金匮云。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。欲卧不能
卧。欲行不能行。饮食或有美时。或有不欲闻食臭时。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。若溺时快然。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。百合病下之后者。滑石代赭汤主之。百合病吐之后者。
百合鸡子汤主之。百合病不经吐下发汗。病形如初者。百合地黄汤主之。百合病一月不解。变成
渴者。百合洗方主之。百合病渴不瘥者。栝蒌牡蛎散主之。百合病变发热者。百合滑石散主之。
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。
所谓百脉一宗。言周身之血。尽归于心主也。心主血脉。又主火。若火淫则热蓄不散。流于
血脉。故百脉一宗。悉致其病也。人身气阳而血阴。若气盛则热。气衰则寒。今病在血。不干于
气。所以如寒无寒。如热无热。欲食不食。欲卧不卧。欲行不行。皆阳火烁阴。无可奈何之状也。
又上热则为口苦。下热则为便赤。亦阳火烁阴之患也。药虽治病。然必藉胃气以行之。若毒血在
脾胃。经脉闭塞。药虽入而胃弱不能行。故得药转剧而吐利也。病不在皮肉筋骨。则身形如和。
惟热在血。故脉微数也。脉数血热。则心火上炎。不下交于肾。而膀胱之经亦不得引精于上。上虚则
溺时淅然头眩。甚则为头痛。以此微甚。可卜其愈日之远近也。其治法咸用百合为君。以安心补
神。能去血中之热。利大小便。导涤瘀积。然必鲜者。始克有济。若汗之而失者。佐知母以调其
上焦之津液。下之而失者。佐滑石、代赭以理其下焦之痹结。吐之而失者。佐鸡子黄以补其中焦
之荣血。若不经吐下发汗。但佐生地黄汁以凉血。血凉则热毒解而蕴积自行。故大便出如黑漆矣。
其一月不解。百脉壅塞。津液不化而成渴者。故用百合洗之。则一身之脉皆得通畅。而津液行。
渴自止。勿食盐豉者。以味咸而凝血也。若洗后渴不瘥。是中无津液。则以栝蒌、牡蛎主之。若
变发热。乃脉郁而成热。佐滑石以通利之。百合病皆持两端。不表不里。为其热行血脉之中。非
如伤寒可行汗下等法。所以每多误治之失。往往有绵延经岁不已者。愈期不复可拘也。至于误行
汗下。变证救治。大略不逾上法。但当随所禀虚实偏胜而调之。切勿误认下元虚弱而用温补之法
也。按百合病。即痿证之暴者。伤寒后得此为百合。肺病日久而得者。为痿。
石顽治内翰孟端士尊堂太夫人。因端士职任兰台。久疏定省。兼闻稍有违和。虚火不时上升。
自汗不止。心神恍惚。饮食不能食。欲卧不能卧。口苦小便难。溺则洒淅头晕。自去岁迄今。历
更诸医。每用一药。辄增一病。用白术则窒塞胀满。用橘皮则喘息怔忡。用远志则烦扰哄热。用
木香则腹热咽干。用黄 则迷闷不食。用枳壳则喘咳气乏。用门冬则小便不禁。用肉桂则颅胀咳逆。
用补骨脂则后重燥结。用知、柏则小腹枯瘪。用芩、栀则脐下引急。用香薷则耳鸣目眩。时时欲
人扶掖而走。用大黄则脐下筑筑。少腹愈觉收引。遂致畏药如蝎。惟日用人参钱许。入粥饮和服。
聊藉支撑。交春虚火倍剧。火气一升则周身大汗。神气 欲脱。惟倦极少寐。则汗不出而神思稍宁。
觉后少顷。火气复升。汗亦随至。较之盗汗迥殊。直至仲春中浣。邀石顽诊之。其脉微数。而左
尺与左寸倍于他部。气口按之。似有似无。诊后。款述从前所患。并用药转剧之由。曾遍询吴下
诸名医。无一能识其为何病者。石顽曰。此本平时思虑伤脾。脾阴受困。而厥阳之火。尽归于心。
扰其百脉致病。病名百合。此证惟仲景金匮要略言之甚详。本文原云。诸药不能治。所以每服一
药。辄增一病。惟百合地黄汤为之专药。奈病久中气亏乏殆尽。复经药误而成坏病。姑先用生脉
散加百合、茯神、龙齿以安其神。稍兼萸、连以折其势。数剂稍安。即令勿药。以养胃气。但令
日用鲜百合煮汤服之。交秋天气下降。火气渐伏。可保无虞。迨后仲秋。端士请假归省。欣然勿
药而康。后因劳心思虑。其火复有升动之意。或令服佐金丸而安。嗣后稍觉火炎。即服前丸。第
苦燥之性。苦先入心兼。之辛臊入肝。久服不无反从火化之虞。平治权衡之要。可不预为顾虑乎。
《金匮要略》中说：论述道，百合病这种病症，是因为全身血脉同出一源（心），导致全部血脉都受到邪气侵袭而发病。患者想要进食，却又吃不下；常常沉默不语；想要躺卧却睡不着；想要行走却走不动。饮食有时觉得美味，有时又厌恶食物的气味。感觉像冷又不冷，感觉像热又不热。口苦，小便颜色深红。各种药物都不能治愈，服药后反而剧烈呕吐和腹泻，好像有神灵作祟一样。身体外形看起来正常，脉象微数。每次小便时如果头痛的，六十天痊愈；如果小便时头不痛，只是感到怕风发冷的，四十天痊愈；如果小便时感觉畅快，只是头晕的，二十天痊愈。这种病症，有的还没发病就预先出现症状，有的发病四五日后才出现，有的发病二十日或一个月后才轻微显现，都要根据具体证候进行治疗。
百合病经过发汗治疗后的，用百合知母汤主治。百合病经过泻下治疗后的，用滑石代赭汤主治。百合病经过催吐治疗后的，用百合鸡子汤主治。百合病没有经过催吐、泻下或发汗治疗，病情表现如初的，用百合地黄汤主治。百合病一个月未愈，转变为口渴的，用百合洗方主治。百合病口渴未愈的，用栝蒌牡蛎散主治。百合病变为发热的，用百合滑石散主治。百合病表现为阴证的，用阳法救治；表现为阳证的，用阴法救治。见到阳证却攻伐阴分，又再次发汗，这是逆治；见到阴证却攻伐阳分，又再次泻下，这也是逆治。
所谓“百脉一宗”，是说全身的血液都归心所主。心主血脉，又主火。如果火邪过盛，则热邪蓄积不散，流注于血脉之中，所以百脉一宗，全部致病。人身之气属阳，血属阴。如果气盛则热，气衰则寒。现在病在血分，不涉及气分，所以感觉像冷又不冷，像热又不热。想吃饭不吃，想睡觉睡不着，想走走不了，这都是阳火灼烧阴液，无可奈何的状态。上部有热则口苦，下部有热则小便赤，也是阳火灼烧阴液的祸患。药物虽然能治病，但必须依靠胃气来运行。如果毒邪瘀血阻滞在脾胃，经脉闭塞，药虽进入体内，但胃气虚弱不能推动药力运行，所以服药后病情反而加重，出现呕吐腹泻。病不在皮肉筋骨，所以身形如常。只有热在血分，所以脉象微数。脉数表示血热，心火上炎，不能下交于肾，膀胱经也不能引精气上行。上焦虚损，所以小便时淅淅然头晕，严重时头痛。根据症状的轻重，可以推断痊愈时间的远近。其治疗方法都用百合作为君药，以安心补神，能清除血中的热邪，通利大小便，导涤瘀积。但必须是鲜百合，才能见效。如果是发汗失误导致的，配合知母以调理上焦津液；如果是泻下失误导致的，配合滑石、代赭石以疏通下焦的痹结；如果是催吐失误导致的，配合鸡蛋黄以补益中焦营血。如果没有经过吐、下、汗法治疗，只需配合生地黄汁以凉血，血凉则热毒解除，蕴积自行排出，所以大便排出如黑漆状。如果一个月未愈，百脉壅塞，津液不化而成口渴，所以用百合洗浴，使周身血脉通畅，津液运行，口渴自然停止。不要食用盐和豉，因为味咸会凝血。如果洗浴后口渴仍未缓解，是中焦无津液，就用栝蒌、牡蛎为主治疗。如果变为发热，是脉气郁结而成热，配合滑石以通利之。百合病皆处于半表半里之间，不表不里，因为其热行于血脉之中，不像伤寒可以用汗、下等法治疗，所以往往多误治，常有绵延一年不愈的情况。痊愈日期不再拘泥于前述天数。至于误用汗、下法后的变证救治，大致不出上述方法，但应根据患者禀赋的虚实偏胜进行调理，切勿误认为下元虚弱而使用温补之法。按：百合病，就是暴发的痿证。伤寒后得的称为百合病，肺病日久得的称为痿证。
石顽医生治疗内阁学士孟端士尊堂太夫人。因为孟端士任职兰台（翰林院），长期疏于早晚问安，加上听说老人家稍有不适，虚火不时上升，自汗不止，心神恍惚，饮食难进，想睡睡不着，口苦，小便困难，小便时洒淅然头晕。从去年到现在，历经多位医生，每用一种药，就增加一种病症。用白术则窒塞胀满，用橘皮则喘息心悸，用远志则烦扰烘热，用木香则腹热咽干，用人参则迷闷不食，用枳壳则喘咳气乏，用麦冬则小便不禁，用肉桂则颅胀咳逆，用补骨脂则后重燥结，用知母、黄柏则小腹枯瘪，用黄芩、栀子则脐下牵引急迫，用香薷则耳鸣目眩，时时想要人搀扶行走，用大黄则脐下悸动，少腹更加收缩牵引，于是导致畏药如蝎子，只每天用人参一钱，放入粥饮中调和服用，勉强支撑。到了春季，虚火加倍剧烈，火气一升则周身大汗，神气几乎脱失，只有疲倦极少睡眠时，汗不出而神思稍安宁。醒来不久，火气又升，汗也随之而至，与盗汗截然不同。直到仲春中旬，邀请石顽诊脉。其脉微数，左尺和左寸脉比其他部位明显有力，气口脉按之似有似无。诊脉后，详细陈述从前所患疾病及用药后加重的原因。曾遍询吴地各位名医，没有人能识别这是什么病。石顽说：“这原本是平时思虑伤脾，脾阴受困，厥阳之火全部归于心，扰乱百脉致病。病名百合。此证只有张仲景《金匮要略》说得非常详细。原文本来就说‘诸药不能治’，所以每服一药，就增加一种病。只有百合地黄汤是它的专药。无奈病久中气亏乏殆尽，又经药物误治成为坏病。暂且先用生脉散加百合、茯神、龙齿以安神，稍微兼用山茱萸、黄连以折其火势。几剂后稍安，随即令停药，以养胃气，只让每天用鲜百合煮汤服用。到了秋季天气下降，火气渐伏，可保无虞。后来仲秋时节，孟端士请假回家探望，欣然停药而康复。后来因劳心思虑，火气又有升动之意，有人让他服用佐金丸而安定。此后稍觉火炎，即服用前丸。只是苦燥之性，苦先入心，兼之辛臊入肝，久服不无反从火化的担忧。平治权衡的要领，能不预先顾虑吗？”
According to the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet): It states that Baihe Bing (Lily Disease) occurs because all meridians share a single origin (the Heart), leading to pathological involvement of all meridians. The patient desires to eat but cannot; remains often silent; desires to lie down but cannot sleep; desires to walk but cannot move. Food may sometimes taste good, or at other times the patient may dislike the smell of food. They feel as if cold but are not actually cold, and feel as if hot but are not actually hot. There is bitter taste in the mouth and dark red urine. Various medicines cannot cure it; taking medicine causes severe vomiting and diarrhea, as if possessed by spirits. The physical appearance seems normal, but 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 feels comfortable but with dizziness, recovery takes twenty days. This disease may manifest symptoms before the illness fully develops, or appear four to five days after onset, or twenty days later, or even a month later with mild symptoms. Treatment should follow the specific syndrome presentation.
For Baihe Bing treated with sweating methods, Baihe Zhi Mu Tang (Lily and Anemone Decoction) is the primary prescription. For Baihe Bing treated with purgation methods, Huashi Daizhe Tang (Talcum and Hematite Decoction) is used. For Baihe Bing treated with emetic methods, Baihe Jizi Tang (Lily and Egg Yolk Decoction) is indicated. For Baihe Bing not treated with emetics, purgatives, or sweating methods, where the condition remains unchanged, Baihe Dihuang Tang (Lily and Rehmannia Decoction) is the main treatment. If Baihe Bing persists for a month and transforms into thirst, Baihe Xi Fang (Lily Bathing Prescription) is used. If thirst persists after bathing, Gualou Muli San (Trichosanthes Root and Oyster Shell Powder) is administered. If fever develops, Baihe Huashi San (Lily and Talcum Powder) is prescribed. For Baihe Bing presenting with Yin syndromes, Yang-rescuing methods are used; for Yang syndromes, Yin-rescuing methods are applied. Attacking Yin when Yang signs are present, followed by sweating, is a contraindication (Ni). Attacking Yang when Yin signs are present, followed by purgation, is also a contraindication.
The phrase "all meridians share a single origin" refers to the fact that all blood in the body is governed by the Heart. The Heart governs blood vessels and is associated with Fire. If Fire pathogen is excessive, heat accumulates and does not dissipate, flowing into the blood vessels, thus causing all meridians to be affected. Qi belongs to Yang, and Blood belongs to Yin. Excess Qi leads to heat, while deficient Qi leads to cold. Since the pathology is in the Blood aspect and does not involve Qi, the patient feels neither truly cold nor truly hot. The inability to eat, sleep, or walk despite the desire to do so reflects the scorching of Yin by Yang-Fire, a state of helplessness. Upper heat causes bitter taste, and lower heat causes dark urine, both resulting from Yang-Fire damaging Yin. Although medicines treat diseases, they must rely on Stomach-Qi to circulate. If toxic blood stasis blocks the Spleen and Stomach and closes the meridians, the medicine enters but the weak Stomach-Qi cannot propel it, causing the condition to worsen with vomiting and diarrhea after administration. Since the disease is not in the skin, flesh, sinews, or bones, the body shape appears normal. Only heat in the blood causes the slightly rapid pulse. A rapid pulse indicates blood heat; Heart-Fire flares upward without descending to communicate with the Kidney, and the Bladder meridian fails to guide essence upward. Upper deficiency leads to dizziness during urination, and severely, headache. Based on the severity, one can predict the time to recovery. All treatments use Baihe (Lily Bulb) as the sovereign herb to calm the Heart and nourish the Spirit, clearing heat from the blood and promoting urination and defecation to drain stagnation. Fresh Baihe is essential for efficacy. If caused by improper sweating, add Zhi Mu (Anemone Root) to regulate upper Jiao fluids. If caused by improper purgation, add Huashi (Talcum) and Daizheshi (Hematite) to resolve lower Jiao obstruction. If caused by improper emesis, add Jizi Huang (Egg Yolk) to nourish middle Jiao Ying-Blood. If not treated with emesis, purgation, or sweating, simply add Sheng Dihuang (Fresh Rehmannia Juice) to cool the blood; cooling the blood resolves heat-toxins and allows accumulation to pass naturally, resulting in black, lacquer-like stool. If unresolved after a month, with blocked meridians and failure to transform fluids causing thirst, bathing with Baihe opens the meridians and restores fluid flow, stopping thirst. Do not consume salt or Chi (Fermented Soybeans), as salty flavors congeal blood. If thirst persists after bathing due to lack of middle Jiao fluids, use Gualou (Trichosanthes Root) and Muli (Oyster Shell). If fever develops due to meridian stagnation, add Huashi (Talcum) to promote free flow. Baihe Bing exists between exterior and interior, not strictly in either, as heat travels within the blood vessels, unlike Shanghan (Cold Damage) which can be treated with sweating or purging. Thus, misdiagnosis is common, and the disease may linger for years. Recovery dates are no longer fixed. Regarding rescue from complications due to improper sweating/purging, the general principles above apply, adjusted for the patient's constitutional deficiency or excess. One must not mistake lower Yuan deficiency for the indication and use warming tonification. Note: Baihe Bing is essentially an acute form of Wei Zheng (Flaccidity Syndrome). Acquired after Shanghan, it is called Baihe Bing; acquired from chronic Lung disease, it is called Wei Zheng.
Shi Wan treated the mother of Hanlin Academician Meng Duan Shi. Because Meng served in the Hanlin Academy, he neglected regular filial visits, and reports indicated slight discomfort. Deficient fire rose intermittently, causing spontaneous sweating, mental restlessness, difficulty eating, insomnia, bitter taste, difficult urination, and dizziness/chilliness during urination. From last year until then, various physicians were consulted; each medication added new symptoms. Baizhu (Atractylodes Rhizome) caused bloating; Chuanpi (Citrus Peel) caused palpitations and panting; Yuanzhi (Polygala Root) caused irritability and heat; Muxiang (Aucklandia Root) caused abdominal heat and dry throat; Renshen (Ginseng Root) caused confusion and anorexia; Zhike (Immature Bitter Orange) caused cough and shortness of breath; Maidong (Ophiopogon Tuber) caused urinary incontinence; Rougui (Cinnamon Bark) caused cranial distension and cough; Buguzhi (Psoralea Fruit) caused tenesmus and dryness; Zhimu (Anemone Rhizome) and Huangbai (Phellodendron Bark) caused empty lower abdomen; Huangqin (Scutellaria Root) and Zhizi (Gardenia Fruit) caused umbilical tightness; Xiangru (Elsholtzia Herb) caused tinnitus and vertigo; the patient constantly needed support to walk; Dahuang (Rhubarb Root) caused umbilical throbbing and lower abdominal contraction. Consequently, the patient feared medicine like scorpions, relying only on 1 qian of Renshen daily mixed in porridge to sustain life. In spring, deficient fire intensified; upon rising, profuse whole-body sweating occurred, nearly depleting Shen-Qi. Only deep fatigue with little sleep prevented sweating and calmed the mind. Shortly after waking, fire rose again, bringing sweat, distinct from Dao Han (Night Sweats). By mid-second lunar month, Shi Wan was invited to diagnose. The pulse was slightly rapid; the Left Chi and Left Cun positions were significantly stronger than others; the Qi Kou position felt faint. After diagnosis, the patient recounted previous illnesses and worsening due to medications. Many famous doctors in Wu region could not identify the disease. Shi Wan stated: "This originates from long-term overthinking injuring the Spleen, trapping Spleen-Yin, causing Jue-Yang Fire to gather in the Heart, disturbing the hundred meridians. The disease name is Baihe. Zhang Zhongjing's *Jin Gui Yao Lue* details this extensively. The text states 'various medicines cannot cure it,' hence each drug adds symptoms. Only Baihe Dihuang Tang is the specific remedy. However, chronic illness has depleted Middle Qi, and iatrogenic errors have created complex complications. Initially, use Sheng Mai San (Generate the Pulse Powder) plus Baihe, Fushen (Poria with Hostwood), and Longchi (Dragon Bone) to calm the Spirit, with少量 ShanYuzhu (Cornus Fruit) and Huanglian (Coptis Rhizome) to curb the fire. After several doses stabilize, stop all herbs to nourish Stomach-Qi, using only fresh Baihe decoction daily. As autumn arrives, Heaven's Qi descends, fire subdues, and safety is ensured. Later, in mid-autumn, Meng returned home and recovered happily without medication. Subsequently, due to mental labor, fire rose again. Zuojin Wan (Assist the Metal Pill) was prescribed successfully. Thereafter, whenever slight fire flare-ups occurred, this pill was taken. However, the bitter-dry nature enters the Heart first, and pungent-salty flavors enter the Liver. Long-term use risks transforming into fire. Must one not consider this balance proactively?"