Library

Pulse: The pulses in all six positions are hidden and imperceptible. The pulse at the right Guan position is wiry and slippery. If a floating and surging pulse is observed, the condition is treatable; if the pulse is faint and slow, accompanied by weak breath and reluctance to speak, it is difficult to treat. A wiry and moderate pulse at both Guan positions indicates Wood overacting on Earth (Liver Wood suppressing Spleen Earth). Without urgent treatment, death will ensue.

Symptoms: Chen Wuyue stated: Huoluan (cholera-like syndrome) is characterized by sudden pain in the heart and abdomen, vomiting with diarrhea, aversion to cold with high fever, headache, and dizziness. If heart pain occurs first, vomiting precedes; if abdominal pain occurs first, diarrhea precedes; if both heart and abdomen hurt, vomiting and diarrhea occur simultaneously. In severe cases, muscle cramps may pull into the abdomen, leading to sudden death. This syndrome arises from the reversal of Yin and Yang Qi, where clear and turbid Qi interfere with each other, Yang Qi rises suddenly, and Yin Qi abruptly ceases. Treatment should favor warming and tonifying, strictly avoiding cooling agents. Muscle cramps occur because the Yangming channel nourishes the Zongjin (major sinews), which belong to the Stomach and Large Intestine. Now, due to sudden violent vomiting and diarrhea, body fluids are instantly lost. Combined with external contraction of the Four Qi (Wind, Cold, Summerheat, Dampness), internal injury from the Seven Emotions, and consumption of sweet and greasy foods, various meridians are blocked, causing the Zongjin to wither and lose nourishment, inevitably resulting in spasms. In severe cases, tongue retraction and testicular retraction occur, which are difficult to treat. There is also a type called Gan Huoluan (Dry Cholera), characterized by sudden abdominal distension and fullness, twisting stabbing pain, mental distress, inability to vomit or defecate, leading to suffocation and coma within moments. It is the most difficult to treat, often causing death in an instant due to the obstruction of ascending and descending mechanisms. Only emesis (inducing vomiting) is the best method, or purgation can also be effective. After emesis or purgation, Erchen Tang (Two-Aged Decoction) combined with Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala Rhizome) should be used for regulation.

Treatment: Huoluan belongs to the Yangming syndrome category. Treatment should focus on harmonizing the middle and regulating the stomach. Shengjiang Lizhong Tang (Fresh Ginger Regulate the Middle Decoction) is most effective. For cases with vomiting, diarrhea, muscle cramps, hypochondriac pain, and a wiry pulse, indicating Wood overacting on Earth, Pingwei San (Regulate the Stomach Powder) with Mugua (Chaenomelis Fructus) is indicated. For cases with vomiting, diarrhea, muscle cramps, abdominal pain, heavy body sensation, and a deep, fine pulse, Sijunzi Tang (Four Gentlemen Decoction) with Baishao (White Peony Root) and Ganjiang (Dried Ginger) is indicated. For cases with cold limbs and a faint pulse, Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) is indicated. For cases with body heat, irritability, and thirst, Qianshi Baizhu San (Qian's Atractylodes Powder) is indicated. For muscle cramps, men should have their scrotum gently pulled by hand, and women should have their breasts gently pulled by hand; this is a wonderful method from Qianjin Fang. Generally, when this syndrome strikes urgently without available medicine, Chen's emesis method is best, followed by symptom-based regulation.

Formula: Liuhe Tang (Six Harmonies Decoction) treats Huoluan caused by latent summerheat.
Ingredients: Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Banxia (Pinelliae Tuber), Xingren (Armeniacae Semen Amarum) (each 8 fen), Gancao (Licorice Radix et Rhizoma) (4 fen), Sharen (Amomi Fructus) (6 fen), Huoxiang (Agastaches Herba), Mugua (Chaenomelis Fructus), Fuling (Poria), Bian Dou (Vigna Seed), Houpo (Magnoliae Officinalis Cortex) (each 1 qian), Xiangru (Elsholtziae Herba) (1.5 qian).
Preparation: Combine as one dose. Add three slices of fresh ginger and one jujube. Add 1.5 zhong of water, decoct until 0.8 zhong remains. Take at any time.
Modifications:
If not thirsty, with abdominal pain, vomiting, and diarrhea, add Ganjiang (Dried Ginger) (7 fen).
If thirsty, with abdominal pain, vomiting, and diarrhea, add Ge Gen (Puerariae Lobatae Radix) (8 fen), Zexie (Alismatis Rhizoma), Huashi (Talcum) (each 7 fen), Maidong (Ophiopogonis Radix) (8 fen), Wuweizi (Schisandrae Fructus) (5 fen).
For muscle cramps, add Jiudanggui (Wine-processed Angelica Sinensis Radix), Jiu Honghua (Carthami Flos) (each 7 fen), Huangqin (Scutellariae Radix) (8 fen).
For cold limbs and faint pulse, add Ganjiang (Dried Ginger) and Fuzi (Aconiti Lateralis Radix Praeparata) (each 1 qian).

Another Formula: Sanyin Tu Fa (Three Causes Emesis Method) treats Huoluan and Gan Huoluan, especially when urgent medication is unavailable. This method is extremely effective. Use highly saline salt water (2 sheng), drink 1 sheng hot, stimulate the throat to induce vomiting until old food residue is expelled. If vomiting does not occur, administer again. Continue after vomiting stops, repeating three times then cease. This method far surpasses others. Secular practitioners despise and do not use it, sitting idly while patients die, which is lamentable. After emesis, regulate with Erchen Tang (Two-Aged Decoction) plus Renshen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma); this ensures success without failure.