论曰、百合病者。（分为）百脉（合为）一宗。（无经络可别。）悉致其病也。（
第见其证）意欲食。（而）复不能食。（口欲言。而又不言而）常默默。欲卧（而又
躁而）不能卧。欲行（而又懒而）不能行。欲饮食。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。（以上诸证。全是恍惚去来不可为凭之象。惟凭之于脉与溺。确知其为热。）其脉微
数。（数则主热也。溺出膀胱。膀胱为太阳之腑。其脉上至巅顶。溺时头痛者。太阳乍
虚。而热气乘之也。今）每溺时（而）头（每）痛者。（乃热气之甚者。必）六十
日（之久。月再周而阴气复。阴气复而阳邪平。然后）乃愈。若溺时头不痛。淅淅然者。
（则病稍浅矣。大约）四十日（可）愈。若溺（时）快然。但头眩者。（则更浅矣。
不过）二十日（可）愈。其（百合）证（多于伤寒大病后见之。）或未病而预见。（热气先
动也。）或病四五日而出。或病二十日。或一月后见者。（遗热不去也。）各随证治之。
此详言百合病之证脉也。此证多见于伤寒大病前后。或为汗吐下失法而变。或平素
多思不断。情志不遂。或偶触惊疑。猝临异遇。以致行住坐卧饮食等。皆若不能自主之
势。此病最多。而医者不识耳。
程云来云。头者诸阳之首。溺则阳气下施。头必为之摇动。曷不以老人小儿观之。
小儿元气未足。脑髓不满。溺将出。头为之摇。此阳气不充故耳。老人血气衰。肌肉涩。
脑髓清。故溺出时不能射远。将完必湿衣。而头亦为之动者。此阳气已衰。不能施射
故耳。由此观之。溺出头之痛与不痛。可以观邪之浅与深矣。故百合病溺出头痛者。言
邪舍深而阳气衰也。内衰则入于脏腑。上则牵连脑髓。是以六十日愈。若
溺出头不痛淅淅然者。淅淅如水洒淅皮毛。外舍于皮肤肌肉。尚未入脏腑之内。但阳气
微耳。是以四十日愈。若溺出快然。但头眩者。言邪犹浅。快则阴阳和畅。营卫通利。
脏腑不受邪。外不淅淅然。则阳气尚是完固。但头眩者。是邪在阳分。阳实则不为邪所
牵。故头不疼而眩。是以二十日愈也。其说亦通。
百合病。（见于）发汗（之）后者。（以其不应汗而汗之。以致津液衰少者。以）百合知母汤主之。
百合知母汤方
百合（七枚） 知母（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。（见于）下之后者。（以其不应下而下之。以致热入于下也。以）百合
滑石代赭汤主之。
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。（见于）吐之后者。（以其不应吐而吐之。以致内伤脏阴也。以）百合鸡
子汤主之。
百合鸡子汤方
百合（七枚擘） 鸡子黄（一枚）
上先煎百合如前法了。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。（即所谓未病预见是也。此因热气先动。
以）百合地黄汤主之。（然亦有太阳病久久不愈。始终在太阳经者。亦用此汤。）
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。分温再服。中病勿更服。大盒饭
如漆。
百合病。一月不解。变成渴者。（热壅皮毛。皮毛为肺之合也。以）百合洗方主之。
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。（洗后而）渴不瘥者。（内热盛而津伤也。以）栝蒌牡蛎散主之。
栝蒌牡蛎散方
栝蒌根 牡蛎（等分）
上为细末。饮服方寸匕。日三服。
百合病。（如寒无寒。如热无热。原病无热。今）变发热者。（其内热可知也。以
）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。
百合病见于阴者。以阳法救之。（即内经用阳和阴之道也。）见于阳者。以阴法救
之。（即内经用阴和阳之道也。若）见阳（之病而）攻（其）阴。（则并伤其阴矣。乃
）复发其汗。（是重伤其阳也。）此为逆。见阴（之病）攻（其）阳。（则并伤其阳矣。
）乃复下之。（是重竭其阴也。）此亦为逆。
程扶生云、前治皆用阴和阳法也。此复补以用阳和阴。故仲景用思。最为精密。
狐惑之为病。（虫病也。）状如伤寒。默默欲眠。目不得闭。卧起不安。（何其如此
之躁。实因虫扰之为害也。虫）蚀于喉为惑。蚀于阴为狐。（而口）不欲饮食。恶闻食
臭。（虫闻食臭而动。动则令烦心有如此者。而且虫大动则交乱于胃中。胃主面目。）其
面目（之）乍赤乍黑乍白。（亦随虫之聚散而变易。）蚀于上部。则（喉伤而）声（自
）嗄。（以）甘草泻心汤主之。蚀于下部。则（邪伤厥阴。厥阴为阴之尽。其病自下而
冲上。故）咽干。（以）苦参汤洗之。蚀于肛者。（以）雄黄熏之。（熏洗二法。皆就
其近治之也。）
此言狐惑之病证治法也。伤寒论乌梅丸。亦可消息用之。
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。
尤在泾云。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。又曰、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。
赤小豆当归散方
赤小豆（三升浸令芽出曝干） 当归（十分）
上二味。杵为散。浆水服方寸匕。日三服。
（阴阳二毒。是感非常灾疠之气。从口鼻而下入咽喉。致死甚速。试以阳毒言之。）
阳毒之为病。（为异气中人之阳也。）面赤斑斑如锦纹。咽喉痛。吐脓血。五日（经气
未遍。故
尚）可（救）治。（五日之外。五脏相传俱受邪。至）七日（阴阳经气已周而再行。则
）不可治。升麻鳖甲汤主之。
（异气适中人之阴。则为阴毒。）阴毒之为病。面目青。身痛如被杖。咽喉痛。五
日（经气未遍。尚）可（救）治。（至）七日（阴阳经气已周而再行。则）不可治。升
麻鳖甲汤去雄黄蜀椒主之。
此言阴阳二毒。治之不可姑缓也。仲师所论阴毒阳毒。言天地之疠气。中人之阳气
阴气。非阴寒极阳热极之谓也。盖天地灾疠之气。便为毒瓦斯。人之血气。昼行于阳。夜
行于阴。疠气之毒。值人身行阳之度而中人。则为阳毒。面者诸阳之会。阳毒上干阳位。
故面赤斑斑如锦纹。阳毒上迫胸膈。故吐脓血。以阳气法天。本乎天者亲上也。值人
身行阴之度而中人。则为阴毒。邪入于阴。则血凝泣。血不上荣于面。而面目青。血不
环周于一身。而身痛如被杖。以阴气主静。凝而不流之象也。夫阴阳二毒。皆从口鼻而下
入咽喉。咽喉者。阴阳之要会也。感非时之疠气。则真气出入之道路。不无妨碍。故二
毒俱有咽喉痛之证。要之异气中人。毒流最猛。五日经气未遍。尚可速治。若至七日。
阴阳经气已周。而作再经。则不可治矣。方用升麻鳖甲汤以解之。升麻。本经云、气味
甘平苦。微寒无毒。主解百毒。辟瘟疫邪气。入口皆吐出。中恶腹痛。时气毒疠。诸毒喉
痛口疮云云。君以升麻者。以能排气分。解百毒。能吐能升。俾邪从口鼻入者。仍从口
鼻而出。鳖甲气味酸平无毒。佐当归而入肝。肝藏血。血为邪气所凝。鳖甲禀坚刚之性。
当归具辛香之气。直入厥阴。而通气血。使邪毒之侵于营卫者。得此二味而并解。甘
草气味甘平。解百毒。甘能入脾。使中土健旺。逐邪以外出。妙在使以蜀椒辛温。雄黄
苦寒。禀纯阳之色。领诸药以解阳毒。其阴毒去雄黄蜀椒者。以邪毒不在阳分。不若当归鳖甲。直入阴分之为得也。
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。阴毒去雄黄蜀椒。 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。
原文说：百合病，是由于全身百脉汇聚于同一源头（指心肺），没有单独的经络可以区分，导致所有经脉都受到波及而发病。
主要症状表现为：想吃东西，却又吃不下；想说话，却又不想说，常常沉默不语；想躺下，却又烦躁不安，无法躺下；想走动，却又懒怠无力，无法走动；想要饮食，有时觉得美味，有时又完全不想吃，甚至闻到食物的气味就感到不适。感觉像冷又不冷，像热又不热。口苦，小便颜色深红。各种药物都无法治愈，服药后反而剧烈呕吐或腹泻，好像有神灵作祟一样。但身体外形看起来却是平和正常的。（以上这些症状，全是恍惚不定、来去无常、不可作为确凿依据的表现，只有依靠脉象和小便情况，才能确切知道这是热邪所致。）其脉象微数（数脉主热证）。小便由膀胱排出，膀胱是太阳经的腑，其经脉上行至头顶。如果每次小便时头痛，说明太阳经暂时虚弱，热气乘虚而入。现在如果每次小便时都头痛，说明热邪非常严重，必须经过六十天（月亮两次圆缺周期，阴气恢复，阴气恢复则阳热邪气平息，然后）才能痊愈。如果小便时不头痛，只是感觉怕冷（淅淅然），病情稍轻，大约四十天可以痊愈。如果小便时感觉畅快，只是头晕目眩，病情更轻，不过二十天就可以痊愈。这种百合病的症状，多见于伤寒大病之后。或者还没生病时就预先出现（因为热邪先动）。或者生病四五天就出现，或者生病二十天，或者一个月后才出现（因为余热未清）。应当根据具体症状进行治疗。这里详细论述了百合病的症状和脉象。此病多见于伤寒大病前后，或因发汗、催吐、泻下等治疗方法不当而变生，或因平素思虑过多、情志不畅，或偶然受到惊吓疑虑、突然遭遇意外事件，导致行走、站立、坐卧、饮食等，都呈现出不能自主的状态。这种病很常见，只是医生不认识罢了。
程云来说：头是诸阳经汇聚之首，小便时阳气向下施布，头部必然会摇动。为什么不以老人和小孩为例呢？小儿元气不足，脑髓未满，即将排尿时，头部会摇动，这是因为阳气不充盛的缘故。老人气血衰退，肌肉干枯涩滞，脑髓空虚，所以排尿时不能射得远，快结束时必定弄湿衣服，而且头部也会随之晃动，这是因为阳气已经衰败，不能推动排泄的缘故。由此看来，通过观察小便时头部是否疼痛，可以判断邪气的浅深。所以百合病小便时头痛，说明邪气深入且阳气衰弱。内部阳气衰弱则邪气进入脏腑，向上牵连脑髓，所以需要六十天才能痊愈。如果小便时头部不痛，只是感觉怕冷（淅淅然），淅淅像是水洒在皮毛上，说明邪气停留在皮肤肌肉之间，尚未进入脏腑内部，只是阳气微弱，所以需要四十天才能痊愈。如果小便时感觉畅快，只是头晕目眩，说明邪气尚浅，畅快意味着阴阳调和通畅，营卫运行流利，脏腑不受邪气侵扰，外部也不感觉怕冷，说明阳气尚且完固。只是头晕目眩，是因为邪气在阳分，阳气充实则不被邪气牵制，所以头部不疼而是眩晕，因此二十天就能痊愈。他的说法也是通顺合理的。
百合病，见于发汗之后的（因为本不应发汗而误用发汗法，导致津液亏损的，用百合知母汤主治）。
百合知母汤方
百合（七枚） 知母（三两）
先将百合用水清洗，浸泡一夜，当出现白色泡沫时，倒掉水，再用泉水二升，煎取一升，滤去药渣。另外用泉水二升，煎煮知母，取一升，滤去药渣。然后将两药汁混合，再煎取一升五合，分两次温服。
百合病，见于泻下之后的（因为本不应泻下而误用泻下法，导致热邪陷入下焦的，用百合滑石代赭汤主治）。
百合滑石代赭汤方
百合（七枚掰开） 滑石（三两，碎后用绵布包裹） 代赭石（如弹丸大一枚，碎后用绵布包裹）
先按前述方法煎煮百合。另外用泉水二升，煎煮滑石和代赭石，取一升，滤去药渣。然后将药汁混合，再次煎取一升五合，分两次温服。
百合病，见于催吐之后的（因为本不应催吐而误用催吐法，导致内伤脏阴的，用百合鸡子汤主治）。
百合鸡子汤方
百合（七枚掰开） 鸡蛋黄（一枚）
先按前述方法煎煮百合，加入鸡蛋黄搅匀，再煎至五分量，温服。
百合病，未经过催吐、泻下、发汗治疗，病情表现如初的（即所谓未病先见的情况。这是因为热邪先动，用百合地黄汤主治。（但也有太阳病久久不愈，始终在太阳经的，也用此汤。）
百合地黄汤方
百合（七枚掰开） 生地黄汁（一升）
先按前述方法煎煮百合，加入地黄汁，煎取一升五合，分两次温服。中病（见效）后不要继续服用。大便通常会像漆一样黑。
百合病，一个月未愈，变成口渴的（热邪壅滞皮毛，皮毛是肺的外合，用百合洗方主治）。
百合洗方
百合一升，用水一斗，浸泡一夜，用来洗浴身体。洗完后进食煮饼，不要用咸豆豉调味。
百合病，（洗浴后）口渴仍未缓解的（内热盛而津液受伤，用栝蒌牡蛎散主治）。
栝蒌牡蛎散方
栝蒌根 牡蛎（等分）
研成细末，用米汤送服一方寸匕，每日三次。
百合病，（像冷又不冷，像热又不热，原本无热，现在）变为发热的（其体内热邪可知，用百合滑石散主治）。
百合滑石散方
百合（一两炙） 滑石（三两）
研为散剂，用米汤送服一方寸匕，每日三次。如果出现轻微腹泻，停止服药。热邪即可消除。
百合病见于阴证的，用阳法来救治（即《内经》中用阳气和阴的道理）。见于阳证的，用阴法来救治（即《内经》中用阴气和阳的道理。如果）见到阳证（的病而）攻伐（其）阴，（就会同时损伤阴气，于是）再次发汗，（这是重伤阳气）。这属于逆治。见到阴证（的病）攻伐（其）阳，（就会同时损伤阳气，于是）再次泻下，（这是重竭阴气）。这也属于逆治。
程扶生说：前面的治疗都是用阴和阳的方法。这里又补充用阳和阴的方法，所以张仲景的构思最为精密。
狐惑病，（是虫蚀之病）。症状像伤寒，沉默想睡，眼睛却无法闭合，卧起不安。（为何如此躁动，实在是因为虫扰造成的危害。虫）侵蚀咽喉称为惑，侵蚀前阴称为狐。（并且）不想吃东西，厌恶闻食物气味。（虫子闻到食物气味就活动，活动则让人心烦意乱到如此程度。而且虫子大动时在胃中交乱，胃主管面目。）其面部颜色（时而）发红、发黑、发白。（也随着虫子的聚散而变化）。侵蚀上部，则（喉部受损而）声音嘶哑。（用）甘草泻心汤主治。侵蚀下部，则（邪气伤害厥阴经，厥阴经是阴经的尽头，其病自下而上冲，所以）咽干。（用）苦参汤清洗。侵蚀肛门者，（用）雄黄熏蒸。（熏洗两种方法，都是就近治疗。）
这里论述了狐惑病的证治方法。《伤寒论》中的乌梅丸，也可以斟酌使用。
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）
以上七味药，用水一斗，煮取六升，滤去药渣，再煎取三升，温服一升，每日三次。
苦参汤方
苦参一升，用水一斗煎取七升，滤去药渣，用于熏洗，每日三次。
雄黄熏法
将雄黄一味药研成粉末，用两片筒瓦合起来烧，对着肛门熏蒸。
病人脉数，无发热，轻微烦躁，沉默只想睡觉，出汗。初得病三四天，眼睛发红像斑鸠的眼睛一样。七八天后，眼周发黑。如果能吃东西，说明脓已成。用赤小豆当归散主治。
尤在泾说：脉数、微烦、沉默只想睡觉，是热盛于里。无热而汗出，说明病不在表。初得病三四天，眼睛发红像斑鸠眼睛，是肝脏血中的热邪，随经脉上注于目。经脉热邪如此，脏腑热邪可知。这肯定是蓄热不去，将要形成痈肿无疑。到了七八天，眼周发黑，红色极盛而变为黑色，则痈肿更加严重。肝与胃，互为胜负的关系。肝正有热，势必以其热侵犯胃；而肝既已成痈，胃即以其热并归于肝。所以说：如果能吃东西，就知道脓已成了。而且脓成则毒化，毒化则不仅胃气和，肝气也调和了。赤小豆和当归，是排脓血、除湿热的良剂。又说：这一条，注释家有将其归为狐惑病的，有归为阴阳毒的。总之这也是湿热蕴结毒邪的病。如果不腐化为虫，则积聚而成痈肿。不发生在身面，则发生在肠脏，这也是病机发展的自然趋势。张仲景的意思认为是与狐惑、阴阳毒同源而异流的病，所以特别论述列于此篇吗？
赤小豆当归散方
赤小豆（三升，浸泡令芽长出，晒干） 当归（十分）
以上两味药，捣碎为散剂，用浆水送服一方寸匕，每日三次。
（阴阳二毒，是感受了异常的灾疠之气，从口鼻向下侵入咽喉，致死速度很快。试以阳毒为例来说明。）
阳毒之为病，（是异常之气中人阳分）。面色红润，斑驳如锦纹，咽喉痛，吐脓血。五日（经气尚未遍行全身，所以）还可以救治。（五日之外，五脏相传均受邪气，至）七日（阴阳经气已循环一周并再次运行，则）不可救治。用升麻鳖甲汤主治。
（异常之气中人阴分，则为阴毒。）阴毒之为病，面目青紫，身体疼痛如同被棍棒打过，咽喉痛。五日（经气尚未遍行，尚）可以救治。（至）七日（阴阳经气已循环一周并再次运行，则）不可救治。用升麻鳖甲汤去掉雄黄、蜀椒主治。
这里论述了阴阳二毒，治疗不可拖延。张仲景所论述的阴毒阳毒，说的是天地间的疠气，中人阳气或阴气，并非指阴寒至极或阳热至极而言。大概天地灾疠之气，就是毒瓦斯。人的血气，白天行于阳分，夜晚行于阴分。疠气之毒，正值人身阳气运行的时候中人，就成为阳毒。面是诸阳经汇聚之处，阳毒上犯阳位，所以面色红润斑驳如锦纹。阳毒上迫胸膈，所以吐脓血。因为阳气法天，本乎天者亲上。正值人身阴气运行的时候中人，就成为阴毒。邪气入于阴分，则血液凝滞，血液不能上荣于面，所以面目青紫。血液不能环流一身，所以身体疼痛如同被杖打。因为阴气主静，是凝而不流的象。夫阴阳二毒，都是从口鼻向下侵入咽喉。咽喉是阴阳交汇的要道。感受非时之疠气，则真气出入的道路，难免受到妨碍。所以二毒都有咽喉痛的证候。总之，异气中人，毒流最猛。五日经气未遍，尚可快速治疗。若至七日，阴阳经气已周，并作再经，则不可治了。方用升麻鳖甲汤来解除它。升麻，《本经》说：气味甘平苦，微寒无毒。主治解百毒，辟瘟疫邪气。入口皆吐出，中恶腹痛，时气毒疠，诸毒喉痛口疮等等。君药以升麻，是因为它能排气分，解百毒，能吐能升，使从口鼻入的邪气，仍从口鼻而出。鳖甲气味酸平无毒，佐助当归而入肝。肝藏血，血被邪气凝滞，鳖甲禀赋坚刚之性，当归具辛香之气，直入厥阴经，而通调气血，使邪毒侵于营卫者，得此两味药而一并解除。甘草气味甘平，解百毒，甘能入脾，使中土健旺，驱逐邪气向外排出。妙在用蜀椒辛温，雄黄苦寒，禀纯阳之色，领诸药以解阳毒。其阴毒去掉雄黄、蜀椒的原因，是因为邪毒不在阳分，不如当归、鳖甲直入阴分更为得当。
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）
以上六味药，用水四升，煮取一升，一次性服用。老人小孩可再服以取汗。阴毒证去掉雄黄、蜀椒。《肘后备急方》和《千金方》，阳毒用升麻汤，无鳖甲，有桂枝。阴毒用甘草汤，无雄黄。
The text states: Baihe Bing (Lily Disease) occurs because the hundred vessels of the body converge into a single source (referring to the Heart and Lung), without distinct meridians to differentiate them, causing all vessels to be affected and diseased.
The main symptoms manifest as: desiring to eat but being unable to; desiring to speak but unwilling to, often remaining silent; desiring to lie down but feeling restless and unable to do so; desiring to walk but feeling lethargic and unable to move; desiring food, sometimes finding it delicious, at other times having no appetite, or even feeling aversion to the smell of food. It feels like cold but is not cold, feels like heat but is not heat. There is bitter taste in the mouth and dark red urine. Various medications cannot cure it; taking medicine results in severe vomiting or diarrhea, as if possessed by spirits. However, the physical appearance seems normal and harmonious. (All the above symptoms are elusive, fluctuating, and unreliable indicators; only by relying on the pulse and urination can one accurately determine that this is caused by Heat pathogen.) The pulse is slightly rapid (Rapid pulse indicates Heat syndrome). Urine is discharged from the Bladder, which is the Fu organ of the Taiyang channel, whose meridian ascends to the vertex of the head. If headache occurs every time urinating, it indicates a temporary deficiency of the Taiyang channel, allowing Heat pathogen to invade due to weakness. Now, if headache occurs with every urination, it indicates severe Heat pathogen, requiring sixty days (two lunar cycles for Yin Qi to restore; once Yin Qi restores, Yang pathogenic Heat levels off, then) recovery will occur. If there is no headache during urination, but rather a sensation of chills (Xixi ran), the condition is slightly milder, and recovery may occur in approximately forty days. If urination feels smooth, accompanied only by dizziness, the condition is even lighter, and recovery may occur within twenty days. This Baihe Bing symptom pattern often appears after a major febrile disease such as Shanghan (Cold Damage). Or it may appear before illness onset (because Heat pathogen moves first). Or it may appear four to five days into the illness, or twenty days later, or after a month (because residual Heat has not cleared). Treatment should follow the specific symptoms. This section details the symptoms and pulses of Baihe Bing. This condition is common around the time of major febrile diseases, or arises from improper use of sweating, vomiting, or purging therapies, or from chronic excessive thinking and emotional stagnation, or from sudden fright, doubt, or unexpected encounters, leading to a loss of autonomy in walking, standing, sitting, lying, and eating. This disease is very common, yet physicians often fail to recognize it.
Cheng Yunlai stated: The head is the gathering point of all Yang channels. During urination, Yang Qi descends, causing the head to tremble. Why not observe infants and the elderly? Infants have insufficient Yuan Qi and unfilled brain marrow; their heads tremble just before urination because Yang Qi is not充盈 (abundant). The elderly have declining Qi and Blood, dry and stagnant muscles, and empty brain marrow; thus, they cannot urinate forcefully, wetting their clothes near the end, and their heads also shake because Yang Qi has declined and cannot drive excretion. From this, observing whether the head hurts during urination reveals the depth of the pathogen. Therefore, headache during urination in Baihe Bing indicates deep-seated pathogen and deficient Yang Qi. Internal Yang deficiency allows pathogen to enter the Zang-Fu organs, affecting the brain marrow upwards, hence requiring sixty days for recovery. If there is no headache during urination, but a sensation of chills (Xixi ran), where Xixi resembles water sprinkling on skin and hair, it indicates the pathogen resides in the skin and muscles, not yet entering the Zang-Fu, merely indicating slight Yang deficiency, hence forty days for recovery. If urination is smooth with only dizziness, it indicates shallow pathogen; smoothness implies harmonious Yin and Yang and free flow of Ying and Wei; the Zang-Fu are unaffected, and externally there is no chilliness, indicating intact Yang Qi. Dizziness alone suggests the pathogen is in the Yang aspect; sufficient Yang prevents pathogen constraint, so the head does not hurt but feels dizzy, hence recovery in twenty days. His explanation is also reasonable.
Baihe Bing appearing after sweating therapy (because sweating was incorrectly used when not indicated, depleting Body Fluids, is treated with Baihe Zhimu Tang).
Baihe Zhimu Tang Formula
Baihe (Lilii Bulbus) (7 bulbs) Zhimu (Anemarrhenae Rhizoma) (3 liang)
First, wash the Baihe and soak it overnight. When white foam appears, discard the water. Add 2 sheng of Spring Water, decoct to obtain 1 sheng, strain. Separately, add 2 sheng of Spring Water to decoct Zhimu, obtaining 1 sheng, strain. Mix the two decoctions and decoct again to obtain 1.5 sheng. Divide into two warm doses.
Baihe Bing appearing after purging therapy (because purging was incorrectly used when not indicated, driving Heat into the lower jiao, is treated with Baihe Huashi Daizhe Tang).
Baihe Huashi Daizhe Tang Formula
Baihe (Lilii Bulbus) (7 bulbs, broken) Huashi (Talcum) (3 liang, crushed and wrapped in silk) Daizheshi (Ochre) (size of a bullet, 1 piece, crushed and wrapped in silk)
First, decoct Baihe as previously described. Separately, add 2 sheng of Spring Water to decoct Huashi and Daizheshi, obtaining 1 sheng, strain. Mix the decoctions and re-decoct to obtain 1.5 sheng. Divide into two warm doses.
Baihe Bing appearing after emesis therapy (because emesis was incorrectly used when not indicated, injuring internal Zang Yin, is treated with Baihe Jizi Tang).
Baihe Jizi Tang Formula
Baihe (Lilii Bulbus) (7 bulbs, broken) Jizi Huang (Yolks of Chicken Egg) (1 yolk)
First, decoct Baihe as previously described. Add the chicken egg yolk, stir well, and decoct until reduced to 0.5 sheng. Take warm.
Baihe Bing, not subjected to emesis, purging, or sweating, with symptoms unchanged from the beginning (i.e., premonitory appearance mentioned earlier. This is due to Heat pathogen moving first, treated with Baihe Dihuang Tang). (However, some cases of Taiyang disease persisting long-term without resolution, remaining in the Taiyang channel, also use this formula.)
Baihe Dihuang Tang Formula
Baihe (Lilii Bulbus) (7 bulbs, broken) Shengdihuangzhi (Juice of Rehmanniae Radix Recens) (1 sheng)
First, decoct Baihe as previously described. Add the Rehmannia juice, decoct to obtain 1.5 sheng. Divide into two warm doses. Stop taking if effective. Stool will likely turn black like lacquer.
Baihe Bing unresolved for one month, developing thirst (Heat obstructing the skin and hair; skin and hair are the exterior correspondence of the Lung, treated with Baihe Xi Fang).
Baihe Xi Fang
Baihe (Lilii Bulbus) (1 sheng), soaked in 1 dou of water overnight. Use the water to bathe the body. After bathing, consume boiled wheat noodles (Zhu Bing), without salty fermented soybeans (Chi).
Baihe Bing, (after bathing) thirst persists (indicating intense internal Heat and damaged Body Fluids, treated with Gualou Muli San).
Gualou Muli San Formula
Gualougen (Trichosanthis Radix) Muli (Ostreae Concha) (equal parts)
Grind into fine powder. Take 1 fangcun bi with rice water, three times daily.
Baihe Bing, (feeling like cold but not cold, like heat but not heat, originally no heat, now) developing fever (internal Heat is evident, treated with Baihe Huashi San).
Baihe Huashi San Formula
Baihe (Lilii Bulbus) (1 liang, roasted) Huashi (Talcum) (3 liang)
Grind into powder. Take 1 fangcun bi with rice water, three times daily. Stop administration if mild diarrhea occurs. Heat will be eliminated.
For Baihe Bing presenting as Yin syndrome, rescue using Yang methods (as per Neijing: harmonizing Yin with Yang). For presenting as Yang syndrome, rescue using Yin methods (as per Neijing: harmonizing Yang with Yin). If (one sees Yang pathology and) attacks the Yin, (it injures Yin further, and then) inducing sweating again (severely injures Yang). This is contrary treatment. Seeing Yin pathology and attacking Yang (injures Yang further, and then) purging again (exhausts Yin severely). This is also contrary treatment.
Cheng Fusheng said: Previous treatments all used Yin to harmonize Yang. Here, adding Yang to harmonize Yin shows Zhang Zhongjing's thought process is extremely precise.
Huo Er Bing (Fox and Charm Disease), (a disease caused by worms). Symptoms resemble Shanghan: silence, desire to sleep, eyes unable to close, restlessness in lying and rising. (Why such agitation? Truly due to harm caused by worms. Worms) eroding the throat is called "Hu" (Charm); eroding the genitalia is called "Hu" (Fox). (And) loss of appetite, aversion to food odors. (Worms move upon smelling food, causing such心烦 (vexation). Moreover, when worms move violently, they disturb the Stomach; the Stomach governs the face and eyes.) The facial color (alternates between) red, black, and white. (Changing with the aggregation and dispersion of worms). Erosion of the upper part causes (throat damage and) hoarseness. (Treated with) Ganxie Xi Xin Tang. Erosion of the lower part causes (pathogen injuring Jueyin channel; Jueyin is the end of Yin, disease rises from below, causing) dry throat. (Treated with) Kushen Tang wash. Erosion of the anus is (treated with) Xionghuang fumigation. (Fumigation and washing methods treat locally).
This discusses the syndrome and treatment of Huo Er Bing. Wumei Wan from Shanghan Lun can also be considered for use.
Gancao Xi Xin Tang Formula
Gancao (Licorice Root) (4 liang, roasted) Huangqin (Scutellariae Radix) Ganjiang (Zingiberis Rhizoma) Renshen (Ginseng Radix) (each 3 liang) Banxia (Pinelliae Rhizoma) (0.5 sheng) Huanglian (Coptidis Rhizoma) (1 liang) Dazao (Jujubae Fructus) (12 pieces)
Seven ingredients. Decoct in 1 dou of water to obtain 6 sheng, strain. Re-decoct to obtain 3 sheng. Take 1 sheng warm, three times daily.
Kushen Tang Formula
Kushen (Sophorae Flavescentis Radix) (1 sheng), decoct in 1 dou of water to obtain 7 sheng, strain. Use for fumigation and washing, three times daily.
Xionghuang Fumigation Method
Grind Xionghuang (Realgar) into powder. Place in two tube-shaped tiles, burn, and fumigate towards the anus.
Patient has rapid pulse, no fever, slight vexation, silence, desire only to sleep, sweating. In the first 3-4 days, eyes are red like a turtledove's eye. By day 7-8, the area around the eyes turns black. If the patient can eat, pus has formed. Treated with Chixiaodou Danggui San.
You Zaijing said: Rapid pulse, slight vexation, silence, desire to sleep indicate Heat excess internally. No fever with sweating indicates the pathogen is not in the exterior. Eyes red like a turtledove's eye in 3-4 days indicates Heat in Liver blood ascending via the channel to the eyes. If channel Heat is this severe, Zang Heat is known. This is undoubtedly accumulated Heat failing to disperse, about to form an abscess. By day 7-8, eyes turning black indicates extreme Red transforming to Black, meaning the abscess is worse. Liver and Stomach compete for dominance. When Liver has Heat, it inevitably invades the Stomach; once Liver forms an abscess, Stomach Heat merges into the Liver. Thus: if the patient can eat, it indicates pus has formed. Pus formation transforms toxin; transformed toxin harmonizes both Stomach and Liver. Chixiaodou (Adzuki Bean) and Danggui (Angelicae Sinensis Radix) are excellent agents for draining pus/blood and removing damp-Heat. Also, commentators classify this passage as either Huo Er Bing or Yin-Yang Du. Essentially, it is a disease of damp-Heat accumulating into toxin. If not rotting into worms, it accumulates into abscesses. If not occurring on the body/face, it occurs in intestines/organs, following natural disease progression. Zhang Zhongjing likely intended this to be a disease originating from the same source as Huo Er and Yin-Yang Du but diverging in manifestation, hence listing it here.
Chixiaodou Danggui San Formula
Chixiaodou (Vigna Angularis Seed) (3 sheng, soaked until sprouted, dried) Danggui (Angelicae Sinensis Radix) (10 fen)
Two ingredients. Pound into powder. Take 1 fangcun bi with Jiangshui (fermented bean water), three times daily.
(Yin-Yang Er Du are caused by contracting abnormal epidemic pestilence Qi, entering downwards from mouth/nose into the throat, causing death rapidly. Taking Yang Du as an example:)
Yang Du disease, (caused by abnormal Qi invading Yang aspects). Face is red with mottled patterns like brocade, sore throat, vomiting pus and blood. Within five days (meridian Qi has not circulated fully, so) it is still treatable. (After five days, Five Zang transmit pathogen to each other; by) seven days (Yin-Yang meridian Qi has completed a cycle and begun again, then) it is untreatable. Treated with Shengma Biejia Tang.
(Abnormal Qi invading Yin aspects becomes Yin Du.) Yin Du disease, face and eyes are cyan, body pain as if beaten with a stick, sore throat. Within five days (meridian Qi has not circulated fully, so) it is still treatable. (By) seven days (Yin-Yang meridian Qi has completed a cycle and begun again, then) it is untreatable. Treated with Shengma Biejia Tang removing Xionghuang and Shujiao.
This discusses Yin-Yang Er Du, emphasizing that treatment must not be delayed. Zhang Zhongjing's discussion of Yin/Yang Du refers to Heaven-Earth pestilence Qi invading human Yang or Yin Qi, not referring to extreme Cold or extreme Heat. Generally, Heaven-Earth pestilence Qi acts as toxic vapor. Human Qi and Blood circulate in Yang during day and Yin during night. Pestilence Toxicity invading during the phase when human Qi circulates in Yang becomes Yang Du. The face is the gathering of all Yang channels; Yang Du harasses Yang positions, hence red mottled face. Yang Du presses upward on chest/diaphragm, hence vomiting pus/blood. Yang Qi follows Heaven, and things belonging to Heaven tend to rise. Invading during the phase when human Qi circulates in Yin becomes Yin Du. Pathogen entering Yin causes blood coagulation/stasis; blood fails to nourish the face, hence cyan face/eyes. Blood fails to circulate the body, hence body pain like being beaten. Yin Qi is static, representing stagnation. Both Yin-Yang Er Du enter downwards from mouth/nose into the throat. The throat is the critical intersection of Yin and Yang. Contracting out-of-season pestilence Qi obstructs the pathway of True Qi entry/exit. Hence both toxins present with sore throat. Ultimately, abnormal Qi invading humans brings fierce toxicity. Within five days, meridian Qi is not fully circulated, allowing rapid treatment. By seven days, Yin-Yang meridian Qi has cycled and restarted, making it untreatable. The formula uses Shengma Biejia Tang to resolve it. Shengma (Cimicifugae Rhizoma): Ben Jing states flavor is sweet, neutral, bitter, slightly cold, non-toxic. Mainly resolves hundred toxins, wards off plague Qi. Causes expulsion from mouth/nose. Treats evil abdominal pain, seasonal toxic plagues, various throat pains and mouth ulcers. Using Shengma as Sovereign herb because it moves Qi in the Qi level, resolves hundred toxins, induces vomiting/lifting, allowing pathogens entering via mouth/nose to exit via mouth/nose. Biejia (Testudinis Carapax et Plastrum): Flavor sour, neutral, non-toxic. Assists Danggui entering Liver. Liver stores Blood; Blood is congealed by pathogen. Biejia possesses firm/hard nature; Danggui has pungent/aromatic qi, directly entering Jueyin channel, unblocking Qi and Blood, allowing pathogens invading Ying/Wei to be resolved by these two herbs. Gancao (Licorice Root): Flavor sweet, neutral, resolves hundred toxins. Sweet enters Spleen, strengthening Middle Earth to expel pathogen outward. Ingeniously, using Shujiao (Sichuan Pepper) pungent/warm and Xionghuang (Realgar) bitter/cold, possessing pure Yang color, leading herbs to resolve Yang Du. Removing Xionghuang/Shujiao for Yin Du because pathogen is not in Yang aspect; instead, Danggui/Biejia directly entering Yin aspect is more appropriate.
Shengma Biejia Tang Formula
Shengma (Cimicifugae Rhizoma) Danggui (Angelicae Sinensis Radix) Gancao (Licorice Root) (each 2 liang) Shujiao (Sichuan Pepper) (1 liang, stir-fried to remove sweat) Biejia (Testudinis Carapax et Plastrum) (size of finger, 1 piece, roasted)
Xionghuang (Realgar) (0.5 liang, ground)
Six ingredients. Decoct in 4 sheng of water to obtain 1 sheng. Take in one dose. Elderly and children may take another dose to induce sweating. For Yin Du, remove Xionghuang and Shujiao. Zhouhou Qianjin Fang: Yang Du uses Shengma Tang, without Biejia, with Guizhi. Yin Du uses Gancao Tang, without Xionghuang.