脾土，
故当以十八日为期。然治之宜先，故治之十日以上即当差。至十日以上不差，而疸病
反剧者，是谓难治，谓土气虚败不可治也。
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谷疸之为病，寒热不食，食即头眩，心胸不安，久久发黄为谷疸，茵陈蒿汤主之。
【注】
此详申谷疸之为病也。未成谷疸之时，其人多病寒热，寒热作时，则不能食，寒热止
时，则或能食，虽能食，然食后即头晕目眩，心烦不安，此为湿瘀热郁而内蒸，将作
谷疸之征也。久久身面必发黄，为谷疸矣。宜茵陈蒿汤利下，使从大、小二便而出之
。
茵陈蒿末十分，五苓散五分（方剂见痰饮篇中）。
将上述两味药混合，饭前用温水送服一方寸匕，每日服用三次。
【集解】
尤怡说：这是治疗湿热所致黄疸的正治法，茵陈能疏散热郁，五苓散能通利湿瘀。
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黄疸病，小便颜色没有改变，想要自发性腹泻，腹部胀满且气喘，不可使用清热法，若强行清热必定导致呃逆，呃逆者以小半夏汤主治。
【注】
黄疸病的小便本应赤红，现在不赤而白，且伴有想要自发性腹泻的症状，虽然腹部胀满且气喘，但这是湿气盛而无热的表现，属于阴黄证。切不可使用清热法，如果用凉药攻下除热，则胃气必寒从而引发呃逆。出现呃逆时，以主方小半夏汤来止住呃逆。
【集注】
李□说：小便颜色不变且想要自发性腹泻，可知里无实邪；腹部胀满且气喘，是脾气虚弱而肺气不利所致！若用苦寒药攻里除热，则会导致胃寒和虚气上逆，从而引起呃逆，适宜用小半夏汤来降逆止呃。
高世栻说：小便颜色不变，并非赤色；想要自发性腹泻，并非真正的下利。如果腹部胀满且气喘，虽然看似里实证，但不可投用寒凉药剂来除热，如大黄硝石汤等不可使用。若投用寒凉药剂除热，则必然导致呃逆，呃逆即打嗝。半夏和生姜性辛温可散寒，因此呃逆者，应当以小半夏汤主治。
（见痰饮篇中）
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黄疸病，病程应以十八天为期限，治疗十天后病情好转，若反而加重则难以治愈。
【注】
疸病归属于脾，脾属土，土没有固定的方位，寄旺于四季之末，每个季节的最后十八天。设定十八天为期限，是因为这是土气旺盛的日子，治疗十天后以上应当痊愈，且不应超过十八天之外。如果超过十八天仍未痊愈反而加重，则是土气衰败了。所以说：难以治愈。
【集注】
高世栻说：十八天，是脾土寄旺于四季的周期，十天是土的成数，黄疸病在于脾土，所以应当以十八天为期限。然而治疗应当尽早，所以治疗十天后以上就应当痊愈。到了十天后以上仍未痊愈，而疸病反而加重的，这就叫难治，意思是土气虚败无法治愈。
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谷疸这种病，表现为恶寒发热、不能进食，进食后随即头晕目眩，心胸不安，日久身体发黄即为谷疸，以茵陈蒿汤主治。
【注】
此处详细阐述谷疸的病症。在未形成谷疸之前，患者多患有寒热往来，寒热发作时，则不能进食；寒热停止时，则或许能进食。虽然能进食，但进食后即感到头晕目眩、心烦不安，这是湿邪瘀滞、热邪郁结而在体内蒸腾，即将发生谷疸的征兆。时间久了，身面必然发黄，成为谷疸。适宜用茵陈蒿汤利湿泄热，使邪气从大、小便排出。
Coptidis Rhizoma powder (Yinchen Hao Mo) 10 parts, Wuling San (Five-Ingredient Powder with Poria) 5 parts (formula see in Phlegm-Fluids section).
Mix the above two ingredients. Take one fangcun bi (a square-inch measure) with warm water before meals, three times a day.
[Collected Explanations]
You Yi stated: This is the correct treatment method for jaundice caused by damp-heat. Yinchen disperses heat stagnation, and Wuling San promotes the drainage of dampness stasis.
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In jaundice disease, if the urine color remains unchanged, there is a desire for spontaneous diarrhea, abdominal fullness, and wheezing, heat-clearing methods must not be used. If heat is cleared forcibly, hiccups (yue) will inevitably occur; hiccups are primarily treated with Xiaobanxia Tang (Minor Ginger and Pinellia Decoction).
[Annotation]
In jaundice disease, urine should be reddish; now it is not red but white, and there is a desire for spontaneous diarrhea. Although there is abdominal fullness and wheezing, this indicates abundant dampness without heat, constituting a syndrome of Yin Jaundice. Heat-clearing methods must absolutely not be used. If cool medicines are used to purge and clear heat, the stomach will become cold and cause hiccups. For hiccups, Xiaobanxia Tang is the primary formula to stop them.
[Collected Notes]
Li [Name obscured] said: Unchanged urine color and desire for spontaneous diarrhea indicate no excess pathogen in the interior. Abdominal fullness and wheezing result from Spleen Qi deficiency and impaired Lung Qi movement. Using bitter-cold medicines to attack the interior and clear heat will cause Stomach cold and upward reversal of deficient Qi, leading to hiccups. It is appropriate to use Xiaobanxia Tang to descend rebellious Qi and stop hiccups.
Gao Shishi said: Unchanged urine color means it is not red; desire for spontaneous diarrhea does not mean actual diarrhea. If there is abdominal fullness and wheezing, although it resembles an interior excess syndrome, cold agents to clear heat, such as Dahuang Xiaoshi Tang (Rhubarb and Nitrostone Decoction), must not be administered. If cold agents are used to clear heat, hiccups will inevitably occur; hiccups refer to hiccupping. Pinellia and Fresh Ginger are acrid-warm and disperse cold; therefore, for hiccups, Xiaobanxia Tang should be primarily used.
(See Phlegm-Fluids section)
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For jaundice disease, the duration should be set at eighteen days. If treated for more than ten days and the condition improves, but then worsens, it is difficult to treat.
[Annotation]
Jaundice disease belongs to the Spleen. The Spleen governs Earth. Earth has no fixed position but thrives at the end of each season, specifically the last eighteen days of each season. Setting the limit at eighteen days corresponds to the days when Earth Qi is prosperous. Treatment should lead to recovery within ten or more days, and certainly not beyond eighteen days. If the condition does not improve after eighteen days and instead worsens, it indicates that Earth Qi is declining. Therefore, it is said to be difficult to treat.
[Collected Notes]
Gao Shishi said: Eighteen days is the period when Spleen Earth thrives at the end of the four seasons. Ten is the completed number of Earth. Since jaundice disease resides in Spleen Earth, the duration should be set at eighteen days. However, treatment should be initiated early, so recovery should occur within ten or more days. If, after ten or more days, the condition does not improve and jaundice worsens, it is termed difficult to treat, meaning the Earth Qi is deficient and exhausted, making it incurable.
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The disease of Grain Jaundice (Gu Dan) manifests as aversion to cold and fever, inability to eat, dizziness upon eating, and mental uneasiness in the chest and heart. After a long time, yellowing of the body occurs, which is diagnosed as Grain Jaundice, primarily treated with Yinchenhao Tang (Artemisiae Scopariae Decoction).
[Annotation]
This elaborates on the pathology of Grain Jaundice. Before the formation of Grain Jaundice, patients often suffer from alternating chills and fever. When these symptoms occur, they cannot eat; when they subside, they may be able to eat. Even if they can eat, dizziness and vertigo occur immediately after eating, accompanied by vexation and restlessness. This is a sign that dampness is stagnant and heat is郁 (stagnant), steaming internally, indicating the impending onset of Grain Jaundice. Eventually, the body and face will turn yellow, confirming the diagnosis of Grain Jaundice. Yinchenhao Tang should be used to promote urination and purgation, allowing pathogens to exit through both large and small bowels.