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[Dai Yuanli] Vomiting accompanied by diarrhea is named Huoluan (Huoluan, cholera-like syndrome). The etiology stems from deficiency-cold in the stomach and intestines, excessive food intake, and exposure to wind-cold, causing disharmony of Yin and Yang and interference between clear and turbid qi, resulting in sudden chaotic turmoil. Some present with heart pain followed by vomiting, some with abdominal pain followed by diarrhea, some with simultaneous vomiting and diarrhea, some with headache, high fever, and floating-hong pulse, and some with sudden collapse of Yang qi, cold extremities, and faint pulse. Treatment requires distinguishing Yin and Yang, examining deficiency and excess, differentiating heat and cold, and observing the pulse. For heat patterns, use cooling methods; for cold patterns, use warming methods, aiming for balance. *Baiwen* states: For all Huoluan with vomiting and diarrhea, if there is more heat and thirst, use Wuling San (Poria Decoction). If there is more cold and no desire to drink water, use Lizhong Wan (Regulate the Middle Pill). After vomiting and diarrhea cease, if sweating occurs with cold extremities, persistent limb stiffness, and a faint pulse nearly imperceptible, use Tongmai Sini Jia Zhu Danzi Decoction (Pulse-Recovering Four Reversal Decoction with Pig Bile). In summer, for Huoluan caused by heatstroke presenting with severe irritability and thirst, cold extremities, cold sweat, and calf cramps, use Xiangru San (Moslae Herba Decoction) prepared strongly and taken cold; this is effective. (Generally, a floating-hong pulse in Huoluan indicates an easier prognosis, while a faint-slow pulse with shortness of breath indicates a difficult one.)

[Xue Ji] Mr. Jia Yuanliang stated: Summerheat is the pathogenic factor of Ministerial Fire in season. When humans contract it in summer, it enters via the mouth and nose, damaging the Pericardium Meridian. Symptoms include headache, dry mouth, greasy complexion with spontaneous sweating, fatigue, and shortness of breath, or aversion to cold on the back but aversion to heat. Severe cases may involve coma and loss of consciousness, or Huoluan with vomiting and diarrhea, vomiting phlegm, abdominal pain, bloody stools, jaundice, and sores. The treatment principle focuses on clearing Heart Fire and promoting urination. If there is spontaneous sweating and intense heat, use Baihu Tang (White Tiger Decoction). If there is headache and aversion to cold, use Shiwei Xiangru San (Ten-Ingredient Moslae Herba Decoction). For diarrhea with irritability and thirst, where drinking causes vomiting, use Wuling San. For intense heat with irritability and thirst, use Yiyuan San (Benefit Origin Powder) to clear. If the exterior is resolved but interior heat is severe, use Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity). If the pulse is faint with diarrhea, thirst preferring warmth, or cold extremities with unconsciousness, use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) with half a prepared Aconite Root (Fuzi), taken chilled; subsequently treat with Laifu Dan (Revival Pill) and Wuling San. Thus, Dongyuan said: With Spleen-Stomach weakness during summer rainy seasons, leading to heavy body, shortness of breath, and even flaccidity of limbs or dizziness, one should nourish Lung Qi to replenish the source of Water. Hence, formulas containing Schisandra Berry (Wuweizi), Ginseng Root (Renshen), and Ophiopogon Tuber (Maidong) are commonly taken in May because heat damages Yuan Qi. This aligns with Danxi’s concept of latent Yin inside during summer. Essentially, the abdomen corresponds to Earth. In the Si month, all Yang Qi emerges above ground; similarly, human Yang Qi floats to the muscle surface and disperses in the skin and hair, leaving internal Yang deficient. Adding to this, staying in cool pavilions, using large fans, drinking cold spring water, eating fruits, and consuming icy foods further depletes Yang internally and externally. Without warming therapies, disease arises. Chen Wuyue stated: For heatstroke, cold medicines must never be used; only warming and nourishing methods are appropriate, as cold usage leads to death. If hot water is unavailable on the road, applying hot earth to the umbilicus or pouring hot urine can restore consciousness, illustrating this point. *Neijing* states: Faint pulse and body heat result from Summerheat injury. *Nanjing* states: Summerheat injury is a direct pathogen, originating from Fire pathology. Patients may dislike odors, presenting with body heat, irritability, heart pain, and a floating-large-dispersed pulse. *Shanghan Lun* states: Taiyang Heatstroke presents with body heat, headache, and weak pulse, or fever with aversion to cold and string-thin-empty-slow pulse. Generally, Cold damages Form (body structure), while Heat damages Qi. Injury to Qi without damaging Form leads to Qi consumption and weak pulse. Therefore, ancient sages legislated that summer requires tonification, which is well-founded. For the aforementioned syndromes, if there is internal accumulation and external contraction, use Erchen Tang (Two-Cured Decoction) with modifications; or crush Radish Seed (Luobozhi), ingest, and induce vomiting. Drinking rice soup may cause death, as discussed previously. For persistent cramps, men should pull the scrotum with hand, women the breasts near the sides; this is a brilliant method from *Qianjin Fang*. Dry Huoluan (Dry Cholera), where ascending and descending functions fail, leads to death quickly; induce vomiting with salt water, then administer Erchen Tang modified with Ligusticum Rhizome (Chuanxiong), Atractylodes Rhizome (Cangzhu), Saposhnikovia Root (Fangfeng), Angelica Dahurica Root (Baizhi), and Ginger decoction. If constipation occurs despite straining, add Aurantium Fruit (Zhiqiao). For Huoluan due to eating melons/fruits, drinking cold, exposure to wind, use Liuhe Tang (Six-Harmony Decoction) with doubled Agastache Herb (Huoxiang). Most deaths from heatstroke occur because of weak Yuan Qi allowing Summerheat to invade, causing diarrhea and sudden Yang collapse, constituting a Yin-cold pattern. Urgent Yang tonification is required to save life; delay is fatal. Others insisting on Summerheat-heat and administering cold medicines rarely avoid errors. Therefore, I list Yang-restoring and root-firming formulas below.

Modified Lizhong Wan: Main formula for acute Huoluan, also applicable to men.
Ginseng Root (Renshen), Atractylodes Macrocephala Rhizome (Baizhu), Dried Ginger (Ganjiang), Licorice Root (Gancao) (1 liang each).
Grind into fine powder, make pills with refined honey. Each liang makes five pills. Dissolve one pill in warm water and take three times daily. For more vomiting than diarrhea, take three roasted Ziziphus Fruit (Zhishi) slices, boiled in 3 sheng water to 1 sheng, mix with one pill. For less vomiting than diarrhea, add Ganjiang. For vomiting, diarrhea, and dry heaving, take 0.5 liang Pinellia Tuber (Banxia), processed, boiled in 2 sheng water to 1 sheng, mix with one pill. For unbearable body pain, take three Jujube (Dazao), boiled in 2 sheng water to 1 sheng, mix with one pill. For severe vomiting/diarrhea with cramps, wash the abdomen and kidney area with Chinese Chive Juice (Jiuji), from chest to ankle, without reversing direction, to stop symptoms. For cold body with slight sweat and cold abdomen, take one prepared Aconite Root (Fuzi), peeled and cut, boiled in 2 sheng water to 1 sheng, mix with one pill. If vomiting/diarrhea cease but pulse is absent and body remains cold, various tonic soups may be used.

Sishun Tang: Treats Huoluan with vomiting, diarrhea, abdominal pain, cold extremities, and faint pulse.
Aconite Root (Fuzi, 1 piece, broken into 8), Dried Ginger (Ganjiang, 3 liang), Ginseng Root (Renshen), Licorice Root (Gancao) (1 liang each).
Cut into pieces, decoct in water, and take.

Sini Jia Zhu Danzi Tang: Treats cessation of vomiting and diarrhea, sweating with cold extremities, persistent limb stiffness, and faint pulse.
Licorice Root (Gancao, 2 liang), Dried Ginger (Ganjiang, 3 liang), Raw Aconite Root (Fuzi, 1 piece), Pig Bile (Zhu Danshi, 0.5 he).
Decoct the first three ingredients in 3 cups water until 2 cups remain, strain, add Pig Bile, divide into two doses, take warm; pulse will return.

Xiangru San: Treats disharmony of cold/heat in organs, irregular diet, excessive raw/cold/fishy food, irregular lifestyle, sleeping in damp places, or exposure to wind while cooling. Wind-cold affects the Triple Burner, transmitting to Spleen/Stomach, impairing digestion, causing conflict between true and pathogenic qi, weakening intestines/stomach, leading to chaotic vomiting/diarrhea, heart/abdominal pain, and rebellious Qi. Effective for pre-heart pain vomiting, pre-abdominal pain diarrhea, simultaneous vomiting/diarrhea, fever/headache/body ache followed by vomiting/diarrhea with emptiness/irritability, stabbing heart/abdominal pain during vomiting/diarrhea, cramping/pain, dry retching, cold extremities/faint pulse, or severe oppression/coma. Also treats pregnant women with Huoluan.
Moslae Herba (Xiangru Ye, 4 liang), Soybean (Bai Biandou), Magnolia Bark (Houpo) (2 liang each).
Cut into pieces, take 0.5 liang per dose, decoct with 1 large cup water and 1 part wine over slow fire until 0.6 parts remain. Strain, chill in well water, take at once anytime. One to three doses yield miraculous effects. (*Su Shen Liang Fang* calls it Xiangrong San; *Baiwen* adds Coptis Rhizome (Huanglian) and omits Soybean).

Hezi San: Treats elderly and children with Huoluan vomiting/diarrhea, effective in one dose. Also treats nine types of heart pain and unbearable cold pain in heart/spleen.
Chebula Fruit (Hezi Pi), Licorice Root (Gancao), Magnolia Bark (Houpo), Dried Ginger (Ganjiang), Tsaoko Cardamom Seed (Caoguoren), Tangerine Peel (Chenpi), Galangal Rhizome (Gangjiang), Poria (Fuling), Medicated Leaven (Shenqu), Ophiopogon Tuber (Maidong) (equal parts).
Grind into powder. Take 2 qian when stabbing pain is unbearable. Decoct in 1 cup water to 0.7 parts, add salt, take immediately.

Hujiao Tang: Excellent for Huoluan vomiting/diarrhea.
Black Pepper (Hujiao, 49 grains), Mung Bean (Lvdou, 149 grains).
Grind into powder. Take 2 qian mixed with Quince (Mugua) decoction.

[Supplement] For Huoluan with body heat, floating-hong pulse, and thirst, this indicates Stomach Heat; use Zhurou Tang (Bamboo Sheath Decoction). After vomiting stops, treat with Wuling San, Buhuanjin Zhengqi San (Non-Exchanging Golden Upright Qi Powder), or Liuhe Tang. If Yang collapses suddenly with cold extremities and faint pulse, use Lizhong Tang, Lizhong Wan, or Zhizhong Tang, adding Fuzi for severe cases. For heatstroke Huoluan, I once added Banxia to Xiangru San, kneaded with fresh Ginger Juice, stir-fried in a copper pot until dry, then added red yeast rice wine, kneaded again, fried dry, added 1.5 cups water, decocted to 0.7 parts, strained, chilled in well water, and taken; this was effective.