金匮要略曰。狐惑之为病。状如伤寒。王叔和曰。其气如伤寒。
活人书曰。名狐惑伤寒。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。乍白。乍黑。千
金同。病源曰。或因伤寒而变成此疾。
又曰。蚀于上部则声喝。（一作嗅。金匮作声嗄。）甘草泻心汤主
之。（千金同）
又曰。蚀于下部则咽干。苦参汤淹洗之。
千金又曰。此
由温毒瓦斯所为也。（病源作湿毒者所为。误。）
又曰。蚀于肛者。雄黄散熏之。（千金同）外熏法。宜用千金也。
又曰。其人脉数无热。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。叔和曰。黄黑。若能食者。脓已成
也。赤小豆当归散主之。千金云。治狐惑。当用黄连熏草汤。叔和曰。
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。并用猪苓散主之。
千金曰。此由湿毒瓦斯。（湿当作温）然湿所为者。狐惑正病也。
又曰。伤寒不发汗。变成狐惑。狐惑者。此自伤寒气而变也。
又曰。 病与狐惑百合湿温之病鬼魅皆相似。宜精察节气。其
新故二气相搏。成此病也。
活人书曰。狐惑伤寒。与湿 。皆虫证。初得状如伤寒。或因伤
寒成此疾。雍曰。狐惑与 。虽是两疾。治法不相远矣。
又曰。大抵伤寒病。腹内热入食少。肠胃空虚。三虫行作求食。
蚀人五脏。及下部为 病。其候齿无色。舌上尽白。甚者唇黑有疮。
四肢沉重。忽忽喜眠。虫蚀其肛。烂见五脏则死。当数看其上下唇。
上唇有疮。虫蚀其脏。下唇有疮。虫食其肛也。杀人甚多。因下利而
得。治 。桃仁汤、黄连犀角汤、雄黄锐散主之。雍曰。常见有舌上
成疮。不止唇而已。病源作上唇内。下唇内为当。
雍曰。狐惑之 病。亦多有之。因医者既汗又吐。或又下。或利
小便。亡津液太过。热毒内攻。脏腑枯焦。虫不得安。故上下求食。亦
有不发汗。内热焦枯而成者。凡人之喉及阴肛常有。是皆比其他肌
肉最津润处。故虫缘津润而食之。 病又不止因伤寒而成。多自下
感之。因居湿地。下利不止。日久者。必得根据朱氏服汤。用锐散。若在
肛外可见。用芦荟龙胆涂之尤妙。然必先汤内攻。而后淋洗外涂也。
夏秋之交。小儿因下利。感此疾尤多。当须淋洗肛外。频视之。见细
红点初有十数。即急治之。稍迟则增多。经夕即十数倍。如仓卒不能
辨。只先以芦荟加小豆以涂之。他药能杀虫而不能毒人者亦可用。
医工不识。误小儿甚多。若夫汤淹法屡验。
《金匮要略》说：狐惑病的症状，像伤寒病。王叔和说：其气机表现如同伤寒。
《活人书》说：称为狐惑伤寒。患者神情沉默想睡觉，但眼睛无法闭合，躺下坐起都不得安宁。腐蚀咽喉部位称为“惑”，腐蚀前后阴部位称为“狐”。不想吃东西，厌恶闻到食物的气味。面色时而发红，时而发白，时而发黑。《千金方》记载相同。
《诸病源候论》说：有的因患伤寒而转变为这种疾病。
又说：腐蚀在上部（咽喉）则声音嘶哑。（另一种版本作“嗅”，《金匮要略》作“声嗄”。）用甘草泻心汤主治。（《千金方》记载相同）
又说：腐蚀在下部（前后阴）则咽喉干燥。用苦参汤浸泡清洗患处。
《千金方》又说：这是由于温毒之气所致。（《诸病源候论》作“湿毒”所致，是错误的。）
又说：腐蚀在肛门者，用雄黄散熏蒸治疗。（《千金方》记载相同。外用熏蒸法，宜采用《千金方》的方法。）
又说：患者脉象数快而无发热，轻微烦躁，沉默只想躺卧，出汗。刚得病三四天，眼睛发红像斑鸠的眼睛；七八天后，眼四角发黑。王叔和说：颜色呈黄黑色，如果能吃饭的，说明脓已经形成。用赤小豆当归散主治。《千金方》说：治疗狐惑，应当用黄连熏草汤。王叔和说：病人有的从呼吸上部腐蚀咽喉，有的从下焦腐蚀肛门。腐蚀上部为惑，腐蚀下部为狐。狐惑病，都用猪苓散主治。
《千金方》说：这是由于湿毒之气。（“湿”字当作“温”字。然而由湿邪所致的，是狐惑的正病。）
又说：伤寒病如果不发汗，会转变为狐惑病。狐惑病，这是自伤寒气而变成的。
又说：此病与狐惑、百合病、湿温病、鬼魅病都相似。应当仔细辨别节气，新旧二气相互搏结，形成此病。
《活人书》说：狐惑伤寒，与阴蚀病（古称“蝕”，此处指一种以虫蚀为特征的病症），都是虫证。初起症状像伤寒，有的因患伤寒而变成此疾。郭雍说：狐惑与阴蚀病，虽然是两种疾病，但治法不相上下。
又说：大抵伤寒病，腹内热盛而进食少，肠胃空虚，三虫（泛指肠道寄生虫）活动求食，腐蚀人的五脏。及至下部则为阴蚀病。其征象是牙齿颜色无光泽，舌头上全部发白，严重的嘴唇发黑并有疮疡，四肢沉重，恍惚嗜睡。虫子腐蚀肛门，烂到见五脏则死。应当经常查看上下嘴唇。上唇有疮，是虫子腐蚀内脏；下唇有疮，是虫子腐蚀肛门。杀人很多，常因腹泻而得病。治疗阴蚀病，用桃仁汤、黄连犀角汤、雄黄锐散主治。郭雍说：常见有人舌头上成疮，不止嘴唇而已。《诸病源候论》作“上唇内、下唇内”比较恰当。
郭雍说：狐惑病的阴蚀病状，也多有发生。因为医生既发汗又催吐，或者又攻下，或者利小便，导致津液流失过多，热毒内攻，脏腑枯焦，虫子不得安宁，所以上下寻求食物。也有不发汗，因内热焦枯而形成的。凡是人的喉部和阴肛部位常有虫子，这些都是比其他肌肉最津润的地方，所以虫子沿着津润之处啃食。阴蚀病又不止因伤寒而成，多是从下部感染而来。因居住在湿地，腹泻不止，日久的人，必须依据朱氏服用汤药，使用锐散。如果在肛外可见，用芦荟、龙胆草涂抹尤其奇妙。然而必须先以内服汤药攻邪，然后再进行淋洗和外涂。
夏秋之交，小儿因腹泻，感染此疾尤为多见。应当须对肛外进行淋洗，频繁观察。见到细小红点初起只有十几个时，就紧急治疗。稍晚则数量增多，过一夜就会增加十几倍。如果仓促间不能辨别，只先用芦荟加赤小豆粉末涂抹。其他能杀虫但不能对人有毒性的药物也可以使用。医生不认识，误害小儿很多。至于汤药浸泡法屡试有效。
The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) states: The disease of Huhe (Fox and Charm, a syndrome characterized by mucosal ulceration) presents with symptoms resembling Taiyang Cold Damage (Exterior Syndrome caused by Cold pathogen). Wang Shuhe stated: Its Qi manifestation is like Taiyang Cold Damage.
The *Huo Ren Shu* (Book that Revives People) states: It is named Huhe Cold Damage. The patient is silent and desires to sleep, yet cannot close their eyes; they are restless when lying down or sitting up. Ulceration in the throat is called "He" (Charm); ulceration in the yin organs (genitals/anus) is called "Hu" (Fox). There is a lack of desire for food, and an aversion to the smell of food. The complexion may suddenly turn red, white, or black. The *Qian Jin Fang* (Thousand Gold Formulas) records this similarly.
The *Zhu Bing Yuan Hou Lun* (Source Book of All Diseases and Their Prognoses) states: This disease may arise from transformation due to Taiyang Cold Damage.
It further states: If ulceration occurs in the upper part (throat), the voice becomes hoarse. (Another version reads "smell", while *Jin Gui Yao Lue* reads "hoarse voice"). It should be treated primarily with Gancao Xiexin Tang (Licorice Decoction for Draining the Epigastrium). (*Qian Jin Fang* records this similarly).
It further states: If ulceration occurs in the lower part (genitals/anus), there is dryness of the throat. It should be washed with Kushen Tang (Sophora Root Decoction).
*Qian Jin Fang* further states: This is caused by Warm Toxic Qi. (*Zhu Bing Yuan Hou Lun* attributes it to Damp Toxicity, which is considered an error).
It further states: For ulceration in the anus, treat with Xionghuang San (Realgar Powder) via fumigation. (*Qian Jin Fang* records this similarly. For external fumigation methods, the approach from *Qian Jin Fang* is recommended).
It further states: The patient's pulse is rapid without fever, with slight irritability, silence, and a desire to lie down, accompanied by sweating. In the first three to four days of onset, the eyes appear red like those of a turtledove; after seven to eight days, the corners of the eyes turn black. Wang Shuhe stated: If the color is yellowish-black and the patient can eat, it indicates that pus has formed. Treat with Chixiaodou Danggui San (Adzuki Bean and Angelica Sinensis Powder). *Qian Jin Fang* states: To treat Huhe, one should use Huanglian Xuncao Tang (Coptis Fumigating Herb Decoction). Wang Shuhe stated: Patients may have ulceration in the throat from respiration affecting the upper part, or ulceration in the anus/genitals from the Lower Jiao. Upper ulceration is He; lower ulceration is Hu. For Huhe, Zhuling San (Polyporus Powder) should be used.
*Qian Jin Fang* states: This is caused by Damp Toxic Qi. (The character "Damp" should likely be "Warm". However, cases caused by Dampness represent the typical presentation of Huhe).
It further states: If Taiyang Cold Damage is not treated with sweating, it transforms into Huhe disease. Huhe disease arises from self-injury by Cold Qi leading to transformation.
It further states: This disease resembles Huhe, Baihe Disease (Lily Disease), Shiwen Disease (Damp-Warmth), and Gui Mei Disease (Spirit Affliction). One must carefully observe the solar terms; the conflict between new and old Qi forms this disease.
The *Huo Ren Shu* states: Huhe Cold Damage and Yin Erosion Disease (Chi) are both insect syndromes. Initial symptoms resemble Taiyang Cold Damage, possibly arising from transformation due to Taiyang Cold Damage. Guo Yong stated: Although Huhe and Yin Erosion are two different diseases, their treatment methods are not far apart.
It further states: Generally, in Taiyang Cold Damage, internal heat leads to poor appetite and empty intestines/stomach, causing Three Worms (parasites) to move seeking food, eroding the Five Zang Organs. When it affects the lower part, it becomes Yin Erosion Disease. Signs include teeth lacking luster, the entire tongue turning white, severe cases showing black lips with sores, heavy limbs, dizziness, and excessive sleepiness. Worms eroding the anus lead to death if the viscera are exposed. One should frequently examine the upper and lower lips. Sores on the upper lip indicate worms eroding the viscera; sores on the lower lip indicate worms eroding the anus. This causes many deaths, often acquired through diarrhea. Treat Yin Erosion Disease with Tao Ren Tang (Peach Kernel Decoction), Huanglian Xijiao Tang (Coptis and Rhinoceros Horn Decoction), or Xionghuang Rui San (Realgar Sharp Powder). Guo Yong stated: It is common to see sores on the tongue, not just the lips. *Zhu Bing Yuan Hou Lun*'s description of "inside the upper and lower lips" is more accurate.
Guo Yong stated: Yin Erosion manifestations also frequently occur in Huhe disease. This happens because physicians induce sweating, vomiting, purgation, or diuresis excessively, leading to severe loss of Body Fluids. Internal attacking Heat Toxicity causes the Zang-Fu organs to become withered and scorched, making the environment uninhabitable for worms, so they seek food above and below. Some cases arise without sweating, due to internal heat causing withering. The throat and genital/anal regions naturally harbor worms, as these are the most moist areas compared to other muscles, so worms feed along these moist paths. Yin Erosion disease is not only caused by Taiyang Cold Damage but is often contracted from below, such as living in damp places or prolonged diarrhea. For long-standing cases, one must follow Zhu's method of taking decoctions and using Rui San. If visible externally on the anus, applying Aloe and Gentian is particularly effective. However, internal decoction therapy must precede external washing and application.
During the transition between summer and autumn, children contracting this disease due to diarrhea are especially common. One must wash the exterior of the anus frequently and observe closely. When fine red spots first appear (initially a dozen or so), urgent treatment is required. Delaying allows them to multiply; overnight, they can increase tenfold. If differentiation is difficult in haste, apply Aloe mixed with Adzuki Bean powder initially. Other herbs that kill parasites without being toxic to humans may also be used. Physicians' failure to recognize this has harmed many children. The decoction soaking method has proven effective repeatedly.