完颜正卿丙寅二月间。因官事劳役。饮食不节。心火乘脾。脾气虚弱。又以恚怒。气逆伤肝。心
下痞满。四肢困倦。身体麻木。次传身目俱黄。微见青色颜黑。心神烦乱。怔忡不安。兀兀欲吐。
口生恶味。饮食迟化。时下完谷。小便癃闭而赤黑。辰巳间发热。日暮则止。至四月尤盛。其子以
危急求予治之。具说其事。诊其脉浮而缓。金匮要略云。寸口脉浮为风。缓为痹。痹非中风。四肢
苦烦。脾色必黄。瘀热以行。趺阳脉紧。为伤脾。风寒相搏。食谷则眩。谷气不消。胃中苦浊。浊
气下流。小便不通。阴被其寒。热流膀胱。身体尽黄。名曰谷疸。宜茯苓栀子茵陈汤主之。
【茯苓栀子茵陈汤】
茵陈叶（一钱） 伏苓（去皮。五分） 栀子仁 苍术（去皮炒）
白术（各三钱） 黄芩（生六分） 黄连（去须） 枳实（麸炒）
猪苓（去皮） 泽泻 陈皮 汉防己（各二分）
青皮（去白一分）
上十三味。 咀。作一服。用长流水三盏。煎至一盏。去渣。温服。食前。一服减半。二服良
愈。内经云。热淫于内。治以咸寒。佐以苦甘。又湿化于火。热反胜之。治以苦寒。以苦泄之。以
淡渗之。以栀子、茵陈苦寒。能泻湿热而退其黄。故以为君。难经云。并主心下满。以黄连、枳实
苦寒。泄心下痞满。肺主气。今热伤其气。故身体麻木。以黄芩苦寒。泻火补气。故以为臣。二
术苦甘温。青皮苦辛温。能除胃中湿热。
泄其壅滞。养其正气。汉防己苦寒。能去十二经留湿。泽泻咸平。茯苓、猪苓甘平。导膀胱中湿热
利小便而去癃闭也。
完颜正卿在丙寅年二月期间，因为公务劳役，饮食没有节制，导致心火侵犯脾脏，脾气虚弱。又加上愤怒情绪，致使气机逆乱损伤肝脏。出现胃脘部痞塞胀满、四肢困倦乏力、身体麻木的症状，随后发展为全身和眼睛都发黄，面色微现青色且发黑，心神烦躁混乱，心悸不安，头晕恶心欲吐，口中产生异味，饮食消化缓慢，时常排出未消化的食物残渣，小便不通畅且颜色赤黑。在上午7点到11点之间发热，傍晚时热退，到了四月症状尤为严重。他的儿子因情况危急前来请求我诊治，详细陈述了病情。诊察其脉象浮而缓。《金匮要略》中说：寸口脉浮表示有风邪，缓表示有痹证。这种痹证并非中风，而是四肢苦于烦扰，脾的色泽必现黄色，瘀滞的热邪随之运行。趺阳脉紧，表示伤及脾脏。风寒相互搏结，进食后感到眩晕，谷气不能消散，胃中苦于浊气，浊气向下流注，小便不通。阴分受寒邪影响，热邪流入膀胱，导致全身发黄，这叫做谷疸（因饮食不当引起的黄疸）。适宜用茯苓栀子茵陈汤主治。
【茯苓栀子茵陈汤】
茵陈叶（一钱） 茯苓（去皮，五分） 栀子仁 苍术（去皮炒制）
白术（各三钱） 黄芩（生用六分） 黄连（去须） 枳实（麸皮炒制）
猪苓（去皮） 泽泻 陈皮 汉防己（各二分）
青皮（去白，一分）
以上十三味药，切碎，作为一剂服用。用长流水三盏，煎煮至一盏，去渣滓，温服，饭前服用。服用一剂后减半剂量，再服用两剂即可痊愈。《内经》说：体内热邪过盛，用咸寒之品治疗，辅以苦甘之品。又说：湿气由火化生，热邪反而占优势，用苦寒之品治疗，以苦味泄热，以淡味渗湿。用栀子和茵陈的苦寒之性，能泻除湿热并消退黄疸，所以将它们作为君药。《难经》说：这些药共同主治心下痞满。用黄连和枳实的苦寒之性，泄除心下的痞满。肺主气，现在热邪损伤了肺气，所以身体麻木，用黄芩的苦寒之性，泻火补气，所以将它们作为臣药。白术和苍术的苦甘温性，青皮的苦辛温性，能清除胃中的湿热，泄除壅滞，养护正气。汉防己的苦寒之性，能去除十二经脉中留存的湿气。泽泻的咸平之性，茯苓和猪苓的甘平之性，引导膀胱中的湿热，通利小便以消除小便不通的症状。
Wanyan Zhengqing, during the second month of the Bingyin year, due to official duties and labor, irregular diet, caused Heart Fire (Xin Huo) to invade the Spleen (Pi), resulting in Spleen Qi deficiency. Additionally, anger caused Qi rebellion and injured the Liver (Gan). Symptoms included epigastric fullness and obstruction (Xin Xia Pi Man), fatigue and heaviness in the four limbs, numbness of the body, which subsequently progressed to jaundice affecting both the body and eyes, with a slight bluish-black discoloration of the face. The patient experienced mental restlessness, palpitations (Zheng Chong), dizziness, nausea, bad taste in the mouth, delayed digestion of food, frequent passage of undigested food, and oliguria with dark red-black urine. Fever occurred between 7:00 AM and 11:00 AM (Chen-Si hours) and ceased at dusk, becoming particularly severe by April. His son sought my treatment due to the critical condition, detailing the history. The pulse was floating and moderate (Fu Er Huan). The *Jingui Yaolue* states: "A floating pulse at the Cun position indicates Wind; a moderate pulse indicates Bi syndrome. This Bi is not wind-stroke; the four limbs suffer from vexation, the color of the Spleen must be yellow, and stagnant heat circulates." A tight pulse at the Fuyang position indicates injury to the Spleen. When Wind-Cold contend, dizziness occurs after eating; Grain Qi fails to digest, causing the Stomach to suffer from turbidity. Turbid Qi flows downward, leading to urinary obstruction. Yin is affected by cold, while Heat flows into the Bladder (Pang Guang), resulting in whole-body jaundice, named Gu Dan (Grain Jaundice). It is appropriate to treat with Fur Ling Zhi Zi Yin Chen Tang.
[Fur Ling Zhi Zi Yin Chen Tang]
Yin Chen Ye (Artemisiae Scopariae Folium, 1 qian)
Fu Ling (Poria, peeled, 5 fen)
Zhi Zi Ren (Gardeniae Fructus)
Cang Zhu (Atractylodis Rhizoma, peeled and stir-fried)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, each 3 qian)
Huang Qin (Scutellariae Radix, raw, 6 fen)
Huang Lian (Coptidis Rhizoma, de-soured)
Zhi Shi (Aurantii Fructus Immaturus, bran-fried)
Zhu Ling (Polyporus, peeled)
Ze Xie (Alismatis Rhizoma)
Chen Pi (Citri Reticulatae Pericarpium)
Han Fang Ji (Stephaniae Tetrandrae Radix, each 2 fen)
Qing Pi (Citri Reticulatae Pericarpium Viride, white pith removed, 1 fen)
The above thirteen herbs are coarsely crushed. Prepare as one dose. Use three cups of running water, decoct until one cup remains. Strain and take warm before meals. After one dose, reduce the dosage by half. Two doses lead to good recovery. The *Neijing* states: "When Heat dominates internally, treat with salty-cold substances, assisted by bitter-sweet substances." It also states: "When Dampness transforms via Fire, and Heat overcomes it, treat with bitter-cold substances, using bitterness to drain, and blandness to leach out." Yin Chen and Zhi Zi are bitter-cold, capable of draining Damp-Heat and resolving jaundice, thus serving as the Sovereign (Jun) herbs. The *Nanjing* states they jointly manage epigastric fullness. Huang Lian and Zhi Shi are bitter-cold, draining epigastric fullness. The Lung (Fei) governs Qi; currently, Heat injures Qi, causing body numbness. Huang Qin is bitter-cold, draining Fire and tonifying Qi, thus serving as the Minister (Chen) herb. Bai Zhu and Cang Zhu are bitter-sweet-warm; Qing Pi is bitter-acrid-warm, capable of removing Damp-Heat in the Stomach, draining stagnation, and nourishing righteous Qi. Han Fang Ji is bitter-cold, removing retained Dampness from the twelve meridians. Ze Xie is salty-neutral; Fu Ling and Zhu Ling are sweet-neutral, guiding Damp-Heat from the Bladder, promoting urination, and relieving urinary obstruction.