钱乙曰。诸黄皆相似。如身皮目皆黄者。黄病也。身痛膊背强。大小便涩。一身尽黄。面目指爪皆黄。小便如屋尘
色。着物皆黄。渴者难治。此黄胆也。其症多患于大病后。别有一症。不因病后身微黄者。胃热也。大人亦同。又有面
黄腹大。食土而渴者。脾疳也。又有自生而身黄者。胎疸也。古书云。诸疸皆热也。深黄者是也。若淡黄兼白者胃怯。
胃不和也。难知云。色如熏黄。乃湿病也。则一身尽痛。若色如橘子黄者。黄病也。身不痛。有干黄者。燥也。小便自
利。四肢不沉重。渴而引饮。宜栀子柏皮汤。有湿黄者。脾也。小便不利。四肢沉重。似渴不欲饮。宜大茵陈汤。如大
便自利而黄者。茵陈栀子黄连三物汤。或往来寒热。一身尽黄者。小柴胡加栀子汤。
曾氏曰。黄病不可一概论。标本不同。症治亦异。乃脾胃气虚。感受湿热。郁于腠理。淫于皮肤。蕴积成黄。熏发
于外。故有是症。或脾胃虚弱。内因症癖。攻之而成。然疳泻亦主皮黄。肚大发直筋青。肌肉消瘦。外无色泽。身必发
黄。治法。感湿热者。以 咀五苓散加麻黄、姜。汗之即愈。或茵陈蒿汤调下五苓散亦可。若得干疳癖者。形如
黄土。宜醒脾。或化癖丸。
罗谦甫曰。予治一小儿。季夏身体蒸热。胸膈烦满。皮肤如橘黄。眼白亦黄。筋骨瘦弱。不能行立。此由热加以湿。
而蒸搏于经络。入于骨髓。使脏气不生。故脾遂乘心。湿热相合而成以疾也。盖心火实。则身体蒸热。胸膈烦满。脾湿
胜。则皮肤如橘色。有余之气。必乘己所胜而侮所不胜。是肾肝受邪。而筋骨痿弱。不能行立。内经言。脾热者。色黄
而肉蠕动。又言湿热成痿。是也。所谓子能令母实。实则泻其子也。盖脾土退其本位。肾水得复。心火自平矣。加减泻
黄散。
钱乙说：各种黄疸病症状都相似。如果身体皮肤和眼睛都发黄，这是黄病。身体疼痛，胳膊和背部僵硬，大小便不通畅，全身都发黄，面目、手指和指甲都发黄，小便像屋尘的颜色，沾染衣物都会变黄，伴有口渴的难以治疗，这是黄疸病。这种病症多在大病之后发生。另外有一种症状，不是在大病后出现，只是身体微微发黄，这是胃热。成人也是如此。又有面色发黄、腹部胀大、吃泥土且口渴的，这是脾疳。又有出生后即身体发黄的，这是胎疸。古书说：各种黄疸都是热证，深黄色的是这种情况。如果是淡黄色兼带白色的，是胃气虚弱。胃气不和。难知说：颜色像熏过的黄色，是湿病，则全身都疼痛。如果颜色像橘子皮那样的黄色，是黄病，身体不痛。有干黄的，是燥证，小便自利，四肢不沉重，口渴想喝水，适宜用栀子柏皮汤。有湿黄的，是脾病，小便不利，四肢沉重，好像口渴但不想喝水，适宜用大茵陈汤。如果大便自利而发黄的，用茵陈栀子黄连三物汤。或者寒热往来，全身发黄的，用小柴胡加栀子汤。
曾世荣说：黄病不能一概而论。标本不同，症状和治疗也不同。这是由于脾胃气虚，感受湿热，郁结在腠理，浸淫于皮肤，蕴积而成黄，熏蒸发作于外，所以有此症状。或者是脾胃虚弱，内因症癖（腹内结块），攻伐而成。然而疳泻也会导致皮肤发黄，肚子大且直，筋脉青紫，肌肉消瘦，外表没有光泽，身体必然发黄。治疗方法：感受湿热的，用咀五苓散加麻黄、生姜，发汗即愈。或者用茵陈蒿汤调服五苓散也可以。如果是得了干疳癖的，形体像黄土一样枯槁，适宜醒脾，或者用化癖丸。
罗谦甫说：我治疗过一个小孩，夏末身体蒸蒸发热，胸膈烦闷胀满，皮肤像橘子黄，眼白也黄，筋骨瘦弱，不能行走站立。这是由于热加上湿，蒸腾搏结于经络，进入骨髓，使脏气不能生发，所以脾遂乘克心火，湿热相合而成为疾病。大概心火实盛，则身体蒸热，胸膈烦满；脾湿胜，则皮肤像橘色。有余之气，必定乘其所胜而侮其所不胜，导致肾肝受邪，而筋骨痿弱，不能行走站立。《内经》说：脾热的人，面色黄且肌肉蠕动。又说湿热成痿，就是这个道理。所谓“子能令母实”，实则泻其子。大概脾土退去本位，肾水得以恢复，心火自然平息了。使用加减泻黄散。
Qian Yi said: Various jaundice diseases have similar symptoms. If the body skin and eyes are yellow, it is a yellow disease. Body pain, stiffness in the arms and back, difficulty in urination and defecation, whole body yellowing, face, eyes, fingers, and nails all yellow, urine like the color of house dust, staining clothes yellow, with thirst which is difficult to treat, this is Dan Huang (Jaundice). This condition often occurs after a severe illness. There is another symptom where the body is slightly yellow not due to post-illness, which is Wei Re (Stomach Heat). Adults present similarly. There is also facial yellowing with abdominal distension, eating earth, and thirst, which is Pi Gan (Spleen Malnutrition). There is also yellowing from birth, which is Tai Dan (Fetal Jaundice). Ancient texts state that all jaundices are heat syndromes; deep yellow indicates this. If pale yellow mixed with white, it is Wei Qie (Stomach Weakness) or Wei Bu He (Stomach Disharmony). Nan Zhi stated: Color like smoked yellow indicates Shi Bing (Dampness Disease), accompanied by whole-body pain. If the color is like orange peel, it is Huang Bing (Yellow Disease), without body pain. Dry Huang indicates Zao (Dryness), with free urination, non-heavy limbs, thirst with desire to drink, suitable for Zhizi Bopi Tang (Gardenia and Phellodendron Bark Decoction). Wet Huang indicates Pi (Spleen) issues, with difficult urination, heavy limbs, apparent thirst but no desire to drink, suitable for Da Yinchen Tang (Major Artemisia Capillaris Decoction). If stool is free yet yellow, use Yinchens Zhizi Huanglian Sanwu Tang (Artemisia Capillaris, Gardenia, and Coptis Three-Ingredient Decoction). Or if there are alternating chills and fever with whole-body yellowing, use Xiaochaihu Jia Zhizi Tang (Minor Bupleurum Decoction plus Gardenia).
Zeng Shirong said: Yellow disease cannot be generalized. The root and branch differ, so symptoms and treatments vary. It arises from Spleen and Stomach Qi deficiency, contracting damp-heat, stagnating in the Cou Li (interstices), flooding the skin, accumulating into yellow, steaming outward, thus causing these symptoms. Alternatively, Spleen and Stomach weakness with internal Zheng Xi (masses/accumulations) caused by aggressive treatment. However, Gan Xie (Malnutrition Diarrhea) also leads to yellow skin, large and rigid abdomen, blue-green veins, emaciation, lackluster appearance, and inevitable body yellowing. Treatment: For contracted damp-heat, use Ju Wuling San (Five-Ling Powder prepared by chewing/crushing) added with Mahuang (Ephedrae Herba) and Shengjiang (Zingiberis Rhizoma Fresh); sweating will cure it. Or Yinchen Hao Tang (Artemisiae Scopariae Decoction) taken with Wuling San is also acceptable. If suffering from Gan Pi (Malnutrition Masses) with a form resembling yellow earth, one should Xing Pi (Awaken the Spleen) or use Huapi Wan (Mass-Dissolving Pill).
Luo Qianfu said: I treated a child in late summer with steaming body heat, chest and diaphragm fullness and irritability, skin like orange yellow, sclera yellow, weak bones and sinews, unable to walk or stand. This was due to heat combined with dampness, steaming and binding in the meridians, entering the bone marrow, preventing Zang Qi from generating, causing the Spleen to overact on the Heart. Damp-heat combined to form the disease. Generally, excess Heart Fire causes steaming heat and chest/diaphragm fullness; Spleen Dampness excess causes orange-colored skin. Excess Qi attacks what it conquers and insults what it cannot conquer, leading to Kidney and Liver pathogen invasion, resulting in weak sinews and bones, inability to walk. The Neijing states: Those with Spleen Heat have yellow complexion and twitching muscles. It also states damp-heat leads to Wei (Flaccidity Syndrome). This is correct. As stated, "The child can make the mother full"; when full, drain the child. Essentially, Spleen Earth retreats from its original position, Kidney Water recovers, and Heart Fire calms naturally. Use Jiawei Xiehuang San (Modified Draining Yellow Powder).