腹满时痛吐利不渴者太阴病（论见腹满活人云理中汤主之）病患脉阴阳俱紧反汗出者亡阳也此属少阴法当咽痛而复
吐利（桂枝干姜汤）少阴病吐利手足厥冷烦躁欲死者吴茱萸汤主之少阴病吐利手足不逆冷反发热者不死脉不至者灸少阴
七壮（庞云在内踝后跟骨上动脉陷中发热谓其身发热也余按少阴之络非特一穴今曰少阴而不指某穴者针法当随四时随运
气以取井荣俞经合不可执泥也庞氏定以为太溪恐非仲景本旨）少阴病吐利烦躁四逆者死少阴病下利咳而呕渴心烦不得眠
者猪苓汤主之（论见下利）少阴病腹痛小便不利四肢重痛自下利或呕者真武去附子加生姜汤（论见下利）少阴病下利脉
微涩呕而汗出者当温其上灸之（论见欲寐温其上谓下有寒气当温其上以助阳气也）既吐且利小便复利而大汗出下利清谷
内寒外热脉微欲绝者四逆汤主之（王叔和入霍乱篇）
太阳与少阳合病头痛胁痛往来寒热自利而呕者黄芩加半夏生姜汤（论见合病）发热汗出不解心中痞硬呕吐下利者宜
大柴胡汤（论见痞）发汗后水浆不得入口者为逆若更发汗必吐下不止呕吐而利者名曰霍乱病发热头痛身疼恶寒吐利者此
名霍乱自吐下又利止复更发热也霍乱头疼发热身疼痛热多饮水者五苓散主之寒多不饮水者宜理中汤
理中汤方
人参 干姜（炮） 甘草（灸各一两） 白术（二两）上锉每服四钱水煎去滓温服如寒甚者加干姜一两半渴欲得水
者加白术一两半脐上筑筑者肾气动也去白术加桂枝二两吐多者去白术加生姜四两下利多者倍用白术悸者加茯苓二两腹
满去白术加附子一枚服汤后如食顷者饮热粥一升许自温勿发揭衣被（活人云或四肢拘急或转筋者亦去术加附子）
吐利汗出发热恶寒四肢拘急手足厥冷者四逆汤主之吐利止而身痛不休者当消息和解其外宜桂枝汤恶寒脉微利止者
四逆加人参汤（方论见恶寒）
吐已下断汗出而厥四肢拘急不解脉微欲绝者通脉四逆汤加猪胆汁主之
甘草（炙二两） 干姜（三两） 附子（大者一枚去皮破八片） 猪胆汁（半合）上三味 咀水三盏煎至二盏去滓
纳猪胆汁分作二次温服其脉即来
吐利发汗脉平不烦者以新虚不胜谷气故也干呕而利兼胁痛而表解者宜十枣汤心下痞硬而烦者宜甘草泻心汤兼厥逆
脉微者通脉四逆汤白通加猪胆汁汤（详见前干呕门）
诊 脉阴阳俱紧至于吐利其脉独不解紧人惟安静者是为欲解若脉迟至六七日不欲食此为晚发水停故也此为未解
食自可者为欲解
霍乱证治已详杂病门中兹不赘
腹部胀满，时而疼痛，呕吐腹泻，口不渴的，属于太阴病（相关论述见“腹满”篇，《活人书》认为用理中汤主治）。患者脉象寸关尺三部都紧，反而出汗的，这是亡阳证，这属于少阴病，按照法度应当出现咽喉疼痛并且又呕吐腹泻的症状（用桂枝干姜汤）。少阴病出现呕吐腹泻，手足冰冷，烦躁得快要死去的，用吴茱萸汤主治。少阴病出现呕吐腹泻，手足不冰冷，反而发热的，不会死亡；如果脉搏摸不到，就灸少阴经穴位七壮（庞安时注解说：在内踝后方跟骨上方的动脉凹陷处发热，是指身体发热。我按：少阴的络脉不仅仅是一个穴位，现在说“少阴”而不指定某个穴位，是因为针刺方法应当随四季、随运气变化来选取井、荥、俞、经、合穴，不可拘泥固执。庞氏将其定为太溪穴，恐怕不符合张仲景的本意）。少阴病出现呕吐腹泻，烦躁，四肢逆冷的，是死证。少阴病出现下利，咳嗽，呕吐，口渴，心烦，不能入睡的，用猪苓汤主治（相关论述见“下利”篇）。少阴病出现腹痛，小便不利，四肢沉重疼痛，自行下利，或者呕吐的，用真武汤去掉附子加上生姜的方剂（相关论述见“下利”篇）。少阴病出现下利，脉象微而涩，呕吐而且出汗的，应当温补上部，进行艾灸（相关论述见“欲寐”篇。“温其上”是指下部有寒气，应当温补上部以助长阳气）。既呕吐又腹泻，小便反而通畅，大汗出，下利排出未消化的食物，内寒外热，脉象微弱几乎要断绝的，用四逆汤主治（王叔和将其归入霍乱篇）。
太阳病与少阳病合病，出现头痛，胁痛，往来寒热，自行下利且呕吐的，用黄芩加半夏生姜汤主治（相关论述见“合病”篇）。发热，出汗但病不解，心中痞塞坚硬，呕吐，下利的，适宜用大柴胡汤（相关论述见“痞”篇）。发汗后，水浆都无法入口的，属于逆证；如果再发汗，必定导致呕吐腹泻不止。呕吐而且腹泻的，名叫霍乱病。发热，头痛，身体疼痛，恶寒，呕吐腹泻的，这也名叫霍乱。如果是自己呕吐腹泻，后来腹泻停止却又再次发热的，也是霍乱。霍乱病，头疼，发热，身体疼痛，热多想要喝水的，用五苓散主治；寒多不想喝水的，适宜用理中汤。
理中汤方：人参、干姜（炮制）、甘草（炙，各一两）、白术（二两）。以上药物切碎，每次服用四钱，用水煎煮，去渣滓，温服。如果寒邪严重的，加干姜一两半；口渴想喝水的，加白术一两半；脐上跳动不安的，是肾气发动，去掉白术，加桂枝二两；呕吐多的，去掉白术，加生姜四两；下利多的，加倍使用白术；心悸的，加茯苓二两；腹部胀满的，去掉白术，加附子一枚。服药后大约像吃一顿饭的时间，喝热粥一升左右，保持身体温暖，不要掀开衣被（《活人书》说：如果出现四肢拘急或者转筋的，也去掉白术加附子）。
呕吐腹泻，出汗，发热，恶寒，四肢拘急，手足冰冷的，用四逆汤主治。呕吐腹泻停止但身体疼痛不休的，应当斟酌情况调和其表证，适宜用桂枝汤。恶寒，脉微，腹泻停止的，用四逆加人参汤（方论见“恶寒”篇）。
呕吐结束，腹泻停止，出汗且手脚冰冷，四肢拘急不缓解，脉象微弱几乎要断绝的，用通脉四逆汤加猪胆汁主治。甘草（炙二两）、干姜（三两）、附子（大者一枚，去皮，破成八片）、猪胆汁（半合）。以上三味药切碎，用水三盏，煎至两盏，去渣滓，纳入猪胆汁，分两次温服，脉象就会恢复。
呕吐腹泻后发汗，脉象平和，没有烦闷的，是因为新近体虚，不能承受谷气的缘故。干呕而且腹泻，兼有胁痛且表证已解的，适宜用十枣汤；心下痞塞坚硬而且烦闷的，适宜用甘草泻心汤；兼有四肢厥冷，脉象微弱的，用通脉四逆汤或白通加猪胆汁汤（详见前文“干呕”门）。
诊察：脉象寸关尺三部都紧，到了呕吐腹泻的时候，唯独脉象仍然紧而不解，只有人神志安静的，这才是将要解除。如果脉象迟，到了六七天，不想吃东西，这是晚发症，因为水饮停聚的缘故，这属于病未解除。如果饮食正常，则是将要解除。
Abdominal fullness, occasional pain, vomiting and diarrhea, with no thirst, constitutes Taiyin disease (for related discussions, see "Abdominal Fullness"; *Huoren Shu* states it is primarily treated with Lizhong Tang). If a patient's pulse is tight in all three positions (cun, guan, chi) yet there is spontaneous sweating, this indicates the loss of Yang. This belongs to Shaoyin disease; according to the principles, one should expect sore throat accompanied by vomiting and diarrhea (treated with Guizhi Ganjiang Tang). In Shaoyin disease, if there is vomiting and diarrhea, cold limbs, and severe irritability bordering on death, Wuzhuyu Tang is primarily indicated. In Shaoyin disease, if there is vomiting and diarrhea, but the limbs are not cold and instead there is fever, the prognosis is not fatal; if the pulse cannot be felt, moxibustion should be applied to the Shaoyin channel for seven moxa cones (Pang Anshi notes: "Fever at the depression of the arterial pulse behind the medial malleolus and above the calcaneus" refers to general body fever. I observe: The collaterals of Shaoyin are not limited to a single acupoint. The text mentions "Shaoyin" without specifying an acupoint because acupuncture methods should select Jing-River, Ying-Spring, Shu-Stream, Jing-Well, and He-Sea points according to the seasons and Qi dynamics, rather than being rigidly fixed. Pang's specification of Taixi (KI3) may not align with Zhang Zhongjing's original intent). In Shaoyin disease, if there is vomiting and diarrhea, irritability, and cold limbs extending to the extremities (Si Ni), it is a fatal condition. In Shaoyin disease, if there is diarrhea, cough, vomiting, thirst, mental restlessness, and inability to sleep, Zhu Ling Tang is primarily indicated (for related discussions, see "Diarrhea"). In Shaoyin disease, if there is abdominal pain, difficulty urinating, heaviness and pain in the four limbs, spontaneous diarrhea, or vomiting, Zhenwu Tang with Fuzi removed and Shengjiang added is used (for related discussions, see "Diarrhea"). In Shaoyin disease, if there is diarrhea, a faint and choppy pulse, vomiting, and sweating, the upper part should be warmed via moxibustion (for related discussions, see "Desire to Sleep". "Warming the upper part" implies that cold qi exists below, so warming the upper part assists Yang Qi). If both vomiting and diarrhea occur, followed by free urination, profuse sweating, diarrhea with undigested food, internal cold with external heat, and a pulse that is faint and nearly absent, Sini Tang is primarily indicated (Wang Shuhe included this in the Huoluan chapter).
When Taiyang and Shaoyang diseases combine, symptoms include headache, hypochondriac pain, alternating chills and fever, spontaneous diarrhea, and vomiting; Huangqin Jia Banxia Shengjiang Tang is primarily indicated (for related discussions, see "Combined Diseases"). If there is fever, sweating, unresolved exterior syndrome, epigastric stuffiness and hardness, vomiting, and diarrhea, Dahuang Tang is appropriate (for related discussions, see "Stagnation"). After sweating therapy, if neither water nor grain can be taken, this is a adverse reaction (Ni); if sweating is induced again, vomiting and diarrhea will certainly become incessant. Vomiting accompanied by diarrhea is named Huoluan disease. Fever, headache, body ache, aversion to cold, vomiting, and diarrhea also constitute Huoluan. If one vomits and has diarrhea, and after the diarrhea stops, fever recurs, this is also Huoluan. In Huoluan, if there is headache, fever, body ache, and a predominance of heat with desire for water, Wuling San is primarily indicated; if there is a predominance of cold with no desire for water, Lizhong Tang is appropriate.
Lizhong Tang Formula: Renshen (Ginseng Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma, processed), Gancao (Licorice Root, honey-fried, each 1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 2 liang). The above herbs are coarsely crushed. Take 4 qian per dose, decoct in water, remove dregs, and take warm. If cold is severe, add 1.5 liang of Ganjiang. If thirsty and desiring water, add 1.5 liang of Baizhu. If there is palpitation/throbbing above the navel, indicating Kidney Qi movement, remove Baizhu and add 2 liang of Guizhi. If vomiting is frequent, remove Baizhu and add 4 liang of Shengjiang. If diarrhea is frequent, double the amount of Baizhu. If palpitations occur, add 2 liang of Fuling. If abdominal fullness occurs, remove Baizhu and add one Fuzi. About the time of a meal after taking the decoction, drink about 1 sheng of hot porridge to maintain warmth; do not expose the body to cold (*Huoren Shu* adds: if there is limb contracture or muscle twitching/cramping, also remove Baizhu and add Fuzi).
In cases of vomiting and diarrhea with sweating, fever, aversion to cold, limb contracture, and cold hands and feet, Sini Tang is primarily indicated. If vomiting and diarrhea stop but body pain persists, the exterior should be harmonized cautiously; Guizhi Tang is appropriate. If there is aversion to cold, a faint pulse, and cessation of diarrhea, Sini Jia Renshen Tang is used (formula discussion see "Aversion to Cold").
If vomiting ceases and diarrhea stops, but there is sweating, cold limbs, unrelieved limb contracture, and a pulse that is faint and nearly absent, Tongmai Sini Tang with Zhu Danzhi (Porcine Bile) is primarily indicated. Gancao (honey-fried, 2 liang), Ganjiang (3 liang), Fuzi (one large piece, peeled and broken into eight pieces), Zhu Danzhi (0.5 he). The first three ingredients are coarsely crushed, decocted in three cups of water until two cups remain, dregs removed, and Zhu Danzhi added. Divide into two doses and take warm; the pulse will then return.
After vomiting and diarrhea, if sweating leads to a normal pulse and absence of irritability, it is due to recent deficiency being unable to handle the energy from food. If there is dry heaving and diarrhea, accompanied by hypochondriac pain and resolved exterior syndrome, Shizao Tang is appropriate. If there is epigastric stuffiness, hardness, and irritability, Gancao Xiexin Tang is appropriate. If accompanied by cold limbs and a faint pulse, Tongmai Sini Tang or Baitong Jia Zhu Danzhi Tang is used (see previous section on "Dry Heaving").
Diagnosis: When the pulse is tight in all three positions, leading to vomiting and diarrhea, if the pulse remains tight and does not resolve, but the patient remains calm and quiet, this indicates the disease is resolving. If the pulse is slow, reaching six or seven days, with anorexia, this is a late-onset complication due to fluid retention, indicating the disease is unresolved. If appetite returns normally, it indicates resolution.
The syndrome differentiation and treatment of Huoluan have been detailed in the Miscellaneous Diseases section; thus, they are not repeated here.