论曰狐惑之病，或初得状似伤寒，或因伤寒而变，皆虫证也，虫食其喉为惑，使人生嗄，
虫食其下部为狐，使人咽干，其候皆默默欲眠，不得卧，起居不安，恶饮食，面目乍白乍黑
是也，此由伤寒病腹内热，饮食少，肠胃空虚，而虫为之不安，故随所食上下部，而病名狐
惑也。
治伤寒变成狐惑，其脉数，无热微烦，默默但欲卧，汗出，初得之三四日眼赤，得之七
八日目四 黑，能食者，脓已成也。宜赤小豆当归散方
赤小豆（一升水浸令芽生焙干） 当归（切焙一两）
上二味，捣罗为细散，每服二钱匕，浆水一盏，煎五七沸，和滓温服，不拘时。
治伤寒不发汗十日以上，成狐惑病，腹胀面赤，恶闻食臭。羚羊角汤方
羚羊角（镑） 大腹（并皮子用锉） 柴胡（去苗） 朴硝各半两 葳蕤（三分） 石
膏（碎）
桑根白皮（锉各一两）
上七味，粗捣筛，每服五钱匕，水一盏半，煎至八分，去滓温服，不拘时。
治伤寒不发汗后变成狐惑，脉数无热，微烦目赤，但欲眠睡，咽干不能食。黄芩汤方
黄芩（去黑心） 射干（各一两） 黄连（去须炒三分） 甘草（炙锉） 前胡（去芦
头） 青竹
茹知母（焙各半两）
上七味，粗捣筛，每服五钱匕，水一盏半，煎至八分，去滓食后温服。
治伤寒发汗后，变成狐惑，毒瓦斯发盛，恶闻饮食，咽中干痛，胸胁满闷。犀角汤方
犀角（镑三分） 黄连（去须炒） 芍药 木通（锉） 木香 枳实（去瓤麸炒） 射
干人参
半
上九味，粗捣筛，每服五钱匕，水一盏半，生姜一枣大拍碎，煎至八分，去滓食前温服。
治伤寒狐惑 病。桃仁汤方
桃仁（去皮尖双仁炒） 槐子 艾（各一两）
上三味， 咀如麻豆大，每服五钱匕，水一盏半，枣三枚劈破，煎至八分，去滓温服。
治伤寒狐惑，咽喉涩痛，唇口破，唾脓血。知母汤方
知母（焙一两） 石膏（二两） 黄芩（去黑心） 甘草（炙锉各三分）
上四味，粗捣筛，每服五钱匕，水一盏半，糯米一匙，煎至八分，去滓食前温服。
治伤寒病后，有疮出下部。黄连犀角汤方
黄连（去须半两） 犀角（镑一两如无以升麻代之） 乌梅（七枚） 木香（一分）
上四味， 咀如麻豆大，每服三钱匕，水一盏，煎至六分，去滓温服。
治伤寒阴阳不和，变成狐惑，目如鸠赤，面色斑纹如锦。木通汤方
木通（锉一两） 吴茱萸（汤洗三遍炒干） 桂（去粗皮） 细辛（去苗叶各半两） 甘
草（三分锉炙）
上五味，粗捣筛，每服五钱匕，水一盏半，枣二枚劈破，葱白五寸，煎至八分，去滓食
前温服。
治伤寒不发汗成狐惑，六七日不解，寒热未去，胸胁满痛，默默欲睡卧，不欲食心烦善
呕腹痛。前胡汤方
前胡（去芦头一两） 半夏（一两半汤洗七遍炒干） 黄芩（去黑心） 甘草（炙锉各
三分） 人参（一两）
上五味，粗捣筛，每服五钱匕，水一盏半，生姜一枣大拍碎，枣三枚劈破，煎至八分，
去滓空心温服。
治伤寒发汗不解，变成狐惑，寒热无常，心中躁闷，不欲饮食。半夏汤方
半夏（汤洗七遍炒干） 木通（锉） 桃仁（汤浸去皮尖双仁炒） 附子（炮裂去皮脐）
桂（去粗皮） 葛根 枳壳（去瓤麸炒） 黄芩（去黑心各半两） 羚羊角（镑一分） 升
麻（一分半） 麻黄（去根节三分）
上一十一味，锉如麻豆，每服五钱匕，水一盏半，生姜一枣大拍碎，煎至八分，去滓温
服。
治伤寒不发汗，变成狐惑病，在阳曰惑，在阴曰狐，其状默默眠睡，起则不安，喉中干
燥，恶闻食臭，其面或赤或白，语声微弱，先宜服此薰草汤方
零陵香 黄连（去须炒各一两）
上二味，锉如麻豆大，分二服，每服用浆水二盏，浸药一宿，煎至一盏去滓，食前温服，
日再。
治伤寒狐惑，下部 疮。雄黄导气散方
雄黄（研） 青葙子 苦参 黄连（各半两） 桃仁（去皮尖双仁炒研一分）
上五味，捣研为散，以生艾捣汁和如枣子大，绵裹导下部， 蓄汁和更佳，冬月无艾，
只用散绵裹亦得。
治伤寒发汗下利不解，心中躁闷，复发壮热，大肠不通，咽中干痛，变成狐惑。皂荚丸
方皂荚（二挺去皮子慢火炙黑） 大黄（半两生用） 槟榔（锉） 木香（各一分）
上四味，捣罗为末，炼蜜和捣三五百杵，丸如梧桐子大，每服二十丸，生姜茶清下，不
拘时、日再。
治伤寒狐惑，微烦默默欲卧，毒瓦斯上攻，咽干声嗄，下蚀湿 ，或便脓血。雄黄丸方
雄黄（研） 当归（锉炒各三分） 芦荟（研） 麝香（研各一分） 槟榔（锉半两）
上五味，捣研为末，煮面糊和丸，如梧桐子大，每服十五丸至二十丸，食前温粥饮下，
日三。
治伤寒狐惑，神思昏闷，大便难，肌肤热。柴胡散方
柴胡（去苗） 大黄（锉炒） 赤芍药 槟榔（锉） 枳实（麸炒去瓤各一两） 半夏
（半两姜汁浸令透焙）
上六味，捣罗为散，每服二钱匕，浓煎苦楝根汤调下，米饮亦得。
治伤寒狐惑，虫蚀上部则声嗄。甘草泻心汤方
甘草（炙四两） 黄芩（去黑心） 人参 干姜（炮各三两） 黄连（去须一两） 半
夏（汤洗去滑七遍曝干二两）
上六味， 咀如麻豆大，每服五钱匕，水一盏半，生姜二枣大拍碎，煎取八分，去滓温
服、日再。
治伤寒不发汗，变成狐惑，毒瓦斯上攻，喉咽疼痛，下利不止。地榆汤方
地榆 黄连（去须） 木香（各半两） 白术（一分半） 甘草（炙锉） 阿胶（炙燥
各一分）
上六味，粗捣筛，每服五钱匕，水一盏半，生姜一枣大拍碎，煎至八分，去滓食前温服。
治伤寒狐惑病在上焦。撩膈汤方
苦参（一两） 甘草（半两生用）
上二味，细锉，用浆水一盏半，煎至八分去滓，五更初服，良久即吐。
治伤寒狐惑，毒攻下部，肛内生疮。熏洗四皮汤方
槐白皮 柳白皮 桑白皮 桃白皮
上四味，等分，各细锉，每用四两，以浆水一斗，煎至七升去滓，熏洗下部。
治伤寒不发汗，变成狐惑，毒瓦斯下蚀肛门，痒甚不已，或下脓血。槟榔丸方
槟榔（半两生捣末） 杏仁（四十九粒汤浸去皮尖双仁研） 丹砂（半两别研） 麝香
（一钱研）
上四味，同研匀细，用饧和丸，如枣核大，先用椿根槐白皮各二两，以水一斗煎十余沸，
熏洗肛门后，将药内之。
治伤寒狐惑，毒蚀下部，肛外如 ，痛痒不止。雄黄熏方
雄黄（研半两）
上一味，先用瓶一只口稍大者，入灰半瓶，灰上放火，将雄黄烧之，候烟出，坐瓶口熏
之。
Discussion: The disease of Hu-Huo (Hu-Huo Disease) may initially present with symptoms resembling Taiyang disease (Taiyang Syndrome), or it may develop as a transformation from Taiyang disease; both are classified as "Worm Syndromes" (Syndromes caused by parasites). When worms erode the throat, causing hoarseness, it is termed "Huo" (Confusion); when worms erode the lower body, causing dryness of the throat, it is termed "Hu" (Fox). The clinical manifestations include silence and desire to sleep but inability to do so, restlessness in daily activities, aversion to food and drink, and facial complexion that alternates between pale and dark. This occurs because after Taiyang disease, internal heat accumulates in the abdomen, dietary intake decreases, leading to emptiness in the intestines and stomach, which disturbs the worms. Consequently, the worms move up and down, causing the disease, hence named Hu-Huo.
For treating Hu-Huo transformed from Taiyang disease, characterized by a rapid pulse, absence of fever but slight irritability, silence with a desire to lie down, sweating, red eyes in the first three to four days, and blackening around the eyes on the seventh or eighth day, with the ability to eat indicating that pus has formed, use Chi Xiao Dou Dang Gui San (Red Bean and Angelica Decoction).
Chi Xiao Dou (Vigna angularis, one sheng, soaked in water until sprouts emerge, then dried by baking) Dang Gui (Angelica sinensis, sliced and dried by baking, one liang)
The above two ingredients are pounded into a fine powder. Each dose consists of two qian bi (approx. 6-9g), boiled in one zhan of Jiang Shui (fermented rice water) for five to seven boils. Take warm with the dregs, at any time.
For treating Hu-Huo resulting from failure to induce sweating in Taiyang disease for more than ten days, presenting with abdominal distension, flushed face, and aversion to the smell of food, use Ling Yang Jiao Tang (Antelope Horn Decoction).
Ling Yang Jiao (Saiga Tatarica Horn, shaved) Da Fu Pi (Arecae Pericarpium, including peel and seed, chopped) Chai Hu (Bupleuri Radix, stems removed) Po Xiao (Natrii Sulfas, half liang each) Wei Rui (Polygonati Odorati Rhizoma, three fen) Shi Gao (Gypsum Fibrosum, crushed) Sang Bai Pi (Mori Cortex, chopped, one liang each)
The above seven ingredients are coarsely pounded and sifted. Each dose consists of five qian bi, boiled in one and a half zhan of water until reduced to eight parts. Strain and take warm, at any time.
For treating Hu-Huo transformed after failure to induce sweating in Taiyang disease, presenting with rapid pulse, no fever, slight irritability, red eyes, somnolence, dry throat, and inability to eat, use Huang Qin Tang (Scutellaria Decoction).
Huang Qin (Scutellariae Radix, remove black heart) She Gan (Belamcandae Rhizoma, one liang each) Huang Lian (Coptidis Rhizoma, remove whiskers, stir-fried, three fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, chopped) Qian Hu (Peucedani Radix, remove rhizome head) Qing Zhu Ru (Bambusae Caulis in Taeniam, baked) Zhi Mu (Anemarrhenae Rhizoma, baked, half liang each)
The above seven ingredients are coarsely pounded and sifted. Each dose consists of five qian bi, boiled in one and a half zhan of water until reduced to eight parts. Strain and take warm after meals.
For treating Hu-Huo transformed after inducing sweating in Taiyang disease, characterized by vigorous toxic qi, aversion to smells of food, dry and painful throat, and fullness/stuffiness in chest and hypochondrium, use Xi Jiao Tang (Rhinoceros Horn Decoction).
Xi Jiao (Rhinocerotis Cornu, shaved, three fen) Huang Lian (Coptidis Rhizoma, remove whiskers, stir-fried) Shao Yao (Paeoniae Radix) Mu Tong (Akebiae Caulis, chopped) Mu Xiang (Aucklandiae Radix) Zhi Shi (Aurantii Fructus Immaturus, remove pulp, bran-fried) She Gan (Belamcandae Rhizoma) Ren Shen (Ginseng Radix et Rhizoma, half liang each)
The above nine ingredients are coarsely pounded and sifted. Each dose consists of five qian bi, boiled in one and a half zhan of water with one date-sized piece of fresh ginger (shaken apart) until reduced to eight parts. Strain and take warm before meals.
For treating Taiyang Hu-Huo Disease, use Tao Ren Tang (Peach Kernel Decoction).
Tao Ren (Persicae Semen, remove skin and pointed ends, double-kernel type, stir-fried) Huai Zi (Sophorae Tonkinensis Fructus) Ai Ye (Artemisiae Argyi Folium, one liang each)
The above three ingredients are cut into pieces the size of hemp seeds. Each dose consists of five qian bi, boiled in one and a half zhan of water with three split dates until reduced to eight parts. Strain and take warm.
For treating Taiyang Hu-Huo with astringent pain in the throat, cracked lips and mouth, and expectoration of pus and blood, use Zhi Mu Tang (Anemarrhena Decoction).
Zhi Mu (Anemarrhenae Rhizoma, baked, one liang) Shi Gao (Gypsum Fibrosum, two liang) Huang Qin (Scutellariae Radix, remove black heart) Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, chopped, three fen each)
The above four ingredients are coarsely pounded and sifted. Each dose consists of five qian bi, boiled in one and a half zhan of water with one spoonful of glutinous rice until reduced to eight parts. Strain and take warm before meals.
For treating post-Taiyang disease with ulcers in the lower part, use Huang Lian Xi Jiao Tang (Coptis and Rhinoceros Horn Decoction).
Huang Lian (Coptidis Rhizoma, remove whiskers, half liang) Xi Jiao (Rhinocerotis Cornu, shaved, one liang; if unavailable, substitute with Sheng Ma) Wu Mei (Mume Fructus, seven pieces) Mu Xiang (Aucklandiae Radix, one fen)
The above four ingredients are cut into pieces the size of hemp seeds. Each dose consists of three qian bi, boiled in one zhan of water until reduced to six parts. Strain and take warm.
For treating Hu-Huo transformed due to disharmony of Yin and Yang after Taiyang disease, presenting with red eyes like a turtledove's, and mottled facial complexion like brocade, use Mu Tong Tang (Akebia Decoction).
Mu Tong (Akebiae Caulis, chopped, one liang) Wu Zhu Yu (Evodiae Fructus, washed three times in hot water, stir-fried dry) Gui Zhi (Cinnamomi Ramulus, remove coarse bark) Xi Xin (Asari Radix et Rhizoma, remove stems and leaves, half liang each) Gan Cao (Glycyrrhizae Radix et Rhizoma, three fen, chopped and honey-fried)
The above five ingredients are coarsely pounded and sifted. Each dose consists of five qian bi, boiled in one and a half zhan of water with two split dates and five cun of scallion white until reduced to eight parts. Strain and take warm before meals.
For treating Hu-Huo resulting from failure to induce sweating in Taiyang disease, unresolved after six to seven days, with lingering chills and fever, chest and hypochondriac fullness and pain, silence with desire to sleep, anorexia, irritability, frequent vomiting, and abdominal pain, use Qian Hu Tang (Peucedanum Decoction).
Qian Hu (Peucedani Radix, remove rhizome head, one liang) Ban Xia (Pinelliae Rhizoma, one and a half liang, washed seven times in hot water, stir-fried dry) Huang Qin (Scutellariae Radix, remove black heart) Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, chopped, three fen each) Ren Shen (Ginseng Radix et Rhizoma, one liang)
The above five ingredients are coarsely pounded and sifted. Each dose consists of five qian bi, boiled in one and a half zhan of water with one date-sized piece of fresh ginger (shaken apart) and three split dates until reduced to eight parts. Strain and take warm on an empty stomach.
For treating Hu-Huo transformed after failure of sweating therapy in Taiyang disease, with irregular chills and fever, mental restlessness, and anorexia, use Ban Xia Tang (Pinellia Decoction).
Ban Xia (Pinelliae Rhizoma, washed seven times in hot water, stir-fried dry) Mu Tong (Akebiae Caulis, chopped) Tao Ren (Persicae Semen, soaked in hot water, remove skin and pointed ends, double-kernel type, stir-fried) Fu Zi (Aconiti Lateralis Radix Praeparata, roasted, remove skin and umbilicus) Gui Zhi (Cinnamomi Ramulus, remove coarse bark) Ge Gen (Puerariae Lobatae Radix) Zhi Ke (Aurantii Fructus, remove pulp, bran-fried) Huang Qin (Scutellariae Radix, remove black heart, half liang each) Ling Yang Jiao (Saiga Tatarica Horn, shaved, one fen) Sheng Ma (Cimicifugae Rhizoma, one and a half fen) Ma Huang (Ephedrae Herba, remove roots and joints, three fen)
The above eleven ingredients are chopped into pieces the size of hemp seeds. Each dose consists of five qian bi, boiled in one and a half zhan of water with one date-sized piece of fresh ginger (shaken apart) until reduced to eight parts. Strain and take warm.
For treating Hu-Huo transformed from failure to induce sweating in Taiyang disease: involvement of Yang meridians is called "Huo," involvement of Yin meridians is called "Hu." Symptoms include silence and somnolence, restlessness upon rising, dry throat, aversion to food smells, alternating red or pale complexion, and weak voice. Initially, use Xun Cao Tang (Fragrant Herb Decoction).
Ling Ling Xiang (Linglingxiang, zero-lingia fragrans) Huang Lian (Coptidis Rhizoma, remove whiskers, stir-fried, one liang each)
The above two ingredients are cut into pieces the size of hemp seeds. Divide into two doses. Soak each dose in two zhan of Jiang Shui overnight, boil until reduced to one zhan. Strain and take warm before meals, twice daily.
For treating lower body ulcers in Taiyang Hu-Huo, use Xiong Huang Dao Qi San (Realgar Guiding Qi Powder).
Xiong Huang (Realgar, ground) Qing Xiang Zi (Celosiae Semen) Ku Shen (Sophorae Flavescentis Radix) Huang Lian (Coptidis Rhizoma, half liang each) Tao Ren (Persicae Semen, remove skin and pointed ends, double-kernel type, stir-fried and ground, one fen)
The above five ingredients are pounded and ground into powder. Mix with juice from fresh Artemisia argyi to form pills the size of a jujube. Wrap in cotton and insert into the lower orifice. Mixing with accumulated discharge is better. In winter without mugwort, using the powder wrapped in cotton alone is acceptable.
For treating post-Taiyang disease with persistent diarrhea, mental restlessness, recurrent high fever, intestinal obstruction, dry and painful throat, transforming into Hu-Huo, use Zao Jia Wan (Soap Fruit Pill).
Zao Jia (Gleditsiae Sinensis Fructus, two stalks, remove skin and seeds, slow-fire roast until black) Da Huang (Rhei Radix et Rhizoma, half liang, raw) Bing Lang (Arecae Semen, chopped) Mu Xiang (Aucklandiae Radix, one fen each)
The above four ingredients are pounded into powder. Mix with refined honey and pound three to five hundred times. Form pills the size of Sophora seeds. Take twenty pills per dose with ginger-tea water, at any time, twice daily.
For treating Taiyang Hu-Huo with slight irritability, silence with desire to lie down, attacking toxic qi, dry throat, hoarseness, lower erosion with dampness, or bloody/purulent stool, use Xiong Huang Wan (Realgar Pill).
Xiong Huang (Realgar, ground) Dang Gui (Angelicae Sinensis Radix, chopped and stir-fried, three fen each) Lu Hui (Aloe, ground) She Xiang (Moschus, ground, one fen each) Bing Lang (Arecae Semen, chopped, half liang)
The above five ingredients are pounded and ground into powder. Mix with wheat paste to form pills the size of Sophora seeds. Take fifteen to twenty pills per dose before meals with warm porridge water, three times daily.
For treating Taiyang Hu-Huo with mental confusion, difficult defecation, and skin heat, use Chai Hu San (Bupleurum Powder).
Chai Hu (Bupleuri Radix, remove stems) Da Huang (Rhei Radix et Rhizoma, chopped and stir-fried) Chi Shao Yao (Paeoniae Radix Rubra) Bing Lang (Arecae Semen, chopped) Zhi Shi (Aurantii Fructus Immaturus, bran-fried, remove pulp, one liang each) Ban Xia (Pinelliae Rhizoma, half liang, soaked in ginger juice until penetrated, baked)
The above six ingredients are pounded into powder. Take two qian bi per dose, mixed with thick decoction of Meliae Cortex (Kuan Jin Gen Tang) or rice drink.
For treating Taiyang Hu-Huo where worms erode the upper part causing hoarseness, use Gan Cao Xie Xin Tang (Licorice Decoction for Draining the Epigastrium).
Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, four liang) Huang Qin (Scutellariae Radix, remove black heart) Ren Shen (Ginseng Radix et Rhizoma) Gan Jiang (Zingiberis Rhizoma, roasted, three liang each) Huang Lian (Coptidis Rhizoma, remove whiskers, one liang) Ban Xia (Pinelliae Rhizoma, washed seven times in hot water to remove slipperiness, sun-dried, two liang)
The above six ingredients are cut into pieces the size of hemp seeds. Each dose consists of five qian bi, boiled in one and a half zhan of water with two date-sized pieces of fresh ginger (shaken apart) until reduced to eight parts. Strain and take warm, twice daily.
For treating Hu-Huo transformed from failure to induce sweating in Taiyang disease, with attacking toxic qi, sore throat, and continuous diarrhea, use Di Yu Tang (Sanguisorba Decoction).
Di Yu (Sanguisorbae Radix) Huang Lian (Coptidis Rhizoma, remove whiskers) Mu Xiang (Aucklandiae Radix, half liang each) Bai Zhu (Atractylodis Macrocephalae Rhizoma, one and a half fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, chopped) E Jiao (Colla Corii Asini, honey-fried and dried, one fen each)
The above six ingredients are coarsely pounded and sifted. Each dose consists of five qian bi, boiled in one and a half zhan of water with one date-sized piece of fresh ginger (shaken apart) until reduced to eight parts. Strain and take warm before meals.
For treating Taiyang Hu-Huo affecting the Upper Jiao (Upper Burner), use Liao Ge Tang (Pharynx-Lifting Decoction).
Ku Shen (Sophorae Flavescentis Radix, one liang) Gan Cao (Glycyrrhizae Radix et Rhizoma, half liang, raw)
The above two ingredients are finely chopped. Boil in one and a half zhan of Jiang Shui until reduced to eight parts. Strain and take at dawn (fifth watch). Vomiting will occur after some time.
For treating Taiyang Hu-Huo where toxic qi attacks the lower part, causing ulcers inside the anus, use Xun Xi Si Pi Tang (Fumigation and Washing Four Barks Decoction).
Huai Bai Pi (Morus Alba Bark) Liu Bai Pi (Salix Alba Bark) Sang Bai Pi (Mori Cortex) Tao Bai Pi (Prunus Persica Bark)
The above four ingredients are equal parts, finely chopped. Use four liang per dose, boil in one dou of Jiang Shui until reduced to seven sheng. Strain and use for fumigation and washing of the lower orifice.
For treating Hu-Huo transformed from failure to induce sweating in Taiyang disease, with toxic qi eroding the anus, severe itching, or purulent/bloody discharge, use Bing Lang Wan (Areca Pill).
Bing Lang (Arecae Semen, half liang, raw ground powder) Xing Ren (Pruni Semen, forty-nine grains, soaked in hot water, remove skin and pointed ends, double-kernel type, ground) Dan Sha (Cinnabar, half liang, separately ground) She Xiang (Moschus, one qian, ground)
The above four ingredients are ground together uniformly. Mix with maltose to form pills the size of a jujube pit. First, boil two liang each of Chun Gen (Toona Sinensis Root Bark) and Huai Bai Pi in one dou of water for more than ten boils. Use for fumigation and washing of the anus, then insert the pill.
For treating Taiyang Hu-Huo where toxic qi erodes the lower part, causing external anal lesions resembling eczema with unceasing pain and itching, use Xiong Huang Xun (Realgar Fumigation).
Xiong Huang (Realgar, ground, half liang)
Take one bottle with a slightly wide mouth. Fill half with ash, place fire on the ash, and burn the realgar. When smoke emerges, sit over the bottle mouth to fumigate.