胡氏 秋间吐泻欲死，诊脉知为积寒感暑而发。用藿香、砂仁、半夏、焦神曲、茯苓、小茴香、陈皮、
炙草、煨姜，煎服一剂愈。此症多由温凉不调，生冷失节，以致阴阳乖格，清浊相干，
夏秋间为多也。
门人某 于道光辛巳暑夜吐泻，是年时疠大行，凡吐泻霍乱，见脚麻转筋囊缩者，立毙，城乡日以数十
计。大率口鼻吸入秽邪，头晕胸闷，心腹猝痛，倾吐注泻，阳脱肢冷，目陷筋掣，身温汗油，顷刻昏厥矣。沿
门阖境，病势一辙。用六和汤去扁豆、白术、杏仁，加薄荷梗、木青、煨姜，半日服二剂，遂定。后加意调摄
得安。
王 腹痛吐泻，烦躁不安，腿足筋掣。症由长夏务农，水田烈日中，多受湿 ，脾阳不司运化，吐泻骤
作，烦渴无寐。又下多伤阴，筋失荣养，故拘急而抽搐也。若厥逆躁扰者死。诊其脉虚而促，用生脉散加藿梗、
茯苓、砂仁、陈皮、木瓜、当归、白芍，数服而平。
王 暑夜停食腹痛霍乱。用大和中饮，干姜改煨姜，一服止。
李（婺源）暑月霍乱，泻利稀水，呕出宿腐，右脉微小，左更模糊，不但脾失转输，清浊相干，且察
其神气索然，理防痉厥。急须主以温中，佐以分利。参六和四苓合方，半夏、砂仁、茯苓、茯神、猪苓、藿梗、
潞参、炙草、煨姜、谷芽。一服吐泻止，再服小便利，随去猪苓，加白术，用锅巴汤煎，二服霍然以起，后
误以冷冻饮料，卒致不救。
Patient Hu suffered from vomiting and diarrhea in autumn, feeling as if death were imminent. Upon pulse diagnosis, it was determined to be caused by accumulated cold combined with summer-heat pathogen. Huoxiang San (Agastache Powder) ingredients including Huoxiang (Patchouli Herb), Sharen (Amomum Fruit), Banxia (Pinellia Tuber), Jiao Shenqu (Fried Medicated Leaven), Fuling (Poria), Xiaohuixiang (Fennel Seed), Chenpi (Tangerine Peel), Zhigancao (Prepared Licorice Root), and Wei Jiang (Ginger prepared by baking) were decocted and administered. One dose resulted in recovery. This condition often arises from improper adjustment of warmth and coolness, and irregular consumption of raw and cold foods, leading to the rebellion and rejection of Yin and Yang, and the interference of clear and turbid qi. It is common in summer and autumn.
A student of mine contracted vomiting and diarrhea on a hot night in the Xin Si year of the Daoguang reign (1821). During that year, a pestilential epidemic was widespread. For those suffering from vomiting, diarrhea, or cholera who exhibited numbness in the legs, muscle spasms, and retraction of the scrotum, death occurred immediately. Dozens died daily in both urban and rural areas. Generally, this results from inhaling foul pathogens through the mouth and nose, causing dizziness, chest tightness, sudden pain in the heart and abdomen, violent vomiting and profuse diarrhea, loss of Yang Qi with cold limbs, sunken eyes, tendon twitching, warm body with oily sweat, and sudden syncope within moments. The disease progression was uniform across households. Liuhe Tang (Six Harmonies Decoction) was used, removing Bian Dou (Hyacinth Bean), Baizhu (Atractylodes Rhizome), and Xingren (Apricot Seed), and adding Bohe Geng (Mint Stem), Muqing (a local herb, possibly referring to a specific variety or typo for another herb like Muxiang or similar, kept as original name), and Wei Jiang (Ginger prepared by baking). Two doses were taken within half a day, stabilizing the condition. Subsequent careful nursing led to full recovery.
Mr. Wang presented with abdominal pain, vomiting, diarrhea, restlessness, and muscle spasms in the legs and feet. The etiology was attributed to agricultural work during the long summer, exposing him to dampness under the scorching sun in paddy fields. Spleen Yang failed to govern transformation and transportation, leading to sudden onset of vomiting and diarrhea, irritability, thirst, and insomnia. Furthermore, excessive diarrhea damaged Yin fluids, depriving the tendons of nourishment, resulting in stiffness and convulsions. If cold extremities accompanied by restlessness occur, the prognosis is fatal. His pulse was deficient and rapid. Shengmai San (Generate the Pulse Powder) was prescribed with additions: Huoxiang Geng (Patchouli Stem), Fuling (Poria), Sharen (Amomum Fruit), Chenpi (Tangerine Peel), Mugua (Chaenomeles Fruit), Danggui (Angelica Sinensis Root), and Baishao (White Peony Root). Several doses brought the condition under control.
Mr. Wang suffered from cholera with abdominal pain due to food stagnation on a hot summer night. Da Hezhong Yin (Great Middle-Harmonizing Decoction) was used, substituting Ganjiang (Dried Ginger) with Wei Jiang (Ginger prepared by baking). One dose stopped the symptoms.
Mr. Li (from Wuyuan) suffered from cholera in the heat of summer, with watery diarrhea and vomiting of undigested food. The right pulse was minute and faint, while the left pulse was even more indistinct. This indicated not only the failure of the Spleen to transform and transport, causing interference between clear and turbid qi, but also a depletion of Shen (Spirit) energy, raising concern for impending tetany or syncope. Urgent treatment required warming the Middle Jiao primarily, assisted by separating clear from turbid. A combined formula of Shen Liuhe Tang (Ginseng Six Harmonies Decoction) and Si Ling Tang (Four Poria Decoction) was used, containing Banxia (Pinellia Tuber), Sharen (Amomum Fruit), Fuling (Poria), Fushen (Poria with Hostwood), Zhuling (Polyporus), Huoxiang Geng (Patchouli Stem), Lushen (Codonopsis Root), Zhigancao (Prepared Licorice Root), Wei Jiang (Ginger prepared by baking), and Guya (Sprouted Grain). After one dose, vomiting and diarrhea ceased; after the second dose, urination became normal. Zhuling (Polyporus) was then removed, and Baizhu (Atractylodes Rhizome) added. The decoction was prepared using Guoba Tang (Rice Charcoal Soup). After two doses, he recovered completely. However, he later mistakenly consumed frozen beverages, which ultimately proved fatal.