（附论）
夫四肢为诸阳之本。阳气之所通也。霍乱吐痢。阳气暴逆冷。而脉微欲绝也。古法治四
逆。
方
四逆汤（出千金方）治寒多。手足厥冷脉绝。
生姜（八两） 芍药 当归 细辛 桂心（各三两） 大枣（二十五枚） 通草 甘草
（各二
两）
十
枚。以
者一枚
通脉四逆汤（出医方集成）治霍乱多寒。肉冷。脉绝。暴虚气少。
吴茱萸（炒二两） 附子（炮去皮脐一两） 桂心（去皮不见火） 细辛（洗去芦土） 通
草（一作
以水
一盏。
人参散（出圣惠方）治霍乱。身体疼痛。四肢逆冷。服理中四逆不效者。
人参（一两去芦头） 附子（二两炮去脐） 白芍药（一两） 桂心（二两） 当归（一
两锉碎
微炒）
每服四
钱。以
吴茱萸汤（出圣惠方）治霍乱多寒。手足厥冷。脉绝。
吴茱萸（半升洗焙干） 当归（切焙） 桂（去粗皮） 芍药（三分） 细辛（去苗叶）
木通（锉）
一片。
拍碎。大
无酒。
附子散（出圣惠方）治霍乱。腹满虚鸣。气逆。手足俱冷。
附子（炮去皮脐） 草豆蔻（去皮） 桂心 陈橘皮（汤浸去白焙） 高良姜（锉各半
两） 甘
草（
温
人参散 治霍乱。吐泻不定。四肢逆冷。大渴欲水。
人参（三两去芦头） 附子（炮裂去皮脐） 甘草（炙微赤锉） 白术 干姜（炮裂锉）
麦门
冬（
服。
附子粳米汤（出千金方）治霍乱四逆。吐少呕多者。
中附子（一枚） 粳米（五合） 半夏（半升） 大枣（十枚） 干姜 甘草（各一两）
上
咀。以
当归散 治霍乱呕吐。及下后腹中干痛。手足逆冷。
当归（微炒） 人参（去芦头） 附子（炮裂去皮脐以上各一两） 干姜 甘草（炙微
赤锉各
半两）
甘草饮 治主脾肾冷气乘心。痛闷吐利。四肢逆冷。或则烦痛。病源云。霍乱而
吐。大下后
也。
甘草（炙） 人参 干姜 浓朴（炙） 白术（各三两） 上切。以水五升。煮取一升
五合。
分三
桔梗汤（出圣济总录）治霍乱。吐利已定。汗出厥冷。四肢拘急。腹中痛不
解。脉欲绝。
桔梗（锉炒） 干姜（炮各一两） 甘草（炙） 附子（炮裂去皮脐各二两） 上锉。
如麻豆。
每服
四顺附子汤（出圣惠方一名加味姜附汤）治吐泻过多。手足逆冷。脉沉细。
气
少不语。急服
生附子 白姜（炮） 人参 甘草（炒各一分） 上锉。每服四钱。水二盏。空腹服。
腹痛
加桂
腹
香薷饮（一名黄连饮出圣济总录）治霍乱吐泻。四肢厥冷。
香薷（去根二两半） 藿香（去根焙二两） 草乌头（浸切去皮脐晒干二两入盐三两同
炒乌
头黄
通脉四逆汤（一名姜附汤出十便良方）治霍乱。脉微欲绝。或恶寒。四肢拘
急。手足厥逆。
甘草（炙二两） 干姜（炮三两） 附子（炮去皮脐二两） 上锉如麻豆。每服五钱匕。
水一
盏半
二两
疼痛
天南星散（一名回阳散出危氏方）治吐下。四肢逆冷。不省人事。
南星（末二钱） 枣（五枚） 姜（五片） 上水煎极热服之。一方无生姜。
半夏汤（出危氏方）治吐下。四肢逆冷。不省人事。
半夏（末三钱） 生姜汁（少许） 上以热汤点。一服可效。白矾末。点服亦验。
治霍乱吐泻。冷气攻心。腹痛。四肢逆冷。汗出。（出圣惠方）
用硫黄一两。细研如面。以热酒调下一钱。
回阳散（出本草）治吐泻不止。或致转筋。四肢发厥。虚风不省人事。服
此。
四肢渐暖。神
用天南星为末。每服三钱。入京枣三枚。同煎八分。温服。未省再服。
(Attached Discussion)
The four limbs are the root of all Yang meridians and the pathways through which Yang Qi circulates. In cholera (Huoluan), vomiting and diarrhea cause a sudden reversal and coldness of Yang Qi, resulting in a faint pulse that is on the verge of disappearing. The ancient methods for treating Si Ni (Four Coldness) syndrome are as follows:
Formulas
Si Ni Tang (Cinnamon Twig, Aconite, and Licorice Decoction) (from *Qianjin Fang*): Treats cases with severe cold, cold extremities (Jue Leng), and an imperceptible pulse.
Shengjiang (Fresh Ginger Rhizome, 8 liang), Shaoyao (Peony Root), Danggui (Angelicae Sinensis Radix), Xixin (Asarum Root), Guixin (Cinnamomi Cortex, 3 liang each), Dazao (Jujubae Fructus, 25 pieces), Tongcao (Tetrapanacis Medulla), Gancao (Licorice Root, 2 liang each).
[Text fragment missing regarding quantity/water], use one zhen of water to decoct.
Tong Mai Si Ni Tang (Pulse-Reviving Four Coldness Decoction) (from *Yifang Jicheng*): Treats cholera with severe cold, cold flesh/muscles, imperceptible pulse, sudden deficiency, and shortness of breath.
Wuzhuyu (Evodiae Fructus, stir-fried, 2 liang), Fuzi (Prepared Aconiti Lateralis Radix, peeled and de-navelled, 1 liang), Guixin (Cinnamomi Cortex, peeled, not exposed to direct fire), Xixin (Asarum Root, washed to remove rhizome and soil), Tongcao (Tetrapanacis Medulla, variant reading...).
Use one zhen of water to decoct.
Renshen San (Ginseng Powder) (from *Shenghui Fang*): Treats cholera, body pain, and cold extremities. Indicated when Lizhong Tang and Si Ni Tang are ineffective.
Renshen (Ginseng Radix, 1 liang, remove rhizome), Fuzi (Prepared Aconiti Lateralis Radix, 2 liang, prepared and de-navelled), Baishaoyao (White Peony Root, 1 liang), Guixin (Cinnamomi Cortex, 2 liang), Danggui (Angelicae Sinensis Radix, 1 liang, sliced and slightly stir-fried).
Take 4 qian per dose, decoct with [text missing]...
Wuzhuyu Tang (Evodia Decoction) (from *Shenghui Fang*): Treats cholera with severe cold, cold extremities, and imperceptible pulse.
Wuzhuyu (Evodiae Fructus, half sheng, washed and dried), Danggui (Angelicae Sinensis Radix, sliced and dried), Gui (Cinnamomi Ramulus/Cortex, remove coarse bark), Shaoyao (Peony Root, 3 fen), Xixin (Asarum Root, remove seedlings and leaves), Mutong (Akebiae Caulis, sliced).
One slice, crushed. Da [text missing] without wine [or with wine].
Fuzi San (Aconite Powder) (from *Shenghui Fang*): Treats cholera, abdominal fullness with empty rumbling, rebellious Qi, and cold hands and feet.
Fuzi (Prepared Aconiti Lateralis Radix, peeled and de-navelled), Caodoukou (Grass Cardamom Seed), Guixin (Cinnamomi Cortex), Chenjupi (Dried Tangerine Peel, soaked in hot water, white pith removed, dried), Gaoliangjiang (Galangal Rhizome, sliced, half liang each), Gancao (Licorice Root, [text missing]).
Warm administration.
Renshen San (Ginseng Powder) [Unspecified source]: Treats cholera with irregular vomiting and diarrhea, cold extremities, extreme thirst wanting water.
Renshen (Ginseng Radix, 3 liang, remove rhizome), Fuzi (Prepared Aconiti Lateralis Radix, cracked, peeled, de-navelled), Gancao (Licorice Root, honey-fried until slightly red, sliced), Baizhu (Atractylodis Macrocephalae Rhizoma), Ganjiang (Zingiberis Rhizoma, cracked, sliced), Maimendong (Ophiopogonis Radix, [text missing]).
Administration [text missing].
Fuzi Jingmi Tang (Aconite and Rice Decoction) (from *Qianjin Fang*): Treats cholera with Si Ni syndrome, where vomiting is slight but retching is frequent.
Zhongfuzi (Central Aconite, 1 piece), Jingmi (Glutinous Rice, 5 he), Banxia (Pinelliae Tuber, half sheng), Dazao (Jujubae Fructus, 10 pieces), Ganjiang (Zingiberis Rhizoma), Gancao (Licorice Root, 1 liang each).
The above ingredients [text missing] cut into small pieces. Use [water amount missing] to decoct.
Danggui San (Angelica Powder): Treats cholera with vomiting, and abdominal dryness/pain after purgation, with cold extremities.
Danggui (Angelicae Sinensis Radix, slightly stir-fried), Renshen (Ginseng Radix, remove rhizome), Fuzi (Prepared Aconiti Lateralis Radix, cracked, peeled, de-navelled; above ingredients 1 liang each), Ganjiang (Zingiberis Rhizoma), Gancao (Licorice Root, honey-fried until slightly red, sliced, half liang each).
[Text missing]
Gancao Yin (Licorice Drink): Treats cold Qi from Spleen and Kidney attacking the Heart, causing pain, oppression, vomiting, and diarrhea, with cold extremities, or irritability and pain. Disease etiology states: Cholera with vomiting, after severe purgation...
Gancao (Licorice Root, honey-fried), Renshen (Ginseng Radix), Ganjiang (Zingiberis Rhizoma), Houpo (Magnoliae Officinalis Cortex, honey-fried), Baizhu (Atractylodis Macrocephalae Rhizoma, 3 liang each). Cut the above ingredients. Use 5 sheng of water, boil to obtain 1.5 sheng.
Divide into three [doses]...
Jiegeng Tang (Platycodon Decoction) (from *Shengji Zonglu*): Treats cholera after vomiting and diarrhea have subsided, with sweating, cold extremities, limb stiffness and cramping, unresolved abdominal pain, and a pulse on the verge of disappearing.
Jiegeng (Platycodon Radix, sliced and stir-fried), Ganjiang (Zingiberis Rhizoma, prepared, 1 liang each), Gancao (Licorice Root, honey-fried), Fuzi (Prepared Aconiti Lateralis Radix, cracked, peeled, de-navelled, 2 liang each). Slice the above ingredients like hemp seeds.
Each dose [text missing]...
Si Shun Fuzi Tang (Four-Smooth Aconite Decoction) (from *Shenghui Fang*, also known as Jiawei Jiangfu Tang): Treats excessive vomiting and diarrhea, cold extremities, deep and fine pulse, scanty Qi, inability to speak. Take urgently.
Shengfuzi (Raw Aconite Lateralis Radix), Baijiang (White Ginger Rhizome, prepared), Renshen (Ginseng Radix), Gancao (Licorice Root, stir-fried, 1 fen each). Slice the above ingredients. Take 4 qian per dose, with 2 zhen of water, take on an empty stomach.
Abdominal pain [add Gui]... Abdomen [text missing]...
Xiangru Yin (Mosla Drink, also called Huanglian Yin) (from *Shengji Zonglu*): Treats cholera with vomiting and diarrhea, and cold extremities.
Xiangru (Moslae Herba, remove roots, 2.5 liang), Huoxiang (Agastaches Herba, remove roots and dry, 2 liang), Caowutou (Aconiti Kusnezoffii Radix, soak, slice, peel, remove navel, dry, 2 liang, stir-fry with 3 liang salt until Wutou turns yellow [text missing]).
Tong Mai Si Ni Tang (Pulse-Reviving Four Coldness Decoction, also known as Jiangfu Tang) (from *Shibian Liangfang*): Treats cholera, faint pulse on the verge of disappearing, aversion to cold, limb stiffness and cramping, and cold extremities.
Gancao (Licorice Root, honey-fried, 2 liang), Ganjiang (Zingiberis Rhizoma, prepared, 3 liang), Fuzi (Prepared Aconiti Lateralis Radix, peeled, de-navelled, 2 liang). Slice the above ingredients like hemp seeds. Take 5 qianbi per dose, with 1.5 zhen of water [decoct]...
Two liang [text missing]
Pain [text missing]
Tiannanxing San (Arisaema Powder, also known as Huiyang San) (from *Weishi Fang*): Treats vomiting and diarrhea, cold extremities, and loss of consciousness.
Tiannanxing (Arisaematis Rhizoma, powdered, 2 qian), Zao (Jujubae Fructus, 5 pieces), Jiang (Zingiberis Rhizoma, 5 slices). Boil in water until very hot and take. Another method excludes fresh ginger.
Banxia Tang (Pinellia Decoction) (from *Weishi Fang*): Treats vomiting and diarrhea, cold extremities, and loss of consciousness.
Banxia (Pinelliae Tuber, powdered, 3 qian), Shengjiangzhi (Fresh Ginger Juice, a little). Mix with hot water. One dose can be effective. Also effective if mixed with Baijian powder (Alumen) and taken.
Treats cholera with vomiting and diarrhea, cold Qi attacking the Heart, abdominal pain, cold extremities, and sweating. (From *Shenghui Fang*)
Use 1 liang of Liuhuang (Sulfur), finely ground like flour. Mix with hot wine and take 1 qian.
Huiyang San (Yang-Recovering Powder) (from *Bencao*): Treats persistent vomiting and diarrhea, potentially leading to muscle spasms (Zhuanjin), cold extremities, and loss of consciousness due to deficient wind. Take this medicine...
Extremities gradually warm, Spirit [text missing]...
Use Tiannanxing (Arisaematis Rhizoma) as powder. Take 3 qian per dose, add 3 Jingzao (Beijing Jujubes), decoct together until 0.8 parts remain. Take warm. If not conscious, take again.