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1 黃膽
2 錢乙論黃相似云:身皮目皆黃者,黃病也。身疼膊背強,大小便澀,一身盡黃,面目指爪皆黃,小便如屋塵色,看物皆黃,渴者難治,此黃膽也。二証多病於大病後。別有一証,不因病後、身微黃者,胃熱也,大人亦同。又有面黃腹大,食土渴者,脾疳也。又有自生而身黃者,胎疸也。古書云:諸疸皆熱也,深黃者是也,若淡黃兼白者,胃怯,胃不和也。《難知》云:色如熏黃,乃濕病也。一身盡痛。色如橘子黃者,黃病也,身不痛。乾黃燥也,小便自利,四肢不沉重,渴而引飲者,梔子柏皮湯。濕黃脾也,小便不利,四肢沉重,似渴不欲飲者,大茵陳湯。大便自利而黃者,茵陳梔子黃連三物湯。往來寒熱,一身盡黃者,小柴胡加梔子湯。潔古云:陽黃則大小便赤澀身熱,是脾土與心火相搏,為陽病,法當先利小便,後下大便。陰黃則清便自調,面目及身黃,四肢冷,是脾虛不能制腎水,當用益黃散,下使君子丸益黃散方見脾,使君子丸方見疳。凡治黃病腹脹,當用茵陳蒿湯調下五苓散,若欲利小便,去大黃。欲利大便,則加大黃之類。有陽証可服,謂面赤飲水者是也。湯氏云:身疼膊背疼,大小便澀,皮膚面目齒爪皆黃,小便如屋塵色,利者易治,澀者難治,宜服五苓散加茵陳煎湯調,又宜服導赤散加茵陳煎。或身熱,宜服小柴胡湯,甚者服承氣湯。〔曾〕凡黃病者,不可一概而論,標本不同,証治亦異,乃脾胃氣虛,感受濕熱,鬱於腠理,淫於皮膚,蘊積成黃,熏發於外,故有此証。或脾胃虛弱,內因症癖,攻之而成。然疳瀉亦主皮黃髮豎,肚大青筋,肌肉消瘦,外無色澤,身必發黃,此又本於疳病而作,致有是証。治法,若感濕熱而得,身黃如煙熏之色,以 咀五苓散加麻黃、水姜煎投,汗之即愈。或用茵陳蒿湯調下五苓散亦好。若得於疳癖者,其形如黃土相類,以醒脾散慢驚、化癖丸醒脾快胃,磨積理疳,胃氣既和,飲食倍進,運化精微,榮養百骸,灌溉髒腑,五色各見於本部,精華乃形於面貌,其黃自除。〔薛〕經曰:中央黃色,入通於脾,故黃膽者,脾之色也,夫人身之神,貴於藏而默,用見於外,則內虛矣。其証皆因脾氣有虧,運化失職,濕熱留於肌膚,發而為疸,錢仲陽所謂身痛背強,二便澀滯,遍身面目爪甲皆黃是也,小便褐色者難治。療法宜固脾為先,如專用克伐寬中,澹洩利水之藥,則鮮有不至危者矣。若初生及百日半年之間,不因病而身黃者,胃熱胎黃也,腹大食土為脾疳,兼作渴飲冷者,用瀉黃散。小便不利者,茵陳湯。病後發黃,肢體浮腫者用白術散。清便自調,肢冷嗜臥者益黃散。身澹黃白者調中丸腹痛及補中益氣湯虛熱加茵陳。身熱膈滿,肌膚面目皆黃者加減瀉黃散。辨其所以,若閉目壯熱,多哭不已,大小便赤澀,口中熱氣者,乃妊娠濃味,胎毒之候也,母子並服生地黃湯胎黃,仍忌酒面五辛熱物。設不自慎,誤傷脾土,急則變為驚風吐瀉,緩則肢體浮腫,小便不利,眼目障閉,多成疳疾矣。又有脾虛發黃者,當於脾胃中求之。
URN: ctp:ws74088

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