百合病者，皆缘时疫新愈，其三焦腠理荣卫之交，余热未清，正气困乏，不能流畅。如人在云雾之中，倏清倏浑。
如日月被蚀之后，或明或暗，故有种种不可名言之状。而其口苦、小便赤、脉微数，乃余热的证也。病不在经络脏腑，
杨云∶此句欠酌。
治不能补泻温凉，惟以清气为主。气归于肺，而肺朝百脉，一宗者，统宗于一，即悉致其病之谓
也。溺时头痛者，小便由于气化，水去则火上冲也。其病为重，六十日愈，月再周而阴必复也。溺时淅淅然者，膀胱腑
气一空，表气亦因之失护也。但头眩者，阳气不能上达也。热渐衰，病渐轻，故愈日渐速也。曰其证，指溺时头痛诸证
而言。曰未病预见，谓未成百合病，先见头痛等证也。百合清热养阴，专润肺气，治以百合，即以百合名病也。
雄按∶此病仲景以百合主治，即以百合名其病。其实余热逗留肺经之证，凡温暑湿热诸病后皆有之，不必疫也。肺
主魄，魄不安则如有神灵，肺失整肃，则小便赤，百合功专清肺，故以为君也。杨云∶前注已平正通达，读此更亲切不
易，觉前注尚隔一层。余尝谓孟英学识，前无古人，试取其所注，与古人所注较论之，当知余言之，非阿所好也。忆辛
丑暮春，于役兰溪，在严州舟次，见一女子患此证，其父母以为祟也。余询其起于时证之后，察其脉数，第百合无觅处，
遂以苇茎、麦冬、丝瓜子、冬瓜皮、知母为方。汪按∶百合本治肺之品，从此悟入，可谓在人意中，出人意外矣。服之，
一剂知，二剂已。
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。
此推究致百合病之源。见于阴者，即阴中于邪也，阴既受邪，不即与阳气通调，则阴邪愈闭，法当攻阳以救其阴也；
见于阳者，即阳中于邪也，阳既受邪，不即与阴气通调，则阳邪不化，法当攻阴以救其阳也。若不攻阴救阳，复发其汗，
是为见阳攻阳；不知攻阳救阴，复下之，是为见阴攻阴。二者均之为逆，皆因治不如法，阴阳未能透解，所以致有百合
之病。若于百合病中并无汗下之证，毋用汗下之法也。下之，汗、吐、下皆此意。此处“阴阳”二字，但就营卫讲，不
说到气血脏腑上。
百合病，发汗后者，百合知母汤主之。
得之汗后者，其阳分之津液必伤，余热留连而不去，和阳必以阴，百协议知母、泉水，以清其余热，而阳邪自化也。
○按∶初病邪重，故上节言救、言攻，此病后余邪，当用和法。
百合病，吐之后者，百合鸡子黄汤主之。
其得之吐后者，吐从上逆，较发汗更伤元气，阴火得以上乘，清窍为之蒙蔽矣。故以鸡子黄之纯阴养血者，佐百合
以调和心肺，是亦用阴和阳矣。
百合病，下之后者，百合滑石代赭汤主之。
其得之于下后者，下多伤阴，阴虚则阳往乘之，所以有下焦之热象，百合汤内加滑石、代赭，取其镇逆利窍以通阳
也。是谓用阳和阴法。
百合病，不经吐、下、发汗，病形如初者，百合地黄汤主之。
不经吐、下、发汗，正虽未伤，而邪热之袭于阴阳者，未必透解，所以致有百合病之变也。病形如初，指百合病首
节而言，地黄取汁，下血分之瘀热，故云∶大盒饭如漆，非取其补也。百合以清气分之余热，为阴阳和解法。
百合病，一月不解，变成渴者，百合洗方主之。
百合病，至一月不解，缠绵日久，变成渴者，津液消耗，求水以自滋也。渴而不致下消，病犹在肺，肺主皮毛，故
以百合汤洗之，使毛脉合行，精气于腑也。食煮饼，假麦气以助津液。勿以盐豉，恐夺津增渴也。
百合病，渴不瘥者，栝蒌牡蛎散主之。杨云∶此条证比上条较重。
雄按∶尤在泾曰∶病变成渴，与百合洗方而不瘥者，热盛而津液伤也。栝蒌根苦寒，生津止渴。牡蛎，咸寒，引热
下行，不使上铄也。此注已极该括，陈注较逊，故从尤本。
百合病，变发热者，百合滑石散主之。
变发热者，余邪郁久，淫于肌表，热归阳分也。百合，清金退热，加滑石，以利窍通阳，日当微利，指小便利言，
谓热从小便去也。
狐蜮之为病，状如伤寒，默默欲眠，目不得闭，卧起不得安，蚀于喉为蜮，蚀于阴为狐。不欲饮食，恶闻食臭也。
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。
百合病是余热留连于气机者，狐蜮病是余毒停积于幽阴者。狐蜮，水虫也。原疫邪不外湿热，久留不散，积而生虫。
顾听泉云∶疫邪久留，人不活矣。久留上宜加“余邪”二字。喉与二阴为津液湿润之处，故虫生于此也。声嗄因知其蚀
于喉，咽干而知其蚀于阴者，因其热郁于下，津液不能上升也。余热内郁，故状似伤寒。内热，故默默欲眠。内烦，故
目不得闭，卧起不安。面目乍赤、乍黑、乍白，以热邪隐见不常，非虫动也。苦参、雄黄，皆燥湿杀虫之品，甘草泻心，
不特使中气运而湿热自化，抑亦苦辛杂用，足胜杀虫之任也。略参尤氏。
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，脓已成。赤
豆当归散主之。
此疫邪热毒蕴伏于内也。故有脉数、身不热、微烦、欲卧之证。初得之汗出，表气尚通也。至三四日目赤如鸠眼，
热伤血分也。七八日，目四 黑，血已腐败也。能食者，病不在胸腹，脓成于下也。赤小豆，清热去湿，兼以解毒。当
归，和血化脓，使毒从下解也。
先辈喻嘉言将《辨脉篇》中“清邪中上焦，浊邪中下焦”一节，为仲景论疫根据，可谓独具只眼者矣。其治法以逐
秽为第一义。上焦如雾，升而逐之，兼以解毒；中焦如沤，疏而逐之，兼以解毒；下焦如渎，决而逐之，兼以解毒。此
论识超千古。
雄按∶林北海亦云∶喻氏论疫，高出千古，直发前人所未发。盖仲景于吐利、霍乱等，不过感一时冷热之
气者，犹且论及，而谓疫病之为流行大毒者，反不之及耶！然则《伤寒论》中之必有疫证，是非臆说，坤学识浅陋，不
敢妄自搜罗，扰乱经旨，但将《伤寒》《金匮》中证治，与风寒等法不合，寓有毒意者，均归之疫！
雄按∶守真论温，风
逵论暑，又可论疫，立言虽似创辟，皆在仲景范围内也。
杨按∶此篇搜辑甚佳，俱古人所未及，然原论不可解处甚多，其用方与病不相登对处亦有之，读者师其意，而于其
不可解者，勿强事穿凿则善矣。汪按∶此评大妙，如此方不为昔人所愚，所谓尽信书不如无书也。
百合病，都是由于时行疫病刚刚痊愈，三焦腠理与营卫之气交接之处，余热尚未清除，正气困乏，不能流畅运行。就像人在云雾之中，忽然清明忽然浑浊；又像日月被蚀之后，或明或暗，所以有种种无法用言语形容的症状。而其口苦、小便赤红、脉象微数，是余热的证候。病不在经络脏腑，杨云：这一句值得斟酌。治疗不能采用补泻温凉的方法，只以清泄气分热邪为主。气归属于肺，而肺朝会百脉，“一宗”的意思，就是统摄于一处，即导致全身各部位发病的意思。排尿时头痛的，是因为小便依赖气化功能，水液排出则虚火上冲所致。病情严重的，六十日痊愈，因为两个月一个周期，阴气必然恢复。排尿时感觉身体发冷的，是因为膀胱腑气空虚，表气也因此失去护卫。只是头晕目眩的，是因为阳气不能上达头部。热势逐渐衰退，病情逐渐减轻，所以痊愈的日子加快。“其证”，指的是排尿时头痛等各种症状而言。“未病预见”，是指还没有形成百合病，先出现头痛等症状。百合能清热养阴，专门润肺气，用百合来治疗，因此就用百合来命名这个病。
王士雄按：这个病张仲景用百合主治，因此就用百合命名这个病。其实这是余热逗留于肺经的证候，凡是温病、暑病、湿热病等病后都有这种情况，不一定是疫病。肺主魄，魄不安定则好像有神灵作祟，肺失掉肃降功能，则小便赤红，百合功效专于清肺，所以作为君药。杨云：前面的注释已经平正通达，读这个注释更加亲切不易，觉得前面的注释还隔了一层。我曾经说孟英（王士雄）的学识前无古人，试着把他所注的内容，与前人注释比较讨论，就会知道我的话不是阿谀奉承。回忆辛丑年暮春，我在兰溪服役，在严州船停泊处，看见一个女子患这种病，她的父母认为是鬼怪作祟。我询问她起病是在时行疫病之后，观察她的脉象数，只是找不到百合，于是用苇茎、麦冬、丝瓜子、冬瓜皮、知母组成方剂。汪按：百合本是治疗肺脏的药物，从这里领悟进去，可以说是在情理之中，出人意料之外。服用后，一剂见效，二剂痊愈。
百合病，表现为阴证特征的，用阳法救治；表现为阳证特征的，用阴法救治。见到阳证特征却攻伐阴分，又再发其汗，这是逆治；见到阴证特征却攻伐阳分，又再用下法，这也是逆治。
这是在推究导致百合病的根源。所谓“见于阴”，就是阴分受了邪气，阴既然受邪，如果不立即与阳气通调，那么阴邪会更加闭郁，治法应当攻伐阳分以救助阴分；所谓“见于阳”，就是阳分受了邪气，阳既然受邪，如果不立即与阴气通调，那么阳邪就不能化解，治法应当攻伐阴分以救助阳分。如果不攻伐阴分来救助阳分，反而发汗，这就是见阳证而攻阳分；不知道攻伐阳分来救助阴分，反而用下法，这就是见阴证而攻阴分。这两种情况都属于逆治，都是因为治疗方法不合法度，阴阳未能透解，所以才导致百合病的发生。如果在百合病中并没有汗、下的适应证，就不要使用汗、下之法。下法、汗法、吐法都是这个意思。这里的“阴阳”二字，只是就营卫来讲，不涉及气血脏腑。
百合病，经过发汗治疗后未愈的，用百合知母汤主治。
得了百合病又经过发汗治疗的，其阳分的津液必定受伤，余热留恋不去，调和阳气必须借助阴液，百合配合知母、泉水，来清泄余热，阳邪自然化解。○按：初病邪气重，所以上一节讲救治、讲攻伐，这是病后余邪，应当用和法。
百合病，经过催吐治疗后未愈的，用百合鸡子黄汤主治。
得了百合病又经过催吐治疗的，呕吐是从上焦逆出，比发汗更伤元气，阴火得以向上乘袭，清窍因此被蒙蔽。所以用鸡子黄这种纯阴养血的东西，辅助百合来调和心肺，这也是用阴来调和阳的方法。
百合病，经过泻下治疗后未愈的，用百合滑石代赭汤主治。
得了百合病又经过泻下治疗的，泻下过多损伤阴液，阴虚则阳邪乘虚而入，所以有下焦的热象，百合汤内加入滑石、代赭石，取其镇逆利窍以通阳的作用。这叫做用阳来调和阴的方法。
百合病，没有经过催吐、泻下、发汗治疗，病情表现如初的，用百合地黄汤主治。
没有经过催吐、泻下、发汗治疗，正气虽然未伤，但邪热侵袭阴阳的情况，未必透解，所以导致百合病的变化。病形如初，指百合病首节所述的症状，地黄取汁，下行血分的瘀热，所以说大便像漆一样黑，不是为了取其补益作用。百合清泄气分的余热，这是阴阳和解的方法。
百合病，一个月不好转，变成口渴的，用百合洗方主治。
百合病，到一个月不好转，缠绵日久，变成口渴的，津液消耗，寻求水液来自我滋润。口渴但没有发展到下消（糖尿病晚期多尿消瘦），病还在肺，肺主皮毛，所以用百合汤外洗，使毛脉并行，精气归于腑。吃煮饼，借麦子之气来帮助生成津液。不要用盐豉，恐怕夺取津液增加口渴。
百合病，口渴不好的，用栝蒌牡蛎散主治。杨云：这条证候比上一条较重。
王士雄按：尤在泾说：病变成口渴，用了百合洗方而不好转的，是热盛而津液受伤。栝蒌根苦寒，生津止渴。牡蛎咸寒，引热下行，不让热气上灼。这个注释已经非常全面概括，陈修园的注释较差，所以遵从尤氏的本子。
百合病，变成发热的，用百合滑石散主治。
变成发热，是余邪郁结日久，浸淫于肌表，热归入阳分。百合清金退热，加滑石，以利窍通阳，每天应当轻微得利，指小便利而言，意思是热从小便排出。
狐惑病这种病，症状像伤寒，沉默想睡觉，眼睛不能闭合，躺下坐起都不安宁，腐蚀咽喉叫惑，腐蚀前后阴叫狐。不想饮食，厌恶闻到食物的气味。
其面目时而发红、时而发黑、时而发白。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（前后阴）则咽干，用苦参汤外洗。腐蚀在肛门的，用雄黄熏蒸。
百合病是余热留恋于气机，狐惑病是余毒停积于幽阴之处。狐惑，是水虫。原来疫邪不外乎湿热，久留不散，积聚而生虫。顾听泉说：疫邪久留，人就不活了。久留上面应该加“余邪”二字。喉与二阴是津液湿润的地方，所以虫生在这里。声音嘶哑是因为知道腐蚀在咽喉，咽干是因为知道腐蚀在前阴，这是因为热郁结在下部，津液不能上升。余热内郁，所以症状像伤寒。内有热，所以沉默想睡觉。内有烦热，所以眼睛不能闭合，躺下坐起不安。面目时而发红、时而发黑、时而发白，是因为热邪隐现无常，不是虫动造成的。苦参、雄黄，都是燥湿杀虫的药物，甘草泻心汤，不仅使中气运转而湿热自化，也是苦辛杂用，足以胜任杀虫的任务。略参考尤氏的观点。
病人脉数，没有发热但轻微烦躁，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，眼睛四周发黑。如果能吃东西，说明脓已成。用赤豆当归散主治。
这是疫邪热毒蕴伏在体内。所以有脉数、身不热、微烦、想睡的症状。刚得病时出汗，表气还是通畅的。到了三四天眼睛红得像斑鸠的眼睛，是热伤了血分。七八天，眼睛四周发黑，血已经腐败了。能吃东西，说明病不在胸腹，脓成于下部。赤小豆，清热去湿，兼以解毒。当归，和血化脓，使毒邪从下部排出。
先辈喻嘉言将《辨脉篇》中“清邪中上焦，浊邪中下焦”一节，作为张仲景论述疫病的根据，可以说是独具慧眼的人。他的治法以驱逐秽浊为第一要义。上焦如雾，升提而驱逐它，兼以解毒；中焦如沤，疏通而驱逐它，兼以解毒；下焦如渎，决泄而驱逐它，兼以解毒。这个论述见识超过千古。
王士雄按：林北海也说：喻氏论述疫病，高出千古，直接阐发了前人未曾发表的观点。大概张仲景对于吐利、霍乱等，不过是感受一时冷热之气的人，尚且加以论述，难道认为疫病作为流行大毒的疾病，反而不加论述吗！既然如此，《伤寒论》中必然有疫病证候，这不是臆测之谈，坤（王士雄自称）学识浅陋，不敢妄自搜集罗列，扰乱经典主旨，只是将《伤寒》《金匮》中证治，与风寒等方法不合，寓有毒意的，都归结为疫病！
王士雄按：守真论述温病，逵论述暑病，又可论述疫病，立言虽然看似开创，都在张仲景的范围内。
杨按：这一篇搜集得很好，都是古人所未涉及的，然而原论不可理解的地方很多，其中用药与病症不相符合的地方也有，读者学习其意旨，而对于那些不可理解的地方，不要强行穿凿附会就好了。汪按：这个评价非常妙，这样才不被古人愚弄，所谓尽信书不如无书。
Baihe Disease (Lily Disease) arises primarily from the recent recovery from an epidemic febrile disease. At the junction of the Sanjiao (Triple Burner), couli (interstices), Ying (Nutritive Qi), and Wei (Defensive Qi), residual heat remains unclarified, while Zheng Qi (Upright Qi) is exhausted and unable to flow smoothly. It is like a person amidst clouds and mist, suddenly clear then turbid; or like the sun and moon after an eclipse, sometimes bright, sometimes dark. Thus, there are various indescribable manifestations. The symptoms of bitter taste in the mouth, red urine, and a slightly rapid pulse are signs of residual heat. The disease does not reside in the meridians or zang-fu organs. Yang notes: This sentence warrants consideration. Treatment cannot employ tonification, purgation, warming, or cooling methods; it focuses primarily on clearing Qi-level heat. Qi belongs to the Lung, which governs all vessels. "Yi Zong" (One Source) implies unity, meaning the pathology affects the whole body. Headache during urination occurs because urination relies on Qi transformation; when water leaves, fire flares upward. In severe cases, recovery takes sixty days, as two lunar cycles allow Yin to recover. Chills during urination indicate emptiness of Bladder Fu Qi, leading to a loss of Defensive Qi protection. Dizziness alone indicates that Yang Qi fails to ascend. As heat declines and symptoms lighten, recovery accelerates. "Its symptoms" refers to headache during urination and similar signs. "Premonitory signs before disease formation" means symptoms like headache appear before Baihe Disease fully develops. Baihe (Lily Bulb) clears heat and nourishes Yin, specifically moistening Lung Qi. Using Baihe for treatment gives the disease its name.
Wang Shixiong adds: Zhang Zhongjing used Baihe as the main herb, hence the name. Actually, this is a condition where residual heat lingers in the Lung Meridian. It occurs after warm, summer-heat, or damp-heat diseases, not necessarily epidemics. The Lung governs Po (Corporeal Soul); if Po is unsettled, it feels like spiritual possession. If Lung loses its descending function, urine becomes red. Since Baihe specializes in clearing the Lung, it serves as the Sovereign herb. Yang notes: The previous annotation was sound and accessible; reading this one feels more intimate, suggesting the previous one was somewhat detached. I once said Mengying’s (Wang Shixiong’s) scholarship was unparalleled. Comparing his annotations with ancient ones will prove my words are not flattery. Recalling late spring of the Xinchou year, while serving in Lanxi at Yanzhou, I saw a woman suffering from this condition. Her parents thought it was a spirit affliction. I asked if it started after an epidemic illness and found her pulse rapid. Since Baihe was unavailable, I prescribed Weijing (Eupatorium Herb), Maidong (Ophiopogon Tuber), Sigua Zi (Luffa Seed), Dongguapi (Winter Melon Rind), and Zhimu (Anemarrhena Rhizome). Wang notes: Baihe treats the Lung; realizing this connection is logical yet unexpected. One dose brought improvement; two doses cured her.
In Baihe Disease, if Yin-type manifestations predominate, treat with Yang-methods; if Yang-type manifestations predominate, treat with Yin-methods. Treating Yang manifestations by attacking Yin and inducing sweating is contrary (Ni); treating Yin manifestations by attacking Yang and using purgation is also contrary.
This section explores the origin of Baihe Disease. "Manifesting in Yin" means the Yin aspect is affected by pathogenic factors. If Yin is affected and not immediately harmonized with Yang, Yin pathogens become closed off; thus, one should attack Yang to rescue Yin. "Manifesting in Yang" means the Yang aspect is affected. If Yang is affected and not harmonized with Yin, Yang pathogens fail to transform; thus, one should attack Yin to rescue Yang. Failing to attack Yin to rescue Yang, but instead inducing sweating, constitutes "attacking Yang upon seeing Yang." Failing to attack Yang to rescue Yin, but instead using purgation, constitutes "attacking Yin upon seeing Yin." Both are contrary treatments due to improper methods preventing the resolution of Yin-Yang imbalance, leading to Baihe Disease. If there are no indications for sweating or purgation in Baihe Disease, these methods should not be used. This logic applies to emesis, sweating, and purgation. Here, "Yin and Yang" refer specifically to Ying and Wei Qi, not Blood, Qi, or Zang-Fu organs.
For Baihe Disease persisting after sweating, Baihe Zhi Mu Tang (Lily Bulb and Anemarrhena Decoction) is indicated. Sweating injures Yang-level fluids, allowing residual heat to linger. Harmonizing Yang requires Yin; Baihe combined with Zhi Mu and Spring Water clears residual heat, resolving Yang pathogens. Note: Early disease involves heavy pathogens, requiring rescue or attack; post-disease residual pathogens require harmonization.
For Baihe Disease persisting after vomiting, Baihe Jizi Huang Tang (Lily Bulb and Egg Yolk Decoction) is indicated. Vomiting causes rebellion from above, injuring Yuan Qi more than sweating. Yin Fire ascends, obscuring clear orifices. Jizi Huang (Egg Yolk), being purely Yin and blood-nourishing, assists Baihe to harmonize Heart and Lung, employing Yin to harmonize Yang.
For Baihe Disease persisting after purgation, Baihe Huashi Daizhe Tang (Lily Bulb, Talcum, and Hematite Decoction) is indicated. Purgation damages Yin excessively; Yin deficiency allows Yang pathogens to invade, causing Lower Jiao heat signs. Adding Huashi (Talcum) and Daizhe (Hematite) to Baihe Tang calms rebellion, opens orifices, and unblocks Yang. This is using Yang to harmonize Yin.
For Baihe Disease not treated with emesis, purgation, or sweating, with symptoms remaining unchanged, Baihe Dihuang Tang (Lily Bulb and Rehmannia Decoction) is indicated. Without these treatments, Zheng Qi is intact, but pathogenic heat affecting Yin-Yang may not resolve, causing Baihe Disease variations. "Symptoms unchanged" refers to initial signs. Dihuang juice drains blood-level stasis-heat, causing black stool (not for tonification). Baihe clears Qi-level residual heat, achieving Yin-Yang harmony.
If Baihe Disease persists for a month and transforms into thirst, Baihe Xi Fang (Lily Bulb Wash Formula) is indicated. Prolonged Baihe Disease consumes fluids, causing thirst seeking self-nourishment. If thirst does not progress to Xia Xiao (Lower Wasting-Thirst), the disease remains in the Lung. The Lung governs skin and hair; washing with Baihe decoction promotes circulation between hair follicles and vessels, returning essence to the Fu organs. Eating Zhu Bing (boiled wheat noodles) utilizes Wheat Qi to assist fluid generation. Avoid Yan Chi (salted beans) as salt may deplete fluids and worsen thirst.
If thirst persists despite the wash, Gualou Muli San (Trichosanthes Root and Oyster Shell Powder) is indicated. Yang notes: This condition is heavier than the previous one. Wang Shixiong adds: You Zaijing stated: Thirst developing after Baihe Disease, failing to improve with washing, indicates intense heat damaging fluids. Gualou Gen (Trichosanthes Root) is bitter and cold, generating fluids and stopping thirst. Muli (Oyster Shell) is salty and cold, guiding heat downward to prevent upper scorching. This annotation is comprehensive; Chen’s is inferior, so we follow You.
If Baihe Disease transforms into fever, Baihe Huashi San (Lily Bulb and Talcum Powder) is indicated. Fever results from residual pathogens lingering and invading the muscle layer, entering the Yang level. Baihe clears Metal and reduces heat; adding Huashi opens orifices and unblocks Yang. Slight diuresis daily indicates heat exiting via urine.
Hu E Disease resembles Taiyang disease. The patient is silent, desires sleep, cannot close eyes, and is restless lying down or sitting up. Erosion of the throat is called "E"; erosion of the genital/anal region is called "Hu". There is aversion to food odors and poor appetite. The face alternates between red, black, and white. Erosion in the upper part (throat) causes hoarseness, treated with Gancao Xi Xin Tang (Licorice and Heartsease Decoction). Erosion in the lower part causes dry throat, washed with Kushen Tang (Sophora Decoction). Erosion of the anus is fumigated with Xionghuang (Realgar).
Baihe Disease involves residual heat lingering in Qi mechanisms; Hu E Disease involves residual toxins accumulating in deep Yin. Hu E refers to water insects. Epidemic pathogens are essentially damp-heat; prolonged stagnation generates worms. Gu Tingquan noted: Prolonged epidemic pathogens kill humans; "prolonged" should specify "residual pathogens". The throat and orifices are moist, favoring worm growth. Hoarseness indicates throat erosion; dry throat indicates genital erosion, caused by heat stagnation preventing fluid ascent. Internal heat retention mimics Taiyang disease. Internal heat causes silence and desire to sleep. Internal vexation causes inability to close eyes and restlessness. Facial color changes are due to fluctuating heat, not worm movement. Kushen and Xionghuang dry dampness and kill worms. Gancao Xi Xin Tang moves Middle Jiao Qi, transforming damp-heat, and uses bitter-pungent combinations to kill worms. Referencing You’s views.
Patients with a rapid pulse, no fever but slight vexation, silence, desire to sleep, and sweating: After 3-4 days, eyes turn red like a turtledove’s; after 7-8 days, eye corners turn black. If the patient can eat, pus has formed. Chixiao Dou Danggui San (Adzuki Bean and Angelica Decoction) is indicated.
This is epidemic heat-toxin hidden internally. Hence, rapid pulse, no fever, slight vexation, and desire to sleep. Initial sweating indicates open exterior Qi. Red eyes at 3-4 days indicate heat injuring Blood levels. Black eye corners at 7-8 days indicate blood corruption. Ability to eat indicates the disease is not in the chest/abdomen but pus forms below. Chixiao Dou (Adzuki Bean) clears heat, removes dampness, and detoxifies. Danggui (Angelica Sinensis) harmonizes blood and resolves pus, expelling toxins downward.
Ancestor Yu Jiayan cited "Clear pathogens strike the Upper Jiao, turbid pathogens strike the Lower Jiao" from Bian Mai Pian as evidence of Zhang Zhongjing discussing epidemics, showing unique insight. His treatment prioritizes eliminating filth. Upper Jiao is like fog; lift and eliminate, plus detoxify. Middle Jiao is like fermenting vat; dredge and eliminate, plus detoxify. Lower Jiao is like drain; discharge and eliminate, plus detoxify. This insight surpasses ages.
Wang Shixiong adds: Lin Beihai also said Yu’s theory on epidemics surpasses antiquity, revealing what predecessors missed. Zhang Zhongjing discussed vomiting/diarrhea and cholera from transient cold-heat, so surely he addressed epidemic plagues? Thus, epidemic patterns in Shanghan Lun are not speculation. Kun (Wang’s self-reference) lacks profound knowledge and dares not disrupt classics arbitrarily, but categorizes Shanghan/Jingui patterns incompatible with wind-cold methods as epidemics.
Wang Shixiong adds: Shouzhen discussed Warm diseases, Kui discussed Summer-heat, Keyou discussed Epidemics. Though seemingly innovative, they remain within Zhang Zhongjing’s framework.
Yang notes: This collection is excellent, covering ground unknown to ancients. However, original texts have many obscure points and mismatches between formulas and diseases. Readers should grasp the intent without forcing interpretations on unclear parts. Wang notes: This critique is brilliant; one must not be fooled by ancients. "Believing everything in books is worse than having no books."