茵陈（二两） 附子（一枚） 干姜（一两半） 炙甘草（一两）
发黄，脉沉而迟，肢体冷逆，腰以上自汗者，此方冷服。
此阴证发黄也。阴寒盛于下，则戴阳于上，故上体见阳证，下体见阴证。阴盛于下，故
见阴脉之沉迟，兼阴证之四逆，阳戴于上，故见阳证之发黄，上体之自汗也。茵陈，治黄之
要药，故无分于寒热而用之。附子、干姜、炙甘草，回阳之要品也，故有阴寒即用之。然必
冷服者，恐姜、附发于上焦阳盛之区，而下部阴寒之分反不及也。是方也，韩祗和、李思训、
朱奉议咸用之矣，使据丹溪翁不必分五，同是湿热之言，而执其方以疗之，则药与证不相反
耶？韩、李事见《汤液本草》，朱奉议见《活人书》。
硝石 矾石（烧，等分）
二共为末，大麦粥汤和服方寸匕，日三。
仲景《金匮要略》云∶黄家日晡所发热，而反恶寒，此为女劳疸。得之膀胱急，小腹
满，额上黑，足下热，因作黑疸。其腹胀如水状，大便必黑，时溏，此女劳之病，非水也。
腹满者难治。此方主之。
阳邪传至于胃，热无以越，土色自见而发黄，则日晡所必发热。所以然者，土位旺于日
晡故也。今反恶寒，则知其以女劳虚之矣。女劳虚者，责之肾。膀胱者，肾之腑。前阴者，
肾之窍。肾虚而阳邪袭之，故令膀胱急，小腹满。黑者，北方肾水之色，额上黑者，肾病而
色自见也。足下热者，肾脉起于涌泉，肾水一虚，则相火凑之，故足下热也。因作黑疸者，
阳邪尽陷于肾，而肾色尽显于外也。腹胀者，肾脉行于腹里，邪气居之，故令胀如水状，实
非水也。若是水病，则大便澄澈而濡泻。今是肾病，故大便必黑而时溏。盖肾主二便，病故
黑溏而失其常也。此可以辨其为女劳之病，而非水矣。腹满难治者，腹满与腹胀不同，腹胀
是肾脉行于腹，故令胀于外。腹满是脾胃受邪，不能健运，而满于中也。脾胃属土，能克肾
水，故曰难治。硝石、矾石，咸寒者也，咸能入肾，寒能胜热，故以二物主之。和以大麦粥
汤者，恐二物之损胃也。呜呼！仲景公说证立方，精良曲当，大都如此，譬之选将练兵，知
人善任，则万举万当，罔不奏功。彼用方不合证者，譬则出师无名。用药不知性者，譬则将
不知兵，其不丧师辱国者鲜矣，恶乎建功？
出现身目发黄，脉象沉而迟缓，四肢冰冷逆冷，腰部以上自然出汗的症状，此方需冷服。
这是阴证发黄。阴寒之邪盛于下部，导致虚阳浮越于上部，所以上半身表现为阳证，下半身表现为阴证。阴寒盛于下部，所以出现阴脉的沉迟，兼有阴证的四肢厥逆；虚阳浮越于上，所以出现阳证的身黄，以及上半身的自汗。茵陈是治疗黄疸的要药，因此不分寒热均可使用。附子、干姜、炙甘草是回阳救逆的重要药物，所以只要有阴寒之证就使用它们。然而必须冷服的原因，是担心姜、附子的辛热之性发散于上焦阳盛的区域，而导致下部的阴寒分位反而得不到温煦。这个方剂，韩祗和、李思训、朱肱都曾经使用过，如果依据丹溪翁“不必分五（行），同是湿热”的说法，执着于此方来治疗，那么药物与证候不是相反了吗？韩、李的事迹见于《汤液本草》，朱肱的事迹见于《活人书》。
将二者共研为细末，用大麦粥汤调和服用一方寸匕，每日三次。
张仲景在《金匮要略》中说：黄疸病患者通常在傍晚时分发热，却反而恶寒，这称为女劳疸。这是由于房劳过度损伤肾精所致，伴有膀胱拘急，小腹胀满，额头色黑，足心发热，因而形成黑疸。如果腹部胀大像有水状，大便必然发黑，时而稀溏，这是女劳疸的病，不是水气病。腹部胀满的难以治疗。此方主治。
阳邪传入胃中，热邪无法向外透越，脾土之色外露而发黄，所以在傍晚时分必然发热。之所以这样，是因为脾土之气在傍晚时分旺盛的缘故。现在反而恶寒，就知道这是因为房劳过度导致的虚损。房劳过度导致的虚损，责任在于肾。膀胱是肾的腑。前阴是肾的窍。肾虚而阳邪侵袭它，所以导致膀胱拘急，小腹胀满。黑色是北方肾水的颜色，额头色黑，是肾病而本色外露。足心发热，是因为肾脉起于涌泉穴，肾水一旦亏虚，相火就会凑集于此，所以足心发热。因为形成黑疸，是阳邪完全陷入肾中，而肾的黑色完全显露于外。腹部胀大，是因为肾脉行于腹内，邪气占据其中，所以导致胀大像有水状，实际上并不是水。如果是水气病，那么大便应当清澈且呈濡泻状。现在是肾病，所以大便必然发黑且时而稀溏。大概因为肾主管二便，患病后所以大便黑溏而失去常态。这可以辨别其为女劳疸的病，而不是水气病。腹部胀满难治的原因，在于腹部胀满与腹部胀大不同，腹部胀大是肾脉行于腹部，所以导致外部胀大；腹部胀满是脾胃受邪，不能健运，所以导致内部胀满。脾胃属土，能够克制肾水，所以说难以治疗。硝石、矾石，属于咸寒性质的药物，咸味能入肾，寒性能胜热，所以用这两味药为主治。用大麦粥汤调和的原因，是担心这两味药损伤胃气。唉！张仲景公论述证候并制定方剂，精良恰当，大多都是如此，譬如选拔将领训练士兵，知人善任，那么万举万当，没有不成功的。那些用药不合证候的，譬如出兵没有正当理由。用药不了解药性的，譬如将领不了解士兵，他们不丧失军队、羞辱国家的很少了，怎么能建立功业呢？
Yinchen (Er Liang, approx. 90g) Fuzi (One piece, processed) Ganjiang (Liang Ban, approx. 75g) Zhigancao (Liang, approx. 30g, honey-fried)
For symptoms of jaundice (yellowing of skin and eyes), pulse that is deep and slow, cold extremities with reversal of cold, and spontaneous sweating above the waist, this formula should be taken cold.
This is jaundice due to a Yin syndrome. When Yin-cold is excessive in the lower part, it forces Yang to float upwards, thus the upper body manifests Yang syndrome signs, while the lower body manifests Yin syndrome signs. Because Yin is excessive in the lower part, a deep and slow Yin pulse is seen, accompanied by the Yin syndrome sign of cold extremities; because Yang floats on top, yellowing of the body (jaundice) characteristic of Yang syndrome and spontaneous sweating of the upper body are seen. Yinchen (Artemisiae Scopariae Herba) is an essential herb for treating jaundice, therefore it is used regardless of whether the condition is cold or hot. Fuzi (Aconiti Lateralis Radix Praeparata), Ganjiang (Zingiberis Rhizoma), and Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle) are key items for restoring Yang, therefore they are used whenever there is Yin-cold. However, the reason for taking them cold is to prevent the acrid-hot nature of Ginger and Aconite from dispersing in the upper Jiao where Yang is abundant, leaving the Yin-cold region in the lower part insufficiently warmed. This formula was used by Han Zhihe, Li Sixun, and Zhu Fengyi (Zhu Gong). If one were to follow Danxi Weng's statement that "there is no need to distinguish among the Five [types], as all are damp-heat," and stubbornly use this formula to treat such cases, would not the medicine contradict the syndrome? The deeds of Han and Li are recorded in *Tangye Bencao*, and those of Zhu Fengyi are found in *Huren Shu*.
Xiaoshi (Niter, calcined, equal parts) Fanshi (Alumen, calcined, equal parts)
Grind both into powder. Mix with barley porridge soup and take one Fangcunbi (approx. 2-3 grams) per dose, three times daily.
Zhang Zhongjing stated in *Jingui Yaolue*: "In patients with jaundice, fever occurs at dusk, yet there is contrary aversion to cold; this is called Nulao Dan (Jaundice due to sexual exhaustion)." It arises from bladder urgency, abdominal fullness, blackening of the forehead, and heat in the soles of the feet, thereby forming Heidan (Black Jaundice). If the abdomen is distended resembling water accumulation, the stool must be black and occasionally loose. This is the disease of Nulao, not Water Disease. Abdominal fullness indicates a difficult-to-treat case. This formula governs it.
When Yang pathogenic factors transmit to the Stomach, heat has no outlet to vent outwards, the color of Earth (yellow) becomes visible, resulting in jaundice, and thus fever necessarily occurs at dusk. The reason for this is that the Qi of Earth flourishes at dusk. Now, since there is contrary aversion to cold, we know this is due to deficiency caused by sexual exhaustion. Deficiency due to sexual exhaustion is attributed to the Kidney. The Bladder is the Interior-Exterior pair of the Kidney. The anterior yin orifice is the opening of the Kidney. When Kidney deficiency allows Yang pathogens to invade, it causes bladder urgency and lower abdominal fullness. Black is the color of Kidney Water in the North. Blackening of the forehead indicates that Kidney disease manifests its true color. Heat in the soles of the feet occurs because the Kidney meridian originates at Yongquan (KI1); when Kidney Water is deficient, Ministerial Fire gathers there, causing heat in the soles. The formation of Black Jaundice occurs because Yang pathogens have completely sunk into the Kidney, and the color of the Kidney fully manifests externally. Abdominal distension occurs because the Kidney meridian runs inside the abdomen, and pathogenic qi occupies it, causing distension resembling water, though it is actually not water. If it were a Water Disease, the stool would be clear and watery diarrhea. Since this is a Kidney disease, the stool must be black and occasionally loose. Generally, the Kidney governs the two excretions; upon illness, the stool becomes black and loose, losing its normal state. This allows us to distinguish it as Nulao disease rather than Water Disease. The reason abdominal fullness is difficult to treat is that abdominal fullness differs from abdominal distension. Abdominal distension is due to the Kidney meridian running in the abdomen, causing external distension. Abdominal fullness is due to the Spleen and Stomach receiving pathogens, failing to transport and transform, leading to internal fullness. The Spleen and Stomach belong to Earth, which can overcome Kidney Water; therefore, it is said to be difficult to treat. Xiaoshi (Natrii Sulfas) and Fanshi (Alumen) are salty and cold. Salty enters the Kidney, and cold overcomes heat; thus, these two substances are used as the main treatment. Mixing with barley porridge soup is done to prevent these two substances from damaging the Stomach Qi. Alas! Master Zhongjing’s exposition of syndromes and formulation of prescriptions is exquisite and precisely appropriate, mostly like this. It is like selecting generals and training soldiers: knowing people and assigning them well leads to success in every attempt, achieving merit without fail. Those who use formulas incompatible with syndromes are like launching a campaign without just cause. Those who use medicines without understanding their properties are like generals who do not know their troops; few among them avoid losing their army and bringing shame to the state. How can they achieve merit?