不知人事亦不能语言状似尸厥遂用人参三白汤加熟附子半枚干姜二钱水二钟煎一钟与之服不待一时许斑色渐红手足渐
暖而苏醒后复有余热不清此伏火后作也以黄连解毒竹叶石膏汤调之而愈
(外证欲眠目不闭声哑)
狐惑之为病状如伤寒或因伤寒而变成斯病其状默默欲眠目牵不得闭卧起不安虫蚀于喉咽为惑蚀于阴肛为狐不欲食
恶闻食臭其面目乍赤乍黑乍白蚀于上部则声嗄甘草泻心汤主之(方见痞)蚀于下部则咽干苦参汤洗之蚀于肛者雄黄散熏
之用雄黄一味为末取二瓦合之烧向肛熏之
脉经云病患或从呼吸后蚀其咽喉或从下焦蚀其肛阴蚀上为惑蚀下为狐狐惑病者猪苓散主之(方未考)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 (一本 下有黄字)黑若能食者脓已成也赤豆当归散主之(方
见杂病下血门)
附
一妇人狐惑声嗄多眠目不闭恶闻食臭不省人事半月后又手足拘强脉数而微细先与竹沥姜汁一盏服之忽胸中有汗腹
鸣即目闭省人事遂用参术归陈入竹沥姜汁饮之五六点而愈
活 狐惑伤寒与湿 皆虫证初得状如伤寒或因伤寒变成此疾大抵伤寒腹内热食少肠胃空虚三虫行作求食蚀人五
脏
及下部为 虫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
虫蚀其藏下唇有疮虫蚀其肛杀人甚急多因下利而得治 桃仁汤黄连犀角汤雄黄锐散主之
治 桃仁汤
生艾 桃仁(去皮尖炒双仁不用) 槐花子(碎各一两) 大枣(十五个去核)上水二盏煎至一盏半分三服
黄连犀角汤 治伤寒及诸病之后有 出下部者
黄连(半两) 犀角(一两) 乌梅(七个) 没药(二钱半)上水二大盏半煎至一盏半分三服
雄黄丸 治伤寒狐惑微烦默默欲卧毒瓦斯上攻咽干声嗄下蚀湿 或便脓血
雄黄(研) 当归(炒各七钱半) 芦荟(研) 麝香(研各二钱半) 槟榔(半两)上捣研为末煮面糊为丸如梧
桐子大每服十五丸至一十丸食前温粥饮下日三服
雄黄锐散 治下部 疮
雄黄 苦参 青葙子 黄连(各半两) 桃仁(去皮尖二钱半)上为散以生艾捣汁为丸如枣核大绵裹纳下部匾竹叶
汁更佳冬月无艾只用散裹纳亦得
(患者)神志昏迷,不能言语,症状类似尸厥,于是使用人参三白汤加入半枚熟附子、二钱干姜,加水两钟煎煮至一钟,给患者服用。不到一个时辰,斑色逐渐变红,手足逐渐回暖,患者苏醒。之后仍有残余热邪未清,这是伏火发作所致,用黄连解毒汤和竹叶石膏汤调理而痊愈。
(外在证候表现为想睡觉但眼睛闭不上,声音嘶哑)
狐惑病,症状像伤寒,有的因患伤寒后转变为这种病。其表现是神情沉默,想睡觉但眼睛睁不开,躺下坐起都不得安宁。虫侵蚀咽喉称为“惑”,侵蚀阴部和肛门称为“狐”。患者不想吃东西,厌恶食物的气味。面目颜色时而发红,时而发黑,时而发白。如果侵蚀上部(咽喉),则声音嘶哑,主方用甘草泻心汤(方剂见痞证篇)。如果侵蚀下部,则咽干,用苦参汤清洗。如果侵蚀肛门,用雄黄散熏蒸。方法是将一味雄黄研成粉末,取两个瓦盆扣合,点燃雄黄对着肛门熏蒸。
《脉经》说:病患有的从呼吸之气传入后侵蚀咽喉,有的从下焦侵蚀肛阴。侵蚀上部称为惑,侵蚀下部称为狐。狐惑病患者,主方用猪苓散(方剂未能考证)。患者脉数,身体无发热,只有轻微烦躁,神情沉默只想躺卧,出汗。初得病的三四天,眼睛发红像斑鸠的眼睛;到了七八天,眼睛四周发黑(另一版本在“四”字下有“黄”字)。如果能吃东西,说明脓已经形成,主方用赤豆当归散(方剂见杂病下血门)。
附录:
一位女性患者,患狐惑病,声音嘶哑,嗜睡多眠,眼睛闭不上,厌恶食物气味,不省人事。半个月后又出现手足拘挛强直,脉象数而微细。先给予一盏竹沥姜汁服用,忽然胸中有汗出,腹中鸣响,随即眼睛闭上,恢复神志。随后用人参、白术、当归、陈皮加入竹沥姜汁饮中服用,五六次后痊愈。
按语:狐惑、伤寒与湿毒,都是虫证。初起时症状像伤寒,有的因患伤寒后转变为这种疾病。大抵来说,伤寒导致腹内热盛,饮食减少,肠胃空虚,三虫活动寻求食物,侵蚀人的五脏。
以及下部为虫病,其征候是牙齿颜色淡白,舌苔全部发白,严重的嘴唇发黑并有疮疡,四肢沉重,恍惚嗜睡。虫侵蚀肛门,腐烂见到五脏则死。应当经常查看上下唇。上唇有疮,虫侵蚀内脏;下唇有疮,虫侵蚀肛门,杀人非常急迫。多因腹泻痢疾而得此病。治疗用桃仁汤、黄连犀角汤、雄黄锐散为主。
治疗方剂:桃仁汤
生艾叶、桃仁(去皮尖,炒,双仁者不用)、槐花子(捣碎,各一两)、大枣(十五个,去核)。以上药材加水两盏,煎煮至一盏半分,分三次服用。
黄连犀角汤:治疗伤寒及诸病之后,虫蚀出在下部的情况。
黄连(半两)、犀角(一两)、乌梅(七个)、没药(二钱半)。以上药材加水两大盏半,煎煮至一盏半分,分三次服用。
雄黄丸:治疗伤寒狐惑病,轻微烦躁,神情沉默想躺卧,毒气上攻导致咽干声嘶,下部侵蚀湿润或大便脓血。
雄黄(研末)、当归(炒,各七钱半)、芦荟(研末)、麝香(研末,各二钱半)、槟榔(半两)。以上药物捣碎研成粉末,用面糊煮制为丸,如梧桐子大小。每次服用十五丸至十丸,饭前用温粥送服,每日三次。
雄黄锐散:治疗下部虫疮。
雄黄、苦参、青葙子、黄连(各半两)、桃仁(去皮尖,二钱半)。以上药物研成散剂,用生艾叶捣汁制成丸药,如枣核大小,用棉布包裹纳入下部患处,用竹叶汁润滑更佳。冬季没有艾叶时,只用散剂包裹纳入也可。
(Translation based on the vernacular Chinese text)
The patient was unconscious and unable to speak, with symptoms resembling *Shijue* (Corpse-like Coma). Therefore, *Renshen Sanbai Tang* (Ginseng Three Whites Decoction) was administered with half a piece of *Shu Fuzi* (Prepared Aconite Root), two qian of *Ganjiang* (Dried Ginger), boiled in two zhong of water until reduced to one zhong, and given to the patient. Within less than an hour, the macules gradually turned red, the hands and feet warmed up, and the patient regained consciousness. Subsequently, residual heat remained unclear; this was due to the manifestation of latent fire. The condition was cured by regulating with *Huanglian Jiedu Tang* (Coptis Decoction for Resolving Toxicity) and *Zhuye Shigao Tang* (Bamboo Leaf and Gypsum Decoction).
(External signs include drowsiness but inability to close the eyes, and hoarseness.)
The disease of *Huhu* (Fox-Hu Syndrome) presents like *Shanghan* (Cold Damage Disease); some cases develop into this illness following *Shanghan*. Its manifestations include taciturnity, desire to sleep but inability to keep the eyes closed, restlessness when lying down or sitting up. Parasites eroding the throat are termed "Hu" (Confusion/Erosion), while those eroding the yin and anus are termed "Hu" (Fox). The patient has no appetite and is disgusted by food odors. The complexion alternates between red, black, and white. If erosion occurs in the upper part (throat), hoarseness ensues, primarily treated with *Gancao Xiexin Tang* (Licorice Decoction for Draining the Epigastrium) (see formula under Pi syndrome). If erosion occurs in the lower part, dryness of the throat results, treated by washing with *Kushen Tang* (Sophora Decoction). If the anus is eroded, treat with *Xionghuang San* (Realgar Powder) for fumigation. Method: Grind Realgar into powder, place it between two tiles, ignite it, and fumigate towards the anus.
The *Mai Jing* (Pulse Classic) states: Patients may have parasites erode the throat via respiratory qi, or erode the anal yin from the lower jiao. Erosion of the upper part is called "Hu" (Confusion), and erosion of the lower part is called "Hu" (Fox). For *Huhu* disease, the primary formula is *Zhu Ling San* (Polyporus Powder) (formula not verified). The patient presents with a rapid pulse, no fever, slight irritability, taciturnity, desire to lie down, and sweating. In the first three to four days of onset, the eyes turn red like those of a turtledove; by the seventh or eighth day, the corners of the eyes turn black (another version adds the character "yellow" after "four"). If the patient can eat, it indicates that pus has formed, primarily treated with *Chidou Danggui San* (Red Bean and Angelica Powder) (see formula under miscellaneous diseases, hematochezia section).
Appendix:
A female patient suffered from *Huhu*, exhibiting hoarseness, excessive sleepiness, inability to close her eyes, aversion to food odors, and unconsciousness. Half a month later, she developed spasms and rigidity of the hands and feet, with a rapid yet fine and weak pulse. Initially, one zhan of *Zhuli Jiangzhi Yin* (Bamboo Sap and Ginger Juice Drink) was administered. Suddenly, sweat appeared in the chest, abdominal borborygmi occurred, and her eyes closed as she regained consciousness. Subsequently, *Renshen* (Ginseng), *Baizhu* (Atractylodes Macrocephala Rhizome), *Danggui* (Angelica Sinensis Root), and *Chenpi* (Tangerine Peel) were added to the bamboo sap and ginger juice drink. After five or six doses, she recovered.
Commentary: *Huhu*, *Shanghan*, and damp-toxin are all parasite-related syndromes. Early symptoms resemble *Shanghan*; some cases transform into this disease following *Shanghan*. Generally, *Shanghan* causes internal heat, reduced food intake, and empty intestines and stomach, allowing the three parasites to become active, seek food, and erode the five zang organs.
When affecting the lower part, it is a parasite disease. Signs include colorless teeth, complete white coating on the tongue, severe cases showing black lips with sores, heavy limbs, lethargy, and drowsiness. Parasites eroding the anus lead to rotting and exposure of the five zang organs, resulting in death. One should frequently inspect the upper and lower lips. Sores on the upper lip indicate parasites eroding the viscera; sores on the lower lip indicate parasites eroding the anus, which kills rapidly. This often arises from diarrhea/dysentery. Treat primarily with *Taoren Tang* (Peach Kernel Decoction), *Huanglian Xijiao Tang* (Coptis and Rhinoceros Horn Decoction), and *Xionghuang Ruisan* (Realgar Sharp Powder).
Treatment Formulas:
**Taoren Tang** (Peach Kernel Decoction)
* *Sheng Ai Ye* (Fresh Mugwort Leaf)
* *Taoren* (Peach Kernel) (remove skin and tips, stir-fry; avoid double-kernel kernels)
* *Huaihua Zi* (Stamen Sophorae Flower Bud) (crushed)
* Each: 1 liang
* *Dazao* (Jujube) (15 pieces, remove pits)
Boil the above ingredients in two zhan of water until reduced to one zhan and half. Divide into three doses.
**Huanglian Xijiao Tang** (Coptis and Rhinoceros Horn Decoction): Treats cases where parasites erode the lower part after *Shanghan* and other diseases.
* *Huanglian* (Coptis Rhizome): 0.5 liang
* *Xijiao* (Rhinoceros Horn) [Note: Modern substitutes like Water Buffalo Horn are used]: 1 liang
* *Wumei* (Mume Fruit): 7 pieces
* *Moyao* (Myrrh): 2.5 qian
Boil the above ingredients in two large zhan and half of water until reduced to one zhan and half. Divide into three doses.
**Xionghuang Wan** (Realgar Pill): Treats *Shanghan* and *Huhu* with slight irritability, taciturnity, desire to lie down, toxic qi attacking upward causing dry throat and hoarseness, lower erosion with dampness, or bloody/purulent stool.
* *Xionghuang* (Realgar) (ground)
* *Danggui* (Angelica Sinensis Root) (stir-fried)
* Each: 7.5 qian
* *Luhui* (Aloe) (ground)
* *Shexiang* (Musk) (ground)
* Each: 2.5 qian
* *Binglang* (Areca Seed): 0.5 liang
Grind the above ingredients into powder, mix with wheat paste to form pills the size of tung tree seeds. Take 10–15 pills before meals, washed down with warm porridge water, three times daily.
**Xionghuang Ruisan** (Realgar Sharp Powder): Treats lower parasite sores.
* *Xionghuang* (Realgar)
* *Kushen* (Sophora Root)
* *Qingxiangzi* (Seed of Celosia)
* *Huanglian* (Coptis Rhizome)
* Each: 0.5 liang
* *Taoren* (Peach Kernel) (remove skin and tips): 2.5 qian
Grind the above into a powder. Use fresh mugwort juice to form pills the size of a date pit. Wrap in cotton and insert into the lower orifice. Lubricating with bamboo leaf juice is better. In winter without mugwort, using the powder wrapped for insertion is also acceptable.