经曰，足太阴厥气上逆，则霍乱。又曰，不连热则热至，热至则身热，吐下霍乱。此病起于仓猝，挥霍扰乱，
无有或止，然小儿得之，多因夹食伤寒，阴阳乖隔，上吐下泻，烦躁闷乱，即此证也。盖人有三焦，上焦受纳水谷，
主入而不主出，中焦腐化水谷，流行于五脏六腑，下焦分别水谷，主出而不主纳，故邪在上焦则吐，邪在下焦则
泻，邪在中焦，则上吐下泻。大凡湿霍乱能吐能泻，则邪气上下得出，迨秽滞出尽，则吐泻自止，故治之尚易。若
干霍乱则上不得吐，下不得泻，脾胃六邪，毫无出路，若加喘满作搐，多不可救，故称难治。且治须分别寒热，
慎勿错认误投，此最要关键也。
干霍乱乃寒暑凝结，欲吐不吐，欲泻不泻，腹中绞痛，俗名绞肠痧。其证烦渴大饮者属热，古法主桂苓甘露
饮（如土炒白术、茯苓、泽泻、石膏、水飞滑石、猪苓、寒水石，加肉桂少许）。
若厥逆不渴者，属寒，古法主理中汤（如人参、白术、干姜、炙甘草）。
〔真按〕小儿体弱不能忍耐，得绞肠痧证尤易生变，无论阴痧阳痧，急用食盐和阴阳水与服，一面令儿伏
卧，以手蘸温水，轻轻拍其两膝弯，名曰委中穴，细看弯内有紫黑点出现，以银针
刺出恶血，立时即松，脾脉、肝脉、肾脉三阴之脉皆从此委中穴经过。
又一法以软帛蘸香油擦两手肘内弯，名曰曲池穴，刮起紫疹，亦立时即松，肺脉、心脉、心包络脉皆从此曲
池穴经过。
继以汤剂，腹痛手足冷者、为阴痧，方用藿香梗一钱，广木香八分，油浓朴八分，炒枳实一钱，炙甘草五分，
煎好、再以苏合香丸半粒，研细，调药温服，腹痛手足暖者，为阳痧，方用生扁豆钱半，川浓朴八分，赤茯苓钱
半，砂仁粉五分，姜黄连五分，引用荷花露半两，冲服。
《黄帝内经》说：足太阴脾经的厥逆之气向上冲逆，就会发生霍乱。又说：如果不伴随发热，热邪到来时身体会发热，出现呕吐和腹泻的霍乱症状。这种病发作突然，上吐下泻，挥霍无度，没有片刻停歇。然而小儿患此病，多因夹带食积又感受伤寒，导致阴阳之气乖违阻隔，出现上吐下泻、烦躁闷乱的症状，这就是该证候。
大概人有上、中、下三焦。上焦接受并容纳水谷，主要功能是受纳而不主排泄；中焦腐熟消化水谷，将其精微流行输布于五脏六腑；下焦分别清浊水谷，主要功能是排泄而不主受纳。所以，邪气在上焦则引起呕吐，邪气在下焦则引起腹泻，邪气在中焦，则既呕吐又腹泻。
一般来说，湿霍乱既能呕吐又能腹泻，说明邪气可以从上下排出，等到秽浊停滞之物排尽，呕吐和腹泻自然停止，所以治疗相对容易。如果是干霍乱，则上面不能呕吐，下面不能腹泻，脾胃受到六种邪气侵袭，毫无出路，如果再加上气喘胸满、抽搐等症状，大多无法救治，所以称为难治之症。而且治疗必须分辨寒热属性，千万不要认错误投药物，这是最关键的地方。
干霍乱是由于寒暑之气凝结所致，想吐吐不出来，想拉拉不出来，腹中剧烈绞痛，俗称“绞肠痧”。其证候中，烦渴且大量饮水的属于热证，古法主张使用桂苓甘露饮（如土炒白术、茯苓、泽泻、石膏、水飞滑石、猪苓、寒水石，加少许肉桂）。如果是四肢厥冷且不口渴的，属于寒证，古法主张使用理中汤（如人参、白术、干姜、炙甘草）。
【真按】（陈守真按语）：小儿体质虚弱，不能忍耐病痛，患上绞肠痧证尤其容易产生变证。无论是阴痧还是阳痧，都要紧急用食盐混合阴阳水给患儿服用。同时让患儿伏卧，用手蘸温水，轻轻拍打其两膝弯处，这个部位名叫委中穴。仔细观察膝弯内是否有紫黑色的血点出现，若有，用银针刺破放出恶血，症状会立即缓解。因为脾脉、肝脉、肾脉这三条阴经都经过委中穴。
另一种方法是用柔软的丝帛蘸取香油，擦拭两手肘内侧弯处，这个部位名叫曲池穴。刮拭出紫红色的疹子后，症状也会立即缓解。因为肺脉、心脉、心包络脉都经过曲池穴。
随后再服用汤剂。如果腹痛且手足冰冷的是阴痧，方剂使用藿香梗一钱，广木香八分，油浓朴八分，炒枳实一钱，炙甘草五分。煎好药后，再取苏合香丸半粒，研成细末，调和药汁温服。如果腹痛但手足温暖的是阳痧，方剂使用生扁豆钱半，川浓朴八分，赤茯苓钱半，砂仁粉五分，姜黄连五分，引用荷花露半两，冲服。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "When the rebellious Qi of the Foot-Taiyin Spleen channel ascends, Huoluan (cholera-like syndrome with sudden vomiting and diarrhea) occurs." It also states: "If heat does not precede, when heat arrives, the body becomes feverish, accompanied by vomiting and diarrhea in Huoluan." This disease arises suddenly, characterized by chaotic and violent vomiting and diarrhea without cessation. However, when children contract this illness, it is often due to exogenous cold-evil combined with food stagnation, leading to a disruption of Yin-Yang harmony, resulting in upper vomiting, lower diarrhea, restlessness, and mental confusion; this constitutes this syndrome.
Generally, the human body possesses the Upper, Middle, and Lower Jiao (Triple Burner). The Upper Jiao receives and accepts water and grain, governing intake but not excretion. The Middle Jiao rots and ripens water and grain, circulating their essence to the Five Zang and Six Fu organs. The Lower Jiao separates water and grain, governing excretion but not reception. Therefore, if pathogenic factors are in the Upper Jiao, vomiting occurs; if in the Lower Jiao, diarrhea occurs; if in the Middle Jiao, both vomiting and diarrhea occur.
Typically, Shi Huoluan (Damp Huoluan), which involves both vomiting and diarrhea, allows pathogenic factors to exit from above and below. Once the turbid stagnation is completely expelled, vomiting and diarrhea cease spontaneously, making treatment relatively easy. In contrast, Gan Huoluan (Dry Huoluan) prevents both vomiting and diarrhea. With six types of pathogenic factors affecting the Spleen and Stomach having no outlet, especially if accompanied by panting, chest fullness, and convulsions, the condition is often incurable, hence termed "difficult to treat." Treatment must carefully distinguish between Cold and Heat patterns; misidentification and incorrect prescription are critical errors. This is the most crucial point.
Gan Huoluan results from the congealing of Cold and Summerheat. Symptoms include inability to vomit or defecate despite the urge, and severe colicky abdominal pain, commonly known as "Jiaochang Sha" (Intestinal Twisting Sha). Cases with irritability, thirst, and excessive drinking belong to the Heat pattern. Ancient methods prescribe Guiling Ganlu Yin (Cassia Twig and Poria Decoction for Moistening the Dryness) [ingredients: Earth-fried Atractylodis Macrocephalae Rhizoma, Poria, Alisma, Gypsum Fibrosum, Flaveded Talcum, Polyporus, Hypocaustum, plus a small amount of Cinnamon Twig]. Cases with cold limbs and absence of thirst belong to the Cold pattern. Ancient methods prescribe Lizhong Tang (Regulate the Middle Decoction) [ingredients: Ginseng Radix, Atractylodis Macrocephalae Rhizoma, Zingiberis Rhizoma, Prepared Licorice Root].
[Author's Note]: Children have weak constitutions and poor tolerance for pain. Contracting Jiaochang Sha makes them particularly prone to complications. Regardless of whether it is Yin Sha or Yang Sha, urgently administer a mixture of salt and Yin-Yang Water (water collected from rain and well water) orally. Simultaneously, have the child lie prone. Dip fingers in warm water and gently tap the popliteal fossa on both knees, known as Weizhong BL-40. Observe closely for the appearance of purple-black spots within the fossa. If present, puncture with a silver needle to release evil blood; symptoms will relieve immediately. The Spleen, Liver, and Kidney Yin meridians all pass through Weizhong BL-40.
Another method involves using soft silk dipped in sesame oil to rub the medial aspect of the elbow creases, known as Quchi LI-11. Scraping until purple rashes appear also provides immediate relief. The Lung, Heart, and Pericardium meridians all pass through Quchi LI-11.
Subsequently, administer decoctions. For abdominal pain with cold hands and feet (Yin Sha), use the formula: Agastache Rhizome 1 qian, Costus Root 8 fen, Magnolia Bark processed with oil 8 fen, Fried Immature Bitter Orange 1 qian, Prepared Licorice Root 5 fen. After decocting, mix with half a pill of Suhexiang Wan (Styrax Pill), finely ground, and take warm. For abdominal pain with warm hands and feet (Yang Sha), use the formula: Raw Lablab Bean 1.5 qian, Magnolia Bark 8 fen, Red Poria 1.5 qian, Amomum Villosum Seed Powder 5 fen, Ginger-processed Coptis Rhizoma 5 fen. Use Lotus Flower Dew 0.5 liang as the vehicle, mixed and taken.