黄胆皆由湿热成,色分黯滞与鲜明(阴黄色暗滞,阳黄色鲜明,)理中(汤)小建(中汤)阴黄主,
阳证茵陈(蒿汤)子(柏皮甘草汤)行。
伤寒麻黄汤证,桂枝汤证,表寒也。三阴寒化证用理中,四逆,真武,吴茱萸等汤,里寒
也。头痛,项强,恶寒,又兼呕逆,腰痛,表里俱寒也,时法用五积散。
麻(麻黄汤)桂(桂枝汤)二汤去表寒,理中(汤)四逆(汤)里寒看,若还表里皆寒证,五积(散)方中叩两
端。
霍乱吐泻,乃中气虚寒,阴阳杂错,寒多不欲饮水者,理中汤主之。夏月伏阴在内,最
多此证。若霍乱头痛,发热身疼痛,热多欲饮水者,以五苓散主之,藿香正气散,香薷饮不
可轻用。若大汗出,内寒外热,四肢厥冷,微脉欲绝者,宜通脉四逆汤。若大吐大下,厥逆
烦躁,手足拘挛者,通脉四逆汤加猪胆汁、人尿以急救之。
(经义)《经脉篇》曰∶“足太阴厥气上逆,则霍乱。”《气交变大论》曰∶“岁吐不及,
民病飧泄,霍乱。”《六元正纪大论》曰∶“不远热,则热至,热至则身热,吐下霍乱。”
太阴所至为中满,霍乱吐下,吐郁之发为呕吐霍乱。
Jaundice is all caused by damp-heat. Its color is divided into two types: dull and stagnant (Yin jaundice presents with a dark, stagnant hue; Yang jaundice presents with a bright, lustrous hue). Lizhong Tang (Cinnamon Twig and Atractylodes Macrocephala Decoction) and Xiaojianzhong Tang (Minor Construct the Middle Decoction) are the primary treatments for Yin jaundice, while Yinyin Hao Tang (Artemisiae Scopariae Decoction) and Zhizi Baipi Gancao Tang (Gardenia, Phellodendri, and Licorice Decoction) are used for Yang patterns.
In Shanghan (Cold Damage), the Mahuang Tang (Ephedra Decoction) syndrome and Guizhi Tang (Cinnamon Twig Decoction) syndrome belong to Exterior Cold patterns. The Cold Transformation syndromes of the Three Yin meridians utilize formulas such as Lizhong Tang, Sini Tang (Frigid Extremities Decoction), Zhenwu Tang (True Warrior Decoction), and Wuzhuyu Tang (Evodia Decoction), which address Interior Cold patterns. If headache, neck stiffness, aversion to cold occur together with vomiting, regurgitation, and lower back pain, it indicates an Exterior and Interior Cold pattern. In such cases, Wuji San (Five Accumulations Powder) is commonly prescribed according to standard methods.
Mahuang Tang and Guizhi Tang are used to dispel Exterior Cold; Lizhong Tang and Sini Tang are observed for Interior Cold. If the condition remains one of simultaneous Exterior and Interior Cold, one should consult both ends within the principles of Wuji San (addressing both exterior and interior).
Huoquan (Cholera-like disorder) characterized by vomiting and diarrhea results from deficiency-cold of the Middle Qi and a chaotic intermingling of Yin and Yang. If cold predominates and there is no desire to drink water, Lizhong Tang is the primary treatment. In summer, latent Yin cold resides within the body, making this syndrome most common. If Huoquan is accompanied by headache, fever, and body pain, with heat predominating and a desire to drink water, Wuling San (Poria Powder) is the primary treatment; Huoxiang Zhengqi San (Patchouli Powder to Rectify the Qi) and Xiangru Yin (Elsholtzia Drink) should not be used lightly. If there is profuse sweating, interior cold with exterior heat, cold limbs (Jue Ni), and a faint pulse nearly imperceptible, Tongmai Sini Tang (Pulse-Restoring Frigid Extremities Decoction) is appropriate. If there is severe vomiting and purging, leading to Jue Ni, restlessness, and spasms/contractions of the hands and feet, Tongmai Sini Tang added with Porcine Bile (Zhu Danzhi) and Human Urine (Ren Niao) should be used for emergency rescue.
(Classic Theoretical Basis) The *Jingmai Pian* (Chapter on Meridian Channels) states: "When the rebellious Qi of the Foot-Taiyin Spleen meridian ascends, Huoquan occurs." The *Qijiao Bian Dalun* (Great Treatise on Changes in Qi Intercourse) states: "When the annual cycle fails to produce sufficient [yang qi], causing vomiting and diarrhea, the people suffer from unformed stool diarrhea and Huoquan." The *Liuyuan Zhengji Dalun* (Great Treatise on the Correct Records of the Six Origins) states: "If one does not stay away from heat, heat will arrive; when heat arrives, the body becomes hot, leading to vomiting, downward discharge, and Huoquan." When Taiyin Dampness prevails, it causes middle jiao fullness, Huoquan, vomiting, and downward discharge. The outbreak of pent-up Qi also manifests as vomiting and Huoquan.
Alternating vomiting and diarrhea constitute the name Huoquan. For chaotic Yin and Yang, Lizhong Tang is used to harmonize and calm. For thirst and desire to drink, Wuling San is used. For absent pulse and tendon contractions, the protocol involves Sini Tang (specifically Tongmai Sini Tang added with Pig Bile, or similar formulations, can be used for emergency rescue).