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-> -> 卷之八·脾脏部

《卷之八·脾脏部[View] [Edit] [History]

1 黄胆
2 钱乙论黄相似云:身皮目皆黄者,黄病也。身疼膊背强,大小便涩,一身尽黄,面目指爪皆黄,小便如屋尘色,看物皆黄,渴者难治,此黄胆也。二证多病于大病后。别有一证,不因病后、身微黄者,胃热也,大人亦同。又有面黄腹大,食土渴者,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。一身尽痛。色如橘子黄者,黄病也,身不痛。乾黄燥也,小便自利,四肢不沉重,渴而引饮者,栀子柏皮汤。湿黄脾也,小便不利,四肢沉重,似渴不欲饮者,大茵陈汤。大便自利而黄者,茵陈栀子黄连三物汤。往来寒热,一身尽黄者,小柴胡加栀子汤。洁古云:阳黄则大小便赤涩身热,是脾土与心火相搏,为阳病,法当先利小便,后下大便。阴黄则清便自调,面目及身黄,四肢冷,是脾虚不能制肾水,当用益黄散,下使君子丸益黄散方见脾,使君子丸方见疳。凡治黄病腹胀,当用茵陈蒿汤调下五苓散,若欲利小便,去大黄。欲利大便,则加大黄之类。有阳证可服,谓面赤饮水者是也。汤氏云:身疼膊背疼,大小便涩,皮肤面目齿爪皆黄,小便如屋尘色,利者易治,涩者难治,宜服五苓散加茵陈煎汤调,又宜服导赤散加茵陈煎。或身热,宜服小柴胡汤,甚者服承气汤。〔曾〕凡黄病者,不可一概而论,标本不同,证治亦异,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,故有此证。或脾胃虚弱,内因症癖,攻之而成。然疳泻亦主皮黄发竖,肚大青筋,肌肉消瘦,外无色泽,身必发黄,此又本于疳病而作,致有是证。治法,若感湿热而得,身黄如烟熏之色,以 咀五苓散加麻黄、水姜煎投,汗之即愈。或用茵陈蒿汤调下五苓散亦好。若得于疳癖者,其形如黄土相类,以醒脾散慢惊、化癖丸醒脾快胃,磨积理疳,胃气既和,饮食倍进,运化精微,荣养百骸,灌溉脏腑,五色各见于本部,精华乃形于面貌,其黄自除。〔薛〕经曰:中央黄色,入通于脾,故黄胆者,脾之色也,夫人身之神,贵于藏而默,用见于外,则内虚矣。其证皆因脾气有亏,运化失职,湿热留于肌肤,发而为疸,钱仲阳所谓身痛背强,二便涩滞,遍身面目爪甲皆黄是也,小便褐色者难治。疗法宜固脾为先,如专用克伐宽中,澹泄利水之药,则鲜有不至危者矣。若初生及百日半年之间,不因病而身黄者,胃热胎黄也,腹大食土为脾疳,兼作渴饮冷者,用泻黄散。小便不利者,茵陈汤。病后发黄,肢体浮肿者用白术散。清便自调,肢冷嗜卧者益黄散。身澹黄白者调中丸腹痛及补中益气汤虚热加茵陈。身热膈满,肌肤面目皆黄者加减泻黄散。辨其所以,若闭目壮热,多哭不已,大小便赤涩,口中热气者,乃妊娠浓味,胎毒之候也,母子并服生地黄汤胎黄,仍忌酒面五辛热物。设不自慎,误伤脾土,急则变为惊风吐泻,缓则肢体浮肿,小便不利,眼目障闭,多成疳疾矣。又有脾虚发黄者,当于脾胃中求之。
URN: ctp:ws74088

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