仲景《伤寒论》,黄家腹满,小便不利而赤,身汗出者,表和里实也,宜下之,大黄黄
柏皮栀子硝石汤方。
大黄(四分) 黄柏(四两) 栀子(十五枚) 硝石(四两)
上四味,切,以水六升,煮三物得二升半,去滓,纳硝石更煎取一升。先食顿服尽。
(《短剧》、《千金翼》、《深师》、《范汪》并同)
又黄胆小便色不变,欲自利,腹满而喘者,不可除其热,热除必哕,哕者,小半夏汤主
之方。
半夏(五两炮) 生姜(八两)
上二味,以水六升,煮取一升半,去滓,分温三服。忌羊肉、饧。(《范汪》同,并第
十四卷中)
《病源》黄汗之为病,身体洪肿,发热汗出而渴,状如风水,汗染衣,色正黄如柏汁,
其脉自沉,此由脾胃有热,汗出而入水中,若浴,水入汗孔得之。(出第十二卷中)
仲景《伤寒论》师曰,黄汗为病,身体肿,发热汗出而渴,状如风水,汗沾衣色,正黄
如柏汁,脉自沉也。问曰,从何得之?师曰,以汗出水入汗孔,水从外入而得之,宜黄 芍
药桂心酒汤主之方。
黄 (五两) 芍药(三两) 桂心(三两)
上三味,切,以苦酒一升,水七升,和煮取三升,去滓,温服一升。正当心烦也,至六
七日稍稍自除,其心烦不止者,以苦酒阻故也。(阻作)一方用美清醯代酒。忌生葱。(《备
急》、张文仲、《千金》、《古今录验》、《深师》、《范汪》、《经心录》同)
又凡黄汗之病,两胫自冷,假令发热,此属历节。食已则汗出,又身常夜卧盗汗出者,
此劳气也。若汗出即发热者,久久身必甲错也;发热不止者,必生恶疮也;若身重汗出已辄
轻者,久久必身 , 则胸中痛,又从腰以上必汗出,下无汗,腰髋弛痛,如虫在皮中状,
剧者不能食,身疼重,烦躁,小便不利者,名曰黄汗。桂枝汤加黄 五两主之方。
桂心(三两) 芍药(三两) 甘草(三两炙) 生姜(三两) 大枣(十二枚) 黄
(五两)
上六味,切,以水八升,微火煎取三升,去滓,温服一升。覆取微汗,须臾间不汗者,
食稀热粥一升余以助汤力,若不汗者,更服汤也。忌海藻、菘菜、生葱。(《古今录验》、
《范汪》同,出第十四卷中)
疗黄胆身肿,发热汗出而渴,状如风水,汗出着衣皆黄。黄汗吴蓝汤方。
吴蓝(六分) 芍药 麦门冬(去心) 桑白皮 汉防己 白藓皮 山栀子(各六分)
上七味,各细切,以水二升,煎取八合,去滓,空腹分二服,未效再合服。(此方未详
所出)
张仲景《伤寒论》中指出,黄疸病患者出现腹部胀满、小便不利且颜色深红、身体出汗的症状,这是表证已解而里实证存在的表现,适宜采用攻下法治疗,方用大黄黄柏皮栀子硝石汤。
以上四味药,切碎,用水六升,煎煮前三味药,取汁二升半,滤去药渣,加入硝石再煎至一升。饭前一次性服完。
(《短剧》、《千金翼方》、《深师方》、《范汪方》均与此相同)
另外,黄疸病患者小便颜色正常,想要自发性腹泻,腹部胀满且伴有气喘的,不可单纯清除其热邪,若强行清热必会导致呃逆,呃逆者,用小半夏汤主治。
以上两味药,用水六升,煎取一升半,滤去药渣,分三次温服。忌食羊肉、饴糖。(《范汪方》相同,并收录于第十四卷中)
《诸病源候论》记载:黄汗这种病,身体高度浮肿,发热出汗且口渴,症状类似风水病,汗水染湿衣物,颜色正黄如柏树汁液,脉象沉细,这是由于脾胃有热,出汗后进入水中或洗浴时,水气从汗孔侵入所致。(出自第十二卷中)
张仲景《伤寒论》中老师说,黄汗这种病,身体浮肿,发热出汗且口渴,症状类似风水病,汗水沾湿衣物,颜色正黄如柏树汁液,脉象沉细。问道:这是什么原因引起的?老师说:因为出汗后入水,水气从汗孔侵入,由外而入导致此病,适宜用黄芍药桂心酒汤主治。
以上三味药,切碎,用醋一升,水七升,混合煎取三升,滤去药渣,温服一升。服药后正当心中烦闷,到了六七天会稍稍自行缓解,如果心烦不止,是因为醋的阻滞作用所致。(“阻”字作解释)。另一方案使用优质米醋代替酒。忌食生葱。(《备急千金要方》、张文仲、《千金方》、《古今录验方》、《深师方》、《范汪方》、《经心录》均相同)
另外,凡是黄汗病,两小腿自然发冷,假如发热,这属于历节病。饭后则出汗,又经常夜间睡眠时盗汗的,这是劳气病。如果出汗后即发热,久而久之身体必然会出现肌肤甲错;发热不止的,必定会生恶疮;如果身体沉重,出汗后随即减轻的,久而久之必然身体麻木不仁,则胸中疼痛,并且腰部以上必然出汗,腰部以下无汗,腰髋部弛缓疼痛,感觉像有虫子在皮肤中爬行,病情严重的不能进食,身体疼痛沉重,烦躁,小便不利的,名为黄汗。用桂枝汤加黄芪五两主治。
桂心(三两) 芍药(三两) 甘草(三两,炙) 生姜(三两) 大枣(十二枚) 黄芪(五两)
以上六味药,切碎,用水八升,用微火煎取三升,滤去药渣,温服一升。服药后覆盖衣被取微汗,片刻间若无汗出,喝稀热粥一升多以助药力,若仍无汗,再服用汤药。忌食海藻、白菜、生葱。(《古今录验方》、《范汪方》相同,出自第十四卷中)
治疗黄疸身肿,发热出汗且口渴,症状类似风水病,汗水沾湿衣物皆发黄。黄汗吴蓝汤方。
吴蓝(六分) 芍药 麦门冬(去心) 桑白皮 汉防己 白鲜皮 山栀子(各六分)
以上七味药,分别细细切碎,用水二升,煎取八合,滤去药渣,空腹分两次服用,若无效再煎服一次。(此方出处不详)
In Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Pathogenic Diseases), it is stated that for patients with Huangdan (Jaundice) presenting with abdominal fullness, difficult and dark red urination, and sweating, this indicates that the exterior syndrome has resolved while an interior excess syndrome exists. It is appropriate to use a purgative method, prescribing the Dahuang Huangbopi Zhizi Xiaoshi Tang (Rhubarb, Phellodendron Bark, Gardenia, and Niter Decoction).
Dahuang (Rhei Radix et Rhizoma) (4 fen) Huangbai (Phellodendri Cortex) (4 liang) Zhizi (Gardeniae Fructus) (15 pieces) Xiaoshi (Natrii Sulfas) (4 liang)
The above four ingredients are sliced. Using 6 sheng of water, decoct the first three ingredients to obtain 2.5 sheng. Strain the dregs, add Xiaoshi (Natrii Sulfas), and decoct further to obtain 1 sheng. Take the entire dose in one go before meals.
(The texts *Duanju*, *Qianjin Yifang*, *Shenshi Fang*, and *Fan Wang Fang* all agree with this.)
Furthermore, for patients with Huangdan (Jaundice) whose urine color remains unchanged, who desire spontaneous diarrhea, and who present with abdominal fullness and wheezing, heat should not be cleared directly. Clearing the heat will inevitably lead to hiccups (Yue). For hiccups, the Xiaobanxia Tang (Minor Pinellia Decoction) is the primary treatment.
Banxia (Pinelliae Rhizoma) (5 liang, processed) Shengjiang (Zingiberis Rhizoma Recens) (8 liang)
The above two ingredients are decocted in 6 sheng of water to obtain 1.5 sheng. Strain the dregs and divide into three warm doses. Avoid mutton and maltose syrup. (*Fan Wang Fang* agrees; see Volume 14.)
According to *Zhubing Yuanhou Lun* (Source Book of All Categories of Diseases and Syndromes): The disease known as Huanghan (Yellow Sweat) presents with severe body edema, fever, sweating, and thirst. Its appearance resembles Fengshui (Wind-Water Edema). The sweat stains clothing yellow, resembling the juice of the Phellodendron tree. The pulse is naturally deep. This condition arises from heat in the Spleen and Stomach; when sweating, entering water or bathing allows water to enter through the sweat pores. (From Volume 12.)
In Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Pathogenic Diseases), the Master said: The disease Huanghan (Yellow Sweat) presents with body swelling, fever, sweating, and thirst, resembling Fengshui (Wind-Water Edema). The sweat stains clothing yellow, like Phellodendron juice, and the pulse is deep. Asked: How is it contracted? The Master replied: It is contracted because water enters the sweat pores after sweating, entering from the exterior. It should be treated primarily with Huang Shaoyao Guixin Jiu Tang (Astragalus, Peony, and Cinnamon Heart Wine Decoction).
Huangqi (Astragali Radix) (5 liang) Shaoyao (Paeoniae Radix) (3 liang) Guixin (Cinnamomi Ramulus/Cortex) (3 liang)
The above three ingredients are sliced. Using 1 sheng of vinegar (Ku Jiu) and 7 sheng of water, decoct together to obtain 3 sheng. Strain the dregs and take 1 sheng warm. After taking the medicine, there may be initial mental restlessness (Xin Fan); by the sixth or seventh day, it will gradually resolve spontaneously. If the restlessness persists, it is due to the obstructive nature of the vinegar. (Alternative formula uses good rice vinegar instead of wine. Avoid raw green onions. *Beiji Qianjin Yaofang*, Zhang Wenzhong, *Qianjin Fang*, *Gujin Luyan Fang*, *Shenshi Fang*, *Fan Wang Fang*, and *Jingxin Lu* all agree.)
Furthermore, regarding any case of Huanghan (Yellow Sweat), if the lower legs are naturally cold, but if they feel hot, this belongs to Lijie (Periarthritis/Gout). Sweating after eating, along with frequent night sweats during sleep, indicates Laoqi (Consumptive Qi deficiency). If fever occurs immediately after sweating, over time the skin will become rough and scaly (Jiacuo). If fever persists without stopping, malignant sores will likely develop. If the body feels heavy but becomes lighter after sweating, over time the body may become numb (Ma Mu), accompanied by chest pain. There will be sweating above the waist but none below, with flaccid pain in the loins and hips, feeling like insects crawling on the skin. In severe cases, inability to eat, body pain and heaviness, irritability, and difficult urination occur; this is named Huanghan (Yellow Sweat). It is treated with Guizhi Tang (Cinnamon Twig Decoction) plus Huangqi (Astragali Radix) 5 liang.
Guixin (Cinnamomi Ramulus/Cortex) (3 liang) Shaoyao (Paeoniae Radix) (3 liang) Gancao (Glycyrrhizae Radix et Rhizoma) (3 liang, honey-fried) Shengjiang (Zingiberis Rhizoma Recens) (3 liang) Dazao (Jujubae Fructus) (12 pieces) Huangqi (Astragali Radix) (5 liang)
The above six ingredients are sliced. Using 8 sheng of water, decoct gently over low fire to obtain 3 sheng. Strain the dregs and take 1 sheng warm. Cover the patient to induce slight sweating. If no sweat appears after a short while, drink more than 1 sheng of hot thin porridge to assist the medicinal power. If still no sweat, administer another dose. Avoid seaweed, Chinese cabbage, and raw green onions. (*Gujin Luyan Fang* and *Fan Wang Fang* agree; see Volume 14.)
To treat Huangdan (Jaundice) with body swelling, fever, sweating, and thirst, resembling Fengshui (Wind-Water Edema), where sweat stains clothing yellow. Huanghan Wulan Tang (Yellow Sweat Indigo Decoction).
Wulan (Indigotis Folium) (6 fen) Shaoyao (Paeoniae Radix) Maimendong (Ophiopogonis Radix) (decored) Sangbaipi (Mori Cortex) Hanfangji (Stephaniae Tetrandrae Rhizoma) Baixianpi (Dictamni Cortex) Shanzhizi (Gardeniae Fructus) (each 6 fen)
The above seven ingredients are finely sliced. Using 2 sheng of water, decoct to obtain 8 ge. Strain the dregs and divide into two doses taken on an empty stomach. If ineffective, prepare and take another dose. (Origin of this formula is unclear.)