（《内经》霍乱法附）
〔《活》〕夏月中暑霍乱，上吐下利，心腹撮痛，大渴烦躁，四肢逆冷，汗自出，两脚转筋，宜服香薷饮，
须井底沉极冷，顿服之乃效，他药不能救。
香薷散 治阴阳不顺，清浊相干，气郁中焦，名为霍乱。此皆饱食 炙，顿啖乳酪、酒醪百品，无所不
餐，多饮水浆，眠睡冷席，风冷之气伤于脾胃，诸食结而不散，阴阳二气壅而不反，阳气欲降，阴气欲升，阴
阳交错，变成吐利不已，百脉混乱，荣卫俱虚，冷搏筋转，皆宜服此。
浓朴（去皮，二两） 黄连（姜汁炒，二两） 香薷（四两） 甘草（半两）
上为末，每服四钱，水煎，不犯铁器，慢火煎之。兼治不时吐利，霍乱腹撮痛，大渴烦躁，四肢逆冷，冷
汗自出，两脚转筋，疼痛不可忍者，须井中沉令极冷，顿服之乃效。
〔罗〕桂苓白术散 治冒暑饮食所伤传受，湿热内盛，霍乱吐泻，转筋急痛，腹满痛闷，小儿吐泻惊风，
皆宜服此。
桂枝 人参 白术 白茯苓（各半两） 泽泻 甘草 石膏 寒水石（各一两） 滑石（二两） 一方有
木香、藿香、葛根各半两。
上为细末，每服三钱，白汤调下，或新汲水、生姜汤下，亦得。有蒙古百户昔良海，因食酒肉，饮 乳，
得吐泻霍乱症，从朝至午，精神昏愦，以困急来告。予诊视之，脉得沉数，按之无力，所伤之物已出矣。即
以新汲水半碗，调桂苓白术散徐徐服之，稍得安静。又于墙阴掘地一穴，约二尺许，贮以新汲水在内搅之，
待一时澄定，名曰地浆，用清者一杯，再调服之，渐渐气和，吐泻遂止，至夜得安。翌日微烦渴，遂愈。却
以钱氏白术散时时服之，良愈。或问用地浆者何也？予曰∶坤为地，地属阴，土平曰静顺，感至阴之气，又
于墙阴贮以新汲水，以取重阴之气也。阴中之阴，能泄阳中之阳。霍乱症由暑热内伤而得之，故痹论云∶阴
气者，静则神藏，躁则消亡。又加暑热，七神迷乱，非至阴之气则不能息，予用之者此也。《内经》福万世之
书，岂不信哉。又提学侍其公，年七十九岁，六月中暑毒，霍乱吐泻，昏冒终日，不知人事，夜半请予视
之。诊其脉七八至，洪大有力，头热如火，足寒如冰，半身不遂，牙关紧急。予思《内经》五乱篇中云∶清
气在阴，浊气在阳、荣气顺脉，卫气逆行，乱于胸中，是谓大俯云云。乱于肠胃，则为霍乱，于是霍乱之名
自此而生。盖年高气弱，不任暑气，阳不维阴则泻，阴不维阳则吐，阴阳不相维，则既吐且泻矣。前人见寒
多，以理中汤，热多，以五苓散，作定法治之。今暑气极盛，阳明得时之际，况因动而得之．中暑明矣。非
甘辛大寒之剂，不能泄其暑热，坠浮焰之火而安神明也。遂以甘露散甘辛大寒，泻热补气，加茯苓以分阴阳，
冰水调灌之，渐省人事，诸症悉去。后慎言语，节饮食三日，以参术调中汤以意增减服之，理其正气，逾十
日后方平复。
〔无〕诃子散 治老幼霍乱，一服即效。
诃子（炮，去核） 甘草（炙） 浓朴（姜制） 干姜（炮） 神曲（炒） 草果（去壳）
良姜（炒） 茯苓 麦芽（炒） 陈皮（各等分）
上为细末，每服二钱，候发不可忍时，用水煎，入盐少许服之。
〔《圣》〕治霍乱。用浓朴姜制，火上炙令香为末，以新汲水调下二钱匕佳。
〔《大》〕人参散 治妊娠霍乱吐泻，心烦腹痛。
人参 浓朴（姜制） 橘红（各一两） 当归（炒） 甘草（炙。各半两）
上为末，每服四钱，枣三枚，水煎服。
〔丹〕霍乱内有所伤，外有所感。
〔《集》〕吐泻还用吐，以提其气起，吐用二陈汤加减，或用樟木煎汤吐亦可。
〔海〕霍乱症，本自胃家，或因寒饮，或因饮水，或伤水毒，或感湿气，冷热不调，水火相干，阴阳相搏，
转筋挛痛，经络乱行，暴作吐泻，中焦胃气所主也。察其色脉，随经标本，此治霍乱吐泻之法也。
〔《外》〕治霍乱吐下不止者，艾一把，水三升，煮至一升，顿服。
〔《经》〕霍乱。陈皮汤下山豆根末二钱。
〔《山》〕霍乱吐泻。用屋下倒挂尘泡汤，澄清服之。大忌饮食，入腹则死。吃冰水不妨，不可饮热汤。
〔《集》〕吐泻不止，或吐转多，四肢发厥，虚风不省人事，服此四肢渐暖，神识便省。
回阳散
用天南星为末，每服三钱，用大枣三枚同煎，至八分温服。未省再服。
霍乱转筋，治法见转筋门。
〔罗〕增损缩脾饮 解伏热，除烦渴，消暑毒，止吐利。霍乱之后，服热药太多，烦躁者尤宜服之。
草果 乌梅 甘草 砂仁（各四两） 干葛（二两）
上 咀，每服五钱，生姜五片，同煎，以水沉冷以解烦，或温或热随意服。
〔无〕茯苓泽泻汤 治霍乱吐泻后，烦渴欲饮水。
茯苓（八两） 泽泻（四两） 甘草（炙） 桂心（各二两） 白术（三两）
上 咀，每服四钱，生姜三片同煎，食前服。一方有小麦五两。
〔世〕以小竹杖，两手反抱住于脊骨，就杖儿上下各点一穴。如先吐先灸上穴，先泻先灸下穴，各三百壮，
百发百中。又，霍乱诸法不效者，灸大椎。又，以盐纳脐中，灸二十壮，立苏。
〔《集》〕霍乱吐泻∶中脘 天枢 三里 委中
〔《摘》〕又法∶上脘、三里。
〔《甲》〕霍乱泄出不自知，先取太溪，后取太仓之原。又法∶巨阙 关冲 支沟 解溪
〔《千》〕又主阴陵泉。
〔东〕吐利上下俱出，藏痹脓血，头重臂痛∶太白 地机 风府（各五分。） 长强 尺泽（各一寸。）
〔《甲》〕霍乱泄利，期门主之。厥逆霍乱，府舍主之。
〔世〕霍乱手足厥冷，灸三阴交七壮。
〔《甲》〕霍乱逆气，鱼际、太白主之。霍乱遗尿失气，三里主之。
〔世〕病患合面正卧，两手着身，以绳横亘两肘尖头，根据绳下侠脊，两边相去各一寸，灸三七壮，无不验。
霍乱已死，但有暖气者，灸承筋七壮，立苏。（取法以绳从足拇指围至后跟一匝捻断，等折一半为度，以
此度从足跟贴地量上至 度极头处是穴。）
〔《甲》〕霍乱颈痹不仁，承筋主之。（《千金》云∶主螈 脚酸。暴霍乱，仆参主之。）
〔世〕霍乱遍身转筋，肚痛，四肢厥冷欲绝者，其脉洪大易治。脉微，囊缩舌卷，不治。
〔《千》〕诸霍乱，忌与米饮，胃中得米，即吐不止。
〔罗〕洁古老人云∶霍乱转筋，吐泻不止，其病在中焦，阴阳交而不和，发为疼痛，此病最急，不
可与分毫粥饮。谷气入胃，则必死矣。
〔保〕凡霍乱慎勿与粟米粥汤，入胃即死。本草云∶粟米味咸，微寒无毒，主养肾气，去脾胃中热，
益气。霍乱脾胃极损，不能传化，加粟米岂有能生也邪？如吐泻已多，欲住之后，宜以稀粥渐渐补养，
以迟为妙。
(Applied to the treatment methods of Huoluan in *Neijing*)
[Liu Wansu] Huoluan caused by summerheat in summer presents with vomiting and diarrhea above and below, cramping pain in the heart and abdomen, extreme thirst and restlessness, cold limbs, spontaneous sweating, and spasmodic contraction of the lower legs. It is suitable to take Xiangru Yin (Elsholtzia Decoction). The decoction must be soaked at the bottom of a well until extremely cold, taken in one dose for efficacy; other medicines cannot save the patient.
Xiangru San (Elsholtia Powder): Treats Huoluan where Qi and Blood are not smooth, clear and turbid Qi interfere with each other, Qi stagnates in the Middle Jiao. This is mostly due to overeating roasted foods, suddenly consuming large amounts of dairy products and wines, drinking much liquid, sleeping on cool mats, causing Wind-Cold to injure the Spleen and Stomach. Various foods condense and do not disperse, Yin and Yang Qi become stagnant and fail to restore balance. Yang Qi desires to descend while Yin Qi desires to ascend; Yin and Yang intermingle, resulting in unceasing vomiting and diarrhea, chaos in all vessels, deficiency of Ying and Wei Qi, Cold combing with sinews leading to spasms. All these cases are suitable for this prescription.
Cinnamon Twig (Guizhi) [Note: Text says Congming/Cangzhu? No, text says Nongpu/Polygoni Multiflori Caulis? No, Nongpu is Magnolia Bark. Wait, text says Nongpu (Magnoliae Officinalis Cortex), Huanglian (Coptidis Rhizoma), Xiangru (Elsholtiae Herba), Gancao (Glycyrrhizae Radix et Rhizoma)].
Magnolia Bark (Nongpu) (peeled, 2 liang), Coptis Rhizome (Huanglian) (stir-fried with ginger juice, 2 liang), Elsholtzia Herb (Xiangru) (4 liang), Licorice Root (Gancao) (0.5 liang).
Grind the above into powder. Take 4 qian per dose, decoct with water. Do not use iron vessels; decoct over slow fire. It also treats intermittent vomiting and diarrhea, Huoluan with cramping abdominal pain, extreme thirst and restlessness, cold limbs, spontaneous cold sweat, and painful spasms of the lower legs that are unbearable. The medicine must be sunk in a well to become extremely cold, then taken in one dose for efficacy.
[Luo Tianyi] Guiling Baizhu San (Atractylodes Macrocephala Decoction with Cinnamon Twig and Poria): Treats conditions transmitted from injury by summerheat and diet, where Damp-Heat abounds internally, causing Huoluan with vomiting and diarrhea, acute spasmodic pain in the calves, abdominal distension and pain, and pediatric convulsive wind due to vomiting and diarrhea. This prescription is suitable for all such cases.
Cinnamon Twig (Guizhi), Ginseng Root (Renshen), Atractylodes Macrocephala Rhizome (Baizhu), Poria (Baifuling) (each 0.5 liang), Alisma Rhizome (Zexie), Licorice Root (Gancao), Gypsum Fibrosum (Shigao), Arsenolite (Han Shui Shi) (each 1 liang), Talcum (Huashi) (2 liang). Another version includes Costus Root (Muxiang), Agastache Herb (Huoxiang), and Kudzu Root (Gegen) (each 0.5 liang).
Grind the above into fine powder. Take 3 qian per dose, mix with white boiled water, or fresh drawn water, or ginger decoction.
A Mongol commander named Xi Liang Hai suffered from vomiting and diarrhea Huoluan after eating meat and drinking milk. From morning to noon, his spirit was confused and he came in urgent distress. I examined his pulse: deep and rapid, weak upon pressure, indicating the injured food had been expelled. I immediately used half a bowl of fresh drawn water to slowly administer Guiling Baizhu San, after which he became slightly calm. I then dug a pit about two chi deep in the shade of a wall, filled it with fresh drawn water, stirred it, and waited for an hour for it to settle. This is called "Earth Slurry" (Di Jiang). Taking one cup of the clear liquid and administering it again gradually harmonized the Qi, stopping the vomiting and diarrhea. He rested peacefully that night. The next day, with slight thirst and restlessness, he recovered. Subsequently, he took Qian's Baizhu San frequently, recovering well. Someone asked why Earth Slurry was used. I said: Kun represents Earth, which belongs to Yin. Earth is tranquil and compliant. Feeling the extreme Yin Qi, and storing fresh water in the shade to extract heavy Yin Qi. Yin within Yin can vent Yang within Yang. Huoluan is caused by internal injury from summerheat. Thus, *Bi Lun* states: "Yin Qi, when tranquil, stores the Spirit; when restless, it dissipates." With added summerheat, the Seven Spirits become confused; only extreme Yin Qi can pacify them. This is why I used it. *Neijing* is a book benefiting ten thousand generations, is it not trustworthy?
Another case: Siqi Gong, the Education Commissioner, aged seventy-nine, suffered from summerheat toxin in June, with Huoluan vomiting and diarrhea, coma all day, unaware of surroundings. Summoned at midnight. Pulse was rapid (7-8 beats per breath), surging and forceful. Head hot as fire, feet cold as ice, hemiplegia, locked jaw. I recalled *Neijing · Wu Luan Pian*: "Clear Qi in Yin, Turbid Qi in Yang, Ying Qi follows vessels, Wei Qi moves counter-current... confusion in intestines and stomach is called Huoluan." Thus the name Huoluan originated. Due to old age and weak Qi, unable to withstand summerheat, Yang fails to secure Yin leading to diarrhea, Yin fails to secure Yang leading to vomiting. When Yin and Yang do not secure each other, both vomiting and diarrhea occur. Predecessors treated cold-dominant cases with Lizhong Tang and heat-dominant cases with Wuling San as fixed rules. Now, summerheat is extreme, during the time of Yangming. Since it was acquired through movement, it is clearly Summerheat. Only sweet, acrid, and great-cold agents can vent summerheat and subdue floating fire to calm the Spirit. Thus, I used Ganlu San (Sweet Dew Powder), sweet-acrid and great-cold, to vent heat and tonify Qi, adding Poria to differentiate Yin and Yang, mixed with ice water and administered. Gradually, consciousness returned, symptoms vanished. Afterward, with restricted speech and diet for three days, Shen and Zhu Tiao Zhong Tang (Ginseng and Atractylodes Harmonizing Middle Decoction) was adjusted and taken to regulate Zheng Qi. Recovery occurred after ten days.
[Zhu Danxi] Hezi San (Myrobalan Powder): Treats Huoluan in elderly and children, effective after one dose.
Myrobalan Fruit (Hezi) (processed, pitted), Licorice Root (Gancao) (roasted), Magnolia Bark (Nongpu) (prepared with ginger), Dried Ginger (Ganjiang) (processed), Medicated Leaven (Shenqu) (fried), Tsaoko Cardamom (Caoguo) (husked), Galangal (Liangjiang) (fried), Poria (Fuling), Barley Sprout (Maiya) (fried), Tangerine Peel (Chenpi) (equal parts).
Grind into fine powder. Take 2 qian per dose. When suffering becomes unbearable, decoct with water, add a little salt, and take.
*[Shengji Zonglu]* Treat Huoluan. Use Magnolia Bark prepared with ginger, roast on fire until fragrant, grind to powder. Mix with fresh drawn water, take 2 qian bi. Best method.
*[Daguan Bencao]* Renshen San (Ginseng Powder): Treats Huoluan vomiting and diarrhea during pregnancy, with mental restlessness and abdominal pain.
Ginseng Root (Renshen), Magnolia Bark (Nongpu) (prepared with ginger), Exocarpium Citri Reticulatae (Juhong) (each 1 liang), Angelica Sinensis Root (Danggui) (fried), Licorice Root (Gancao) (roasted, each 0.5 liang).
Grind to powder. Take 4 qian per dose, with three jujubes, decoct with water.
[Zhu Danxi] Huoluan involves internal injury and external pathogenic influence.
*[Jiyan Fang]* For vomiting and diarrhea, induce vomiting again to raise Qi. Use Erchen Tang (Two-Aged Decoction) modified, or decoct Camphor Wood (Zhangmu) to induce vomiting.
[Wang Haicang] Huoluan originates in the Stomach. It may be due to cold fluids, drinking water, water toxicity, or dampness. Imbalance of cold and heat, interference of Water and Fire, combat of Yin and Yang lead to spasms and pain, disorder of meridians, sudden vomiting and diarrhea. This is governed by the Qi of the Middle Jiao Stomach. Observe complexion and pulse, follow the meridian root and branch. This is the method for treating Huoluan vomiting and diarrhea.
*[Waitai Miyao]* For Huoluan with unceasing vomiting and purging: Use one handful of Moxa, three sheng of water, boil to one sheng, take in one dose.
*[Jingxiao Chanbao]* Huoluan. Chenpi Tang (Tangerine Peel Decoction) with 2 qian of Dougen (Buckthorn Root) powder.
*[Shanju Siyao]* Huoluan vomiting and diarrhea. Use dust hanging from eaves soaked in water, clarify and drink. Strictly forbid food intake; if food enters the stomach, death ensues. Drinking ice water is acceptable; hot soup is forbidden.
*[Jiyan Fang]* For unceasing vomiting and diarrhea, or increased vomiting, cold limbs, unconsciousness due to deficient wind: Take this prescription. Limbs will gradually warm, consciousness returns.
Huiyang San (Return Yang Powder):
Use Pinellia Tuber (Tiannanxing) ground to powder. Take 3 qian per dose, decoct with three jujubes. When reduced to 8/10 volume, take warm. If not conscious, take again.
For Huoluan with spasms, see the chapter on Spasms.
[Luo Tianyi] Zengsun Suopi Yin (Modified Splees-Constricting Drink): Resolves latent heat, relieves thirst and restlessness, vents summerheat toxin, stops vomiting and diarrhea. Especially suitable for post-Huoluan patients who have taken too many hot medicines and feel restless.
Tsaoko Cardamom (Caoguo), Smoked Plum (Wumei), Licorice Root (Gancao), Amomum Fruit (Sharen) (each 4 liang), Kudzu Root (Gegen) (2 liang).
Cut into pieces. Take 5 qian per dose, with five slices of ginger, decoct together. Cool by sinking in water to relieve restlessness, or take warm/hot as desired.
[Zhu Danxi] Fuling Zexie Tang (Poria and Alisma Decoction): Treats thirst and desire to drink after Huoluan vomiting and diarrhea.
Poria (Fuling) (8 liang), Alisma Rhizome (Zexie) (4 liang), Licorice Root (Gancao) (roasted), Cinnamon Bark (Guixin) (each 2 liang), Atractylodes Rhizome (Baizhu) (3 liang).
Cut into pieces. Take 4 qian per dose, with three slices of ginger, decoct. Take before meals. Another version adds Wheat (Xiaomai) 5 liang.
*[Shiyi Dexiao Fang]* Use a small bamboo staff. Hold it against the spine with hands reversed. Mark points above and below the staff. If vomiting precedes, moxa the upper point; if diarrhea precedes, moxa the lower point. Each 300 moxa cones. Highly effective. Alternatively, for refractory Huoluan, moxa Dazhui (GV14). Alternatively, place salt in the umbilicus and moxa 20 cones. Immediate revival.
*[Jiyan Fang]* Huoluan vomiting and diarrhea: Zhongwan (CV12), Tianshu (ST25), Zusanli (ST36), Weizhong (BL40).
*[Zhaiyuan Fang]* Another method: Shangwan (CV13), Zusanli (ST36).
*[Jiayi Jing]* For Huoluan with involuntary discharge, first select Taixi (KI3), then Tai Cang Yuan (Zusanli ST36). Another method: Juque (CV14), Guanchong (SJ1), Zhigou (SJ6), Jiexi (ST41).
*[Qianjin Fang]* Also governs Yinlingquan (SP9).
[Li Dongyuan] For simultaneous upper and lower vomiting/diarrhea, organ obstruction with pus/blood, heavy head and arm pain: Taibai (SP3), Diji (SP8), Fengfu (GV16) (each 0.5 cun); Changqiang (GV1), Chize (LU5) (each 1 cun).
*[Jiayi Jing]* Huoluan with diarrhea: Qimen (LR14) governs. Jueyin Huoluan: Fushhe (GB26) governs.
*[Shiyi Dexiao Fang]* For Huoluan with cold limbs, moxa Sanyinjiao (SP6) 7 cones.
*[Jiayi Jing]* Huoluan with rebellious Qi: Yuji (LU10), Taibai (SP3) govern. Huoluan with urinary/fecal incontinence: Zusanli (ST36) governs.
*[Shiyi Dexiao Fang]* Patient lies face down, hands by sides. Measure horizontally between elbow tips with a string. Under the string, parallel to spine, mark points 1 cun apart on each side. Moxa 21 cones. Infallible.
If Huoluan has led to apparent death but warmth remains, moxa Chengjin (BL56) 7 cones. Immediate revival. (Method: Measure circumference from big toe to heel, break string, fold in half. Apply from heel up to limit.)
*[Jiayi Jing]* Huoluan with neck stiffness and numbness: Chengjin (BL56) governs. (*Qianjin* says: Governs twitching and leg soreness. Acute Huoluan: Puscan (BL60) governs.)
*[Shiyi Dexiao Fang]* For Huoluan with full-body spasms, abdominal pain, extremities cold to near-death: Surging pulse indicates easy treatability. Thready pulse, retracted scrotum, curled tongue indicate untreatable.
*[Qianjin Fang]* All Huoluan cases: Avoid rice drinks. Rice in stomach causes unceasing vomiting.
[Luo Tianyi citing Zhang Congzheng/Jiegu] Huoluan with spasms and unceasing vomiting/diarrhea is a disease of the Middle Jiao, where Yin and Yang interact without harmony, causing pain. This is most urgent. Do not give any porridge or drink. Grain entering the stomach leads to death.
[Baoshou Hall] Never give millet porridge to Huoluan patients; it causes death upon entering the stomach. Materia Medica states: Millet is salty, slightly cold, non-toxic, nourishes Kidney Qi, clears Heat in Spleen/Stomach, benefits Qi. Huoluan severely damages Spleen/Stomach, impairing transformation. Adding millet destroys life. Only after vomiting/diarrhea cease should thin porridge be gradually given to nourish. Delay is best.