《金匮》云∶理者，皮肤脏腑之文理也。以此推之，肠胃之膜，其有罅缝可知。人若脾
虚不
为胃消水谷，则水谷之停于胃者久，久则瘀而为热，其气从腑理中溢出，食气溢则皮色黄，
水气溢则皮色黑。其有脾本不虚，但因饥暴多食、渴暴多饮，所受倍常，则脾不及消，亦久
留于胃而为热，即亦从腑理溢出，此 瘕、系气、溢饮等证所由来也。夫腑既有理，则寻常
饮食，
其气何尝不溢？不溢则何以生卫以肥
肌熏肤、充身泽毛，生营以成脉、华色乎？特所溢者是精气非滞气；精气益人，滞气病患耳！
人若肺虚，为风湿寒热怕袭，则皮肤之理实而闭，腑理中之应溢者，不得通于外，则水谷之
气亦久留于胃而为热，滞则溢迟，故色变也。伤寒、温病所致之疸及风疸、湿疸，皆取诸此
，虽不自饮食致之，而其为溢之滞，在理则同矣。独是水色虽黑，然留胃之水，亦黄中带黑
，不能全黑，以胃为土，土色但黄故也。惟涉及于肾，则黑黄相半，所以然者，肾为胃关，
关门不利，则水之流于肾部者，留久其责在膀胱，膀胱亦腑也，亦有理也。不挟热者，水溢
为饮，《巢源》云痰在胸膈，饮在膀胱者此也。其挟热者，则气与水蒸而为疸。《金匮》诊
疸，于谷疸、酒疸但言黄，而于女劳疸必言额上黑。以女劳则肾虚而利水迟，水即久留而气
溢，且胃中之水，乘肾虚而流疾，肾故不及利也。推之风水、正水、石水为病之义，亦当如
是。黄胆久之皆亦为黑疸者，胃实滞多则乘肾，肾以得水谷之精气少，则益易乘也。知腑理
之为病，而推之奇病中有饭粒出疮孔、蛔虫在皮中者，皆不足为奇矣。
又《金匮》之例，于风湿搏于水谷而成疸者，称黄胆，与谷疸、酒疸、女劳疸、黑疸为
五。
其与伤寒同法，不必搏于水谷者，则但称黄。论中诸黄胆云云，以此别之。疸为劳热，食劳
、女劳之有疸，犹食劳，女劳之有复也。
《金匮要略》说：理，是指皮肤和脏腑的纹理。由此推断，肠胃的膜，其中存在缝隙是显而易见的。如果人脾虚不能帮助胃消化水谷，那么停留在水谷在胃中的时间就会长久，时间久了就会瘀滞而产生热邪，这股气从腑理中溢出，食气溢出则皮肤颜色发黄，水气溢出则皮肤颜色发黑。如果脾本身不虚，但因为饥饿后突然大量进食、口渴时突然大量饮水，摄入的量超过平常，导致脾来不及消化，食物也会长时间停留在胃中产生热邪，同样会从腑理中溢出，这就是瘕（腹内结块）、系气（气机郁滞）、溢饮（水液泛滥）等病症的来源。既然腑有纹理，那么寻常饮食，其气何尝不溢出？如果不溢出，又怎么能生成卫气以滋养肌肉、熏蒸皮肤、充盈身体、润泽毛发，生成营气以形成血脉、荣华面色呢？只是所溢出的是精气而非滞气；精气有益于人，滞气则是致病的原因！如果人肺虚，被风、湿、寒、热等邪气侵袭，导致皮肤的纹理坚实而闭塞，腑理中应当溢出的气，无法通达于体外，那么水谷之气也会长时间停留在胃中产生热邪，因滞涩而溢出缓慢，所以肤色发生变化。伤寒、温病引起的黄疸以及风疸、湿疸，都取法于此，虽然并非由饮食直接导致，但它们作为溢出之滞，在理（纹理/机理）上是相同的。只是水的颜色虽然是黑的，但停留在胃中的水，也是黄中带黑，不能完全变黑，因为胃属土，土的颜色本来就是黄色的。只有当病涉及肾脏时，才会出现黑黄各半的情况，之所以这样，是因为肾是胃的关口，关门不利，那么流注到肾部的水，停留久了责任在于膀胱，膀胱也是腑，也有纹理。如果不夹杂热邪，水溢出成为饮，《巢氏病源》所说痰在胸膈，饮在膀胱，指的就是这种情况。如果夹杂热邪，那么气与水蒸腾就成为黄疸。《金匮要略》诊断黄疸，对于谷疸、酒疸只说黄色，而对于女劳疸必定说额头发黑。因为女劳疸是由于肾虚导致利水迟缓，水即长时间停留而气溢出，且胃中的水，趁着肾虚而流注迅速，肾因此来不及利水。推究风水、正水、石水这些疾病的含义，也应当如此。黄疸日久都会变成黑疸，是因为胃实滞多就会侵犯肾，肾因为得到的水谷精气少，就越容易被侵犯。知道了腑理作为病因的道理，再推究奇病中有饭粒从疮孔排出、蛔虫在皮中游走等情况，也就不足为奇了。
另外，《金匮要略》的体例，对于风湿与水谷搏结而成的黄疸，称为黄胆，与谷疸、酒疸、女劳疸、黑疸合为五种。那些与伤寒治法相同，不必与水谷搏结的，就只称黄。论中各种关于黄胆的说法，以此加以区别。疸属于劳热，食劳、女劳导致的有黄疸，就像食劳、女劳导致的有复证一样。
The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) states: "Li" refers to the textures and patterns of the skin and internal organs. From this, it can be inferred that there are gaps within the membranes of the intestines and stomach. If a person has Spleen deficiency (Spleen Qi deficiency) and fails to assist the Stomach in digesting food and fluids, the food and fluids remaining in the Stomach will stay for a long time. Prolonged stagnation leads to heat generation. This qi overflows from the "Fu Li" (textures/patterns of the Fu organs). When food qi overflows, the skin turns yellow; when water qi overflows, the skin turns black. Even if the Spleen is not inherently deficient, sudden excessive eating after hunger or sudden excessive drinking after thirst results in intake far exceeding normal capacity. The Spleen cannot digest it promptly, causing food to remain in the Stomach for a long time and generate heat, subsequently overflowing through the Fu Li. This is the origin of conditions such as Jia (abdominal masses), Xi Qi (qi stagnation), and Yi Yin (overflowing fluid retention). Since Fu organs have textures, does the qi from ordinary diet not overflow? If it did not overflow, how could Wei Qi (Defensive Qi) be generated to nourish muscles, warm the skin, fill the body, and moisten hair? How could Ying Qi (Nutritive Qi) be generated to form vessels and manifest luster in the complexion? The key distinction is that what overflows normally is Jing Qi (Essence Qi), not stagnant qi; Jing Qi benefits the person, whereas stagnant qi causes disease! If Lung deficiency occurs, making the person susceptible to invasion by Wind, Dampness, Cold, and Heat, the textures of the skin become solid and closed. The qi that should overflow from the Fu Li cannot reach the exterior. Consequently, food and fluid qi remains in the Stomach for a long time, generating heat. Due to stagnation, the overflow is slow, leading to changes in skin color. Jaundice caused by Shang Han (Cold Damage), Wen Bing (Warm Diseases), Feng Dan (Wind Jaundice), and Shi Dan (Damp Jaundice) all derive from this mechanism. Although not directly caused by dietary indiscretion, the nature of the stagnation in overflow is the same regarding the "Li". However, although water appears black, water retained in the Stomach is yellow mixed with black, not purely black, because the Stomach corresponds to Earth, and the color of Earth is yellow. Only when the pathology involves the Kidney does one see half black and half yellow. This is because the Kidney serves as the gatekeeper for the Stomach. If the gate is dysfunctional, water flowing into the Kidney region stays for a long time, and the responsibility lies with the Bladder. The Bladder is also a Fu organ and possesses textures. If there is no accompanying heat, the overflowing water becomes Yin (fluid retention). As stated in the *Chao Yuan Fang Lun* (General Treatise on Epidemic Diseases and All Causes of Disease), phlegm resides in the chest and diaphragm, while Yin resides in the Bladder. If accompanied by heat, the qi and water steam together to cause jaundice. In diagnosing jaundice, the *Jin Gui Yao Lue* mentions only yellow for Gu Dan (Grain Jaundice) and Jiu Dan (Wine Jaundice), but specifies black on the forehead for Nu Lao Dan (Female Labor Jaundice). This is because Nu Lao Dan involves Kidney deficiency and delayed diuresis; water remains for a long time while qi overflows. Moreover, due to Kidney deficiency, water from the Stomach flows rapidly, and the Kidney fails to drain it effectively. By analogy, the pathogenesis of Feng Shui (Wind Edema), Zheng Shui (True Water), and Shi Shui (Stone Water) should be understood similarly. Long-standing Huang Dan (Yellow Jaundice) eventually transforms into Hei Dan (Black Jaundice) because excessive stagnation in the Stomach invades the Kidney. With less Essence Qi from food and fluids reaching the Kidney, it becomes more susceptible to invasion. Understanding the pathology of Fu Li makes rare cases, such as rice grains emerging from wound pores or roundworms moving under the skin, seem less extraordinary.
Furthermore, following the convention of the *Jin Gui Yao Lue*, jaundice formed by the interaction of Wind-Dampness with food and fluids is termed Huang Dan, grouped with Gu Dan, Jiu Dan, Nu Lao Dan, and Hei Dan as five types. Those treated similarly to Shang Han, which do not require interaction with food and fluids, are simply referred to as Huang (Yellow). Various discussions on Huang Dan in the treatise are distinguished by this classification. Dan is considered a type of labor-heat; jaundice resulting from dietary labor or sexual exhaustion is analogous to recurrence caused by dietary labor or sexual exhaustion.