凡三阴症。吐泻并作后即转筋。未泻时腹不痛。泻后腹微痛。惟颡中与鼻尖。有冷
汗如珠。又指尖罗顶有直缝。罗顶低凹者。邪即下陷。不可救药。初起时。宜饮以姜汁。切忌茶汤甜物。
下咽即死。再进附子回阳汤。外治用挑痧法。缩脚法。灸脐用雷公散。俱有救死回生之妙。
凡治霍乱。宜戒谷食以清胃。惟宜荞麦、芦稷炒熟作汤。用以代茶。既有去邪逐秽
之能。又有养胃和中之妙。但荞麦性凉通利。热实之症为宜。芦稷性温和中。中气虚者尤宜。
伤津呕逆 凡霍乱大吐后。暑湿秽邪已去。胸中通泰。而干呕大渴。舌中心绛燥
无苔者。此津液消耗也。急宜鲜生地、钗石斛、麦冬、花粉、北沙参、绿豆皮之类养之。
霍乱转筋 不拘因寒因暑。总加木瓜于药内。邪去。转筋自止。若吐泻已停。而
筋尚转。是耗其津液而然也。宜养液舒筋。如鲜生地、花粉、钩藤、米仁、木瓜之类。
阴霍乱 凡霍乱。实热症。皆中焦胃病。寒症。即胃伤生冷。太阴感寒是也。治法俱
见前。阴霍乱者。乃少阴症。初起吐利。脉沉伏。手足冷。其舌形胖嫩。淡红不渴者。是
也。四逆汤、理阴煎之类。察其宜刚宜柔。投之。如见舌苔紫色而干。口渴干呕者。
当以金水六君煎和之。如见舌形胖嫩而色黑滑者。是太阴中寒。理中症也。不可认作少阴。凡治太阴。
药宜刚燥。治少阴。药宜温润。
有少阴伤寒。先从吐泻而起。但看舌形紫色无苔。或舌中微白。而四畔色绛。六脉
沉细。似寐非寐者。即是少阴伤寒。治当益阴和中。不可作霍乱治。凡病起吐泻。
而舌上有苔。或黄或白者。方是霍乱。否则 疹未透也。缘二症中有湿热之邪。故
生苔。少阴乃虚症所发。故舌但紫绛或淡红而无苔。临症者辨之。
凡霍乱吐泻。发于夏秋之间。固宜察其暑湿秽食之邪为治。若治之不效。或兼呕
吐烦闷。脉伏足冷之症者。又当察其是否 疹痰饮。不可草率也。
干霍乱 欲吐不吐。欲泻不泻。腹痛欲死。俗名绞肠痧是也。急用淡盐汤。或葱矾
水。用鹅羽探吐。得吐则生。不吐则死。吐后方用理气和中清疏之剂。随症治之。
如已成闭症。神昏不语。放痧、刮痧等法。俱不效者。急以盐填满脐孔灸之。不计壮数。
干霍乱。神昏不语。形脱者不治。如开声神清。但吐泻不得。绞肠痛欲死者。急用探
吐法。并放痧、刮痧之法。毒瓦斯以下行为顺。景岳刮痧法妙。
如见痞满燥实。脐旁硬痛不可忍者。下症也。急以承气汤下之。此以提吐为逆。达下为顺也。
凡干霍乱。神昏不语。而形脉不脱者可治。脉伏而形神不失者。亦可治。或按穴放
痧。或背心刮痧。再以川郁金、石菖蒲、广藿梗、滑石粉、通草等煎汤。冲入西黄二分。投之。
干霍乱。昏神不语。六脉沉伏。是否兼火当清者。是否兼寒当温者。但察其唇齿舌苔之燥润以别之。
干霍乱。大痛难忍。大汗大渴。舌黄燥刺。用黄连绞水服之。汗止者生。汗不止者死。
霍乱发燥 地浆水冷服之。
绞肠痛 荞麦汤冷服之。
呕吐不休。环头芦稷汤冷服之。
霍乱腹痛。行气逐秽药不效者。飞盐点汤冷服之。
探吐法 以阴阳水对冲。先以刀烧红。置盐一撮于刀上。即以热盐冲水中。和匀。
令病患饮之。居密室中。以布袱拴紧其腹。将鹅羽探吐。得吐则生。不吐则死。如醒
时切不可与粥饮。与之立死。不可与热汤。与之则心闭而死。
Whenever the Three Yin syndromes (diseases affecting the Three Yin meridians) present with simultaneous vomiting and diarrhea, followed by muscle cramps. Before diarrhea occurs, there is no abdominal pain; after diarrhea, there is slight abdominal pain. Only at the soft palate (Shangzhong) and the tip of the nose, cold sweat beads up like pearls. Additionally, if the fingerprint lines on the fingertips extend straight to the top of the whorl and the whorl itself is depressed, it indicates that the pathogenic factor has sunk inward, a condition that is incurable.
At the onset, it is appropriate to drink ginger juice. One must strictly avoid tea, water-based soups, or sweet foods. Swallowing these forbidden items will lead to death. Subsequently, administer Fuzi Huiyang Tang (Aconite Decoction for Restoring Yang). For external treatment, use Sha selection (pricking bloodletting for sha), leg curling method, and moxibustion on the navel using Leigong San (Thunder God Powder). These methods possess miraculous efficacy in saving lives from death.
In treating Huoluan (Cholera-like disease), one should abstain from grain food to clear the stomach, preferring instead to drink decoctions made from roasted buckwheat and Sorghum vulgare var. japonicum (Lujizhi) as a substitute for tea. This approach has the ability to expel pathogens and purge turbidity, while also nourishing the stomach and harmonizing the middle. However, buckwheat is cool and purgative, suitable for heat-excess syndromes; Lujizhi is mild and harmonizing, particularly suitable for those with deficient Middle Qi.
Consumption of Body Fluids causing Dry Vomiting: After severe vomiting in Huoluan, when the pathogenic factors of summer-heat, dampness, and filth have been expelled, and the chest feels open and comfortable, yet dry vomiting and extreme thirst persist, with the center of the tongue appearing crimson, dry, and coating-less, this indicates consumption of body fluids. Urgently employ fresh Rehmanniae Radix (Xianshengdi), Dendrobii Nobile Caulis (Chaideshihu), Ophiopogonis Radix (Maidong), Trichosanthis Radix (Huafen), Glehniae Radix (Beishashen), and Mung Bean Peel (Lvdoupi) to nourish the fluids.
Huoluan with Muscle Cramps: Regardless of whether caused by cold or summer-heat, always add Fructus Papaveris (Mu Gua) to the prescription. Once the pathogen is eliminated, the cramps will cease naturally. If vomiting and diarrhea have stopped but the muscles still cramp, it is due to fluid exhaustion. One should employ methods to nourish fluids and relax sinews, such as fresh Rehmanniae Radix, Trichosanthis Radix, Uncariae Ramulus cum Uncis (Gouteng), Coicis Semen (Yiren), and Fructus Papaveris.
Yin Huoluan: Generally, Huoluan with excess-heat characteristics belongs to Stomach diseases of the Middle Jiao; Huoluan with cold characteristics results from the Stomach being injured by raw/cold food or Taiyin Meridian contracting cold. Treatment methods are detailed previously. "Yin Huoluan" specifically refers to Shaoyin Syndrome. It begins with vomiting and diarrhea, deep/hidden pulse, cold extremities, a puffy/tender tongue shape, pale-red color, and absence of thirst. For this, formulas like Sini Tang (Four Reversal Decoction) or Liyin Jian (Decoction for Nourishing Yin) are used. One must assess whether to use rigid/dry herbs or warm/moistening herbs before administration. If the tongue coating is purple and dry, accompanied by thirst and dry retching, Jinshui Liu Jun Jian (Six Gentlemen Decoction of Metal and Water) should be used to harmonize. If the tongue is puffy/tender with a black, slippery appearance, it indicates Cold invading Taiyin, corresponding to Lizhong Syndrome (Middle-Warming Syndrome); do not mistake it for Shaoyin. Treating Taiyin requires rigid/dry herbs; treating Shaoyin requires warm/moistening herbs.
There is a type of Shaoyin Shanghan (Cold Damage) that starts with vomiting and diarrhea. Observe if the tongue is purple without coating, or slightly white in the center with crimson edges, the six pulses are deep and fine, and the patient appears drowsy yet not fully asleep. This is Shaoyin Shanghan. Treatment should focus on benefiting Yin and harmonizing the Middle; do not treat it as Huoluan. Any illness starting with vomiting/diarrhea where the tongue has a coating (yellow or white) is Huoluan. Otherwise, it may be unexanthematous rash (Zhen). This is because Huoluan involves damp-heat pathogens that produce tongue coating, whereas Shaoyin is a deficiency syndrome resulting in a purple-crimson or pale-red tongue without coating. Clinicians must distinguish between them carefully.
Huoluan vomiting and diarrhea occurring in summer and autumn should generally be treated based on summer-heat, dampness, filth, and food stagnation. If treatment fails, or if symptoms include vomiting, restlessness, hidden pulse, and cold feet, one must check for concurrent exanthematous rash or phlegm-fluid retention. Do not act hastily.
Dry Huoluan: Desire to vomit but cannot, desire to defecate but cannot, severe abdominal pain resembling death. Commonly known as Jiaochang Sha (Intestinal Twisting Sha). Urgently use light salt water or scallion-alum water, and induce vomiting using a goose feather probe. Survival depends on successful vomiting; failure leads to death. After vomiting, administer formulas that regulate Qi, harmonize the Middle, clear heat, and disperse accumulation, tailored to specific symptoms.
If a closed syndrome has formed, characterized by coma and inability to speak, and bloodletting/sha-scraping are ineffective, urgently fill the navel cavity with salt and perform moxibustion, regardless of the number of moxa cones.
For Dry Huoluan with coma and inability to speak, if the physical form is depleted, it is untreatable. If the patient can speak and is conscious, but suffers from inability to vomit/defecate and excruciating intestinal pain, urgently use the vomiting induction method combined with bloodletting and scraping. Allowing toxins to exit downward is favorable. Jingyue’s scraping method is excellent.
If epigastric fullness, dryness, and solidity are present, with unbearable hardness and pain around the navel, this is a lower-jiao excess syndrome. Urgently administer Chengqi Tang (Harmonizing the Lower Decoction) to purge. This follows the principle that inducing vomiting is contrary, while promoting downward movement is favorable.
For Dry Huoluan with coma and inability to speak, if the physical form and pulse are not depleted, it is treatable. If the pulse is hidden but the physical form and spirit remain intact, it is also treatable. Perform bloodletting at acupoints or scrape the back. Then decoct Chuan Yujin (Curcuma aromatica Rhizome), Shichangpu (Acori Tatarinowii Rhizoma), Guang Huoxiang (Pogostemonis Herba), Huashi (Talcum), Tongcao (Tetrapanacis Medulla), etc., and mix in 2 fen of Xihuang (Calculus Bovis/Niu Huang). Administer orally.
For Dry Huoluan with coma, hidden pulses, determine if fire pathogens need clearing or cold pathogens need warming. Differentiate by observing the dryness or moisture of lips, teeth, and tongue coating.
For Dry Huoluan with unbearable pain, profuse sweating, extreme thirst, and yellow, dry, prickly tongue coating, administer juice extracted from Coptidis Rhizoma (Huanglian). If sweating stops, the patient survives; if sweating continues, the patient dies.
Huoluan with dryness: Drink earth-water (Di Jiang) cold.
Intestinal Twisting Pain: Drink Buckwheat Decoction cold.
Unceasing Vomiting: Drink Ring-head Lujizhi Decoction cold.
Huoluan Abdominal Pain unresponsive to Qi-regulating and turbidity-purging medicines: Drink water mixed with refined salt (Fei Yan) cold.
Vomiting Induction Method: Mix Yin-Yang water (boiled and unboiled water mixed). Heat a knife until red-hot, place a pinch of salt on the blade, then plunge the hot salt into the water, stirring well. Have the patient drink this mixture. Keep the patient in a sealed room, tightly bind the abdomen with cloth, and use a goose feather to induce vomiting. Survival depends on vomiting; failure leads to death. Once awake, absolutely do not give porridge or drinks, as this causes immediate death. Do not give hot soup, as this causes heart-orifice closure and death.