论曰呕吐而利，病名霍乱，此由邪气在中焦，使阴阳二气，不能升降，则心腹绞痛而作
吐利也。其候先心痛则先吐，先腹痛则先利，心腹俱痛，则吐利并作，古人以其病迅暴，挥
霍之间，便致撩乱，故谓之霍乱，伤寒霍乱，亦由中焦阴阳不和所致，故其状有热而渴者，
有寒而不渴者，有发热恶寒，汗出厥逆者，有病势已，而身体疼痛不休者，治之不可概以一
法。
治伤寒后霍乱吐利。寒多不喜饮水。理中丸方
人参 干姜（炮裂） 甘草（炙锉） 白术（各三两）
上四味，捣罗为末，炼蜜丸如鸡子黄大，每服一丸，沸汤化破温服，日三夜二，腹中未
热，加至三四丸。
治伤寒霍乱，头痛发热，多欲饮水。五苓散方
猪苓（去黑皮） 白术（各三分） 泽泻 赤茯苓（去黑皮各一两） 桂（去粗皮半两）
上五味，捣罗为散，每服二钱匕，温水调下日再。
治伤寒后霍乱，心烦干呕。芦参汤方
芦根（锉二两） 人参 麦门冬（去心焙） 赤茯苓（去黑皮各一两） 枇杷叶（拭去
毛炙一分）
上五味，粗捣筛，每服五钱匕，水一盏半，薤白三寸，煎至一盏，去滓温服日三。
治伤寒后霍乱，心膈不利。朴姜汤方
朴浓（去粗皮生姜汁炙） 高良姜（炒） 陈橘皮（去白炒） 人参（各三分） 草豆
蔻（去皮半两）
上五味，粗捣筛，每服三钱匕，水一盏，生姜三片，枣一枚劈破，煎至七分，去滓温服
日三。
治伤寒后霍乱，吐利不止，吃食不消，心腹胀闷。人参汤方
人参 浓朴（去粗皮生姜汁炙） 干木瓜（各一两） 高良姜（炒） 木香 白茯苓（去
黑皮 芍药） 白豆蔻（去皮） 桂（去粗皮） 白术 陈橘皮（去白炒各半两）
上一十一味，粗捣筛，每服三钱匕，水一盏，煎至七分，去滓温服日三。
治伤寒后霍乱转筋。呕吐不止闷绝。藿香汤方
藿香叶 当归（切焙） 附子（炮裂去皮脐） 人参 桂（去粗皮） 木瓜（各一两）
上六味，锉如麻豆，每服三钱匕，水一盏，生姜三片，煎至七分，去滓温服，不拘时。
治伤寒后霍乱，吐泻不止，及脚转筋。肉豆蔻汤方
肉豆蔻仁 高良姜（炒） 枇杷叶（拭去毛炙各半两） 浓朴（去粗皮生姜汁炙锉） 桂
（去粗皮各一两） 吴茱萸（汤洗焙干炒一分）
上六味，粗捣筛，每服三钱匕，水一盏，枣一枚劈煎至七分，去滓温服日三。
治伤寒霍乱转筋，风寒客于胃腑，吐利不止，心腹气胀，不思饮食。浓朴汤方
浓朴（去粗皮生姜汁炙锉） 干木瓜（各一两） 高良姜（炒） 香薷叶 陈橘皮（去
白炒） 紫苏茎（各半两）
上六味，粗捣筛，每服三钱匕，水一盏，入生姜三片，盐少许，煎至七分，去滓温服，
不拘时。
治伤寒后霍乱，吐利腹胀，转筋手足冷，饮食不消。吴茱萸汤方
吴茱萸（一分汤洗焙干炒） 浓朴（去粗皮生姜汁炙锉一两） 人参（三分） 干木瓜 藿
香叶 甘草（炙锉） 桂（去粗皮） 丁香（炒各半两）
上八味，粗捣筛，每服三钱匕，水一盏，入生姜三片，煎至七分，去滓温服，日三。
治伤寒后霍乱吐利，脚转筋。白术汤方
白术 陈橘皮（汤浸去白炒各一两） 干木瓜（二两）
上三味，粗捣筛，每服三钱匕，水一盏，入生姜三片，煎至七分，去滓温服日再。
治伤寒霍乱，呕吐不止，手足厥逆。姜附丸方
干姜（炮半两） 附子（炮裂去皮脐二两） 浓朴（去粗皮生姜汁炙锉一两）
上三味，捣罗为末，醋煮面糊丸，如梧桐子大，每服三十丸，食前米饮下。
治伤寒霍乱后，身体疼痛不休。桂枝汤方
桂（去粗皮） 芍药（各三分） 甘草（炙锉半两）
上三味，粗捣筛，每服五钱匕，水一盏半，入生姜一枣大拍碎，枣二枚去核，同煎至一
盏，去滓温服，不拘时以微汗为度，未汗更服，仍作生姜稀粥投之，以助药力。
治伤寒霍乱吐利，脉微欲绝，或恶寒四肢厥逆，小便复利，或吐利已定，汗出而厥，四
肢拘急不解。通脉四逆汤方
甘草（炙二两） 附子（炮裂去皮脐二枚） 干姜（炮三两）
上三味，锉如麻豆，每服五钱匕，水一盏半，煎至八分，去滓温服，脉出即愈，面色赤
者，加葱白二茎同煎。腹痛去葱白，加芍药二两，呕加生姜一分切同煎，咽痛去芍药，加桔
梗并人参二两，以吐利止。手足温为度。
Commentary states: Vomiting accompanied by diarrhea is a disease named Huoluan (Cholera-like syndrome). This is caused by pathogenic factors lingering in the Middle Jiao (Middle Burner), preventing the ascending and descending of Yin and Yang Qi, resulting in severe cramping pain in the heart and abdomen, thereby inducing vomiting and diarrhea. The clinical manifestations are as follows: if heart pain occurs first, vomiting appears first; if abdominal pain occurs first, diarrhea appears first; if both heart and abdominal areas are painful, vomiting and diarrhea occur simultaneously. Ancient physicians termed it "Huoluan" because the disease onset is sudden and violent, causing chaos and disorder within a brief moment. Choluan induced by Shanghan (Cold Damage) is also caused by disharmony of Yin and Yang in the Middle Jiao. Therefore, its presentations vary: some cases involve fever with thirst, others involve cold sensation without thirst, some present with fever, aversion to cold, sweating, and cold extremities, while others have subsiding acute symptoms but persistent body pain. Treatment cannot be uniformly applied using a single method.
For treating Huoluan vomiting and diarrhea following Shanghan, characterized by excess cold and preference against drinking water. Lizhong Wan (Regulate the Middle Pill) Formula:
Ren Shen (Ginseng Radix), Gan Jiang (Zingiberis Rhizoma Preparata), Gan Cao (Licorice Radix et Rhizoma Preparated and cut into pieces), Bai Zhu (Atractylodis Macrocephalae Rhizoma) [each 3 liang].
The above four ingredients are crushed, sifted into powder, and formed into pills using refined honey, sized like a chicken egg yolk. Take one pill per dose, dissolve in boiling water, and take warm. Administer three times during the day and twice at night. If warmth is not felt in the abdomen, increase to three or four pills per dose.
For treating Shanghan Huoluan with headache, fever, and excessive desire for drinking water. Wuling San (Five-Ingredient Powder with Poria) Formula:
Zhu Ling (Polypori Umbellati Sclerotium, black skin removed), Bai Zhu (Atractylodis Macrocephalae Rhizoma) [each 3 fen], Ze Xie (Alismatis Rhizoma), Chi Fu Ling (Poria cum Rubro, black skin removed) [each 1 liang], Gui Zhi (Cinnamomi Ramulus, coarse bark removed) [0.5 liang].
The above five ingredients are crushed and sifted into powder. Take 2 qianbi (approx. 6g) per dose, mixed with warm water. Administer twice daily.
For treating post-Shanghan Huoluan with mental restlessness and dry retching. Lushen Tang (Reed Root and Ginseng Decoction) Formula:
Lu Gen (Phragmitis Rhizoma, cut into pieces, 2 liang), Ren Shen (Ginseng Radix), Mai Men Dong (Ophiopogonis Tuber, heart removed and dried), Chi Fu Ling (Poria cum Rubro, black skin removed) [each 1 liang], Pi Pa Ye (Eriobotryae Folium, hairs brushed off and prepared) [1 fen].
The above five ingredients are coarsely crushed and sifted. Take 5 qianbi per dose, with 1.5 sheng of water and 3 cun of Xie Bai (Allii Macrostemonis Bulbus). Decoct until reduced to 1 sheng, strain, and take warm. Administer three times daily.
For treating post-Shanghan Huoluan with stagnation in the heart and diaphragm. Pujiang Tang (Magnolia Bark and Ginger Decoction) Formula:
Hou Po (Magnoliae Officinalis Cortex, coarse bark removed, prepared with ginger juice), Gao Liang Jiang (Galangal Rhizoma, stir-fried), Chen Pi (Citri Reticulatae Pericarpium, white pith removed and stir-fried), Ren Shen (Ginseng Radix) [each 3 fen], Cao Dou Kou (Cardamomi Fructus, husked) [0.5 liang].
The above five ingredients are coarsely crushed and sifted. Take 3 qianbi per dose, with 1 sheng of water, 3 slices of fresh ginger, and one cracked jujube. Decoct until reduced to 70%, strain, and take warm. Administer three times daily.
For treating post-Shanghan Huoluan with incessant vomiting and diarrhea, indigestion, and abdominal distension and fullness. Renshen Tang (Ginseng Decoction) Formula:
Ren Shen (Ginseng Radix), Hou Po (Magnoliae Officinalis Cortex, coarse bark removed, prepared with ginger juice), Gan Mu Gua (Dried Chaenomelis Fructus) [each 1 liang], Gao Liang Jiang (Galangal Rhizoma, stir-fried), Mu Xiang (Aucklandiae Radix), Bai Fu Ling (Poria, black skin removed), Shao Yao (Paeoniae Radix Alba), Bai Dou Kou (Cardamomi Albi Fructus, husked), Gui Zhi (Cinnamomi Ramulus, coarse bark removed), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Pi (Citri Reticulatae Pericarpium, white pith removed and stir-fried) [each 0.5 liang].
The above eleven ingredients are coarsely crushed and sifted. Take 3 qianbi per dose, with 1 sheng of water. Decoct until reduced to 70%, strain, and take warm. Administer three times daily.
For treating post-Shanghan Huoluan with muscle cramps (Zhuanjin), incessant vomiting leading to fainting or suffocation. Huoxiang Tang (Agastache Decoction) Formula:
Huo Xiang Ye (Agastaches Herba), Dang Gui (Angelicae Sinensis Radix, sliced and dried), Fu Zi (Aconiti Lateralis Radix Preparata, cracked, skin and bud removed), Ren Shen (Ginseng Radix), Gui Zhi (Cinnamomi Ramulus, coarse bark removed), Mu Gua (Chaenomelis Fructus) [each 1 liang].
The above six ingredients are cut like hemp seeds. Take 3 qianbi per dose, with 1 sheng of water and 3 slices of fresh ginger. Decoct until reduced to 70%, strain, and take warm. Take at any time.
For treating post-Shanghan Huoluan with incessant vomiting and diarrhea, and foot cramps. Roudoukou Tang (Myristica Decoction) Formula:
Rou Dou Kou Ren (Myristicae Semen, kernel), Gao Liang Jiang (Galangal Rhizoma, stir-fried), Pi Pa Ye (Eriobotryae Folium, hairs brushed off and prepared) [each 0.5 liang], Hou Po (Magnoliae Officinalis Cortex, coarse bark removed, prepared with ginger juice and cut), Gui Zhi (Cinnamomi Ramulus, coarse bark removed) [each 1 liang], Wu Zhu Yu (Evodiae Fructus, washed with water, dried, and stir-fried) [1 fen].
The above six ingredients are coarsely crushed and sifted. Take 3 qianbi per dose, with 1 sheng of water and one cracked jujube. Decoct until reduced to 70%, strain, and take warm. Administer three times daily.
For treating Shanghan Huoluan with muscle cramps, where wind-cold invades the Stomach organ, causing incessant vomiting and diarrhea, abdominal qi distension, and loss of appetite. Houpo Tang (Magnolia Bark Decoction) Formula:
Hou Po (Magnoliae Officinalis Cortex, coarse bark removed, prepared with ginger juice and cut), Gan Mu Gua (Dried Chaenomelis Fructus) [each 1 liang], Gao Liang Jiang (Galangal Rhizoma, stir-fried), Xiang Ru Ye (Elsholtziae Herba), Chen Pi (Citri Reticulatae Pericarpium, white pith removed and stir-fried), Zi Su Jing (Perillae Caulis) [each 0.5 liang].
The above six ingredients are coarsely crushed and sifted. Take 3 qianbi per dose, with 1 sheng of water, 3 slices of fresh ginger, and a little salt. Decoct until reduced to 70%, strain, and take warm. Take at any time.
For treating post-Shanghan Huoluan with vomiting, diarrhea, abdominal distension, muscle cramps, cold hands and feet, and indigestion. Wuzhuyu Tang (Evodia Decoction) Formula:
Wu Zhu Yu (Evodiae Fructus, 1 fen, washed with water, dried, and stir-fried), Hou Po (Magnoliae Officinalis Cortex, coarse bark removed, prepared with ginger juice and cut, 1 liang), Ren Shen (Ginseng Radix, 3 fen), Gan Mu Gua (Dried Chaenomelis Fructus), Huo Xiang Ye (Agastaches Herba), Gan Cao (Licorice Radix et Rhizoma, prepared and cut), Gui Zhi (Cinnamomi Ramulus, coarse bark removed), Ding Xiang (Caryophylli Flos, stir-fried) [each 0.5 liang].
The above eight ingredients are coarsely crushed and sifted. Take 3 qianbi per dose, with 1 sheng of water and 3 slices of fresh ginger. Decoct until reduced to 70%, strain, and take warm. Administer three times daily.
For treating post-Shanghan Huoluan vomiting and diarrhea with foot cramps. Baizhu Tang (Atractylodes Macrocephala Decoction) Formula:
Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Pi (Citri Reticulatae Pericarpium, soaked in water, white pith removed, and stir-fried) [each 1 liang], Gan Mu Gua (Dried Chaenomelis Fructus, 2 liang).
The above three ingredients are coarsely crushed and sifted. Take 3 qianbi per dose, with 1 sheng of water and 3 slices of fresh ginger. Decoct until reduced to 70%, strain, and take warm. Administer twice daily.
For treating Shanghan Huoluan with incessant vomiting and cold extremities. Jiangfu Wan (Ginger and Aconite Pill) Formula:
Gan Jiang (Zingiberis Rhizoma Preparata, 0.5 liang), Fu Zi (Aconiti Lateralis Radix Preparata, cracked, skin and bud removed, 2 liang), Hou Po (Magnoliae Officinalis Cortex, coarse bark removed, prepared with ginger juice and cut, 1 liang).
The above three ingredients are crushed and sifted into powder. Form pills using vinegar-boiled wheat paste, sized like paulownia seeds. Take 30 pills per dose before meals, swallowed with rice drink.
For treating post-Shanghan Huoluan with persistent body pain. Guizhi Tang (Cinnamon Twig Decoction) Formula:
Gui Zhi (Cinnamomi Ramulus, coarse bark removed), Shao Yao (Paeoniae Radix Alba) [each 3 fen], Gan Cao (Licorice Radix et Rhizoma, prepared and cut, 0.5 liang).
The above three ingredients are coarsely crushed and sifted. Take 5 qianbi per dose, with 1.5 sheng of water, one date-sized piece of smashed fresh ginger, and two pitted jujubes. Decoct together until reduced to 1 sheng, strain, and take warm. Take at any time, aiming for mild sweating. If no sweat occurs, take again. Simultaneously consume thin ginger congee to assist the medicinal power.
For treating Shanghan Huoluan vomiting and diarrhea with faint pulse nearly imperceptible, or aversion to cold with cold extremities, frequent urination, or cessation of vomiting/diarrhea followed by sweating and cold extremities with unresolved limb spasms. Tongmai Sini Tang (Decoction to Restore the Pulse and Reverse Cold) Formula:
Gan Cao (Licorice Radix et Rhizoma, prepared, 2 liang), Fu Zi (Aconiti Lateralis Radix Preparata, cracked, skin and bud removed, 2 pieces), Gan Jiang (Zingiberis Rhizoma Preparata, 3 liang).
The above three ingredients are cut like hemp seeds. Take 5 qianbi per dose, with 1.5 sheng of water. Decoct until reduced to 80%, strain, and take warm. Recovery is indicated when the pulse reappears. If the face is red, add two stems of Cong Bai (Allii Cepae Bulbus) and decoct together. If abdominal pain, remove Cong Bai and add 2 liang of Shao Yao. If vomiting, add 1 fen of sliced fresh ginger and decoct together. If throat pain, remove Shao Yao and add Jie Geng (Platycodonis Radix) and Ren Shen (Ginseng Radix), each 2 liang. Continue until vomiting and diarrhea cease. The endpoint is when hands and feet become warm.