提学侍其公。年七十九岁。至元丙寅六月初四日中暑毒。霍乱吐利。昏冒终日。不省人事。时
夜方半。请予治之。诊其脉洪大而有力。一息七八至。头热如火。足寒如冰。半身不遂。牙关紧急
。予思内经五乱篇中云。清气在阴。浊气在阳。营气顺脉。冒气逆行。乱于胸中。是谓大 云云。
乱于肠胃。则为霍乱。于是霍乱之名。自此而生。盖因年高气弱。不任暑气。阳不维阴则泻。阴不
维阳则吐。阴阳不相维。则既吐且泻矣。前贤见寒多以理中丸。热多以五苓散为定法治之。今暑气
极盛。阳明得时。况因动而得之。中暑明矣。非甘辛大寒之剂。则不能泻其暑热。坠浮焰之火而安
神明也。遂以甘露散甘辛大寒。泻热补气。加白茯苓以分阴
阳。约重一两。冰水调灌。渐渐省事而诸证悉去。后慎言语。节饮食。三日。以参术调中汤之剂增
减服之。理正气。逾十日后。方平复。
戊午春。攻襄阳回。住夏曹州界。有蒙古百户昔良海。因食酒肉饮 乳。得霍乱吐泻。从朝至
午。精神昏愦。以困急来求予视之。脉得浮数。按之无力。所伤之物已出矣。即以新汲水半碗。调
桂苓白术散。徐徐服之。稍安。又于墙阴撅地一穴。约二尺许。贮以新汲水。在内搅动。待一时澄
定。名曰地浆。用清者一盏。再调服之。渐渐气调。吐利遂止。至夜安眠。翌日微燥渴。却以钱氏
白术散时时服之。良愈。或问用地浆者。何也。予曰。坤为地。地属阴土。平曰静顺。感至阴之气
。又于墙阴。贮以新汲水。取重阴之气也。阴中之阴。能泻阳中之阳。今霍乱因暑热内伤而得之。
故痹论云。阴气者静则神藏。躁则消亡。又加以暑热。七神迷乱。非至阴之气则不愈。予用之者此
也。或曰。内经福世之方书。岂不信然。
【桂苓白术散】治冒暑饮食所伤。传受湿热内盛。霍乱吐泻。转筋急痛。腹满闷。小儿吐
泻惊风宜服。
茯苓（去皮） 白术 桂（各半两） 甘草
泽泻 石膏（各一两） 滑石（二两） 寒水石（一两）
上八味为末。热汤调下三钱。喜冷。新汲水调姜汤亦得。小儿服一钱。
【桂苓甘露饮】流湿润燥。治痰涎。止咳嗽。调脏腑。寒热呕吐服之。令人遍身气溢宣平。
及治水肿泄利。
官桂 藿香 人参（各半两） 木香（一分）
茯苓 白术 甘草 泽泻
葛根 石膏 寒水石（各一两） 滑石（二两）
上十二味为末。每服二钱。白汤调下。新汲水或姜汤亦得。
【宣明益元散】又名天水散。
滑石（六两） 炙甘草（一两）
上为末。每服三钱。蜜少许温水调下。日三服。新汲水亦得。欲解肌发汗者。煎葱白豆豉汤调
。无时。
【附录圣惠方】治霍乱吐泻。
浓朴（生姜汁。炙）
上为末。新汲水调下二钱。无时。如神。
提学侍其公，七十九岁。至元丙寅年六月初四日，因中暑毒，出现霍乱吐利症状，整日昏迷不醒，人事不知。当时正值半夜，请我诊治。诊察其脉象洪大且有力，一息跳动七八次，头部发热如火，双脚寒冷如冰，半身不遂，牙关紧闭。我思考《内经·五乱篇》中所述：“清气在阴，浊气在阳，营气顺脉，冒气逆行，乱于胸中……”以及“乱于肠胃，则为霍乱”，因此霍乱这一病名便由此产生。大概是因为年老气弱，无法承受暑热之气，阳气不能固摄阴液则导致腹泻，阴气不能固摄阳气则导致呕吐，阴阳相互失守，于是既呕吐又腹泻。前贤见到寒证多使用理中丸，热证多使用五苓散作为固定法则治疗。如今暑气极盛，正值阳明主令之时，况且是因活动而得病，确属中暑无疑。若非甘辛大寒的方剂，就不能清泻暑热，压制上浮之火以安定神明。于是使用甘露散，此方甘辛大寒，能泻热补气，加入白茯苓以分理阴阳，药量约重一两，用冰水调匀灌服。患者渐渐苏醒，各种症状全部消除。后来注意言语节制，饮食有度，三天后，服用参术调中汤加减，调理正气，过了十天后，才完全康复。
戊午年春季，攻打襄阳归来，夏季驻扎在曹州地界。有一位蒙古百户名叫昔良海，因为食用酒肉和饮奶，患上霍乱吐泻。从早晨到中午，精神昏沉混乱，病情危急前来求我诊治。脉象浮数，按之无力，所伤之物已经排出。立即取半碗新汲水，调服桂苓白术散，慢慢服用，症状稍安。又在墙根背阴处挖一个坑，约二尺深，装入新汲水，在水中搅动，等待一时辰沉淀澄清，称为“地浆”。取上层清澈的一盏，再次调服，渐渐气息调和，吐泻停止。到了夜晚安然入睡。第二天略有燥渴，随即让钱氏白术散频频服用，痊愈。有人问使用地浆的原因是什么？我说：坤卦代表地，地属于阴土，平时安静顺从，感受至极阴之气，又在墙阴处，装入新汲水，是取重阴之气。阴中之阴，能清泻阳中之阳。如今霍乱因暑热内伤所致，所以《痹论》说：“阴气者，静则神藏，躁则消亡。”再加上暑热，七神迷乱，非至极阴之气不能治愈。我使用它就是这个原因。有人说：《内经》是福泽世人的经典书籍，难道不是这样吗？
【桂苓白术散】治疗冒受暑邪、饮食所伤，湿热内盛，霍乱吐泻，转筋急痛，腹部胀闷，小儿吐泻惊风适宜服用。
茯苓（去皮）、白术、桂枝（各半两）、甘草、泽泻、石膏（各一两）、滑石（二两）、寒水石（一两）。
以上八味药研为末，用热开水调下三钱。喜欢冷服的，用新汲水调姜汤也可以。小儿服用一钱。
【桂苓甘露饮】流动湿气，润燥，治疗痰涎，止咳嗽，调理脏腑，寒热呕吐服用后，使人全身气机宣通平和。也治疗水肿泄利。
官桂、藿香、人参（各半两）、木香（一分）、茯苓、白术、甘草、泽泻、葛根、石膏、寒水石（各一两）、滑石（二两）。
以上十二味药研为末，每次服用二钱，用白开水调下。用新汲水或姜汤调服也可以。
【宣明益元散】又名天水散。
滑石（六两）、炙甘草（一两）。
以上研为末，每次服用三钱，加少许蜂蜜，用温水调下，每日三次。用新汲水也可以。想要解肌发汗的，煎葱白豆豉汤调服，不拘时间。
Ti Xue Shi Qi Gong, aged seventy-nine. In the fourth day of the sixth month of Bingyin year of Zhiyuan era, he suffered from heatstroke toxin, presenting with Huoluan (cholera-like syndrome characterized by vomiting and diarrhea), coma throughout the day, and loss of consciousness. It was midnight when I was invited to treat him. His pulse was surging and forceful, beating seven or eight times per breath. His head was hot as fire, his feet cold as ice, he had hemiplegia, and his jaw was clenched. I reflected on the statement in the "Wu Luan" chapter of the *Neijing* (Classic of Internal Medicine): "Clear qi resides in Yin, turbid qi in Yang; Ying qi flows smoothly along the vessels, while Mao qi moves in reverse. Chaos in the chest..." and "Chaos in the intestines and stomach results in Huoluan." Thus, the name Huoluan originated from this. It is likely due to his advanced age and weak Qi, unable to withstand the summer heat. When Yang fails to secure Yin, diarrhea occurs; when Yin fails to secure Yang, vomiting occurs. When Yin and Yang fail to support each other, both vomiting and diarrhea ensue. Previous sages often used Lizhong Wan for cold syndromes and Wuling San for heat syndromes as standard treatments. However, given the extreme prevalence of summer heat, the dominance of the Yangming phase, and the fact that it was contracted through exertion, this is clearly a case of Zhongshu (heatstroke). Only a formula of sweet, acrid, and great cold nature can clear the summer heat, suppress the floating flame of fire, and calm the Shen (Spirit). Therefore, I used Ganlu San (Sweet Dew Powder), which is sweet, acrid, and greatly cold, to drain heat and tonify Qi. I added Bai Fuling (Poria) to differentiate Yin and Yang. The dosage was approximately one liang. It was mixed with ice water and administered gradually. He slowly regained consciousness, and all symptoms disappeared. Later, he exercised caution in speech and diet. After three days, he took modified Shenzhu Tiaozhong Tang (Ginseng and Atractylodes Decoction to Regulate the Middle) to regulate Zheng Qi (Upright Qi). After ten days, he fully recovered.
In the spring of Wuwu year, upon returning from the siege of Xiangyang, I spent the summer in the Caozhou region. A Mongol commander named Xi Lianghai developed Huoluan vomiting and diarrhea after consuming alcohol, meat, and milk. From morning until noon, his spirit was confused and lethargic, and he sought my help in a critical state. His pulse was floating and rapid, but empty upon deep pressure. The ingested pathogenic matter had already been expelled. I immediately took half a bowl of fresh well water, mixed it with Guiling Baizhu San (Cassia, Poria, and Atractylodes Powder), and administered it slowly. His condition slightly improved. Then, I dug a pit about two chi deep in the shady corner of a wall, filled it with fresh well water, stirred it, and let it settle for one shi (two hours). This clarified water is called Dijiang (Earth Slurry). One cup of the clear supernatant was taken again, mixed and administered. Gradually, his breathing regulated, and vomiting and diarrhea ceased. He slept peacefully at night. The next day, he felt slightly dry and thirsty, so Qian's Baizhu San was administered frequently, leading to a good recovery. Someone asked why Earth Slurry was used. I replied: Kun represents the Earth, which belongs to Yin earth. Normally quiet and compliant, it absorbs the most Yin Qi. By storing fresh water in the shady wall, we extract the heavy Yin Qi. Yin within Yin can drain Yang within Yang. Since this Huoluan resulted from internal injury by summer heat, the *Bi Lun* states: "Yin Qi, when still, stores the Spirit; when restless, dissipates." With the addition of summer heat, the Seven Spirits become chaotic. Only the most Yin Qi can cure this. This is why I used it. Some said: The *Neijing* is a classic benefiting the world; is it not true?
[Guiling Baizhu San] Treats injuries from summer heat and food, where damp-heat accumulates internally causing Huoluan vomiting and diarrhea, muscle cramps and pain, abdominal fullness and oppression. Suitable for children with vomiting, diarrhea, and convulsive wind.
Fuling (Poria, peeled), Baizhu (Atractylodis Rhizoma), Gui (Cinnamon Twig), each half liang; Gancao (Licorice Root), Zexie (Alisma Rhizome), Shigao (Gypsum Fibrosum), each one liang; Huashi (Talcum), two liang; Hanshui Shi (Calcitum), one liang.
The above eight ingredients are powdered. Take three qian mixed with hot boiled water. If preferring cold intake, mixing with fresh well water and ginger decoction is also acceptable. Children take one qian.
[Guiling Ganlu Yin] Moves dampness, moistens dryness, treats phlegm-saliva, stops cough, regulates zang-fu organs. For cold-heat alternating patterns and vomiting. After taking it, Qi flows evenly throughout the body. Also treats edema and diarrhea.
Guigui (Cinnamon Bark), Huoxiang (Patchouli Herb), Renshen (Ginseng Radix et Rhizoma), each half liang; Muxiang (Aucklandiae Radix), one fen; Fuling (Poria), Baizhu (Atractylodis Rhizoma), Gancao (Licorice Root), Zexie (Alisma Rhizome); Gegen (Puerariae Lobatae Radix), Shigao (Gypsum Fibrosum), Hanshui Shi (Calcitum), each one liang; Huashi (Talcum), two liang.
The above twelve ingredients are powdered. Take two qian each time, mixed with white boiled water. Fresh well water or ginger decoction may also be used.
[Xuanming Yiyuan San] Also known as Tianshui San.
Huashi (Talcum), six liang; Zhigancao (Honey-fried Licorice Root), one liang.
Powdered. Take three qian each time, mixed with a small amount of honey and warm water, three times daily. Fresh well water is also acceptable. To release the muscle layer and induce sweating, mix with scallion white and fermented soybean decoction, at any time.
[Appendix Shenghui Fang] Treats Huoluan vomiting and diarrhea.
Houpo (Magnolia Bark), processed with ginger juice.
Powdered. Take two qian mixed with fresh well water, at any time. Effectively miraculous.