论曰四肢为诸阳之本，阳气之所通也，霍乱吐利，阳气曝厥，故四肢逆冷而脉微欲绝也
。古法治四逆，专于通脉，盖营卫流行，气道升降，则手足自和，逆者顺矣。
治霍乱多寒，手足厥冷，脉绝。四逆茱萸汤方
吴茱萸（洗炒四两） 当归（切焙） 桂（去粗皮） 芍药（各三两） 细辛（去苗叶）
木通（锉） 甘草（炙各
上七味，粗捣筛，每服五钱匕。生姜一枣大拍碎，枣三枚劈破，水一盏，酒半盏，煎至
八分，去滓温服。
治霍乱呕逆，四肢厥冷，烦闷流汗，饮食不化，心腹虚满，拘急短气。理中汤方
麦门冬（去心焙六两） 人参 白术（各五两） 干姜（炮六两） 甘草（炙五两） 附
子（炮裂去皮脐）
上七味。锉如麻豆，每服三钱匕，水一盏，煎至五分，去滓温服。
治霍乱四逆吐下，烦呕转筋，肉冷汗出，体痹气急垂死，音声不出，脉不通者。附子汤
方
附子（炮裂去皮脐） 人参 浓朴（去粗皮生姜汁涂炙干） 白茯苓（去黑皮） 甘草
（炙） 陈橘皮（去
上一十味。锉如麻豆，每服五钱匕，水一盏半，煎至八分，去滓温服，随药吐者，更服
勿止。
治霍乱脉微欲绝，或恶寒四肢拘急，手足厥逆，或吐利已定，汗出而厥，四逆不解。通
脉四逆汤方
甘草（炙二两） 附子（炮裂去皮脐二枚） 干姜（炮三两）
上三味。锉如麻豆，每服五钱匕，水一盏半，煎至八分，去滓温服，脉出即愈，面色赤
者，加葱白二茎同煎，腹痛去葱白，加芍药二两，呕加生姜一分切同煎，咽痛去芍药，加桔
梗并人参二两，以吐利止为度。
治霍乱吐利，手足逆冷。龙骨汤方
龙骨（白者碎） 附子（炮裂去皮脐各一两） 干姜（炮） 甘草（炙） 人参（各一
两半）
上五味。锉如麻豆，每服三钱匕，水一盏，煎至七分，去滓温服。
治霍乱吐利已定，汗出厥冷，四肢拘急，腹中痛不解，脉欲绝。桔梗汤方
桔梗（锉炒一两） 甘草（炙） 附子（炮裂去皮脐各二两） 干姜（炮一两）
上四味。锉如麻豆，每服三钱匕，水一盏，煎至七分，去滓温服。
治霍乱吐下，虚冷厥逆。干姜汤方
干姜（炮） 甘草（炙） 人参（各二两） 附子（炮裂去皮脐一枚）
上四味。 咀，如麻豆，每服六钱匕，水二盏，煎至一盏，去滓温服，下甚者，加龙骨
捣研二两，腹痛不止，加当归二两切焙。
论述说：四肢是诸阳经的根本，也是阳气通行的部位。霍乱引起的呕吐和腹泻，导致阳气暴脱厥逆，所以出现四肢冰冷且脉搏微弱几乎摸不到的症状。古代治疗四逆证，专门注重通脉，因为营气和卫气流行顺畅，气道升降正常，那么手足自然调和，逆乱的状态就会转为顺常。
治疗霍乱多寒症，手足厥冷，脉搏断绝的方剂：四逆茱萸汤方
吴茱萸（洗净炒制四两） 当归（切后焙干） 桂枝（去除粗皮） 芍药（各三两） 细辛（去根叶）
木通（切碎） 甘草（炙制，各...[原文此处似有缺字或排版错误，通常指上述药材]）
以上七味药，捣碎过筛，每次服用五钱匕。生姜一块如枣大拍碎，大枣三枚劈破，用水一盏、酒半盏，煎煮至八分满，滤去药渣，温服。
治疗霍乱呕吐逆气，四肢厥冷，烦闷流汗，饮食不消化，心腹部虚胀，拘挛急迫短气的方剂：理中汤方
麦门冬（去心焙干六两） 人参 白术（各五两） 干姜（炮制六两） 甘草（炙制五两） 附子（炮裂去皮脐）
以上七味药。切碎如麻豆大小，每次服用三钱匕，用水一盏，煎煮至五分满，滤去药渣，温服。
治疗霍乱四肢厥逆、呕吐下利，烦躁呕吐、转筋，肌肉冷汗出，身体麻木气急濒临死亡，声音发不出，脉搏不通畅的方剂：附子汤方
附子（炮裂去皮脐） 人参 浓朴（去除粗皮，用生姜汁涂后炙干） 白茯苓（去黑皮） 甘草（炙制） 陈橘皮（去...[原文此处似有缺字]）
以上十味药。切碎如麻豆大小，每次服用五钱匕，用水一盏半，煎煮至八分满，滤去药渣，温服。如果服药后呕吐，继续服用不要停止。
治疗霍乱脉搏微弱几乎摸不到，或者恶寒四肢拘挛急迫，手足厥逆，或者吐泻已止但出汗而厥冷，四逆症状未解的方剂：通脉四逆汤方
甘草（炙制二两） 附子（炮裂去皮脐二枚） 干姜（炮制三两）
以上三味药。切碎如麻豆大小，每次服用五钱匕，用水一盏半，煎煮至八分满，滤去药渣，温服。脉搏恢复即痊愈。如果面色发红，加葱白两根同煎；如果腹痛，去掉葱白，加芍药二两；如果呕吐，加生姜一分切碎同煎；如果咽痛，去掉芍药，加桔梗并人参二两。以吐泻停止为度。
治疗霍乱吐泻，手足逆冷的方剂：龙骨汤方
龙骨（白色的打碎） 附子（炮裂去皮脐各一两） 干姜（炮制） 甘草（炙制） 人参（各一两半）
以上五味药。切碎如麻豆大小，每次服用三钱匕，用水一盏，煎煮至七分满，滤去药渣，温服。
治疗霍乱吐泻已止，出汗厥冷，四肢拘挛急迫，腹中疼痛不解，脉搏欲绝的方剂：桔梗汤方
桔梗（切碎炒制一两） 甘草（炙制） 附子（炮裂去皮脐各二两） 干姜（炮制一两）
以上四味药。切碎如麻豆大小，每次服用三钱匕，用水一盏，煎煮至七分满，滤去药渣，温服。
治疗霍乱吐泻，虚冷厥逆的方剂：干姜汤方
干姜（炮制） 甘草（炙制） 人参（各二两） 附子（炮裂去皮脐一枚）
以上四味药。切碎如麻豆大小，每次服用六钱匕，用水二盏，煎煮至一盏，滤去药渣，温服。如果下利严重，加龙骨捣研二两；如果腹痛不止，加当归二两切后焙干。
Commentary states: The four limbs are the root of all Yang meridians and the pathways through which Yang Qi circulates. In cholera with vomiting and diarrhea, Yang Qi is suddenly depleted and rebels, resulting in cold extremities and a faint pulse nearly imperceptible. Ancient methods for treating Si Ni (Four Coldness) focused specifically on unblocking the pulse. When Ying (Nutritive) and Wei (Defensive) Qi circulate freely, and the Qi mechanism ascends and descends normally, the hands and feet naturally harmonize, and rebellion transforms into compliance.
Formula for treating cholera with excessive cold, cold extremities, and absent pulse: Sini Zhuyu Tang (Four Reversal Evodia Decoction)
Evodiae Fructus (Wu Zhu Yu, 吴茱萸) (washed and stir-fried, 4 liang)
Angelicae Radix Sinensis (Dang Gui, 当归) (sliced and dried)
Cinnamomi Ramulus (Gui Zhi, 桂枝) (coarse bark removed)
Paeoniae Radix Alba (Bai Shao, 芍药) (each 3 liang)
Asari Radix et Rhizoma (Xi Xin, 细辛) (roots and leaves removed)
Akebiae Caulis (Mu Tong, 木通) (chopped)
Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao, 炙甘草) (roasted)... [text implies these ingredients]
The above seven herbs are coarsely crushed and sifted. Each dose consists of 5 qian bi (approx. 15-20g). Crush ginger the size of a jujube, split three jujubes. Add one sheng of water and half a sheng of wine, decoct until reduced to 8/10 volume, strain, and take warm.
Formula for treating cholera with vomiting and rebellious Qi, cold extremities, restlessness with sweating, indigestion, empty fullness in the heart and abdomen, spasms, shortness of breath: Lizhong Tang (Regulate the Middle Decoction)
Ophiopogonis Radix (Mai Men Dong, 麦门冬) (heart removed, dried, 6 liang)
Ginseng Radix (Ren Shen, 人参)
Atractylodis Macrocephalae Rhizoma (Bai Zhu, 白术) (each 5 liang)
Zingiberis Rhizoma Recens (Sheng Jiang, 生姜 - *Note: Text says Gan Jiang Dry Ginger below but lists Sheng Jiang here? Context implies Gan Jiang based on formula name usually, but text says 'Gan Jiang' later. Wait, text says 'Gan Jiang (pao 6 liang)' in the list below. Let's re-read carefully.* Text: "Gan Jiang (pao 6 liang)". Okay.)
*Correction*: Zingiberis Rhizoma (Gan Jiang, 干姜) (processed, 6 liang)
Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao, 炙甘草) (roasted, 5 liang)
Aconiti Lateralis Radix Praeparata (Fu Zi, 附子) (processed, cracked, skin and umbilicus removed)
The above seven herbs are chopped like hemp seeds. Each dose is 3 qian bi. Add one sheng of water, decoct to 5/10 volume, strain, and take warm.
Formula for treating cholera with Si Ni, vomiting and purging, restlessness, vomiting, muscle cramps, cold sweat from muscles, body numbness,急促 breathing nearing death, inability to speak, and unobstructed pulse: Fuzi Tang (Aconite Decoction)
Aconiti Lateralis Radix Praeparata (Fu Zi, 附子) (processed, cracked, skin and umbilicus removed)
Ginseng Radix (Ren Shen, 人参)
Magnoliae Officinalis Cortex (Hou Po, 厚朴) (coarse bark removed, coated with fresh ginger juice, roasted dry)
Poria (Fu Ling, 茯苓) (black skin removed)
Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao, 炙甘草) (roasted)
Citri Reticulatae Pericarpium (Chen Pi, 陈皮) (removed... [text incomplete])
The above ten herbs are chopped like hemp seeds. Each dose is 5 qian bi. Add one and a half sheng of water, decoct to 8/10 volume, strain, and take warm. If vomiting occurs after taking the medicine, continue administering without stopping.
Formula for treating cholera with a faint, nearly imperceptible pulse, or aversion to cold with spasmodic stiffness of the four limbs and cold extremities, or after vomiting and purging have ceased but sweating and coldness persist with unresolved Si Ni: Tongmai Sini Tang (Unblock the Pulse Four Reversal Decoction)
Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao, 炙甘草) (roasted, 2 liang)
Aconiti Lateralis Radix Praeparata (Fu Zi, 附子) (processed, cracked, skin and umbilicus removed, 2 pieces)
Zingiberis Rhizoma (Gan Jiang, 干姜) (processed, 3 liang)
The above three herbs are chopped like hemp seeds. Each dose is 5 qian bi. Add one and a half sheng of water, decoct to 8/10 volume, strain, and take warm. Recovery occurs when the pulse emerges. If the face is red, add two stems of Scallion White (Cong Bai, 葱白) and decoct together. If abdominal pain, remove Cong Bai and add Paeoniae Radix (Bai Shao, 芍药) 2 liang. If vomiting, add 1 fen of Fresh Ginger (Sheng Jiang, 生姜) sliced and decoct together. If throat pain, remove Bai Shao and add Platycodonis Radix (Jie Geng, 桔梗) and Ginseng Radix (Ren Shen, 人参) 2 liang. Continue until vomiting and purging cease.
Formula for treating cholera with vomiting and purging, and cold extremities: Longgu Tang (Dragon Bone Decoction)
Os Draconis et Mastodi (Long Gu, 龙骨) (white ones, crushed)
Aconiti Lateralis Radix Praeparata (Fu Zi, 附子) (processed, cracked, skin and umbilicus removed, each 1 liang)
Zingiberis Rhizoma (Gan Jiang, 干姜) (processed)
Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao, 炙甘草) (roasted)
Ginseng Radix (Ren Shen, 人参) (each 1.5 liang)
The above five herbs are chopped like hemp seeds. Each dose is 3 qian bi. Add one sheng of water, decoct to 7/10 volume, strain, and take warm.
Formula for treating cholera where vomiting and purging have ceased, but sweating and coldness persist, with spasmodic stiffness of the four limbs, unrelenting abdominal pain, and a pulse about to vanish: Jiegeng Tang (Platycodon Decoction)
Platycodonis Radix (Jie Geng, 桔梗) (chopped and stir-fried, 1 liang)
Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao, 炙甘草) (roasted)
Aconiti Lateralis Radix Praeparata (Fu Zi, 附子) (processed, cracked, skin and umbilicus removed, each 2 liang)
Zingiberis Rhizoma (Gan Jiang, 干姜) (processed, 1 liang)
The above four herbs are chopped like hemp seeds. Each dose is 3 qian bi. Add one sheng of water, decoct to 7/10 volume, strain, and take warm.
Formula for treating cholera with vomiting and purging, deficiency-cold, and cold extremities: Ganjiang Tang (Dry Ginger Decoction)
Zingiberis Rhizoma (Gan Jiang, 干姜) (processed)
Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao, 炙甘草) (roasted)
Ginseng Radix (Ren Shen, 人参) (each 2 liang)
Aconiti Lateralis Radix Praeparata (Fu Zi, 附子) (processed, cracked, skin and umbilicus removed, 1 piece)
The above four herbs are chopped like hemp seeds. Each dose is 6 qian bi. Add two sheng of water, decoct to one sheng, strain, and take warm. For severe purging, add Os Draconis et Mastodi (Long Gu, 龙骨) 2 liang, pounded and ground. For unrelenting abdominal pain, add Angelicae Radix Sinensis (Dang Gui, 当归) 2 liang, sliced and dried.