Internal accumulation and external pathogenic invasion lead to vomiting and diarrhea. Use Er Chen Tang (Chenpi Decoction, a formula for drying dampness and resolving phlegm) with modifications to induce vomiting and raise Qi. This is not caused by ghosts or spirits, but is entirely due to dietary indiscretion, as confirmed by predecessors. It results from the failure of Yang Qi to ascend and Yin Qi to descend, leading to an obstruction between the upper and lower jiao. Do not provide any grain food; even a sip of rice water can be fatal upon ingestion. One must wait until vomiting and diarrhea have ceased for two to three shichen (4-6 hours), and only when the patient feels extreme hunger should thin porridge be given. The pulse is often deep and faint, nearly imperceptible. If the existing vomiting and diarrhea are incomplete, one should still use induced vomiting to raise and release the Qi, or decoct camphor wood (Cinnamomum camphora) in water and induce vomiting, which is also effective. The general principle: Shengjiang Lizhong Tang (Ginger Decoction to Regulate the Middle) is best, suitable for those without thirst. For those with thirst, Wuhua San (Five-Flower Powder) should be used. If vomiting is present, use Er Chen Tang to probe for vomiting; there are also cases where purgation is applicable. For persistent muscle cramps, men should have their genitals gently pulled by hand, and women their breasts, near the sides; this is a wonderful method from Qianjin Fang. Muscle cramps are attributed to blood heat; Si Wu Tang (Four Substances Decoction) combined with wine, Huangqin (Scutellariae Radix), Honghua (Carthami Flos), Cangzhu (Atractylodis Rhizoma), and Nanting (Arisaematis Rhizoma Praeparatum) should be decocted and taken. Gan Huoluan (Dry Cholera, characterized by inability to vomit or defecate) is the most difficult to treat, with changes occurring in an instant. When ascending and descending mechanisms are blocked, inducing vomiting to raise Qi is an excellent method; people commonly use salt water for this. This condition arises from internal injury by retained substances and external obstruction by pathogens. Induced vomiting has a dispersing effect; warm herbs can also be used to resolve the pathogen. Cool herbs should not be used; instead, Er Chen Tang combined with dispersing herbs is appropriate.

Er Chen Tang plus Chuanxiong (Ligustici Chuanxiong Rhizoma), Cangzhu (Atractylodis Rhizoma), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix) (some say Baizhu).
Crush the above ingredients. Add five slices of fresh ginger, decoct, and take.

Formula for Treating Cholera:
Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Gegen (Puerariae Lobatae Radix) (each 1.5 qian), Huashi (Talcum) (3 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (2 qian), Muzhong (1 qian), Gancao (Licorizia Radix et Rhizoma Praeparata cum Melle) (roasted).
Crush the above ingredients. Decoct with ginger in water, and administer Baohe Wan (Preserve Harmony Pill) 40-50 pills.

Dai Yuanli stated: Huoluan refers to vomiting, accompanied by sound and material discharge. Cases with sound but no material discharge, accompanied by restlessness and chaos, are called Gan Huoluan (Dry Cholera).

[Appendix] The symptoms of Huoluan involve sudden upheaval, arising abruptly, often due to cold damage complicated by food retention, causing a discordance of Yin and Yang. Upper vomiting and lower diarrhea, with restlessness, are its signs. Predominantly Yang patterns manifest more heat; predominantly Yin patterns manifest cold. Sudden onset makes it as critical as a candle in the wind. Shi Huoluan (Wet Cholera) has fewer deaths, while Gan Huoluan has more. This is because the offending substance may be completely expelled through vomiting or diarrhea, stopping the disease process, hence fewer deaths. If one cannot vomit upward nor defecate downward, and the offending substance remains, possibly causing cold-induced abdominal fullness and pain, limb stiffness, cramps, and diarrhea, use Lizhong Tang (Decoction to Regulate the Middle) plus Sheng Fuzi (Prepared Aconiti Lateralis Radix) and Guongui (Cinnamomi Cortex). For summerheat-induced Huoluan with irritability, severe thirst, heart and abdominal pinching pain, cold limbs, cold sweat, and leg cramps, use Huoxiang San (Patchouli Powder). Qianjin Fang states: For cramps, use Lizhong Tang plus Huo Shigao (Calcined Gypsum). If Huoluan involves vomiting and diarrhea with heart and abdominal pain, first probe with salt water to induce vomiting, then administer Huoxiang Zhengqi San (Patchouli Powder to Rectify the Qi) plus Muxiang (Aucklandiae Radix) half a qian. If there is frequent urge to defecate but inability to do so, add Zhike (Aurantii Fructus) one qian. In summer, excessive consumption of melons and fruits, drinking cold water, and exposure to wind cause food stagnation and indigestion, forming pi (glomus) that obstructs the upper and lower jiao, resulting in Huoluan. Use Liuhe Tang (Six Harmonies Decoction) with doubled Huoxiang (Agastaches Herba) decocted and taken; these are essential medicines.

Attached Formulas

Liuhe Tang (Six Harmonies Decoction)
Sharen (Amomi Fructus Rotundus), Banxia (Pinelliae Rhizoma Praeparatum), Xingren (Armeniacae Semen Amarum), Renshen (Ginseng Radix et Rhizoma), Gancao (Licorizia Radix et Rhizoma Praeparata cum Melle) (roasted, each 1 liang), Chi Fuling (Poria with Red Host), Huoxiang (Agastaches Herba), Biandou (Dolichoris Lablab Semen Album) (stir-fried), Mugua (Chaenomelis Fructus) (each 2 liang).
Crush the above ingredients. Take 5 qian per dose, with 2 zhong of water, three slices of fresh ginger, and one jujube. Decoct and take warm. Another version includes Xiangru (Elsholtziae Herba) and Houpo (Magnoliae Officinalis Cortex) each 4 liang.

Er Chen Tang See Stroke section.
Wu Ling San See Summerheat section.
Lizhong Tang See Cold Damage to the Interior section.
Huoxiang Zhengqi San See Stroke section.
Tongmai Sini Tang Treats Huoluan with excess cold, cold body, and absent pulse.
Wuzhuyu (Evodiae Fructus) (2 liang, roasted), Fuzi (Aconiti Lateralis Radix Praeparata) (processed, 1 liang), Guixin (Cinnamomi Ramulus), Tongcao (Tetrapanacis Medulla), Xixin (Asari Radix et Rhizoma), Shaoyao (Paeoniae Radix Alba), Gancao (Licorizia Radix et Rhizoma Praeparata cum Melle) (roasted, each half liang), Danggui (Angelicae Sinensis Radix) (2 qian).
Crush the above. Take 4 qian per dose, with half water and half wine, plus fresh ginger, and decoct.

Mugua Tang Treats Huoluan with vomiting and diarrhea, generalized cramps, and cramps entering the abdomen causing suffocation.
Gan Mugua (Dried Chaenomelis Fructus) (1 liang), Wuzhuyu (Evodiae Fructus) (half liang), Huixiang (Foeniculi Fructus), Zhi Gancao (Prepared Licorizia Radix et Rhizoma) (each 1 qian).
Crush the above. Take 4 large qian per dose, with three slices of fresh ginger and ten leaves of Zisu (Perillae Folium), and decoct.