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，故病多不救。
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（方见伤暑）
辰砂益元散（方见暑劂）
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 猪苓 肉桂（少许） 滑石（水飞） 寒水石 石膏
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）
Huo Luan (cholera-like syndrome) arises from pathogenic factors of Wind, Cold, Summerheat, and Dampness/Fluid retention. It manifests suddenly with vomiting, diarrhea, and pain in the heart and abdomen. When Dampness and Summerheat are predominant, it is termed Shi Huo Luan (Damp-type Cholera); when Cold is predominant, it becomes Gan Huo Luan (Dry-type Cholera), which is a more severe condition.
[Annotation] Huo Luan refers to a disease caused by mixed pathogens such as Wind, Cold, Summerheat, Dampness, and Fluid retention. It presents with sudden chaotic symptoms, severe pain in the heart and abdomen, and alternating vomiting and diarrhea. Those who can vomit and have diarrhea are diagnosed with Shi Huo Luan (Damp-type Cholera). Although Summerheat and Fluid retention pathogens may be strong, if vomiting and diarrhea occur, the pathogens are expelled and resolved, making it easier to treat. Conversely, those who wish to vomit but cannot, or wish to defecate but cannot, are diagnosed with Gan Huo Luan (Dry-type Cholera). This is because excessive Cold causes stagnation; without the outlet of vomiting or defecation, the pathogens have no way to exit, so the prognosis is often poor.
Persistent vomiting and diarrhea accompanied by frequent abdominal pain, thirst with desire for drinking, and chest fullness/distension. If Dampness/Fluid retention 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.
[Annotation] Shi Huo Luan (Damp-type Cholera) results from the combination of Summerheat and Dampness/Fluid pathogens. The symptoms include persistent vomiting and diarrhea, abdominal pain, thirst with desire for water, and chest diaphragm stuffiness and distension. For cases where Dampness/Fluid is predominant, Er Xiang Yin (Two Fragrances Decoction) is used; for cases where Summerheat is predominant, Chen Sha Yi Yuan San (Cinnabar Yi Yuan Powder) is used. By treating according to the syndrome, the Summerheat-Damp pathogens are cleared, and the Huo Luan resolves immediately. Physicians should distinguish carefully.
Er Xiang Yin (Formula see "Shang Shu" chapter)
Chen Sha Yi Yuan San (Formula see "Shu Jue" chapter)
Desire to vomit or defecate but inability to do so, with unbearable colicky abdominal pain. If there is irritability, thirst, and large intake of fluids, indicating Heat, Gui Ling Gan Lu Yin (Cassia Twig, Poria, and Sweet Dew Decoction) is used. If there are cold limbs and no thirst, indicating Cold, Li Zhong Tang (Regulate the Middle Decoction) is decocted and administered.
[Annotation] Gan Huo Luan (Dry-type Cholera) is caused by the coagulation of Cold and Summerheat, characterized by the inability to vomit or defecate despite the urge, and severe colicky abdominal pain, commonly known as "Jiao Chang Sha" (Intestinal Twisting Miasma Disease). Treatment requires distinguishing between Cold and Heat. Cases with irritability, thirst, and large fluid intake are Heat syndromes, treated with Gui Ling Gan Lu Yin (Cassia Twig, Poria, and Sweet Dew Decoction). Cases with cold limbs and no thirst are Cold syndromes, treated with Li Zhong Tang (Regulate the Middle Decoction). Treating according to the syndrome leads to natural recovery.
Gui Ling Gan Lu Yin (Cassia Twig, Poria, and Sweet Dew Decoction)
Bai Zhu (Atractylodis Rhizoma, stir-baked with soil) Fu Ling (Poria) Ze Xie (Alismatis Rhizoma) Zhu Ling (Polyporus) Rou Gui (Cinnamomi Cortex, small amount) Hua Shi (Talcum, water-ground) Han Shui Shi (Lapis Gypsosus Ruber) Shi Gao (Gypsum Fibrosum)
Decoct with water and take orally.
[Prescription Verse] Cold and Summerheat coagulation causes Huo Luan, do not delay using Gui Ling Gan Lu Yin; Bai Zhu, Fu Ling, Zhu Ling, Ze Xie, and Rou Gui; Shi Gao, Hua Shi, and Han Shui Shi are used equally.
Li Zhong Tang (Regulate the Middle Decoction) (Formula see "Bu Ru" chapter)