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Zi Hezi said: During the Taihe era, I visited Guangji Zen Temple in Chenzhou. The abbot monk there suffered from cholera (Huo Luan). A physician used one piece of Fuzi (Aconite Root) weighing two liang and one liang of Ganjiang (Dried Ginger), soaked in a bowl of water, boiled together, cooled, and administered orally. After ingestion, the patient vomited blood and died. Shortly after, Li Yanzhi of Heliu Town suddenly experienced vomiting and diarrhea at midnight. He self-administered Lizhong Wan (Regulate the Middle Pill). When the doctor arrived, he diagnosed food stagnation and administered Radix Crotonis Fructus (Badou) to purge. Three to five pills had no effect, and the patient died by dawn. Is this not tragic?

Subsequently, Li Zhongan traveled to Yancheng with a servant and a tenant farmer. They stayed overnight in Shao Fuzhi's study. That night, the servant escaped. Upon realizing this, Li Zhongan rode a horse with the tenant farmer to pursue him urgently. It was July, extremely hot, with scorching winds like arrows and dust filling the sky. They returned at the Chen hour (7-9 AM). In less than three shichen (6 hours), they covered 120 li round trip but failed to catch the man, so they stayed again at the Shao residence. Suddenly, moaning sounds were heard at night, only shouting "Save me," without knowing who it was. Lighting a fire to search, it turned out to be Li Zhongan's tenant farmer. He suffered from upper vomiting and lower diarrhea, eyes fixed upward unable to look down, severe pain in the chest and hypochondrium making movement impossible, jaw dislocation due to yawning, and cold limbs. This is precisely a syndrome where Wind, Dampness, and Summerheat combine. His son-in-law recalled a method, took Liuyi San (Six-to-One Powder), mixed it with fresh well-water and chopped fresh ginger, and administered half a sheng at once. The patient vomited again. So, another half sheng was prepared for slow administration. After a long time, the symptoms subsided. By dawn, after several more doses, he could get up and recovered after three days of recuperation. (Xu Lingtai's note: This condition is common nowadays, mostly occurring in years of extreme summer heat and drought. This autumn, it prevailed in Jiangsu and Zhejiang, causing many deaths. I consulted physicians, and all patients survived. Asking about premonitory signs, some reported five-center heat for several days; others felt nothing unusual but saw everything as red before the sudden onset. Such clues indicate latent summerheat. In mid-July, I treated an elderly woman surnamed Chen, aged over seventy, with vomiting, diarrhea, muscle cramps, cold limbs, hoarse voice, hidden pulse, anuria, thirst, profuse sweating, abdominal pain, and yellowish complexion. She attempted suicide by jumping into a well. I prescribed Baihu Tang (White Tiger Decoction) combined with Sanhuang (Three Yellows), adding Mugua (Chaenomeles Fruit) and Weilingxian (Swallowwort Stem), with a trace of Xixin (Asarum), and advised liberal drinking of watermelon juice. She recovered that day. Another female patient surnamed Li suffered from this, accompanied by profuse hematuria, splitting headache, wiry and rapid pulse, palpitations, and fear. I stated that although it belongs to Summerheat pathogen, Liver Yang is blazing intensely. I used a large dose of Xijiao (Rhinoceros Horn - substitute with Buffalo Horn in modern practice), Zhizi (Gardenia Fruit), Bieye (Platycodon Root or Platycodi Radix, here likely referring to Ce Bai Ye/Platycladi Cacumen based on context of bleeding), Maogen (Imperata Rhizome), Shihu (Dendrobium Stem), Huashi (Talcum), Zhuru (Bamboo Shavings), Jinyinhua (Lonicera Flower), and Sheng Yiren (Coix Seed), mixed with lotus root juice, and administered Danggui Longhui Wan (Angelica Longan Pill) three qian orally. Cholera stopped immediately. Treating the blood aspect, she recovered in ten days. These two methods were not mentioned in my previous discussions.)

Zhang Jia resided at the home of Cui Mo, Minister of Personnel. After being away for several nights, Cui Mo dreamed of Zhang Jia saying, "I suddenly suffered heart and abdominal pain, abdominal distension, inability to vomit, and died." The disease was Gan Huoluan (Dry Cholera), which was treatable, but people did not know the remedy, hence death. The cure is to take a live spider, break its legs, and swallow it whole. Cui Mo woke up, checked, and found Zhang Jia indeed dead. Later, when encountering cases of Dry Cholera, this method was tried and proved effective. (From Youming Lu, cited in Ke Zhong Jian Ji).

Sun Wen Yuan treated the son of the Cheng family. He had first drunk excessively, then engaged in sexual activity. The next morning, his limbs were cold, epigastric pain was severe, and the pulse was only four beats per breath. Someone treated it as stagnant fire and administered cooling herbs, worsening the pain. The watermelon eaten three days prior was vomited undigested. The father suspected Yin-type Cold Damage and wanted to use Fuzi Lizhong Tang (Aconite Regulate Middle Decoction) but hesitated, so he invited Sun Wen Yuan. Observing the blueish-pale complexion, suppressed cry of pain, restlessness in sitting and lying, Sun diagnosed this as Cholera complicated by Ascariasis Colic (Hui Jue). Pain relief and worm-calming should come first, followed by Cholera treatment, to avoid death; delay would be fatal. Urgently, Wulingzhi (Trogopterus Dung) stir-fried with vinegar 3 qian, Cangzhu (Atractylodes Rhizome) 1.5 qian, Wumei (Mume Fruit) 3 pieces, Chuanjiao (Sichuan Pepper), Paojiang (Prepared Ginger), and Meixin (Apricot Kernel) each 0.5 fen, were decocted in water and given. Pain reduced by more than half. In the afternoon, Dafupi (Citrus Peel), Huoxiang (Patchouli), Banxia (Pinellia), Chenpi (Aged Tangerine Peel), Shanzha (Hawthorn Fruit), Wulingzhi, and Fuling (Poria) were used. Two prescriptions led to full recovery.

Shen Ji'an's wife suffered from fever, headache, generalized body pain, dry retching, thirst, chest and diaphragm oppression, and restlessness. The physician gave Shen Su Yin (Ginseng and Perilla Drink), which worsened the dry retching and added irritability. Sun Wen Yuan's pulse diagnosis showed the right hand pulse was twice as surging as the left, and the left was floating and rapid. He diagnosed Dry Cholera. He modified Huoxiang Zhengqi San (Regulate Qi and Resolve Exterior Powder) by removing Baizhu (Atractylodes Macrocephala Rhizome) and Jiegeng (Platycodon Root), adding Baibiandou (White Hyacinth Bean) and Xiangru (Mosla Herb). One prescription stopped the vomiting. Thirst and forehead pain remained. He prescribed Shigao (Gypsum), Xiangru, and Huashi each 5 qian, Juhong (Aged Tangerine Peel), Huoxiang, and Gegen (Kudzu Root) each 2 qian, Binglang (Areca Seed) and Mugua each 1 qian, Gancao (Licorice Root) 0.5 fen, and 3 slices of Shengjiang (Fresh Ginger). One prescription cured her.

Chai Yu Qing treated De Fu, Vice Minister of Rites in Shenyang. In summer, he suffered muscle cramps, vomiting, and diarrhea, cured by Liuhe Tang (Six Harmonies Decoction). In autumn, he thanked Chai. Re-examining the pulse, it was exceptionally wiry and surging. Chai suggested taking pill preparations for maintenance. De Fu claimed he was well and disagreed. Chai told Wu Ying'an, Capital Prefect, "De Fu's pulse qi is poor. Had he taken medicine earlier, the pulse changes would have been addressed. Next spring and summer will be worrying." At the predicted time, he suffered sudden collapse. Invitations came too late. (Note: For vomiting, diarrhea, and cramps, the Liver pulse must be wiry and surging; it does not necessarily imply chronic illness.)

Chen San Nong treated a woman. In summer, after eating, she drank water and slept. She woke with severe central abdominal pain, cold limbs extending above elbows and knees, desire to vomit and defecate but unable to do so, colicky pain nearing death, and all six pulses hidden. He ordered Huoxiang Zhengqi San decocted to induce vomiting. Vomiting once reduced symptoms by half; vomiting again brought peace. Ju Fang Huoxiang Zhengqi San contains: Houpo (Magnolia Bark), Chenpi, Jiegeng, Banxia, Gancao, Baizhi (Angelica Dahurica Root), Fuling, Huoxiang, Dafupi, Ziyey (Perilla Leaf).

Lu Zu Ru treated the mother of Chen Jingqiao, over forty, obese, who consumed much raw/cold food in summer. Midnight abdominal pain, unable to vomit or defecate. Huoxiang Zhengqi San was given, but she vomited it immediately upon entry. Pulse: Left three positions deep, tight, and fine; Right Cun and Guan deep, solid, and forceful. Complexion purple and swollen, limbs cold, unconscious, teeth clenched. This is severe Cold Qi causing Stagnation in the Middle Jiao, preventing transformation. First, Wumei (Mume Fruit) was rubbed on teeth to open the mouth. Then, Bao Yi Wan (Embrace One Pill) 3 li was administered. Abdominal rumbling occurred, foul matter was expelled, limbs warmed, complexion normalized, but she remained drowsy and taciturn. Fearing significant Qi depletion, Guizhi (Cinnamon Twig), Shaoyao (Peony Root), Chuanxiong (Szechwan Lovage Rhizome), Fuling, Doukou (Cardamom), Muxiang (Aucklandia Root), Chenpi, Mutong (Akebia Stem) were used. Four prescriptions led to complete recovery.

Wang Yu Tai treated an elderly man with summer Cholera, unconscious, pulse 7-8 beats per breath, surging and forceless, head hot as fire, feet cold as ice, hemiplegia, and locked jaw. Due to advanced age and weak Qi, he could not withstand Summerheat. Yang failing to anchor Yin leads to diarrhea; Yin failing to anchor Yang leads to vomiting. Lack of mutual anchoring causes both vomiting and diarrhea. During peak Summerheat, only sweet-acrid great-cold formulas can clear heat, subdue Yang, and calm the Spirit. Ganlu Yin (Sweet Dew Drink), a sweet-acrid great-cold formula to drain heat and tonify Qi, plus Fuling to separate Yin and Yang, administered with snow water, cured him.

He treated a woman with vomiting and diarrhea for over ten days, unable to intake water or grain, fever, irritability, desire to remove clothes, floating and surging pulse, empty upon heavy pressure. Liujun Zi Tang (Six Gentlemen Decoction) with Huoxiang, Sharen (Amomum Fruit), and Fuzi, administered cold, cured all symptoms.

Xue Lizhai treated the wife of Jinshi Li Tongfu. In winter, opening a wardrobe containing summer-dried undergarments, she felt invaded by residual Summerheat. Soon after, she developed Cholera with muscle cramps in toes and heels, feared death. Xiangru Yin (Mosla Drink) one dose, rapidly decocted, cured her upon swallowing.

Yibu Li Beichuan, in mid-summer, suffered abdominal pain, vomiting, and diarrhea. Hands felt hot to touch but cold to press. Light pulse floating and large, heavy pulse minute and fine. This is a Yin-Cold syndrome. Urgent administration of Fuzi Lizhong Tang had no effect initially. Continuing to the fourth dose resulted in recovery.

Bao Ruixue Xuechuan transmitted Miu Zhong Chun's divine prescription for Summerheat Cholera: 1 jin of Loofah Leaf, one white frost plum meat (with pit kernel), ground extremely fine, mixed with fresh well-water and taken orally. Immediate cure. (From Guang Biji).

Ma Mingju transmitted a Cholera formula: Crushed Millet (with husk) decocted in water. Taken orally, immediate cure. Proven efficacious repeatedly.

Gu Shengfu from Liangxi transmitted a Cholera formula: Juice extracted from Lablab Leaf (one bowl), drunk, immediate cure.

Miu Zhong Chun treated a maid-servant in Gao Cun's household with Cholera. Sandalwood (Sharen) 1 liang, stir-fried and ground, mixed with a pinch of salt, diluted in boiling water, taken cold. One dose cured. If caused by cold food, add Wuzhuyu (Evodia Fruit) 4 qian.