心下痛。年余屡发。痛缓能食。渐渐目黄溺赤。此络脉中凝瘀蕴热。与水谷
之气。交蒸所致。若攻之过急。必变胀满。此温燥须忌。议用河间金铃子散。合无
择谷芽枳实小柴胡汤法。
金铃子 延胡 枳实 柴胡 半夏 黄芩 黑山栀 谷芽
述初病似疟。乃夏暑先伏。秋凉继受。因不慎食物。胃脘气滞。生热内蒸。变
现黄胆。乃五疸中之谷疸也。溺黄便秘。当宣腑湿热。但不宜下。恐犯太阴变胀。
绵茵 茯苓皮 白蔻仁 枳实皮 杏仁 桔梗 花粉
面目悉黄。微见黑滞。烦渴腹满。左脉弦数。右脉空大。此内伤发黄。为厥阴
肝木太阴脾土二脏交伤之候也。夫肝为风脏。其性喜伸而恶屈。郁则木不得
伸而屈矣。郁极则其气盛而风乃发。风发必挟其势以贼脾。脾为湿土之司。土
受克而气不行。则湿胜矣。风性虽善行。遇湿以留之。反壅滞经络而不解。由是
湿停阳瘀而烦渴有加。其发黄也必矣。虽曰风湿所致。实由木亢而不宁。土困
而不舒。非外来风湿之比。况黑色见于面。则知并伤其肾。以脾病不行。胃中谷
气入肾。反将脾中浊气下流。故于黄中见黑滞耳。即其腹满。亦是中气不行。虚
热内壅。非结热当下之比。若误下之。则藏气空虚。风从内生矣。若误汗之。则阳
气外解。湿愈不能行矣。为商治法。平肝之亢。扶土之虚。兼解郁热以清气道。除
湿蒸而和中气。
人参 白术 白芍 黄连 山栀 归身 丹皮 茵 秦艽 柴胡 甘草 半夏
心下部位疼痛。病程已有一年多，反复发作。疼痛缓解时能够进食。逐渐出现眼睛发黄、小便色赤的症状。这是络脉中瘀血凝滞蕴结化热，与水谷之气相互交蒸所导致的。如果治疗时攻伐过急，必然会导致腹部胀满的变证。此时必须忌用温燥药物。建议采用刘河间（刘完素）的金铃子散，配合无择（可能指某位医家或特定流派）的谷芽、枳实及小柴胡汤的治法。
起初发病症状类似疟疾，这是因为夏季暑邪先伏于体内，秋季凉邪继之侵袭所致。因为不慎饮食，导致胃脘气机阻滞，产生内热并向上蒸腾，从而转变为黄疸。这属于五疸中的谷疸。患者小便黄、大便干结，应当宣通腑道的湿热，但不宜使用泻下法，恐怕会触犯太阴脾经而导致腹胀变证。
面目全部发黄，微微显现出黑色的滞涩感，伴有烦躁口渴、腹部胀满。左脉弦数，右脉空大。这是内伤引起的发黄，是厥阴肝木与太阴脾土两脏同时受损的表现。肝为风脏，其本性喜欢舒展而厌恶屈曲。郁结则肝木不得舒展而屈曲。郁结至极则肝气盛极而生风。风动必然挟带其势来克制脾土。脾属湿土，受肝木克制则脾气不行，湿气就会胜复。风性虽然善于行走，但遇到湿气便会停留，反而壅滞经络而不能解除。因此湿气停聚、阳气瘀阻，导致烦躁口渴加重，发黄也就必然发生了。虽然说是风湿所致，实际上是由于肝木亢盛而不安宁，脾土困顿而不舒展，并非外来的风湿可比。况且黑色出现在面部，可知同时也损伤了肾脏。因为脾病运化不行，胃中的谷气进入肾脏，反而将脾中的浊气下流，所以在黄色中见到黑色的滞涩。至于腹满，也是中焦气机不行，虚热内壅所致，并非实热结聚应当用下法的证候。如果误用下法，脏腑之气就会空虚，风气会从内生发。如果误用汗法，阳气就会外泄，湿气更加不能运行。为此商议治疗方法：平抑肝木的亢盛，扶持脾土的虚弱，兼解郁热以清利气道，除湿蒸之邪以调和 middle qi（中气）。
Pain in the epigastrium. The condition has recurred repeatedly for over a year. When the pain subsides, the patient is able to eat. Gradually, yellowing of the eyes and reddish urine appeared. This is caused by stagnant blood and accumulated heat in the collaterals (Luo Mai), steaming together with the Qi of food and drink. If treated with overly aggressive purgation, it will inevitably transform into abdominal distension. Warming and drying methods must be avoided. It is proposed to use Liu Hejian's Jinlingzi San (Corydalis and Melia Decoction) combined with the method of Guoya (Valerian Seed), Zhishi (Immature Bitter Orange), and Xiaochaihu Tang (Minor Bupleurum Decoction).
Jinlingzi (Corydalis Rhizome), Yanhu (Corydalis Tuber), Zhishi (Immature Butterfruit Orange), Chaihu (Bupleurum Root), Banxia (Pinellia Tuber), Huangqin (Scutellaria Root), Hei Shanzhi (Black Gardenia Fruit), Guya (Sprouted Grain).
Initially, the illness resembled malaria. This was due to summer-heat lying latent first, followed by autumn-coolness invading subsequently. Because of careless diet, Qi stagnation occurred in the stomach and epigastrium, generating internal heat that steamed upward, transforming into jaundice. This is the "Grain Jaundice" among the five types of jaundice. With yellow urine and constipation, one should ventilate the damp-heat from the fu organs, but purgation is not suitable, lest it violate the Taiyin spleen and cause distension.
Mian Yinchen (Artemisia Capillaris Herb), Fulingpi (Poria Peel), Baokouren (White Cardamom Seed), Zhishipi (Immature Bitter Orange Peel), Xingren (Apricot Seed), Jiegeng (Platycodon Root), Huafen (Trichosanthes Root).
The face and eyes are entirely yellow, with a slight blackish stagnation visible. There is irritability, thirst, and abdominal fullness. The left pulse is wiry and rapid; the right pulse is empty and large. This is jaundice caused by internal injury, representing a simultaneous damage to the Jueyin Liver Wood and Taiyin Spleen Earth. The liver is the organ of wind; its nature prefers extension and dislikes constriction. Stagnation causes Liver Wood to fail to extend and becomes constricted. Extreme stagnation leads to excessive Qi and the generation of wind. Wind movement necessarily carries its momentum to attack Spleen Earth. The spleen governs damp-earth; when constrained by Liver Wood, Spleen Qi fails to move, and dampness prevails. Although wind nature is good at moving, encountering dampness causes it to linger, instead obstructing the collaterals without resolution. Thus, dampness stagnates and Yang Qi is blocked, aggravating irritability and thirst, making jaundice inevitable. Although said to be caused by wind-damp, it is actually due to Hyperactive Liver Wood failing to be tranquil and Deficient Spleen Earth failing to be comfortable, which is not comparable to external wind-damp. Moreover, since black color appears on the face, it is known that the Kidney is also injured. Because Spleen disease fails to transport, Grain Qi from the Stomach enters the Kidney, and conversely, turbid Qi from the Spleen flows downward, hence the blackish stagnation seen amidst the yellow. As for the abdominal fullness, it is also due to the failure of Middle Qi to move and internal accumulation of deficient heat, not comparable to excess heat accumulation requiring purgation. If mistakenly purged, Zang Qi will become empty, and wind will generate internally. If mistakenly sweated, Yang Qi will escape externally, and dampness will be even less able to move. Therefore, the treatment method discussed is: to calm the hyperactivity of Liver Wood, support the deficiency of Spleen Earth, simultaneously resolve stagnant heat to clear the Qi pathway, remove damp-steaming to harmonize Middle Qi.
Renshen (Ginseng Radix), Baizhu (Atractylodes Macrocephala Rhizome), Baishao (White Peony Root), Huanglian (Coptis Rhizome), Shanzhi (Gardenia Fruit), Guishen (Angelica Sinensis Root Body), Danpi (Moutan Cortex), Yinchen (Artemisiae Scopariae Herba), Qinjiao (Gentiana Macrophylla Root), Chaihu (Bupleuri Radix), Gancao (Licorice Root), Banxia (Pinelliae Rhizoma).