山阴田雪帆明经晋元，着《时行霍乱指迷辨正》，世俗所称吊脚痧一证，以为此真寒直
中厥
阴肝经，即霍乱转筋是也。初起先腹痛，或不痛，泻利清水，顷刻数十次，少者十余次，未
几即手筋抽掣，呕逆，口渴恣饮，手足厥逆，脉微欲绝，甚则声嘶舌短，目眶陷，目上视，
手足青紫色，或遍身青筋硬凸如索，汗出脉绝，急者旦发夕死，夕发旦死，缓者二三日或五
六日死，世医认为暑湿，妄投凉泻，或认为痧气，妄投香散，（十香丸、卧龙丹之类。）鲜有
不毙。宜用当归四逆加吴茱萸、生姜汤，（当归二钱，炒白芍钱半，桂枝钱半，炙草一钱，
通草一钱，吴萸钱半，细辛八分，生姜三片，黑枣三枚，水煎冷服。）轻者二三剂（一日中倾
频进二三剂。）即愈，重者多服数剂，立可回生，百治百效，真神方也。如呕者，本方加姜
制半夏三钱，淡干姜一钱；口渴恣饮舌黄，加姜炒川连五分为反佐，经所谓热因寒用也。腹
中绞痛，各转筋入腹，加酒炒木瓜三钱；手冷过肘膝，色现青紫，加制附子三钱，若声嘶目
上视，舌卷囊缩，脉已绝，为不治，服药亦无及，速用艾灸法。（脐下三寸关元穴，用附子
捣烂 作饼如钱大，安穴上以龙眼大艾柱加其上，灸十四壮，重者三十壮，呕泻止厥回即愈
。如无附子，用生姜切片如钱，贴灸亦可，无姜贴肉灸亦妙。病入腹内知温，呕泻即渐止。
量寸法以病患中指中一节若干长为一寸，用草心候准量之，不可截断，只须折作三叠即三寸
矣。）此症种种，皆肝经现症，亦寒邪为病，可疑者口渴舌黄，喜冷冻饮料，及不欲衣被两症耳
。缘坎中真阳，为寒邪所逼，因之飞越，所谓内真寒而外假热，但以脉辨之，自无游移矣。
有习用温补之医，知此证为阴寒，治用附子理中、四逆等汤，温补脾肾，究非直走厥阴，仍
不能奏效。余按∶此证自嘉庆庚辰年后患者不绝，其势至速，医不如法，立时殒命，而方书
罕有详载治法者，特备述之以贻世云。
许辛木云∶治吊脚痧莫妙于来复丹，然硫黄须用真倭产，如用土硫黄即不验，而服此丹
用小
丸者，每即吐出，惟作大丸，临用舂作末服，虽吐亦不尽，再服再吐，少顷药性发即不复吐
而愈。用姜汤送下，须极浓极辣乃佳。道光辛巳，此证盛行，有捣浓姜汁频服而愈者。
山阴人田雪帆（名晋元，举人出身）撰写了《时行霍乱指迷辨正》一书。世俗所称的“吊脚痧”这一病证，被认为是真正的寒邪直中厥阴肝经，也就是霍乱转筋。发病初期先出现腹痛，或者不痛，泻下清水，短时间内多达数十次，少的也有十余次，不久即出现手部筋脉抽掣、呕吐逆气、口渴大量饮水、手足冰冷厥逆、脉搏微弱几乎摸不到，严重时声音嘶哑、舌头短缩、眼球上翻、手足呈现青紫色，或者全身青色筋脉僵硬凸起如绳索状，出汗且脉搏消失，病情急骤者早晨发作晚上死亡，晚上发作早晨死亡，病情稍缓者两三天或五到六天后死亡。世间的医生误认为是暑湿之邪，胡乱投用凉药泻下；或者误认为是痧气，胡乱投用香散类药物（如十香丸、卧龙丹之类），几乎没有不导致死亡的。适宜使用当归四逆加吴茱萸生姜汤（当归二钱，炒白芍一钱半，桂枝一钱半，炙甘草一钱，通草一钱，吴茱萸一钱半，细辛八分，生姜三片，黑枣三枚，水煎后冷服）。轻症服用二三剂（一天内频繁进服二三剂）即可痊愈，重症多服几剂，立刻可以起死回生，百治百效，真是神方啊。如果有呕吐症状的，在本方基础上加姜制半夏三钱、淡干姜一钱；如果口渴大量饮水且舌苔黄，加姜炒黄连五分作为反佐，这就是经书所说的“热因寒用”。如果腹中绞痛，各种转筋牵引至腹部，加酒炒木瓜三钱；如果手冷超过肘部和膝部，肤色呈现青紫，加制附子三钱。如果声音嘶哑、眼球上翻、舌头卷曲、阴囊收缩、脉搏已经消失，属于不治之症，服药也来不及了，应迅速使用艾灸法。（在脐下三寸的关元穴，将附子捣烂做成如铜钱大小的饼，放在穴位上，上面放置如龙眼大小的艾柱进行艾灸，灸十四壮，重症灸三十壮，呕吐腹泻停止、四肢回暖即痊愈。如果没有附子，可以用生姜切片如铜钱大小，贴在穴位上艾灸也可以，没有生姜直接贴肉艾灸也很妙。病邪深入体内感觉温热，呕吐腹泻就会逐渐停止。测量一寸的方法是以患者中指中间一节若干长度为一寸，用草心对准测量，不可截断，只需折叠成三叠即为三寸。）这些病症种种表现，都是肝经的典型症状，也是寒邪致病，令人疑惑的是口渴舌黄、喜欢冷冻饮料，以及不喜欢盖衣被这两点症状罢了。这是因为坎宫中的真阳，被寒邪逼迫，因而飞越散失，所谓“内真寒而外假热”，只要通过脉象来辨别，自然就不会犹豫不决了。有些习惯使用温补疗法的医生，知道此证为阴寒，治疗使用附子理中汤、四逆汤等，温补脾肾，终究不是直接针对厥阴肝经，仍然不能奏效。我考察认为：此证自从嘉庆庚辰年以后患者络绎不绝，其势头极快，医生如果不依法治疗，病人立刻死亡，而医书中很少有详细记载治疗方法的，特此详细叙述以留给世人。
许辛木说：治疗吊脚痧没有比来复丹更妙的了，然而硫黄必须使用真正的日本产，如果使用土硫黄就不见效。而且服用此丹如果是小丸剂，往往会引起呕吐，只有做成大丸，临用时捣碎成粉末服用，即使呕吐也不会全部吐出，再服再吐，过一会儿药性发作就不再呕吐而痊愈。用姜汤送服，姜汤必须极浓极辣才好。道光辛巳年，此证盛行，有人捣碎浓姜汁频繁服用而痊愈的。
Tian Xuefan (courtesy name Jinyuan, a *Juren* degree holder) from Shanyin authored the book *Shixing Huoluan Zhimi Bianzheng* (Clarifying and Correcting Epidemic Cholera). The condition commonly known in secular terms as "Diaojiao Sha" (Hanging Leg Cholera) is considered to be true cold pathogen directly invading the *Jueyin Liver Meridian*, which is precisely *Huoluan Zhuanjin* (Cholera with Muscle Cramps). At the onset, there is initially abdominal pain, or sometimes no pain, followed by diarrhea of clear water, occurring dozens of times within a short period, or at least ten-plus times. Soon after, cramping and pulling of the tendons in the hands occur, accompanied by vomiting and regurgitation, intense thirst with excessive drinking, cold limbs (*Jue Ni*), and a faint pulse nearly imperceptible. In severe cases, hoarseness, a shortened tongue, upward deviation of the eyes, cyanosis of the hands and feet, or stiff, rope-like protrusion of blue veins over the entire body may appear, along with sweating and absence of pulse. Acute cases may result in death from morning to evening or evening to morning; slower cases may lead to death within two to three days or five to six days. Physicians of the world often misdiagnose this as *Shushi* (Summerheat-Dampness) and recklessly administer cooling purgatives, or misdiagnose it as *Sha Qi* (Sha Poison) and recklessly administer aromatic dispersants (such as *Shixiang Wan* [Ten-Aromatic Pill] or *Wolong Dan* [Sleeping Dragon Pill]), rarely failing to cause death. The appropriate prescription is *Danggui Sini Jia Wuzhuyu Shengjiang Tang* (Angelica Sinensis Decoction for Cold Extremities plus Evodia and Ginger) [Dang Gui 2 qian, Chao Baishao 1.5 qian, Guizhi 1.5 qian, Zhi Cao 1 qian, Tongcao 1 qian, Wuzhuyu 1.5 qian, Xixin 8 fen, Shengjiang 3 slices, Hei Zao 3 pieces, decocted in water and taken cold]. Mild cases recover after taking two or three doses (administered frequently throughout one day); severe cases recover immediately after taking several more doses. It is truly a miraculous formula, effective in every case. If vomiting is present, add Jiangzhi Banxia (Ginger-processed Pinellia Rhizome) 3 qian and Danganjiang (Lightly Dried Ginger) 1 qian to the base formula. If there is intense thirst with excessive drinking and a yellow tongue coating, add Jiangchao Chuanlian (Ginger-fried Coptis Rhizoma) 0.5 fen as an antagonistic agent, following the classic principle of "treating heat with cold administration" (*Re Yin Han Yong*). If there is colicky abdominal pain and various cramps pulling into the abdomen, add Jiuchao Mugua (Wine-fried Chaenomelis Fructus) 3 qian. If the hands are cold beyond the elbows and knees, and the skin shows cyanosis, add Zhifu Zi (Prepared Aconite Lateralis Radix) 3 qian. If there is hoarseness, upward deviation of the eyes, curled tongue, and retracted scrotum, with an absent pulse, it is an untreatable condition; medication will be too late. One should quickly employ moxibustion therapy. (At the *Guanyuan* CV4 acupoint, located three cun below the umbilicus, crush Fu Zi (Aconite Lateralis Radix Preparata) into a cake the size of a coin, place it on the acupoint, and apply a moxa cone the size of a longan nut on top. Moxibustion for fourteen *Zhuang*; for severe cases, thirty *Zhuang*. Recovery occurs when vomiting and diarrhea stop and extremities warm up. If Fu Zi is unavailable, slice fresh Shengjiang (Fresh Ginger Rhizome) to the size of a coin and apply it for moxibustion; even direct skin moxibustion without ginger is excellent. When warmth is felt deep inside the abdomen, vomiting and diarrhea gradually cease. To measure one *cun*, use the length of the middle segment of the patient's middle finger as the standard, using a grass stem to mark the measurement accurately without cutting it; simply folding it three times yields three *cun*.) These various symptoms all manifest in the Liver Meridian and are caused by cold pathogen. The confusing aspects are the thirst, yellow tongue coating, preference for cold drinks, and aversion to clothing/bedding. This is because the True Yang in the Kan palace is forced outward by the cold pathogen, leading to its dispersion—described as "true cold inside and false heat outside." By differentiating based on the pulse, there should be no hesitation. Some physicians accustomed to using warming and tonifying methods know this condition is Yin-Cold and treat it with *Fuzi Lizhong Tang* (Aconite Decoction to Regulate the Middle) or *Sini Tang* (Reverse the Cold Decoction) to warm and tonify the Spleen and Kidney. However, since these do not directly target the Jueyin Liver Meridian, they still fail to produce results. I observe that since the Gengchen year of the Jiaqing reign, patients have been continuous, with the disease progressing rapidly. If physicians do not follow proper protocols, death ensues instantly, yet medical texts rarely detail treatment methods. I hereby describe it thoroughly to benefit future generations.
Xu Xinmu stated: There is nothing more exquisite for treating Diaojiao Sha than *Laifu Dan* (Return to Life Pill). However, the Sulfur used must be genuine Japanese origin; if local sulfur is used, it is ineffective. Furthermore, if this pill is taken in small pellets, it often induces vomiting. Only when made into large pills and crushed into powder before administration will it work; even if vomiting occurs, not all medicine is expelled. After repeated dosing and vomiting, once the medicinal properties take effect, vomiting ceases and recovery follows. It should be taken down with strong, spicy ginger soup. In the Xinsi year of the Daoguang reign, this disease was prevalent, and some recovered by frequently consuming crushed concentrated ginger juice.