霍者。挥霍眩晕。乱者。心神烦乱。若上吐下泻。不烦乱者。谓之吐泻。非霍乱也。夫霍乱之因。由于暑食伤脾。
中州郁结。清气不得上升。浊气不得下降。先心痛则先吐。先腹痛则先泻。心腹俱痛者。则吐泻齐作。初起之时。脉多
代结。或见沉细。最难辨其寒热。大法口渴转筋知其为热。宜用清暑化滞汤。至于霍乱已除。转筋不愈者。水谷
之气。传于肝经。热伤其血。则大筋为之软短。湿伤其筋。则小筋为之弛长。宜于消食之中。佐以木瓜苡仁黄芩
麦冬当归白芍。无不应也。但男子之筋聚于阴器。女子之筋聚于乳头。男子用手扯其阴器。女子用手扯其两乳。
可免转筋入腹之死。又有阴邪霍乱者。脉沉细缓。肢凉唇青。此因冷物伤脾。气不宣通。宜用浓朴温中汤。更
有干霍乱者。欲吐不得吐。欲泻不得泻。心腹绞痛。须臾即死。当以手 吐之。方可用药。其间冷热之治。亦与前症
无异也。凡患此者。不可与之饮食。一周时许。热退身凉。方可少与米饮。助其元气。若痛止即食。病再复来。勿
归咎于医也。脉诀云。霍乱之脉。见微迟气少不语。大为难医。盖言暑伤于气。正气欲脱。故难治也。
清热化滞汤
枳壳 浓朴 山楂 杏仁 半夏 黄芩 赤茯 桔梗 枇杷叶 麦冬
转筋倍加木瓜。（治热霍乱主剂他如热甚加川连吴萸除楂朴方为合拍要在辨其有食滞否）
浓朴温中汤
浓朴 枳壳 杏仁 半夏 桔梗 炮姜 甘草 藿香 香茹 陈皮
（按寒霍乱此方尚欠斟酌果系三阴经证宜从治中汤甚则四逆汤白通汤皆可随证选择
而用惟藿茹枳桔应在删除之列盖邪既入阴挽之犹恐不及岂可再事耗散其真气哉）
霍乱，所谓“霍”，是指突然发生的眩晕；所谓“乱”，是指心神烦乱。如果只有上吐下泻，而没有心神烦乱的症状，这称为吐泻，而不是霍乱。
霍乱的病因，是由于暑邪和饮食损伤了脾脏，导致中焦（脾胃）气机郁结。清气不能上升，浊气不能下降。如果先出现心痛，就会先呕吐；如果先出现腹痛，就会先腹泻；如果心腹都痛，那么呕吐和腹泻就会同时发生。在疾病初起时，脉象多表现为代脉或结脉，或者呈现沉细脉，此时最难辨别是寒证还是热证。
大致的辨证法则：如果出现口渴、转筋（肌肉痉挛），则判断为热证，适宜使用清暑化滞汤。
至于霍乱的主症（呕吐腹泻）已经消除，但转筋症状仍未痊愈的情况，这是因为水谷之气传入肝经，热邪损伤了血液，导致大筋收缩变短；湿邪损伤了筋脉，导致小筋松弛变长。治疗应在消食导滞的药物中，辅以木瓜、薏苡仁、黄芩、麦冬、当归、白芍，没有不奏效的。
但是，男子的筋汇聚于阴器（生殖器），女子的筋汇聚于乳头。男子可以用手拉扯其阴器，女子可以用手拉扯其双侧乳房，这样可以避免转筋入腹导致的死亡。
又有阴寒性质的霍乱，脉象沉细而缓，四肢发凉，嘴唇青紫。这是由于冷物损伤了脾脏，气机不能宣通所致，适宜使用浓朴温中汤。
还有干霍乱，想吐却吐不出来，想泻却泻不出来，心腹剧烈绞痛，片刻之间即可致死。应当先用手指探喉催吐，然后才可以用药。其中对于寒证和热证的治疗原则，也与上述病症无异。
凡是患有此病的人，不可立即给予饮食。大约一周左右的时间，待热退身凉后，才可以少量给予米汤，以辅助元气。如果疼痛刚停止就进食，病情会再次复发，不要归咎于医生。
《脉诀》说：霍乱的脉象，如果见到微迟脉，且患者气短、不愿说话，这是很难治疗的征象。这是因为暑邪损伤了正气，正气即将脱失，所以难以治愈。
清暑化滞汤
枳壳、浓朴、山楂、杏仁、半夏、黄芩、赤茯苓、桔梗、枇杷叶、麦冬。
若出现转筋，加倍使用木瓜。（这是治疗热霍乱的主方。其他如热势严重可加黄连、吴茱萸，去除山楂、浓朴，这样方剂更为契合。关键在于辨别是否有食积停滞。）
浓朴温中汤
浓朴、枳壳、杏仁、半夏、桔梗、炮姜、甘草、藿香、香茹、陈皮。
（按语：治疗寒霍乱，此方尚需斟酌。如果确实是三阴经的证候，应从治中汤选用，严重时甚至可以使用四逆汤、白通汤，皆可随证选择使用。唯独藿香、香茹、枳壳、桔梗应在删除之列。因为邪气既然已经进入阴分，想要挽回正气还怕来不及，岂可再从事耗散真气的行为呢？）
Huo Luan (Colic and Vomiting-Diarrhea Syndrome), the term "Huo" refers to sudden dizziness; the term "Luan" refers to mental restlessness. If there is only vomiting and diarrhea without mental restlessness, it is called Tu Xie (Vomiting and Diarrhea), not Huo Luan.
The etiology of Huo Luan lies in damage to the Spleen by Summerheat and dietary injury, leading to stagnation in the Middle Jiao (Middle Burner). Clear Qi fails to ascend, and Turbid Qi fails to descend. If Heart pain occurs first, vomiting precedes; if Abdominal pain occurs first, diarrhea precedes; if both Heart and Abdomen are painful, vomiting and diarrhea occur simultaneously. At the onset, the pulse is often characterized by Dai Pulse (Intermittent Pulse) or Jie Pulse (Knotted Pulse), or appears deep and fine, making it difficult to distinguish between Cold and Heat patterns.
The general principle for differentiation: If thirst and Zhuan Jin (Muscle Spasm/Cramp) are present, it is judged as a Heat pattern, suitable for Qing Shu Hua Zhi Tang (Clear Summerheat and Resolve Stagnation Decoction).
As for cases where the main symptoms of Huo Luan have subsided but Zhuan Jin persists, this is because the Qi of food and drink has transmitted to the Liver Meridian. Heat injuring Blood causes the large tendons to contract and shorten; Dampness injuring the tendons causes the small tendons to relax and lengthen. Treatment should employ digestive herbs supplemented with Mugua (Chaenomeles Fruit), Yiren (Coix Seed), Huangqin (Scutellaria Root), Maidong (Ophiopogon Tuber), Danggui (Angelica Sinensis), and Baishao (White Peony Root), which will invariably be effective.
However, in men, tendons gather at the Yin Qi (Genitals); in women, tendons gather at the Nipple. Men can be treated by pulling their genitals, and women by pulling their breasts, which can prevent death from Zhuan Jin entering the abdomen.
There is also Yin-type Huo Luan, characterized by a deep, fine, and slow pulse, cold limbs, and cyanotic lips. This is caused by cold substances damaging the Spleen and obstructing Qi circulation, suitable for Nong Po Wen Zhong Tang (Magnolia Bark Warming the Middle Decoction).
Furthermore, there is Gan Huo Luan (Dry Huo Luan), where one desires to vomit but cannot, desires to defecate but cannot, accompanied by severe colic and abdominal pain, leading to death within moments. One must first induce vomiting using fingers, after which medication can be administered. The treatment principles for Cold and Heat patterns here are no different from the aforementioned conditions.
Patients suffering from this disease should not be given food immediately. After approximately one week, when the heat recedes and the body cools, a small amount of rice water may be given to support Yuan Qi (Primal Qi). If food is consumed as soon as pain stops, the illness will recur; do not blame the physician.
The Mai Jue (Pulse Classic) states: For Huo Luan, if the pulse presents as Wei Chi (Weak and Slow) and the patient suffers from shortness of breath and unwillingness to speak, it is difficult to treat. This indicates that Summerheat has damaged Qi, and Zheng Qi (Upright Qi) is on the verge of collapse, hence the difficulty in treatment.
Qing Shu Hua Zhi Tang (Clear Summerheat and Resolve Stagnation Decoction)
Zhi Qiao (Immature Bitter Orange), Nong Po (Magnolia Bark), Shan Zha (Hawthorn Fruit), Xing Ren (Apricot Seed), Ban Xia (Pinellia Tuber), Huang Qin (Scutellaria Root), Chi Fu Ling (Red Poria), Jie Geng (Platycodon Root), Pi Pa Ye (Loquat Leaf), Mai Dong (Ophiopogon Tuber).
If Zhuan Jin occurs, double the dosage of Mugua. (This is the primary formula for treating Heat-type Huo Luan. Other adjustments include adding Chuan Lian Zi (Sichuan Chinaberry) and Wu Zhu Yu (Evodia Fruit) for severe heat, removing Shan Zha and Nong Po, ensuring the formula fits the condition. The key lies in distinguishing whether there is Food Stagnation.)
Nong Po Wen Zhong Tang (Magnolia Bark Warming the Middle Decoction)
Nong Po (Magnolia Bark), Zhi Qiao (Immature Bitter Orange), Xing Ren (Apricot Seed), Ban Xia (Pinellia Tuber), Jie Geng (Platycodon Root), Pao Jiang (Prepared Ginger), Gan Cao (Licorice Root), Huo Xiang (Patchouli), Xiang Ru (Perilla Leaf), Chen Pi (Tangerine Peel).
(Note: For treating Cold-type Huo Luan, this formula requires careful consideration. If it is indeed a syndrome of the Three Yin Meridians, one should select from Zhi Zhong Tang (Regulate the Middle Decoction); in severe cases, Si Ni Tang (Four Reversals Decoction) or Bai Tong Tang (White Passage Decoction) may be chosen according to the syndrome. However, Huo Xiang, Xiang Ru, Zhi Qiao, and Jie Geng should be deleted. Since the pathogen has entered the Yin level, it is already difficult enough to salvage Zheng Qi; how can one further dissipate True Qi?)