(亦名黄病,余发黄附)
《巢氏病源》小儿黄病候∶黄病者,是热入于脾胃,热气蕴积,与谷气相搏,蒸发于外,故皮肤悉黄,眼亦
黄。脾与胃合候肌肉,俱象土,其色黄,故皮肤、肉热积,蒸发令肌肤黄。此或者伤寒,或时行,或温病,皆
由热不时解,所以入胃也。凡发黄而下痢,心腹满者,死。诊其脉沉细者,死。又有百日、半岁小儿,非关伤
寒、温病而身微黄者,亦是胃气热,慎不可灸也。灸之则热甚,此是将息过度所为,微薄其衣,数与除热粉散
粉之,自歇。不得妄与汤药及灸也。
《活人书》论伤寒小儿、大人治,一般但小分剂,药差凉耳。问∶发黄者,何也?病患寒湿在里不散,热蓄
于脾胃,腠理不开,瘀热与宿谷相搏,郁蒸不消化,故发黄。(汉赞南方暑湿,近夏瘅热,盖瘅者,黄也。古人以黄为
瘅,湿热相搏,民多病瘅,甚为跗肿。)然发黄与瘀血外证及脉俱相似,但小便不利为黄,小便自利为瘀血。要之发黄
之人心脾蕴积发热引饮,脉必浮滑而紧数。若瘀血证,即如狂,大便必黑,此为异耳。凡病患身体发热,头面汗出,身
无汗,剂颈而止;渴引水浆,小便不利,如此必发黄。茵陈蒿汤、五苓加茵陈散也。(茵陈蒿汤十分,五苓散五分,二
十件拌匀,每服三钱,温水调下,日三服。)病患服得汤,小便利,如皂荚汁赤,一宿腹减,则黄从小便中出也。古人
云∶治湿不利小便,非其治也。(大抵发黄者,瘀热在里,由小便不利而致也。)栀子柏皮汤、麻黄连翘赤小豆汤,可选
而
用之。又方∶伤寒欲发黄者,急用瓜蒂末,口含水,搐一字许入鼻中,出黄水甚验,即用茵陈汤调五苓散服之,最良。
又问∶白虎诸亦身热,烦渴引饮,小便不利,何以不发黄?答曰∶白虎与发黄证相近,遍身汗出,此为热越,白虎证也。
头面汗出,颈以下都无汗,发黄证也。又问∶太阳病,一身尽痛,发热,身如熏黄者,何也?太阳中湿也。仲景云∶
伤寒发汗已,身目为黄,所以然者,以寒湿在里不解故也。以为不可下也,于寒湿中求之。(在第六卷,第十问。第十
问曰∶一身尽痛,发热身黄,小便不利,大便反快也,何也?此名中湿也。风雨袭虚,山泽蒸气,人多中湿。湿流关节,
须身体烦痛,其脉沉缓,为中湿。脉细者,非已至一身尽痛,发热身黄,小便自利者,术附汤。若小便不利,大便反快,
当利其小便,宜甘草附子汤、五苓散主之。麻黄加白术汤。)又问∶病患脉弦浮大,而短气腹都满,胁下及心痛;久按
之气不通,鼻干,不得汗,嗜卧,一身及目悉黄,小便难,有潮热,时时咳嗽者,何也?少阳中风也。小柴胡汤主之。
《千金》治小儿伤寒发黄方。
捣土瓜根,汁三合服之。(《圣惠》取土瓜根汁一大合,蜜半匙相和,渐渐服之。)
《千金》又方
捣青麦汁服之。
《千金》又方
捣韭根汁,澄清,以滴儿鼻中大豆许,即出黄水瘥。
《千金》又方
小豆(三七粒) 瓜蒂(十四枚) 糯米(十四粒)
上三味为末,吹鼻中。(《圣惠》以糯米为粳米,用四十粒。乃云∶用药绿豆大,吹鼻中,有黄水出,立瘥。)
《外台》∶《近效》疗天行,三日外若忽觉心上妨满坚硬,脚手心热,则变为黄。不疗杀人。秦艽汤方
秦艽 紫草 白藓皮 黄芩 栀子仁(各一两)
上五味切,以水一大升半,牛乳一大升,煮取七合,分为二服。老小以意量之,一剂不愈,更与一剂,试
有效。
《广利方》治小儿忽发黄,面目皮肉并黄。
生栝蒌根捣,取汁二合,蜜一大匙,二味暖相和,分再服。
《经验方》治遍身如金色。
瓜蒂(四十九个,须是六月六日收者为末) 丁香(四十九个,入甘锅烧,烟尽为度,细研)
上同研匀,小儿用半字,吹鼻内及揩牙。
《圣惠》治小儿黄病,身如橘色。茵陈散方
茵陈 川芒硝(各一两) 栀子仁 川大黄(锉碎,微炒) 黄芩 犀角 木通(锉) 寒水石(各半两)
上件药捣筛为散。每服一钱,以水一小盏,煎至五分去滓。不计时候,温服。量儿大小加减服之。
《圣惠》治小儿天行病,发黄,心腹胀急。三黄散方
川大黄(锉碎,微炒) 黄芩(各半两) 栀子仁(一分)
上件药捣,粗罗为散。每服一钱,以水一小盏,煎至五分,去滓,不计时候,温服。更量儿大小加减服之。
(《婴孺》用三物各十分,水三升半,浸少时,猛火煮取一升二合,百日儿一合半;一、二岁分四服,取利。)
《圣惠》治小儿脾胃热毒,致肌肉变黄,小便赤色,心中烦燠。茵陈丸方
茵陈 栀子仁 川大黄(锉碎,微炒) 甘草(炙微赤,锉) 秦艽(去苗。各一两) 川朴硝(半两)
上件药捣,罗为末,炼蜜和丸如绿豆大。不计时候,以温水下五丸。量儿大小加减服之。
《圣惠》治小儿诸黄。大黄散方
川大黄(锉碎,微炒) 黄连(去须) 栝蒌根 黄芩 栀子仁(各半两)
上件药捣,粗罗为散。每服一钱,以水一小盏,煎至五分,去滓。不计时候,温服。量儿大小以意增减。
《圣惠》治小儿热毒攻脾胃,遍身俱黄,小便赤涩,大便难,心神躁热,两目亦黄。升麻丸方
川升麻 龙胆(去芦头) 栀子仁 黄芩 川大黄(锉碎,微炒) 秦艽(去苗) 甘草(炙微赤。各半两)
上件药捣,罗为末,炼蜜和丸如桐子大。不计时候,以新汲水研下三丸。三岁以上加丸数服。
《圣惠》治小儿诸黄,心胸壅闷。宜服大黄丸方
川大黄(锉碎,微炒) 甜葶苈(隔纸炒,令紫色) 茵陈(各半两)
上件药捣,罗为末,炼蜜和丸如桐子大。不计时候,以新汲水研下三丸。量儿大小增减服之。
《圣惠》治小儿浑身及面色俱黄。宜服黄瓜丸方
黄连(一两,去须) 胡黄连(半两)
上件药捣,罗为末。用黄瓜一枚,去瓤,留一小盖子,入药末后,以盖子盖定,用大麦面裹烧,令面匀 ,
去面捣熟,丸如绿豆大。七岁儿每服以温水下七丸,看儿大小,加减丸数服之。
《圣惠》又方
秦艽(半两)
上件药捣,细罗为散。每服一钱,以牛乳一合,煎一、二沸,去滓。不计时候,温服。三岁以下即可半钱。
《婴孺》治小儿发黄茵陈汤
茵陈 升麻 黄芩 柴胡 知母 羚羊角(屑。各八分) 大黄 石膏(各一钱二分) 栀子(一钱) 芍药(六
分) 瓜蒂(七个) 蓝叶(切,一升) 甘草(二分,炙)
上切,以水五升,煮一升半。一、二岁为八服,四、五岁为四服,量儿大小与之。
张涣治伤寒时气,热入于胃,与谷气相搏,蒸发肌肉,使面目皮肤悉黄,谓之黄病。亦名发黄。芦根汤方
芦根(一两) 茵陈 山栀子 黄芩 甘草(炙。各半两)
上件为细末。每服一钱,以水八分,薄荷三叶,煎五分,去滓温服。
张涣子芩散方 治黄病。
黄芩 栝蒌根 茯神(各一两) 胡黄连 甘草(炙。各半两)
上件捣罗为细末。每服一钱,以水八分,煎至五分,去滓,放温服。
张涣茵陈汤方 治小儿发黄等病,身如橘色。
山茵陈 山栀子仁(各一两) 川大黄 川芒硝 木通 寒水石(各七两)
上件捣罗为细末。每服一钱,以水八分,煎至五分,去滓温服。
张涣三黄散方 治黄病。
川大黄(锉碎,微炒,一两) 黄芩 黄连(各半两,去须)
上件捣罗为细末。每服一钱,以水一盏,煎至五分,去滓温服,食后。
《活人书》仲景茵陈蒿汤
茵陈蒿(嫩者,一两半) 大黄(半两,去皮) 栀子(大者,三枚半)
上锉如麻豆大。以水二大白盏,先煮茵陈,减半盏,次内二味,煮八分,去滓温服,日三服。小盒饭利,
尿如皂荚汁状,色正赤。一宿腹减,黄从小便中去也。
《活人书》五苓加茵陈散,方在证注中。
《活人书》仲景栀子柏皮汤
栀子(八枚) 黄柏(一两) 甘草(炙,半两)
上锉如麻豆大。每服抄五钱匕,以水一盏半,煮至七分,去滓温服。
《活人书》仲景麻黄连翘赤小豆汤
麻黄(去节) 连翘(连翘根是也) 甘草(炙。各一两) 赤小豆(半升) 生梓白皮(切,二两半) 杏仁(二
十枚,去皮尖)
上锉如麻豆大。每服抄五钱匕,生姜四片,枣子一枚,水一盏半,煮至八分,去滓温服。
《活人书》仲景小柴胡汤,方见头汗门中。
《活人书》仲景术附汤
白术(二两) 附子(一个半) 甘草(一两,炙)
上锉如麻豆大。每服抄五钱匕,生姜五片,枣子一枚,水一盏半,煮至七分,去滓温服。日三服。一服觉
身痹,半日许再服。三服都尽,其人如冒状,勿怪也,即是附子与术并走皮中,逐水气,未得除,故使之耳。
法当加桂一两。其大便坚,小便自利,故不加桂也。
《活人书》仲景甘草附子汤
甘草 白术(各一两) 附子(一枚,炮) 桂枝(二两,身肿者加防风二两;悸气、小便不利者加茯苓一两半)
上锉如麻豆大。每服抄五钱匕,以水一盏半,煮至七分。去滓温服,汗出即解。
《活人书》仲景五苓散,方见伤寒自汗门中。
《活人书》麻黄加术汤
麻黄(一两半) 桂枝(一两,去皮) 甘草(炙) 苍术(各半两) 杏仁(三十五枚,去皮尖)
上锉如麻豆大。每服抄五钱匕,以水一盏半,煮至八分,去滓温服。
《巢氏病源》中关于小儿黄病的论述:所谓黄病,是热邪侵入脾胃,热气蕴结积聚,与谷气相互搏结,向外蒸腾,所以皮肤全部变黄,眼睛也变黄。脾与胃相合,主司肌肉,都象征土行,其颜色为黄色,因此皮肤和肌肉中的热邪积聚,蒸腾导致肌肤变黄。这或者是伤寒,或者是时行疾病,或者是温病,都是因为热邪不能及时解除,所以传入胃中。凡是出现发黄并伴有下痢、心腹部胀满的,预后不良(死证)。诊察其脉象沉细的,也是死证。又有百日或半岁大的婴儿,并非因为伤寒、温病而身体轻微发黄的,这也是胃气有热,千万不可使用灸法。如果施灸则热势更盛,这是调养过度所致,应减少衣物,多次用除热粉散涂抹身体,自然就会缓解。不可随意给予汤药及进行灸治。
《活人书》讨论伤寒在小儿和大人身上的治疗,大体相同,只是剂量较小,药物性质偏凉罢了。问:为什么会发黄?答:患者体内寒湿停滞不散,热邪蓄积在脾胃,腠理闭塞不开,瘀热与宿食相互搏结,郁蒸导致食物无法消化,所以发黄。(汉代张仲景曾言南方暑湿,接近夏季时湿热炽盛,所谓“瘅”就是黄的意思。古人将黄称为瘅,湿热相搏,百姓多患瘅病,甚至出现浮肿。)然而发黄与瘀血的外证及脉象都很相似,区别在于小便不利的是发黄,小便自利的是瘀血。总之,发黄的人心脾蕴积发热而引水自救,脉象必定浮滑而紧数。如果是瘀血证,就会出现如狂的症状,大便必定发黑,这是不同之处。凡是病人身体发热,头面部出汗,身上无汗,汗水仅到颈部为止;口渴想喝水浆,小便不利,这样一定会发黄。可用茵陈蒿汤、五苓散加茵陈散。(茵陈蒿汤十分,五苓散五分,混合均匀共二十份,每次服用三钱,温水调服,每日三次。)病人服药后,小便通利,尿液像皂荚汁一样红赤,一夜之后腹胀减轻,那么黄邪就从小便排出了。古人说:治疗湿邪如果不通利小便,就不是正确的治疗方法。(大抵发黄者,是瘀热在里,由小便不利导致的。)栀子柏皮汤、麻黄连翘赤小豆汤,可以选择使用。又一方:伤寒想要发黄的,急忙用瓜蒂末,口中含水,取一字量吹入鼻中,流出黄水非常有效,随即用茵陈汤调服五苓散,效果最好。
又问:白虎汤证也有身热、烦渴引饮、小便不利,为什么不发黄?答:白虎汤证与发黄证相近,但遍身出汗,这是热邪外越,属于白虎汤证。如果是头面出汗,颈部以下都没有汗,则是发黄证。
又问:太阳病,全身疼痛,发热,身体像熏黄那样,是什么情况?这是太阳中湿。张仲景说:伤寒发汗后,身体和眼睛发黄,之所以这样,是因为寒湿在里不解的缘故。认为不可攻下,应在寒湿中寻求治法。(见第六卷第十问。第十问说:全身疼痛,发热身黄,小便不利,大便反而通畅,这是什么病?这叫中湿。风雨侵袭虚弱之体,山泽蒸气伤人,人多中湿。湿气流注关节,必须身体烦痛,脉象沉缓,为中湿。脉细的,不是这种情况。若至全身疼痛,发热身黄,小便自利的,用术附汤。如果小便不利,大便反而快,应当利小便,宜用甘草附子汤、五苓散主治。麻黄加白术汤。)
又问:病人脉弦浮大,短气,腹部全面胀满,胁下及心痛;久按之气不通,鼻干,无汗,嗜睡,全身及眼睛都黄,小便困难,有潮热,时时咳嗽,这是什么病?这是少阳中风。用小柴胡汤主治。
《千金方》治疗小儿伤寒发黄的方剂。
捣取土瓜根,取汁三合服用。(《圣惠方》取土瓜根汁一大合,蜂蜜半匙调和,慢慢服用。)
《千金方》又一方
捣取青麦汁服用。
《千金方》又一方
捣取韭根汁,澄清,滴入婴儿鼻中约大豆许量,即流出黄水而痊愈。
《千金方》又一方
小豆(三七粒) 瓜蒂(十四枚) 糯米(十四粒)
以上三味研为末,吹入鼻中。(《圣惠方》以糯米为粳米,用四十粒。又说:用药如绿豆大,吹入鼻中,有黄水出,立即痊愈。)
《外台秘要》引《近效方》治疗天行病,三天后如果忽然觉得心上妨闷坚硬,手脚心热,则会变为黄病。不治疗会致死。秦艽汤方
秦艽 紫草 白鲜皮 黄芩 栀子仁(各一两)
以上五味切碎,用水一大升半,牛乳一大升,煮取七合,分两次服用。老人小孩酌情决定用量,一剂无效,再给一剂,试用有效。
《广利方》治疗小儿忽然发黄,面目皮肉都黄。
生栝蒌根捣碎,取汁二合,蜂蜜一大匙,两味加热调和,分两次服用。
《经验方》治疗遍身如金色。
瓜蒂(四十九个,必须是六月六日收集的研为末) 丁香(四十九个,放入甘锅中烧,烟尽为止,细研)
以上共同研匀,小儿用半字量,吹入鼻内及擦拭牙齿。
《圣惠方》治疗小儿黄病,身体如橘色。茵陈散方
茵陈 川芒硝(各一两) 栀子仁 川大黄(锉碎,微炒) 黄芩 犀角 木通(锉) 寒水石(各半两)
以上药物捣筛为散。每次服用一钱,用水一小盏,煎至五分去渣。不限时候,温服。根据孩子大小加减服用。
《圣惠方》治疗小儿天行病,发黄,心腹胀急。三黄散方
川大黄(锉碎,微炒) 黄芩(各半两) 栀子仁(一分)
以上药物捣碎,粗罗为散。每次服用一钱,用水一小盏,煎至五分,去渣,不限时候,温服。再根据孩子大小加减服用。
(《婴孺书》用三物各十分,水三升半,浸泡片刻,猛火煮取一升二合,百日婴儿服一合半;一至二岁分四次服,以求泻下。)
《圣惠方》治疗小儿脾胃热毒,导致肌肉变黄,小便赤色,心中烦热。茵陈丸方
茵陈 栀子仁 川大黄(锉碎,微炒) 甘草(炙微赤,锉) 秦艽(去苗。各一两) 川朴硝(半两)
以上药物捣碎,罗为末,炼蜜和丸如绿豆大。不限时候,用温水送服五丸。根据孩子大小加减服用。
《圣惠方》治疗小儿诸黄。大黄散方
川大黄(锉碎,微炒) 黄连(去须) 栝蒌根 黄芩 栀子仁(各半两)
以上药物捣碎,粗罗为散。每次服用一钱,用水一小盏,煎至五分,去渣。不限时候,温服。根据孩子大小酌情增减。
《圣惠方》治疗小儿热毒攻脾胃,遍身俱黄,小便赤涩,大便难,心神躁热,两眼也黄。升麻丸方
川升麻 龙胆(去芦头) 栀子仁 黄芩 川大黄(锉碎,微炒) 秦艽(去苗) 甘草(炙微赤。各半两)
以上药物捣碎,罗为末,炼蜜和丸如桐子大。不限时候,用新汲水研开送服三丸。三岁以上增加丸数服用。
《圣惠方》治疗小儿诸黄,心胸壅闷。宜服大黄丸方
川大黄(锉碎,微炒) 甜葶苈(隔纸炒,令紫色) 茵陈(各半两)
以上药物捣碎,罗为末,炼蜜和丸如桐子大。不限时候,用新汲水研开送服三丸。根据孩子大小增减服用。
《圣惠方》治疗小儿浑身及面色俱黄。宜服黄瓜丸方
黄连(一两,去须) 胡黄连(半两)
以上药物捣碎,罗为末。用黄瓜一枚,去瓤,留一小盖子,装入药末后,以盖子盖定,用大麦面包裹烧制,令面均匀,去掉面皮捣熟,丸如绿豆大。七岁儿童每次用温水送服七丸,看孩子大小,加减丸数服用。
《圣惠方》又一方
秦艽(半两)
以上药物捣碎,细罗为散。每次服用一钱,用牛乳一合,煎一二沸,去渣。不限时候,温服。三岁以下的可服半钱。
《婴孺书》治疗小儿发黄茵陈汤
茵陈 升麻 黄芩 柴胡 知母 羚羊角(屑。各八分) 大黄 石膏(各一钱二分) 栀子(一钱) 芍药(六分) 瓜蒂(七个) 蓝叶(切,一升) 甘草(二分,炙)
以上切碎,用水五升,煮取一升半。一至二岁分为八次服,四至五岁分为四次服,根据孩子大小给予。
张涣治疗伤寒时气,热邪入于胃,与谷气相搏,蒸腾肌肉,使面目皮肤悉黄,称为黄病。也称为发黄。芦根汤方
芦根(一两) 茵陈 山栀子 黄芩 甘草(炙。各半两)
以上为细末。每次服用一钱,用水八分,薄荷三叶,煎至五分,去渣温服。
张涣子芩散方 治疗黄病。
黄芩 栝蒌根 茯神(各一两) 胡黄连 甘草(炙。各半两)
以上捣罗为细末。每次服用一钱,用水八分,煎至五分,去渣,放温服。
张涣茵陈汤方 治疗小儿发黄等病,身体如橘色。
山茵陈 山栀子仁(各一两) 川大黄 川芒硝 木通 寒水石(各七两)
以上捣罗为细末。每次服用一钱,用水八分,煎至五分,去渣温服。
张涣三黄散方 治疗黄病。
川大黄(锉碎,微炒,一两) 黄芩 黄连(各半两,去须)
以上捣罗为细末。每次服用一钱,用水一盏,煎至五分,去渣温服,饭后服用。
《活人书》仲景茵陈蒿汤
茵陈蒿(嫩者,一两半) 大黄(半两,去皮) 栀子(大者,三枚半)
以上锉如麻豆大。用水二大白盏,先煮茵陈,减半盏,再加入后两味,煮至八分,去渣温服,每日三次。小便通利,尿如皂荚汁状,颜色正赤。一夜之后腹胀减轻,黄邪从小便中去掉。
《活人书》五苓加茵陈散,方子在证注中。
《活人书》仲景栀子柏皮汤
栀子(八枚) 黄柏(一两) 甘草(炙,半两)
以上锉如麻豆大。每次取五钱匕,用水一盏半,煮至七分,去渣温服。
《活人书》仲景麻黄连翘赤小豆汤
麻黄(去节) 连翘(连翘根是也) 甘草(炙。各一两) 赤小豆(半升) 生梓白皮(切,二两半) 杏仁(二十枚,去皮尖)
以上锉如麻豆大。每次取五钱匕,生姜四片,枣子一枚,水一盏半,煮至八分,去渣温服。
《活人书》仲景小柴胡汤,方子见头汗门中。
《活人书》仲景术附汤
白术(二两) 附子(一个半) 甘草(一两,炙)
以上锉如麻豆大。每次取五钱匕,生姜五片,枣子一枚,水一盏半,煮至七分,去渣温服。每日三次。一服后感觉身体麻木,半日后再服。三服都吃完,其人如有冒状,不要奇怪,这就是附子与白术并走皮中,逐水气,尚未去除,所以使之然。
法当加桂枝一两。如果大便坚,小便自利,所以不加桂枝。
《活人书》仲景甘草附子汤
甘草 白术(各一两) 附子(一枚,炮) 桂枝(二两,身肿者加防风二两;悸气、小便不利者加茯苓一两半)
以上锉如麻豆大。每次取五钱匕,用水一盏半,煮至七分。去渣温服,汗出即解。
《活人书》麻黄加术汤
麻黄(一两半) 桂枝(一两,去皮) 甘草(炙) 苍术(各半两) 杏仁(三十五枚,去皮尖)
以上锉如麻豆大。每次取五钱匕,用水一盏半,煮至八分,去渣温服。
(Also known as Huang disease; other cases of jaundice are appended here.)
*Nashu Bingyuan* (Source of Diseases by Chao Yuanfang) on the syndrome of pediatric jaundice: Jaundice is caused by heat pathogen entering the Spleen and Stomach. The heat qi accumulates and stagnates, combats with grain qi, and steams outward, causing the entire skin to turn yellow and the eyes also to become yellow. The Spleen and Stomach combine to govern the muscles and both correspond to the Earth element, whose color is yellow. Therefore, heat accumulation in the skin and muscles steams and causes the flesh and skin to turn yellow. This may result from Cold Damage (Shanghan), seasonal epidemics, or Warm diseases, all due to heat not resolving in time, thus entering the Stomach. Whenever jaundice occurs accompanied by dysentery and fullness/distension of the heart and abdomen, it is a fatal prognosis. If the pulse is deep and fine upon diagnosis, it is also fatal. Furthermore, infants aged one hundred days or half a year who present with slight yellowing of the body, unrelated to Cold Damage or Warm diseases, also suffer from heat in the Stomach qi. Moxibustion must strictly be avoided. Applying moxibustion will exacerbate the heat; this condition arises from improper nursing/care. One should reduce clothing and frequently apply cooling powder to the body, which will naturally resolve. Do not recklessly administer decoctions or perform moxibustion.
*Liuren Shu* (Book of Vitality) discusses the treatment of Cold Damage in children and adults, which is generally the same, except for smaller dosages and cooler-natured herbs. Question: Why does jaundice occur? Answer: When cold-dampness remains unresolved inside the body, heat accumulates in the Spleen and Stomach. The pores (Couli) remain closed, and stagnant heat combats with retained food, leading to depression and steaming that prevents digestion, resulting in yellowing. (Han dynasty scholar Zhang Zhongjing noted that in the south, summer dampness prevails, and near summer, damp-heat is intense. "Dan" means yellow. Ancients referred to yellow as Dan. When damp-heat combines, people often suffer from Dan disease, sometimes presenting with edema.) However, the external signs and pulse of jaundice resemble those of blood stasis. The distinction lies in urination: if urination is difficult, it is jaundice; if urination is normal/free, it is blood stasis. Generally, patients with jaundice have heat accumulating in the Heart and Spleen, leading to thirst and desire for water intake, and their pulse must be floating, slippery, tight, and rapid. In contrast, blood stasis syndromes present with manic-like behavior and black stools, which are the differences. Whenever a patient has feverish body, sweating only on the head and face but no sweat on the body, stopping at the neck; thirst with desire to drink fluids, and difficult urination, jaundice will inevitably develop. *Yinchen Hao Tang* (Cinnamon Twig and Coix Seed Decoction - Note: Standard translation is Yinchen Hao Decoction / Artemisiae Scopariae Decoction) or *Wuling San* (Five-Ingredient Powder with Poria) added with *Yinchen* (Artemisiae Scopariae Herba) can be used. (*Yinchen Hao Tang* ten parts, *Wuling San* five parts, mixed evenly totaling twenty parts; take three qian each time, mixed with warm water, three times daily.) After taking the decoction, if urination becomes free, urine resembles soybean curd juice and is bright red, and abdominal distension decreases overnight, then the yellow pathogen exits through the urine. The ancients said: Treating dampness without promoting urination is not the correct method. (Generally, jaundice is caused by stagnant heat inside, resulting from difficult urination.) *Zhizi Bopi Tang* (Gardenia and Phellodendron Bark Decoction) and *Mahuang Lianqiao Chixiaodou Tang* (Ephedra, Forsythia, and Adzuki Bean Decoction) can be selected for use. Another prescription: For Cold Damage impending jaundice, urgently use *Gua Di* (Melon Spicule) powder. Hold water in the mouth, insufflate about one zi amount into the nose; expelling yellow water is very effective. Immediately follow with *Yinchen Tang* (Artemisiae Scopariae Decoction) mixed with *Wuling San*, which is best.
Another question: *Baihu* (White Tiger) syndrome also presents with body heat, irritability, thirst with desire to drink, and difficult urination. Why does it not cause jaundice? Answer: *Baihu* syndrome is similar to jaundice, but with sweating over the whole body, this indicates heat venting outward, characterizing *Baihu* syndrome. If there is sweating only on the head and face, with no sweat below the neck, it is the jaundice syndrome.
Another question: In Taiyang disease, with pain throughout the body, fever, and a body color like smoked yellow, what is this? This is Taiyang Dampness Strike. Zhang Zhongjing stated: After treating Cold Damage with sweating, if the body and eyes turn yellow, it is because cold-dampness remains unresolved inside. It is considered inadvisable to purge; instead, seek treatment within the context of cold-dampness. (See Volume 6, Question 10. Question 10 states: Pain throughout the body, fever, yellowing of the body and eyes, difficult urination, yet loose stools—what is this? This is named Dampness Strike. Wind and rain attack deficiency, mountain and marsh vapors injure humans, many suffer Dampness Strike. Dampness flows into joints, causing bodily discomfort and pain, with a deep-slow pulse, indicating Dampness Strike. A fine pulse indicates otherwise. If progressing to pain throughout the body, fever, yellowing, and free urination, use *Zhu Fu Tang* (Atractylodes and Aconite Decoction). If urination is difficult and stools are loose, one should promote urination, preferably using *Gancao Fuzi Tang* (Licorice and Aconite Decoction) or *Wuling San*. *Mahuang Jia Baizhu Tang* (Ephedra plus Atractylodes Macrocephala Decoction) is also mentioned.)
Another question: If a patient has a string-taut, floating, large pulse, shortness of breath, complete abdominal fullness, pain in the hypochondrium and heart region; pressing long yields no relief, dry nose, inability to sweat, lethargy, yellowing of the entire body and eyes, difficult urination, tidal fever, and occasional coughing—what is this? This is Shaoyang Wind Strike. Treat primarily with *Xiaochaihu Tang* (Minor Bupleurum Decoction).
*Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) treats pediatric Cold Damage jaundice.
Crush *Tugua Gen* (Trichosanthes Kirilowii Root), take three he of juice and ingest. (*Shenghui Fang* takes one da he of *Tugua Gen* juice, mixes with half a spoon of honey, and ingests slowly.)
*Qianjin Fang* another formula
Crush *Qingmai* (Green Wheat) juice and ingest.
*Qianjin Fang* another formula
Crush *Jiu Gen* (Chinese Leek Root) juice, clarify, and instill an amount the size of a soybean into the infant's nostrils; expelling yellow water leads to recovery.
*Qianjin Fang* another formula
*Chixiaodou* (Adzuki Bean) (37 grains), *Gua Di* (Melon Spicule) (14 pieces), *Nuomi* (Glutinous Rice) (14 grains).
Grind the above three ingredients into powder and insufflate into the nose. (*Shenghui Fang* uses *Jingmi* (Rice) instead of glutinous rice, 40 grains. It says: Use medicine sized like mung beans, insufflate into the nose; expulsion of yellow water leads to immediate recovery.)
*Waitai Mi Yao* (Secret Essentials of the Outer Palace) citing *Jinxiao Fang*: Treats epidemic disease. After three days, if one suddenly feels oppression, fullness, and hardness in the heart region, along with heat in the palms and soles, it transforms into jaundice. Untreated, it is fatal. *Qinjiao Tang* (Gentiana Decoction) Formula:
*Qinjiao* (Gentianae Radix), *Zicao* (Arnebiae Radix), *Baixianpi* (Dictamni Cortex), *Huangqin* (Scutellariae Radix), *Zhizi Ren* (Gardeniae Semen) (each 1 liang).
Cut the above five herbs. Boil with 1.5 sheng of water and 1 sheng of cow's milk until reduced to 7 ge. Divide into two doses. Adjust for age/size. If one dose is ineffective, give another. Trial shows efficacy.
*Guangli Fang* treats sudden jaundice in children, where face, eyes, skin, and flesh all turn yellow.
Crush fresh *Gualou Gen* (Trichosanthes Radix), take 2 he of juice, mix with 1 large spoon of honey. Warm and mix the two ingredients, divide into two doses.
*Jingyan Fang* treats body turning entirely golden-yellow.
*Gua Di* (49 pieces, collected on the 6th day of the 6th lunar month, ground to powder), *Dingxiang* (Caryophylli Flos) (49 pieces, roasted in a sweet pot until smoke ceases, finely ground).
Grind together uniformly. For children, use half a zi amount, insufflate into the nose and rub on teeth.
*Shenghui Fang* treats pediatric jaundice, body color like orange. *Yinchen San* (Artemisiae Scopariae Powder):
*Yinchen* (Artemisiae Scopariae Herba), *Chuan Mangxiao* (Natrii Sulfas) (each 1 liang), *Zhizi Ren* (Gardeniae Semen), *Chuan Dahuang* (Rhei Radix et Rhizoma) (cut small, slightly stir-fried), *Huangqin* (Scutellariae Radix), *Xi Jiao* (Rhinocerotis Cornu), *Mutong* (Akebiae Caulis), *Hanshuishi* (Halloysit Rubrum) (each 0.5 liang).
Pound and sieve the above medicines into powder. Take 1 qian each time, boil in 1 small zhan of water until reduced to 0.5 zhan, strain. Take warm at any time. Adjust dosage based on child's size.
*Shenghui Fang* treats pediatric epidemic disease with jaundice, abdominal fullness and urgency. *Sanhuang San* (Three Yellows Powder):
*Chuan Dahuang* (Rhei Radix et Rhizoma) (cut small, slightly stir-fried), *Huangqin* (Scutellariae Radix) (each 0.5 liang), *Zhizi Ren* (Gardeniae Semen) (1 fen).
Pound the above medicines, sieve coarsely into powder. Take 1 qian each time, boil in 1 small zhan of water until reduced to 0.5 zhan, strain. Take warm at any time. Adjust dosage based on child's size.
(*Yingru Shu* uses equal parts of the three items, 3.5 sheng of water, soak briefly, boil vigorously to obtain 1.2 sheng. Infants under 100 days take 1.5 he; 1-2 year olds divide into four doses, aiming for purgation.)
*Shenghui Fang* treats pediatric Spleen-Stomach heat-toxin causing muscle yellowing, red urine, and internal restlessness. *Yinchen Wan* (Artemisiae Scopariae Pill):
*Yinchen* (Artemisiae Scopariae Herba), *Zhizi Ren* (Gardeniae Semen), *Chuan Dahuang* (Rhei Radix et Rhizoma) (cut small, slightly stir-fried), *Gancao* (Glycyrrhizae Radix et Rhizoma) (roasted until slightly red, cut), *Qinjiao* (Gentianae Radix) (remove sprouts, each 1 liang), *Chuan Pu Xiao* (Natrii Sulfas) (0.5 liang).
Pound and sieve into powder, mix with refined honey to form pills the size of mung beans. Take 5 pills with warm water at any time. Adjust dosage based on child's size.
*Shenghui Fang* treats various types of jaundice in children. *Dahuang San* (Rhubarb Powder):
*Chuan Dahuang* (Rhei Radix et Rhizoma) (cut small, slightly stir-fried), *Huanglian* (Coptidis Rhizoma) (remove roots), *Gualou Gen* (Trichosanthis Radix), *Huangqin* (Scutellariae Radix), *Zhizi Ren* (Gardeniae Semen) (each 0.5 liang).
Pound and sieve coarsely into powder. Take 1 qian each time, boil in 1 small zhan of water until reduced to 0.5 zhan, strain. Take warm at any time. Adjust dosage based on child's size.
*Shenghui Fang* treats heat-toxin attacking Spleen-Stomach in children, causing whole-body yellowing, red/astringent urine, difficult defecation, mental restlessness, and yellow eyes. *Shengma Wan* (Cimicifugae Pill):
*Chuan Shengma* (Cimicifugae Rhizoma), *Longdan* (Gentianae Radix) (remove root stock), *Zhizi Ren* (Gardeniae Semen), *Huangqin* (Scutellariae Radix), *Chuan Dahuang* (Rhei Radix et Rhizoma) (cut small, slightly stir-fried), *Qinjiao* (Gentianae Radix) (remove sprouts), *Gancao* (Glycyrrhizae Radix et Rhizoma) (roasted until slightly red, each 0.5 liang).
Pound and sieve into powder, mix with refined honey to form pills the size of paulownia seeds. Take 3 pills crushed in fresh well-water at any time. Increase pill count for children over three years old.
*Shenghui Fang* treats various jaundices in children with chest/heart oppression. Use *Dahuang Wan* (Rhubarb Pill):
*Chuan Dahuang* (Rhei Radix et Rhizoma) (cut small, slightly stir-fried), *Tian Tingli* (Descurainiae Semen Lepidii Seminis) (stir-fried between papers until purple), *Yinchen* (Artemisiae Scopariae Herba) (each 0.5 liang).
Pound and sieve into powder, mix with refined honey to form pills the size of paulownia seeds. Take 3 pills crushed in fresh well-water at any time. Adjust dosage based on child's size.
*Shenghui Fang* treats children with whole-body and facial yellowing. Use *Huanggua Wan* (Cucumber Pill):
*Huanglian* (Coptidis Rhizoma) (1 liang, remove roots), *Huhuanglian* (Coptidis Rhizoma alternative/Berberis) (0.5 liang).
Pound and sieve into powder. Take one cucumber, remove pulp, leave a small lid. Insert powder, cover with lid, wrap in barley flour dough and roast until dough is even. Remove dough, mash cooked cucumber and powder, form pills the size of mung beans. Seven-year-old children take 7 pills with warm water; adjust pill count based on child's size.
*Shenghui Fang* another formula
*Qinjiao* (Gentianae Radix) (0.5 liang).
Pound and sieve finely into powder. Take 1 qian each time, boil in 1 he of cow's milk for 1-2 boils, strain. Take warm at any time. Children under three years old take half a qian.
*Yingru Shu* treats pediatric jaundice with *Yinchen Tang* (Artemisiae Scopariae Decoction):
*Yinchen* (Artemisiae Scopariae Herba), *Shengma* (Cimicifugae Rhizoma), *Huangqin* (Scutellariae Radix), *Chaihu* (Bupleuri Radix), *Zhimu* (Anemarrhenae Rhizoma), *Lingyangjiao* (Saigae Tataricae Cornu) (shavings, each 8 fen), *Dahuang* (Rhei Radix et Rhizoma), *Shigao* (Gypsum Fibrosum) (each 1.2 qian), *Zhizi* (Gardeniae Fructus) (1 qian), *Shaoyao* (Paeoniae Radix Alba) (6 fen), *Gua Di* (Melon Spicule) (7 pieces), *Lanye* (Isatidis Folium) (cut, 1 sheng), *Gancao* (Glycyrrhizae Radix et Rhizoma) (2 fen, roasted).
Cut herbs. Boil in 5 sheng of water until reduced to 1.5 sheng. Ages 1-2 divide into 8 doses; ages 4-5 divide into 4 doses. Administer according to child's size.
Zhang Huan treats Cold Damage and seasonal qi, where heat enters the Stomach, combats with grain qi, steams the muscles, causing yellowing of face, eyes, and skin, called Huang disease or Fa Huang. *Lugen Tang* (Reed Rhizome Decoction):
*Lugen* (Phragmitis Rhizoma) (1 liang), *Yinchen* (Artemisiae Scopariae Herba), *Shanzhizi* (Gardeniae Fructus), *Huangqin* (Scutellariae Radix), *Gancao* (Glycyrrhizae Radix et Rhizoma) (roasted, each 0.5 liang).
Grind to fine powder. Take 1 qian each time, boil in 0.8 sheng of water with 3 mint leaves until reduced to 0.5 sheng, strain, take warm.
Zhang Huan *Ziqin San* (Scutellaria and Trichosanthes Powder) treats Huang disease.
*Huangqin* (Scutellariae Radix), *Gualou Gen* (Trichosanthis Radix), *Fushen* (Poria with Hostwood) (each 1 liang), *Huhuanglian* (Berberidis Rhizoma), *Gancao* (Glycyrrhizae Radix et Rhizoma) (roasted, each 0.5 liang).
Pound and sieve to fine powder. Take 1 qian each time, boil in 0.8 sheng of water until reduced to 0.5 sheng, strain, let cool slightly, take warm.
Zhang Huan *Yinchen Tang* (Artemisiae Scopariae Decoction) treats pediatric jaundice etc., body color like orange.
*Shanyinchen* (Artemisiae Scopariae Herba), *Shanzhizi Ren* (Gardeniae Semen) (each 1 liang), *Chuan Dahuang* (Rhei Radix et Rhizoma), *Chuan Mangxiao* (Natrii Sulfas), *Mutong* (Akebiae Caulis), *Hanshuishi* (Halloysit Rubrum) (each 7 liang - *Note: Text says 7 liang, likely typo for 0.7 or similar relative proportion, but translating literally*).
Pound and sieve to fine powder. Take 1 qian each time, boil in 0.8 sheng of water until reduced to 0.5 sheng, strain, take warm.
Zhang Huan *Sanhuang San* (Three Yellows Powder) treats Huang disease.
*Chuan Dahuang* (Rhei Radix et Rhizoma) (cut small, slightly stir-fried, 1 liang), *Huangqin* (Scutellariae Radix), *Huanglian* (Coptidis Rhizoma) (remove roots, each 0.5 liang).
Pound and sieve to fine powder. Take 1 qian each time, boil in 1 zhan of water until reduced to 0.5 zhan, strain, take warm after meals.
*Liuren Shu* Zhang Zhongjing *Yinchen Hao Tang* (Artemisiae Scopariae Decoction):
*Yinchen Hao* (Artemisiae Scopariae Herba) (tender, 1.5 liang), *Dahuang* (Rhei Radix et Rhizoma) (0.5 liang, peeled), *Zhizi* (Gardeniae Fructus) (large, 3.5 pieces).
Cut like hemp/millet seeds. Use 2 large white cups of water. First boil Yinchen until reduced by half a cup. Then add the other two ingredients. Boil until 0.8 remains. Strain, take warm. Three times daily. Urine becomes free, resembling soybean curd juice, bright red. Abdominal distension decreases overnight; yellow pathogen exits via urine.
*Liuren Shu* *Wuling San* with Yinchen, formula see in syndrome notes.
*Liuren Shu* Zhang Zhongjing *Zhizi Bopi Tang* (Gardenia and Phellodendron Bark Decoction):
*Zhizi* (Gardeniae Fructus) (8 pieces), *Huangbai* (Phellodendri Cortex) (1 liang), *Gancao* (Glycyrrhizae Radix et Rhizoma) (roasted, 0.5 liang).
Cut like hemp/millet seeds. Take 5 qian bi each time, boil in 1.5 zhan of water until reduced to 0.7, strain, take warm.
*Liuren Shu* Zhang Zhongjing *Mahuang Lianqiao Chixiaodou Tang* (Ephedra, Forsythia, and Adzuki Bean Decoction):
*Mahuang* (Ephedrae Herba) (remove joints), *Lianqiao* (Forsythiae Fructus - note text specifies root), *Gancao* (Glycyrrhizae Radix et Rhizoma) (roasted, each 1 liang), *Chixiaodou* (Vigna Angularis Semen) (0.5 sheng), *Shengzi Bapi* (Morus Alba Cortex - fresh), *Xingren* (Prunus Armeniaca Semen) (20 pieces, remove skin and tips).
Cut like hemp/millet seeds. Take 5 qian bi each time, add 4 slices of ginger, 1 jujube, 1.5 zhan of water. Boil until 0.8 remains. Strain, take warm.
*Liuren Shu* Zhang Zhongjing *Xiaochaihu Tang* (Minor Bupleurum Decoction), formula see Head Sweating section.
*Liuren Shu* Zhang Zhongjing *Zhu Fu Tang* (Atractylodes and Aconite Decoction):
*Baizhu* (Atractylodis Macrocephalae Rhizoma) (2 liang), *Fuzi* (Aconiti Lateralis Radix Praeparata) (1.5 pieces), *Gancao* (Glycyrrhizae Radix et Rhizoma) (1 liang, roasted).
Cut like hemp/millet seeds. Take 5 qian bi each time, add 5 slices of ginger, 1 jujube, 1.5 zhan of water. Boil until 0.7 remains. Strain, take warm. Three times daily. After first dose, if body numbness occurs, wait half a day and take again. After finishing three doses, if the patient feels dizzy/confused, do not be alarmed; this is because Fuzi and Baizhu move together in the skin, driving out water qi, which has not yet fully cleared.
Standard protocol suggests adding Guizhi (Cinnamomi Ramulus) 1 liang. However, if stool is hard and urination is free, Guizhi is not added.
*Liuren Shu* Zhang Zhongjing *Gancao Fuzi Tang* (Licorice and Aconite Decoction):
*Gancao* (Glycyrrhizae Radix et Rhizoma), *Baizhu* (Atractylodis Macrocephalae Rhizoma) (each 1 liang), *Fuzi* (Aconiti Lateralis Radix Praeparata) (1 piece, processed), *Guizhi* (Cinnamomi Ramulus) (2 liang; if body swelling, add Fangfeng 2 liang; if palpitations/difficult urination, add Fuling 1.5 liang).
Cut like hemp/millet seeds. Take 5 qian bi each time, boil in 1.5 zhan of water until reduced to 0.7. Strain, take warm. Recovery occurs when sweat appears.
*Liuren Shu* Zhang Zhongjing *Wuling San* (Five-Ingredient Powder with Poria), formula see Cold Damage Spontaneous Sweating section.
*Liuren Shu* *Mahuang Jia Baizhu Tang* (Ephedra plus Atractylodes Macrocephala Decoction):
*Mahuang* (Ephedrae Herba) (1.5 liang), *Guizhi* (Cinnamomi Ramulus) (1 liang, peeled), *Gancao* (Glycyrrhizae Radix et Rhizoma) (roasted), *Cangzhu* (Atractylodis Rhizoma), *Xingren* (Prunus Armeniaca Semen) (35 pieces, remove skin and tips, each 0.5 liang).
Cut like hemp/millet seeds. Take 5 qian bi each time, boil in 1.5 zhan of water until reduced to 0.8. Strain, take warm.