有得黄病已瘥,而将息失宜,饮食过度,犯触禁忌,致病发胃,名为犯黄候。
脾脏中风,风与瘀热相搏,故令身体发黄。额上黑,微汗出,手足中热,薄暮发,膀胱
急,四肢烦,小便自利,名为劳黄。
热邪在骨髓,而脑为髓海,故热气从骨髓流入于脑,则身体发黄,头脑痛,眉疼,名为
阳气伏,阴气盛,热毒加之,故但身面色黄,头痛而不发热,名为阴黄。
热毒瓦斯在脾胃,与谷气相搏,热蒸在内,不得宣散,先心腹胀满气急,然后身面悉黄,
瘀热在脾脏,但肉微黄而身不甚热,其人头痛心烦,不废行立,名为行黄。
气水饮停滞结聚成癖。因热气相搏,则郁蒸不散,故胁下满痛而身发黄,名为癖黄。
心脾二脏有瘀热所为。心主于舌,脾之络脉出于舌下。若身面发黄,舌下大脉起青黑色
,舌噤强,不能语,名为噤黄也。
凡人着黄,五种黄皆同。其人至困,冥漠不知东西者,看其左手脉,名手肝脉,两筋中
,其脉如有如无。又看近手屈肘前臂上,当有三歧脉,中央者,名为手肝脉;两厢者,名歧
脉。看时若肝脉全无,两厢坏,其人十死一生,难可救济。若中央脉近掌三指道有如不绝,
其人必不死。脉经三日,渐彻至手掌,必得汗,汗罢必愈。妇人患黄,看右手脉。
其人身热,眼青黄,视其瞳子青,脉亦青,面色青者是,其由脾移热于肝,肝色青也。
其人身热而发黄赤,视其眼赤,高视,心腹胀满,脉赤便是,此由脾移热于心。心色赤,故
其人身热而发赤黄,不可治,治之难瘥。其人身热发黄白,视其舌下白垢生者是,此由脾移
热于肺,肺色白也。其人身热发黑黄,视其唇黑眼黄,舌下脉黑者是,此由脾移热于肾,肾
色黑也,故其身热而发黑黄也。
有的患者黄病虽然已经痊愈,但在调养过程中失当,饮食过量,触犯禁忌,导致疾病复发于胃,这被称为犯黄候。
脾脏感受风邪,风邪与体内瘀滞的热邪相互搏结,因而导致身体发黄。症状表现为额头发黑,微微出汗,手足心发热,傍晚时分发作,膀胱拘急,四肢烦扰不适,小便通畅自如,这被称为劳黄。
热邪潜伏在骨髓中,而脑是髓海(精髓汇聚之处),所以热气从骨髓流入脑部,导致身体发黄,头脑疼痛,眉骨疼痛,这被称为……(原文此处似有缺漏或断句问题,依文意译为:此证候)。
阳气伏郁在内,阴气偏盛,加之热毒侵袭,因此仅见身体和面色发黄,头痛但不发热,这被称为阴黄。
热毒之气滞留于脾胃,与谷气相互搏结,热气在体内蒸腾,无法宣散,起初出现心腹胀满、气短急促,随后全身和面部全部发黄,……(原文此处似有缺漏,依前文格式推测为某黄名,但原文未给出名称,故仅翻译现象)。
瘀热停滞在脾脏,仅肌肉微黄而身体不很热,病人头痛心烦,但不影响行走站立,这被称为行黄。
气和水饮停滞积聚形成癖块(腹内结块)。因热气与之相搏,导致郁蒸不散,因此胁下胀满疼痛且身体发黄,这被称为癖黄。
这是由心和脾两脏的瘀热所致。心开窍于舌,脾的络脉出于舌下。如果身体和面部发黄,舌下大血管呈现青黑色,舌体僵硬强直,不能言语,这被称为噤黄。
凡是患有黄病的人,五种黄病(指前文提到的劳黄等)都会让人感到极度困倦,神志昏沉,不知东西南北。诊察时看左手脉,名为手肝脉,位于两筋之间,其脉象若有若无。再看靠近手腕屈肘前臂上方,应当有三条分支脉,中间的一条,名为手肝脉;两侧的两条,名为歧脉。诊察时如果肝脉完全摸不到,两侧的歧脉也败坏,那么病人十死一生,难以救治。如果中间的脉在距离手掌三指宽的地方仍有微弱跳动且不绝断,病人必定不死。脉象经过三天,逐渐通达至手掌,一定会出汗,汗出后必然痊愈。妇女患黄病,要看右手脉。如果病人身体发热,眼睛周围青黄,观察瞳孔呈青色,脉象也带青色,面色发青的是这种情况,这是由于脾将热邪转移到了肝,肝色主青的缘故。如果病人身体发热且发黄赤色,观察眼睛发红,向上凝视,心腹胀满,脉象赤红便是这种情况,这是由于脾将热邪转移到了心。心色主赤,所以病人身体发热并发出赤黄色,这种病情难以治愈,治疗很难好转。如果病人身体发热且发黄白色,观察舌下生出白垢的是这种情况,这是由于脾将热邪转移到了肺,肺色主白的缘故。如果病人身体发热且发黑黄色,观察嘴唇发黑、眼睛发黄、舌下脉象发黑的是这种情况,这是由于脾将热邪转移到了肾,肾色主黑的缘故,所以病人身体发热而发出黑黄色。
Some patients whose jaundice has recovered may relapse due to improper convalescence, excessive diet, or violating taboos, causing the disease to flare up in the Stomach. This condition is named Fanhuang (Relapsed Jaundice).
When Wind pathogen invades the Spleen and combats with stagnant Heat, it causes yellowing of the body. Symptoms include blackening of the forehead, slight sweating, heat in the hands and feet, onset at dusk, urgency in the Bladder, restlessness in the four limbs, and free urination. This is named Laohuang (Labor-induced Jaundice).
Heat pathogen resides in the Marrow, and the Brain is the Sea of Marrow. Thus, heat flows from the marrow into the brain, causing yellowing of the body, headache, and pain in the eyebrows. [Note: The specific name for this syndrome is missing in the source text.]
When Yang Qi is latent and Yin Qi is abundant, compounded by toxic heat, only the body and face turn yellow, accompanied by headache but without fever. This is named Yinhuang (Yin Jaundice).
Toxic heat lingers in the Spleen and Stomach, combusting with grain qi. Heat steams internally without dispersing, initially causing abdominal distension, fullness, and shortness of breath, followed by complete yellowing of the body and face. [Note: The specific name for this syndrome is missing in the source text.]
Stagnant heat resides in the Spleen, causing slightly yellow flesh but not significant body heat. The patient experiences headache and irritability but can walk and stand normally. This is named Xinghuang (Walking Jaundice).
Qi and fluid retention stagnate and accumulate to form Pi masses (abdominal masses). Combating with heat, they cause郁蒸 (stagnant steaming) that does not dissipate, resulting in hypochondriac fullness, pain, and yellowing of the body. This is named Pihuang (Pi-mass Jaundice).
This is caused by stagnant heat in the Heart and Spleen. The Heart opens into the tongue, and the collaterals of the Spleen emerge under the tongue. If the body and face are yellow, the large vessels under the tongue appear dark blue-black, the tongue is stiff and rigid, and speech is impaired, this is named Jinhuang (Locked-Jaw Jaundice).
In all cases of jaundice, regardless of the type, the patient becomes extremely fatigued and delirious, unaware of directions. Examination of the left hand pulse reveals the Shouganmai (Hand Liver Pulse), located between two tendons; its pulse may be faint or imperceptible. Also examine the upper forearm near the wrist when flexed; there should be three diverging pulses. The central one is the Shouganmai (Hand Liver Pulse); the lateral ones are Qimai (Diverging Pulses). If the Liver pulse is completely absent and the diverging pulses are corrupted, the prognosis is ten deaths to one survival, making rescue difficult. If the central pulse is palpable about three finger-widths from the palm and continuous, death is unlikely. If the pulse extends to the palm within three days, sweating will occur, and recovery will follow after sweating ceases. For women with jaundice, examine the right hand pulse. If the patient has fever, yellowish-green eyes, blue pupils, a blue-tinged pulse, and a blue complexion, it indicates Heat transferring from the Spleen to the Liver, as the Liver corresponds to the color Blue. If the patient has fever, red-yellow jaundice, red eyes, upward gazing, abdominal distension, and a red pulse, it indicates Heat transferring from the Spleen to the Heart, as the Heart corresponds to the color Red. Such red-yellow jaundice is difficult to treat and hard to cure. If the patient has fever and white-yellow jaundice, with white turbidity under the tongue, it indicates Heat transferring from the Spleen to the Lung, as the Lung corresponds to the color White. If the patient has fever and black-yellow jaundice, with black lips, yellow eyes, and black sublingual veins, it indicates Heat transferring from the Spleen to the Kidney, as the Kidney corresponds to the color Black. Thus, the patient presents with fever and black-yellow jaundice.