大全云∶饮食过度，触冒风冷，阴阳不和，清浊相干，谓之霍乱（论霍乱详明，杂症亦不
外此）。其间或先吐，或腹痛吐利，是因于热也；若头痛体疼发热，是挟风邪也。若风折皮
肤，则气不宣通，而风热上冲为头痛；若风入肠胃，则泄利呕吐，甚则手足逆冷，此阳气暴
竭，谓之四逆。妊娠患之，多致伤胎也。
薛氏曰∶前证若因内伤饮食，外感风寒，用藿香正气散；若因饮食停滞，用平胃散；若
果脾胃顿伤，阳气虚寒，手足逆冷者，须用温补之剂。治当详审，毋使动胎也。
万密斋曰∶霍乱者，阳明胃经之病名也。盖因平日五味肥酿，腐积成痰，七情郁结，气
盛为火，停蓄胃中，乍因寒热之感，邪正交争，阴阳相混，故令心腹绞痛，吐利并作，挥霍变
乱，故名霍乱。如邪在上胃脘，则当心而痛，其吐多；邪在下胃脘，则当脐而痛，其利多；邪在
中脘，其腹中痛，吐利俱多。吐多则伤气，利多则伤血，血气受伤，不能护养其胎，况邪气鼓
击胎元，母寿未有不殒者矣。此危恶之证，不可不亟治也，宜香苏散加藿香叶主之。
香苏散加藿香方 治妊娠霍乱。（此方平正可法）
香附（炒） 紫苏（各二钱） 陈皮（一钱） 甘草（炙） 藿香叶 缩砂（各五分）
上锉，水煎服、如转筋，加木瓜一钱。胎动不安，加白术一钱半。如夏月得之，加
黄芩一钱半，黄连一钱，香薷二钱。如冬月得之，加人参、白术各一钱，干姜炮五分。
回生散 治中气不和，霍乱吐泻，但一点胃气存者，服之回生，（此方甚良）
陈皮（去白） 藿香（各五分）
上为末，水煎，温服。
七味白术散 治脾胃虚弱，吐泻作渴不食。
白术 人参 茯苓 甘草（炙） 木香 藿
香（各半两） 干葛（一两）
上为末，沸汤调服二钱。吐甚者，加生姜汁频频服之。
理中汤 治妊娠霍乱腹痛，四肢逆冷，汗出脉虚弱者。
白术 人参 干姜（炮） 甘草（炙，各一钱）
上锉，水煎服。甚者，加熟附子五分。
人参散 治妊娠霍乱吐泻，心烦腹痛，饮食不入。（心烦腹痛而用人参、炮姜，岂烦非
热，而痛属虚乎，虚实寒热，用者须斟酌之）
人参 浓朴（姜制） 橘红（各二钱） 当归（炒） 干姜（炮） 甘草（炙，各一钱）
上作一服，加生姜三片，枣一枚，水煎服。
白术散 治妊娠霍乱腹痛，吐利不止。（此真虚寒腹痛吐利方也，勿妄用）
白术（炒） 益智仁 枳壳（麸炒） 橘红（各七钱半） 草豆蔻（煨去皮） 良姜（炒，各半两）
上为散，每服五钱，入生姜半分，水煎，去滓，温服。
木瓜煎 治妊娠霍乱吐泻，转筋闷绝。（此方可常用）
吴茱萸（汤洗七次） 生姜（切，各七钱半） 木瓜（竹刀切，一两半）
上细锉，水二盏煎一盏二分，去滓，分三服，热服。
一方有 香七钱半，甘草一钱，茱萸半两加紫苏煎。
上四方，用干姜、豆蔻、茱萸，俱大温之剂（霍乱切忌温药，犹者必死，即不发热烦渴者，
亦不可轻用，慎之慎之）。若发热烦渴，脉数阳证者，服之即死，宜用后方。
竹茹汤（方见胎前门恶阻）
益元散 桂苓甘露饮 冬葵子汤（并治霍乱，方见胎前门子淋）
The *Daquan* records: Overeating and exposure to wind-cold pathogens cause disharmony of Yin and Yang, with turbid and clear qi interfering with each other; this is called Huoluan (Vomiting and Diarrhea Syndrome) (Discussions on Huoluan are detailed, and other miscellaneous diseases do not deviate from this principle). Among these cases, if vomiting occurs first, or abdominal pain accompanies vomiting and diarrhea, it is due to heat pathogen. If accompanied by headache, body ache, and fever, it involves an external wind pathogen. If wind-cold constricts the skin, Qi mechanism fails to circulate freely, and wind-heat rushes upward causing headache; if wind enters the intestines and stomach, it results in diarrhea and vomiting. In severe cases, cold extremities occur, indicating sudden exhaustion of Yang Qi, termed Sini (Four Reversals) syndrome. Pregnant women suffering from this condition often experience fetal injury.
Xue Ji stated: For the aforementioned symptoms caused by internal dietary injury and external wind-cold invasion, use Huoxiang Zhengqi San (Patchouli Powder to Rectify the Qi); if caused by food stagnation, use Pingwei San (Calm the Stomach Powder); if the Spleen and Stomach are suddenly damaged, leading to deficiency-cold of Yang Qi and cold extremities, warming and tonifying formulas must be used. Treatment requires careful examination to avoid disturbing the fetus.
Wan Mizhai said: Huoluan is a disease name of the Yangming Stomach Meridian. It generally arises because daily consumption of rich, greasy, and fermented foods leads to rotting accumulation forming phlegm-dampness, combined with emotional depression causing Qi stagnation transforming into fire, which accumulates in the Stomach. Suddenly triggered by cold or heat sensations, evil qi and righteous qi contend, and Yin and Yang mix chaotically, causing severe heart and abdominal colic with simultaneous vomiting and diarrhea, creating chaotic turmoil; hence named Huoluan. If the pathogen is in the upper Jiao epigastrium, pain centers around the heart with predominant vomiting; if in the lower Jiao epigastrium, pain centers around the umbilicus with predominant diarrhea; if in the middle Jiao epigastrium, abdominal pain occurs with both significant vomiting and diarrhea. Excessive vomiting damages Qi, excessive diarrhea damages Blood. When Qi and Blood are injured, they cannot nourish the fetus. Moreover, as the pathogen agitates and strikes the fetal origin, the mother’s life is invariably lost. This is a critical and malignant syndrome requiring urgent treatment. Xiangsu San (Elsholtzia and Cyperus Powder) added with Huoxiang Ye (Patchouli Leaf) is appropriate.
**Xiangsu San Added with Huoxiang Formula**: Treats Huoluan during pregnancy. (This formula is balanced and standard.)
Cyperus Rhizome (Chao/Fried), Perilla Leaf (each 2 qian), Tangerine Peel (1 qian), Licorice Root (Zhi/Roasted), Patchouli Leaf, Amomum Fruit (each 5 fen).
Crush the herbs, decoct in water, and take orally. If muscle cramps (Zhuanjin) occur, add Quince Fruit (Mugua) 1 qian. For restless fetus, add Atractylodes Macrocephala Rhizome (Baizhu) 1.5 qian. If contracted in summer, add Scutellaria Root (Huangqin) 1.5 qian, Coptis Rhizome (Huanglian) 1 qian, Mosla Herb (Xiangru) 2 qian. If contracted in winter, add Ginseng Radix (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu) each 1 qian, Ginger Rhizome (Ganjiang) processed 5 fen.
**Huisheng San (Life-Restoring Powder)**: Treats Disharmony of Middle Qi, Huoluan with vomiting and diarrhea. Effective for restoring life provided even a trace of Stomach Qi remains. (This formula is excellent.)
Tangerine Peel (deprived of white pith), Patchouli (each 5 fen).
Grind into powder, decoct in water, and take warm.
**Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder)**: Treats Spleen-Stomach deficiency with vomiting, diarrhea, thirst, and anorexia.
Atractylodes Macrocephala Rhizome (Baizhu), Ginseng Radix (Renshen), Poria (Fuling), Licorice Root (Zhi/Roasted), Aucklandia Root (Muxiang), Patchouli (each half liang), Kudzu Root (Gegen) (1 liang).
Grind into powder, mix with boiling water, and take 2 qian. For severe vomiting, add Ginger Juice and take frequently.
**Lizhong Tang (Regulate the Middle Decoction)**: Treats Huoluan during pregnancy with abdominal pain, cold extremities, sweating, and weak pulse.
Atractylodes Macrocephala Rhizome (Baizhu), Ginseng Radix (Renshen), Ginger Rhizome (Pao/Processed), Licorice Root (Zhi/Roasted, each 1 qian).
Crush, decoct in water, and take orally. For severe cases, add Prepared Aconite Lateral Root (Shu Fuzi) 5 fen.
**Renshen San (Ginseng Powder)**: Treats Huoluan during pregnancy with vomiting, diarrhea, restlessness, abdominal pain, and inability to retain food. (Note: Using Renshen and Pao Jiang for restlessness and abdominal pain implies that the restlessness is not due to heat, and the pain is due to deficiency. Practitioners must carefully consider patterns of deficiency/excess and cold/heat.)
Ginseng Radix (Renshen), Magnolia Bark (Zhi/Ginger-processed), Tangerine Peel (Ju Hong), Angelica Sinensis Radix (Chao/Fried), Ginger Rhizome (Pao/Processed), Licorice Root (Zhi/Roasted, each 1 qian).
Take as one dose, add 3 slices of Fresh Ginger and 1 Jujube, decoct in water, and take orally.
**Baizhu San (Atractylodes Macrocephala Powder)**: Treats Huoluan during pregnancy with abdominal pain and unceasing vomiting/diarrhea. (This is a true formula for deficiency-cold abdominal pain and diarrhea; do not use indiscriminately.)
Atractylodes Macrocephala Rhizome (Chao/Fried), Alpinia Oxyphylla Fruit (Yizhiren), Bitter Orange (Fu Chao/Wheat-bran fried), Tangerine Peel (each 7.5 qian), Cardamom Seed (Wei/Roasted and peeled), Galangal Root (Chao/Fried, each half liang).
Grind into powder. Take 5 qian per dose, add 0.5 qian of Fresh Ginger, decoct in water, strain, and take warm.
**Mugua Jian (Quince Decoction)**: Treats Huoluan during pregnancy with vomiting, diarrhea, and severe muscle cramps leading to fainting. (This formula can be commonly used.)
Evodia Fruit (Xi/Twice-washed in hot water seven times), Fresh Ginger (sliced, each 7.5 qian), Quince Fruit (Cut with bamboo knife, 1.5 liang).
Finely crush, decoct in 2 zhan of water until 1.2 zhan remain, strain, divide into three doses, and take hot.
Alternative prescription: adds Agarwood (Chenxiang) 7.5 qian, Licorice Root 1 qian, Evodia Fruit half liang, and Perilla Leaf for decoction.
The above four formulas all contain Ganjiang (Dried Ginger), Doukou (Cardamom), and Zhuyu (Evodia), which are strongly warming agents. (Huoluan strictly contraindicates warming medicines; using them will certainly lead to death. Even if the patient does not present with fever, restlessness, or thirst, they should not be lightly employed. Exercise extreme caution.) If the patient presents with fever, restlessness, thirst, and rapid pulse (Yang syndrome), taking these warming formulas will cause death. Instead, use the following formulas.
**Zhuru Tang (Bamboo Shave Decoction)** (See Fangji under Taiqian Men - Emetic Syndrome).
**Yiyuan San (Benefit Primordial Powder)**, **Guiling Ganlu Yin (Cassia and Poria Sweet Dew Decoction)**, **Dongkuizi Tang (Abelmoschus Manihot Seed Decoction)** (All treat Huoluan; see Fangji under Taiqian Men - Dysuria during Pregnancy).