内有所积，外有所感，见成吐泻，不彻者，还用吐，提其气起，吐用二陈汤加减或盐汤或盐水皆可吐。治霍乱∶
苍术 浓朴 陈皮 葛根（以上各一钱半） 滑石（三钱） 白术（二钱） 木通（一钱） 甘草（炙） 又法用姜汤
下保和丸四十粒。治干霍乱大法，发汗吐亦不妨，此系内有所伤，外为邪气所遏；有用吐法者，则兼发散之义；有用
温药解散者，其法解散，不用凉药。二陈汤加川芎、苍术、防风、白芷等剂。夏月霍乱吐泻，大欲饮水或狂乱奔走，姜
制浓朴、官桂、干姜、茯苓、半夏。霍乱方∶藿香、苍术、浓朴、陈皮、缩砂、白芷、甘草、半夏、茯苓、人参、炒神
曲等分。遇寒加干姜，寒甚加附子。吐泻霍乱，夏月以冰水调益元散加姜汁服之。又以地浆清水调桂苓甘露饮，新汲水
亦可，所以至阴之物能生阳中之阴。霍乱微烦躁渴，钱氏白术散，以上二方俱见《宝鉴》中。夏月吐泻，黄连香薷汤，
井中浸冷服。霍乱脉多伏或绝，大法理中汤好。阳不升阴不降，乘隔而成霍乱，切不可与米汤饮，即致死。夏月多食
瓜果饮冷乘
风，以致食留不化，因食成痞，隔绝上下，遂成霍乱，以六和汤倍藿香。挥霍撩乱而不得吐泻，名干霍乱。干乱最
难治，须以盐汤吐之。治搅肠沙，用樟木屑煎浓汤，呷一碗，须臾吐泻即可。（一云干霍乱俗名搅肠沙也。）又法，
就委中穴，有紫处刺出血即安；或于十指头出血，亦是良法。一法治霍乱已死，腹中尚有暖气，用盐纳脐中，灸
七壮仍灸气海。
When there is accumulation internally and pathogenic factors externally, resulting in severe vomiting and diarrhea, if the symptoms are not completely resolved, emesis should still be induced to raise the stagnant Qi. Emesis can be achieved using Er Chen Tang (Two-Cured Decoction) with modifications, or simply by drinking salt water or saline solution.
Treatment for Huoluan (Cholera-like syndrome): Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Gegen (Puerariae Lobatae Radix) (each 1.5 qian); Huashi (Talcum) (3 qian); Baizhu (Atractylodis Macrocephalae Rhizoma) (2 qian); Mutong (Akebiae Caulis) (1 qian); Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma). Another method involves administering Baohe Wan (Preserve Harmony Pill) forty pills with ginger decoction.
The general principle for treating Gan Huoluan (Dry Cholera, characterized by inability to vomit or defecate) allows for diaphoresis (sweating-inducing therapy) or emesis, as this condition arises from internal injury (dietary) and external constraint by pathogenic factors. Using emesis incorporates the meaning of dispersing pathogens; using warm herbs to resolve the condition also aims at dispersion, avoiding cold/cooling herbs. Modifications to Er Chen Tang may include Chuanxiong (Ligustici Chuanxiong Rhizoma), Cangzhu, Fangfeng (Saposhnikoviae Radix), and Baizhi (Angelicae Dahuricae Radix).
In summer cases of Huoluan with vomiting and diarrhea, where the patient has an intense desire for water or exhibits manic restlessness, use Jiangzhi Houpo (Ginger-processed Magnoliae Officinalis Cortex), Guanzi (Cinnamomi Cortex), Ganjiang (Zingiberis Rhizoma), Fuling (Poria), and Banxia (Pinelliae Rhizoma).
Formula for Huoluan: Huoxiang (Agastaches Herba), Cangzhu, Houpo, Chenpi, Suosha (Amomi Fructus Rotundus), Baizhi, Gancao, Banxia, Fuling, Renshen (Ginseng Radix et Rhizoma), Chao Shenqu (Fried Massa Medicata Fermentata), all in equal proportions. If cold is prominent, add Ganjiang; if cold is severe, add Fuzi (Aconiti Lateralis Radix Praeparata).
For vomiting and diarrhea type Huoluan in summer, Yi Yuan San (Benefit One Powder) mixed with ice water and ginger juice can be taken. Alternatively, Gui Ling Gan Lu Yin (Cinnamon, Poria, and Sweet Dew Drink) can be administered with Di Jiang Shui (Earth Slurry Water) or clear water; fresh well water is also acceptable, as extreme yin substances can generate yin within yang.
For mild irritability and thirst in Huoluan, Qian Shi Bai Zhu San (Dr. Qian's Atractylodes Powder) is used. Both formulas above are recorded in *Bao Jian* (*Health Treasure*). For summer vomiting and diarrhea, Huanglian Xiangru Tang (Coptis and Elsholtzia Decoction) soaked in a well until cold can be taken.
The pulse in Huoluan is often deep (Fu pulse) or imperceptible (Jue pulse); the primary treatment is Li Zhong Tang (Regulate the Middle Decoction). When Yang fails to ascend and Yin fails to descend, causing obstruction in the middle jiao leading to Huoluan, rice soup must strictly be avoided, as it can lead to death.
Summer Huoluan often results from excessive consumption of melons, fruits, and cold drinks while exposed to wind, leading to food stagnation and indigestion. This dietary retention causes Pi (glomus/blockage), obstructing the upper and lower jiao, resulting in Huoluan. It should be treated with Liu He Tang (Six Harmonies Decoction) with doubled Huoxiang.
When there is chaotic abdominal pain with inability to vomit or defecate, it is named Gan Huoluan (Dry Cholera). Gan Huoluan is the most difficult to treat and requires inducing emesis with salt water.
To treat Jiaochang Sha (Intestinal Twisting Sand, a colloquial term for severe acute abdominal pain with vomiting/diarrhea difficulty), boil Camphor Wood chips (Zhangmuxie) into a strong decoction and drink one bowl; vomiting and diarrhea will ensue shortly. (Note: Some say Gan Huoluan is commonly known as Jiaochang Sha.)
Another method involves puncturing the Weizhong point (BL40) where purple collaterals appear to release blood, which brings relief; or bleeding the tips of the ten fingers is also an effective method.
For a case of apparent death from Huoluan where warmth remains in the abdomen, place salt in the umbilicus and moxa seven cones, followed by moxa on Qihai point (CV6).