Yellow Water Disease—cited from the "Chinese Medical Encyclopedia—Tibetan Medicine"

　　This disease arises from an imbalance among three factors, leading to an excess of the yellow water—a biochemical substance derived from bile essence—that spreads throughout the body, causing harm and even posing a threat to life. According to Tibetan medicine, after food enters the stomach and undergoes digestion, its finest components are transformed into blood. If one overindulges in nutrient-rich foods such as meat and alcohol, the blood becomes excessively abundant. The waste products of this overabundant blood then transform into bile, which accumulates in the gallbladder. Bile itself is divided into two components: the essence and the residue. The essence of bile is further transformed into yellow water. This yellow water circulates throughout the body, permeating muscles, bones, internal organs, and other tissues—both inside and outside the body. In particular, it accumulates between the skin layers and in the joints of the limbs. Physiologically, yellow water plays crucial roles such as lubricating joints and regulating fluid balance. However, when dietary and lifestyle habits undergo abnormal changes—whether insufficient, excessive, or contradictory—they can lead to an imbalance in yellow water levels, resulting in either an excess or deficiency and triggering yellow water disease. An excess of yellow water can provoke various skin conditions, including pityriasis rosea, psoriasis, insect bites, stubborn eczema, herpes, tinea corporis, and skin itching. Moreover, conditions such as edema, ascites, abscesses, erysipelas, gout, rheumatic disorders, diphtheria, anthrax, and heat-toxemia are all manifestations of yellow water disease. Similarly, sores and ulcers on the head, limbs, and body cavities are also caused by yellow water. Furthermore, carbuncles and leprosy are both linked to yellow water disease. Therefore, treatment for yellow water disease must not be neglected.

　　Clinically, Huangshui disease is classified into two types: Black Huangshui Disease and White Huangshui Disease. Black Huangshui Disease is caused by an imbalance of Pigan and Long, and is categorized as a cold syndrome. White Huangshui Disease, on the other hand, is triggered by an imbalance of Chiba and is classified as a hot syndrome. Additionally, according to the route of invasion, the disease can be further subdivided into several types, including those that spread across the skin, diffuse into the muscles, travel along the meridians, lodge in the bones, descend into the internal organs, and infiltrate the visceral organs.

　　Symptoms are categorized into general symptoms and syndrome-specific symptoms.

　　General symptoms include generalized itching, clustered herpes lesions, swelling, bluish discoloration of the skin, and roughness all over the body, covered with fine rashes. Upon contact with substances such as wheat chaff or bran, immediate itching and swelling occur, accompanied by loss of eyebrows.

　　The symptom of “white-yellow watery discharge” is characterized by cold signs in both the pulse and urine. It flares up especially on rainy days, in humid weather, or when one gets chilled after wading through water. The condition eases somewhat when the body is warmed and one consumes nutritious, warming foods. The symptom of “black-yellow watery discharge” shows hot signs in both the pulse and urine. It tends to occur more readily under intense sunlight, from exposure to fire or heat, after drinking alcohol, or during autumn. The symptom of “skin yellow watery discharge” causes intense itching of the skin, accompanied by numerous small rashes that ooze yellow fluid when scratched. The skin turns bluish, becomes rough and hardened, and the affected areas develop tiny insect-like eruptions. The symptom of “muscle yellow watery discharge” involves yellow fluid-filled sores appearing in the calf muscles (gastrocnemius of the legs and feet), accompanied by muscle spasms and swelling. The symptom of “pulse-channel yellow watery discharge” manifests as numbness in all pulses, with a taut and floating pulse quality. During hot weather, the pulses feel warm; in cold weather, they become itchy. Patients may experience a sensation of worms crawling along their pulse channels. The symptom of “bone yellow watery discharge” causes severe bone pain and joint discomfort, making it difficult to bend, stretch, walk, or sit. The joints become swollen and itchy, with small rashes appearing around them. The symptom of “five-organ yellow watery discharge” refers to yellow fluid invading the heart: patients may experience confusion, palpitations, a feeling of fullness and pain in the upper body, chest and heart discomfort, shortness of breath, irritability, and mood swings. They may also develop insect-like rashes or flesh-colored patches on the chest, and their tongue often displays papules. If the yellow fluid invades the lungs, patients frequently cough, their eyelids and dorsum of the feet swell, they suffer chest and back pain, become hoarse, and experience dry lips. When the yellow fluid affects the liver, patients often have watery eyes, feel heavy-bodied, experience nosebleeds, and suffer liver-stomach pain. If the yellow fluid affects the spleen, patients experience abdominal distension, intestinal rumbling, and cracked lips. When the yellow fluid affects the kidneys, patients suffer pain in the hip, waist, and thigh muscles, feel heaviness in the lower body, experience numbness in both legs, and have throbbing pains in the pulses connected to the kidney meridians. If the yellow fluid descends into the viscera, symptoms include yellowing of the eyes, fever, abdominal pain, difficulty urinating, occasional diarrhea, and stools that are yellowish-purple in color.

　　Treatment is divided into general treatment and syndrome-specific treatment.

　　General treatment

　　For white-yellow water disease, it is advisable to live in warm environments and wear warm clothing. It is best to consume warming, nourishing foods such as wine, mutton, aged butter, marmot meat, and donkey meat. These should be accompanied by red sugar liquor. Additionally, one may take Qingzili wine or five-root fermented tsampa cakes sweetened with red sugar. Avoid prolonged stays in damp, cold, and windy places, as well as locations containing sharp objects like wheat awns. As for medicinal treatments, honey can be used as a carrier to ingest nine-ingredient mercury-clearing formula, eighteen-ingredient Codonopsis powder, five-root medicine, Tibetan cat’s milk, three-fruited herb, and aged butter decocted with red sugar and ginger—these are all warming herbs taken internally and prove effective against various cold-induced yellow-water diseases. Depending on the specific condition, one may choose Caowu pills, sulfur-infused butter-preserved honey pills, five-root oil, or wine-based preparations. For external treatment, acupoints corresponding to the affected organs where yellow water has accumulated should be treated with moxibustion. For black-yellow water disease, diet and daily routines should favor cooling foods, such as yellow cattle, yaks, goat cheese, fresh butter, barley porridge, and fresh meat from wild animals. Avoid alcohol, aged butter, spoiled meats, and red sugar; instead, rest quietly in cool, shaded areas. As for medicinal remedies, decoctions made from blue bellflower, rhubarb, chebulic myrobalan, Euphorbia neriifolia, Daphne odora, Rheum palmatum, Phyllanthus emblica, and three-yellow-water herbs can be taken internally to promote bowel movements and cleanse the internal organs. Afterwards, according to the “Subsequent Section” guidelines, use the purgative pulse method to induce bowel movements, and grind together Berberis vulgaris bark, Rosa rugosa leaves, Tibetan cat’s milk, and Terminalia chebula into a fine powder. This powder should be combined with ten-ingredient frankincense powder and taken internally. Alternatively, one may opt for twenty-three-ingredient “Beiqiong” powder, the “Verified Prescription Collection” mercury pills, or mercury treasure pills.

　　Separate diagnosis and treatment

　　For skin lesions caused by yellow fluid, grind together finely the seeds of hibiscus syriacus, Acorus calamus, cloves, and small chili peppers, then mix with clarified butter and apply topically. Alternatively, soak white-flowered Astragalus ash in mare’s or donkey’s milk before applying it topically. For itching, apply the Eight-Flavor Sulfur Powder. For blistering rashes, apply the Five-Flavor Aconite Powder externally. For areas where yellow fluid has oozed outward, apply the Eleven-Flavor Aconite Powder. If the above treatments still fail to provide relief, employ the “Drainage Meridian” method and take the Seven-Flavor Tibetan Cat Milk Oil from the “Subsequent Section.” When yellow fluid has invaded the meridians, perform bloodletting at the point of pain and nearby meridians, then follow the “Drainage Meridian” method outlined in the “Subsequent Section” to induce purging. Afterwards, apply the Body Trauma Therapy to dry up the yellow fluid. If the yellow fluid has adhered to the bones, first administer purgation and meridian drainage, then apply the Five-Root and Sulfur Powder Oil to all joints and areas where yellow fluid has accumulated; alternatively, use the Red Five-Peng Powder externally. For heat-type conditions, use cupping to extract the yellow fluid; for cold-type conditions, employ moxibustion, natural hot spring baths, or the Five-Flavor Sweet Dew medicinal bath—these methods prove highly effective. Finally, take the Seven-Flavor Tibetan Cat Milk Oil internally to prevent recurrence. If the yellow fluid has invaded the heart, take the “Secrets Section” Shi Jing Formula internally. For external treatment, perform bloodletting for heat-type conditions and moxibustion on the sixth thoracic vertebra for cold-type conditions; also take internally the Aconite Pill and the Wen Guan Mu Oil. If the yellow fluid has invaded the lungs, take the Twelve-Flavor Tianzhu Yellow Powder internally. For heat-type conditions, perform bloodletting at the “Zhou Guo” meridian; for cold-type conditions, apply moxibustion to the fourth and fifth thoracic vertebrae. If the yellow fluid has invaded the liver and spleen, follow the “Subsequent Section” guidelines for meridian drainage and downward purging, combined with liver-spleen-specific purgatives. Take internally a fine powder made from safflower, rock essence, musk, long pepper, and granulated sugar. For heat-type conditions, perform bloodletting at the “Tong” meridians on both sides; for cold-type conditions, apply moxibustion to acupuncture points near the area where the yellow fluid has accumulated. If the yellow fluid has invaded the kidneys, first take the Four-Red Decoction, then follow the “Subsequent Section” drainage method to induce purging, and finally take the Five-Root Oil internally while applying moxibustion to acupuncture points near the site where the yellow fluid has accumulated. For yellow fluid that has accumulated in the viscera, the key is to administer the aforementioned Ten-Flavor Bluebell Pill for purging. In summary, whether the yellow fluid disease is caused by Lung, Pitta, or Kapha individually, or as a combined type, or occurs concurrently with plague, blood disorders, or has invaded the five viscera and six bowels, all cases should be treated primarily with Mercury Pills, supplemented by appropriate medications tailored to each specific condition. Additionally, once the yellow fluid has dried up and the skin becomes dry and the body weakens, nourish the body with high-quality meats and alcohol-based tonics.

　　(Prepared by the Qinghai Provincial Health Department, translated by Carlo, and edited by Xing Quanzhang)