（论一首证三条方十二首）
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。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。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。
百合病。发汗后者。百合知母汤主之。
百合知母汤方
百合（七枚擘） 知母（三钱切）
上先以水洗百合渍一宿。当白沫出。去其水。更以泉水二升。煎取一升。去滓。别
以泉水二升煎知母。取一升。去滓。后合和煎。取一升五合。分温再服。
百合病下之后者。滑石代赭汤主之。
滑石代赭汤方
百合（七枚擘） 滑石（三两碎绵裹） 代赭石（如弹丸大一枚碎绵裹）
上先以水洗百合。渍一宿。当白沫出。去其水。更以泉水二升。煎取一升。去滓。别
以泉水二升。煎滑石、代赭取一升。去滓。后合和。重煎。取一升五合。分温服。
百合病吐之后者。百合鸡子汤主之。
百合鸡子汤方
百合（七枚擘） 鸡子黄（一枚）
上先以水洗百合。渍一宿。当白沫出。去其水。更以泉水二升。煎取一升。去滓。内
鸡子黄搅匀。煎五分。温服。
百合病。不经吐下发汗。病形如初者。百合地黄汤主之。
百合地黄汤方
百合（七枚擘） 生地黄（一升）
上以水洗百合渍一宿。当白沫出。去其水。更以泉水二升。煎取一升。去滓。内地
黄汁。煎取一升五合。分温再服。中病。勿更服。大便常如漆。
百合病。一月不解。变成渴者。百合洗方主之。
百合洗方
上以百合一升。以水一斗。渍之一宿。以洗身。洗已。食煮饼。勿以盐豉也。
百合病。渴不瘥者。栝蒌牡蛎散主之。
栝蒌牡蛎散方
栝蒌根 牡蛎（熬等分）
上为细末。饮服方寸匕。日三服。
百合病。变发热者（一作发寒热）百合滑石散主之。
百合滑石散方
百合（一两炙） 滑石（三两）
上为散。饮服方寸匕。日三服。当微利者。止服。热则除。
〔衍义〕所谓百脉一宗。悉致其病者。然则经脉十二。络脉十五。此云百脉。果何脉
欤。盖脉者血之府。即是血行于脉。灌溉表里。联系俞会。遍布形体。言其百者。举
夫数之众多也。犹言百骸尔。且又脉之循行。与天地合度。应水漏百刻。是故脉
之流行者。各有定位。因之而为百脉亦宜矣。又何其一宗而悉致病耶。盖尽归
于手心主也。手心主者。主血主脉。而心又为火之主。心君也。君不用事而手心
主代之。由是手心主得专行一身阴血之生化。因号之为母气。百脉皆宗之。若
火淫则热。热蓄不散则积。积则毒生而伤其血。热毒之血流于脉。本因母气之
淫邪。是故百脉一宗。悉致其病也。考之内经。有解 证。与此百合证无少异。解
既属之热中无血。百合岂非亦是热中无血者乎。请试逐病论之。血属阴。阴
者肾水之所主。内经曰。肾虚则饥不欲食。故欲食复不能食也。阴虚者恶烦。所
以常默默也。卫气者。夜行阴则寐。今卫气因阴虚不得降。故欲卧而不得卧也。
足得血则能步。血既病。于是欲行不能行也。饮食者。由血气运化而后安。脾属
血而喜香。血时和则食美。时不和则闻食臭也。气阳而血阴。若气盛则热。气衰
则寒。今病在血。不干于气。所以虽如寒而无寒。虽如热而无热也。血气和合则
流通。不和则塞。塞则热。上热为口苦。下热为便赤也。药虽治病。然必藉胃气以
行之。若毒血在脾胃经络。而闭塞之。药虽入。亦莫行也。胃弱不安于药者。得药
则反剧吐利。有如鬼神之为祟也。病不在皮肉筋骨。则身如和。惟热在于血而
血虚。故脉微数也。脉之微数。阴之虚也。阴虚则肾虚。肾与膀胱为表里。肾虚则
膀胱不得引精于肾而亦虚。膀胱之使下入会阴。上至巅。为诸阳主气。今溺而
膀胱之脉。为气下泄。轻则不能举之于上而上虚。上虚则淅然。头眩重虚。气逆
上于巅。而为头痛。以此之轻重。则可知愈日之远近也。夫病有定所。则可言定
期。今以百脉之痛。流转无定处。故其证之发现。亦无定期。或未病而见。或数日
一月而见。用是以察其病之表里浅深。出见形状。如下文之阴阳见者。随证而
救之。故以所列方观之。日华子谓百合安心定胆。益志五脏。为能补阴也。治产
后血眩晕。为能去血中热也。除痞满。利大小便。为能导涤血之瘀塞也。而是证
用之为主。盖可见瘀积者矣。若汗之而失者。是涸其上焦津液。而上焦阳也。阳
宜体轻之药。故用知母佐以救之。知母泻火。生津液。润心肺。若下之而失者。则
损其阴。瘀血下积。而下焦阴也。阴宜镇重之剂。故用滑石、代赭佐以救之。滑石
开结利窍。代赭除脉中风痹瘀血。若吐而失者。则损上中二焦之血。用鸡子黄
补血。佐以救之。若不经吐下发汗。未有所治之失。病形得如初者。但佐之生地
黄汁。补血凉血。凉则热毒消。补则新血生。蕴积者行。而自大便出。如黑漆矣。其
一月不解。百脉壅塞。津液不化而成渴者。故用百合洗。则一身之脉。皆得通畅
而津液行。其渴自止。勿食盐豉。以味咸而凝血。且走之也。若渴不瘥。是中无津
液。则以栝蒌牡蛎主之。若变发热者。乃因脉塞郁而成热。以硝石通利。佐之滑
石性凉。又可治热血之积塞者。自微利而出。故热除矣。夫百合病。自见金匮要
略。后诸方书。皆不收。独朱奉议收之。谓伤寒变成斯疾。此乃病由之一端尔。窃
尝思之。是病多从心主。或因情欲不遂。或因离绝菀结。或忧惶煎迫。致二火郁
之所成。百脉既病。故百体皆不安。所以见不一之病状。自今观之。诸方书不收
百合病。乃有劳瘵之名。殆将以百合病与劳瘵同形状。或瘀血积于脉亦同。因
而不收。但并其方而弃之。深为可惜。于脉病救之二法遂不明于世矣。
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。
〔衍义〕伤寒治法。有谓阳盛阴虚。汗之则死。下之则愈。阴盛阳虚。汗之则愈。下之
则死。今百合病。所云见于阴者。以阳法救之。见于阳者。以阴法救之。与伤寒之
语意。大同而小异。何则。在彼直言其盛。所以行汗下之法。此但言其见以救之。
则是无汗下之宜施。何以知其然。所叙百合病。皆持两端。欲卧不卧。欲食不食。
如寒无寒。如热无热。为其脉行表里之病。但当救之。非如伤寒阳气之变。见于
内外。必行汗下者也。设用伤寒法。见病在表辄汗。入里辄下。虽表里不逆。然亦伤之
。是以前条用方救之是也。其后所结汗下之逆者。为反表里汗下之逆者也。
狐惑之为病。状如伤寒。默默欲眠。目不得闭。卧起不安。蚀于喉为惑。蚀于阴为狐。
不欲饮食。恶闻食臭。其面目。乍黑乍赤乍白。蚀于上部则声喝。（一作嗄）甘草泻心汤主之。
甘草泻心汤方
甘草（四两） 黄芩 人参 干姜（各三两）
黄连（一两） 大枣（十二枚） 半夏（半升）
上七味。水一斗。煮取六升。去滓再煎。温服一升。日三服。
〔衍义〕狐惑病。谓虫蚀上下也。世谓风中有虫。凡虫自风生固矣。然风阳也。独阳
不生。必有所凭而后化。盖因湿热久停。蒸腐气血而成瘀浊。于是风化所腐为
虫矣。设风不由湿热。而从寒凉者。肃杀之气。纵然腐物。虫亦不化也。由是知此
病也。虫生于湿热败气瘀血之中。其来渐矣。遇极乃发。非若伤寒一日而暴病
者也。病发默默欲眠。目不得闭。卧起欠安者。皆五脏久受湿热。伤其阴精。卫不
内入。神不内宁故也。更不欲食。恶闻食臭者。仓廪之府伤也。其面乍赤乍黑乍
白者。由五脏不足。更为衰旺。迭见其色也。其虫者。从湿热之极。所发之处而蚀
之。蚀上部者。内损心肺。外伤咽喉。肺者气之主。咽喉声音之户。由是其声嗄矣。
故用甘草泻心汤主之。治其湿热。分利其阴阳。而黄连非惟治心脾热也。而亦
治虫。后世方论谓是证。或初得。状似伤寒。或因伤寒所变也。然皆虫证也。又谓
伤寒病。腹内热。饮食少。肠胃空虚。而虫不安。故随所食上下部。而病名孤惑也。
以此二或字观之。则非独伤寒变是证。凡热病皆得生虫也。
蚀于下部则咽干苦参汤洗之。
〔衍义〕虫蚀下部则咽干者。下部肾之所在。任脉附焉。肾、水也。湿热甚于下。则虫
蚀于上。而肾水受伤。经脉乏水以资之。挟湿热逆而燥其咽嗌。故用苦参汤洗。
苦参能除热毒。疗下部 。因以洗之。虽然。此治之外者尔。若究其源。病则自内
而外出。岂独治其标而已哉。试用上部服泻心汤者观之。则下部亦必有可服
之药。自下部用洗法者观之。则上部咽喉。亦必有可治之理。此仲景特互发之
尔。不然。何后世方论有服下部药者。与内食五脏者乎。
蚀于肛者。雄黄散熏之。
雄黄一味为末。筒瓦二枚合之。烧向肛熏之。
脉经云。病患或从呼吸。上蚀其咽。或从下焦。蚀其肛阴。蚀上为惑。蚀下为狐。狐
惑病者。猪苓散主之。
〔衍义〕蚀于肛。湿热在下。二阴虽皆主于肾。然肝脉循于肛。肛又为大肠之门户。
大肠、金也。湿热伤之。则木来侮。是以虫蚀于此焉。雄黄本主 疮杀虫。又有治
风之义。故用熏之。注引脉经猪苓散主之者。亦分别湿热尔。
病者脉数。无热微烦。默默但欲卧。汗出。初得之三四日。目赤如鸠眼。七八日目四
（一本此有黄字）黑。若能食者。脓已成也。赤小豆当归散主之。
赤小豆当归散方
赤小豆（三升浸令芽出曝干） 当归（十两）
上二味。杵为散。浆水服方寸匕。日三服。
〔衍义〕凡脉数则发热而烦。此热在血。不在荣卫。故不发热。但微烦尔。汗出者。以
血病不与卫和。血病则恶烦。故欲默。卫不和则阳陷。故欲卧。腠理因开而津液
泄也。三四日目赤如鸠眼者。热血循脉炎上。注见于目也。七八日四 黑者。其
血凝蓄。则色变成黑也。若能食脓已成者。湿热之邪散漫。则毒血流。伤其中和
之气不清。故不能食。若能食。可知其毒血已结成脓。胃气无扰。故能食也。用赤
豆、当归治者。其赤小豆能消热毒。散恶血。除烦排脓。补血脉。用之为君。当归补
血生新去陈为佐。浆水味酸。解热疗烦。入血为辅使也。
阳毒之为病。面赤斑斑如锦纹。咽喉痛。吐脓血。五日可治。七日不可治。升麻鳖甲
汤主之。
阴毒之为病。面目青。身痛如被杖。咽喉痛。五日可治。七日不可治。升麻鳖甲汤去雄黄、蜀椒主之。
升麻鳖甲汤方
升麻（二两） 当归（一两） 蜀椒（炒去汗一两） 甘草（二两） 鳖甲（手指大一片炙）
雄黄（半两研）
上六味。以水四升。煮取一升。顿服之。老小再服取汗。肘后千金方。阳毒用升麻
汤无鳖甲。有桂。阴毒用甘草汤。无雄黄。
〔衍义〕按古方书谓阳毒者。阳气独盛。阴气暴衰。内外皆阳。故成阳毒。谓阴毒者。
阴气独盛。阳气暴衰。内外皆阴。故成阴毒。二者或伤寒初得。便为是证。或服药
后变而成之。阳毒尽治以寒凉。阴毒尽治以温热。药剂如冰炭之异。何乃仲景
用一方治之乎。虽曰阴毒。去雄黄、蜀椒。则是反去其温热者矣。且注曰肘后千
金方。阳毒用升麻汤。无鳖甲。有桂。阴毒用甘草汤。无雄黄。岂非皆是热毒之伤
于阴阳二经络耶。在阳经络。则面赤斑斑如锦纹。吐脓血。在阴经络。则面青身
如被杖。此皆阴阳水火动静之本象如此。岂是寒热之邪乎。尝以升麻、鳖甲之
药考之。本草谓升麻能解时气毒厉。诸毒攻咽喉痛。与热毒成脓。开壅闭。疗发
斑。当归能破恶血。养新血。补五脏肌肤。甘草和中。利血脉。缓急止痛。调药奏功。
鳖甲去恶血。雄黄破骨节积聚。避鬼邪恶气。骨蒸热极。蜀椒通血脉。调关节。逐
肌骨皮肤死肌。去留结破血。治天行时气。诸药所能者如此。即此观之。仲景于
阴阳二毒之证。总用一方。盖可见矣。病形虽由阴阳发证。论邪则一属热毒与
血病也。所以不分表里。俱以升麻解热毒为君。当归和血为臣。余者佐之而已。
但雄黄、蜀椒。理阳气药也。故病在阴者去之。如肘后千金。阳毒去鳖甲有桂枝
者。鳖、水族。乃阴中之阳。不如桂枝能调阳络之血。阴毒不去蜀椒者。蜀椒亦阴
中之阳。非若雄黄阳中之阳。故留之以治阴也。方旨如此而已。所谓五日可治。
七日不可治者。五日乃土之生数。热未极也。尚可以治。七日为火之成数。热之
极。阴阳消灭。不可治矣。其邪比之伤寒。加之以毒。故伤寒至七日犹得再经。而
此至七日。不惟灭其阴。且火极亦自灭矣。
(One treatise, three syndrome patterns, and twelve prescriptions)
The treatise states: Baihe disease (Lily Disease) occurs because all the vessels share a common origin, and thus all are affected by the pathogenic factor. The patient desires to eat but cannot; often remains silent; desires to lie down but cannot sleep peacefully; desires to walk but lacks the strength. Sometimes food tastes delicious, sometimes there is no desire to eat at all, or even an aversion to the smell of food. There is a sensation of cold without actual coldness, and a sensation of heat without actual heatiness. The mouth is bitter, and urination is dark red. Various medications fail to cure it; taking medicine results in severe vomiting and diarrhea. The symptoms seem as if possessed by spirits. The physical appearance looks normal, yet the pulse is slightly rapid. If headache occurs during urination, recovery takes sixty days. If there is no headache during urination but rather a shivering sensation (feeling chilly), recovery takes forty days. If urination is smooth but accompanied only by dizziness, recovery takes twenty days. This syndrome may appear before illness onset, or emerge four to five days after illness begins, or manifest mildly after twenty days or a month. Treatment should be tailored to the specific presentation.
For Baihe disease following improper sweating therapy, Baihe Zhi Mu Tang (Lily and Anemone Decoction) is indicated.
Baihe Zhi Mu Tang Prescription
He Tian Ma (Baihe, Lily Bulb) [7 bulbs, split] Zhi Mu (Anemone Radix) [3 qian, sliced]
First, wash the He Tian Ma and soak it overnight until white foam appears on the surface; discard this water. Then add two sheng of spring water, decoct to obtain one sheng of liquid, and strain. Separately, decoct the Zhi Mu in two sheng of spring water to obtain one sheng of liquid, and strain. Mix the two filtrates and decoct together to obtain one sheng and five he of liquid. Divide into two warm doses.
For Baihe disease following improper purgative therapy, Hua Shi Dai Zhe Tang (Talcum and Hematite Decoction) is indicated.
Hua Shi Dai Zhe Tang Prescription
He Tian Ma (Baihe, Lily Bulb) [7 bulbs, split] Hua Shi (Talcum) [3 liang, crushed and wrapped in cotton] Dai Zhe Shi (Hematite) [1 piece the size of a bullet, crushed and wrapped in cotton]
First, wash the He Tian Ma and soak it overnight until white foam appears; discard this water. Add two sheng of spring water, decoct to obtain one sheng of liquid, and strain. Separately, decoct the Hua Shi and Dai Zhe Shi in two sheng of spring water to obtain one sheng of liquid, and strain. Mix the liquids and decoct again to obtain one sheng and five he of liquid. Take in divided warm doses.
For Baihe disease following improper emetic therapy, Baihe Ji Zi Tang (Lily and Egg Yolk Decoction) is indicated.
Baihe Ji Zi Tang Prescription
He Tian Ma (Baihe, Lily Bulb) [7 bulbs, split] Ji Zi Huang (Egg Yolk) [1 unit]
First, wash the He Tian Ma and soak it overnight until white foam appears; discard this water. Add two sheng of spring water, decoct to obtain one sheng of liquid, and strain. Add the Ji Zi Huang, stir well, and decoct until reduced by five fen. Take warm.
For Baihe disease not treated with emetics, purgatives, or sweating methods, where the condition remains unchanged, Baihe Di Huang Tang (Lily and Rehmannia Decoction) is indicated.
Baihe Di Huang Tang Prescription
He Tian Ma (Baihe, Lily Bulb) [7 bulbs, split] Sheng Di Huang (Fresh Rehmannia Root) [1 sheng]
Wash the He Tian Ma and soak it overnight until white foam appears; discard this water. Add two sheng of spring water, decoct to obtain one sheng of liquid, and strain. Add the juice of Sheng Di Huang, decoct to obtain one sheng and five he of liquid. Divide into two warm doses. Once effective, do not continue administration. Stool will often appear black like lacquer.
For Baihe disease persisting for a month and developing into thirst, Baihe Xi Fang (Lily Wash Formula) is indicated.
Baihe Xi Fang Prescription
Use one sheng of He Tian Ma, soak in ten dou of water overnight, and use the water to wash the body. After washing, consume boiled noodles (Zhu Bing). Do not consume salted fermented soybeans (Yan Chi).
For Baihe disease with persistent thirst unrelieved by the above, Gua Lou Mu Li San (Trichosanthes Root and Oyster Shell Powder) is indicated.
Gua Lou Mu Li San Prescription
Gua Lou Gen (Trichosanthes Root) Mu Li (Oyster Shell) [calcined, equal parts]
Grind both ingredients into a fine powder. Administer one fang cun bi (square-inch measure) with drinkable liquid, three times daily.
For Baihe disease presenting with fever (alternatively stated as chills and fever), Baihe Hua Shi San (Lily and Talcum Powder) is indicated.
Baihe Hua Shi San Prescription
He Tian Ma (Baihe, Lily Bulb) [1 liang, processed with heat] Hua Shi (Talcum) [3 liang]
Grind into powder. Administer one fang cun bi with drinkable liquid, three times daily. Stop administration if mild diarrhea occurs. The heat will then be eliminated.
[Commentary]: The phrase "all vessels share a common origin, and thus all are affected" implies that while there are twelve main meridians and fifteen collaterals, what does "hundred vessels" refer to? Vessels are the reservoirs of blood; blood flows within them, nourishing the interior and exterior, connecting acupoints and intersections, and permeating the entire body. "Hundred" denotes multitude, similar to saying "hundred bones." Moreover, vessel circulation aligns with heaven and earth, corresponding to the hundred marks of a clepsydra. Thus, vessels have specific locations, justifying the term "hundred vessels." Why would they all become diseased from one source? It is attributed to the Pericardium Meridian of Hand-Jueyin (Shou Xin Zhu). The Pericardium governs blood and vessels. The Heart is the master of fire and the Sovereign Lord. When the Sovereign does not act directly, the Pericardium acts on its behalf. Thus, the Pericardium exclusively manages the transformation and generation of yin blood throughout the body, earning the title "Mother Qi," which all vessels revere. If fire becomes excessive, heat arises; if heat accumulates without dispersing, stagnation forms; prolonged stagnation generates toxicity that damages blood. Blood containing heat-toxin flows into the vessels, originally due to the excess pathogen of the Mother Qi. Hence, "all vessels share a common origin, and thus all are affected." Examining the *Neijing*, there is a condition called "Jie Xie" (a type of consumptive disease), which is nearly identical to Baihe disease. Since Jie Xie belongs to "heat in the middle without blood," is Baihe also "heat in the middle without blood"? Let us analyze this syndrome. Blood belongs to yin, governed by Kidney Water. The *Neijing* states: "Kidney deficiency leads to hunger without desire to eat," explaining the desire to eat but inability to do so. Yin deficiency causes aversion to vexation, hence the silence. Wei Qi enters yin at night to induce sleep; now, due to yin deficiency, Wei Qi cannot descend, causing the desire to sleep but inability to do so. Feet require blood to walk; since blood is diseased, walking is impossible. Food requires qi and blood transformation for digestion. Spleen relates to blood and prefers fragrance; when blood is harmonious, food tastes good; when disharmonious, the smell of food is repulsive. Qi is yang, blood is yin. Excess qi brings heat, deficiency brings cold. Here, the disease is in the blood, not affecting qi, so although there is a sensation of cold, there is no actual cold, and vice versa for heat. Harmonious blood flows smoothly; disharmony causes obstruction, leading to heat. Upper heat causes bitter taste; lower heat causes dark urine. Medicines treat disease but rely on Stomach Qi for transport. If toxic blood blocks the Stomach and Spleen meridians, medicine cannot circulate. A weak Stomach reacting poorly to medicine causes exacerbated vomiting and diarrhea, resembling demonic possession. Since the disease is not in skin, flesh, sinews, or bones, the body appears normal. Only heat in the blood and blood deficiency cause the slightly rapid pulse. A slightly rapid pulse indicates yin deficiency. Yin deficiency leads to Kidney deficiency. The Kidney and Bladder are exterior-interior pairs; Kidney deficiency impairs the Bladder's ability to guide essence back to the Kidney, leading to Bladder deficiency. Bladder qi descends to Huiyin and ascends to the vertex, governing yang qi. During urination, Bladder qi leaks downward. Mildly, upper qi fails to rise, causing upper deficiency and a shivering sensation (Xi Ran); dizziness indicates severe deficiency, with rebellious qi rising to the vertex causing headache. Based on severity, the time to recovery can be predicted. Diseases with fixed locations have fixed recovery periods. Here, pain flows through the hundred vessels without fixed location, so symptom onset varies—sometimes before illness, sometimes after days or months. This helps assess the depth and level of the disease. As seen below regarding yin-yang manifestations, treatment follows the syndrome. From the listed formulas, Ri Huazi noted that Baihe calms the heart, stabilizes the gallbladder, benefits the five zang organs, and tonifies yin. It treats postpartum blood-deficiency vertigo by clearing blood-heat. It removes fullness and promotes urination/defecation by draining blood stasis. Using Baihe as the main herb for this syndrome reveals underlying stasis accumulation. If sweating was used improperly, depleting upper jiao fluids (yang), Zhi Mu is added to rescue. Zhi Mu clears fire, generates fluids, and moistens lungs/heart. If purgatives were used improperly, damaging yin and accumulating blood stasis in the lower jiao (yin), Hua Shi and Dai Zhe Shi are added. Hua Shi opens knots and benefits orifices; Dai Zhe Shi removes wind-bi and blood stasis from vessels. If emetics were used improperly, damaging upper/middle jiao blood, Ji Zi Huang is used to tonify blood. If no improper treatments occurred and the condition remains initial, Sheng Di Huang juice is added to tonify and cool blood. Cooling eliminates heat-toxin; tonifying generates new blood. Accumulations move and exit via stool as black lacquer. If unresolved for a month, hundred vessels are blocked, fluids fail to transform causing thirst, so Baihe is used for bathing to unblock vessels and promote fluid movement, stopping thirst. Salt is avoided as saltiness coagulates blood and scatters fluids. If thirst persists, indicating lack of fluids in the middle, Gua Lou Mu Li San is used. If fever develops due to vessel blockage and stagnation, Shi Xiao (Niter) promotes urination, combined with cooling Hua Shi to resolve blood-heat stasis, exiting via mild diarrhea, eliminating heat. Baihe disease appeared in *Jingui Yaolue*; later texts omitted it, except Zhu Fengyi, who attributed it to transformed Shanghan. I believe this disease often originates from the Heart Master, due to unfulfilled desires, separation/stagnation, or anxiety/oppression, causing郁结 of the two fires. With hundred vessels diseased, the whole body is uneasy, producing varied symptoms. Later texts omitted Baihe disease, listing "Lao Zhai" (consumption) instead, likely due to similar appearances or blood stasis in vessels. Discarding the formulas is regrettable, obscuring the treatment principles.
For Baihe disease manifesting yin characteristics, treat with yang methods; for yang characteristics, treat with yin methods. Treating yang manifestations by attacking yin and inducing sweat again is contrary. Treating yin manifestations by attacking yang and purging again is also contrary.
[Commentary]: Shanghan treatment states: Yang excess/yin deficiency, sweating kills, purging heals; Yin excess/yang deficiency, sweating heals, purging kills. Baihe disease's "treat yin manifestations with yang methods, yang manifestations with yin methods" differs slightly. In Shanghan, excess dictates sweating/purging. Here, it refers to treating based on manifestation, implying sweating/purging are not appropriate. Baihe symptoms are ambivalent (want to sleep but don't, want to eat but don't, feel cold/hot but aren't), indicating pathology moving between exterior/interior, requiring gentle rescue rather than drastic measures like Shanghan. Using Shanghan methods blindly could cause damage. Thus, the previous formulas are correct. The warning against contrary sweating/purging refers to reversing the proper approach to exterior/interior dynamics.
Hu Huo disease resembles Shanghan: silent, sleepy, eyes unable to close, restlessness. Erosion of the throat is "Huo"; erosion of the genitals is "Hu". Anorexia, aversion to food smells. Complexion alternates between black, red, and white. Erosion of the upper part causes hoarseness, treated with Gan Cao Xie Xin Tang (Licorice Decoction for Draining the Epigastrium).
Gan Cao Xie Xin Tang Prescription
Gan Cao (Licorice Root) [4 liang] Huang Qin (Scutellaria Root) Ren Shen (Ginseng Root) Gan Jiang (Dried Ginger) [each 3 liang]
Huang Lian (Coptis Rhizome) [1 liang] Da Zao (Jujube) [12 units] Ban Xia (Pinellia Tuber) [0.5 sheng]
Boil seven ingredients in ten dou of water to obtain six sheng. Strain and decoct again. Take one sheng warm, three times daily.
[Commentary]: Hu Huo disease involves worm erosion of upper and lower orifices. Folklore says worms arise from wind. However, wind is yang; yang alone cannot generate life. It requires a medium. Prolonged damp-heat steams and rots qi and blood, forming turbid stasis, which wind transforms into worms. Without damp-heat, cold air might rot matter but not generate worms. Thus, worms arise slowly from damp-heat and stagnant blood, erupting at their peak, unlike sudden Shanghan. Symptoms of silence, sleepiness, eye closure issues, and restlessness stem from long-term damp-heat damaging five zang yin essence, preventing Wei Qi entry and Spirit tranquility. Anorexia and aversion to smells indicate Spleen/Stomach injury. Fluctuating complexion reflects five zang deficiency and alternating prosperity. Worms emerge from extreme damp-heat, eroding sites. Upper erosion damages Heart/Lungs and throat; Lung governs qi, throat governs voice, causing hoarseness. Gan Cao Xie Xin Tang treats damp-heat and balances yin/yang. Huang Lian clears Heart/Spleen heat and kills worms. Later texts suggest Hu Huo arises from Shanghan or other febrile diseases where internal heat, poor diet, and empty intestines allow worms to wander. Thus, any febrile disease can produce worms.
Erosion of the lower part causes dry throat, treated with Ku Shen Tang (Sophora Root Decoction) for washing.
[Commentary]: Lower erosion causes dry throat because the lower part houses the Kidney and Ren Mai. Kidney is water. Severe lower damp-heat causes worms to erode upward, injuring Kidney water. Meridians lack moisture, and damp-heat rebels upward, drying the throat. Ku Shen Tang washes externally. Ku Shen clears heat-toxin and treats lower orifice sores. However, this is symptomatic treatment. Tracing the root, disease moves from inside out. Just as upper parts use oral formulas, lower parts should have oral remedies. Just as lower parts use washing, upper parts should have topical logic. Zhang Zhongjing intentionally cross-references these methods. Otherwise, why do later texts mention oral medicines for lower parts or internal organ damage?
Erosion of the anus is treated with Xiong Huang San (Realgar Powder) fumigation.
Grind Xiong Huang (Realgar) into powder. Place in two tube-shaped tiles, join them, and burn towards the anus for fumigation.
*Mai Jing* states: Patients may have erosion of the throat from respiration (upper) or anus/genitals from the lower jiao (lower). Upper erosion is "Huo"; lower is "Hu". Hu Huo disease is treated with Zhu Ling San (Polyporus Powder).
[Commentary]: Anal erosion indicates lower damp-heat. Although both orifices belong to the Kidney, the Liver meridian passes through the anus, which is the gate of the Large Intestine. Large Intestine is Metal; damp-heat injures Metal, allowing Wood (Liver) to insult it. Thus, worms erode here. Xiong Huang treats sores, kills worms, and dispels wind, hence fumigation. Citing *Mai Jing*'s Zhu Ling San distinguishes damp-heat.
Patient has rapid pulse, no fever, slight vexation, silence, desire to lie down, sweating. On days 3-4, eyes turn red like a turtledove's. By days 7-8, corners of eyes turn black. If the patient can eat, pus has formed. Chi Xiao Dou Dang Gui San (Adzuki Bean and Angelica Decoction) is indicated.
Chi Xiao Dou Dang Gui San Prescription
Chi Xiao Dou (Adzuki Bean) [3 sheng, soaked until sprouted, dried] Dang Gui (Angelica Sinensis Root) [10 liang]
Pound into powder. Administer one fang cun bi with Jiang Shui (fermented grain water), three times daily.
[Commentary]: Rapid pulse usually means fever/vexation, but here heat is in blood, not Ying/Wei, so no fever, only slight vexation. Sweating occurs because blood disease disrupts Wei harmony; blood disease causes aversion to vexation (silence). Wei disharmony causes yang sinking (desire to lie down). Pores open, leaking fluids. Red eyes on day 3-4 show hot blood rising through vessels to the eyes. Black corners on day 7-8 indicate congealed blood changing color. Ability to eat indicates pus formation; damp-heat toxins scatter, damaging middle harmony, preventing eating. If eating is possible, toxin-blood has formed pus, leaving Stomach Qi undisturbed. Chi Xiao Dou clears heat-toxin, resolves bad blood, relieves vexation, drains pus, and tonifies blood vessels (Monarch). Dang Gui tonifies blood, generates new, removes old (Minister). Jiang Shui is sour, clears heat, relieves vexation, assists blood (Assistant/Envoy).
Yang Du disease presents with red face, mottled rash like brocade, sore throat, vomiting of pus/blood. Treatable within five days; untreatable after seven. Sheng Ma Bie Jia Tang ( Cimicifuga and Turtle Shell Decoction) is indicated.
Yin Du disease presents with blue/green face and body, body pain as if beaten by sticks, sore throat. Treatable within five days; untreatable after seven. Sheng Ma Bie Jia Tang minus Xiong Huang and Shu Jiao is indicated.
Sheng Ma Bie Jia Tang Prescription
Sheng Ma (Cimicifuga Rhizome) [2 liang] Dang Gui (Angelica Sinensis Root) [1 liang] Shu Jiao (Sichuan Pepper) [stir-fried to remove oil, 1 liang] Gan Cao (Licorice Root) [2 liang] Bie Jia (Turtle Shell) [size of a finger, roasted]
Xiong Huang (Realgar) [0.5 liang, ground]
Boil six ingredients in four sheng of water to obtain one sheng. Take in one dose. Elderly and children take a second dose to induce sweating. *Zhou Hou Bei Ji Fang* and *Qian Jin Fang* state: For Yang Du, use Sheng Ma Tang without Bie Jia, adding Gui Zhi. For Yin Du, use Gan Cao Tang without Xiong Huang.
[Commentary]: Ancient texts define Yang Du as exclusive yang excess and sudden yin decline (pure yang). Yin Du is exclusive yin excess and sudden yang decline (pure yin). These may occur initially in Shanghan or after medication. Yang Du is treated with cold/cool herbs; Yin Du with warm/hot herbs. Why does Zhang Zhongjing use one formula? Removing Xiong Huang/Shu Jiao (warm) for Yin Du seems contradictory. *Zhou Hou* adds Gui Zhi (warm) for Yang Du and removes Bie Jia (yin-nourishing). This suggests heat-toxin affects both yin and yang meridians. Yang meridian involvement causes red rash and pus/blood; Yin meridian involvement causes blue face and body pain. These reflect fundamental yin-yang/water-fire dynamics, not simple cold/heat pathogens. Analyzing herbs: Sheng Ma clears seasonal toxins, throat pain, pus, and rashes. Dang Gui breaks bad blood, nourishes new blood, tonifies five zang. Gan Cao harmonizes middle, benefits vessels, relieves pain. Bie Jia removes bad blood. Xiong Huang breaks accumulations, dispels evil qi, treats bone-steaming heat. Shu Jiao unblocks vessels, joints, removes dead tissue and blood stasis, treats epidemic qi. Thus, Zhang uses one formula for both. Although arising from yin/yang signs, the pathogen is heat-toxin and blood disease. No distinction between exterior/interior; Sheng Ma clears heat-toxin (Monarch), Dang Gui harmonizes blood (Minister), others assist. Xiong Huang/Shu Jiao regulate yang, so removed for Yin Du. *Zhou Hou* removes Bie Jia (yin-within-yang) for Yang Du, adding Gui Zhi to regulate yang vessels. Yin Du keeps Shu Jiao (yin-within-yang) to treat yin. The principle is clear. "Five days treatable, seven days not" relates to numerology: Five is Earth's generating number, heat not extreme, treatable. Seven is Fire's completing number, heat extreme, yin/yin exhausted, untreatable. Compared to Shanghan, this has added toxicity. Shanghan allows transmission after seven days; here, extreme fire destroys itself.