霍乱者，食寒饮冷而外感风寒者也。脾胃以消化为能，如水谷不消，在上脘则胃逆而为吐，在下脘则
脾陷而为利，或吐或利，不并作也。若风寒外束，经迫腑郁，则未消之饮食，不能容受，于是吐利并作，
而霍乱之病成矣。肝胆主筋，水土寒湿，木气不荣，是以筋转也。如霍乱头疼发热，身疼痛，热多欲饮
水者，以五苓散主之。寒多不饮水者，以理中丸主之。如吐利汗出，发热恶寒，四肢拘急，手足厥冷者
，或吐利小便复利，而大汗出，下利清谷，内寒外热，脉微欲绝者，以四逆汤主之，如吐已下断，汗出
而厥，四肢拘急不解，脉微欲绝者，以通脉四逆
加猪胆汁汤主之。如恶寒脉微，而复和，利止亡血也，以四逆加人参汤主之。如吐利止，而身痛不休者
，当消息和解其外，宜桂枝汤小和之。
五苓散
（方见痰饮） 用抑扶煎尤妙（方见痢疾）
理中丸
人参 白术 甘草 干姜（各三两） 炼蜜为丸，白滚水调服，作汤亦可。若脐上筑者
，肾气动也，去白术加桂四两。吐者，去白术加生姜三两，下利者，仍用术。
悸者，加茯苓二两。渴欲得水者，加术，足前成四两。腹中痛者，加人参足前成四两。寒加干姜，足前成
四两。腹满者，去术加附子一枚，服汤后，如食顷，饮热粥一杯许，微自温，勿发揭衣被。
四逆汤
（方见呕吐） 用茯苓四逆汤加半夏尤妙（方见泄泻）
通脉四逆汤
（方见泄泻）加猪胆半杯
四逆加人参汤
即四逆汤加人参
桂枝汤
桂枝（三钱） 芍药（三钱） 甘草（二钱炙） 生姜（三钱） 大枣四枚，水煎温服，须臾啜
稀粥，温覆取微似汗。
Huo Luan (Acute Vomiting and Diarrhea) is a disease caused by consuming cold food and drinks combined with external contraction of Wind-Cold pathogens. The Spleen and Stomach possess the function of digestion; if water and grain fail to digest, retention in the Upper Jiao causes Stomach Qi to rebel upward resulting in vomiting, while retention in the Lower Jiao causes Spleen Qi to sink downward resulting in diarrhea. It may present as vomiting alone or diarrhea alone, but not both simultaneously. However, if Wind-Cold binds the exterior, compressing the meridians and stagnating the fu organs, the undigested food and drink cannot be accommodated, leading to simultaneous vomiting and diarrhea, thus forming the disease of Huo Luan. The Liver and Gallbladder govern the sinews. When Cold-Dampness from Water and Earth invades, causing Wood Qi to lack nourishment, sinew spasms occur. For instance, in Huo Luan accompanied by headache, fever, body pain, significant heat sensation, and thirst for water, Wu Ling San (Five-Ingredient Powder with Poria) should be used. If there is significant cold sensation and no desire for water, Li Zhong Wan (Regulate the Middle Pill) should be used. In cases of vomiting and diarrhea with sweating, fever, aversion to cold, stiff and cramped limbs, and cold extremities; or where vomiting and diarrhea are followed by continued urination, profuse sweating, diarrhea with undigested food (Qing Gu), internal cold with external false heat, and a faint pulse nearly imperceptible, Si Ni Tang (Frigid Extremities Decoction) should be used. If vomiting and diarrhea cease, yet sweating and cold extremities persist, limb stiffness remains unresolved, and the pulse is faint and nearly imperceptible, Tong Mai Si Ni Tang Plus Pig Bile Decoction should be used. If there is aversion to cold and a faint pulse, and although diarrhea has stopped, it indicates depletion of blood/fluids rather than recovery, Si Ni Tang Plus Ginseng Decoction should be used. If vomiting and diarrhea stop but body pain persists, one should assess the situation to harmonize and resolve the exterior syndrome, preferably using Gui Zhi Tang (Cinnamon Twig Decoction) in a mild dose.
Wu Ling San (Five-Ingredient Powder with Poria)
(See formula under "Phlegm-Fluids" chapter). Using Yi Fu Jian (Suppress and Support Decoction) is particularly excellent (See formula under "Dysentery" chapter).
Li Zhong Wan (Regulate the Middle Pill)
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Cao (Licorice Root), Gan Jiang (Dried Ginger Rhizome) (each 3 liang). Processed into pills with refined honey, taken with boiled white water; decoction form is also acceptable. If there is palpitation above the umbilicus, indicating Kidney Qi movement, remove Bai Zhu and add Gui Zhi (Cinnamon Twig) 4 liang. If vomiting occurs, remove Bai Zhu and add Sheng Jiang (Fresh Ginger Rhizome) 3 liang; if diarrhea occurs, retain Bai Zhu. If palpitations occur, add Fu Ling (Poria) 2 liang. If thirsty for water, increase Bai Zhu so the total reaches 4 liang. If abdominal pain occurs, increase Ren Shen so the total reaches 4 liang. If cold is severe, increase Gan Jiang so the total reaches 4 liang. If abdominal fullness occurs, remove Bai Zhu and add Fu Zi (Aconite Lateralis Radix Preparata) 1 piece. After taking the decoction, after approximately the time it takes to eat a meal, drink about one cup of hot porridge to induce slight warmth; do not uncover clothing/bedding to sweat.
Si Ni Tang (Frigid Extremities Decoction)
(See formula under "Vomiting" chapter). Using Fu Ling Si Ni Tang Plus Ban Xia (Pinellia Tuber) is particularly excellent (See formula under "Diarrhea" chapter).
Tong Mai Si Ni Tang Plus Pig Bile Decoction
(See formula under "Diarrhea" chapter). Add half a cup of Pig Bile.
Si Ni Tang Plus Ginseng Decoction
Is Si Ni Tang plus Ren Shen (Ginseng Radix et Rhizoma).
Gui Zhi Tang (Cinnamon Twig Decoction)
Gui Zhi (Cinnamon Twig) (3 qian), Bai Shao (White Peony Root) (3 qian), Zhi Gan Cao (Prepared Licorice Root) (2 qian), Sheng Jiang (Fresh Ginger Rhizome) (3 qian), Da Zao (Jujube Fruit) 4 pieces. Decoct in water and take warm. Shortly after ingestion, drink thin porridge and cover with blankets to induce a slight perspiration.