仲阳云∶身痛背转强,大小便涩,一身皆黄,面目爪甲俱黄,小便如屋尘汁色,着物皆黄褐者,难治,此黄胆也。
别有一症,生下百日及半年,不因病后身微黄者,胃热也。大人亦同。又有面黄腹大,食吐渴者,脾疳也。又有初生而
面身黄者,胎疸也。诸疸皆热、色深黄者是也,若淡黄兼白者,胃怯不和也,茵陈汤、栀子柏皮汤、犀角散、连翘赤小
豆汤主之。通治黄胆,茵陈五苓散尤为稳也。又有脾弱痿黄,小便清者,治以温剂,当归丸散主之,小半夏汤亦可用也。
茵陈汤 治阳明病发热汗出者,此为热越不能发黄也。但头汗出,身无汗,齐颈而还,小便不利,渴引水浆者,
此为瘀热在里,身必发黄。伤寒七八日身黄如橘色,小便不利,腹微满者。
茵陈蒿(嫩者、一两) 大黄(三钱半) 栀子(大者、三枚)
上锉散,以水一大碗,先煎茵陈减半,次用二味煎八分,去滓温服,日三服,小盒饭利,如皂角汁状、色正赤,一
宿腹减,黄从小便中去也,量大小加减。
栀子柏皮汤 治伤寒身黄发热。
栀子(八枚) 黄柏(一两) 甘草(炙、半两)
上锉散,每服二钱,水一盏,煎六分,去滓温服。
犀角散 治小儿黄胆,一身尽黄。
犀角(一两) 茵陈 干葛 升麻 龙胆草 生地黄(各半两) 寒水石(七钱半)
上锉散,白水煎。一方治小儿忽发黄,面目皮肉须尽黄,干葛根汁和蜜服。
连翘赤小豆汤 治小儿伤寒,发黄身热。
麻黄(去节) 连翘 甘草 生姜 赤小豆 生梓白皮(各二两) 杏仁(四十一粒) 大枣(十二枚)
上锉散,白水煎。一方小麦苗捣汁,服之立效。
茵陈五苓散
五苓散五分加茵陈汤十分
上二件拌匀,每服一钱,温水调下,日三服。
当归散 治小儿夜啼者,脏寒而腹痛也,面青手冷,不吮乳是也,宜用此方。
甘草(炙) 桔梗 陈皮 当归(各一钱)
上为末,水煎半盏,时时少与服之。又有热痛,亦啼叫不止,夜发面赤唇焦,小便赤,与三黄丸人参汤下。
当归丸 治小儿冷热不调,大便青黄,心腹多痛,或腹中气满,或时呕逆不吮乳食,加枳壳尤妙。
当归 白芍药 人参 川芎(各三钱) 甘草(炙) 白术(各半两)
上为末,煮面糊为丸,如麻子大,三岁小儿每服十丸,粥饮送下,日三服。更量大小加减,冷甚者加陈皮。
小半夏汤 治黄胆小便色不异,欲自利腹满而喘者,不可除热,热去必哕。
半夏(汤洗七次)
上锉散,每服三钱,水一盏,姜十片,煎七分温服。
消食丸 常服宽中快气,消乳食,正颜色。
缩砂仁(炒) 陈皮(炒) 三棱(煨) 莪术(煨) 神曲(炒) 麦 (炒) 香附子(米泔浸一宿、炒用)
枳壳 槟榔 乌梅(各半两) 丁香(二钱半)
上为末,面糊丸如绿豆大,食后苏子汤、下二十丸或三十丸。
鲁伯嗣引用仲阳的话说:身体疼痛,背部僵硬强直,大小便不通畅,全身发黄,面目和指甲都变黄,小便颜色像屋尘的汁液一样,沾染衣物后呈现黄褐色,这种情况难以治疗,这是黄疸病。
另外还有一种症状,婴儿出生一百天到半年期间,并非因为患病之后身体微黄,这是胃热所致。成年人也有类似情况。又有面部发黄、腹部胀大、饮食呕吐且口渴的,这是脾疳。又有刚出生时面部和身体就发黄的,这是胎疸。各种黄疸都是热证,颜色深黄的属于此类;如果颜色淡黄兼带白色,则是胃气虚弱、不和顺所致,可用茵陈汤、栀子柏皮汤、犀角散、连翘赤小豆汤主治。通治黄疸,茵陈五苓散尤为稳妥。又有因脾弱导致面色萎黄、小便清长的,应用温性药物治疗,以当归丸散为主,小半夏汤也可以使用。
茵陈汤:治疗阳明病发热汗出的,这是因为热邪向外发散,不能发黄。但如果只有头部出汗,身上无汗,汗水仅到颈部即止,小便不利,口渴想喝水浆的,这是瘀热郁结在体内,身体必然发黄。伤寒病七八天后,身体黄得像橘子色,小便不利,腹部轻微胀满的,也适用此方。
茵陈蒿(选用嫩叶,一两) 大黄(三钱半) 栀子(大的,三枚)
以上药材切碎成散剂,用水一大碗,先煎茵陈至水量减半,再加入另外两味药煎至剩余八分,滤去药渣,温服,每日三次。小便应当通畅,排出物像皂角汁一样,颜色正红,过一夜腹部胀满减轻,黄色从小便中排出,剂量根据患者年龄大小增减。
栀子柏皮汤:治疗伤寒导致的身黄发热。
栀子(八枚) 黄柏(一两) 甘草(炙过的,半两)
以上药材切碎成散剂,每次服用二钱,用水一盏,煎至六分,滤去药渣,温服。
犀角散:治疗小儿黄疸,全身尽黄。
犀角(一两) 茵陈 干葛 升麻 龙胆草 生地黄(各半两) 寒水石(七钱半)
以上药材切碎成散剂,用清水煎煮。另一方法治疗小儿突然发黄,面目皮肤肌肉全部发黄,用干葛根汁调和蜂蜜服用。
连翘赤小豆汤:治疗小儿伤寒,发黄身热。
麻黄(去节) 连翘 甘草 生姜 赤小豆 生梓白皮(各二两) 杏仁(四十一粒) 大枣(十二枚)
以上药材切碎成散剂,用清水煎煮。另一方法用小麦苗捣汁,服用后立即见效。
茵陈五苓散
五苓散五分 加 茵陈汤十分
将以上两味拌匀,每次服用一钱,温水调下,每日三次。
当归散:治疗小儿夜啼,因内脏寒冷而腹痛,面色青、手脚冷,不吸吮乳汁,适宜使用此方。
甘草(炙过的) 桔梗 陈皮 当归(各一钱)
以上研为末,用水煎取半盏,不时少量喂服。又有因热痛而啼叫不止,夜间发作面红唇焦,小便赤红的,用人参汤送服三黄丸。
当归丸:治疗小儿冷热不调,大便青黄,心腹多痛,或腹部气满,或时常呕吐逆气、不吸吮乳食,加入枳壳尤其妙。
当归 白芍药 人参 川芎(各三钱) 甘草(炙过的) 白术(各半两)
以上研为末,用煮面的糊状物制成丸药,如麻子大小,三岁小儿每次服用十丸,用粥饮送下,每日三次。更需根据年龄大小增减剂量,寒冷严重的加陈皮。
小半夏汤:治疗黄疸小便颜色无明显异常,想要自利(腹泻)但腹部胀满且喘息的,不可清热,热去必会导致呃逆。
半夏(用热水洗七次)
以上切碎成散剂,每次服用三钱,用水一盏,姜十片,煎至七分,温服。
消食丸:常服可宽中快气,消化乳食,改善面色。
缩砂仁(炒) 陈皮(炒) 三棱(煨) 莪术(煨) 神曲(炒) 麦芽(炒) 香附子(米泔水浸泡一夜、炒用) 枳壳 槟榔 乌梅(各半两) 丁香(二钱半)
以上研为末,用面糊制成丸药如绿豆大小,饭后用苏子汤送下二十丸或三十丸。
Lu Bosi quotes Zhongyang: "Body pain, stiffness and rigidity of the back, difficulty in urination and defecation, yellowing of the whole body, yellowing of the face, eyes, and nails, urine the color of sediment from a house, staining clothes with a yellowish-brown hue—this is difficult to treat and constitutes Jaundice (Huangdan).
There is another condition where an infant, between one hundred days and six months of age, has a slight yellowing of the body not caused by illness; this is due to Stomach Heat (Wei Re). Adults may present similarly. Another presentation involves a yellow face, distended abdomen, vomiting after eating, and thirst; this is Spleen Gangrene (Pi Gan). Yet another occurs when a newborn presents with yellowing of the face and body immediately upon birth; this is Fetal Jaundice (Tai Dan). All types of jaundice are heat syndromes characterized by deep yellow coloration. If the color is pale yellow mixed with white, it indicates Stomach Weakness and Disharmony (Wei Qie Bu He), which should be treated with Yinchen Tang (Artemisia Capillaris Decoction), Zhizi Bopi Tang (Gardenia and Phellodendron Bark Decoction), Xijiao San (Rhinoceros Horn Powder), or Lianqiao Chixiaodou Tang (Forsythia and Adzuki Bean Decoction). For general treatment of jaundice, Yichen Wuling San (Artemisia Capillaris and Five-Ingredient Poria Pill) is particularly stable. In cases of Spleen Weakness presenting with sallow complexion and clear urine, warm agents should be used, primarily Danggui Wan/San (Angelica Sinensis Pill/Powder); Xiaobanxia Tang (Minor Pinellia Decoction) may also be employed.
Yinchen Tang: Treats Yangming disease with fever and sweating, indicating that heat is venting outward and cannot cause jaundice. However, if there is sweating only on the head, no sweating on the body, sweating stopping at the neck, difficulty in urination, and thirst for fluids, this indicates stagnant heat trapped inside, leading to inevitable jaundice. It is also indicated for Shaoyang disease persisting for seven to eight days with skin yellow like an orange peel, difficulty in urination, and mild abdominal fullness.
Ingredients: Yinchen Hao (Young Artemisiae Scopariae Herba, 1 liang), Dahuang (Rhei Radix et Rhizoma, 3 qian half), Zhizi (Gardeniae Fructus, 3 large fruits).
Preparation: Coarsely powder the ingredients. Boil in one large bowl of water. First decoct Yinchen until the volume is halved, then add the other two ingredients and decoct until eight-tenths remains. Strain and take warm. Administer three times daily. The patient should experience diuresis; the urine will resemble soap pod juice and appear bright red. After one night, abdominal fullness will decrease as the yellow pigment is expelled via urination. Dosage should be adjusted according to the patient's size/age.
Zhizi Bopi Tang: Treats jaundice and fever resulting from Cold Damage (Shanghan).
Ingredients: Zhizi (Gardeniae Fructus, 8 fruits), Huangbai (Phellodendri Cortex, 1 liang), Gancao (Prepared Glycyrrhizae Radix et Rhizoma, 0.5 liang).
Preparation: Coarsely powder. Take 2 qian per dose. Boil in one cup of water until six-tenths remains. Strain and take warm.
Xijiao San: Treats pediatric jaundice with generalized yellowing.
Ingredients: Xijiao (Rhinocerotis Cornu, 1 liang), Yinchen (Artemisiae Scopariae Herba), Gange (Puerariae Radix), Shengma (Cimicifugae Rhizoma), Longdancao (Gentianae Radix), Shengdihuang (Rehmanniae Radix, each 0.5 liang), Hanshuishi (Halloysit Rubrum, 7 qian half).
Preparation: Coarsely powder and decoct in plain water. An alternative method for sudden pediatric jaundice with yellowing of the face, eyes, skin, and muscles is to administer juice from Gegen (Puerariae Radix) mixed with honey.
Lianqiao Chixiaodou Tang: Treats pediatric Cold Damage with jaundice and fever.
Ingredients: Mahuang (Ephedrae Herba, de-noded), Lianqiao (Forsythiae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), Chixiaodou (Adzuki Bean), Shengzibai pi (Morus Albae Cortex Radicis, each 2 liang), Xingren (Prunus Armeniacae Semen Amarum, 41 grains), Dazao (Jujubae Fructus, 12 fruits).
Preparation: Coarsely powder and decoct in plain water. An alternative method using juice from wheat seedlings yields immediate results.
Yinchen Wuling San
Composition: 0.5 fen of Wuling San (Five-Ingredient Poria Pill) added to 1 fen of Yinchen Tang (Artemisia Capillaris Decoction).
Preparation: Mix evenly. Take 1 qian per dose, mixed with warm water. Administer three times daily.
Danggui San: Treats nocturnal crying in infants due to internal cold causing abdominal pain, manifested by a blueish face, cold hands, and refusal to suckle.
Ingredients: Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Chenpi (Citri Reticulatae Pericarpium), Danggui (Angelicae Sinensis Radix, each 1 qian).
Preparation: Grind into powder. Decoct in water to obtain half a cup. Administer small amounts frequently. For crying due to heat pain, characterized by nighttime onset, red face, scorched lips, and red urine, administer Sanhuang Wan (Three-Yellow Pill) with Ginseng Decoction.
Danggui Wan: Treats pediatric imbalance of cold and heat, greenish-yellow stools, frequent heart and abdominal pain, abdominal distension with gas, or intermittent vomiting and refusal to feed. Adding Zhike (Aurantii Fructus) is especially effective.
Ingredients: Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Renshen (Ginseng Radix et Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma, each 3 qian), Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma, each 0.5 liang).
Preparation: Grind into powder and form pills using flour paste, sized like hemp seeds. For a three-year-old child, administer ten pills per dose with gruel drink, three times daily. Adjust dosage based on age/size. Add Chenpi (Citri Reticulatae Pericarpium) for severe cold.
Xiaobanxia Tang: Treats jaundice where urine color is unremarkable, accompanied by desire for spontaneous diarrhea, abdominal fullness, and wheezing. Do not clear heat; clearing heat will inevitably lead to hiccups.
Ingredients: Banxia (Pinelliae Rhizoma, washed seven times with hot water).
Preparation: Coarsely powder. Take 3 qian per dose. Boil in one cup of water with ten slices of ginger until seven-tenths remains. Take warm.
Xiaoshi Wan: Regular use promotes middle-jiao relaxation and qi movement, aids digestion of milk and food, and improves complexion.
Ingredients: Suosharen (Amomi Fructus Rotundus, stir-fried), Chenpi (Citri Reticulatae Pericarpium, stir-fried), Sanleng (Sparganii Rhizoma, baked), Ezhu (Curcumae Rhizoma, baked), Shenqu (Massa Medicata Fermentata, stir-fried), Maiya (Hordei Fructus Germinatus, stir-fried), Xiangfuzi (Cyperi Rhizoma, soaked in rice wash overnight and stir-fried), Zhike (Aurantii Fructus), Binglang (Arecae Semen), Wumei (Mume Fructus, each 0.5 liang), Dingxiang (Caryophylli Flos, 2 qian half).
Preparation: Grind into powder and form pills using flour paste, sized like mung beans. Take twenty or thirty pills after meals with Perilla Seed Decoction.