茯苓 猪苓 白术(各十八铢) 泽泻(一两六铢) 桂(半两)
霍乱热多欲饮水者,阳邪也,此方主之。
邪在上焦则吐,邪在下焦则泻,邪在中焦则既吐且泻,名曰霍乱。霍乱责之里邪,里邪
责之水谷。是方也,桂能建中,术能安谷,茯苓、猪苓、泽泻能安水。水谷得其安,则霍乱
自止矣。此五苓治霍乱之意也。正考见伤寒门。
陈皮(去白) 藿香(各五钱,为末)
中气不和,吐泻霍乱者,此方主之。
中气者,脾气也。喜疏利而恶闭塞,喜香窜而恶腐秽,故用陈皮之辛以醒之,藿香之窜
以开之。
草果仁(三两) 附子(一两) 橘红(一两) 甘草(五钱)
姜煎冷服。
夏月饮食,杂以水果、寒冰之物食之,胸腹大痛,霍乱者,此方主之。
肉食得冰寒、水果而冷,冰寒、水果因肉食而滞,由是填塞至阴,乖隔而成霍乱。草果
辛温,善消肉食;附子辛热,能散沉寒;橘红之辛,可调中气;甘草之温,堪以益脾。而必
冷服者,假其冷以从治,《内经》所谓必伏其所主,而先其所因也。
吴茱萸 木瓜 食盐(各一钱)
夏月过用水果,填塞至阴,抑遏肝气,霍乱转筋者,此方主之。
水果得食盐,则收敛而不为患;肝部得茱萸,则疏利而不为抑;转筋得木瓜,则筋舒而
不复痛。
茯苓、猪苓、白术(各十八铢)、泽泻(一两六铢)、桂枝(半两)。
霍乱病中热象明显且想喝水的,属于阳邪致病,此方主治。
邪气在上焦则引起呕吐,邪气在下焦则引起腹泻,邪气在中焦则既呕吐又腹泻,称为霍乱。治疗霍乱要责之于里邪,而里邪的产生要责之于水谷失调。这个方剂中,桂枝能建立中气,白术能安和谷物运化,茯苓、猪苓、泽泻能安和水液代谢。水谷得以安和,那么霍乱自然就会停止。这就是五苓散治疗霍乱的用意所在。详细的考证见伤寒门。
陈皮(去除白色内层)、藿香(各五钱,研为粉末)。
中气不和,出现呕吐、腹泻及霍乱的,此方主治。
所谓中气,指的是脾气。脾气喜欢疏利通畅而厌恶闭塞,喜欢芳香走窜而厌恶腐秽之气,所以使用陈皮的辛味来唤醒脾机,使用藿香的走窜之性来开通郁结。
草果仁(三两)、附子(一两)、橘红(一两)、甘草(五钱)。
用生姜煎煮,冷却后服用。
夏季饮食时,混杂食用水果、寒冰等生冷之物,导致胸腹部剧烈疼痛,发生霍乱的,此方主治。
肉食遇到冰寒和水果变得寒冷,冰寒和水果因为肉食而停滞不化,由此填塞至阴之地,造成阴阳乖隔而形成霍乱。草果仁辛温,善于消化肉食;附子辛热,能驱散深层的寒气;橘红的辛味,可以调和中气;甘草的温性,足以补益脾气。而必须冷服的原因,是假借其冷性来进行从治(反佐),正如《内经》所说的“必须制服其主要病邪,并先针对其病因”。
吴茱萸、木瓜、食盐(各一钱)。
夏季过度食用水果,填塞至阴之地,抑制肝气,导致霍乱并伴有转筋(肌肉痉挛)的,此方主治。
水果遇到食盐,则收敛而不致为害;肝部得到吴茱萸,则疏利通畅而不受抑制;转筋得到木瓜,则筋脉舒展而不再疼痛。
Fuling (Poria), Zhuling (Polyporus), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 18 zhu), Zexie (Alismatis Rhizoma) (1 liang 6 zhu), Guizhi (Cinnamomi Ramulus) (0.5 liang).
In cases of Huoluan (cholera-like syndrome with sudden vomiting and diarrhea) where there is significant heat sensation and thirst, it is caused by Yang pathogenic factors; this formula is indicated.
When the pathogen is in the Upper Jiao (Upper Burner), it causes vomiting; when in the Lower Jiao (Lower Burner), it causes diarrhea; when in the Middle Jiao (Middle Burner), it causes both vomiting and diarrhea, which is named Huoluan (cholera-like syndrome). The treatment of Huoluan focuses on interior pathogens, and interior pathogens are attributed to the disorder of food and fluids. In this formula, Guizhi (Cinnamomi Ramulus) can establish the Middle Jiao Qi, Baizhu (Atractylodis Macrocephalae Rhizoma) can stabilize grain digestion, and Fuling (Poria), Zhuling (Polyporus), and Zexie (Alismatis Rhizoma) can stabilize water metabolism. When food and fluids are stabilized, Huoluan (cholera-like syndrome) will cease naturally. This is the rationale for using Wuling San (Five-Ingredient Powder with Poria) to treat Huoluan (cholera-like syndrome). For detailed examination, refer to the Shanghan (Cold Damage) section.
Chenpi (Citri Reticulatae Pericarpium) (remove white pith), Huoxiang (Agastaches Herba) (each 5 qian, powdered).
For cases where Middle Qi (Spleen Qi) is disharmonious, resulting in vomiting, diarrhea, and Huoluan (cholera-like syndrome), this formula is indicated.
The term "Middle Qi" refers to Spleen Qi. It prefers free flow and dislikes obstruction; it prefers aromatic penetrating properties and dislikes foulness. Therefore, the acrid nature of Chenpi (Citri Reticulatae Pericarpium) is used to awaken the Spleen, and the penetrating nature of Huoxiang (Agastaches Herba) is used to open the stagnation.
Caoguo Ren (Tsaoko Fructus), Fuzi (Aconiti Lateralis Radix Praeparata), Juhong (Citri Reticulatae Pericarpium Rubrum) (1 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (5 qian).
Decoct with Shengjiang (Zingiberis Rhizoma Recens) and take cold.
In summer, if one consumes fruits or icy/cold foods mixed with regular meals, leading to severe chest and abdominal pain and Huoluan (cholera-like syndrome), this formula is indicated.
Meat becomes cold when combined with ice/cold foods and fruits; ice/cold foods become stagnant due to meat. This fills the "Extreme Yin" region, causing a deviation and separation of Yin and Yang, resulting in Huoluan (cholera-like syndrome). Caoguo Ren (Tsaoko Fructus) is acrid and warm, good at digesting meat; Fuzi (Aconiti Lateralis Radix Praeparata) is acrid and hot, capable of dispersing deep-seated cold; the acridity of Juhong (Citri Reticulatae Pericarpium Rubrum) can regulate Middle Qi; the warmth of Gancao (Glycyrrhizae Radix et Rhizoma) is sufficient to benefit the Spleen. The reason for taking it cold is to borrow its cold property for "following treatment" (counter-treatment), as stated in the Neijing (Inner Canon): "One must subdue the main pathogen and first address the cause."
Wuzhuyu (Evodiae Fructus), Mugua (Chaenomelis Fructus), Yanshi (Sal) (each 1 qian).
In summer, excessive consumption of fruits fills the "Extreme Yin," suppressing Liver Qi, leading to Huoluan (cholera-like syndrome) with Jinzhuan (muscle cramps/tendon retraction); this formula is indicated.
When fruits meet salt, they become astringent and do not cause harm; when the Liver region receives Wuzhuyu (Evodiae Fructus), it becomes freely flowing and is not suppressed; when muscle cramps receive Mugua (Chaenomelis Fructus), the tendons relax and pain ceases.