开胃进食,止呕吐。
人参 木香(各三钱) 枳壳(麸炒,一两) 白术(一两半) 陈皮(四钱) 干生
姜(二钱
上为细末,用荷叶包米煨饭和丸,如梧桐子大,每服五七十丸,不拘时用米汤送下。
《内经》云∶太阴所至,为中满霍乱吐下。河间言∶霍乱吐下,湿为留饮痞膈,而传化
失常,故甚则霍乱吐泻也。病起于中焦,皆因冒暑中热,或因渴大饮,或饮而过量,或饥而
饱食,或食而过度,饮食不节,寒热不调,清浊相干,阴阳乖隔,时当夏月,风湿 三气应
之,故其邪大作矣。风者风木也,内应足厥阴肝木;湿者湿土也,内应足太阴脾土; 者火
热也,内应手少阴心火,此三经各为显然之病。经言诸转反戾,水液混浊,皆属于热。热气
燥烁于筋,故筋转而痛,应风属于肝也,故诸转筋以汤渍之,而使腠理开泄,阳气散则愈矣
,因汤渍而愈,俗反疑于寒也。又言湿胜则濡泻,泻为湿土也,而脾主湿,应湿属于脾也。
又言诸呕吐逆,皆属于热。王注曰∶炎热薄烁,心之气也。心火炎上,胃膈热甚,故为吐,
应属于心也,是则风动肝热则转筋,水湿伤脾,则为泻, 热乘胃则为吐,三气杂乃为霍
乱。又有干霍乱湿霍乱之分∶吐利并作,邪气得出,名为湿霍乱,十存八九;设若不吐不利
,挥霍撩乱,邪无所出,名为干霍乱,九死一生。且夫人既有入必有出,今有其入而不得出
者,痞也塞也,此其郁甚而不通也。且东垣发明,木郁则达之,意正谓此也。如饱食所伤,
填塞胸中,当吐不吐者死也。《内经·五乱篇》云∶清气在阴,浊气在阳,营气顺转,卫气
逆行,乱于胸中,是谓大 ,乱于肠胃,则成霍乱。《内经》又云∶阴之所生,本在五味,
阴之五宫,伤在五味,由此观之,虽五味能养五脏,过则亦能伤人之体弱,遂感前证。长沙
公论治之法,有所生矣。若邪在上焦则吐,邪在下焦则泻,邪在中焦则既吐且利。热多欲饮
水者,五苓散,寒多不饮水者,理中丸。《原病式》曰∶大法吐利,烦渴为热,不渴为寒,
或热吐利,始得亦不渴者,此亡津液,后必渴也。或寒本不渴,若亡津液过多,则燥而渴。
但寒者脉当沉细而迟,热者脉当实大而数。戴人论此,死生反掌之说为急病,土为风木所克
,土化不行也,书以治验,而斥巢氏论因为寒之非,以及方士妄用热剂,误治而死,主以六
一散通疗脾胃受伤,风湿 三气为邪,于时宜矣。故言饮食调养之节,大忌饮食太早,谓脾
胃极损,不能传化,谷入于胃,则必危矣。病安之后,宜以粥饮渐渐养之。大凡霍乱,脉大
者生,沉细而迟、气少不语者,为难治也。
To open the appetite, promote digestion, and stop vomiting.
Ren Shen (Ginseng Radix), Mu Xiang (Aucklandiae Radix) (each 3 qian); Zhi Ke (Bitter Orange Pericarpium, stir-fried with bran) (1 liang); Bai Zhu (Atractylodis Macrocephalae Rhizoma) (1.5 liang); Chen Pi (Citri Reticulatae Pericarpium) (4 qian); Gan Sheng Jiang (Dried Fresh Ginger) (2 qian).
Grind the above herbs into a fine powder. Wrap rice in lotus leaves and bake it, then mix with cooked rice to form pills the size of Sophora japonica seeds. Take 50–70 pills each time, at any time, washed down with rice gruel.
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "When Taiyin [Spleen/Stomach] is affected, it leads to fullness in the middle jiao, cholera-like syndrome, and vomiting and diarrhea." Liu Hejian stated: Cholera-like syndrome with vomiting and diarrhea occurs because dampness remains as retained fluid, causing chest and diaphragm obstruction, and disrupting the transmission and transformation functions, thus leading to severe cholera-like vomiting and diarrhea. This disease originates in the middle jiao, caused by exposure to summer-heat, excessive drinking when thirsty, overconsumption of alcohol, eating a large meal after fasting, or overeating. Irregular diet, imbalance of cold and heat, interference between clear and turbid qi, and separation of yin and yang occur. In summer, wind, dampness, and heat (yue) pathogens act upon the body, causing strong pathogenic factors. Wind corresponds to Wood and internally relates to the Foot Jueyin Liver Meridian; Dampness corresponds to Earth and internally relates to the Foot Taiyin Spleen Meridian; Yue (summer-heat/heat) corresponds to Fire and internally relates to the Hand Shaoyin Heart Meridian. These three meridians manifest distinct diseases. The classics state: "All cases of twisting, convulsions, and turbid urine belong to Heat." Heat dries and scorches the sinews, causing them to twist and hurt; this corresponds to Wind relating to the Liver. Therefore, for various cases of muscle cramps, soaking in hot water opens the cou-li (pores/skin texture), allows Yang Qi to dissipate, and results in recovery. Because recovery follows hot water soaking, laypeople mistakenly suspect Cold. It is also said: "Excess Dampness leads to loose stools." Diarrhea belongs to Damp-Earth, and the Spleen governs Dampness, corresponding to Dampness relating to the Spleen. It is further stated: "All vomiting and regurgitation belong to Heat." Wang Bing’s commentary notes: "Intense heat approaches and scorches, which is the Qi of the Heart." Heart Fire flares upward, causing extreme heat in the stomach and diaphragm, resulting in vomiting; this corresponds to relating to the Heart. Thus, Wind stirring Liver Heat causes muscle cramps; Water-Damp injuring the Spleen causes diarrhea; Summer-Heat attacking the Stomach causes vomiting. The mixture of these three pathogens constitutes Cholera-like syndrome. There are also distinctions between Dry Cholera-like Syndrome and Wet Cholera-like Syndrome: When vomiting and diarrhea occur together, allowing pathogenic factors to exit, it is named Wet Cholera-like Syndrome, with eight or nine out of ten survivors. If there is neither vomiting nor diarrhea, but sudden turmoil and chaos, with no way for pathogens to exit, it is named Dry Cholera-like Syndrome, with only one out of ten survivors. Since humans must have both intake and output, having intake without output indicates blockage and stagnation, representing severe constraint and obstruction. Li Dongyuan elucidated "If Wood is constrained, unblock it," referring precisely to this situation. For example, injury from overeating fills the chest; if one should induce vomiting but fails to do so, death ensues. The *Huangdi Neijing · Wu Luan Pian* (Chapter on Five Disorders) states: "Clear Qi is in the Yin, Turbid Qi is in the Yang, Ying Qi circulates smoothly, Wei Qi moves in reverse. Disorder in the chest is called great oppression; disorder in the intestines and stomach becomes Cholera-like syndrome." The *Huangdi Neijing* also states: "The source of Yin lies in the Five Flavors; the five palaces of Yin are damaged by the Five Flavors." From this, although the Five Flavors can nourish the Five Zang Organs, excess can damage the body, leading to weakness and triggering the aforementioned symptoms. Changsha Gong (Zhang Zhongjing) discussed treatment methods derived from this. If pathogens are in the Upper Jiao, vomiting occurs; if in the Lower Jiao, diarrhea occurs; if in the Middle Jiao, both vomiting and diarrhea occur. For cases with more heat and desire for water, use Wuling San (Five-Ling Powder); for cases with more cold and no desire for water, use Lizhong Wan (Regulate the Middle Pill). The *Yuanbing Shi* (Book on Original Causes of Disease) states: "The general rule is that vomiting and diarrhea with irritability and thirst indicate Heat; without thirst indicates Cold. Or, in Heat-type vomiting/diarrhea, initial lack of thirst is due to loss of Jin-Ye (Body Fluids), followed by thirst later. Or, in Cold-type cases originally without thirst, excessive loss of Jin-Ye leads to dryness and thirst." Pure Cold patterns present with deep, fine, and slow pulses; Heat patterns present with solid, large, and rapid pulses. Dai Ren (Zhang Congzheng) discussed this disease, stating life and death depend on quick action. Earth (Spleen) is overcome by Wind-Wood, failing to transform. The book records successful treatments, refutes Chao Yuanfang’s theory that the cause is Cold, and criticizes quacks for using hot remedies erroneously, leading to death. It advocates using Liuyi San (Six-One Powder) to treat Spleen-Stomach injury caused by Wind, Dampness, and Heat pathogens, which is appropriate for the season. Therefore, dietary regulation is crucial; it is strictly forbidden to eat too early, as the Spleen-Stomach is severely damaged and unable to transmit and transform. Food entering the stomach will be critical. After the illness subsides, gradually nourish with rice gruel. Generally, in Cholera-like syndrome, a large pulse indicates survival; a deep, fine, slow pulse with shortness of breath and inability to speak indicates difficult-to-treat cases.