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If the cold and hot qi are not in harmony, and dietary habits are irregular, it causes the yin and yang, clear and turbid qi of the human body to interfere with each other and become chaotic between the stomach and intestines, resulting in Huoluan (cholera-like syndrome).

In cases of Huoluan accompanied by abdominal distension and fullness, this is due to the struggle between cold qi and the qi of the zang organs, where healthy qi and pathogenic factors attack each other. The inability to vomit or have diarrhea leads to abdominal distension and fullness.

For those who have experienced excessive vomiting and diarrhea, the zang organs become deficient while the pathogenic factors remain. The pathogen combats the qi, preventing its free diffusion, which also results in abdominal distension and fullness.

In cases of Huoluan accompanied by dysentery (diarrhea), cold qi enters the stomach and intestines first. When the qi of the stomach and intestines encounters cold, they clash causing pain; thus, if abdominal pain precedes the symptoms in Huoluan, diarrhea follows.

In cases of Huoluan with persistent dysentery, it is because both the stomach and intestines are cold, compounded by underlying deficiency. The qi of food grains fails to digest, and the intestines become slippery, leading to continuous profuse watery stools. Persistent dysentery leads to extreme deficiency and cold; when cold enters the sinews, it transforms into muscle cramps (zhuanjin). If the stomach is deficient and cold qi takes advantage of this, it also transforms into vomiting and hiccups.

Cases of Huoluan approaching death occur because undigested food and internal cold qi struggle. Whether vomiting and diarrhea have not yet occurred, or although they have occurred, the cold qi has not subsided, causing a conflict between healthy and pathogenic qi and a fierce struggle between yin and yang. This leads to qi jue (reversal) and dysfunction, resulting in restlessness, oppression, chest fullness, and exhaustion, making the patient feel as if dying.

Cases of Huoluan with vomiting and hiccups occur because after vomiting and diarrhea, the stomach becomes deficient, causing rebellious qi to lead to vomiting. When rebellious qi meets the constraint of cold, the blockage of qi flow results in hiccups.

Cases of Huoluan with irritability and thirst occur because severe vomiting causes deficiency in the upper jiao and dysfunction of qi regulation. When qi attacks the heart, it causes restlessness; severe dysentery exhausts body fluids. Exhaustion of body fluids leads to dryness of the zang organs, which causes thirst. Persistent irritability and thirst lead to drinking water; however, if the spleen and stomach cannot transform it, the dysentery will not cease.