论曰。医之用药。如将帅之用兵。本草曰。良医不能以无药愈疾。犹良将无兵。不足以胜敌也。故用药如
用兵。转筋霍乱者。治法同用兵之急不可缓也。故吐泻不止者。其本在于中焦。或因渴大饮。或因饮而过量。
或饥而饱甚。或湿内甚。故阴阳交而不和。是为吐泻。仲景曰。邪在上焦则吐。邪在下焦则泻。邪在中焦。则
既吐且泻。此为急病也。然吐利为急。十死其一二。如挥霍撩乱。而不得吐泻。此名干霍乱。必死。法曰。既
有其入。必有所出。今有其入。而不得其出者。痞也塞也。故转筋吐泻者。其气有三。一曰火。二曰风。三曰
湿。吐为 。热也。王注曰。炎热薄烁。心之气也。火能炎上。故吐也。泻为湿也。叔和云。湿多成五泄。内
经曰。湿胜则濡泻。又曰。风胜则动。筋属肝而应于风木。故脚转筋燥急也。内经曰。诸转反戾。水液混浊。
皆属于热。故仲景治法曰。热多欲饮水。五苓散。寒多不饮水者。理中丸。凡觉此证。或先五苓益元桂苓甘露
饮。乃吐泻之圣药也。慎无与粟米粥汤。谷入于胃则必死。本草曰。粟米味咸。微寒无毒。主养胃气。去脾胃
中热。益气。霍乱者。脾胃极损。不能传化。加以粟米。如人欲毙。更以利刀锯其首。岂有能生者耶。如吐泻
多时。欲住之后。宜微以粥饮。渐以养之。以迟为妙。
半夏汤 治霍乱转筋。吐泻不止。
半夏曲 茯苓 白术（各半两） 淡桂（二钱半） 甘草（炙二钱半）
上为细末。渴者凉水调下。不渴者温水调下。不计时候。
五苓散
白术 茯苓 木猪苓（各一两半） 泽泻（二两半） 桂枝（一两）
上为细末。冷水调下。或水煎三沸。冷服亦得。
理中丸
白术 人参 干姜 甘草（各等分）
上为细末。炼蜜为丸。如弹子大。每服一丸。冷水化下。
如吐泻不止。身出冷汗无脉者。可服后泻痢论中浆水散。兼桂枝汤白术汤。皆可用。后痢门中药。亦可选
用。
凡霍乱不可饮热白米汤。饮之死。必不救。切须慎之。
It is stated that a physician's use of medicine is like a general's deployment of troops. The *Bencao* (Materia Medica) records: "A skilled physician cannot cure diseases without medicines, just as a capable general cannot defeat enemies without soldiers." Therefore, using medicine is akin to using troops. For cholera presenting with muscle spasms (Zhuanjin), the treatment principle is like the urgency of military action and must not be delayed. In cases of incessant vomiting and diarrhea, the root lies in the Middle Jiao (the digestive system, primarily spleen and stomach). This may result from drinking excessively due to thirst, overconsumption of alcohol, eating too much when hungry, or severe internal dampness. These factors cause Yin and Yang to clash and lose harmony, resulting in vomiting and diarrhea. Zhang Zhongjing said: "Pathogenic factors in the Upper Jiao cause vomiting; those in the Lower Jiao cause diarrhea; those in the Middle Jiao cause both vomiting and diarrhea." This constitutes an acute condition. However, violent vomiting and diarrhea are critical emergencies, with three out of ten patients dying. If a patient experiences sudden chaotic distress but cannot vomit or defecate, this is named Dry Cholera (Gan Huoluan), a fatal condition where pathogenic factors enter but have no exit, leading to blockage. Thus, the etiology of vomiting, diarrhea, and spasms involves three types of Qi: Fire, Wind, and Dampness. Vomiting is caused by Heat. Wang Bing's commentary states: "Intense heat scorches, reflecting the Qi of the Heart." Since Fire flares upward, it causes vomiting. Diarrhea is caused by Dampness. Wang Shuhe stated: "Excessive Dampness leads to five types of diarrhea." The *Neijing* says: "Excess Dampness results in loose stools." It also states: "Excess Wind leads to movement." Tendons belong to the Liver and correspond to the Wind-Wood element; thus, the legs experience spasms and dryness/tightness. The *Neijing* states: "All turning, twisting, convulsions, and turbid body fluids belong to Heat." Therefore, Zhang Zhongjing's therapeutic principles are: for cases with significant Heat and desire for water, use Wuling San; for cases with significant Cold and no thirst, use Lizhong Wan. Upon sensing these symptoms, one may initially administer Wuling San, Yiyuan San, or Guiling Ganlu Yin, which are miraculous remedies for vomiting and diarrhea. One must strictly avoid giving millet porridge or soup. Grain entering the stomach will inevitably lead to death. The *Bencao* states: "Millet is salty, slightly cold, non-toxic, nourishes Stomach Qi, clears Heat from the Spleen and Stomach, and benefits Qi." In cholera, the Spleen and Stomach are extremely damaged and unable to transform and transport. Adding millet is like sawing the head of a dying person with a sharp knife; survival is impossible. After prolonged vomiting and diarrhea cease, one should gradually nourish the body with small amounts of rice gruel, favoring slowness.
Banxia Tang: Treats cholera with spasms, incessant vomiting and diarrhea.
Banxia Qu (Prepared Pinellia Curd), Fuling (Poria), Baizhu (Atractylodes Macrocephala Rhizome) (each 0.5 liang); Dan Gui (Cinnamon Twig) (2.5 qian); Zhigancao (Honey-fried Licorice Root) (2.5 qian).
Grind into fine powder. Mix with cool water if thirsty; mix with warm water if not thirsty. Take at any time.
Wuling San:
Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Muzhuling (Polyporus) (each 1.5 liang); Zexie (Alisma Rhizome) (2.5 liang); Guizhi (Cinnamon Twig) (1 liang).
Grind into fine powder. Mix with cold water. Alternatively, boil in water for three boils and take when cool.
Lizhong Wan:
Baizhu (Atractylodes Macrocephala Rhizome), Renshen (Ginseng Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Gancao (Licorice Root) (equal parts).
Grind into fine powder. Form pills with refined honey, size of a bullet. Take one pill per dose, dissolved in cold water.
If vomiting and diarrhea persist, accompanied by cold sweat and absence of pulse, one may administer Jiangshui San from the subsequent section on Dysentery, combined with Guizhi Tang (Cinnamon Twig Decoction) and Baizhu Tang. Medications from the subsequent Dysentery chapter may also be selected.
Patients with cholera must never drink hot white rice soup; doing so leads to death and is incurable. Exercise utmost caution.