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Ten syndromes, three prescriptions.

Question: What is the condition known as Huoluan (Colic and Diarrhea)? Answer: Vomiting accompanied by diarrhea constitutes Huoluan.

Question: If a patient presents with fever, headache, body pain, aversion to cold, along with vomiting and diarrhea, what disease does this belong to? Answer: This should be diagnosed as Huoluan. In Huoluan, after vomiting and diarrhea cease, fever may recur.

In Shaoyin Cold Damage (Taiyang Cold Damage), if the pulse is faint and choppy, it was originally Huoluan; now it is diagnosed as Taiyang Cold Damage. After four or five days, when the pathogen enters the Yin meridians and transitions into the Yin stage, diarrhea should occur. If the patient has a history of chronic vomiting and diarrhea, the prognosis is poor. If the patient feels the urge to defecate but only passes flatus without stool, this indicates involvement of the Yangming stage; the stool will likely be hard, and recovery will occur in twelve days. This is because the meridian cycle has completed its course.

After diarrhea ceases, the stool should become hard. If the patient can eat, they will recover. If they cannot eat now, but later, during the next meridian cycle, begin to eat slightly, and then eat normally in the subsequent cycle, they will recover one day after that. If they do not recover, the disease does not belong to the Yangming stage. If there is aversion to cold, a faint pulse, and diarrhea, and the diarrhea subsequently stops, this indicates exhaustion of blood/fluids. Si Ni Jia Ren Shen Tang (Four Reversal Decoction plus Ginseng) is indicated. Prescription: Add one qian of Renshen (Ginseng Radix et Rhizoma) to Si Ni Tang (Four Reversal Decoction).

For Huoluan accompanied by headache, fever, and body pain, if heat signs are prominent and the patient desires water, Wu Ling San (Five-Ingredient Powder with Poria) is indicated. If cold signs are prominent and the patient does not desire water, Li Zhong Tang (Regulate the Middle Decoction) is indicated.

Prescription (Wu Ling San is found in the Jie Xiong [Chest Binding] section):
Li Zhong Tang: Renshen (Ginseng Radix et Rhizoma), Gan Jiang (Dried Ginger Rhizome), Zhi Gan Cao (Prepared Licorice Root), Bai Zhu (Atractylodis Macrocephalae Rhizoma) — each 3 liang.
These four ingredients are boiled in eight sheng of water until three sheng remain. The dregs are removed, and one sheng is taken warm, three times daily. If there is palpitation above the navel indicating Kidney Qi movement, remove Bai Zhu and add Gui Zhi (Cinnamon Twig) 4 liang. For excessive vomiting, remove Bai Zhu and add Sheng Jiang (Fresh Ginger Rhizome) 3 liang. For severe diarrhea, retain/use Bai Zhu. For palpitations, add Fu Ling (Poria) 2 liang. For thirst, increase Bai Zhu to 4.5 liang. For abdominal pain, increase Renshen to 4.5 liang. For cold conditions, increase Gan Jiang to 4.5 liang. For abdominal fullness, remove Bai Zhu and add one Fu Zi (Prepared Aconite Lateralis Radix).
After taking the medicine, wait about the time it takes to eat a meal, then drink one sheng of hot porridge to induce slight warmth. Do not uncover clothes or blankets.

Another method: Mix with honey to form pills the size of a chicken egg. Dissolve one pill in several he of boiling water, crush, and take warm. Take three times during the day and twice at night. If warmth is not felt in the abdomen, increase to three or four pills, though this is less effective than the decoction.

If vomiting and diarrhea cease but body pain persists, adjust the treatment to harmonize the exterior; Gui Zhi Tang (Cinnamon Twig Decoction) in a small dose is appropriate.

If vomiting and diarrhea are accompanied by sweating, fever, aversion to cold, tetanic spasms of the limbs, and cold extremities, Si Ni Tang (Four Reversal Decoction) is indicated. If there is simultaneous vomiting and diarrhea, frequent urination, profuse sweating, undigested food in the stool (Qing Gu Xia Li), internal cold with external heat, and a faint pulse nearly imperceptible, Si Ni Tang (Four Reversal Decoction) is indicated.

If vomiting and diarrhea have stopped, but there is sweating and cold extremities, limbs that do not relax, and a faint pulse nearly imperceptible, Tong Mai Si Ni Jia Zhu Dan Tang (Pulse-Restoring Four Reversal Decoction plus Pig Bile) is indicated. Prescription: Add half he of Zhu Dan (Pig Gallbladder Bile) to Tong Mai Si Ni Tang (Pulse-Restoring Four Reversal Decoction). After administration, the pulse will reappear. If pig bile is unavailable, sheep gallbladder bile may be substituted.

After vomiting and diarrhea, if sweating occurs and the pulse becomes normal but slight irritability remains, this is due to recent deficiency being unable to tolerate the qi of food (impaired digestive capacity).