Library

Vomiting accompanied by diarrhea is named Huoluan (Huo Luan, Cholera-like syndrome). Cold limbs becoming cold constitute this affliction. For cases with excess cold and no thirst, Lizhong Tang (Regulate the Middle Decoction) is indicated. For cases with excess heat and thirst, Wuling San (Five-Ingredient Powder with Poria) is indicated. In the summer months, sudden cramping pain in the heart region, twisting of the tendons in both legs, profuse cold sweat, simultaneous vomiting and diarrhea, and dryness with irritability are treated by swallowing several cups of Agastache Herba (Huoxiang, 藿香) soaked in water. Huoluan refers to a sudden onset and chaotic disorder. External pathogenic factors are contracted, and internal damage occurs from diet. Yin and Yang contend and obstruct each other; pathogens and healthy Qi struggle. Thus, there is upper vomiting and lower diarrhea, along with abdominal pain. If the pathogen is in the Upper Jiao (Upper Burner), vomiting occurs. If the pathogen is in the Lower Jiao (Lower Burner), diarrhea occurs. If the pathogen is in the Middle Jiao (Middle Burner), vomiting and diarrhea occur simultaneously. This is Shi Huoluan (Damp Huoluan), which presents with mild symptoms and is easy to treat. If one cannot vomit above nor defecate below, the pathogen cannot exit, blocking and stagnating Healthy Qi, leading to Guan Ge (Guan Ge Syndrome, Obstruction and Repletion where Yin and Yang are isolated). This is Gan Huoluan (Dry Huoluan), commonly known as Jiaochang Sha (Intestinal Colic Sha), which leads to rapid death. Do not give grain food; even swallowing rice soup will cause death. However, the main treatment for Huoluan varies. For those with excess heat, thirst, vomiting, and diarrhea, Wuling San is indicated. For those with excess cold, no thirst, vomiting, and diarrhea, Lizhong Tang is indicated. For those complicated by dampness in the middle causing vomiting and diarrhea, Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi) is indicated. For those complicated by summerheat causing vomiting and diarrhea, Sanwu Xiangru Yin (Three-Ingredient Xiangru Decoction) is indicated. Generally, Huoluan may be complicated by external contraction or internal injury; distinguishing the main treatment is difficult. Ancient formulas generally used salt-fried Tongbian (Child's Urine) mixed and drunk, which was very appropriate. Recent times generally use Yinyang Shui (Yin-Yang Water), which is most stable and effective.

Huoxiang Zhengqi San uses Zisu Ye (Perilla Leaf), Dafupi (Areca Peel), Chenpi (Aged Tangerine Peel), and Jiegeng (Platycodon Root) cut into pieces. Gancao (Licorice Root), Yunling (Poria), Banxia Qu (Pinellia Fermented Paste), Houpo (Magnolia Bark), Baizhi (Angelica Dahurica Root), combined with Zao (Jujube) and Jiang (Ginger). The ingredients of Xiangru Yin include four herbs: Houpo combined with Renshen (Ginseng) and Bian Dou (Lablab Bean). Adding Huanglian (Coptis Rhizome) makes it excellent, harmonizing the middle and dispelling summerheat, providing considerable peace.

Alternating chills and fever represent the struggle of Yin and Yang; Xiao Chaihu Tang (Minor Bupleurum Decoction) or Chaihu Guizhi Ganjiang Tang (Bupleurum, Cinnamon Twig, and Ginger Decoction) are used. If heat is knotted in the interior causing irritability and still desiring to vomit, and there is thirst with only head sweating, these formulas are beneficial.

The condition of alternating chills and fever arises from Yin and Yang competing and the struggle between pathogens and Healthy Qi. Chills belong to Yin, fever belongs to Yang; Interior belongs to Yin, Exterior belongs to Yang. When pathogens lodge in the Half-Exterior Half-Interior (Shaoyang stage), Yin exits to contend with Yang; when Yin prevails, chills occur. Yang exits to contend with Yin; when Yang prevails, fever occurs. If Yang is insufficient, chills appear first; if Yin is insufficient, fever appears first. Therefore, chills and fever alternate without fixed timing. However, alternating chills and fever also differ. There are cases due to heat knotting in the interior causing alternating chills and fever, for which Da Chaihu Tang (Major Bupleurum Decoction) is indicated. There are cases after sweating, vomiting, or purging treatments, where there is no vomiting but thirst, only slight head sweating, and alternating chills and fever, for which Chaihu Guizhi Ganjiang Tang is indicated.