《病源》谷疸之状,食毕头眩,心忪怫郁不安而发黄。由失饥大食,胃气冲熏所致,阳
明病脉迟,食难用饱,饱则发烦头眩者,必小便难,此欲为谷疸,虽下之,其腹必满,以其
脉迟故也。(出第十二卷中)
《范汪》疗谷疸。茵陈汤方。
茵陈四两切,以水一斗,煮取六升,以汁煎大黄二两、栀子七枚,得二升,分为三服。
黄从小便去,病出立愈。(《肘后》同,出第十四卷中)
《集验》疗劳疸。谷疸丸方
苦参(三两) 龙胆草(一两)
上二味,下筛牛胆汁和丸。先食以麦粥饮服如梧子大五丸,日三,不知稍增。(《千金
》同,出第二卷中)
《删繁》疗劳疸、谷疸。苦参丸方。(劳疸者,因劳为名也;谷疸者,因食而劳,故曰
谷疸)
苦参(三两) 龙胆草(二两) 栀子仁(三七枚)
上三味,捣筛为散,若病甚,取猪胆和为丸,如梧子大。一服五丸,日三四服,以饮汁
下之。
许仁则疗急黄病,此病始得,与前天行病不多异,五六日但加身体黄,甚者 (音夷,
鼻液也,下同)。泪、汗、唾、小便如柏色,眼白睛正黄,其更重状,与天行病候最重者无
别。如至此困,自须依前救天行最重半夏等分十味汤救之,若未至是者,宜依后法。急黄状
始得,大类天行病经三两日,宜合麻黄等五味汤服之,发汗以泄黄势方。
麻黄(三两去节) 干葛(五两) 石膏(八两) 生姜(六两) 茵陈(二两)
上药切,以水八升,煮取二升七合,去滓,分温三服,服相去十里久,服讫当欲汗,则
覆被微取汗以散之。
又依前麻黄等五味汤服之取汗,汗出后未歇,经三五日,又合栀子等五味汤以取利方。
栀子(二十枚) 柴胡(三两) 黄芩(三两) 茵陈(三两) 芒硝(六两)
上药切,以水八升,煮四味,取二升六合,去滓,纳芒硝搅令消,分温三服,如人行
十里久,更服之,效。
又依前栀子等五味汤服之取利,利后病势不歇,经六七日,又合秦艽牛乳二味汤服之方
秦艽(六两) 牛乳(二升)
上药切,秦艽以牛乳煮之,可三分减一,去滓,带暖顿服令尽,极验。(文仲、《必效
》同,西域法也)
又依前秦艽等二味汤药服后,不觉病退,渐加困笃,势如前天行最重状,则不可更服诸
冷物。冷物在心唯是痞,速宜同前天行用半夏等十味汤以救之,亦可合瓜蒂等三味散吹鼻孔
中,并与之服方。
瓜蒂(七枚) 丁香(七枚) 赤小豆(七枚)
上药捣筛末,取如大豆,分吹两鼻孔中。须臾当出黄水,正如煮柏汁,及出黄虫。亦可
以新汲水和一方寸匕与患人服,或利或吐,吐利所出亦如煮黄柏汁,天行用此疗,亦与崔氏
同。
又论云,此病俗间亦有单煮瓜蒂汁灌鼻孔中者,亦有单服生麻油者。
又疗黄胆病,此病与前急黄不同,自外状与平常无别,但举体正黄,甚者眼色如柏,涕
涎小便及汗,悉如柏汁,食消多于寻常,稍觉瘦悴乏力,此病不甚杀人,亦有经年累岁不
疗而瘥者。此由饮酒多,亦是积虚热所致。黄胆初得,稍觉心中烦热,满身黄色,眼白睛黄
,觉如此者,宜合白藓皮等七味汤以泄之,黄连十味丸以压之。
白藓皮(三两) 干葛(五两) 黄芩(三两) 郁金(三两) 豉(五两) 栀子(十
枚) 芒硝
(六两)
上药切,以水八升,煮取二升半,去滓,纳芒硝,分温三服,服相去如人行二十里久,
更服此汤当得利,利后将息一二日,则合后黄连等十味丸服之。
又黄连丸方
黄连(五两) 黄芩(五两) 苦参(六两) 沙参(五两) 干地黄(六两) 干葛
(六两) 栀
子仁(三两) 麦门冬(一升去心) 地骨白皮(五两) 茯苓(五两)
上十味,捣筛为末,蜜和为丸。以米饮下,初服十丸,日三服,稍稍加至三十丸,如梧
子大。黄胆亦有单服猪脂得瘥者。忌猪肉、冷水、大酢、芜荑等物。(吴升同)
《诸病源候论》中记载谷疸的症状是:吃完饭后头晕目眩,心中悸动、烦闷郁结而不得安宁,随后身体发黄。这是由于长期饥饿后突然暴饮暴食,导致胃气上冲熏蒸所致。阳明病脉象迟缓,进食难以吃饱,若吃饱了就出现心烦、头晕目眩,必然伴有小便困难,这是将要发生谷疸的征兆。即使使用攻下法治疗,腹部必定胀满,这是因为脉象迟缓的缘故。(出自第十二卷)
《范汪方》治疗谷疸。茵陈汤方。
茵陈四两(切碎),用水一斗,煮取六升药汁,用此药汁煎煮大黄二两、栀子七枚,最终得到二升药液,分三次服用。湿热之邪从小便排出,病立刻痊愈。(《肘后备急方》相同,出自第十四卷)
《集验方》治疗劳疸。谷疸丸方
苦参(三两) 龙胆草(一两)
以上两味药,研成细粉,用牛胆汁调和制成丸剂。饭前用麦粥送服,丸剂大小如梧桐子大,每次五丸,每日三次,若效果不明显可稍增加剂量。(《千金方》相同,出自第二卷)
《删繁方》治疗劳疸、谷疸。苦参丸方。(劳疸,是因劳累而得名;谷疸,是因饮食不节而引发劳累,所以称为谷疸)
苦参(三两) 龙胆草(二两) 栀子仁(三七枚)
以上三味药,捣碎研成细散。如果病情严重,取猪胆汁和药散制成丸剂,大小如梧桐子大。每次服五丸,每日三四次,用药汁送服。
许仁则治疗急黄病,此病初起时,与当时的流行性传染病(天行病)没有太大区别,到了第五六天只是加重身体发黄,严重的会出现鼻流浊涕(音夷,指鼻液,下同)、流泪、出汗、唾液、小便都像柏树汁一样的颜色,眼白睛完全变黄。其更严重的症状,与最重的流行性传染病症状没有区别。如果病情发展到这种危重程度,必须依照之前救治最重流行性传染病的“半夏等分十味汤”来抢救;如果未达到这种程度,适宜依照后面的方法治疗。急黄病初起,大体类似流行性传染病经过两三天,适宜合用麻黄等五味汤服用,通过发汗来宣泄黄毒之势。
麻黄(三两,去节) 干葛(五两) 石膏(八两) 生姜(六两) 茵陈(二两)
以上药物切碎,用水八升,煮取二升七合,滤去药渣,分三次温服。两次服药间隔时间相当于人行走十里路所需的时间,服药后应当想要出汗,则覆盖被子微微取汗以发散病邪。
又依照前面的麻黄等五味汤服用以取汗,汗出之后尚未休息,经过三五天,再合用栀子等五味汤以利小便,这样才有效。
栀子(二十枚) 柴胡(三两) 黄芩(三两) 茵陈(三两) 芒硝(六两)
以上药物切碎,用水八升,煮前四味药,取二升六合,滤去药渣,加入芒硝搅拌使其溶解,分三次温服。两次服药间隔时间相当于人行走十里路所需的时间,再次服用,见效。
又依照前面的栀子等五味汤服用以利小便,利小便后病势未止,经过六七天,再合用秦艽牛乳二味汤服用。
秦艽(六两) 牛乳(二升)
以上药物切碎,用牛乳煮秦艽,煮至减少三分之一,滤去药渣,趁热一次性服完,效果极佳。(文仲、《必效方》相同,是西域的方法)
又依照前面的秦艽等二味汤药服用后,感觉病未消退,逐渐加重困顿,势头如同最重的流行性传染病,则不可再服用各种寒凉药物。寒凉药物在心胸只会导致痞塞,应立即同治疗最重流行性传染病一样,使用半夏等十味汤来抢救。也可以合用瓜蒂等三味散吹入鼻孔中,并配合内服。
瓜蒂(七枚) 丁香(七枚) 赤小豆(七枚)
以上药物捣碎研成末,取如大豆大小的量,分别吹入两个鼻孔中。片刻之后会流出黄色液体,正如煮过的柏树汁,并且会排出黄色虫体。也可以用新汲水调和一立方寸匕的药末给患者服用,或者引起腹泻,或者引起呕吐,吐泻出的东西也像煮过的黄柏汁。治疗流行性传染病也用此法,也与崔氏相同。
又有论述说,民间也有单煮瓜蒂汁灌入鼻孔中的,也有单服生麻油的。
又治疗黄疸病,此病与前所述的急黄不同,外表症状与平常无异,只是全身正黄,严重的眼睛颜色像柏树汁,鼻涕、涎液、小便及汗水,都像柏树汁一样,消化食物多于常人,稍微觉得消瘦憔悴、乏力。此病不太致命,也有经过数年不治疗而自愈的。这是由于饮酒过多,也是积滞虚热所致。黄疸初起时,稍微觉得心中烦热,满身黄色,眼白睛黄,感觉如此者,适宜合用白鲜皮等七味汤以泄热,并用黄连十味丸以压制病势。
白鲜皮(三两) 干葛(五两) 黄芩(三两) 郁金(三两) 豆豉(五两) 栀子(十枚) 芒硝(六两)
以上药物切碎,用水八升,煮取二升半,滤去药渣,加入芒硝,分三次温服。两次服药间隔时间相当于人行走二十里路所需的时间,再次服用此汤应当能通利大便,利便后将养一两天,然后合用后面的黄连等十味丸服用。
又有黄连丸方
黄连(五两) 黄芩(五两) 苦参(六两) 沙参(五两) 干地黄(六两) 干葛(六两) 栀子仁(三两) 麦门冬(一升,去心) 地骨白皮(五两) 茯苓(五两)
以上十味药,捣碎研成末,用蜂蜜调和制成丸剂。用米饮送服,初次服用十丸,每日三次,逐渐增加到三十丸,丸剂大小如梧桐子大。黄疸也有单服猪脂而痊愈的。忌食猪肉、冷水、大醋、芜荑等物。(吴升方相同)
According to *Zhu Bing Yuan Hou Lun* (Treatise on the Pathogenesis and Symptoms of All Diseases), the manifestation of *Gu Dan* (Grain Jaundice) is dizziness after eating, palpitations, mental depression, restlessness, followed by yellowing of the body. This is caused by stomach qi rushing upward and steaming due to overeating after a period of starvation. In Yangming disease with a slow pulse, one cannot eat until full; if fullness leads to irritability and dizziness, there will inevitably be difficulty in urination. This indicates the impending onset of *Gu Dan*. Even if purgative therapy is used, abdominal fullness will persist because of the slow pulse. (From Volume 12)
*Fan Wang Fang* treats *Gu Dan*. Yinchen Decoction Formula:
Yin Chen Hao (Artemisiae Scopariae Herba) four liang, cut into pieces, decocted in ten dou of water to obtain six sheng of liquid. Use this liquid to decoct Da Huang (Rhei Radix et Rhizoma) two liang and Zhi Zi (Gardeniae Fructus) seven fruits, obtaining two sheng of final liquid. Divide into three doses. The damp-heat exits through the urine, and the illness is cured immediately. (Same as *Zhou Hou Bei Ji Fang*, From Volume 14)
*Ji Yan Fang* treats Lao Dan (Labor Jaundice). Gu Dan Pill Formula:
Ku Shen (Sophorae Flavescentis Radix) (three liang) Long Dan Cao (Gentianae Radix) (one liang)
Sift the above two herbs into fine powder, mix with ox bile to form pills. Take before meals with wheat porridge water, pill size like wu zi (Chinese quince seeds), five pills per dose, three times daily. Increase dosage slightly if ineffective. (Same as *Qian Jin Fang*, From Volume 2)
*Shan Fan Fang* treats Lao Dan and *Gu Dan*. Ku Shen Pill Formula. (Lao Dan is named for being caused by labor/overwork; *Gu Dan* is named because dietary irregularity leads to fatigue/labor, hence called *Gu Dan*.)
Ku Shen (Sophorae Flavescentis Radix) (three liang) Long Dan Cao (Gentianae Radix) (two liang) Zhi Zi Ren (Gardeniae Semen) (twenty-seven fruits)
Pulverize the above three herbs. If the condition is severe, mix with pig bile to form pills, size like wu zi. Five pills per dose, three to four times daily, taken with medicinal juice.
Xu Renze treats Ji Huang (Urgent Yellow/Jaundice). At the onset, this disease is not very different from contemporary epidemic febrile diseases (Tian Xing Bing). By the fifth or sixth day, the body becomes increasingly yellow. Severe cases present with nasal discharge (Yi, sound for nasal mucus, same below), tears, sweat, saliva, and urine resembling the color of cypress bark juice. The whites of the eyes turn completely yellow. Its most severe manifestations are indistinguishable from the heaviest epidemic febrile diseases. If it reaches this critical state, one must rescue using the Ban Xia Deng Fen Shi Wei Tang (Pinellia Equal Parts Ten-Herb Decoction) used for the heaviest epidemic febrile diseases. If it has not reached this stage, follow the subsequent methods. At the onset of Ji Huang, it resembles an epidemic febrile disease that has lasted two to three days. It is appropriate to administer Ma Huang Deng Wu Wei Tang (Ephedra Five-Herb Decoction) to induce sweating and dissipate the jaundice pathogen.
Ma Huang (Ephedrae Herba) (three liang, remove joints) Gan Ge (Puerariae Radix) (five liang) Shi Gao (Gypsum Fibrosum) (eight liang) Sheng Jiang (Zingiberis Rhizoma Recens) (six liang) Yin Chen Hao (Artemisiae Scopariae Herba) (two liang)
Cut the above herbs, decoct in eight sheng of water to obtain two sheng seven he, strain, and divide into three warm doses. Space the doses by the time it takes a person to walk ten li. After taking the medicine, when sweating is desired, cover with a blanket to induce slight sweating to disperse the pathogen.
Again, after inducing sweat with the aforementioned Ma Huang Five-Herb Decoction, without resting, after three to five days, administer Zhi Zi Deng Wu Wei Tang (Gardenia Five-Herb Decoction) to promote urination/drainage for efficacy.
Zhi Zi (Gardeniae Fructus) (twenty fruits) Chai Hu (Bupleuri Radix) (three liang) Huang Qin (Scutellariae Radix) (three liang) Yin Chen Hao (Artemisiae Scopariae Herba) (three liang) Mang Xiao (Natrii Sulfas) (six liang)
Cut the above herbs, decoct the first four in eight sheng of water to obtain two sheng six he, strain, add Mang Xiao, stir until dissolved, and divide into three warm doses. Administer again after the time it takes a person to walk ten li. Effective.
Again, after promoting drainage with the aforementioned Zhi Zi Five-Herb Decoction, if the pathogenic trend persists after six to seven days, administer Qin Jiao Niu Nai Er Wei Tang (Gentiana and Cow's Milk Two-Herb Decoction).
Qin Jiao (Gentianae Macrophyllae Radix) (six liang) Niu Nai (Cow's Milk) (two sheng)
Cut the herbs, decoct Qin Jiao in cow's milk until reduced by one-third, strain, and drink all while warm. Highly effective. (Same as Wen Zhong and *Bi Xiao Fang*, a Western Regions method)
If, after taking the Qin Jiao Two-Herb Decoction, the illness does not recede but gradually worsens to a critical state resembling the heaviest epidemic febrile diseases, do not take any more cold-natured substances. Cold substances in the heart/chest only cause palpitations/stuffiness. Immediately rescue using the Ban Xia Ten-Herb Decoction used for the heaviest epidemic febrile diseases. Alternatively, use Gua Di Deng San Wei San (Melon Seed Three-Powder) blown into the nostrils, combined with internal administration.
Gua Di (Cucumeritis Fructus) (seven fruits) Ding Xiang (Caryophylli Flos) (seven fruits) Chi Xiao Dou (Vigna umbellatae Semen) (seven fruits)
Pulverize the above herbs. Take an amount the size of a soybean, blow into both nostrils. Within moments, yellow fluid will flow out, resembling boiled cypress bark juice, and yellow worms may be expelled. Alternatively, mix one cubic-inch spoonful of powder with fresh well water and give to the patient. It may induce diarrhea or vomiting. The discharged material resembles boiled Phellodendron bark juice. This treatment for epidemic febrile diseases is also consistent with Cui Shi's methods.
Another discussion states that in common practice, some boil Gua Di juice alone and instill it into the nostrils, while others take raw sesame oil alone.
Also treat Huang Dan Bing (Jaundice Disease). This differs from the previously described Ji Huang. Externally, it appears normal except for generalized yellowing. In severe cases, the eye color resembles cypress bark juice, and nasal discharge, saliva, urine, and sweat are all like cypress bark juice. Digestion is faster than usual, accompanied by slight emaciation, frailty, and weakness. This disease is rarely fatal; some recover spontaneously after years without treatment. It is caused by excessive alcohol consumption and accumulation of deficient heat. Upon initial onset of Huang Dan, one feels slight mental heat and irritability, whole-body yellowing, and yellowing of the sclera. In such cases, administer Bai Xian Pi Qi Wei Tang (Dictamni Seven-Herb Decoction) to drain heat, and apply Huang Lian Shi Wei Wan (Coptis Ten-Pill) to suppress the pathogen.
Bai Xian Pi (Dictamni Cortex) (three liang) Gan Ge (Puerariae Radix) (five liang) Huang Qin (Scutellariae Radix) (three liang) Yu Jin (Curcumae Radix) (three liang) Chi Xiao Dou (Vigna umbellatae Semen) (five liang) Zhi Zi (Gardeniae Fructus) (ten fruits) Mang Xiao (Natrii Sulfas) (six liang)
Cut the herbs, decoct in eight sheng of water to obtain two sheng half, strain, add Mang Xiao, and divide into three warm doses. Space doses by the time it takes a person to walk twenty li. Taking this decoction should induce bowel movement. After recovery, rest for one to two days, then administer the subsequent Huang Lian Shi Wei Wan (Coptis Ten-Pill).
Another Huang Lian Pill Formula:
Huang Lian (Coptidis Rhizoma) (five liang) Huang Qin (Scutellariae Radix) (five liang) Ku Shen (Sophorae Flavescentis Radix) (six liang) Sha Shen (Glehniae Radix) (five liang) Gan Di Huang (Rehmanniae Radix Preparata) (six liang) Gan Ge (Puerariae Radix) (six liang) Zhi Zi Ren (Gardeniae Semen) (three liang) Mai Men Dong (Ophiopogonis Tuber) (one sheng, remove heart) Di Gu Bai Pi (Lycii Cortex) (five liang) Fu Ling (Poria) (five liang)
Pulverize the above ten herbs, mix with honey to form pills. Take with rice water. Initial dose: ten pills, three times daily. Gradually increase to thirty pills. Pill size like wu zi. Some cases of jaundice can be cured by taking pig fat alone. Avoid pork, cold water, strong vinegar, and Euodia fruit. (Same as Wu Sheng's formula)