千金论曰。百合病者。谓无经络。百脉一宗。悉致病也。皆因伤
寒病虚劳大病以后不平复。变成斯疾。其状恶寒而呕者。病在上焦
也。二十三日当愈。其状腹满微喘。大便坚。三四日一大便。时复小
溏者。病在中焦也。六十三日当愈。其状小便淋漓难者。病在下焦
也。三十三日当愈。各随其症以治之。雍曰。孙氏着论。皆见于古书。
独此论中分三焦症。古无所见。岂其书亡乎。果分三焦。则各有所
在。诸药可治。不应仲景曰诸药不能治。乃时用诸百合汤也。千金百
合病余论。则皆见于金匮矣。惟此一论有异。
金匮要略论曰。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。复不得卧。欲行。复不能行。饮食或有美
时。或有不用闻食臭时。如有寒。实无寒。如有热。实无热。口苦。小
便赤。（千金云。至朝口苦。小便赤涩。）诸药不能治。得药则剧吐利。
如有神灵所加者。百合之病。身形如和。其脉微数。其候于溺时即觉
头痛者。六十日乃愈。溺时头不痛。淅淅然寒者。四十日愈。若溺时
觉快然。但头眩者。二十日愈。其症或未病而预见。或病四五日而
出。或病二十日或一月微见者。各随症治之。千金。或病一月二十日
后见其症者。治之喜误也。雍曰。此论有言不甚明处。今皆以千金论
中字足之。又如一月二十日后症方出。则一月二十日之前为治。安
得不误。故千金论中治之喜误四字。最为要切。论言其症者。谓溺时
三症也。
叔和曰。百合之为病。其状若默默。欲卧复不得卧。或如强健
人。欲出行而复不能行。意欲得食复不能食。或有美时。或有不用闻
饮食臭时。如寒无寒。如热无热。至朝口苦。小便赤黄。身形如和。其
脉微数。百脉一宗悉病。各随症治之。
金匮又曰。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。
千金曰。百合病见在于阴。而攻其阳。则阴不得解也。复发其汗。为
逆也。见在于阳。而攻其阴。则阳不得解也。复下之。其病不愈。雍
曰。金匮之意。谓见阳当攻阴。若不攻阴而发其汗。则为逆。见阴当
攻阳。若不攻阳而复下之。亦为逆。此为易明。千金言见阴攻阳。阴
未解之间。不可复发汗。恐阳再受攻。故为逆。见阳攻阴。阳未解之
间。不可复下之。恐阳再受攻。故为逆。其意难明。
又曰。治百合病。发汗后者。宜百合知母汤。外台云。发汗已。更
发者。下之已。更发者。吐之已。更发者。
又曰。治百合病。下之后者。宜百合滑石代赭汤。
又曰。治百合病。吐之后者。宜百合鸡子汤。
又曰。治百合病。不经吐下发汗。病形如初者。宜百合地黄汤。
又曰。百合病。经月不解。变成渴者。宜百合洗方。
又曰。百合病。渴不瘥。宜栝蒌牡蛎散。
又曰。百合病。变发热者。宜百合滑石散。
千金曰。治百合病。变腹中满痛者。宜百合散。
雍曰。详金匮言发汗后。下之后。吐之后。皆有百合病也。而千
金方言百合病已经发汗之后更发者。百合病已经下之后更发者。百
合病已经吐之后更发者。其意谓百合本病。汗下吐之后而更发。非
伤寒汗下吐之后。变成百合病也。反似百合病中治劳复之伤。而不
见正行汗下吐百合病之药。于义未甚安。恐因数百年间。传录校正。
误有增加。非孙氏之本文。故活人书只用金匮本文。不用千金增加
更发等字。而庞氏直改其语云。治汗后百合病。治下后百合病。治吐
后百合病。尤使人不疑也。
又论曰。仲景以药之百合治百合病者。与神农经主治不相当。
自古莫能晓其义。是以孙真人言。伤寒杂病。自古有之。前古明贤。
多所防御。至于仲景。时有神功。寻思旨趣。莫测其致。所以医人不
能钻仰。此亦未能钻仰之一也。古人以孙真人之智犹如此。况乎后
之来者。然百合须百合治之。智者不能知。则前所谓三焦者。既有所
在。又三焦各有主对之药。按图可治。何难之有。不必须百合而后
治。雍是以疑非孙氏之言。或因而见三焦之症有如前所言。更不必
问是百合非百合。皆以三焦药治之可也。然百合之为物。岂因治百
合之病而后得名哉。或因是病须百合可治。因名曰百合乎。皆莫能。
测知也。然少时见先生言以百合汤治一仆病得愈。是时雍未甚留
意。不解仔细看症。虽见其似寒似热。似饥似饱。欲行欲卧。如今百
合之症。又自呼其姓名。有终夕不绝者。时至醒时问之。皆去不知。
此症殊不可晓。岂所谓如有神灵所加者乎。恐人有如是症者。因笔
于此后。此症又与素问所谓解 者相类。
《千金方》论述说：百合病，是指没有固定的经络病变部位，因为百脉同出一源，所以全身血脉都受到致病因素的影响。这通常是因为在伤寒、虚劳或大病之后，身体未能完全康复，从而演变成这种疾病。如果症状表现为怕冷且呕吐，说明病位在上焦，大约二十三天可以痊愈；如果症状表现为腹部胀满、轻微气喘、大便干结、三四天才解一次大便，偶尔又有少量稀便，说明病位在中焦，大约六十三天可以痊愈；如果症状表现为小便淋漓不尽、排尿困难，说明病位在下焦，大约三十三天可以痊愈。应当根据各自的症状进行治疗。郭雍说：孙思邈（孙氏）的论述，大多能在古书中找到依据。唯独这篇论述中将症状分为上、中、下三焦，这在古书中未曾见过。难道是原书已经散佚了吗？如果真的分属三焦，那么各病位都有对应的治疗药物，不应该像张仲景所说“各种药物都不能治愈”。实际上当时使用的是各种百合汤剂。《千金方》中关于百合病的其他论述，都收录在《金匮要略》中了。只有这一篇论述有所不同。
《金匮要略》论述说：百合病，是百脉同出一源，全部受到疾病的影响。患者想吃东西，却又吃不下；常常沉默寡言；想躺下，却又睡不着；想走动，却又走不动。饮食有时觉得味道好，有时又闻到食物气味就厌恶。好像有寒战，但实际上并没有寒战；好像有发热，但实际上并没有发热。口苦，小便颜色红赤。（《千金方》记载：早晨起来口苦，小便红赤涩痛。）各种药物都无法治愈，服药后反而剧烈呕吐或腹泻，好像有神灵加害一样。百合病患者，身形看起来如同常人，脉象微数。如果在排尿时感到头痛的，六十天后痊愈；排尿时不头痛，但感觉淅淅怕冷的，四十天痊愈；如果排尿时感觉畅快，只是头晕的，二十天痊愈。这些症状有的在发病前就预先出现，有的在发病四五日后才显现，有的在发病二十天或一个月后才轻微显现，都应随症治疗。《千金方》补充说：有的患者在发病一个月二十天后才出现症状，此时治疗容易出错。郭雍说：这篇论述中有表述不够明确的地方，现在都用《千金方》中的文字来补足。例如，如果说一个月二十天后症状才出现，那么在一个月二十天前进行治疗，怎么能不出错呢？所以《千金方》中“治疗容易出错”这四个字，最为关键重要。文中所说的“症状”，指的是排尿时的三种情况。
王叔和说：百合病的症状，若表现为沉默寡言，想躺下却睡不着；或者像健康人一样，想外出却走不动；想吃东西却又吃不下；有时觉得饮食美味，有时又厌恶闻见饮食的气味；好像寒冷却没有寒冷，好像发热却没有发热；早晨起来口苦，小便黄赤；身形看似正常，脉象微数。这是百脉同出一源而全部患病，应当随症治疗。
《金匮要略》又说：百合病表现于阴分的，用阳法来救治；表现于阳分的，用阴法来救治。如果见到阳证却去攻伐阴分，又再发其汗，这叫逆治。见到阴证却去攻伐阳分，又再用下法，这也叫逆治。
《千金方》说：百合病病位在阴，却去攻伐阳分，则阴分之病不能解除；如果再发其汗，就是逆治。病位在阳，却去攻伐阴分，则阳分之病不能解除；如果再使用下法，病就不会痊愈。郭雍说：《金匮要略》的意思，是说见到阳证应当攻阴，如果不攻阴而发汗，就是逆治；见到阴证应当攻阳，如果不攻阳而用下法，也是逆治。这一点比较容易明白。《千金方》的意思是，见到阴证攻伐阳分时，在阴证未解之间，不可再发汗，恐怕阳气再次受攻伐，所以称为逆治；见到阳证攻伐阴分时，在阳证未解之间，不可再使用下法，恐怕阳气再次受攻伐，所以称为逆治。这里的含义比较难以理解。
《金匮要略》又说：治疗百合病，经过发汗治疗的，适宜用百合知母汤。《外台秘要》记载：发汗后，再次发汗的；泻下后，再次发汗的；催吐后，再次发汗的。
《金匮要略》又说：治疗百合病，经过泻下治疗的，适宜用百合滑石代赭汤。
《金匮要略》又说：治疗百合病，经过催吐治疗的，适宜用百合鸡子汤。
《金匮要略》又说：治疗百合病，未经过催吐、泻下、发汗治疗，病情如初的，适宜用百合地黄汤。
《金匮要略》又说：百合病，经过一个月仍未解除，转变为口渴的，适宜用百合洗方。
《千金方》说：治疗百合病，转变为腹中胀满疼痛的，适宜用百合散。
郭雍说：详细考察《金匮要略》中提到发汗后、泻下后、催吐后，都会产生百合病。而《千金方》却说百合病在已经发汗之后再次发汗，已经泻下之后再次发汗，已经催吐之后再次发汗。它的意思似乎是说，百合病本身在汗、下、吐治疗后再次发作，而不是指伤寒经过汗、下、吐治疗后变成了百合病。这反而像是百合病中治疗劳复损伤的情况，而没有看到正行汗、下、吐法治疗百合病的药物，从义理上讲不太妥当。恐怕是因为几百年来传抄校正，错误地增加了内容，并非孙思邈的原著本文。所以《活人书》只采用《金匮要略》的原文，不使用《千金方》增加的“更发”等字，而庞安直直接修改语句为：“治疗汗后的百合病，治疗泻下后的百合病，治疗催吐后的百合病”，这样更让人不生疑窦。
又论述说：张仲景用百合这种药物治疗百合病，与《神农本草经》中百合的主治功效不相符合。自古以来没有人能明白其中的道理。所以孙思邈说：伤寒杂病，自古就有。前代的明贤，多有防范防御。至于张仲景，时常展现神功。探寻其中的旨趣，无法测度其深意。因此医生们不能深入钻研仰慕，这也是其中未能深入钻研的一个原因。古人认为像孙思邈这样的智者尚且如此，何况后来的学者呢？然而百合必须用百合来治疗。如果智者不能知晓，那么前面所说的三焦理论，既然各有病位，且三焦各有主治的药物，按照图谱即可治疗，有什么难的？不一定非要用百合才能治疗。郭雍因此怀疑这不是孙思邈的话。或者是因为看到了前述的三焦症状，更不必问是不是百合病，都可以用治疗三焦的药物来治疗。然而百合作为一种植物，难道是因为治疗百合病而得名吗？或者是因为这个病需要用百合治疗，所以才命名为百合病呢？这些都无从推测知晓。然而我年轻时曾见先生用百合汤治愈了一个仆人的病，当时我并未太在意，也没有仔细查看症状。虽然看到他似寒似热，似饥似饱，想走想卧，如今看来很像百合病的症状，但他又不停地呼唤自己的名字，整夜不停。到了醒来时问他，他都记不得了。这个症状非常奇怪，难以理解，难道就是所谓“好像有神灵加害”的情况吗？恐怕有人有类似的病症，因此记录下来放在后面。这个症状又与《素问》中所谓的“解㑊”（jiě xiè，一种肢体懈怠无力的病症）相似。
The *Qianjin Fang* (Thousand Gold Formulas) states: Baihe Bing (Lily Disease) refers to a condition where there is no fixed meridian pathology, because all vessels share a single origin, thus affecting the entire network of vessels. This typically arises after Shanghan (Cold Damage), Xu Lao (Deficiency and Emaciation), or major illnesses, when the body fails to fully recover, evolving into this disease. If symptoms manifest as aversion to cold and vomiting, the pathology is in the Upper Jiao (Upper Burner), and it should heal in approximately twenty-three days. If symptoms manifest as abdominal fullness, slight wheezing, hard stools, bowel movements only once every three to four days, occasionally with small amounts of loose stool, the pathology is in the Middle Jiao (Middle Burner), and it should heal in approximately sixty-three days. If symptoms manifest as dribbling urine and difficult urination, the pathology is in the Lower Jiao (Lower Burner), and it should heal in approximately thirty-three days. Treatment should follow the specific symptoms. Guo Yong stated: Sun Simiao’s (Sun Shi) discussions are mostly found in ancient texts. Only this discussion divides symptoms into the Upper, Middle, and Lower Jiao, which is not seen in ancient books. Could the original text have been lost? If it were truly divided by Jiao, each location would have corresponding treatments, and it should not be said, as Zhang Zhongjing did, that "various medicines cannot cure it." In fact, various Baihe Tang (Lily Decoction) formulas were used at that time. Other discussions on Baihe Bing in the *Qianjin Fang* are recorded in the *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet). Only this particular discussion differs.
The *Jin Gui Yao Lue* states: Baihe Bing occurs when all vessels, sharing a single origin, are affected by the disease. The patient desires to eat but cannot; often remains silent; desires to lie down but cannot sleep; desires to walk but cannot move. Food sometimes tastes good, but at other times the smell of food causes disgust. There may appear to be chills, but actually there are none; there may appear to be fever, but actually there is none. The mouth is bitter, and the urine is red. (*Qianjin Fang* notes: In the morning, the mouth is bitter, and urination is red and painful.) Various medicines cannot cure it; taking medicine results in severe vomiting and diarrhea, as if afflicted by spirits. Patients with Baihe Bing appear physically normal, with a pulse that is slightly rapid. If headache occurs during urination, healing takes sixty days. If there is no headache during urination but a sensation of shivering cold, healing takes forty days. If urination feels comfortable but dizziness occurs, healing takes twenty days. These symptoms may appear before the illness starts, emerge four to five days after onset, or appear mildly after twenty days or a month. Treatment should follow the symptoms. The *Qianjin Fang* adds: If symptoms appear more than one month and twenty days after onset, treatment is prone to error. Guo Yong stated: This discussion has unclear expressions, which are now supplemented with words from the *Qianjin Fang*. For example, if symptoms appear after one month and twenty days, treating before that period would inevitably lead to error. Thus, the phrase "treatment is prone to error" in the *Qianjin Fang* is most critical. The "symptoms" mentioned refer to the three conditions during urination.
Wang Shuhe stated: The symptoms of Baihe Bing include silence, desire to lie down but inability to sleep; appearing like a healthy person who desires to go out but cannot; desiring to eat but unable; sometimes finding food palatable, sometimes repulsed by the smell of food; seeming cold without actual cold, seeming hot without actual heat; bitter mouth in the morning, yellow-red urine; physical appearance is normal, pulse is slightly rapid. All vessels share one origin and are diseased; treatment should follow the symptoms.
The *Jin Gui Yao Lue* further states: When Baihe Bing manifests in Yin, treat it using Yang methods; when it manifests in Yang, treat it using Yin methods. Attacking Yin when Yang signs are present, and then inducing sweating, is a counter-therapeutic approach (Ni). Attacking Yang when Yin signs are present, and then using purgation, is also a counter-therapeutic approach.
The *Qianjin Fang* states: If Baihe Bing is located in Yin, attacking Yang will not resolve the Yin pathology. Inducing sweating again is a counter-therapeutic approach. If located in Yang, attacking Yin will not resolve the Yang pathology. Using purgation again will prevent the disease from healing. Guo Yong stated: The meaning of the *Jin Gui Yao Lue* is that when Yang signs are seen, one should attack Yin; if one does not attack Yin but induces sweating instead, it is a counter-therapeutic approach. When Yin signs are seen, one should attack Yang; if one does not attack Yang but uses purgation instead, it is also a counter-therapeutic approach. This is easy to understand. The *Qianjin Fang* means that when attacking Yang while Yin signs are present, one must not induce sweating while Yin is unresolved, lest Yang be attacked again, hence it is called counter-therapeutic. When attacking Yin while Yang signs are present, one must not use purgation while Yang is unresolved, lest Yang be attacked again, hence it is called counter-therapeutic. The intent here is difficult to comprehend.
The *Jin Gui Yao Lue* further states: For Baihe Bing treated with sweating, Baihe Zhi Mu Tang (Lily and Anemone Decoction) is appropriate. The *Wai Tai Mi Yao* (Prescriptions from the Imperial Outer Library) records: After sweating, if sweating is induced again; after purgation, if sweating is induced again; after vomiting, if sweating is induced again.
The *Jin Gui Yao Lue* further states: For Baihe Bing treated with purgation, Baihe Huashi Daizhe Tang (Lily, Talcum, and Hematite Decoction) is appropriate.
The *Jin Gui Yao Lue* further states: For Baihe Bing treated with vomiting, Baihe Jizi Tang (Lily and Egg Yolk Decoction) is appropriate.
The *Jin Gui Yao Lue* further states: For Baihe Bing not treated with vomiting, purgation, or sweating, with symptoms remaining as initially, Baihe Di Huang Tang (Lily and Rehmannia Decoction) is appropriate.
The *Jin Gui Yao Lue* further states: If Baihe Bing persists for a month and transforms into thirst, Baihe Xi Fang (Lily Wash Formula) is appropriate.
The *Jin Gui Yao Lue* further states: If Baihe Bing involves thirst that does not resolve, Gualou Muli San (Trichosanthes Root and Oyster Shell Powder) is appropriate.
The *Jin Gui Yao Lue* further states: If Baihe Bing transforms into fever, Baihe Huashi San (Lily and Talcum Powder) is appropriate.
The *Qianjin Fang* states: For Baihe Bing transforming into abdominal fullness and pain, Baihe San (Lily Powder) is appropriate.
Guo Yong stated: Examining closely, the *Jin Gui Yao Lue* mentions that sweating, purgation, and vomiting can all result in Baihe Bing. However, the *Qianjin Fang* says that after Baihe Bing has already undergone sweating, if sweating is induced again; after purgation, if sweating is induced again; after vomiting, if sweating is induced again. Its implication seems to be that Baihe Bing itself recurs after sweating, purgation, or vomiting, rather than indicating that Shanghan transforms into Baihe Bing after these treatments. This resembles the treatment of relapse due to overexertion within Baihe Bing, rather than showing the correct medications for sweating, purgation, or vomiting in the context of Baihe Bing. This interpretation is not entirely satisfactory. It is likely that due to centuries of transcription and correction, errors were added, and this is not Sun Simiao’s original text. Therefore, the *Huo Ren Shu* (Book Reviving People) uses only the original text of the *Jin Gui Yao Lue*, excluding the added words like "induced again" from the *Qianjin Fang*. Pang Anzhi directly revised the language to: "Treating Baihe Bing after sweating, Treating Baihe Bing after purgation, Treating Baihe Bing after vomiting," which removes doubt even more effectively.
Another discussion states: Zhang Zhongjing used Baihe (Lily Bulb) to treat Baihe Bing, which does not correspond to the main indications of Baihe in the *Shen Nong Ben Cao Jing* (Divine Farmer's Materia Medica). Since ancient times, no one has understood its rationale. Thus, Sun Simiao said: Shanghan and miscellaneous diseases have existed since antiquity. Ancient sages had many preventive measures. As for Zhang Zhongjing, he demonstrated divine efficacy. Seeking the profound meaning, its depth is unfathomable. Therefore, physicians cannot deeply study and admire it. This is one reason for such lack of deep study. Ancients believed that even a sage like Sun Simiao was puzzled, let alone later scholars. However, Baihe must be treated with Baihe. If wise men cannot know, then regarding the previously mentioned Jiao theory, since each has its location and corresponding herbs, treatment according to charts would be easy. One does not necessarily need Baihe to treat it. Guo Yong therefore suspected this was not Sun Simiao’s words. Or perhaps, seeing the Jiao symptoms as described earlier, one need not ask if it is Baihe Bing or not, and could treat all with Jiao-specific herbs. But how could the plant Baihe get its name from treating Baihe Bing? Or was it named Baihe Bing because Baihe is required to treat it? These cannot be determined. However, I recall my teacher curing a servant’s illness with Baihe Tang. At that time, I did not pay much attention nor carefully observe the symptoms. Although he appeared similar to cold/heat, hunger/fullness, desire to walk/lie down—resembling current Baihe Bing symptoms—he continuously called his own name throughout the night. Upon waking, he had no memory of it. This symptom is extremely puzzling. Is this what is meant by "as if afflicted by spirits"? Perhaps someone has such symptoms, so I record it here. This symptom is also similar to the "Xie Xie" (limb flaccidity and weakness) mentioned in the *Su Wen* (Basic Questions).