382．问曰∶病有霍乱者何？答曰∶呕吐而利，此名霍乱。
383．问曰∶病发热、头痛、身疼、恶寒、吐利者，此属何病，答曰∶此名霍乱。霍乱自吐下，又利止，复
更发热也。
384．伤寒，其脉微涩者，本是霍乱，今是伤寒，却四五日，至阴经上，转入阴必利。本呕下利者，不可治
也；欲似大便，而反失气，仍不利者，此属阳明也，便必硬，十三日愈，所以然者，经尽故也。下利后，当便硬，
硬则能食者愈。今反不能食，到后经中，颇能食，复过一经能食，过之一日当愈；不愈者，不属阳明也。
385．恶寒、脉微而复利，利止，亡血也，四逆加人参汤主之。方一。
甘草（炙，二两） 附子（生，去皮，破八片，一枚） 干姜（一两半） 人参（一两）
上四味，以水三升，煮取一升二合，去滓，分温再服。
386．霍乱，头痛、发热、身疼痛、热多欲饮水者，五苓散主之；寒多不用水者，理中丸主之。方二。
五苓散方∶
猪苓（去皮） 白术 茯苓（各十八铢） 桂枝（去皮，半两） 泽泻（一两六铢）
上五味，为散，更治之，白饮和服方寸匕，日三服。多饮暖水，汗出愈。
理中丸方∶（下有作汤加减法。）
人参 干姜 甘草（炙） 白术（各三两）
上四味，捣筛，蜜和为丸，如鸡子黄许大。以沸汤数合，和一丸，研碎，温服之，日三四、夜二服；
腹中未热，益至三四丸，然不及汤。汤法∶以四物根据两数切，用水八升，煮取三升，去滓，温服一升，
日三服。若脐上筑者，肾气动也，去术加桂四两；吐多者，去术加生姜三两；下多者还用术；悸
者，加茯苓二两；渴欲得水者，加术，足前成四两半；腹中痛者，加人参，足前成四两半；寒者，加干
姜，足前成四两半；腹满者，去术，加附子一枚。服汤后，如食顷，饮热粥一升许，微自温，勿发揭衣被。
387．吐利止而身痛不休者，当消息和解其外，
宜桂枝汤小和之。方三。
桂枝（去皮，三两） 芍药（三两） 生姜（三两） 甘草（炙，二两） 大枣（擘，十二枚）
上五味，以水七升，煮取三升，去滓，温服一升。
388．吐利汗出，发热恶寒，四肢拘急，手足厥冷者，四逆汤主之。方四。
甘草（炙，二两） 干姜（一两半） 附子（生，去皮，破八片，一枚）
上三味，以水三升，煮取一升二合，去滓，分温再服。强人可大附子一枚、干姜三两。
389．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。方五。（用前第四方。）
390．吐已下断，汗出而厥，四肢拘急不解，脉微欲绝者，通脉四逆加猪胆汁汤主之。方六。
甘草（炙，二两） 干姜（三两，强人可四两） 附子（生，去皮，破八片，大者一枚） 猪胆汁（半合）
上四味，以水三升，煮取一升二合，去滓；内猪胆汁，分温再服，其脉即来。无猪胆，以羊胆代之。
391．吐、利、发汗，脉平，小烦者，以新虚不胜
谷气故也。
382．问：有一种病叫霍乱（以突发剧烈呕吐和腹泻为主要特征的病证），是怎么回事？答：呕吐并且腹泻，这就叫做霍乱。
383．问：病人出现发热、头痛、身体疼痛、怕冷、呕吐和腹泻的症状，这属于什么病？答：这也叫做霍乱。霍乱病本来就有自发性的呕吐和腹泻，如果腹泻停止后，又再次出现发热。
384．患伤寒病（外感寒邪所致的病证），脉象微细且涩滞的，原本是霍乱病，现在表现为伤寒，过了四五天，病邪传入阴经（三阴经），转入阴经必然会出现腹泻。如果原本就有呕吐和腹泻的症状，是不可以用攻下法治疗的；如果想解大便，反而只是排气，仍然没有腹泻，这属于阳明病（阳明经受邪或胃肠燥热实证），大便必然干硬，十三天就会痊愈，之所以这样，是因为病程经过了一个周期结束了。腹泻之后，大便应当变硬，大便变硬且能进食的，就会痊愈。现在反而不能进食，等到下一个病程周期中，稍微能进食了，再经过一个病程周期如果能进食，过一天就应当痊愈；如果不痊愈，就不属于阳明病。
385．怕冷、脉象微弱并且又出现腹泻，腹泻停止后，出现亡血（阴血耗伤）的情况，用四逆加人参汤主治。方一。
甘草（炙烤，二两） 附子（生用，去皮，破成八片，一枚） 干姜（一两半） 人参（一两）
以上四味药，用水三升，煮取一升二合，去掉药渣，分两次温服。
386．霍乱病，出现头痛、发热、身体疼痛，热象多且想喝水的，用五苓散主治；寒象多且不想喝水的，用理中丸主治。方二。
五苓散方：
猪苓（去皮） 白术 茯苓（各十八铢） 桂枝（去皮，半两） 泽泻（一两六铢）
以上五味药，制成散剂，再加工处理，用米汤调和一方寸匕服用，每天服三次。多喝热水，出汗后就会痊愈。
理中丸方：（下面有改为汤剂的加减方法。）
人参 干姜 甘草（炙烤） 白术（各三两）
以上四味药，捣碎过筛，用蜂蜜调和做成丸药，像鸡蛋黄那么大。用沸水几合，调和一丸，研碎，温服，白天服三到四次，晚上服两次；如果腹中没有热感，增加到三四丸，但效果不如汤剂。汤剂的方法：将四味药按照两数切制，用水八升，煮取三升，去掉药渣，温服一升，每天服三次。如果肚脐上方有跳动感，是肾气（肾脏之气）动，去掉白术加桂枝四两；呕吐多的，去掉白术加生姜三两；腹泻多的，仍然使用白术；心悸的，加茯苓二两；口渴想喝水的，加白术，补足前量共四两半；腹中疼痛的，加人参，补足前量共四两半；寒象重的，加干姜，补足前量共四两半；腹部胀满的，去掉白术，加附子一枚。服汤药后，大约吃一顿饭的时间，喝热粥一升左右，让身体微微温暖，不要揭开衣被受风。
387．呕吐和腹泻停止，但身体疼痛不止的，应当斟酌情况和解表邪，适宜用桂枝汤轻微调和。方三。
桂枝（去皮，三两） 芍药（三两） 生姜（三两） 甘草（炙烤，二两） 大枣（剖开，十二枚）
以上五味药，用水七升，煮取三升，去掉药渣，温服一升。
388．呕吐、腹泻、出汗，发热怕冷，四肢拘挛急迫，手脚冰冷的，用四逆汤主治。方四。
甘草（炙烤，二两） 干姜（一两半） 附子（生用，去皮，破成八片，一枚）
以上三味药，用水三升，煮取一升二合，去掉药渣，分两次温服。体质强壮的人可以用大附子一枚、干姜三两。
389．既呕吐又腹泻，小便反而通利且大汗出，腹泻物中有未消化的食物，内寒外热，脉象微弱几乎摸不到的，用四逆汤主治。方五。（使用前面的第四方。）
390．呕吐和腹泻已经停止，出汗且四肢厥冷，四肢拘挛急迫不缓解，脉象微弱几乎摸不到的，用通脉四逆加猪胆汁汤主治。方六。
甘草（炙烤，二两） 干姜（三两，体质强壮的人可用四两） 附子（生用，去皮，破成八片，大的一枚） 猪胆汁（半合）
以上四味药，用水三升，煮取一升二合，去掉药渣；加入猪胆汁，分两次温服，脉象就会恢复。如果没有猪胆，可以用羊胆代替。
382. Question: What is the disease known as Huoluan (Cholera-like disorder, characterized by sudden severe vomiting and diarrhea)? Answer: Vomiting accompanied by diarrhea is named Huoluan.
383. Question: If a patient presents with fever, headache, body pain, aversion to cold, vomiting, and diarrhea, what disease does this belong to? Answer: This is also named Huoluan. In Huoluan, vomiting and diarrhea occur spontaneously; if the diarrhea stops and fever recurs subsequently.
384. In Shanghan (Cold Damage, exogenous cold-induced disease), if the pulse is faint (Wei) and choppy (Se), it was originally Huoluan, but now manifests as Shanghan. After four or five days, the pathogen enters the Yin Meridians (Three Yin Meridians); transmission into Yin inevitably causes diarrhea. If there was pre-existing vomiting and diarrhea, purgative therapy must not be used. If the patient feels the urge to defecate but only passes flatus without diarrhea, this belongs to Yangming Disease (Yangming Meridian disease or gastrointestinal excess-heat syndrome). The stool will surely be hard, and recovery will occur in thirteen days. This is because the course of the meridian cycle has completed. After diarrhea, the stool should become hard; if the stool is hard and the patient can eat, they will recover. If the patient currently cannot eat, but during the subsequent meridian cycle can eat slightly, and continues to be able to eat after another meridian cycle passes, they should recover one day after that cycle. If they do not recover, it does not belong to Yangming Disease.
385. Aversion to cold, a faint pulse, and recurrent diarrhea; after the diarrhea stops, there is loss of blood (depletion of Yin-Blood). Sini Jia Renshen Tang (Sini Decoction plus Ginseng) governs this. Formula 1.
Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao, Honey-fried Licorice Root and Rhizome, 2 liang), Aconiti Lateralis Radix Praeparata (Sheng Fuzi, Raw Prepared Lateral Root of Aconite, peeled, broken into eight pieces, 1 piece), Zingiberis Rhizoma (Ganjiang, Dried Ginger Rhizome, 1.5 liang), Ginseng Radix et Rhizoma (Renshen, Ginseng Root and Rhizome, 1 liang).
Decoct the above four ingredients in 3 sheng of water to obtain 1 sheng and 2 ge. Remove the dregs and take warm in two divided doses.
386. In Huoluan, with headache, fever, and body pain: if heat signs predominate with desire to drink water, Wuling San (Five-Ingredient Powder with Poria) governs; if cold signs predominate with no desire to drink water, Lizhong Wan (Regulate the Middle Pill) governs. Formula 2.
Wuling San Formula:
Polyporus (Zhuling, peeled, 18 zhu), Atractylodis Macrocephalae Rhizoma (Baizhu, 18 zhu), Poria (Fuling, 18 zhu), Cinnamomi Ramulus (Guizhi, Cinnamon Twig, peeled, 0.5 liang), Alismatis Rhizoma (Zexie, 1 liang 6 zhu).
Grind the above five ingredients into powder. Mix one fangcunbi (square-inch spoonful) with rice gruel and take three times daily. Drink plenty of warm water; recovery occurs upon sweating.
Lizhong Wan Formula: (Below are modifications for decoction.)
Ginseng Radix et Rhizoma (Renshen), Zingiberis Rhizoma (Ganjiang), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao), Atractylodis Macrocephalae Rhizoma (Baizhu) (each 3 liang).
Pound and sift the above four ingredients. Mix with honey to form pills, each about the size of an egg yolk. Dissolve one pill in several ge of boiling water, crush, and take warm. Take three to four times during the day and twice at night. If there is no heat sensation in the abdomen, increase to three or four pills, though this is inferior to the decoction. Decoction method: Cut the four ingredients according to their liang weight. Decoct in 8 sheng of water to obtain 3 sheng. Remove dregs and take 1 sheng warm, three times daily. If there is throbbing above the umbilicus, it indicates movement of Shen Qi (Kidney Qi); remove Baizhu and add Guizhi (4 liang). If vomiting is frequent, remove Baizhu and add Sheng Jiang (Fresh Ginger Rhizome, 3 liang). If diarrhea is frequent, retain Baizhu. If palpitations occur, add Fuling (2 liang). If thirsty and desiring water, add Baizhu to make a total of 4.5 liang. If there is abdominal pain, add Renshen to make a total of 4.5 liang. If cold signs are prominent, add Ganjiang to make a total of 4.5 liang. If there is abdominal fullness, remove Baizhu and add Fuzi (1 piece). After taking the decoction, wait approximately the time it takes to eat a meal, then drink about 1 sheng of hot congee to induce mild warmth. Do not uncover clothing or bedding to avoid wind exposure.
387. If vomiting and diarrhea have ceased but body pain persists, harmonize the exterior appropriately. Guizhi Tang (Cinnamon Twig Decoction) is suitable for mild harmonization. Formula 3.
Cinnamomi Ramulus (Guizhi, peeled, 3 liang), Paeoniae Radix Alba (Shaoyao, White Peony Root, 3 liang), Zingiberis Rhizoma Recens (Sheng Jiang, Fresh Ginger Rhizome, 3 liang), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao, 2 liang), Jujubae Fructus (Dazao, Jujube Fruit, split, 12 pieces).
Decoct the above five ingredients in 7 sheng of water to obtain 3 sheng. Remove dregs and take 1 sheng warm.
388. With vomiting, diarrhea, sweating, fever, aversion to cold, spasmodic urgency of the four limbs, and cold reversal of hands and feet, Sini Tang (Frigid Extremities Decoction) governs. Formula 4.
Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao, 2 liang), Zingiberis Rhizoma (Ganjiang, 1.5 liang), Aconiti Lateralis Radix Praeparata (Sheng Fuzi, peeled, broken into eight pieces, 1 piece).
Decoct the above three ingredients in 3 sheng of water to obtain 1 sheng and 2 ge. Remove dregs and take warm in two divided doses. For robust individuals, use one large piece of Fuzi and 3 liang of Ganjiang.
389. With both vomiting and diarrhea, profuse urination and massive sweating, diarrhea containing undigested food, internal cold and external heat, and a pulse so faint it is almost imperceptible, Sini Tang governs. Formula 5. (Use the fourth formula above.)
390. When vomiting and diarrhea have ceased, but there is sweating and reversal cold (Jue), unresolved spasmodic urgency of the four limbs, and a pulse so faint it is almost imperceptible, Tongmai Sini Jia Zhudanzhi Tang (Channel-Unblocking Sini Decoction plus Pig Bile) governs. Formula 6.
Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao, 2 liang), Zingiberis Rhizoma (Ganjiang, 3 liang; 4 liang for robust individuals), Aconiti Lateralis Radix Praeparata (Sheng Fuzi, peeled, broken into eight pieces, 1 large piece), Sus Scrofa Domestica Fel (Zhudanzhi, Pig Bile, 0.5 ge).
Decoct the first four ingredients in 3 sheng of water to obtain 1 sheng and 2 ge. Remove dregs, add Zhudanzhi, and take warm in two divided doses. The pulse will return immediately. If pig bile is unavailable, sheep bile may be substituted.
391. After vomiting, diarrhea, and sweating, if the pulse is normal (Ping) but there is slight vexation (Fan), it is due to new deficiency being unable to withstand Gu Qi (Grain Qi/Digestive energy from food).