（案当十一首）
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。（默然。赵本作默默。不用闻食臭之用字。徐沈作欲。微见。巢源。作复见。千
金。作后见。魏快。作怏。非。）
〔尤〕百脉一宗者。分之则为百脉。合之则为一宗。悉致其病。则无之非病矣。然详其证。意欲食矣。而
复不能食。常默然静矣。而又躁不得卧。饮食或有时美矣。而复有不用闻食臭时。如有寒如有热矣。而又不
见为寒。不见为热。诸药不能治。得药则剧吐利矣。而又身形如和。全是恍惚去来。
不可为凭之象。惟口苦小便赤。脉微数。则其常也。所以者何。热邪散漫。未统于经。其气游走无定。故其
病亦去来无定。而病之所以为热者。则征于脉。见于口与便。有不可掩然者矣。夫膀胱者。太阳之腑。其脉上
至巅顶。而外行皮肤。溺时头痛者。太阳乍虚。而热气乘之也。淅然快然。则降序矣。夫乍虚之气。溺已
即复。而热淫之气。得阴乃解。故其甚者。必六十日之久。诸阴尽集。而后邪退而愈。其次四十
日。又其次二十日。热瘥减者。愈瘥速也。此病多于伤寒热病前后见之。其未病而预见者。热气先动也。
其病后四五日。或二十日。或一月见者。遗热不去也。各随其证以治。具如
下文。
案魏氏以此证。断为气病。而今验之于病者。气病多类此者。然下条百合诸方。并似与气病不相干。
故其说虽甚巧。竟难信据。千金云。伤寒虚劳。大病已后。不平复。变成斯疾。其状恶寒而呕者。病在上
焦也。二十三日当愈。其状腹满微喘。大便坚。三四日一大便。时复小溏者。病在中焦也。
六十三日当愈。其状小便淋沥难者。病在下焦也。三十三日当愈。各随其证治之。思邈所论如此。参之于
本条。明是百合病。别是一种病。尤注颇详。故今从之。（张氏医通。有治百合病医案一则。当参考。）
百合病。发汗后者。百合知母汤主之。（千金。作百合病。已经
发汗之后。更发者。下文例并同。）
〔尤〕人之有百脉。犹地之有众水也。众水朝宗于海。百脉朝宗于肺。故百脉不可治。而可治其肺。
百合。味甘平微苦。色白入肺。治邪气。补虚清热。故诸方悉以之为主。而随证加药治之。用知母者。以发
汗伤津液故也。
〔魏〕百合病。用百合。盖古有百合病之名。即因百合一味。而瘳此疾。因
得名也。如伤寒论条内云。太阳病桂枝证。亦病因药而得名之义也。
案本草苏颂云。仲景治百合病。凡四方。病名百合。而用百合治之。不识其义。今得魏注。而义自
明。后世有病名河白者。以河白草治之。（出证治大还。）即与此同义。
百合知母汤方
百合（七枚擘） 知母（三两切）
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。（外台。滓别之间。有置
之一处四字。）
百合病。下之后者。滑石代赭汤主之。（外台。滑石上。有百合二字。尤本仍之。）
〔魏〕至下之后。不用知母。而以滑石代赭汤主之者。以重坠之品。随下药之势使邪自下泄也。用
代赭石之涩。涩大便也。用滑石之滑。利小便也。
〔徐〕加之泉水。以泻阳而阴气自调也。
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。（外台。滓别间。
有置一厢三字。别作又。）
百合病吐之后者。用后方主之。
〔鉴〕百合病。不应吐。而吐之不解者。则虚中。以百合鸡子汤。清而补之也。
〔尤〕本草。鸡子。
安五脏治热疾。吐后脏气伤。而病不去。用之不特安内。亦且攘外也。
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。纳鸡子黄。
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。
〔鉴〕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。
〔尤〕此则百合病正治之法也。盖肺主
行身之阳。肾主行身之阴。百合色白入肺。而清气中之热。地黄色黑入肾。而除血中之热。气血既治。百脉
俱清。虽有邪气。亦必自下。服后大便如漆则热除之验也。外台云。大盒饭出黑沫。
百合地黄汤方
百合（七枚擘） 生地黄汁（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。纳地黄汁。煎取一升
五合。分温再服。中病勿更服。大便常如漆。（常。赵本作当是。徐沈尤并同。）
〔程〕如漆。地黄汁也。
案程注亲验之说。今从之。地黄汁。服之必泻利。故云中病勿更服。
百合病。一月不解。变成渴者。百合洗方主之。
〔尤〕病久不解。而变成渴。邪热留聚在肺也。单用百合。渍水外洗者。以皮毛为肺之合。其气相
通故也。洗已。食煮饼。按外台云。洗身讫。食白汤饼。今 也。本草。粳米
小麦。并除热止渴。勿以咸豉者。恐咸味耗水而增渴也。
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。
总病论云。煮饼。是切面条。汤煮水淘过。热汤渍食之。活人书注云。煮饼。即淡熟面条也。张师
正倦游录云。凡以面为食煮之。皆谓汤饼。
百合病。渴不瘥者。栝蒌牡蛎散主之。
〔尤〕病变成渴。与百合洗方。而不瘥者。热盛而津伤也。
栝蒌根。苦寒。生津止渴。牡蛎。咸寒。引热下行。不使上烁也。
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。（〔原注〕一作发寒热。）百合滑石散主之。
〔鉴〕百合病。如寒无寒。如热无热。本不发热。今变发
热者。其内热可知也。故以百合滑石散主之。热从小便而除矣。
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。
千金。一本云。治百合病。小便赤涩。脐下坚急。外台同。
郭白云云。仲景以药之百合。治百合病。与神农经主治不相当。千古难晓其义。是以孙真人言。伤寒杂
病。自古有之。前古名贤。多所防御。至于仲景。时有神功。寻思旨趣。莫测其致。所以医人不能钻仰万一
也。然百合之为物。岂因治百合之病。而后得名哉。或者病须百合可治。因名曰百合乎。少时见先生言。以百
合汤。治一仆病得愈。余是时未甚留意。不解仔细详看。虽见其似寒似热。似饥似饱。欲行欲
卧。如百合之证。又自呼其姓名。有终夕不绝声。至醒问之。皆云不知。岂所谓如有神灵者耶。
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。（脉经。阳法作阴法。阴法作阳法。）
〔沈〕此治百合病之要法也。微邪伏于营卫。流行而病表里。当分阴阳。以施救治可也。
〔鉴〕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。
〔徐〕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。
案千金云。百合病。见在于阴。而攻其阳。则阴不得解也。复发其汗。为逆也。见在于
阳。而攻其阴。则阳不能解也。复下之。其病不愈。文异意同。
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。其面乍赤乍黑乍白。蚀于上部。则声喝。（〔原注〕一作嗄。）甘草泻心汤
主之。（巢源。作目挛不得闭。外台。作目瞑不得眠。为狐之下。巢源外台。有狐惑之
病并五字。其面目。外台无目字。脉经。千金外台。并无甘草二字。然方则载甘草泻心汤。
巢源外台。喝作嗄。○案字书。喝。于遏切。音 。嘶声。嗄。先齐切。音西。声破曰嗄。）
〔程〕此证因伤寒而变斯疾。故初得犹状伤寒。病后犹肠胃空虚。而有热则虫上下作。虫上作。则蚀咽
喉为惑。虫下作。则蚀二阴为狐。灵枢经曰。虫动则令人 心。是以起卧不安。虽默默欲眠。而目不得闭。
虫闻食臭。则求食。故恶闻食臭。而不欲饮食也。虫动胃虚。则面目之色无定。是以乍赤乍黑乍白也。
〔徐〕
毒盛在上。蚀于喉为惑。谓热淫如惑乱之气。感而生惑也。毒偏在下。侵蚀于阴为狐。谓柔害而
幽隐。如狐性之阴也。蚀者。若有食之。而不见其形。如日月之蚀也。
〔尤〕狐惑虫病。即巢氏所谓 病也。
盖虽虫病。而能使人惑乱而狐疑。故曰狐惑。至生虫之由。则赵氏所谓湿热停久。蒸腐气血。而成瘀浊。于
是风化所腐。而成虫者当矣。甘草泻心。不特使中气运。而湿热自化。抑亦苦辛杂
用。足胜杀虫之任。
〔鉴〕狐惑。牙疳下疳等疮之古名也。近
时惟以疳呼之。下疳。即狐也。蚀烂肛阴。牙疳。即惑也。蚀咽。腐龈脱牙。穿腮破唇。每因伤寒病后余毒。
与湿 之为害也。或生斑疹之后。或生癖疾下利之后。其为患亦同。甘草泻心汤。必传写之误也。姑存之。
医说云。古之论疾。多取像取类。使人易晓。以时气声嗄咽干。欲睡复不安眠。为狐惑。以狐多疑惑也。
郭白云云。狐惑。 病。多因医者汗吐下太过。又利小便。重亡津液。热毒内攻。脏腑焦枯。虫不得安。
故上下求食。亦有不发汗。内热焦枯而成者。凡人之喉及阴肛。比他肌肉津润。故虫缘津润而食之。 病又不
止因伤寒而成。多自下感。或居湿地。或下利久而得。当于 中求之。案此说极是。但至言虫不得安。上下
求食。岂有此理。蚀是蚀烂之义。湿热郁蒸所致。非虫实食喉及肛之谓也。
甘草泻心汤方
甘草（四两○案据伤寒论当有炙字） 黄芩 人参 干姜（各三两） 半夏（
半升○案赵本作半斤非） 黄连（一两） 大枣（十二枚○案据伤寒论当有擘字）
上七味。水一斗。煮取六升。去滓再煎。温服一升。日三服。（案据伤寒论。味下脱以字。三服下。外
台。有兼疗下利不止。心中 。坚而呕。肠中鸣者方。十八字。）
案窦氏疮疡全书。李氏医学入门。并用三黄泻心汤。盖因脉经单作泻心汤耶。三黄泻心汤。吐衄篇。称泻心汤。
蚀于下部。则咽干。苦参汤洗之。（巢源。干下。有此皆由湿毒瓦斯所为也九字。）
蚀于肛者。雄黄熏之。（千金外台。肛下有外字。程本黄下有散字。）
雄黄
上一味。为末。筒瓦二枚。合之烧。向肛熏之。
〔原注〕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。○徐程删此注。
〔徐〕下部毒盛。所伤在血。而咽干。喉属阳。咽属阴也。药用苦参熏洗。以去风清热而杀虫也。蚀
于肛。则不独随经而上侵咽。湿热甚。而糜烂于下矣。故以雄黄熏之。雄黄之杀虫。去风解毒。更力也。
苦参汤方（原本缺。徐沈尤本及金鉴。所载如下。）
苦参（一升） 以水一斗。煎取七升。去滓熏洗。日三服。（案尤本金鉴。并无服字。是。）
苦参汤方（徐熔附遗云。以庞安时伤寒总病论补之。程同。）
苦参（半斤） 槐白皮 野狼牙根（各四两）
上锉。以水五升。煎三升半洗之。
案二方未知何是。然以理推之。用苦参一味为佳。用苦参一味。治龋齿。见于史记仓公传。亦取乎清
热杀虫。脉经所载。猪苓散。楼氏纲目云。未考。案证类猪苓条。图经云。
黄胆病。及狐惑病。并猪苓散主之。猪苓、茯苓等分。杵末。每服方寸匕。水调下。盖此方也。
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 （〔原注〕一
本此有黄字。）黑。若能食者。脓已成也。赤小豆当归散主之。（玉函脉经。作目四 皆黄。总病论。 作周。）
(Commentary: This should be the twelfth formula.)
Discussion states. Baihe Bing (Lily Disease) occurs because all meridians share a common origin, thus all are affected by pathogenic factors and become diseased. The patient desires to eat but cannot; often remains silent; desires to lie down but cannot sleep; desires to walk but cannot move. Food sometimes tastes delicious, while at other times the patient feels aversion to food odors. The patient feels cold yet is not actually cold, feels hot yet is not actually hot, has a bitter taste in the mouth, and urine is red. Various medicines fail to cure it; upon taking medicine, severe vomiting or diarrhea occurs, as if possessed by spirits. The physical appearance seems normal, with a slightly rapid pulse. 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. This disease may present symptoms before the onset of illness, or appear four to five days after illness begins, or twenty days later, or even a month later with mild manifestations. Treatment should follow the specific syndrome presentation. ("Momo" [silent], Zhao's edition writes "momo". The character "yong" [use] in "bu yong wen shi chou" [aversion to food smell], Xu and Shen editions write "yu" [desire]. "Wei jian" [mildly appears], *Zhu Bing Yuan Hou Lun* writes "fu jian" [reappears], *Qian Jin Fang* writes "hou jian" [appears later]. Wei's commentary interprets "kuai" [smooth] as "yang" [dissatisfied], which is incorrect.]
[You Zaijing] Although the hundred vessels are divided into many branches, they originate from one source. If all are diseased, then everywhere is diseased. However, examining the symptoms closely: desiring to eat yet unable to; often silent and quiet yet restless and unable to sleep; food sometimes tasting good yet sometimes causing aversion to smells; feeling like cold and like heat yet showing no clear signs of either; various medicines ineffective, leading to severe vomiting and diarrhea upon administration; yet the body shape appears peaceful. These are entirely elusive, fluctuating, unreliable symptoms. Only the bitter taste in the mouth, red urine, and slightly rapid pulse represent the constant pattern. Why? Because the heat pathogen is diffuse and not unified within any single meridian, its qi wanders without fixed location, so the disease also comes and goes unpredictably. The evidence that it is a heat condition is manifested in the pulse, mouth, and urine, which cannot be concealed. The Bladder is the Fu organ of the Taiyang channel, its vessel ascends to the vertex and runs externally over the skin. Headache during urination indicates temporary deficiency of the Taiyang channel allowing heat to invade. A sensation of chilliness or smoothness indicates descending order. The temporarily deficient qi recovers immediately after urination, but the excessive heat requires the gathering of Yin to resolve. Thus, severe cases require sixty days for the convergence of all Yin energies before the pathogen retreats and healing occurs. Next are forty days, then twenty days. Faster reduction of heat leads to faster recovery. This disease often appears around the time of Shanghan (Cold Damage) or febrile diseases. Appearance before illness suggests heat moving first; appearance days or weeks after illness suggests lingering heat. Each case is treated according to its syndrome, as detailed below.
Case note: Wei Li-tong diagnosed this syndrome as a Qi disorder. Modern verification shows many Qi disorders resemble this. However, the subsequent Baihe formulas seem unrelated to Qi disorders. Thus, although his explanation is clever, it is difficult to rely upon. *Qian Jin Fang* states: After Cold Damage or consumptive disease, if full recovery does not occur, this affliction may develop. Symptoms of chills and vomiting indicate pathology in the Upper Jiao, resolving in twenty-three days. Symptoms of abdominal fullness, slight wheezing, hard stool, infrequent bowel movements, and occasional loose stools indicate pathology in the Middle Jiao, resolving in sixty-three days. Symptoms of difficult, dribbling urination indicate pathology in the Lower Jiao, resolving in thirty-three days. Each is treated according to syndrome. Sun Simiao’s discussion aligns with this text, clearly identifying Baihe Bing as a distinct entity. You’s commentary is detailed, so we adopt it. (*Zhang Shi Yi Tong* contains a case study of Baihe Bing treatment for reference.)
For Baihe Bing following sweating therapy, Baihe Zhi Mu Tang (Lily and Anemarrhena Decoction) is the primary formula. (*Qian Jin Fang* reads: Baihe Bing, after having already sweated, and sweating again. The following examples follow this pattern.)
[You Zaijing] Human vessels are like rivers on earth. All waters flow to the sea; all vessels converge on the Lung. Therefore, treating the hundred vessels directly is difficult, but treating the Lung is possible. Lily (Baihe), sweet, neutral, slightly bitter, white in color entering the Lung, treats pathogenic factors, tonifies deficiency, and clears heat. Hence, it is the main ingredient in all formulas, with additions based on syndrome. Zhi Mu (Anemarrhena Rhizome) is used because sweating damages body fluids.
[Wei Litong] The use of Lily in Baihe Bing suggests that the name originated because a single herb, Lily, cured this disease. Similarly, in *Shanghan Lun*, "Taiyang Bing Guizhi Zheng" implies naming a syndrome after its primary herb.
Case note: Su Song in *Bencao* notes Zhang Zhongjing used four formulas for Baihe Bing, named after the herb Lily, but did not explain the rationale. Wei’s annotation clarifies this. Later, a disease named "Hebai" was treated with Hebai Cao (*Zhengzhi Dahuan*), sharing the same logic.
**Baihe Zhi Mu Tang Formula**
Baihe (Lily Bulb) (7 bulbs, split) Zhi Mu (Anemarrhena Rhizome) (3 liang, sliced)
Wash the Baihe first, soak overnight until white foam appears, discard the water. Add 2 sheng of spring water, decoct to 1 sheng, remove dregs. Separately, add 2 sheng of spring water to Zhi Mu, decoct to 1 sheng, remove dregs. Mix the two decoctions, decoct together to obtain 1.5 sheng. Divide into two warm doses. (*Waitai Mi Yao* adds "place in one container" between removing dregs.)
For Baihe Bing following purgation therapy, Huashi Daizhe Tang (Talcum and Hematite Decoction) is the primary formula. (*Waitai Mi Yao* places "Baihe" before Huashi; You’s edition retains this.)
[Wei Litong] After purgation, Zhi Mu is omitted, and Huashi Daizhe Tang is used. Heavy, sinking agents follow the downward momentum of purgatives to expel pathogens downwards. Daizhe Shi (Hematite) provides astringency to firm the stool; Huashi (Talcum) provides slipperiness to promote urination.
[Xu Lingtai] Adding spring water helps drain Yang heat, allowing Yin qi to harmonize naturally.
**Huashi Daizhe Tang Formula**
Baihe (Lily Bulb) (7 bulbs, split) Huashi (Talcum) (3 liang, crushed, wrapped in silk) Daizhe Shi (Hematite) (size of a bullet, crushed, wrapped in silk)
Wash Baihe, soak overnight until white foam appears, discard water. Add 2 sheng spring water, decoct to 1 sheng, remove dregs. Separately, add 2 sheng spring water to Huashi and Daizhe Shi, decoct to 1 sheng, remove dregs. Mix the decoctions, re-decoct to obtain 1.5 sheng. Divide into warm doses. (*Waitai Mi Yao* adds "place separately" between dregs; another version says "again".)
For Baihe Bing following emesis therapy, use the following formula.
[You Zaijing] Baihe Bing should not be treated with emesis. If emesis fails to resolve the condition, it indicates middle Qi deficiency. Baihe Jizi Tang (Lily and Egg Yolk Decoction) clears and tonifies simultaneously.
[You Zaijing] *Bencao* records: Chicken egg yolk anchors the Five Viscera and treats heat affections. After emesis, viscera Qi is damaged, and the disease persists. Using it not only stabilizes the interior but also expels external pathogens.
**Baihe Jizi Tang Formula**
Baihe (Lily Bulb) (7 bulbs, split) Jizi Huang (Chicken Egg Yolk) (1 unit)
Wash Baihe, soak overnight until white foam appears, discard water. Add 2 sheng spring water, decoct to 1 sheng, remove dregs. Add Jizi Huang, stir evenly, decoct until reduced to five parts. Take warm.
For Baihe Bing not treated with emesis, purgation, or sweating, where the condition remains unchanged, Baihe Dihuang Tang (Lily and Rehmannia Decoction) is the primary formula.
[You Zaijing] For Baihe Bing untreated by emesis, purgation, or sweating, remaining unchanged, this indicates a prolonged course without increase or decrease, resembling the initial stage described in Chapter One. Baihe Dihuang Tang unblocks and cools the hundred vessels.
[You Zaijing] This is the standard treatment for Baihe Bing. The Lung governs Yang movement in the body; the Kidney governs Yin movement. Baihe, white, enters the Lung, clearing heat from Qi; Dihuang, black, enters the Kidney, clearing heat from Blood. Once Qi and Blood are regulated, the hundred vessels are cleared. Even if pathogens remain, they will exit naturally. Black, tarry stools after administration indicate heat elimination. *Waitai Mi Yao* states: large amounts of black mucus should be excreted.
**Baihe Dihuang Tang Formula**
Baihe (Lily Bulb) (7 bulbs, split) Sheng Dihuang Zhi (Fresh Rehmannia Juice) (1 sheng)
Wash Baihe, soak overnight until white foam appears, discard water. Add 2 sheng spring water, decoct to 1 sheng, remove dregs. Add Dihuang juice, decoct to obtain 1.5 sheng. Divide into two warm doses. Stop further administration once the disease is addressed. Stools will frequently appear black. ("Chang" [often], Zhao’s edition reads "dang shi" [should be]; Xu, Shen, and You editions agree.)
[Cheng Lin] "Like lacquer" refers to the color of the Rehmannia juice.
Case note: Cheng’s empirical observation is adopted here. Dihuang juice causes diarrhea, hence the instruction to stop after efficacy.
If Baihe Bing persists for a month and transforms into thirst, Baihe Xi Fang (Lily Wash Formula) is the primary formula.
[You Zaijing] Prolonged unresolved disease transforming into thirst indicates lingering heat in the Lung. Using only Lily soaked in water for external washing works because the skin/hair is the exterior correspondence of the Lung, and their Qi connects. After washing, consume boiled noodles. *Waitai Mi Yao* specifies eating plain noodle soup. *Bencao* states: Rice and Wheat clear heat and relieve thirst. Do not use salted pickles, as salty flavors consume fluids and worsen thirst.
**Baihe Xi Fang Formula**
Baihe (Lily Bulb) (1 sheng) Soak in 1 dou of water overnight. Use to wash the body. After washing, eat boiled noodles. Do not use salted pickles.
*Zong Bing Lun* states: Boiled noodles are cut strips of dough, boiled in water, rinsed, and eaten hot with broth. *Huoren Shu* commentary: Boiled noodles are plain cooked noodles. Zhang Shizheng’s *Juan You Lu*: Any food made of flour and boiled is called Tangbing (Soup Cake).
If Baihe Bing involves thirst that does not resolve, Gualou Muli San (Trichosanthes Root and Oyster Shell Powder) is the primary formula.
[You Zaijing] Thirst persisting despite Lily wash indicates severe heat damaging fluids. Gualou Gen (Trichosanthes Root) is bitter and cold, generating fluids and relieving thirst. Muli (Oyster Shell) is salty and cold, guiding heat downward to prevent upper scorching.
**Gualou Muli San Formula**
Gualou Gen (Trichosanthes Root) Muli (Oyster Shell) (calcined, equal parts)
Grind into fine powder. Take one fangcun bi (square-inch spoonful) with water, three times daily.
If Baihe Bing transforms into fever (Original Note: alternatively, alternating chills and fever), Baihe Huashi San (Lily and Talcum Powder) is the primary formula.
[You Zaijing] Baihe Bing typically presents as "feeling cold but not cold, feeling hot but not hot," without actual fever. Transformation into fever indicates severe internal heat. Baihe Huashi San is used to eliminate heat via urination.
**Baihe Huashi San Formula**
Baihe (Lily Bulb) (1 liang, processed with heat) Huashi (Talcum) (3 liang)
Grind into powder. Take one fangcun bi with water, three times daily. Stop administration when slight diarrhea occurs; heat will be eliminated.
*Qian Jin Fang* alternative version: Treats Baihe Bing with red, scanty urine and hardness/urgency below the umbilicus. *Waitai Mi Yao* agrees.
Guo Baiyun states: Zhang Zhongjing using the herb Lily to treat Baihe Bing seems inconsistent with *Shennong Bencao Jing* indications, a mystery since antiquity. Sun Simiao noted that Shanghan and miscellaneous diseases have existed since ancient times, with predecessors offering defenses. Zhang Zhongjing demonstrated divine skill, yet his profound principles remain unfathomable, preventing physicians from fully mastering them. However, did the herb Lily get its name because it treats Baihe Bing? Or was the disease named after the herb because Lily treats it? I recall my teacher curing a servant with Baihe Tang. The patient exhibited symptoms similar to cold/heat, hunger/fullness, desire to walk/sleep, calling his own name incessantly until waking, unaware of his actions—truly "as if possessed by spirits."
For Baihe Bing manifesting in Yin aspects, treat with Yang methods; manifesting in Yang aspects, treat with Yin methods. Treating Yin by attacking Yang and inducing sweat is contraindicated. Treating Yang by attacking Yin and using purgation is also contraindicated. (*Mai Jing* swaps "Yang method" and "Yin method".)
[Shen Mingzong] This is the key principle for treating Baihe Bing. Mild pathogens hidden in Ying and Wei circulate affecting interior/exterior. Differentiate Yin/Yang to apply rescue.
[You Zaijing] Baihe Bing is difficult to differentiate by Yin/Yang or Interior/Exterior, hence Baihe decoctions are used. If manifesting in Yin, use warming/nourishing Yang methods. If manifesting in Yang, use cooling/nourishing Yin methods. Subsequently, attacking Yin when Yang signs appear, or sweating after failing to resolve exterior after attacking Yin, is contraindicated. Attacking Yang when Yin signs appear, or purging after failing to resolve interior after attacking Yang, is also contraindicated.
[Xu Lingtai] *Neijing* states "Use Yin to harmonize Yang, use Yang to harmonize Yin." Thus, treatments center on Lily. When Yang signs appear, add one or two herbs to harmonize Yin; when Yin signs appear, add one or two herbs to harmonize Yang.
Case note: *Qian Jin Fang* states: Attacking Yang when pathology is in Yin prevents Yin resolution and induces sweat (contraindicated). Attacking Yin when pathology is in Yang prevents Yang resolution and induces purgation (ineffective). Text differs, meaning is identical.
Huo Er Bing (Fox-Glaze Disease) resembles Shanghan. The patient is silent, desires sleep, eyes cannot close, restlessness lying down and rising. Erosion of the throat is "Huo" (Glaze); erosion of the genitals is "Hu" (Fox). Aversion to food, dislike of food odors. Face alternates between red, black, and white. Erosion of the upper part causes hoarseness (Original Note: alternatively "sha"). Gancao Xiexin Tang (Licorice Decoction for Draining the Epigastrium) is the primary formula. (*Zhu Bing Yuan Hou Lun* reads "eyes cramped, unable to close"; *Waitai Mi Yao* reads "eyes heavy, unable to sleep". *Zhu Bing Yuan Hou Lun* and *Waitai Mi Yao* add "Huo Er Bing" after "Hu". *Waitai Mi Yao* omits "Mu" [eye] in "Qi Mian Mu". *Mai Jing*, *Qian Jin*, *Waitai* omit "Gancao" [Licorice], though the formula lists Gancao Xiexin Tang. *Zhu Bing Yuan Hou Lun* and *Waitai Mi Yao* write "Sha" instead of "He". *Zishu*: "He" pronounced 'e', hoarse voice. "Sha" pronounced 'xi', broken voice.)
[Cheng Lin] This disease arises from transformation of Shanghan. Initially resembling Shanghan, post-illness intestinal/stomach emptiness allows heat to generate worms. Worms moving upward erode throat (Huo); worms moving downward erode yin/yang openings (Hu). *Ling Shu* states: Worm movement causes heart distress, leading to restlessness. Though desiring sleep, eyes won't close. Worms attracted by food odors cause aversion to eating. Worm movement and stomach deficiency cause fluctuating facial colors (red/black/white).
[Xu Lingtai] Toxicity abundant in the upper part, eroding throat as "Huo," implies heat chaos confusing the mind. Toxicity biased to the lower part, eroding genitals as "Hu," implies stealthy harm like a fox. "Erosion" means devouring invisibly, like solar/lunar eclipses.
[You Zaijing] Huo Er Bing worm disease corresponds to Chao’s "Shi Bing" (Erosion Disease). Though involving worms, it causes confusion and doubt, hence the name. Cause of worms: Zhao’s view that long-standing damp-heat steams and roasts Qi/Blood into turbidity, which wind transforms into worms, is correct. Gancao Xiexin Tang moves Middle Qi, resolving damp-heat, and uses bitter/pungent combinations effective against worms.
[You Zaijing] Huo Er is the ancient name for canker sores and chancres. Recently called "Gan". Chancre (Hu) erodes anus/genitals. Canker sore (Huo) erodes throat, gums, teeth, cheeks, lips. Often caused by residual toxins after Shanghan combined with damp-toxin. Can follow rash or dysentery. Harm is similar. Gancao Xiexin Tang is likely a transcription error. Preserved for reference. *Yi Shuo* notes ancients used analogy for clarity: hoarseness, dry throat, sleep disturbance named "Huo Er" due to fox-like doubt.
Guo Baiyun states: Huo Er/Shi Bing often results from excessive sweating, vomiting, purging, or diuresis by physicians, severely depleting fluids. Heat-toxin attacks internally, scorching organs. Worms unsettled, seek food above/below. Also caused by internal heat/scorching without sweating. Throat and anus are moist, attracting worms. Shi Bing is not solely from Shanghan; often acquired from damp environments or chronic dysentery. Seek in dampness. Case note: This theory is sound. However, claiming worms physically eat throat/anus is absurd. "Erosion" means tissue destruction due to damp-heat stagnation, not literal insect consumption.
**Gancao Xiexin Tang Formula**
Gancao (Licorice Root) (4 liang ○ Case: According to *Shanghan Lun*, "Zhi" [processed with honey] should be added) Huangqin (Scutellaria Root) Renshen (Ginseng Root) Ganjiang (Dried Ginger) (each 3 liang) Banxia (Pinellia Tuber) (0.5 sheng ○ Case: Zhao’s edition says 0.5 jin, incorrect) Huanglian (Coptis Rhizome) (1 liang) Dazao (Jujube) (12 units ○ Case: According to *Shanghan Lun*, "Bo" [split] should be added)
Seven ingredients. Water 1 dou. Decoct to 6 sheng. Remove dregs. Re-decoct. Warm dose 1 sheng, three times daily. (Case: *Shanghan Lun* misses "yi" [with] after ingredients. *Waitai Mi Yao* adds eighteen characters regarding treating persistent diarrhea, epigastric fullness/hardness, vomiting, and borborygmus.)
Case note: Dou Hanqing’s *Chuangsang Quanshu* and Li Chen’s *Yixue Rumeng* use Sanhuang Xiexin Tang, likely due to *Mai Jing* listing only Xiexin Tang. Sanhuang Xiexin Tang is called Xiexin Tang in the Vomiting/Hematemesis chapter.
For erosion of the lower part causing dry throat, use Kushen Tang (Sophora Root Decoction) for washing. (*Zhu Bing Yuan Hou Lun* adds nine characters after "gan": "All caused by damp-toxic vapors".)
For erosion of the anus, use Xionghuang fumigation. (*Qian Jin*, *Waitai* add "wai" [external] after "gang". Cheng edition adds "san" [powder] after "huang".)
Xionghuang (Realgar)
One ingredient. Grind to powder. Combine two tile tubes, burn, and fumigate the anus.
[Original Note] *Mai Jing* states: Patients may have erosion of the throat from respiration (upper), or erosion of anus/genitals from Lower Jiao (lower). Upper erosion is Huo; lower erosion is Hu. For Huo Er Bing, Zhu Ling San (Polyporus Powder) is primary. ○ Xu and Cheng deleted this note.
[Xu Lingtai] Lower toxicity abundant, damaging blood, causing dry throat. Throat is Yang, Pharynx is Yin. Kushen fumigation/washing dispels wind, clears heat, kills parasites. Anal erosion involves damp-heat causing severe decomposition below, not just ascending invasion. Xionghuang fumigation is powerful for killing parasites, dispelling wind, and detoxifying.
**Kushen Tang Formula** (Missing in original; provided by Xu, Shen, You, and *Jin Jian*)
Kushen (Sophora Root) (1 sheng) Water 1 dou. Decoct to 7 sheng. Remove dregs. Fumigate and wash. Three times daily. (Case: You and *Jin Jian* omit "fu" [take], which is correct.)
**Kushen Tang Formula** (Xu Rong’s *Fu Yi* supplements from Pang Anshi’s *Shanghan Zong Bing Lun*; Cheng agrees.)
Kushen (Sophora Root) (0.5 jin) Huaibai Pi (White Bark of Huai Tree) Ye Lang Ya Gen (Wild Wolf Tooth Root) (each 4 liang)
Cut coarse. Water 5 sheng. Decoct to 3.5 sheng. Wash.
Case note: Uncertain which formula is correct. Reasoning favors single herb Kushen. Single herb Kushen for tooth decay is recorded in *Shiji·Canggong Zhuan*, utilizing heat-clearing and parasite-killing properties. *Mai Jing*’s Zhu Ling San: Lou’s *Gangmu* says unverified. *Zhenglei Bencao* Zhu Ling entry, *Tujing* states: Jaundice and Huo Er Bing treated with Zhu Ling San. Zhu Ling and Fuling equal parts, powdered. Take one fangcun bi mixed with water. Likely this formula.
Patient has rapid pulse, no fever, slight irritability, silence, desire to sleep, sweating. In first 3-4 days, eyes red like turtledove eyes. By day 7-8, eye corners turn black. If able to eat, pus is formed. Chixiaodou Danggui San (Adzuki Bean and Angelica Sinensis Powder) is the primary formula. (*Yukan*, *Mai Jing* read "eye corners all yellow"; *Zong Bing Lun* reads "zhou" [circle] instead of "zi" [corner].)