至元丙寅六月。时雨霖霪。人多病瘟疫。真定韩君祥。因劳役过度。渴饮凉茶。及食冷物。遂
病头痛。肢节亦疼。身体沉重。胸满不食。自以为外感伤。用通圣散两服。药后添身体困甚。方命
医治之。医以百解散发其汗。越四日。以小柴胡汤二服。后加烦热躁渴。又六日。以三一承气汤下
之。躁渴尤甚。又投白虎加人参柴胡饮子之类。病愈增。又易医用黄连解散汤、朱砂膏、至宝丹
之类。至十七日后。病势转增传变。身目俱黄。肢体沉重。背恶寒。皮肤冷。心下痞硬。按之而痛
。眼涩不欲开。目睛不了了。懒言语。自汗。小便利。大便了而不了。命予治之。诊其脉紧细。按
之虚空。两寸脉短不及本位。此证得之因时热而多饮冷。加以寒凉药过度。助水乘心。反来侮土。
先囚其母。后薄其子。经云。薄所不胜乘所胜也。时值霖雨。乃寒湿相合。此为阴证发黄明也。予
以茵陈附子干姜汤主之。内经云。寒淫于内。治以甘热。佐以苦辛。湿淫所胜。平以苦热。以淡渗
之。以苦燥之。附子、干姜。辛甘大热。散其中寒。故以为主。半夏、草豆蔻。辛热。白术、陈皮
苦甘温。建脾燥湿。故以为臣。生姜辛温以散之。泽泻甘平以渗之。枳实苦微寒。泄其痞满。茵陈
苦微寒。其气轻浮。佐以姜附。能去肤腠间寒湿而退其黄。故为佐使也。煎服一两。前证减半。再
服悉去。又与理中汤服之。数日气得平复。或者难曰。发黄皆以为热。今暑隆盛之时。又以热药治
之。何也。予曰。理所当然。不得不然。成无己云。阴证有二。一者始外伤寒邪。阴经受之。或因
食冷物伤太阴经也。二者始得阳证。以寒治之。寒凉过度。变阳
为阴也。今君祥因天令暑热。冷物伤脾。过服寒凉。阴气大胜。阳气欲绝。加以阴雨。寒湿相合。
发而为黄也。仲景所谓当于寒湿中求之。李思顺云。解之而寒凉过剂。泻之而逐寇伤君。正以此也
。圣圣之制。岂敢越哉。或者曰。洁古之学。有自来矣。
【茵陈附子干姜汤】治因凉药过剂。变为阴证。身目俱黄。四肢皮肤冷。心下痞硬。眼涩
不欲开。自利蜷卧。
附子（炮。去皮脐。三钱） 干姜（炮。二钱） 茵陈（一钱二分） 白术（四分）
草豆蔻（面裹煨。一钱） 白茯苓（去皮。三分） 枳实（麸炒） 半夏（汤泡七次）
泽泻（各半钱） 陈皮（三分。去白）
上十味 咀。为一服。水一盏半。生姜五片。煎至一盏。去渣。凉服。不拘时候。
至元丙寅年六月。当时雨水连绵不断。许多人患瘟疫病。真定府的韩君祥，因为劳累过度，口渴时喝了凉茶，又吃了生冷食物，于是出现头痛、四肢关节疼痛、身体沉重、胸闷不想吃东西的症状。他自认为是外感风寒，服用了两剂通圣散。服药后身体更加困倦乏力，这才请医生诊治。医生用百解散给他发汗。过了四天，又给他服用了两剂小柴胡汤。之后出现了烦躁发热、躁动口渴的症状。又过了六天，医生用三一承气汤给他泻下。结果躁动口渴更加严重。接着又投予白虎加人参柴胡饮子之类的药物，病情反而加重。又换了医生，使用黄连解散汤、朱砂膏、至宝丹等药物。到了第十七天，病情进一步恶化传变，出现全身和眼睛都发黄、肢体沉重、背部怕冷、皮肤发凉、胃脘部痞塞坚硬、按压时疼痛、眼睛干涩不想睁开、视物模糊不清、懒于说话、自汗、小便通畅、大便虽解但感觉排不干净的症状。请我诊治。诊察他的脉象紧细，重按空虚无力，两手寸脉短促，达不到本位。这个病症是因为天气炎热而多饮冷水，加上寒凉药物使用过度，导致水湿助长心火（此处指水气凌心或寒湿困脾影响心阳），反过来侮害脾土（五行中水克火，土克水，此处意指寒湿伤脾及心阳，或水反侮土之误，原文逻辑为寒湿伤阳，脾失健运）。先囚禁了母脏（脾土生肺金，此处可能指代关系混乱，依原文直译：先囚其母，后薄其子，经云：薄所不胜乘所胜也。时值霖雨，乃寒湿相合。此为阴证发黄明也。予以茵陈附子干姜汤主之。内经云：寒淫于内，治以甘热。佐以苦辛。湿淫所胜，平以苦热。以淡渗之。以苦燥之。附子、干姜，辛甘大热，散其中寒，故以为主。半夏、草豆蔻，辛热，白术、陈皮苦甘温，建脾燥湿，故以为臣。生姜辛温以散之，泽泻甘平以渗之，枳实苦微寒，泄其痞满，茵陈苦微寒，其气轻浮，佐以姜附，能去肤腠间寒湿而退其黄，故为佐使也。煎服一两，前证减半，再服悉去。又与理中汤服之，数日气得平复。或者难曰：发黄皆以为热，今暑隆盛之时，又以热药治之，何也。予曰：理所当然，不得不然。成无己云：阴证有二，一者始外伤寒邪，阴经受之，或因食冷物伤太阴经也。二者始得阳证，以寒治之，寒凉过度，变阳为阴也。今君祥因天令暑热，冷物伤脾，过服寒凉，阴气大胜，阳气欲绝，加以阴雨，寒湿相合，发而为黄也。仲景所谓当于寒湿中求之。李思顺云：解之而寒凉过剂，泻之而逐寇伤君，正以此也。圣圣之制，岂敢越哉。或者曰：洁古之学，有自来矣。
【茵陈附子干姜汤】治疗因凉药过量，变为阴证。全身和眼睛都发黄，四肢皮肤发凉，胃脘部痞塞坚硬，眼睛干涩不想睁开，自利蜷卧。
附子（炮。去皮脐。三钱） 干姜（炮。二钱） 茵陈（一钱二分） 白术（四分）
草豆蔻（面裹煨。一钱） 白茯苓（去皮。三分） 枳实（麸炒） 半夏（汤泡七次）
泽泻（各半钱） 陈皮（三分。去白）
以上十味药切碎，作为一剂。用水一盏半，生姜五片，煎至一盏，去渣，凉服。不拘时候。
In the sixth month of Bingyin year of Zhiyuan, continuous heavy rains prevailed, and many people suffered from epidemic diseases. Han Junxiang from Zhending, due to excessive labor, drank cold tea when thirsty and consumed cold food, subsequently developing headache, pain in limbs and joints, heaviness of the body, chest fullness, and loss of appetite. He believed it was an external contraction and took two doses of Tongsheng San. After medication, his physical fatigue worsened, prompting him to seek medical treatment. The physician administered Baijie San to induce sweating. Four days later, he was given two doses of Xiaochaihu Tang. Subsequently, he developed irritability, fever, restlessness, and thirst. Six days after that, Sanyi Chengqi Tang was used to purge him, which exacerbated his restlessness and thirst. Then, drugs such as Baihu Jia Renshen Chaihu Yinzi were administered, but the condition worsened. Another physician prescribed Huanglian Jieji Tang, Zhusha Gao, and Zhibao Dan. By the seventeenth day, the disease progressed and transformed; he presented with jaundice of both body and eyes, heaviness of limbs, aversion to cold on the back, cold skin, epigastric stuffiness and hardness with tenderness upon pressure, dry and reluctant-to-open eyes, blurred vision, reluctance to speak, spontaneous sweating, free urination, and incomplete defecation sensation. I examined his pulse: it was tight and fine, empty upon deep pressure, and the pulses at both Cun positions were short and did not reach their normal position. This condition arose from drinking cold liquids excessively during hot weather, compounded by the overuse of cold-natured medicines, leading to water dampness assisting the heart (metaphorically referring to cold-damp injuring yang) and counter-acting the spleen earth. As the Classics state, "attacking what one cannot overcome and multiplying what one overcomes." During this time of continuous rain, cold and dampness combined, clearly indicating jaundice due to a yin syndrome. I treated him with Yinchen Fuzi Ganjiang Tang. The Neijing states: "For cold invading internally, treat with sweet-hot substances, assisted by bitter-pungent ones. For dampness prevailing, level it with bitter-hot substances, drain it with bland substances, and dry it with bitter substances." Fuzi and Ganjiang are pungent, sweet, and greatly hot, dispersing internal cold, thus serving as the sovereign herbs. Banxia and Caodoukou are pungent and hot; Baizhu and Chenpi are bitter, sweet, and warm, strengthening the spleen and drying dampness, thus serving as minister herbs. Shengjiang is pungent and warm to disperse; Zexie is bland and neutral to drain; Zhishi is bitter and slightly cold to relieve stuffiness and fullness; Yinchen is bitter and slightly cold, its qi being light and floating. Assisted by Jiang and Fu, it can remove cold-dampness from the skin and pores and resolve jaundice, thus serving as assistant and envoy herbs. One qian liang was decocted and taken; previous symptoms halved. After another dose, all symptoms disappeared. Then Lizhong Tang was administered. Within a few days, his qi recovered. A skeptic questioned: "Jaundice is generally considered heat-related. Now, in the peak of summer heat, why use hot medicines?" I replied: "It is logically necessary and unavoidable. Cheng Wuji stated: There are two types of yin syndromes. First, initial external contraction of cold pathogen affecting yin meridians, or injury to the Taiyin meridian due to eating cold food. Second, initially having a yang syndrome, treating it with cold methods, excessive cold-natured treatment transforms yang into yin. Now, Junxiang, due to summer heat, injured the spleen with cold food, overused cold medicines, causing yin qi to prevail excessively and yang qi to be nearly exhausted. Coupled with rainy weather, cold and dampness combined, manifesting as jaundice. Zhang Zhongjing said, 'Seek within cold-dampness.' Li Sishun said: 'Resolving with excessive cold-natured drugs purges the bandit but injures the ruler; purging with laxatives also injures the ruler. This is precisely the case.' How dare we deviate from the established principles of the sages?" The skeptic remarked: "Jiegou's learning has its origins."
[Chen Yin Fuzi Ganjiang Tang] Treats jaundice resulting from overdose of cold-natured medicines transforming into a yin syndrome. Symptoms include jaundice of body and eyes, cold skin of limbs, epigastric stuffiness and hardness, dry and reluctant-to-open eyes, spontaneous diarrhea, and curling up while lying down.
Fuzi (Pao, peeled and navel removed, 3 qian), Ganjiang (Pao, 2 qian), Yinchen (1.2 qian), Baizhu (0.4 qian), Caodoukou (wrapped in flour and roasted, 1 qian), Baifuling (peeled, 0.3 qian), Zhishi (bran-fried), Banxia (soaked in boiling water seven times), Zexie (each 0.5 qian), Chenpi (0.3 qian, pith removed).
These ten ingredients are coarsely crushed. Take one dose, add 1.5 cups of water and 5 slices of Shengjiang, decoct to 1 cup, strain, and take cool. Anytime.