脉∶霍乱吐泻，滑而不匀，或微而涩，代伏惊人，热多洪滑，弦滑食论。
夫霍乱者，有湿霍乱、有干霍乱，皆是内伤饮食生冷、外感风寒暑湿而成。湿霍乱，忽时心腹疼痛，或上吐，
或下泻，或吐泻齐作，搅乱不安，四肢厥冷，六脉沉欲绝，此名湿霍乱，俗云虎野狼病。因风则伯风有汗；因寒则
怕寒无汗；因暑则热烦躁闷；因湿则身体重着；因食则胸腹饱闷。治用正气散加减。若吐泻烦渴躁不止、厥冷痛甚、
转筋入腹者死。夏月因伏暑热，伏暑霍乱吐泻者甚多，手足虽厥冷，脉虽虚小，切不可用姜附热药治，在暑症香
薷饮内治之。有干霍乱者，最难治，死在须臾，俗云搅肠痧。忽然心腹绞痛、手足厥冷、脉沉细或沉伏、欲吐不得
吐、欲泻不得泻，阴阳乖隔，升降不通，急用盐汤探吐及刺委中穴出血，治用理中汤加减。慎勿用米汤补住邪气难
治。直待吐泻后，方可用清米汤补接元气。若吐泻不出，胸腹胀硬，面唇青，手足冷过肘膝，六
脉伏绝，气喘急，舌短囊缩者，死症也。
湿霍乱者，吐泻腹痛，脉沉伏欲绝也。
藿香正气散 治四时不正之气、寒疫时气、山岚瘴气、雨湿蒸气，或中寒腹痛吐利，中暑冒风吐泻，中
湿身重泄泻，或不服水土，脾胃不和，饮食停滞，复感外寒，头痛憎寒，或呕逆恶心、胸膈痞闷，或发热无汗者
并皆治之。
藿香（二钱） 紫苏 陈皮 浓朴（姜汁炒） 半夏（姜汁炒） 白术（去芦） 茯苓（去皮） 桔梗
大腹皮 白芷 甘草（炙。各一钱）
上锉一剂，生姜枣煎，温服。霍乱转筋加木瓜；腹痛加炒芍药，寒痛加官桂，冷甚加干姜，饮食不化，心下
痞闷加香附、砂仁；米谷不化加神曲、麦芽；肉食不化加山楂；心下痞加枳实、青皮；中暑冒风加香薷、扁豆；
时气憎寒壮热加柴胡、干葛；发热加麦门冬、淡竹叶；口渴作泄，小便不利，合五苓散；湿热相搏，霍乱转筋，烦
渴闷乱，合黄连香薷散，心腹绞痛加木香；若频欲登厕不通利者，加枳壳。
夏月暑热霍乱者，吐泻烦渴、自汗脉浮也。香薷饮（方见暑症。）夏月暑热明知，多食生冷、瓜果、面食，却
于风凉处坐卧，以致饮食停滞，胸腹饱胀作痛，或吐或泻，手足冷，脉沉细，或伏暑，是湿霍乱。用前正气散内加
减治之。不可作夏月伏暑。霍乱吐泻腹痛、口渴烦躁、自汗面垢、脉虚躁乱不宁者，此是伏暑霍乱也，香薷饮加减
治之。
干霍乱者，心腹饱胀绞痛，不吐不泻，脉沉欲绝也。（先用盐汤探吐，急用此方。）
理中汤 治干霍乱，心腹饱胀、绞痛、不吐不泻，脉沉欲绝。
藿香 苍术（米泔制） 浓朴（姜汁炒） 砂仁 香附 木香 枳壳（麸炒） 陈皮（各一钱） 甘草（炙）
干姜 官桂（各五分）
上锉一剂，生姜三片，水煎，磨木香调服。夏月干霍乱不吐不泻、胸腹绞痛、烦渴自汗，不可用姜桂；心腹
绞痛、面唇青、手足冷、脉伏欲绝加附子、茴香，去苍术；心腹饱闷硬痛结实者，加槟榔、枳实、山楂、栝蒌、
萝卜子，去甘草、枳壳、苍术，胃寒呕哕发呃加丁香、茴香、香附、良姜，去官桂、甘草、苍术；虚汗加附子，
去苍术；外用炒生姜渣揉法，急用盐汤探吐，得物出为好，及刺委中穴，血出甚妙。
霍乱吐泻止后，发热头疼身痛、口干脉数者。
参胡三白汤
人参（五分） 柴胡 白术（去芦） 白茯苓（去皮） 白芍（炒） 当归 陈皮 麦门冬（去心） 五味子
（十粒） 山栀子 甘草（各五分） 乌梅（一个）
上锉一剂，枣一枚，灯草一团，水煎温服。
有异乡人初到地方不服水土，或吐或泻、胸腹饱闷，或肿胀不吐泻者，宜服。
加减正气散
藿香 苍术（米泔浸炒） 浓朴（姜汁炒） 陈皮 砂仁 香附 半夏（姜汁炒） 甘草（各等分）
上锉一剂，姜三片、枣一枚、灯芯一团，水煎温服。泻加白术炒、山药、乌梅、炒米，呕吐同上；腹痛加
木香、茴香；饱闷加益智仁、大腹皮；发肿气喘加苏子、桑白皮、木通、猪苓、大腹皮、木香，去甘草；小水短
赤加木通、猪苓、山栀、车前，去半夏、甘草；胸腹饱胀，或四肢浮肿，如不吐泻者，加萝卜子、枳壳、大腹皮、
木通，去半夏、甘草；内热烦渴加葛根、黄连、山栀、乌梅，去半夏、甘草，内寒手足冷、脉沉细，加干姜、官
桂。
补遗方
治霍乱吐泻，用绿豆粉和白砂糖少许，服之即愈。
干霍乱不得吐者，用淡汤一碗，入皂角末三分，盐一撮调服探吐之。慎勿与米汤吃，反动邪气则难治矣。
治霍乱吐泻
干姜 胡椒 胡黄连（各三分）、绿豆粉（五分。）
上为末，每服三分，沸汤点服。
阴阳汤 用井水和百沸汤各半碗同服，神效。
洗法 治霍乱转筋，蓼一把，去两头，水煎熏洗。
灸法 治霍乱已死，腹中有暖气者，用盐纳脐中，灸七壮。
Pulse: In Huoluan (cholera-like syndrome with vomiting and diarrhea), the pulse may be slippery but irregular, or weak and choppy; alternatively, it may present as a Dai pulse (intermittent pulse) that is deep and hidden, which is alarming. If heat is predominant, the pulse is surging and slippery; if due to food stagnation, the pulse is wiry and slippery.
Huoluan (cholera-like syndrome with vomiting and diarrhea) is categorized into Shi Huoluan (damp-type cholera) and Gan Huoluan (dry-type cholera). Both arise from internal injury caused by consuming raw and cold foods and external contraction of wind, cold, summerheat, and dampness. Shi Huoluan (damp-type cholera) presents with sudden epigastric and abdominal pain, vomiting, diarrhea, or simultaneous vomiting and diarrhea, accompanied by abdominal turmoil and restlessness, cold limbs, and a deep, faint pulse nearly imperceptible at the six positions. This is termed Shi Huoluan (damp-type cholera), commonly known as "Tiger Wolf Disease." If caused by wind, sweating occurs; if by cold, aversion to cold without sweating; if by summerheat, fever, irritability, and stifling sensation; if by dampness, heavy body sensation; if by food stagnation, chest and abdominal fullness and oppression. Treatment involves Zhengqi San (Regular Qi Powder) with modifications. Prognosis is poor (death likely) if vomiting and diarrhea are incessant, accompanied by severe thirst, agitation, profound cold limbs, intense pain, and muscle cramps extending to the abdomen. In summer, many cases of Huoluan are due to latent summerheat pathogen. Although hands and feet may be cold and the pulse deficient and small, one must strictly avoid using hot herbs like Shengjiang (Rhizoma Zingiberis Recens) and Fuzi (Radix Aconiti Lateralis Preparata). Instead, treat within the framework of summerheat syndromes using Xiangru Yin (Elsholtzia Decoction). Gan Huoluan (dry-type cholera) is the most difficult to treat and can lead to death suddenly; it is commonly called "Jiaochang Sha" (Intestinal Twisting Miasma). It presents with sudden severe epigastric and abdominal colic, cold limbs, deep and fine or hidden pulse, inability to vomit despite urge, and inability to defecate despite urge. This indicates a disruption of Yin and Yang, with failure of ascending and descending functions. Immediate treatment requires inducing vomiting with salt water solution and bleeding Weizhong (BL40). The formula used is Lizhong Tang (Regulate the Middle Decoction) with modifications. Do not use rice soup to tonify, as this will trap the pathogen and make treatment difficult. Only after vomiting and diarrhea have ceased should clear rice soup be used to support Yuan Qi (Original Qi). If vomiting and diarrhea do not occur, accompanied by hard and distended chest and abdomen, cyanotic face and lips, cold limbs extending beyond elbows and knees, hidden and absent pulses, rapid breathing, short tongue, and retracted scrotum, these are signs of death.
Shi Huoluan (damp-type cholera) is characterized by vomiting, diarrhea, abdominal pain, and a deep, hidden pulse nearly imperceptible.
Huoxiang Zhengqi San (Patchouli and Magnolia Bark Decoction): Treats abnormal qi of the four seasons, cold epidemic qi, mountain miasma, rain-damp vapor, or cold invasion causing abdominal pain, vomiting, and diarrhea; summerheat and wind invasion causing vomiting and diarrhea; damp invasion causing heavy body and diarrhea; acclimatization issues, spleen-stomach disharmony, food stagnation compounded by external cold causing headache and aversion to cold; nausea, retching, chest diaphragm oppression, or fever without sweating.
Ingredients: Huoxiang (Agastache Herba, 2 qian), Zisu (Perilla Leaf), Chenpi (Citri Reticulatae Pericarpium), Nongpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice), Banxia (Pinelliae Rhizoma, stir-fried with ginger juice), Baizhu (Atractylodis Macrocephalae Rhizoma, remove rhizome), Fuling (Poria, remove skin), Jiegeng (Platycodonis Radix), Dafupi (Arecae Pericarpium), Baizhi (Angelicae Dahuricae Radix), Gancao (Licorice Root, honey-fried, each 1 qian).
Grind into coarse powder for one dose. Decoct with fresh ginger and jujube. Take warm. For Huoluan with muscle cramps, add Mugua (Chaenomelis Fructus); for abdominal pain, add Chao Shaoyao (Fried Paeoniae Radix Alba); for cold pain, add Guigui (Cinnamomi Cortex); for severe cold, add Ganjiang (Zingiberis Rhizoma); for undigested food and epigastric oppression, add Xiangfu (Cyperi Rhizoma) and Sharen (Amomi Fructus); for undigested grains, add Shenqu (Massa Medicata Fermentata) and Maiya (Hordei Fructus Germinatus); for undigested meat, add Shanzha (Crataegi Fructus); for epigastric oppression, add Zhishi (Aurantii Fructus Immaturus) and Qingpi (Citri Reticulatae Pericarpium Viride); for summerheat and wind, add Xiangru (Elsholtiae Herba) and Bian Dou (Dolichos Lablab Seed); for epidemic chills and high fever, add Chaihu (Bupleuri Radix) and Gange (Puerariae Radix); for fever, add Maidong (Ophiopogonis Radix) and Danzhuye (Lophatheri Herba); for thirst with diarrhea and dysuria, combine with Wuling San (Five-Ingredient Powder with Poria); for damp-heat conflict with Huoluan muscle cramps, irritability, and confusion, combine with Huanglian Xiangru San (Coptis and Elsholtzia Powder); for severe epigastric-abdominal colic, add Muxiang (Aucklandiae Radix); for frequent urge to defecate without relief, add Zhike (Aurantii Fructus).
Summer heat Huoluan presents with vomiting, diarrhea, severe thirst, spontaneous sweating, and floating pulse. Xiangru Yin (Elsholtzia Decoction) (see Summerheat section). In summer, knowing there is heat, excessive consumption of raw/cold foods, melons, fruits, and wheat products, followed by sitting/lying in cool/windy places, leads to food stagnation, abdominal fullness/pain, vomiting or diarrhea, cold limbs, and deep/fine or hidden pulse. This is Shi Huoluan (damp-type cholera) due to latent summerheat. Treat with modified Zhengqi San. Do not mistake it for simple summerheat latent syndrome. Huoluan with vomiting/diarrhea, abdominal pain, thirst, irritability, spontaneous sweating, dirty complexion, deficient and agitated pulse is Fu Shu Huoluan (latent summerheat cholera). Treat with modified Xiangru Yin.
Gan Huoluan (dry-type cholera) presents with epigastric-abdominal fullness, colic, no vomiting, no diarrhea, and deep, faint pulse. (First induce vomiting with salt water, then urgently use this formula.)
Lizhong Tang (Regulate the Middle Decoction): Treats Gan Huoluan (dry-type cholera) with epigastric-abdominal fullness, colic, no vomiting, no diarrhea, and deep, faint pulse.
Ingredients: Huoxiang (Agastache Herba), Cangzhu (Atractylodis Rhizoma, processed with rice wash water), Nongpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice), Sharen (Amomi Fructus), Xiangfu (Cyperi Rhizoma), Muxiang (Aucklandiae Radix), Zhike (Aurantii Fructus, bran-fried), Chenpi (Citri Reticulatae Pericarpium, each 1 qian), Gancao (Licorice Root, honey-fried), Ganjiang (Zingiberis Rhizoma), Guigui (Cinnamomi Cortex, each 5 fen).
Grind into coarse powder for one dose. Decoct with three slices of fresh ginger. Grind Muxiang (Aucklandiae Radix) and mix with the decoction to take. For summer Gan Huoluan (dry-type cholera) with no vomiting/diarrhea, abdominal colic, thirst, and sweating, do not use Jiang (Ginger) and Gui (Cinnamon). For severe colic, cyanotic face/lips, cold limbs, and hidden pulse, add Fuzi (Aconiti Lateralis Radix Preparata) and Huixiang (Foeniculi Fructus), remove Cangzhu. For hard, painful, solid fullness, add Binglang (Arecae Semen), Zhishi (Aurantii Fructus Immaturus), Shanzha (Crataegi Fructus), Gualou (Trichosanthis Fructus), Luoboziren (Raphani Semen), remove Gancao, Zhike, Cangzhu. For stomach cold with vomiting/hiccups, add Dingxiang (Caryophylli Flos), Huixiang (Foeniculi Fructus), Xiangfu (Cyperi Rhizoma), Liangjiang (Alpiniae Officinarum Rhizoma), remove Guigui, Gancao, Cangzhu. For deficiency sweating, add Fuzi, remove Cangzhu. Externally, rub with fried ginger residue. Urgently induce vomiting with salt water until contents are expelled. Prick Weizhong (BL40) to bleed; this is excellent.
After Huoluan vomiting/diarrhea stops, if fever, headache, body ache, dry mouth, and rapid pulse appear:
Shenhu Sanbai Tang (Ginseng, Bupleurum, and Three Whites Decoction)
Ingredients: Renshen (Ginseng Radix et Rhizoma, 5 fen), Chaihu (Bupleuri Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, remove rhizome), Bai Fuling (Poria, remove skin), Baishao (Paeoniae Radix Alba, stir-fried), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Maidong (Ophiopogonis Radix, remove heart), Wuweizi (Schisandrae Fructus, 10 berries), Shanzhizi (Gardeniae Fructus), Gancao (Licorice Root, each 5 fen), Wumei (Mume Fructus, 1 piece).
Grind into coarse powder for one dose. Decoct with one jujube and a bundle of Jundao Cao (Equiseti Herba). Take warm.
Suitable for travelers experiencing acclimatization issues, presenting with vomiting/diarrhea, abdominal fullness, or swelling without vomiting/diarrhea.
Jiajian Zhengqi San (Modified Regular Qi Powder)
Ingredients: Huoxiang (Agastache Herba), Cangzhu (Atractylodis Rhizoma, soaked in rice water and stir-fried), Nongpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice), Chenpi (Citri Reticulatae Pericarpium), Sharen (Amomi Fructus), Xiangfu (Cyperi Rhizoma), Banxia (Pinelliae Rhizoma, stir-fried with ginger juice), Gancao (Licorice Root, equal parts).
Grind into coarse powder for one dose. Decoct with three slices of ginger, one jujube, and a bundle of Dengxin Cao (Typhae Stamen). Take warm. For diarrhea, add Chao Baizhu (Stir-fried Atractylodis Macrocephalae Rhizoma), Shanyao (Dioscoreae Rhizoma), Wumei (Mume Fructus), Chao Mi (Stir-fried Rice); for vomiting, same as above; for abdominal pain, add Muxiang (Aucklandiae Radix), Huixiang (Foeniculi Fructus); for fullness/oppression, add Yizhiren (Alpiniae Oxyphyllae Fructus), Dafupi (Arecae Pericarpium); for edema and asthma, add Suzi (Perillae Fructus), Sangbaipi (Mori Cortex), Mutong (Akebiae Caulis), Zhuling (Polyporus), Dafupi (Arecae Pericarpium), Muxiang (Aucklandiae Radix), remove Gancao; for scanty dark urine, add Mutong (Akebiae Caulis), Zhuling (Polyporus), Shanzhi (Gardeniae Fructus), Cheqian (Plantaginis Semen), remove Banxia, Gancao; for chest-abdominal fullness or limb edema without vomiting/diarrhea, add Luoboziren (Raphani Semen), Zhike (Aurantii Fructus), Dafupi (Arecae Pericarpium), Mutong (Akebiae Caulis), remove Banxia, Gancao; for internal heat with thirst, add Gegen (Puerariae Radix), Huanglian (Coptidis Rhizoma), Shanzhi (Gardeniae Fructus), Wumei (Mume Fructus), remove Banxia, Gancao; for internal cold with cold limbs and deep/fine pulse, add Ganjiang (Zingiberis Rhizoma), Guigui (Cinnamomi Cortex).
Supplementary Formulas
For Huoluan vomiting/diarrhea, use a small amount of Lvdou Fen (Vigna Radiata Semen Album) mixed with white sugar. Take orally for immediate recovery.
For Gan Huoluan (dry-type cholera) unable to vomit, take one bowl of light soup mixed with 3 fen of Zaojiao Mo (Gleditsiae Sinensis Spina) and a pinch of salt to induce vomiting. Strictly avoid rice soup, as it revives the pathogen and makes treatment difficult.
Treatment for Huoluan Vomiting/Diarrhea
Ingredients: Ganjiang (Zingiberis Rhizoma), Hujiao (Piperis Longi Fructus), Huhuanglian (Coptidis Teetae Rhizoma, each 3 fen), Lv dou Fen (Vigna Radiata Semen Album, 5 fen).
Grind into powder. Take 3 fen per dose, mixed with boiling water.
Yinyang Tang (Yin-Yang Decoction): Mix half a bowl of well water with half a bowl of boiling water and take simultaneously. Miraculous effect.
Washing Method: For Huoluan muscle cramps, take one handful of Lia (Polygoni Multiflori Caulis), remove both ends, decoct in water for fumigation and washing.
Moxibustion Method: For Huoluan where the patient appears dead but warmth remains in the abdomen, place salt in the umbilicus and apply seven moxa cones.