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论曰:百合病者,百脉一宗,悉致其病也。意欲食复不能食,常默默然,欲卧,不能
卧,欲行,不能行,欲饮食,或有美时,或有不用闻食臭时,如寒无寒,如热无热,
口苦,小便赤,诸药不能治,得药,则剧吐利,如有神灵者,身形如和,其脉微数。
每溺时头痛者,六十日乃愈;若溺时头不痛者,淅然者,四十日愈;若溺快然,但头
眩者,二十日愈。其证或未病而预见,或病四、五日而出,或病二十日或一月微见者
,各随证治之。
【注】
百合,百瓣一蒂,如人百脉一宗,命名取治,皆此义也。百合病者,谓人百脉一宗,
悉致其病也。曰百脉即一脉也,犹言百体一体也,是盖以周身言之也。周身之脉,分
而言之曰百,合而言之曰一,故曰百脉一宗。若曰百合之病,总脉病也。脉者谓十二
经脉,三百六十五络脉也。伤寒大病之后,余热未解,百脉未和;或平素多思不断,
情志不遂;或偶触惊疑,卒临景遇,因而形神俱病,故有如是之现证也。百脉周于身
,脉病则身病,故身形如和不和,欲卧不能卧,欲行不能行也。百脉通于心,脉病则
心病,故常默默也。如寒无寒,如热无热,似外感而非外感也。意欲食复不能食,或
有美时,或闻食臭,有不用时,似里病而非里病也。至脉数、口苦、小便赤者,是郁
结之热,虽侵里而其热未甚也。方其初病之时,医者不识,误为表里之病,以药汗下
之,故剧吐利也,虽剧吐利,不变诸逆,苦有神灵,身形如前之和,而脉则比前微数
,故其势即不能遽进,不觉加甚,而亦不能速愈也。试以缓愈之期,约略言之,重者
不过六十日,轻者不过二十日,轻重之间者,不过四十日可愈也。然愈必以每溺时头
痛不头痛,恶风不恶风,快然不快然辨者,以经脉之邪,莫不由太阳而愈也。头痛恶
风,是其经之候也;溺时快然,是其府之征也。其证或未病而预见者,其证指百合病
等证言也。未病,言未病伤寒病也,犹言未病伤寒之前,而预先见百合欲食不食等证
也。或病四、五日而出,谓已病伤寒之后,而始见百合病证也。预先见者,是先有情
志不遂,偶触惊疑而召病也,或病二十日或一月才见者,是因伤寒病后而才见也。故
曰:各随证治之也。
【集注】
李□曰:『活人书』云:伤寒大病后,气血未得平复,变成百合病。今由百脉一宗,
悉致其病观之,当是心、肺二经之病也。如行卧、饮食、寒热等证,皆有莫可形容之
状,在『内经』解□病似之。观篇中有如神灵者,岂非以心藏神、肺藏魄,人生神魄
失守,斯有恍惚错妄之情乎?又曰:『内经』云:凡伤于寒则为病热,热气遗留不去
,伏于脉中,则昏昏默默,凡行卧、饮食、寒热,皆有一种虚烦不耐之像矣。
沈明宗曰:若邪淫于胸中连及上脘,则意欲食,复不能食,走于肝肾,故常默默,流
入脾胃,故欲卧不能卧,欲行不能行,邪不在胃,饮食或有美时,壅抑胃气,则闻食
臭,流于胆则口苦,流于膀胱则便赤,以上诸证,非一齐并见,皆移易变动而见也。
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百合病,见于阴者,以阳法救之;见于阳者,以阴法救之。见阳攻阴,复发其汗,此
为逆;见阴攻阳,乃复下之,此亦为逆。
【注】
此承上条以明其治也。百合一病,难分阴阳表里,故以百合等汤主之。若病见于阴者
,以温养阳之法救之;见于阳者,以凉养阴之法救之;即下文见阳攻阴,或攻阴之后
,表仍不解,复发其汗者,此为逆。见阴攻阳,或攻阳之后,里仍不解,乃复下之者
,此亦为逆也。
【集注】
徐彬曰:『内经』所谓用阴和阳,用阳和阴,即是此义。故诸治法,皆以百合为主。
至病见于阳,加一、二味以和其阴;病见于阴,加一、二味以和其阳。
李□曰:百合病多端,数条之法,亦说不尽。
沈明宗曰:此治百合病之总要法也。微邪伏于荣卫,流行而病表里,当分阴阳以施救
治可也。
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百合病,不经吐、下、发汗,病形如初者,百合地黄汤主之。
【注】
百合一病,不经吐、下、发汗,病形如初者,是谓其病迁延日久,而不增减,形证如
首章之初也。以百合地黄汤,通其百脉,凉其百脉,中病勿更服,恐过服生地黄,大
便常如漆也。
Cucumeris Fructus (Gua Di) 20 pieces.
Crush the above herbs, boil in one sheng of water until reduced to five ge, remove the dregs, and take in a single dose.
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The discussion states: Baihe Bing (Lily Disease) occurs when the hundred vessels of the body, sharing a single origin, are all affected by pathogenic factors. The patient desires to eat but cannot, remains often silent, desires to lie down but cannot rest comfortably, desires to walk but cannot move freely, desires to drink or eat, sometimes finding food palatable, and at other times losing appetite upon smelling food. They feel cold yet have no actual chills, feel hot yet have no actual fever, suffer from a bitter taste in the mouth, and have dark red urine. Various medicines fail to cure it; after taking medicine, severe vomiting and diarrhea occur, as if possessed by spirits. The physical appearance seems normal, while the pulse is slightly rapid. If headache occurs during urination, recovery takes sixty days; if there is no headache during urination but rather a sensation of chilliness, recovery takes forty days; if urination is smooth but accompanied only by dizziness, recovery takes twenty days. These symptoms may appear before the onset of illness, emerge four or five days after the onset, or manifest mildly after twenty days or a month. Treatment should be tailored to the specific syndrome.
[Annotation]
Baihe (Lily Bulb) has one hundred petals attached to a single stamen, analogous to the hundred vessels of the human body sharing a single origin. Both its naming and therapeutic application derive from this meaning. Baihe Bing refers to the condition where the hundred vessels, sharing a single origin, are all diseased. To say "hundred vessels" is essentially to say "one vessel," just as saying "hundred bodies are one body." This expression refers to the whole body. The vessels of the entire body are called "hundred" when analyzed separately, and "one" when considered collectively; hence, "the hundred vessels share a single origin." If referring to the disease of Baihe, it implies a general disorder of the vessels. Vessels refer to the twelve regular meridians and three hundred sixty-five collaterals. After a major febrile disease such as Shanghan (Cold Damage), residual heat remains unresolved, and the hundred vessels are not yet harmonized. Alternatively, chronic excessive thinking and emotional stagnation, or sudden exposure to startling or suspicious events, can cause both physical form and spirit to become diseased, resulting in the aforementioned manifestations. Since the hundred vessels circulate throughout the body, vessel pathology leads to bodily pathology; thus, the body may appear normal or abnormal, with restlessness in lying down and inability to walk smoothly. The hundred vessels connect to the Heart; vessel pathology affects the Heart, leading to constant silence. Feeling cold without actual chills, or feeling hot without actual fever, resembles an exterior syndrome but is not an exterior contraction. Desiring to eat but being unable to, sometimes finding food tasty, sometimes losing appetite upon smelling food, resembles an interior syndrome but is not an interior disorder. Regarding the rapid pulse, bitter taste, and dark urine, these indicate stagnant heat that, although invading the interior, is not yet severe. At the initial stage, if physicians fail to recognize the condition and mistakenly treat it as an exterior or interior syndrome using diaphoretic or purgative methods, severe vomiting and diarrhea result. Despite these severe reactions, no critical reversals occur. The patient suffers from mental agitation as if possessed, while the physical state remains relatively stable, and the pulse becomes slightly more rapid than before. Consequently, the condition does not progress rapidly nor resolve quickly. Estimating the duration of slow recovery: severe cases may take up to sixty days, mild cases up to twenty days, and intermediate cases up to forty days. Recovery must be distinguished by whether headache, aversion to wind, or smoothness of urination occurs during voiding, because pathogenic factors in the meridians typically resolve via the Taiyang (Greater Yang) channel. Headache and aversion to wind are signs of the meridian; smooth urination is a sign of the fu-organ (Bladder). "Symptoms appearing before illness" refers to the manifestation of Baihe Bing prior to contracting Shanghan. "Illness emerging after four or five days" refers to the appearance of Baihe Bing symptoms after contracting Shanghan. Early appearance is due to prior emotional stagnation and sudden startling; late appearance is due to post-Shanghan weakness. Therefore, treatment must follow the specific syndrome.
[Collected Notes]
Li [Name Redacted] states: The *Qiren Shu* (Book of Vitality) records that after a major febrile disease, if Qi and Blood fail to return to equilibrium, Baihe Bing develops. Based on "the hundred vessels share a single origin and are all diseased," this is likely a disease of the Heart and Lung meridians. Symptoms such as restlessness in movement and diet, and alternating sensations of cold and heat, are indescribable, resembling the "Jie Xie" disease described in the *Neijing* (Inner Canon). The phrase "as if possessed by spirits" suggests that since the Heart houses the Shen (Spirit) and the Lungs house the Po (Ethereal Soul), the loss of control over these spiritual aspects leads to恍惚 (trance-like confusion) and erratic emotions. Furthermore, the *Neijing* states that cold invasion leads to heat disease; if residual heat lingers and hides within the vessels, it causes lethargy and a sense of deficiency and irritability during movement, diet, and temperature regulation.
Shen Mingzong states: If pathogenic factors overflow into the chest and affect the upper epigastrium, the patient desires to eat but cannot; if they move to the Liver and Kidneys, the patient remains silent; if they flow into the Spleen and Stomach, the patient desires to lie down but cannot rest, and desires to walk but cannot move; if the pathogen is not in the Stomach, food may seem palatable; if it obstructs Stomach Qi, the smell of food induces nausea; if it flows into the Gallbladder, bitterness results; if it flows into the Bladder, urine becomes dark. These symptoms do not appear simultaneously but shift and change.
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In Baihe Bing, if the patient has not undergone emesis, purgation, or diaphoresis, and the clinical presentation remains unchanged from the beginning, Baihe Dihuang Tang (Lily and Rehmannia Decoction) is the primary formula.
[Annotation]
For Baihe Bing, if the patient has not been treated with emesis, purgation, or diaphoresis, and the condition persists unchanged for a long time, resembling the initial presentation, Baihe Dihuang Tang (Lily and Rehmannia Decoction) is used to unblock and cool the hundred vessels. Stop administration once the desired effect is achieved, as excessive consumption of raw Shengdi Huang (Rehmanniae Radix) may cause stools to resemble lacquer.