呕吐而利名霍乱。四肢逆冷成斯患。寒多不渴理中汤。热多而渴五苓散。暑月忽
然心
撮痛。两脚转筋多冷汗。上吐下利并燥烦。水浸香藿吞数盏。霍乱者。谓挥霍乱也。外有所
感。内有所伤。阴阳争膈。邪正交争。故上吐下泻。而腹中痛也。邪在上焦。则吐。邪在下
焦。则泻。邪在中焦。则吐泻交作。此湿霍乱。症轻易治。若上不能吐。下不能泻。则邪不能
出。壅塞正气。关格阴阳。此干霍乱。俗名绞肠痧。其死甚速。切勿与谷食。即米汤下咽亦
死。然霍乱主治。亦有不同。如热多口渴而吐利者。五苓散主之。寒多不渴而吐利者。理中
汤主之。若挟中湿而吐利者。藿香正气散主之。若挟中暑而吐利者。三物香薷饮主之。大抵
霍乱有挟外感者。有挟内伤者。主治最难分别。古方通用盐熬热童便调饮。极为得治。近时
通用阴阳水最为稳当。服之有神工。
藿香正风用紫苏。大腹陈皮桔梗咀。甘草云苓半夏曲。浓朴白芷枣姜投。香薷饮内药四
般。浓朴相参扁豆攒。加上黄连为绝妙。和中祛暑颇能安。
往来寒热斗阴阳。大小柴胡及桂姜。热结心烦仍喜呕。渴而头汗用之良。
寒热往来者。阴阳相胜。邪正相争而作也。盖寒为阴。热为阳。里为阴。表为阳。邪客
于半
表半里。阴出与阳争。阴胜则寒。阳出与阴争。阳胜则热。阳不足则先寒。阴不足则先热。
是以寒热往来而无定时也。然寒热往来亦有不同。有因热结在里。而寒热往来者。宜大柴胡
汤主之。有因汗吐下后。不呕而渴。但头微汗而寒热往来者。宜柴胡桂姜汤主之。
呕吐且伴有腹泻，称为霍乱。四肢厥冷是此病的特征。寒邪偏盛且不口渴者，用理中汤治疗；热邪偏盛且口渴者，用五苓散治疗。暑月突然发生心窝部拘急疼痛，双脚转筋并出冷汗，上吐下泻并伴烦躁不安，可用冷水浸泡过的藿香吞服数杯。所谓霍乱，是指发病急骤、挥霍缭乱。外有感受邪气，内有饮食损伤，导致阴阳之气争结阻隔，邪气与正气交争，所以上吐下泻，腹部疼痛。邪气在上焦，则表现为呕吐；邪气在下焦，则表现为腹泻；邪气在中焦，则吐泻同时发作。这是湿霍乱，症状较轻，容易治疗。如果上不能吐，下不能泻，那么邪气无法排出，壅塞阻滞正气，导致关格（阴阳隔绝不通），这是干霍乱，俗称绞肠痧，死亡速度极快。切勿给予谷物食物，即使是米汤咽下也会导致死亡。然而霍乱的主治方法也有不同。如热多口渴而吐利的，用五苓散主治。寒多不渴而吐利的，用理中汤主治。若夹杂中焦湿邪而吐利的，用藿香正气散主治。若夹杂中暑而吐利的，用三物香薷饮主治。大抵霍乱有兼夹外感邪气的，有兼夹内伤饮食的，主治最难分辨。古方通用盐炒热的童便调服饮用，极为得当。近时通用阴阳水最为稳妥，服用后效果神奇。
藿香正气散使用紫苏叶，加上大腹皮、陈皮、桔梗切碎。甘草、云茯苓、半夏曲、厚朴、白芷，投以红枣和生姜。香薷饮内的药物有四味：厚朴与人参、扁豆相配。加上黄连则为绝妙，能和中祛暑，颇为安稳。
寒热往来是斗争阴阳的表现，可用小柴胡汤或柴胡桂枝干姜汤。若热结在里心烦仍喜欢呕吐，口渴且只有头部出汗，使用这些方剂疗效良好。
寒热往来的病症，是阴阳相互胜负，邪气与正气相争而产生的。大概寒属于阴，热属于阳；里属于阴，表属于阳。邪气客居在半表半里之间，阴气外出与阳气相争，阴胜则发冷；阳气外出与阴气相争，阳胜则发热。阳气不足则先出现恶寒，阴气不足则先出现发热。因此寒热往来而没有固定时间。然而寒热往来也有不同情况。有因热结在里，而出现寒热往来的，宜用大柴胡汤主治。有因经过汗法、吐法、下法治疗后，不呕吐但口渴，仅头部微汗且寒热往来的，宜用柴胡桂枝干姜汤主治。
Vomiting accompanied by diarrhea is named Huoluan (Huo Luan, Cholera-like syndrome). Cold limbs becoming cold constitute this affliction. For cases with excess cold and no thirst, Lizhong Tang (Regulate the Middle Decoction) is indicated. For cases with excess heat and thirst, Wuling San (Five-Ingredient Powder with Poria) is indicated. In the summer months, sudden cramping pain in the heart region, twisting of the tendons in both legs, profuse cold sweat, simultaneous vomiting and diarrhea, and dryness with irritability are treated by swallowing several cups of Agastache Herba (Huoxiang, 藿香) soaked in water. Huoluan refers to a sudden onset and chaotic disorder. External pathogenic factors are contracted, and internal damage occurs from diet. Yin and Yang contend and obstruct each other; pathogens and healthy Qi struggle. Thus, there is upper vomiting and lower diarrhea, along with abdominal pain. If the pathogen is in the Upper Jiao (Upper Burner), vomiting occurs. If the pathogen is in the Lower Jiao (Lower Burner), diarrhea occurs. If the pathogen is in the Middle Jiao (Middle Burner), vomiting and diarrhea occur simultaneously. This is Shi Huoluan (Damp Huoluan), which presents with mild symptoms and is easy to treat. If one cannot vomit above nor defecate below, the pathogen cannot exit, blocking and stagnating Healthy Qi, leading to Guan Ge (Guan Ge Syndrome, Obstruction and Repletion where Yin and Yang are isolated). This is Gan Huoluan (Dry Huoluan), commonly known as Jiaochang Sha (Intestinal Colic Sha), which leads to rapid death. Do not give grain food; even swallowing rice soup will cause death. However, the main treatment for Huoluan varies. For those with excess heat, thirst, vomiting, and diarrhea, Wuling San is indicated. For those with excess cold, no thirst, vomiting, and diarrhea, Lizhong Tang is indicated. For those complicated by dampness in the middle causing vomiting and diarrhea, Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi) is indicated. For those complicated by summerheat causing vomiting and diarrhea, Sanwu Xiangru Yin (Three-Ingredient Xiangru Decoction) is indicated. Generally, Huoluan may be complicated by external contraction or internal injury; distinguishing the main treatment is difficult. Ancient formulas generally used salt-fried Tongbian (Child's Urine) mixed and drunk, which was very appropriate. Recent times generally use Yinyang Shui (Yin-Yang Water), which is most stable and effective.
Huoxiang Zhengqi San uses Zisu Ye (Perilla Leaf), Dafupi (Areca Peel), Chenpi (Aged Tangerine Peel), and Jiegeng (Platycodon Root) cut into pieces. Gancao (Licorice Root), Yunling (Poria), Banxia Qu (Pinellia Fermented Paste), Houpo (Magnolia Bark), Baizhi (Angelica Dahurica Root), combined with Zao (Jujube) and Jiang (Ginger). The ingredients of Xiangru Yin include four herbs: Houpo combined with Renshen (Ginseng) and Bian Dou (Lablab Bean). Adding Huanglian (Coptis Rhizome) makes it excellent, harmonizing the middle and dispelling summerheat, providing considerable peace.
Alternating chills and fever represent the struggle of Yin and Yang; Xiao Chaihu Tang (Minor Bupleurum Decoction) or Chaihu Guizhi Ganjiang Tang (Bupleurum, Cinnamon Twig, and Ginger Decoction) are used. If heat is knotted in the interior causing irritability and still desiring to vomit, and there is thirst with only head sweating, these formulas are beneficial.
The condition of alternating chills and fever arises from Yin and Yang competing and the struggle between pathogens and Healthy Qi. Chills belong to Yin, fever belongs to Yang; Interior belongs to Yin, Exterior belongs to Yang. When pathogens lodge in the Half-Exterior Half-Interior (Shaoyang stage), Yin exits to contend with Yang; when Yin prevails, chills occur. Yang exits to contend with Yin; when Yang prevails, fever occurs. If Yang is insufficient, chills appear first; if Yin is insufficient, fever appears first. Therefore, chills and fever alternate without fixed timing. However, alternating chills and fever also differ. There are cases due to heat knotting in the interior causing alternating chills and fever, for which Da Chaihu Tang (Major Bupleurum Decoction) is indicated. There are cases after sweating, vomiting, or purging treatments, where there is no vomiting but thirst, only slight head sweating, and alternating chills and fever, for which Chaihu Guizhi Ganjiang Tang is indicated.