经曰、有发热头疼，身痛恶寒，而吐利兼作者，此属何病。答曰、此名霍乱是也。然有干霍乱、湿霍乱之
异。湿霍乱者，上吐下利，所伤之物，得以尽出而自愈矣。干霍乱者，上不得吐，下不得利，物不能泄出，
拥闭邪气，关隔阴阳，烦扰扰闷乱，绞肠腹痛而死矣。大抵伤寒吐利，邪气所伤。杂病吐利，饮食所伤。呜
呼，饮食有节，起居有常，岂能霍乱耶。饮食自倍，肠胃乃伤，丧身之由，实自至耳。
郑声者，声如郑卫之音，不能正也。孔子曰、恶郑声之乱雅乐也。经曰、虚则郑声，盖因汗下过多，表里
虚竭，以致阳脱阴胜，其人正气衰而本音失，精神夺而语句重，手足并冷，神昏舌短，音响糊涂，与谵
语回不相同。此症十无一治，不得已、姑用独参汤或白通汤。
言严语者，谓呢喃而语，又作谵语，谓妄有所见而言也。皆由真气昏乱，神识不清之所致也。又曰、表邪
不散，陷入于胃，胃中热盛，上乘于心，心为热冒，则神气昏乱，妄有所见而言也。轻则睡中呢喃，重则
不睡亦语。有错语，有独语，有狂语，有语言不休，有语言舛乱者之不同，各以见热之轻重也。大抵热
入于胃，水涸粪燥，必发谵语。经曰、邪气盛则实，实则谵语。
动气者，筑筑然跳动者是也。盖因其人素有积气，偶感伤寒，医者妄施汗吐下法，致动其气，随脏所
主，而见于脐之左右上下，是皆真气不足。动及当脐者，以脾为中州，发汗吐下，先动脾气，故不待言
之也。故真气内虚，脏气不治，慎不可汗下也。又有肾脏之气内虚，水结不散，气与水搏，即发奔豚。通
宜理中去术加桂，以术能燥肾水而闭气，桂能泄奔豚故也。
《黄帝内经》说：如果有发热、头痛、身体疼痛、恶寒，同时伴有呕吐和腹泻的情况，这属于什么病？回答说：这叫做霍乱。然而，霍乱有干霍乱和湿霍乱的区别。湿霍乱表现为上吐下泻，致病之物能够全部排出体外，从而自愈。干霍乱则表现为上不能吐，下不能泻，病邪之物无法排出，导致邪气壅闭，阴阳阻隔，患者烦躁闷乱，因肠绞痛腹痛而死亡。大抵而言，伤寒引起的呕吐腹泻，是由邪气侵袭所致；杂病引起的呕吐腹泻，多由饮食损伤所致。唉，如果饮食有节制，起居有规律，怎么会得霍乱呢？饮食过量一倍，肠胃就会受伤，丧身的缘由，实在是自己招致的罢了。
郑声，指声音像郑卫之音（淫靡之乐），不能中正平和。孔子说：“厌恶郑声扰乱雅乐。”《内经》说：“虚证出现郑声”，这是因为发汗和解表攻下过多，导致表里气血极度虚弱，致使阳气脱失、阴气偏胜。此时人体正气衰败，本音丧失，精神被剥夺，说话重复啰嗦，手足冰冷，神志昏迷，舌体短缩，声音含糊不清，这与谵语（热盛神昏时的胡言乱语）截然不同。此症十例中无一能治，不得已时，暂且使用独参汤或白通汤。
言严语（即谵语），指喃喃自语，也称为谵语，指胡乱看见事物而说话。这都是因为真气昏乱，神识不清所导致的。又说：表邪未散，陷入胃中，胃中热盛，向上熏蒸于心，心被热邪蒙蔽，则神气昏乱，胡乱看见事物而说话。轻则在睡眠中喃喃自语，重则即使不睡觉也胡言乱语。有错语、独语、狂语、语言不休、语言错乱等不同表现，各自反映了热邪的轻重程度。大抵热邪入胃，津液枯竭，大便燥结，必然引发谵语。《内经》说：“邪气盛实则为实证，实证则出现谵语。”
动气，指腹部筑筑然跳动的感觉。大概是因为患者素来体内有积气，偶然感受伤寒，医生错误地使用了发汗、催吐、攻下等治法，导致气机扰动，随着脏腑所主的部位，在肚脐的左右上下出现跳动，这些都是真气不足的表现。动气出现在当脐部位，是因为脾居中州（中央），发汗、催吐、攻下首先扰动脾气，所以不言自明。因此，真气内虚，脏气失调，千万不可使用发汗和攻下法。又有肾脏之气内虚，水湿凝结不散，气与水相互搏结，就会引发奔豚（一种气从少腹上冲胸咽的病证）。通常适宜使用理中汤去掉白术加桂枝，因为白术能燥肾水但可能闭塞气机，而桂枝能治疗奔豚。
The *Classic of Internal Medicine* states: If there is fever, headache, body pain, aversion to cold, accompanied by vomiting and diarrhea, what disease does this belong to? The answer is: This is named Huoluan (Cholera-like syndrome). However, there are differences between Gan Huoluan (Dry Cholera) and Shi Huoluan (Wet Cholera). In Shi Huoluan, there is upper vomiting and lower diarrhea; the pathogenic matter can be completely expelled, leading to spontaneous recovery. In Gan Huoluan, one cannot vomit upwards nor defecate downwards; the pathogenic matter cannot be discharged, causing an accumulation and closure of pathogenic factors, blocking the interaction between Yin and Yang. The patient experiences irritability, stifling sensation, and chaotic distress, ultimately dying from colic and abdominal pain. Generally speaking, vomiting and diarrhea caused by Shanghan (Cold Damage) result from pathogenic invasion; those caused by miscellaneous diseases result from dietary injury. Alas, if diet were regulated and daily routines regular, how could one contract Huoluan? "If food intake doubles, the stomach and intestines are injured." The cause of death is truly self-inflicted.
Zhengsheng (abnormal speech resembling music of Zheng and Wei) refers to a voice that resembles the licentious music of Zheng and Wei, lacking uprightness. Confucius said, "I detest the music of Zheng for disrupting the elegant music." The *Classic* states, "Deficiency manifests as Zhengsheng." This occurs due to excessive sweating or purging, leading to extreme deficiency in both exterior and interior, resulting in the collapse of Yang and excess of Yin. The person's righteous Qi declines, losing their normal voice; their spirit is depleted, causing repetitive speech. They present with cold hands and feet, coma, a short tongue, and muffled voice. This differs significantly from Zhanyu (delirious speech). This condition is rarely curable (one in ten cases); out of desperation, one may tentatively use Dushen Tang (Single Ginseng Decoction) or Baitong Tang.
Yanyan Yu (often synonymous with Zhanyu/Delirium) refers to muttering speech, also called Zhanyu, which involves speaking based on hallucinations. Both are caused by the confusion of True Qi and unclear consciousness. Furthermore, if exterior pathogens do not dissipate but sink into the Stomach, where heat becomes excessive, it ascends to harass the Heart. When the Heart is covered by heat, the spirit and Qi become confused, leading to hallucinations and speech. Mild cases involve muttering during sleep; severe cases involve delirious speech even when awake. Variations include Cuoyu (incorrect speech), Duyu (soliloquy), Kuangyu (manic speech), continuous speech, and chaotic speech, each reflecting different degrees of heat. Generally, when heat enters the Stomach, fluids dry up and feces become hard, inevitably triggering Zhanyu. The *Classic* states, "When pathogenic factors are excessive, it is Excess; in Excess conditions, Zhanyu occurs."
Dongqi (pulsating sensation) refers to a throbbing or palpitation feeling. This is generally because the person has pre-existing stagnant Qi, and upon contracting Shanghan, the physician erroneously applies sweating, vomiting, or purging methods. This disturbs the Qi, causing it to manifest as pulsations around the umbilicus (left, right, above, below) according to the associated Zang organs. These are all signs of insufficient True Qi. When Dongqi occurs at the umbilicus, it is because the Spleen resides in the Central Region (Middle Jiao); sweating, vomiting, and purging first disturb Spleen Qi, which is self-evident. Therefore, when True Qi is internally deficient and Zang Qi is unregulated, one must strictly avoid sweating and purging. Additionally, if Kidney Qi is internally deficient, water retention fails to dissipate. Qi and Water contend with each other, triggering Ben Tun (Rushing Pig syndrome, characterized by gas rushing upward from the hypochondrium/abdomen). The appropriate treatment is Lizhong Tang (Regulate the Middle Decoction) with Baizhu (Atractodis Rhizoma) removed and Guizhi (Cinnamon Twig) added. This is because Baizhu dries Kidney water but may obstruct Qi flow, whereas Guizhi treats Ben Tun.