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。或二十日、或一
月微见者。各随证治之。
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。太阳之府。
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。
百合病。发汗后者。百合知母汤主之。
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。
百合知母汤方
百合（七枚擘） 知母（三两）
上先以水洗百合。渍一宿。当白沫出。去其水。别以泉水二升。煎取一升。去滓。别以泉水二升。
煎知母取一升。后合煎取一升五合。分温再服。
百合病。下之后者。百合滑石代赭汤主之。
百合病不可下而下之。必伤其里。乃复以滑石、代赭者。盖欲因下药之势。而抑之使下。导之使出。
亦在下者引而竭之之意也。
百合滑石代赭汤方
百合（七枚擘） 滑石（三两碎绵裹） 代赭石（如弹丸大一枚碎绵裹）
上先煎百合如前法。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。
分温再服。
百合病。吐之后者。百合鸡子汤主之。
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）
上先煎百合如前法。了。内鸡子黄搅匀。煎五分。温服。（按了应作再）
百合病。不经吐下发汗。病形如初者。百合地黄汤主之。
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）
上先煎百合如前法。了。内地黄汁。煎取一升五合。温分再服。中病勿更服。大盒饭如漆。
百合病。一月不解。变成渴者。百合洗方主之。
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
百合一升。以水一斗。渍之一宿。以洗身。洗已食煮饼。勿以咸豉也。
百合病。渴不瘥者。栝蒌牡蛎散主之。
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。百合滑石散主之。
病变发热者。邪聚于里而见于外也。滑石甘寒。能除六腑之热。得微利。则里热除而表热自退。
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。
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。
病见于阴。甚必及阳。病见于阳。穷必归阴。以法救之者。养其阳以救阴之偏。则阴以平而阳不
伤。补其阴以救阳之过。则阳以和而阴不敝。内经用阴和阳。用阳和阴之道也。若见阳之病而攻其阴。
则并伤其阴矣。乃复发汗。是重伤其阳也。故为逆。见阴之病而攻其阳。则并伤其阳矣。乃复下之。是
重竭其阴也。故亦为逆。以百合为邪少虚多之证。故不可直攻其病。亦不可误攻其无病如此。
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。其面目乍赤、乍黑、乍白。蚀于上部则声嗄。甘草泻心汤主之。蚀于下部则咽干。苦参汤
洗之。蚀于肛者。雄黄熏之。
狐惑、虫病。即巢氏所谓 病也。默默欲眠。目不得闭。卧起不安。其躁扰之象。有似伤寒少阴
热证。而实为 之乱其心也。不欲饮食。恶闻食臭。有似伤寒阳明实证。而实为虫之扰其胃也。其面
目乍赤、乍黑、乍白者。虫之上下聚散无时。故其色更改不一。甚者脉亦大小无定也。盖虽虫病。而
能使人惑乱而狐疑。故名曰狐惑。徐氏曰。蚀于喉为惑。谓热淫于上。如惑乱之气感而生 。蚀于阴
为狐。谓热淫于下。柔害而幽隐。如狐性之阴也。亦通。蚀于上部。即蚀于喉之谓。故声嗄。蚀于下
部。即蚀于阴之谓。阴内属于肝。而咽门为肝胆之候。（出千金）病自下而冲上。则咽干也。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。其苦参、雄黄。则皆清燥杀虫之品。洗之熏之。就
其近而治之耳。
甘草泻心汤方
甘草（四两炙） 黄芩 干姜 人参（各三两） 半夏（半升） 黄连（一两） 大枣（十二枚）
上七味。以水一斗。煮取六升。去滓。再煎。取三升。温服一升。日三服。
苦参汤方
苦参一升。以水一斗。煎取七升。去滓。熏洗日三。
雄黄熏法
雄黄一味为末。筒瓦二枚合之。烧。向肛熏之。
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 黑。若
能食者。脓已成也。赤豆当归散主之。
脉数微烦。默默但欲卧。热盛于里也。无热汗出。病不在表也。三四日目赤如鸠眼者。肝脏血中
之热。随经上注于目也。经热如此。脏热可知。其为蓄热不去。将成痈肿无疑。至七八日目四 黑。赤
色极而变黑。则痈尤甚矣。夫肝与胃。互为胜负者也。肝方有热。势必以其热侵及于胃。而肝既成痈。
胃即以其热并之于肝。故曰若能食者。知脓已成也。且脓成则毒化。毒化则不特胃和而肝亦和矣。赤
豆、当归。乃排脓血除湿热之良剂也。
再按此一条。注家有目为狐惑病者。有目为阴阳毒者。要之。亦是湿热蕴毒之病。其不腐而为虫
者。则积而为痈。不发于身面者。则发于肠脏。亦病机自然之势也。仲景意谓与狐惑阴阳毒。同源而
异流者。故特论列于此欤。
赤豆当归散方
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。
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。
毒者。邪气蕴蓄不解之谓。阳毒非必极热。阴毒非必极寒。邪在阳者为阳毒。邪在阴者为阴毒也。
而此所谓阴阳者。亦非脏腑气血之谓。但以面赤斑斑如锦纹。咽喉痛。唾脓血。其邪着而在表者谓之
阳。面目青。身痛如被杖。咽喉痛。不唾脓血。其邪隐而在表之里者谓之阴耳。故皆得用辛温升散之
品。以发其蕴蓄不解之邪。而亦并用甘润咸寒之味。以安其邪气经扰之阴。五日邪气尚浅。发之犹易。
故可治。七日邪气已深。发之则难。故不可治。其蜀椒、雄黄二物。阳毒用之者。以阳从阳。欲其速
散也。阴毒去之者。恐阴邪不可劫。而阴气反受损也。
升麻鳖甲汤方
升麻 当归 甘草（各二两） 蜀椒（炒去汗一两） 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。
[Commentary] It is stated: Baihe disease (a condition characterized by mental restlessness and uncertainty) occurs because all meridians share a common origin, and thus all are affected by the pathogen. The patient may desire to eat but cannot; often remains silent; desires to lie down but cannot due to restlessness; desires to walk but cannot. Sometimes food tastes good, while at other times the patient has an aversion to the smell of food. They feel as if cold but have no actual chills; feel as if hot but have no actual fever. There is bitter taste in the mouth and dark red urine. Various medicines fail to cure it; upon taking medicine, severe vomiting and diarrhea occur. The symptoms seem erratic, as if possessed by spirits. The physical appearance appears normal, yet the pulse is slightly rapid. If headache occurs during urination, recovery takes sixty days. If there is no headache during urination but a sensation of chilliness (like a draft), recovery takes forty days. If urination is smooth and easy but accompanied only by dizziness, recovery takes twenty days. These manifestations may appear before the illness fully develops, or four to five days after onset, or even after twenty days or a month with mild symptoms. Treatment should be tailored to the specific presentation.
The phrase "all meridians share a common origin" means that while divided they are many meridians, united they form one source. If all are diseased, then everywhere is diseased. However, examining the symptoms closely: desiring to eat but unable; being quiet yet restless; food sometimes tasting good yet sometimes causing aversion; feeling like cold or heat but lacking distinct signs; failing to respond to various medicines and suffering severe vomiting/diarrhea upon ingestion, while the body looks peaceful—these are all illusory, fluctuating signs unreliable for diagnosis. Only bitter taste, dark urine, and a slightly rapid pulse represent the constant reality. Why? Because the heat pathogen is diffuse and not confined to a specific meridian, wandering without fixed location, so the disease manifestations come and go unpredictably. However, the evidence of heat is undeniable in the pulse, bitter taste, and urine. The Bladder is the Fu organ of the Taiyang channel; its meridian ascends to the vertex and spreads over the skin. Headache during urination indicates a temporary deficiency of Taiyang Qi allowing heat to invade. A sensation of chilliness or smoothness indicates descending Qi. Temporary deficiency recovers quickly after urination, but lingering heat requires Yin accumulation to resolve. Thus, severe cases take sixty days for Yin to gather and pathogens to retreat; moderately severe cases take forty days; mild cases take twenty days. Faster resolution correlates with quicker heat subsidence. This disease often appears around the time of Cold Damage febrile diseases. Pre-onset appearance suggests early heat movement; post-onset appearance suggests residual heat. Treatment follows the specific syndrome, as detailed below.
For Baihe disease following sweating therapy, Baihe Zhimu Tang (Lily and Anemarrhena Decoction) is indicated. Just as rivers flow to the sea, all meridians converge on the Lung. Therefore, treating the myriad meridians directly is difficult; instead, we treat the Lung. Lili Bulbus (Baihe, Lilii Bulbus) is sweet, neutral, slightly bitter, white in color entering the Lung, clearing pathogenic factors, tonifying deficiency, and clearing heat. Hence, it is the principal herb in all formulas for this condition, with additions based on syndrome. Zhimu (Zhi Mu, Rhizoma Anemarrhenae) is used because sweating damages Body Fluids.
**Baihe Zhimu Tang Formula:**
Lili Bulbus (7 pieces, split), Rhizoma Anemarrhenae (3 liang).
Wash Lili Bulbus, soak overnight until white foam appears, discard water. Decoct in 2 sheng of spring water to obtain 1 sheng, strain. Decoct Rhizoma Anemarrhenae separately in 2 sheng of spring water to obtain 1 sheng. Combine both decoctions, boil to 1.5 sheng. Divide into two warm doses.
For Baihe disease following purgative therapy, Baihe Huashi Daizhe Tang (Lily, Talc, and Hematite Decoction) is indicated. Purgatives injure the interior in Baihe disease. Huashi (Talcum) and Haematitum (Daizhe Shi) are used to guide the downward momentum of the purgative, leading the pathogen out, following the principle of "draining what is below."
**Baihe Huashi Daizhe Tang Formula:**
Lili Bulbus (7 pieces, split), Talcum (3 liang, crushed and wrapped in cloth), Haematitum (1 piece, size of a pellet, crushed and wrapped in cloth).
Decoct Lili Bulbus as before. Decoct Talcum and Haematitum separately in 2 sheng of spring water to obtain 1 sheng, strain. Combine and re-boil to 1.5 sheng. Divide into two warm doses.
For Baihe disease following emetic therapy, Baihe Jizi Tang (Lily and Egg Yolk Decoction) is indicated. Materia Medica states Egg Yolk (Jizi) calms the Five Viscera and treats heat disorders. After vomiting, visceral Qi is injured but the pathogen remains. Egg Yolk not only calms the interior but also assists in expelling the exterior pathogen.
**Baihe Jizi Tang Formula:**
Lili Bulbus (7 pieces, split), Egg Yolk (1).
Decoct Lili Bulbus as before. Add Egg Yolk, stir well, boil briefly. Warm dose. (Note: "Liao" here implies continuing to cook).
For Baihe disease not treated by sweating, purging, or vomiting, presenting with initial symptoms, Baihe Dihuang Tang (Lily and Rehmannia Decoction) is indicated. This is the standard treatment. The Lung governs Yang, the Kidney governs Yin. Lili Bulbus (white) enters the Lung to clear Qi-level heat; Sheng Dihuang Huang (black) enters the Kidney to clear Blood-level heat. Once Qi and Blood are regulated, all meridians clear, and pathogens exit downwards. Black stool after administration confirms heat clearance. *Waitai Mi Yao* notes black discharge.
**Baihe Dihuang Tang Formula:**
Lili Bulbus (7 pieces, split), Juice of Raw Rehmannia Root (Sheng Di Huang Zhi, 1 sheng).
Decoct Lili Bulbus as before. Add Juice of Raw Rehmannia Root, boil to 1.5 sheng. Divide into two warm doses. Stop if cured. Black stool indicates efficacy.
If Baihe disease persists for a month and transforms into thirst, Baihe Xi Fang (Lily Wash Formula) is indicated. Chronic unresolved heat accumulates in the Lung. Washing externally works because skin/hair are external extensions of the Lung, sharing Qi. After washing, eat boiled noodles (Bing). *Waitai Mi Yao* specifies "white noodle soup." Rice and wheat clear heat and generate fluids. Avoid salty pickled beans (Chi), as salt consumes fluids and worsens thirst.
**Baihe Xi Fang:**
Lili Bulbus (1 sheng), Water (1 dou). Soak overnight. Use water to wash body. Eat boiled noodles afterward. Do not use salty pickled beans.
If thirst persists despite washing, Gualou Muli San (Trichosanthes and Oyster Shell Powder) is indicated. Persistent thirst after washing indicates excessive heat and fluid injury. Gualou Gen (Radix Trichosanthis) is bitter/cold, generating fluids and quenching thirst. Muli (Ostrea Shell) is salty/cold, guiding heat downward to prevent upper scorching.
**Gualou Muli San Formula:**
Radix Trichosanthis, Ostrea Shell (calcined, equal parts).
Grind to fine powder. Take one cubic inch spoonful with water, three times daily.
If Baihe disease transforms into fever, Baihe Huashi San (Lily and Talc Powder) is indicated. Fever indicates internal pathogen manifesting externally. Talcum is sweet/cold, clearing Six Fu heat. Mild diarrhea clears internal heat, resolving external fever.
**Baihe Huashi San Formula:**
Lili Bulbus (1 liang, honey-fried), Talcum (3 liang).
Grind to powder. Take one cubic inch spoonful with water, three times daily. Stop if mild diarrhea occurs. Heat will clear.
For Yin-type Baihe, treat with Yang methods; for Yang-type, treat with Yin methods. Attacking Yin when Yang signs appear, followed by sweating, is adverse. Attacking Yang when Yin signs appear, followed by purging, is also adverse. Yin pathology eventually affects Yang; Yang pathology eventually returns to Yin. Correct treatment nourishes Yang to balance Yin deficiency, or tonifies Yin to harmonize Yang excess, following the *Neijing* principle of using Yin to harmonize Yang and vice versa. Attacking Yin when Yang signs exist harms Yin; subsequent sweating severely harms Yang (adverse). Attacking Yang when Yin signs exist harms Yang; subsequent purging severely depletes Yin (adverse). Since Baihe involves little pathogen and much deficiency, direct attack or attacking non-diseased areas is contraindicated.
Huche disease (Fox-Gnaw Disease) resembles Cold Damage. Silence, desire to sleep, eyes unable to close, restlessness. Erosion in throat is "Huo" (Confusion); erosion in genitals/anus is "Hu" (Fox). Anorexia, aversion to food smells. Face changes color (red, black, white) intermittently. Upper erosion causes hoarseness; treated with Gancao Xiexin Tang. Lower erosion causes dry throat; washed with Kushen Tang. Anal erosion; fumigated with Xionghuang.
Huche/Gnawing disease corresponds to Chao Yuanfang's description. Restlessness resembles Shaoyin heat but disturbs the Heart. Anorexia resembles Yangming excess but disturbs the Stomach. Color changes reflect parasites moving up/down. Hoarseness from upper erosion (throat); dry throat from lower erosion (Liver channel connects to throat). Parasites arise from long-standing damp-heat rotting Qi/Blood. Gancao Xiexin Tang moves Middle Qi, resolves damp-heat, and uses bitter/acrid herbs to kill parasites. Kushen and Xionghuang clear dryness/heat and kill parasites via topical application.
**Gancao Xiexin Tang Formula:**
Licorice (4 liang, fried), Scutellaria, Dried Ginger, Ginseng (3 liang each), Pinellia (0.5 sheng), Coptis (1 liang), Jujube (12 pieces).
Boil in 1 dou water to 6 sheng, strain, re-boil to 3 sheng. Take 1 sheng warm, three times daily.
**Kushen Tang Formula:**
Sophora Root (1 sheng), Water (1 dou). Boil to 7 sheng, strain. Fumigate/wash three times daily.
**Xionghuang Fumigation Method:**
Realgar powder. Seal in two tile halves, burn, fumigate anus.
Patient with rapid pulse, no fever, slight irritability, silence, desire to sleep, sweating. Days 3-4: eyes red like turtledove eyes. Days 7-8: eye corners turn black. Ability to eat indicates pus formation. Treat with Chidou Danggui San. Rapid pulse/irritability/silence indicates interior heat. Sweating without fever indicates exterior is clear. Red eyes indicate Liver blood heat ascending. Blackening indicates worsening abscess. Liver and Stomach affect each other; Liver heat invades Stomach. Eating indicates pus formed and toxin transforming, harmonizing Liver/Stomach. Adzuki Bean and Angelica drain pus/blood and clear damp-heat.
Some commentators classify this as Huche or Yinyang Du. It is a damp-heat toxin disease. If not forming parasites, it forms abscesses in intestines/organs. Zhang Zhongjing groups it with Huche/Yinyang Du as same source, different manifestation.
**Chidou Danggui San Formula:**
Adzuki Bean (3 sheng, soaked until sprouted, dried), Angelica Sinensis (10 liang).
Grind to powder. Take one cubic inch spoonful with fermented rice water, three times daily.
Yang Du disease: Red face with rash like brocade, sore throat, vomiting pus/blood. Treatable within 5 days, not after 7. Shengma Biejia Tang is indicated.
Yin Du disease: Blue/green face, body pain like beaten, sore throat. Treatable within 5 days, not after 7. Shengma Biejia Tang minus Xionghuang and Shujiao is indicated.
"Toxin" means accumulated pathogen. Yang Du is not necessarily extreme heat; Yin Du is not necessarily extreme cold. Yang Du involves pathogen in Yang aspects; Yin Du in Yin aspects. Here, Yang refers to surface/expression (red face, pus); Yin refers to hidden/internal (blue face, pain, no pus). Both use acrid/warm dispersants to release pathogen, combined with sweet/salty/cold agents to calm disturbed Yin. Early stage (5 days) is shallow/easy to treat; late stage (7 days) is deep/difficult. Shujiao and Xionghuang in Yang Du use "Yang aiding Yang" for rapid dispersion. Removed in Yin Du to protect Yin Qi from damage by harsh warming agents.
**Shengma Biejia Tang Formula:**
Cimicifuga, Angelica, Licorice (2 liang each), Sichuan Pepper (1 liang, fried), Turtle Shell (1 piece, size of finger, fried), Realgar (0.5 liang, ground).
Boil in 4 sheng water to 1 sheng. Take once. Elderly/children may take again to induce sweat. *Zhouhou* and *Qianjin* formulas vary: Yang Du uses Shengma Tang (no Turtle Shell, adds Cinnamon); Yin Du uses Gancao Tang (no Realgar).