霍乱风寒暑饮成，卒然吐泻腹心疼，饮暑盛兮湿霍乱，寒胜为干症不轻。
[注]
霍乱者，乃风寒暑饮之杂邪为病，
卒然挥霍变乱，心腹大痛，吐泻交作也，其能吐能泻者，谓之湿霍乱，
夫暑饮虽盛，若已经吐泻，其邪即解，故易治也，
若欲吐不能，欲泻不能者，谓之干霍乱，
盖寒盛则凝，既不吐泻，则邪无去路，故多不救也。
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霍乱门
吐泻不已腹频疼，口渴引饮胸闷膨，饮盛主以二香饮，暑盛益元散最灵。
[注]
湿霍乱者，乃暑饮合邪也，
其证吐泻不已，肚腹疼痛，口渴引饮，胸膈膨闷，
饮盛者以二香饮主之，
暑盛者以辰砂益元散主之，
因证调治，则暑饮之邪既清，而霍乱之证立愈矣，治者宜详辨之。
(二香饮)方见伤寒
(辰砂益元散)方见暑厥。
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霍乱门
欲吐泻之不吐泻，腹中绞痛不能堪，烦渴大饮甘露饮，肢厥不渴理中煎。
[注]
干霍乱者，乃寒暑凝结，欲吐不吐，欲泻不泻，腹中绞痛，
俗名绞肠痧病也，
治者当分寒暑，
如烦渴大饮者为热，以桂苓甘露饮主之，
若厥逆不渴者属寒，以理中汤主之，因证调治，其病自愈。
(桂苓甘露饮) 白术土炒 茯苓 泽泻 猪芩 肉桂少许 石膏
滑石水飞 寒水石水煎服。
(方歌)
寒暑凝结霍乱成，桂苓甘露莫从容，白术茯苓猪泽桂，膏滑寒水石相同。
(理中汤) 方见不乳。
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Huo Luan (cholera-like syndrome with sudden vomiting and diarrhea) arises from pathogenic factors such as Wind, Cold, Summerheat, and Dampness, presenting suddenly with vomiting, diarrhea, and pain in the heart and abdomen. When Dampness and Summerheat are predominant, it is called Shi Huo Luan (Wet Cholera); when Cold is predominant, it is called Gan Huo Luan (Dry Cholera), which is a more serious condition.
[Note]
Huo Luan is caused by mixed pathogenic factors including Wind, Cold, Summerheat, and Dampness.
It presents with sudden chaotic symptoms, severe pain in the heart and abdomen, and alternating episodes of vomiting and diarrhea. Those who can vomit and have diarrhea are diagnosed with Shi Huo Luan (Wet Cholera).
Although Summerheat and Dampness may be intense, if vomiting and diarrhea occur, the pathogens are expelled, making it easier to treat.
Those who desire to vomit but cannot, or desire to have diarrhea but cannot, are diagnosed with Gan Huo Luan (Dry Cholera).
Because excessive Cold causes stagnation, and since there is no outlet for expulsion via vomiting or diarrhea, the pathogens remain trapped, often leading to fatal outcomes.
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Chapter on Huo Luan
Persistent vomiting and diarrhea accompanied by frequent abdominal pain, thirst with desire to drink, and chest distension and fullness. If Dampness is predominant, Er Xiang Yin (Two Fragrances Decoction) is the primary formula; if Summerheat is predominant, Chen Sha Yi Yuan San (Cinnabar Yi Yuan Powder) is most effective.
[Note]
Shi Huo Luan (Wet Cholera) results from the combination of Summerheat and Dampness pathogens.
The symptoms include persistent vomiting and diarrhea, abdominal pain, thirst with desire to drink, and chest diaphragm distension and oppression.
For cases where Dampness is predominant, Er Xiang Yin (Two Fragrances Decoction) should be used as the main formula.
For cases where Summerheat is predominant, Chen Sha Yi Yuan San (Cinnabar Yi Yuan Powder) should be used as the main formula.
By treating according to the specific syndrome, the Summerheat and Dampness pathogens will be cleared, and the Huo Luan syndrome will resolve immediately. Practitioners must distinguish carefully.
(Er Xiang Yin) See formulas in Shang Han Lun (Treatise on Cold Damage).
(Chen Sha Yi Yuan San) See formulas in the chapter on Shu Jue (Summerheat Collapse).
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Chapter on Huo Luan
Desire to vomit or have diarrhea but inability to do so, with unbearable cramping abdominal pain. For those with irritability, thirst, and large intake of water, Gui Ling Gan Lu Yin (Cinnamon, Poria, and Sweet Dew Decoction) is indicated. For those with cold extremities and no thirst, Li Zhong Tang (Regulate the Middle Decoction) decocted is indicated.
[Note]
Gan Huo Luan (Dry Cholera) is caused by the coagulation of Cold and Summerheat, characterized by the desire to vomit but inability to do so, desire to have diarrhea but inability to do so, and severe cramping abdominal pain.
It is commonly known as Jiao Chang Sha (Intestinal Twisting Miasma disease).
Practitioners must differentiate between Cold and Heat syndromes.
If the patient is irritable, thirsty, and drinks heavily, it is a Heat syndrome, treated primarily with Gui Ling Gan Lu Yin (Cinnamon, Poria, and Sweet Dew Decoction).
If the patient has cold extremities (Jue Ni) and no thirst, it is a Cold syndrome, treated primarily with Li Zhong Tang (Regulate the Middle Decoction). Treatment based on the syndrome leads to natural recovery.
(Gui Ling Gan Lu Yin) Bai Zhu (Atractylodis Rhizoma, stir-fried with soil) Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Zhu Ling (Polyporus), Rou Gui (Cinnamomi Cortex) in small amount, Shi Gao (Gypsum Fibrosum), Hua Shi (Talcum, water-flown), Han Shui Shi (Calcitum). Decoct in water and take orally.
(Formula Song)
Cold and Summerheat coagulation forms Huo Luan, Gui Ling Gan Lu should not be delayed; Bai Zhu, Fu Ling, Zhu Ling, Ze Xie, and Rou Gui, combined with Shi Gao, Hua Shi, and Han Shui Shi equally.
(Li Zhong Tang) See formulas in the chapter on Infant Refusal to Nurse.
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