霍者。挥霍眩晕。乱者。心神烦乱。若上吐下泻。不烦乱者。谓之吐泻。非霍乱也。夫霍乱之因。由于暑食伤脾。
中州郁结。清气不得上升。浊气不得下降。先心痛则先吐。先腹痛则先泻。心腹俱痛者。则吐泻齐作。初起之时。脉多
代结。或见沉细。最难辨其寒热。大法口渴转筋知其为热。宜用清暑化滞汤。至于霍乱已除。转筋不愈者。水谷
之气。传于肝经。热伤其血。则大筋为之软短。湿伤其筋。则小筋为之弛长。宜于消食之中。佐以木瓜苡仁黄芩
麦冬当归白芍。无不应也。但男子之筋聚于阴器。女子之筋聚于乳头。男子用手扯其阴器。女子用手扯其两乳。
可免转筋入腹之死。又有阴邪霍乱者。脉沉细缓。肢凉唇青。此因冷物伤脾。气不宣通。宜用浓朴温中汤。更
有干霍乱者。欲吐不得吐。欲泻不得泻。心腹绞痛。须臾即死。当以手 吐之。方可用药。其间冷热之治。亦与前症
无异也。凡患此者。不可与之饮食。一周时许。热退身凉。方可少与米饮。助其元气。若痛止即食。病再复来。勿
归咎于医也。脉诀云。霍乱之脉。见微迟气少不语。大为难医。盖言暑伤于气。正气欲脱。故难治也。
清热化滞汤
枳壳 浓朴 山楂 杏仁 半夏 黄芩 赤茯 桔梗 枇杷叶 麦冬
转筋倍加木瓜。（治热霍乱主剂他如热甚加川连吴萸除楂朴方为合拍要在辨其有食滞否）
浓朴温中汤
浓朴 枳壳 杏仁 半夏 桔梗 炮姜 甘草 藿香 香茹 陈皮
（按寒霍乱此方尚欠斟酌果系三阴经证宜从治中汤甚则四逆汤白通汤皆可随证选择
而用惟藿茹枳桔应在删除之列盖邪既入阴挽之犹恐不及岂可再事耗散其真气哉）
Huo Luan (Colic and Vomiting-Diarrhea Syndrome), the term "Huo" refers to sudden dizziness; the term "Luan" refers to mental restlessness. If there is only vomiting and diarrhea without mental restlessness, it is called Tu Xie (Vomiting and Diarrhea), not Huo Luan.
The etiology of Huo Luan lies in damage to the Spleen by Summerheat and dietary injury, leading to stagnation in the Middle Jiao (Middle Burner). Clear Qi fails to ascend, and Turbid Qi fails to descend. If Heart pain occurs first, vomiting precedes; if Abdominal pain occurs first, diarrhea precedes; if both Heart and Abdomen are painful, vomiting and diarrhea occur simultaneously. At the onset, the pulse is often characterized by Dai Pulse (Intermittent Pulse) or Jie Pulse (Knotted Pulse), or appears deep and fine, making it difficult to distinguish between Cold and Heat patterns.
The general principle for differentiation: If thirst and Zhuan Jin (Muscle Spasm/Cramp) are present, it is judged as a Heat pattern, suitable for Qing Shu Hua Zhi Tang (Clear Summerheat and Resolve Stagnation Decoction).
As for cases where the main symptoms of Huo Luan have subsided but Zhuan Jin persists, this is because the Qi of food and drink has transmitted to the Liver Meridian. Heat injuring Blood causes the large tendons to contract and shorten; Dampness injuring the tendons causes the small tendons to relax and lengthen. Treatment should employ digestive herbs supplemented with Mugua (Chaenomeles Fruit), Yiren (Coix Seed), Huangqin (Scutellaria Root), Maidong (Ophiopogon Tuber), Danggui (Angelica Sinensis), and Baishao (White Peony Root), which will invariably be effective.
However, in men, tendons gather at the Yin Qi (Genitals); in women, tendons gather at the Nipple. Men can be treated by pulling their genitals, and women by pulling their breasts, which can prevent death from Zhuan Jin entering the abdomen.
There is also Yin-type Huo Luan, characterized by a deep, fine, and slow pulse, cold limbs, and cyanotic lips. This is caused by cold substances damaging the Spleen and obstructing Qi circulation, suitable for Nong Po Wen Zhong Tang (Magnolia Bark Warming the Middle Decoction).
Furthermore, there is Gan Huo Luan (Dry Huo Luan), where one desires to vomit but cannot, desires to defecate but cannot, accompanied by severe colic and abdominal pain, leading to death within moments. One must first induce vomiting using fingers, after which medication can be administered. The treatment principles for Cold and Heat patterns here are no different from the aforementioned conditions.
Patients suffering from this disease should not be given food immediately. After approximately one week, when the heat recedes and the body cools, a small amount of rice water may be given to support Yuan Qi (Primal Qi). If food is consumed as soon as pain stops, the illness will recur; do not blame the physician.
The Mai Jue (Pulse Classic) states: For Huo Luan, if the pulse presents as Wei Chi (Weak and Slow) and the patient suffers from shortness of breath and unwillingness to speak, it is difficult to treat. This indicates that Summerheat has damaged Qi, and Zheng Qi (Upright Qi) is on the verge of collapse, hence the difficulty in treatment.
Qing Shu Hua Zhi Tang (Clear Summerheat and Resolve Stagnation Decoction)
Zhi Qiao (Immature Bitter Orange), Nong Po (Magnolia Bark), Shan Zha (Hawthorn Fruit), Xing Ren (Apricot Seed), Ban Xia (Pinellia Tuber), Huang Qin (Scutellaria Root), Chi Fu Ling (Red Poria), Jie Geng (Platycodon Root), Pi Pa Ye (Loquat Leaf), Mai Dong (Ophiopogon Tuber).
If Zhuan Jin occurs, double the dosage of Mugua. (This is the primary formula for treating Heat-type Huo Luan. Other adjustments include adding Chuan Lian Zi (Sichuan Chinaberry) and Wu Zhu Yu (Evodia Fruit) for severe heat, removing Shan Zha and Nong Po, ensuring the formula fits the condition. The key lies in distinguishing whether there is Food Stagnation.)
Nong Po Wen Zhong Tang (Magnolia Bark Warming the Middle Decoction)
Nong Po (Magnolia Bark), Zhi Qiao (Immature Bitter Orange), Xing Ren (Apricot Seed), Ban Xia (Pinellia Tuber), Jie Geng (Platycodon Root), Pao Jiang (Prepared Ginger), Gan Cao (Licorice Root), Huo Xiang (Patchouli), Xiang Ru (Perilla Leaf), Chen Pi (Tangerine Peel).
(Note: For treating Cold-type Huo Luan, this formula requires careful consideration. If it is indeed a syndrome of the Three Yin Meridians, one should select from Zhi Zhong Tang (Regulate the Middle Decoction); in severe cases, Si Ni Tang (Four Reversals Decoction) or Bai Tong Tang (White Passage Decoction) may be chosen according to the syndrome. However, Huo Xiang, Xiang Ru, Zhi Qiao, and Jie Geng should be deleted. Since the pathogen has entered the Yin level, it is already difficult enough to salvage Zheng Qi; how can one further dissipate True Qi?)