石顽治内翰孟端士尊堂。因久不见其子。兼闻有病。遂虚火上升。自汗不止。心神恍惚
欲食不能食。欲卧不能卧。口苦小便难。溺则洒淅头晕。已及一岁。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
骨脂则后重燥急。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。较之盗汁迥殊。直至仲春。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。曾遍省吴下诸名医。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。奈病久中气亏乏逮尽。
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
左金丸而安。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。
震按百合病载于金匮。原云百脉一宗。悉致其病。钱塘李 臣归重心肺二经。以心主血
脉。肺朝百脉也。此言与百合地黄汤恰合。今观孟夫人案。实由思子郁结。病在心肝。大半
似百合病形。石顽遂附会之耳。然不用金匮成方。可云老手。若日饮百合汤。何关得失耶。
石顽诊治内阁学士孟端士的母亲。因为她长久未见儿子，又听说儿子有病，于是虚火上炎，自汗不止，心神恍惚，想进食却吃不下，想躺卧却睡不着，口苦，小便困难，排尿时感到寒冷战栗并头晕，病程已持续一年。历经多位医生诊治，每用一种药就增加一种病症：使用白术则导致胸膈窒塞胀满；使用橘皮则引发喘息心悸；使用远志则导致烦躁烘热；使用木香则引起腹部发热咽干；使用黄芩则出现神志昏闷不想饮食；使用枳壳则导致气喘咳嗽气短；使用麦冬则造成小便失禁；使用肉桂则引起头部胀痛咳逆；使用补骨脂则导致肛门坠胀燥急；使用知母、黄柏则导致小腹枯瘪；使用黄芩、栀子则导致脐下牵引拘急；使用香薷则导致耳鸣目眩，时时想要人搀扶才能行走；使用大黄则导致脐下悸动不安，少腹更加收缩牵引。于是患者对药物产生恐惧，如同畏惧蝎子一般，仅每日用人参一钱许，加入粥饮中调和服用，勉强支撑身体。到了春季，虚火加倍剧烈，火气一升，周身大汗淋漓，神气几乎脱散，只有疲倦且极少睡眠时，才不出汗而神思稍安宁。醒来后片刻，火气再次上升，汗也随之而至，这与盗汗截然不同。直到仲春时节，邀请石顽诊脉。其脉象微数，且左尺部和左寸部比其他部位明显盛大，气口（右关）按之似有似无。诊脉后，患者详细陈述了之前的患病经过以及用药后病情加重的原因。曾遍访吴地各位名医，没有一人能识别这是什么病。石顽说：“这原本是因为平时思虑伤脾，脾阴受困，导致厥阳之火全部归于心，扰乱百脉而致病。病名叫做百合病。此证唯有张仲景《金匮要略》论述得非常详尽。原文本来说各种药物都不能治，所以每服一种药就增加一种病症。只有百合地黄汤是专门治疗此病的方剂。无奈病程长久，中气亏乏殆尽，再加上误药治疗形成了坏病。暂且先用生脉散加百合、茯神、龙齿来安神，稍微兼用山茱萸、黄连以折损火势。服用几剂后稍见安宁，随即令停止服药以养胃气，只让每日用鲜百合煮汤服用。到了秋季，天气下降，火气逐渐潜伏，可以保全无忧。后来到了仲秋，孟端士请假回家探望，欣然停药而康复。之后因为劳心思虑，火气又有升动的迹象。有人让他服用左金丸而安定下来。此后稍觉火炎，就服用前面的丸药。只是苦燥的药性，苦味先入心，加上辛臊气味入肝，长期服用不无反从火化的担忧。平治权衡的要领，难道可以不预先顾虑吗？”
俞震按语：百合病记载于《金匮要略》，原文说“百脉一宗，悉致其病”。钱塘李 臣重视心肺二经，认为心主血脉，肺朝百脉。这种说法与百合地黄汤的功效恰好吻合。如今看孟夫人的医案，实际上是由思念儿子导致郁结，病位在心肝，大半症状类似百合病的形态。石顽于是附会此为百合病罢了。然而不使用《金匮要略》中的成方，可以说是一位老练的医生。如果说是每日饮用百合汤，这又有什么得失可言呢？
Shi Wan treated the mother of Hanlin Academician Meng Duanshi. Because she had not seen her son for a long time and heard that he was ill, deficiency fire flared upward, causing spontaneous sweating without cessation, mental agitation, inability to eat despite wanting to, inability to lie down despite wanting to, bitter taste in the mouth, difficult urination, chills and dizziness during urination. This condition persisted for one year. Having undergone treatment by various physicians, each medication administered only added new symptoms: using Baizhu (Atractylodis Rhizoma) caused chest stuffiness and distension; using Jupi (Citri Reticulatae Pericarpium) induced panting and palpitations; using Yuanzhi (Polygalae Radix) caused irritability and hot flashes; using Muxiang (Aucklandiae Radix) led to abdominal heat and dry throat; using Huangqin (Scutellariae Radix) resulted in mental cloudiness and anorexia; using Zhike (Aurantii Fructus Immaturus) caused wheezing, coughing, and qi deficiency; using Maidong (Ophiopogonis Radix) led to urinary incontinence; using Rougui (Cinnamomi Cortex) caused cranial distension and counterflow coughing; using Buguzhi (Psoraleae Fructus) resulted in tenesmus and dry urgency; using Zhimu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex) caused withering of the lower abdomen; using Huangqin (Scutellariae Radix) and Zhizi (Gardeniae Fructus) caused pulling tension below the umbilicus; using Xiangru (Elsholtziae Herba) led to tinnitus and vertigo, requiring support to walk at all times; using Dahuang (Rhei Radix et Rhizoma) caused pulsating pain below the umbilicus and further contraction of the hypogastrium. Consequently, the patient developed a fear of medicine akin to fearing scorpions, relying solely on taking about one qian of Renshen (Ginseng Radix et Rhizoma) daily mixed with porridge drink to barely sustain herself. Upon entering spring, the deficiency fire intensified significantly; whenever the fire qi rose, profuse sweating occurred over the whole body, and the spirit seemed on the verge of collapse. Only when exhausted and sleeping very little did the sweating cease and the mind find slight relief. Shortly after waking, the fire qi would rise again, followed immediately by sweating, which was distinctly different from night sweats. Until mid-spring, Shi Wan was invited to diagnose. The pulse was slightly rapid, with the left Chi (尺) and left Cun (寸) positions being significantly fuller than other parts, while the Qi Kou (Right Guan/气口) felt faint upon pressure. After diagnosis, the patient detailed her previous illness and the reasons for worsening due to medications. She had consulted numerous famous doctors in the Wu region, none of whom could identify the disease. Shi Wan said, "This originates from chronic worry injuring the Spleen, trapping Spleen Yin, causing Jue Yang fire to歸归 to the Heart, disturbing the hundred vessels. The disease is named Baihe Bing (Lily Disease). This syndrome is described in detail only in Zhang Zhongjing's *Jinkui Yaolue* (Essential Prescriptions from the Golden Cabinet). The original text states that various medicines cannot treat it, hence each medication adds new symptoms. Only Baihe Dihuang Tang (Lily Bulb and Rehmannia Decoction) is the specific remedy. However, due to the prolonged illness, Middle Qi is depleted, and iatrogenic errors have created a complex disorder. For now, use Shengmai San (Generate the Pulse Powder) plus Baihe (Lily Bulb), Fushen (Poria with Hostwood), and Longchi (Dragon Bone) to calm the spirit, slightly adding Yuzhu (Cornus Fruit) and Lianzi (Lotus Plumule) or Huanglian (Coptidis Rhizoma) to curb the fire. After a few doses, if there is slight relief, stop medicinal herbs to nourish Stomach Qi, allowing only fresh Baihe decoction daily. When autumn arrives, heaven's qi descends, fire qi gradually submerges, and safety can be ensured. Later, in mid-autumn, Meng Duanshi took leave to visit home, recovered happily by stopping medication. Subsequently, due to mental labor and worry, the fire showed signs of rising again. Someone prescribed Zuojin Wan (Left Metal Pill) to stabilize him. Thereafter, whenever slight fire flare-ups occurred, he took this pill. However, the bitter-dry nature, where bitterness enters the Heart first, combined with pungent-odorous properties entering the Liver, poses a risk of transforming into fire with long-term use. Is it not necessary to consider this balance proactively?"
Yu Zhen commented: Baihe Bing is recorded in *Jinkui Yaolue*, stating "The hundred vessels share one source, all are affected." Li Chen of Qiantang emphasized the Heart and Lung meridians, noting that the Heart governs blood vessels and the Lung faces the hundred vessels. This aligns well with Baihe Dihuang Tang. Observing Madam Meng's case, it was actually caused by sorrowful thinking leading to stagnation, affecting the Heart and Liver, resembling Baihe Bing in most aspects. Shi Wan thus associated it with Baihe Bing. Nevertheless, avoiding the established formula from *Jinkui Yaolue* demonstrates experienced clinical judgment. As for drinking Baihe soup daily, what gain or loss does it truly entail?