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，欲饮食或有美时，或有不用闻食臭时，如寒无寒，如热元热，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。每尿时头痛
者，六十日乃愈；若尿时头不痛者，淅然者，四十日愈；若尿快然，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。
【注】百合，百瓣一蒂，如人百脉一宗，命名取治，皆此义也。百合病者，谓人百脉
一宗，悉致其病也。日百脉即一脉也，犹言百体一体也，是盖以周身言之也，周身之脉，
分而言之曰百，合而言之曰一，故曰百脉一宗。若曰百合之病，总脉病也。脉者谓十二
脉，三百六十五络脉也。伤寒大病之后，余热未解，百脉未和，或平素多思不断，情志
不遂，或偶触惊疑，卒临景遇，因而形神俱病，故有如是之现证也。百脉周于身，脉病
则身病，故身形如和不和，欲卧不能卧，欲行不能行也。百脉通于心，脉病则心病，故
常默默也。如寒无寒，如热无热，似外感而非外感也。意欲食复不能食，或有美时，或
闻食臭，有不用时，似里病而非里病也。至脉数、口苦、小便赤者，是郁结之热，虽侵
里而其热未甚也。方其初病之时，医者不识，误为表里之病，以药汗下之，故剧吐利也。虽
剧吐利，不变诸逆。若有神灵，身形如前之和，而脉则比前微数，故其势即不能遽进，不
觉加甚，而亦不能速愈也。试以缓愈之期，约略言之，重者不过六十日，轻者不过二十日，
轻重之间者，不过四十日可愈也。然愈必以每尿时头痛不头痛，恶风不恶风，快然不快
然辨者，以经脉之邪，莫不由太阳而愈也。头痛恶风，是其经之候也；尿时快然，是其腑
之征也。其证或未病而预见者，其证指百合病等证言也。未病，言未病伤寒病也，犹言
未病伤寒之前，而预先见百合欲食不食等证也。或病四五日而出，谓已病伤寒之后，而
始见百合病证也。预先见者，是先有情志不遂，偶触惊疑而召病也，或病二十日或一月
才见者，是因伤寒病后而才见也。故曰∶各随证治之也。
【集注】李 曰∶《活人书》云∶伤寒大病后，气血未得平复，变成百合病。今由百
脉一宗，悉致其病观之，当是心、肺二经之病也。如行卧、饮食、寒热等证，皆有莫可
形容之状，在《内经》解 病似之。观篇中有如神灵者，岂非以心藏神、肺藏魄，人生
神魄失守，斯有恍惚错妄之情乎？又曰∶《内经》云∶凡伤于寒，则为病热。热气遗留不
去，伏于脉中，则昏昏默默，凡行卧、饮食、寒热，皆有一种虚烦不耐之象矣。
沈明宗曰∶若邪淫于胸中连及上脘，则意欲食，复不能食；走于肝肾，故常默默；流
入脾胃，故欲卧不能卧，欲行不能行；邪不
在胃，饮食或有美时；壅抑胃气，则闻食臭；流于胆则口苦；流于膀胱则便赤。以上诸证，非
一齐并见，皆移易变动而见也。
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。
【注】此承上条以明其治也。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。
【集注】徐彬曰∶《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。
李 曰∶百合病多端，数条之法，亦说不尽。
沈明宗曰∶此治百合病之总要法也。微邪伏于营卫，流行而病表里，当分阴阳以施
救治可也。
百合病，不经吐、下、发汗，病形如初者，百合地黄汤主之。
【注】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。中病勿更服，恐过服生地黄，大
便常如漆也。
百合地黄汤方
百合（擘，七枚） 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，内
地黄汁，煎取一升五合，分温再服。中病勿更服，大便常如漆。
【集解】程林曰∶百合花叶皆四向，故能通达上下四旁，其根亦众瓣合成，故名百合，
用以医百合病也，有以夫。
高世 曰∶百合色白味甘，手太阴之补剂也。其花昼开夜合，如气之日行于阳，夜
行于阴，司开阖，以行荣卫和阴阳。
百合病，变发热者，百合滑石散主之。
【注】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，使其微利，热从小便而除矣。
百合滑石散方
百合（炙，一两） 滑石（三两）
上为散，饮服方寸匕，日三服。当微利，则止服，热则除。
【集解】高世 曰∶滑石亦名液石，又名FS 劳石，石之脂膏也，主治身热，泄 ，利小
便。
百合病，一月不解，变成渴者，百合洗方主之。
【注】百合病本不渴，今一月不解，变成渴者，外以百合汤浸洗其身，通表泻热；内
食煮饼，勿以盐豉，不致引饮，而渴自止也。
百合洗方
百合（一升）
上以水一斗，渍之一宿，以洗身；洗已，食煮饼，勿以盐豉也。
百合病，渴不瘥者，用后方主之。
【注】与百合洗身而渴不瘥者，内热盛而津液竭也。栝萎根苦寒，生津止渴；牡蛎咸
寒，引热下行也。
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，发汗后者，百合知母汤主之。
【注】百合病不应汗而汗之，不解者，则致燥。以百合知母汤主之者，清而润之也。
百合知母汤方
百合（擘，七枚） 知母（切，三两）
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。
【注】百合病不应下而下之，不解者，则怯中，以滑石代赭汤清而镇之也。
滑石代赭汤方
百合（擘，七枚） 滑石（碎，绵裹，三两） 代赭石（碎，绵裹，如弹丸大一枚）
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；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，用后方主之。
【注】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。
百合鸡子汤方
百合（擘，七枚） 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。
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。
【注】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，其为患亦同也。状如伤寒，谓发热憎寒也。默默欲眠，目不得
闭，谓其病或在阴，亦或在阳，故卧起俱不安也。此病有虫，虫闻食臭而动，动则令人
烦心，故不欲饮食，恶闻食也。面目乍赤、乍黑、乍白，亦由虫动交乱胃中，胃主面，故
色无定也。惑蚀于上部之喉，故先声嗄，毒在喉也。狐蚀于下部之阴，故先咽干，毒在
阴也。外治之法，苦参汤、雄黄散解毒杀虫，尚属有理。内用甘草泻心汤，必传写之误也，
姑存之。
【注】程林曰∶《灵枢经》云∶虫动则令 心，是以有卧起不安等项也。
李 曰∶喉肛与前阴，皆关窍所通，津液滋润之处，故虫每蚀于此。
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。
苦参汤方
苦参（一升）
水一斗，煮取七升，熏洗日三。
雄黄熏方
雄黄
上一味为末，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。
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，脓己成也，赤小豆当归散主之。
【注】病者脉数，谓病狐惑之人脉数也。数主疮主热，今外无身热，而内有疮热，疮
之热在于阴，故默默但欲卧也。热在于阳，故微烦汗出也，然其病初得之三四日，目赤如
鸠眼者，是热蕴于血，故 络赤也。七八日四 皆黑者，是热瘀血腐，故 络黑也。若
不能食，其毒尚伏诸里，若已能食，其毒已化成脓也。故以赤小豆排痈肿，当归调疡血，
米浆和胃气也。
【集注】李 曰∶经云∶脉数不止，而热不解，则生恶疮。今脓成何处？大率在喉与
阴肛。盖积热生虫，亦积热成脓，是亦恶疮之类也。
赤小豆当归散方
赤小豆（浸令芽出，曝干，三升） 当归
上二味，杵为散，浆水服方寸匕，日三服。
阳毒之为病，面赤斑斑如锦文，咽喉痛，唾脓血。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。
【注】阴阳平，正气也；阴阳偏，邪气也；阴阳变，异气也。正气者，即四时令平之气
也，中人为病，徐而浅；邪气者，即四时不和之气也，中人为病，速而危；异气者，非
常灾疠之气也，中人为病，暴而死。所以过五日不治，以五脏相抟俱受邪也，此气适中
人之阳，则为阳毒；适中人之阴，则为阴毒。非后人所论阴寒极、阳热极之阴毒、阳毒也。
观其所主之方，要不过升麻、甘草。当归、鳖甲、蜀椒、雄黄，而并不用大寒大热之药，则
可知仲景所论阴毒阳毒，非阴寒极、阳热极之谓也。此二证即今世俗所称痧证是也。阳
毒终属阳邪，故见面赤斑斑如锦文，唾脓血之热证；阴毒终属阴邪，故见面目青，身痛
如被杖之寒证。二证俱咽喉痛者，以此证乃，邪从口鼻而下入咽喉，故痛也。
【按】由此推之，凡邪所过之处无不痛也。故中此气之人，不止咽喉痛，身痛，甚至有
心腹绞痛，大满大胀，通身络脉青紫暴出，手足指甲色如靛叶，口噤牙紧，心中忙乱，死
在旦夕者。若谓必从皮毛而入，未有为病如是之速者也，是必从口鼻，而下入咽喉无疑。
况阴毒反去雄黄、蜀椒，必传写之讹。故治是证者，不必问其阴阳，但刺其尺泽、委中、
手中十指脉络暴出之处出血，轻则用刮痧法，随即服紫金锭，或吐、或下、或汗出而愈者
不少，若吐泻不止，厥逆冷汗，脉微欲绝，用炮附子。炮川乌、吴茱萸、丁香、生干姜、甘
草，虚者加人参救之，亦多得生。
【集注】王履曰∶仲景虽有阴毒之名，其叙证不过面目青，身痛咽痛而已，并不言阴
寒极盛之说。其升麻鳖甲汤，并不用大热药，是知仲景所论阴毒者，非阴寒之病，乃感天
地恶毒异气入于阴经，故曰阴毒耳！后人谓阴寒极盛之证，称为阴毒，引仲景所叙面目
青，身痛如被杖，咽喉痛数语，却用附子散、止阳散等药。窃谓阴寒极盛之证，固可名为
阴毒，然终非仲景所以立名之本意。后人所叙阴毒，与仲景所叙阴毒，自是两般，岂可
混论。盖后人所叙阴毒，只是内伤冷物，或暴寒所中，或过服寒凉药，或内外俱伤于寒
而成耳！非天地恶毒异气所中者也。
李 曰∶赵献可云∶此阴阳二毒，是感天地疫疠非常之气，沿家传染，所谓时疫证
也。观方内“老小再服”可见。
升麻鳖甲汤方
升麻（二两） 当归（一两） 蜀椒（炒，去汗，二两） 甘草（二两） 鳖甲（炙，手掌
大一片） 雄黄（研，半两）
上六味，以水四升，煮取一升，顿服之；老小再服，取汗。
【原文】
论曰：百合病，是因为全身血脉同出一源，都受到了邪气的影响而发病。患者想要进食却又吃不下，常常沉默不语，想躺下却睡不着，想走动却无法行走，想吃东西时有时觉得美味，有时又闻到食物气味就厌恶不想吃，感觉像冷其实并不冷，感觉像热其实并不热，口苦，小便颜色红赤，各种药物都无法治愈，服药后反而出现剧烈呕吐、腹泻，症状好像有神灵附体一样，身体外形看似正常，脉象微数。每次排尿时如果头痛的，六十天可以痊愈；如果排尿时头不痛，而是感到怕风（淅然恶风）的，四十天可以痊愈；如果排尿时感觉畅快，只是头晕目眩的，二十天可以痊愈。这种病症，有的在没生病之前就预先出现症状，有的在生病四五天后才出现，有的在生病二十天或一个月后才轻微显现，治疗都应随证候不同而分别施治。
【注】百合花有一百片花瓣连在一个花蒂上，就像人的百脉同出一宗，命名和治疗方法都取这个含义。所谓百合病，是指人的百脉同出一源，全都受到邪气影响而发病。说“百脉”即指“一脉”，犹如说“百体一体”，这是从全身整体来说的。全身的脉络，分开来说叫“百”，合起来说叫“一”，所以叫“百脉一宗”。如果说这是百合花的病，那其实是总称脉病。这里的“脉”指的是十二正经和三百六十五络脉。在伤寒大病之后，余热未清，百脉尚未调和，或者平时思虑过多、情志不畅，或者偶然受到惊吓疑虑，突然遭遇不良境遇，因而导致形神俱病，所以出现上述症状。百脉周流于全身，脉有病则身有病，所以身体外形看似正常或不正常，想躺下睡不着，想走动走不动。百脉通于心，脉有病则心受累，所以常常沉默不语。感觉像冷其实不冷，感觉像热其实不热，类似外感病却不是外感病。想要吃东西却又吃不下，有时觉得美味，有时闻到食物气味就不想吃，类似里证疾病却不是里证疾病。至于脉数、口苦、小便红赤，这是郁结之热，虽然侵入体内但热势还不严重。在刚发病时，医生不认识此病，误认为是表证或里证，用发汗或攻下的药物治疗，所以导致剧烈呕吐和腹泻。虽然剧烈吐泻，但没有变成其他逆证。好像有神灵作祟，身体外形依然像之前那样平和，但脉象比以前更微数，所以病情不能迅速进展，不觉加重，但也难以快速痊愈。试着以缓慢痊愈的期限来大致说明，重的不超过六十天，轻的不超过二十天，介于轻重之间的，不超过四十天即可痊愈。然而痊愈必须通过每次排尿时是否头痛、是否怕风、是否感觉畅快来辨别，因为经脉中的邪气，没有不是从太阳经而愈的。头痛怕风，是太阳经的症状；排尿时感觉畅快，是膀胱腑的症状。所谓的“未病而预见”，是指百合病等证候。所谓“未病”，是指未患伤寒病，犹言在未患伤寒之前，就预先出现了百合病想食又不食的等症状。所谓“病四五日而出”，是指已经患了伤寒病之后，才开始出现百合病的证候。预先出现的，是先有情志不畅，偶然受到惊吓疑虑而招致发病；或者病了二十天或一个月才见的，是因为伤寒病后才出现的。所以说：各随证候施治。
【集注】李氏说：《活人书》说：伤寒大病后，气血未能平复，变成了百合病。现在从“百脉一宗，悉致其病”来看，应当是心和肺两经的病。如行卧、饮食、寒热等症状，都有难以形容的状态，在《内经》中解谵病与之相似。篇中提到“如有神灵者”，难道不是因为心藏神、肺藏魄，人生之神魄失守，所以才有恍惚错乱的情感吗？又说：《内经》说：凡是受寒邪侵袭，就会变成热病。热气遗留不去，潜伏在脉中，就会昏昏默默，所有的行卧、饮食、寒热，都有一种虚烦不耐受的现象。
沈明宗说：如果邪气淫溢于胸中连及上脘，就会想进食却又吃不下；邪气走窜到肝肾，所以常常沉默；流入脾胃，所以想躺下睡不着，想走动走不动；邪气不在胃，所以饮食有时觉得美味；邪气壅滞抑制胃气，所以闻到食物气味；邪气流于胆则口苦；流于膀胱则小便红赤。以上诸证，并非一齐同时出现，都是移易变动而出现的。
百合病，表现为阴证的，用阳法来救治；表现为阳证的，用阴法来救治。见到阳证而攻伐阴分，又再发其汗，这是逆治；见到阴证而攻伐阳分，又再攻下，这也是逆治。
【注】这是承接上一条来阐明治疗方法。百合病这一种病，难以区分阴阳表里，所以用百合汤等方剂主治。如果病见于阴分，用温养阳的方法救治；见于阳分，用凉养阴的方法救治。即下文所说的见阳证而攻阴，或在攻阴之后，表证仍未解除，又再发其汗的，这是逆治。见阴证而攻阳，或在攻阳之后，里证仍未解除，又再攻下的，这也是逆治。
【集注】徐彬说：《内经》所谓用阴和阳，用阳和阴，就是这个意思。所以各种治法，都以百合为主。至于病见于阳，加一两味药来调和其阴；病见于阴，加一两味药来调和其阳。
沈明宗说：这是治疗百合病的关键法则。微邪潜伏在营卫之间，流行而病及表里，应当分阴阳来实施救治。
百合病，未经过吐、下、发汗治疗，病状如初的，用百合地黄汤主治。
【注】百合病这一种病，未经过吐、下、发汗治疗，病状如初的，是说其病迁延日久，而不增减，形证如同第一章初起时一样。用百合地黄汤，通达百脉并凉润百脉。中病（见效）后不要继续服用，恐怕过量服用生地黄，会导致大便常呈漆黑色。
百合地黄汤方
百合（掰开，七枚） 生地黄汁（一升）
以上药材用水清洗百合，浸泡一夜，当出现白沫时，倒掉水，再用泉水二升，煎取一升，去渣，加入地黄汁，煎取一升五合，分两次温服。中病后不要继续服用，大便常呈漆黑色。
【集解】程林说：百合花叶都朝向四方，所以能通达上下四旁，其根也是由众多花瓣合成，所以名叫百合，用来医治百合病，是有道理的。
高世栻说：百合色白味甘，是手太阴肺经的补剂。它的花白天开放晚上闭合，如同气白天行于阳分，晚上行于阴分，主管开阖，以运行营卫、调和阴阳。
【注】百合病，感觉像冷其实不冷，感觉像热其实不热，本来不发热，现在变发热了，可知其内热存在，所以用百合滑石散主治，使其轻微通利，热从小便除去。
百合滑石散方
百合（炙，一两） 滑石（三两）
以上药材研为散剂，用米汤送服一方寸匕，每日三次。当出现轻微通利时，停止服用，热邪即可消除。
【集解】高世栻说：滑石又名液石，又名符劳石，是石头中的脂膏，主治身体发热、泄泻、通利小便。
【注】百合病本来不渴，现在一个月未愈，变成口渴，外用百合汤浸洗身体，通达体表泻除热邪；内服煮饼（面条），不要用盐豉调味，以免引起饮水增多，而口渴自然停止。
百合洗方
百合（一升）
以上药材用水一斗，浸泡一夜，用来洗身；洗完之后，吃煮饼，不要用盐豉。
【注】给予百合洗身而口渴不愈的，是内热盛而津液枯竭。栝楼根苦寒，生津止渴；牡蛎咸寒，引热下行。
栝楼牡蛎散方
栝楼根 牡蛎（煅，等分）
以上药材研为细末，用米汤送服一方寸匕，每日三次。
【注】百合病不应发汗而发汗，病不解，则导致燥热。用百合知母汤主治，是为了清热润燥。
百合知母汤方
百合（掰开，七枚） 知母（切片，三两）
以上先用水清洗百合，浸泡一夜，当出现白沫时，倒掉水，再用泉水二升，煎取一升，去渣；另外用泉水二升，煎知母，取一升，去渣，然后混合，再煎取一升五合，分两次温服。
【注】百合病不应攻下而攻下，病不解，则损伤中气，用滑石代赭汤清热镇逆。
滑石代赭汤方
百合（掰开，七枚） 滑石（打碎，绵布包裹，三两） 代赭石（打碎，绵布包裹，如弹丸大一枚）
以上先用水清洗百合，浸泡一夜，当出现白沫时，倒掉水，再用泉水二升，煎取一升，去渣；另外用泉水二升，煎滑石、代赭，取一升，去渣，然后混合，再重煎取一升五合，分次温服。
【注】百合病不应催吐而催吐，病不解，则导致中气虚弱，用百合鸡子汤清热补虚。
百合鸡子汤方
百合（掰开，七枚） 鸡蛋黄（一枚）
以上先用水清洗百合，浸泡一夜，当出现白沫时，倒掉水，再用泉水二升，煎取一升，去渣，加入鸡蛋黄，搅拌均匀，再煎五分，温服。
狐惑病，症状像伤寒，沉默想睡觉，眼睛闭不上，躺下坐起都不安宁。腐蚀咽喉叫做惑，腐蚀前后阴叫做狐。不想吃东西，厌恶闻到食物气味，面色一会儿红、一会儿黑、一会儿白。腐蚀在上部（咽喉）则声音嘶哑，用甘草泻心汤主治。腐蚀在下部（前阴）则咽干，用苦参汤清洗。腐蚀在肛门者，用雄黄熏蒸。
【注】狐惑，是牙疳、下疳等疮疡的古名，近代只称为疳，下疳即狐，腐蚀烂坏肛门和前阴；牙疳即惑，腐蚀咽喉腐烂牙龈，脱落牙齿穿腮破唇。多因伤寒病后，余毒与湿邪为害，或者在出斑疹之后，或者在癖疾下利之后，其危害也是一样的。状如伤寒，指发热恶寒。默默欲眠，目不得闭，是说病或在阴分，或在阳分，所以躺下坐起都不安宁。此病有虫，虫闻食物气味而动，动则令人烦心，所以不想吃东西，厌恶闻到食物气味。面目乍赤、乍黑、乍白，也是因为虫动扰乱胃中，胃主面部，所以面色不定。惑腐蚀在上部的咽喉，所以先声音嘶哑，毒在喉。狐腐蚀在下部的前阴，所以先咽干，毒在前阴。外治法，苦参汤、雄黄散解毒杀虫，尚属合理。内服甘草泻心汤，可能是传写错误，姑且保留。
【注】程林说：《灵枢经》说：虫动则令人心烦，所以有躺下坐起不安等症状。
李氏说：喉、肛与前阴，都是关窍相通、津液滋润之处，所以虫往往腐蚀这些地方。
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）
以上七味药，用水一斗，煮取六升，去渣再煎，温服一升，每日三次。
雄黄熏方
雄黄
以上一味药研为末，用两片筒瓦合在一起烧，对着肛门熏蒸。
《脉经》说：病人有的从呼吸，上部腐蚀咽喉；有的从下焦，腐蚀肛门和前阴。腐蚀上部为惑，腐蚀下部为狐。
病人脉数，无身热，轻微心烦，沉默只想睡觉，出汗。刚得病三四天，眼睛红得像斑鸠的眼睛，七八天后，眼四周发黑，如果能吃东西的，说明脓已成，用赤小豆当归散主治。
【注】病人脉数，是说患狐惑病的人脉数。数脉主疮主热，现在外部没有身热，而内部有疮热，疮热在于阴分，所以沉默只想睡觉。热在于阳分，所以轻微心烦出汗。然而刚得病三四天，眼睛红得像斑鸠眼睛的，是热蕴于血，所以络脉红。七八天后眼四周皆黑的，是热瘀血腐，所以络脉黑。如果不能吃东西，毒邪还潜伏在里；如果已经能吃，毒邪已化成脓。所以用赤小豆排痈肿，当归调治疡血，米浆调和胃气。
【集注】李氏说：经文说：脉数不止，而热不解，则生恶疮。现在脓成在哪里？大率在喉与阴肛。大概积热生虫，也是积热成脓，这也是恶疮的一类。
赤小豆当归散方
赤小豆（浸泡令芽出，晒干，三升） 当归
以上两味药，捣为散剂，用浆水送服一方寸匕，每日三次。
阳毒病，症状是面赤斑斑如锦纹，咽喉痛，唾脓血。五天可治，七天不可治。用升麻鳖甲汤主治。
阴毒病，症状是面目青，身痛如被杖击，咽喉痛。五天可治，七天不可治。用升麻鳖甲汤去雄黄蜀椒主治。
【注】阴阳平衡，是正气；阴阳偏颇，是邪气；阴阳变异，是异气。正气，即四时令平之气，中人致病，缓慢而浅；邪气，即四时不和之气，中人致病，迅速而危险；异气，是非常灾疠之气，中人致病，暴烈而死。所以过了五天不治，是因为五脏相搏都受邪气，此气适中人的阳分，则为阳毒；适中人的阴分，则为阴毒。这不是后人所说的阴寒极、阳热极的阴毒、阳毒。看其所主的方剂，不过是升麻、甘草、当归、鳖甲、蜀椒、雄黄，而并不用大寒大热的药，就可以知道仲景所论阴毒阳毒，不是指阴寒极、阳热极。这两个证候就是当今世俗所称的痧证。阳毒终属阳邪，所以见面赤斑斑如锦纹，唾脓血的热证；阴毒终属阴邪，所以见面目青，身痛如被杖击的寒证。两个证候都咽喉痛，是因为此证邪从口鼻而下入咽喉，所以痛。
【按】由此推断，凡邪气经过的地方无不痛。所以中此气的人，不止咽喉痛、身痛，甚至有心中腹绞痛，大满大胀，全身络脉青紫暴出，手足指甲色如靛叶，口噤牙紧，心中忙乱，死在旦夕。如果说必定从皮毛而入，没有发病如此迅速的，这必定是从口鼻而下入咽喉无疑。况且阴毒反去雄黄、蜀椒，必然是传写错误。所以治疗此证，不必问其阴阳，只要刺其尺泽、委中、手中十指脉络暴出之处出血，轻则用刮痧法，随即服紫金锭，或吐、或下、或汗出而愈者不少。若吐泻不止，厥逆冷汗，脉微欲绝，用炮附子、炮川乌、吴茱萸、丁香、生干姜、甘草，虚者加人参救之，也多能得生。
【集注】王履说：仲景虽有阴毒之名，其叙述证候不过面目青，身痛咽痛而已，并不言阴寒极盛之说。其升麻鳖甲汤，并不用大热药，是知道仲景所论阴毒者，不是阴寒之病，乃是感天地恶毒异气入于阴经，故曰阴毒耳！后人谓阴寒极盛之证，称为阴毒，引用仲景所叙面目青，身痛如被杖，咽喉痛数语，却用附子散、止阳散等药。窃谓阴寒极盛之证，固可名为阴毒，然终非仲景所以立名之本意。后人所叙阴毒，与仲景所叙阴毒，自是两般，岂可混论。盖后人所叙阴毒，只是内伤冷物，或暴寒所中，或过服寒凉药，或内外俱伤于寒而成耳！非天地恶毒异气所中者也。
李氏说：赵献可说：此阴阳二毒，是感天地疫疠非常之气，沿家传染，所谓时疫证也。观方内“老小再服”可见。
升麻鳖甲汤方
升麻（二两） 当归（一两） 蜀椒（炒，去汗，二两） 甘草（二两） 鳖甲（炙，手掌大一片） 雄黄（研，半两）
以上六味药，用水四升，煮取一升，顿服；老人小孩再服，取汗。
[Original Text]
Commentary states: Baihe disease (Lily Disease) occurs because all vessels share a single origin, and all are affected by pathogenic factors. Patients desire to eat but cannot; they are often silent; they desire to lie down but cannot sleep; they desire to walk but cannot move; when desiring food, sometimes it tastes good, sometimes they dislike the smell of food and refuse to eat; they feel cold but are not actually cold, feel hot but are not actually hot; their mouth is bitter, urine is red and scanty; various medicines fail to cure it, and taking medicine causes severe vomiting and diarrhea; symptoms seem as if possessed by spirits, body shape appears normal, pulse is slightly rapid. If headache occurs during urination, recovery takes sixty days; if no headache during urination but feeling chilly (aversion to wind), recovery takes forty days; if urination feels smooth but with dizziness, recovery takes twenty days. This disease may present symptoms before illness begins, or appear four to five days after illness onset, or manifest mildly after twenty days or one month. Treatment should follow the specific syndrome differentiation.
[Annotation] The lily flower has one hundred petals connected to a single stamen, analogous to the human body's hundred vessels sharing a single origin. Its naming and treatment derive from this meaning. Baihe disease refers to the condition where the hundred vessels, sharing one source, are all diseased. "Hundred vessels" implies "one vessel," similar to saying "hundred bodies form one unity," referring to the whole body. The vessels of the whole body are called "hundred" when analyzed separately, and "one" when considered collectively, hence "hundred vessels, one origin." If interpreted as a disease of the lily plant, it actually refers to general vessel pathology. Here, "vessels" refer to the twelve regular meridians and three hundred and sixty-five collaterals. After a severe Shanghan (Cold Damage) illness, residual heat remains unresolved, and the hundred vessels are not yet harmonized. Alternatively, chronic overthinking and emotional stagnation, or sudden fright and doubt due to unexpected circumstances, can cause both physical and spiritual disharmony, leading to these manifestations. Since the hundred vessels circulate throughout the body, vessel pathology leads to bodily symptoms; thus, the body appears normal or abnormal, with inability to rest or move freely. The hundred vessels connect to the Heart; vessel pathology affects the Heart, causing silence. Feeling cold without actual coldness, or hot without actual heat, resembles exterior syndromes but is not exterior invasion. Desire to eat but inability to do so, or fluctuating appetite and aversion to food odors, resembles interior syndromes but is not interior disease. Pulse rapidity, bitter taste, and red urine indicate stagnant heat that has invaded the interior but is not yet severe. Initially, physicians unfamiliar with this disease may misdiagnose it as an exterior or interior syndrome and apply sweating or purging methods, resulting in severe vomiting and diarrhea. Despite this, no adverse transformations occur. It seems as if possessed by spirits, yet the body remains physically calm, though the pulse becomes slightly more rapid than before. Thus, the condition does not progress rapidly nor resolve quickly. Regarding the duration of recovery: severe cases take up to sixty days, mild cases up to twenty days, and intermediate cases up to forty days. Recovery is determined by whether headache, aversion to wind, or smoothness occurs during urination, because pathogenic factors in the meridians typically resolve via the Taiyang (Greater Yang) channel. Headache and aversion to wind are signs of the meridian; smooth urination is a sign of the Bladder fu-organ. "Symptoms appearing before illness" refers to Baihe disease symptoms appearing before the onset of Shanghan. "Illness appearing after four to five days" means Baihe symptoms emerge after Shanghan has begun. Early appearance is due to prior emotional stagnation or fright; late appearance is due to post-Shanghan weakness. Therefore, treatment must be tailored to the specific syndrome.
[Collected Commentaries] Li states: The *Huoren Shu* (Book of Living People) says that after severe Shanghan, if Qi and Blood fail to recover balance, Baihe disease develops. Based on "hundred vessels, one origin," this is likely a disease of the Heart and Lung meridians. Symptoms such as restlessness, dietary changes, and sensations of cold/heat are indescribable, resembling the "Jie Dao" (delirious speech) disease in the *Neijing*. The mention of "as if possessed by spirits" suggests that since the Heart houses the Shen (Spirit) and the Lungs house the Po (Ethereal Soul), loss of control over Shen and Po leads to confusion and delusion. Furthermore, the *Neijing* states that cold invasion transforms into heat. Residual heat lingering in the vessels causes lethargy and a sense of vexatious intolerance to movement, eating, and temperature changes.
Shen Mingzong states: If pathogenic factors overflow the chest and affect the upper epigastrium, appetite fluctuates. If they move to the Liver and Kidneys, silence ensues. If they flow into the Spleen and Stomach, restlessness occurs. If the pathogen is not in the Stomach, appetite may vary. If it obstructs Stomach Qi, there is aversion to food odors. Flow into the Gallbladder causes bitter taste; flow into the Bladder causes red urine. These symptoms do not appear simultaneously but shift and change.
In Baihe disease, if Yin manifestations predominate, treat with Yang methods; if Yang manifestations predominate, treat with Yin methods. Treating Yang manifestations by attacking Yin and then inducing sweat is incorrect (Ni). Treating Yin manifestations by attacking Yang and then purging is also incorrect.
[Annotation] This follows the previous section to clarify treatment. Baihe disease is difficult to classify strictly by Yin/Yang or Exterior/Interior, so decoctions containing Baihe (Lily Bulb) are used. If the disease manifests in Yin, warm and nourish Yang. If it manifests in Yang, cool and nourish Yin. As stated later, treating Yang symptoms by attacking Yin and then sweating is erroneous. Similarly, treating Yin symptoms by attacking Yang and then purging is erroneous.
[Collected Commentaries] Xu Bin states: This aligns with the *Neijing* principle of using Yin to harmonize Yang and Yang to harmonize Yin. Treatments primarily use Baihe. For Yang-predominant cases, add herbs to harmonize Yin; for Yin-predominant cases, add herbs to harmonize Yang.
Li states: Baihe disease has many variations; the few formulas provided cannot cover all cases.
Shen Mingzong states: This is the essential method for treating Baihe disease. Mild pathogens lurking in Ying (Nutritive) and Wei (Defensive) levels spread to affect both exterior and interior; treatment must distinguish Yin and Yang.
For Baihe disease that has not been treated with emesis, purgation, or sweating, and symptoms remain unchanged, use Baihe Dihuang Tang (Lily Bulb and Rehmannia Decoction).
[Annotation] This indicates that the disease has persisted for a long time without worsening or improving. Baihe Dihuang Tang unblocks and cools the hundred vessels. Stop medication once effective; excessive Sheng Dihuang (Fresh Rehmannia Root) may cause black stools.
Baihe Dihuang Tang Formula
Baihe (Lily Bulb, separated, 7 bulbs)
Sheng Dihuang Zhi (Fresh Rehmanniae Radix Juice, 1 sheng)
Wash the Baihe, soak overnight until white foam appears. Discard water. Add 2 sheng of Spring Water, decoct to 1 sheng. Strain. Add Dihuang juice. Decoct to 1.5 sheng. Divide into two warm doses. Discontinue if cured. Black stools are expected.
[Collected Explanations] Cheng Lin states: Lily flowers and leaves face all directions, allowing it to unblock upper/lower and left/right pathways. Its root consists of multiple petals, hence the name "Baihe" (Hundred Petals), suitable for treating Baihe disease.
Gao Shishi states: Baihe is white and sweet, tonifying the Hand-Taiyin (Lung) meridian. Its flowers open by day and close by night, mirroring Qi moving through Yang by day and Yin by night, regulating opening/closing to harmonize Ying/Wei and Yin/Yang.
If Baihe disease develops fever, use Baihe Huashi San (Lily Bulb and Talcum Powder).
[Annotation] Baihe disease typically lacks true fever. New-onset fever indicates internal heat. Baihe Huashi San promotes mild diuresis to eliminate heat via urine.
Baihe Huashi San Formula
Baihe (Lily Bulb, roasted, 1 liang)
Huashi (Talcum, 3 liang)
Grind into powder. Take 1 cunbi (square-inch spoonful) with grain water, three times daily. Stop when mild diarrhea occurs; heat will resolve.
[Collected Explanations] Gao Shishi states: Huashi (Talcum), also known as Yeshi, is the "fat" of stone. It treats fever, diarrhea, and promotes urination.
If Baihe disease persists for a month and develops thirst, use Baihe Xi Fang (Lily Wash Formula).
[Annotation] Baihe disease usually does not involve thirst. Persistent thirst after a month indicates external heat retention. Washing the body with Baihe decoction clears surface heat. Eat boiled wheat noodles (Zhu Bing) without salted black beans (Yan Chi) to avoid stimulating thirst. Thirst will subside.
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 without salted beans.
If thirst persists after washing, use the following formula.
[Annotation] Persistent thirst after washing indicates severe internal heat and fluid exhaustion. Gualou Gen (Trichosanthes Root) is bitter and cold, generating fluids and stopping thirst. Muli (Oyster Shell) is salty and cold, guiding heat downward.
Gualou Muli San Formula
Gualou Gen (Trichosanthes Radix)
Muli (Oyster Shell, calcined, equal parts)
Grind into fine powder. Take 1 cunbi with grain water, three times daily.
If Baihe disease was incorrectly treated with sweating, use Baihe Zhimu Tang (Lily Bulb and Anemarrhena Decoction).
[Annotation] Inappropriate sweating causes dryness. Baihe Zhimu Tang clears heat and moistens dryness.
Baihe Zhimu Tang Formula
Baihe (Lily Bulb, separated, 7 bulbs)
Zhimu (Anemarrhenae Rhizoma, sliced, 3 liang)
Wash and soak Baihe overnight. Discard water. Decoct in 2 sheng Spring Water to 1 sheng. Strain. Separately decoct Zhimu in 2 sheng Spring Water to 1 sheng. Strain. Combine and decoct to 1.5 sheng. Divide into two warm doses.
If Baihe disease was incorrectly treated with purgation, use Huashi Daizhe Tang (Talcum and Hematite Decoction).
[Annotation] Inappropriate purgation damages Middle Jiao Qi. Huashi Daizhe Tang clears heat and settles rebellion.
Huashi Daizhe Tang Formula
Baihe (Lily Bulb, separated, 7 bulbs)
Huashi (Talcum, crushed, wrapped in silk, 3 liang)
Daizheshi (Hematitum, crushed, wrapped in silk, size of a bullet, 1 piece)
Wash and soak Baihe overnight. Discard water. Decoct in 2 sheng Spring Water to 1 sheng. Strain. Separately decoct Huashi and Daizheshi in 2 sheng Spring Water to 1 sheng. Strain. Combine and re-decoct to 1.5 sheng. Take warm.
If Baihe disease was incorrectly treated with emesis, use the following formula.
[Annotation] Inappropriate emesis causes Middle Jiao deficiency. Baihe Jizi Tang clears heat and tonifies deficiency.
Baihe Jizi Tang Formula
Baihe (Lily Bulb, separated, 7 bulbs)
Jizi Huang (Egg Yolk, 1 unit)
Wash and soak Baihe overnight. Discard water. Decoct in 2 sheng Spring Water to 1 sheng. Strain. Add Egg Yolk, mix well, and simmer briefly. Take warm.
Huhe Disease presents like Shanghan: silence, desire to sleep but eyes remain open, restlessness lying down or sitting up. Erosion of the throat is called "Huo" (Confusion); erosion of the genitalia/anus is called "Hu" (Fox). Loss of appetite, aversion to food odors, and fluctuating facial color (red, black, white) occur. Erosion in the upper part (throat) causes hoarseness; treat with Gancao Xiexin Tang (Licorice Decoction for Draining the Epigastrium). Erosion in the lower part (genitalia) causes dry throat; wash with Kushen Tang (Sophora Decoction). Erosion of the anus is treated with Xionghuang Fumigation (Realgar Fumigation).
[Annotation] Huhe refers to ancient names for gum disease (Ya Gan) and chancres (Xia Gan). Xia Gan (Hu) erodes the anus and genitals; Ya Gan (Huo) erodes the throat, gums, teeth, cheeks, and lips. It often arises from residual toxins and dampness after Shanghan, or following rash diseases or dysentery. "Like Shanghan" means fever and chills. Restlessness indicates pathogen affecting Yin or Yang channels. Parasites move upon smelling food, causing vexation and anorexia. Fluctuating facial colors result from parasites disturbing the Stomach (which reflects on the face). Hoarseness indicates toxin in the throat; dry throat indicates toxin in the genitals. External treatments (Kushen Tang, Realgar) for detoxification and parasite removal are reasonable. Internal use of Gancao Xiexin Tang may be a transcription error, but is retained here.
Cheng Lin states: The *Ling Shu* says parasites cause heart vexation, leading to restlessness.
Li states: The throat, anus, and genitals are orifices rich in fluids, making them susceptible to parasitic erosion.
Gancao Xiexin Tang Formula
Gancao (Licorice Radix et Rhizoma, 4 liang)
Huangqin (Scutellariae Radix), Renshen (Ginseng Radix), Ganjiang (Zingiberis Rhizoma) (each 3 liang)
Huanglian (Coptidis Rhizoma, 1 liang)
Dazao (Jujubae Fructus, 12 pieces)
Banxia (Pinelliae Rhizoma, 0.5 sheng)
Decoct seven ingredients in 1 dou of water to 6 sheng. Strain and re-decoct. Take 1 sheng warm, three times daily.
Kushen Tang Formula
Kushen (Sophorae Flavescentis Radix, 1 sheng)
Decoct in 1 dou of water to 7 sheng. Use for fumigation and washing, three times daily.
Xionghuang Fumigation Formula
Xionghuang (Realgar)
Grind into powder. Place between two tile halves and burn. Fumigate the anus.
The *Mai Jing* (Pulse Classic) states: Pathogens may erode the throat from respiration (upper) or the anus/genitals from the Lower Jiao (lower). Upper erosion is Huo; lower erosion is Hu.
For Huhe disease, Zhuling San (Polyporus Powder) is indicated.
If the patient has a rapid pulse, no fever, slight vexation, silence, desire to sleep, and sweating: On days 3-4, eyes turn red like a turtledove's; by days 7-8, the eye corners turn black. If the patient can eat, pus has formed. Treat with Chixiaodou Danggui San (Adzuki Bean and Angelica Powder).
[Annotation] Rapid pulse indicates heat and sores. Lack of external fever but internal sore-heat in Yin causes lethargy. Heat in Yang causes slight vexation and sweating. Red eyes (days 3-4) indicate heat accumulating in blood. Black eye corners (days 7-8) indicate blood stasis and rotting. Inability to eat means toxin is latent; ability to eat means toxin has transformed into pus. Chixiaodou drains swelling; Danggui regulates blood; rice gruel harmonizes Stomach Qi.
Li states: The classic says persistent rapid pulse with unresolved heat generates malignant sores. Pus forms in the throat or genitals. Accumulated heat generates parasites and pus, classifying this as a malignant sore.
Chixiaodou Danggui San Formula
Chixiaodou (Adzuki Bean, soaked until sprouted, dried, 3 sheng)
Danggui (Angelicae Sinensis Radix)
Grind into powder. Take 1 cunbi with Jiangshui (fermented grain water), three times daily.
Yangdu (Yang Toxin) disease presents with red facial patches like brocade, sore throat, and expectoration of pus and blood. Treatable within five days; untreatable after seven days. Use Shengma Biejia Tang ( Cimicifugae and Turtle Shell Decoction).
Yindu (Yin Toxin) disease presents with blue-green complexion, body pain like being beaten, and sore throat. Treatable within five days; untreatable after seven days. Use Shengma Biejia Tang minus Xionghuang and Shujiao.
[Annotation] Balance of Yin and Yang is Zheng Qi (Upright Qi); imbalance is Xie Qi (Pathogenic Qi); variation is Yi Qi (Abnormal Qi). Zheng Qi causes slow, mild illness. Xie Qi causes fast, dangerous illness. Yi Qi (plague qi) causes sudden death. Beyond five days, organs are mutually affected. Yi Qi entering Yang causes Yangdu; entering Yin causes Yindu. This is not the extreme cold/heat described by later authors. The formulas contain only mild herbs (Shengma, Gancao, Danggui, Biejia, Shujiao, Xionghuang), not extreme cold/heat drugs. These correspond to modern "Sha Syndrome" (Plague/Toxin). Yangdu is Yang pathogen (red face, pus/blood sputum). Yindu is Yin pathogen (blue face, body pain). Both have sore throats because pathogens enter via mouth/nose to the throat.
[Note] By inference, pain occurs wherever pathogens travel. Symptoms include abdominal cramping, distension, purple veins, dark nails, locked jaw, and mental confusion. Pathogens enter via mouth/nose, not skin. Removing Xionghuang and Shujiao from Yindu formula is likely an error. Treatment involves bleeding acupoints (Quchi, Weizhong, ten fingers), scraping, or administering Zijin Ding. For collapse (cold sweat, faint pulse), use Pao Fuzi, Pao Chuanwu, Wuzhuyu, Dingxiang, Sheng Jiang, Gancao, plus Renshen for deficiency.
Wang Lü states: Zhang Zhongjing’s Yindu describes blue face, body pain, and sore throat, not extreme cold. The formula lacks hot herbs. Thus, Yindu is infection by toxic environmental Qi entering Yin meridians, not internal cold damage from diet or cold exposure as later authors claimed.
Li states: Zhao Xianke notes this is a contagious plague caused by abnormal environmental Qi. The instruction "elderly and children take another dose" supports this.
Shengma Biejia Tang Formula
Shengma (Cimicifugae Rhizoma, 2 liang)
Danggui (Angelicae Sinensis Radix, 1 liang)
Shujiao (Zanthoxyli Pericarpium, stir-fried, 2 liang)
Gancao (Licorice Radix et Rhizoma, 2 liang)
Biejia (Testudinis Carapax et Plastrum, roasted, palm-sized piece)
Xionghuang (Realgar, powdered, 0.5 liang)
Decoct six ingredients in 4 sheng of water to 1 sheng. Take at once. Elderly and children take a second dose to induce sweating.