《素问·生气通天论》曰：因而食饱，经脉横解，肠澼为痔。（此即痢与外症相通之意。）又脉要精微论曰：脉数动一代者，病在阳之脉也。泄及便脓血。（脓血二字、明与痈疡相似。）又通评虚实论曰：肠澼便血，身热则死，寒则生。（此与痈疡逆顺相似。）又曰：肠澼下脓血，脉悬绝则死，滑大则生。（此与痈疡阳症阴症意合。）又太阴阳明论曰：饮食不节，起居不时者，阴受之。入五藏则满闭塞，下为飧泄，久为肠澼。（可见暑湿食毒，薰蒸酝酿于藏府膜原之间，脂液化为脓血，而为肠澼。）又六元正纪大论曰：风湿交争，注下赤白。又至真要大论曰：少阳在泉，火淫所胜，注下赤白。（此风湿相火伤于阴络，血液化为赤白，即痈疡化脓之意。）此《内经》诸篇，分明以痢疾与痈疡相似，曰肠澼为痔，曰便脓血，尤彰明较著者。
《难经》云：溲而便脓血。（此以痢之赤白名脓血，即是痈疡之类。）
《金匮要略》云：脉数而渴，今自愈。设不瘥，必清脓血，以有热故也。（《伤寒论·厥阴篇》与此同。按：《伤寒论》云：数脉不时，则生恶疮，与此意同。）又云：下痢便脓血者，桃花汤主之。（《伤寒论·少阴篇》同。）此《难经》《金匮》，论证论治，与痈疡相合。《北史》载司马膺之，患痢十七年不愈，巢元方论休息痢之乍发乍止，肠蛊痢之先赤后白，连年不愈，此上二条，即痈疡成漏之属。
孙思邈云：藏毒为痢。《唐太宗实录》云：太宗苦于气痢，服乳煎荜茇而愈。（牛乳半斤，荜茇三钱煎服。）雷斅云：阳虚久痢，须假草零。（草零即五倍子为末调服。）《赵溍养疴谩笔》云：宋孝宗食湖蟹患痢，用藕节捣烂酒调服而痊。
《夷坚志》云：暑毒在脾，湿气连脚，不泄则痢，不痢则疟，独炼雄黄，蒸饼和药，甘草作汤，服之安乐。寇宗奭云：洛阳女子耽饮，多食鱼蟹，畜毒在藏，大便脓血，诸药不应，如此期年，垂命待尽，或教服人参散而愈。（人参、椿根皮各一两为末，每服二钱，开水调下。）
刘河间云：下痢赤白，俗言寒热相兼，其说尤误。如热生痈疡，而出白脓，岂可以白为寒欤。由其在皮肤之分，属肺金，故色白也。次在血脉之分，属心火，故色赤也。（此即痈疡化脓之理。）李东垣云：肠澼为水谷与血，另作一派，如FS桶涌出。（此即痈疽出头之意。）
朱丹溪云：赤属血，白属气，下如鱼脑者半生半死，下如尘腐色者死，下纯血者死，下如屋漏水者死。（此与痈疽败症无异。）
张景岳云：痢之脓垢，非糟粕，乃附肠着藏之脂膏，皆精血之属也。（此即痈疽化脓之理。）
吴又可云：温疫愈后，及战汗后，反腹痛里急，欲作滞下也。（此即留热发病遗之意。）又曰：下痢脓血，更加发热而渴，此疫痢兼症。此即热极生痈之意。此上十一条，论痢疾证治之理，正与痈疡机宜暗合，但未有直言痈疖流注疮疡之属，生于膜原连络肠胃之间，脓血内溃，渗入肠中，漂澼而下，为痢之赤白者。由是观之，治痢之法，当参入治痈之义。如痢之初起用芍药等汤，即痈疽初起宜攻之意也。正气偏虚，用补中益气等汤，即痈疽托里之意也。旷日持久，用收涩等法，即痈疡合口之意也。如痢之所忌，身热脉大，禁口不食，亦痈疡之所忌也。痈疡所忌，脓色清稀，尘腐如屋漏水，亦痢疾之所忌也。前贤治痢诸方已备，今参以治痈之法，无遗义矣。然治法多歧，恐滋惑乱，兹约三法，可以类推。一日攻发，二日托补，三日收涩。如有表，败毒散、小柴胡汤等。无表，芍药汤、承气汤等。皆攻发之剂也。气虚四君子汤、补中益气汤等，血虚四物汤、六味地黄汤等，皆托补之剂也。滑泄休息，桃花汤、养藏汤、椿根皮、罂粟壳、乌梅、诃子等，皆收涩之剂也。若医话新制痢疾三方，探本穷源，从博反约，更无出其右者。
略曰：道光甲午，余祖母氏杨，年九十五，凉秋九月，患痢如鱼肠屋漏水，昼夜无度，色臭腐败，脚缩不伸，足胫红肿若肠痈之状，知其不起，未敢进药，八日而卒。（自九月初六至十三亥时终。）又叔母氏王，年六十六，于己亥秋杪，病亦如是而卒。（自九月初十至十八寅时终。又余女年甫五岁，亦于是月病此而卒。）余以是知痢即内痈，赤白即脓血，而著此论也。
痢疾论列方
败毒散（三十一） 桃花汤（五十一） 芍药汤（四十七） 补中益气汤（四十九） 小柴胡汤（三十三） 大承气汤（三十四） 四君子汤（四十八） 四物汤（八） 六味地黄汤（五十） 养藏汤（五十二）
霍乱第十一
《椿田医话》曰：黄土汤，主治霍乱吐泻。此证多在夏秋，乃暑湿食郁于中胃，传化失常，气乱味变，正不容邪，犯上则吐，犯下则泻。既吐且泻，邪有出路，故湿霍乱为轻多生。若上不得吐，下不得泻，邪无出路，故干霍乱为重多死。霍乱既因暑湿而得，而复有寒者，因暑贪凉过食瓜果故也。夏月加香薷一钱，三秋加蓼花根一两，虚则加冬白术钱半土炒，实则加鸡心槟榔一钱，寒则加理中丸五钱同煎，热则加四苓散五钱同煎。干霍乱本方两剂加炒盐一两，童子小便一小碗多服，以手指按舌根探吐，得吐即泻，吐泻后去炒盐童便，照常煎服。忌稠粘粥食，宜老米汤及老米粥，三日后方可食新米，并治转筋霍乱。 净黄土（二两） 广藿香（二钱） 生木香（八分） 宣木瓜（二钱） 陈橘皮（一钱） 紫厚朴（八分） 白扁豆（三钱） 活水芦根（二两） 长流水煎。 前哲掘壁下成坑，灌水搅浑取起，名地浆，治干湿霍乱，洗尽腹中秽浊，甚善。今用黄土为主，加藿香、木香之芳香以解秽浊，木瓜和胃舒筋，以杜转筋，陈皮调畅气机，厚朴、扁豆消暑去湿，芦根致胃清和，犹是地浆之意，而胜于墙阴之不洁远矣。
《春秋考异》邮曰：襄公朝于荆，士卒度岁，愁悲失时，泥雨暑湿，多霍乱之病。
《汉书》曰：淮南王上书云：南越多霍乱之病。（见《太平御览》七百四十三卷。）
柳子厚曰：元和十一年十月得霍乱，上不可吐，下不可利，出冷汗三大升许，气即绝。河南房伟传，此方入口即吐，绝气复通。用盐一大匙，熬令黄，童子小便一升，合和温服，少顷，吐下即愈也。
《九峰医案》曰：客忤霍乱，内有所伤，伤其七情，外有所感，感于六气，阴阳乖错，吐泻交作。吐则伤阳伤胃，泻则伤阴伤肾。吐泻时幸服理中得有转机。今经二十日，胸次胀满，口干非渴，脉弦无力，阳不生阴，阴不化气，阴阳俱亏，五液俱耗，乙癸同源是理，第肾阴不足以制肝阳，肝志为怒，怒则气上，气填胸膈，非食滞可比。肝无补法，补肾即所以补肝。人身之阴阳，阳者亲上而外卫，阴者亲下而内营，难成而易亏，补之非易，无阳则阴无以生，无阴则阳无以化，必得益气生阴，阴从阳化，肾气通于胃，阴精上蒸，清阳开展，自入佳境，二气两协其平，上下互相流贯，自无否象。公议生脉、八味，益火之原，壮水之主，从阴引阳，从阳引阴，是否候酌。 大熟地（八钱） 粉丹皮（三钱） 福泽泻（三钱） 淮山药（四钱） 云茯苓（三钱） 山萸肉（四钱） 制附子（一钱） 油肉桂（八分） 人参（二钱） 大麦冬（三钱） 北五味（一钱） 肝脉渐和，胃脉尚软，夜来半寤半寐，二气渐有和顺之机，素本肾亏，虚寒之体，真阳不健，值大病之后，二气交伤，五液互损，藏府之气，何由骤复，补阴之品，无过熟地，但守补则中枢易钝，得桂附走而不守，达肾火之窟，蕴生中土，方能化液生阴，不独不闷不滞，且于肾胃有赞襄之功，所谓补肾则胃开，补命则脾健。清晨用原方略为加减，培补命肾之阴阳，午后以养胃生阴之品，阴阳交济之法，循理之至，似无背谬，候正诸明哲。 大熟地（八钱） 粉丹皮（三钱） 福泽泻（三钱） 淮山药（四钱） 云茯苓（四钱） 山萸肉（四钱） 制附子（八分） 油肉桂（五分） 人参（一钱） 淡苁蓉（三钱） 福橘皮（一钱） 大麦冬（三钱） 午后服养胃生阴方 南沙参（八钱） 野白术（三钱） 大白芍（三钱） 生甘草（五分） 金钗石斛（五钱） 夜寐初醒，偶虑事情，扰动心火，舌中作燥。照本方去肉桂、茯苓，减附子四分，加酸枣仁、白茯神各三钱，午后仍服养胃生阴方。 立秋后四日，脉神形色俱起，脾胃渐苏，大病新瘥，藏府初和，二气未定，全在静养工夫。当守摇精劳形之戒，澄心息虑，恬憺虚无，乃善后之良谋。五内得太和之气，自臻康豫。拟方仍候酌。 大熟地（八钱） 淮山药（四钱） 山萸肉（四钱） 云茯苓（三钱） 福橘皮（一钱） 人参（一钱） 酸枣仁（三钱） 当归身（三钱） 五味子（一钱） 大病新瘥，藏府初和，脾胃苏而未振，不宜思虑烦劳，七情之伤，虽有五藏之分，不外心肾，天地造化之理，无非静定，静则神藏无为自化，阴平阳秘，精神乃治，食入于阴，长气于阳，阳气者若天与日，失其所，则折寿而不彰，故天运当以日光明。前以从阴引阳，从阳引阴，水升火降，诸恙悉平。兹以黑归脾加减，从心脾肾主治，待中枢大展，饮食加增，再以斑龙丸，培补命肾之元阳，以化素体之沉寒痼冷，乃有层次，然否仍候酌。 大熟地（四两） 人参（五钱） 野白术（二两） 炙甘草（五钱） 当归身（二两） 酸枣仁（二两） 远志肉（一两） 白茯神（二两） 煨木香（三钱） 淮山药（二两） 山萸肉（二两） 为末，龙眼肉三两，煎水叠丸，早晚服二钱，开水下。 蒋宝素曰：霍乱者，霍然变乱非常，胸腹互痛，吐泻交作，乃湿郁于中，气机不运，升降道阻，水谷不化，气乱味变于肠胃之间，郁极而发，兼六化之证也。有不得吐泻者，即名干霍乱，乃湿郁之甚也。《灵枢·经脉篇》曰：足太阴厥气上逆则霍乱。《素问·气交变大论》曰：岁土不及，民病飧泄霍乱。又六元正纪大论曰：土郁之发，心痛胁，呕吐霍乱。又云：太阴所至为中满，霍乱吐下。又云：不远热则热至，（此即因热化热之据。）热至则身热吐下霍乱。此《内经》诸篇，俱以太阴湿土动变成霍乱。盖湿从土化，土无成位，湿无专证，而有六化之别焉。遇热化热，遇寒化寒，因表化表，因里化里，因虚化虚，因实化实。故仲景《伤寒论·辨霍乱条》曰：霍乱头痛，发热身疼痛，热多欲饮水者，五苓散主之。此湿从热化也。又云：寒多不欲水，理中丸主之。此湿从寒化也。又云：吐利而身痛不休者，宜桂枝汤小和之。此因表化表也。又云：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。此因里化里也。又曰：恶寒脉微而复利，利止亡血也，四逆加人参汤主之。此因虚化虚也。又云：下利后当便硬，硬则能食者愈。此因实化实也。岂可执一乎。《易说》曰：谷雨气当至不至，则多霍乱。此亦湿从寒化也。《汉书》淮南王上书云：南越多霍乱之病。此亦湿从热化也。《春秋考异》邮曰：襄公朝于荆，士卒度岁，愁悲失时，泥雨暑湿，多霍乱之病。此亦湿从热化而兼七情也。葛稚川以饮食生冷肥腻酒鲙，而当风履湿，薄衣露坐，或夜卧失覆所致。亦从湿食动变而起。巢元方以温凉不调，阴阳清浊二气有相干乱之时，其乱在于肠胃之间，因遇饮食而变发。又宗仲景之意，以挟风而实者，身发热头痛体疼而复吐利，虚者但吐利心腹刺痛而已。又宗稚川以饮酒食肉腥脍生冷过度，因居处不节，或露卧湿地，或当风取凉，而风冷之气归于三焦，传于脾胃。又以干霍乱是冷气搏于肠胃，又以霍乱转筋，是冷气入筋，大吐下之后，阴阳俱虚，其血气虚极，则手足逆而营卫不理，冷搏于筋，则筋为之转，此湿因风寒之证，乃六化之一也。夫干霍乱不得吐泻者，乃湿郁兼六化之甚也。转筋者在吐泻之前，因实因热也。在吐泻之后，因虚因寒也。柳子厚得干霍乱，用炒盐和童便服之，取吐即泻而愈。此开湿郁之甚，治法精良。陈无择所论与巢元方同。刘河间以热气甚，则传化失常而吐泻霍乱，火性燥动故也。又云：一切霍乱吐泻，通宜五苓散、益元散。又云转筋吐泻者，其气有三。曰风、火、湿也。又云：此证或先五苓、益元、桂苓甘露饮，乃吐泻之圣药也。慎毋与粟米粥。此湿因暑热之证，乃六化之一也。易水老人，亦以霍乱转筋吐泻，乃阴阳交错不和，不可与分毫粥饮。张子和以风湿暍为主，申明巢氏之非，默契河间之意，伟王冰脾热之语，盖不知霍乱皆以湿为主，而有六化之别。巢氏所论湿，因风寒化也。河间所论湿，因暑热化也。二公俱未悉六化之变。若王冰不过注《素问》经文之一端耳。《丹溪心法》，霍乱吐泻用二陈汤加减作吐，以提其气，切莫与谷食，亦有可下者。转筋不住，男子以手挽其阴，女子以手牵其乳，是皆良法。又云：转筋皆属乎血热，四物汤加酒炒黄芩、红花、苍术、南星，亦未分转筋在吐泻前后有寒热之别。戴复庵言挥霍变乱起于仓卒，宜苏合香丸，继进藿香正气散，加木香五分，论治可采。王肯堂言霍乱转筋，舌卷囊缩，及霍乱后遗尿不语，膏汗如珠，躁欲入水，四肢不收等证皆不治，宜须详审。
《素问·生气通天论》说：如果因为饮食过饱，导致经脉松弛散乱，大肠湿热下注形成痢疾（肠澼），进而引发痔疮。（这正是痢疾与体表疮疡相通的意思。）又《脉要精微论》说：脉搏快速跳动且时有间歇的，是病在阳经的脉象。症状表现为腹泻以及大便脓血。（“脓血”二字，明确显示其与痈疡的症状相似。）又《通评虚实论》说：患痢疾便血的，如果身体发热则预后不良会死亡，如果不发热则预后良好能生存。（这与痈疡的逆证和顺证相似。）又说：患痢疾下脓血的，如果脉象悬绝（极细弱或极盛而无根）则死，脉象滑大则生。（这与痈疡的阳证和阴证的机理相合。）又《太阴阳明论》说：饮食不节制，起居没有规律的，邪气首先侵犯阴经。邪气进入五脏则导致胸腹痞满闭塞，向下发展为完谷不化的泄泻，日久则演变为痢疾。（可以看出，暑湿食毒，在脏腑膜原之间熏蒸酝酿，使脂液化为脓血，从而形成痢疾。）又《六元正纪大论》说：风湿之气交争，导致大便下赤白黏液。又《至真要大论》说：少阳司天在泉时，火气淫盛，导致大便下赤白黏液。（这是风湿相火损伤阴络，血液化为赤白黏液，即痈疡化脓的意思。）这些《内经》各篇，分明将痢疾与痈疡视为相似，说“肠澼形成痔疮”，说“便脓血”，尤其明显显著。
《难经》说：小便时伴随大便脓血。（这里用痢疾的赤白黏液称为脓血，即是属于痈疡一类。）
《金匮要略》说：脉数且口渴的，病情将会自愈。假如不痊愈，必定会出现大便脓血，因为有热邪的缘故。（《伤寒论·厥阴篇》与此相同。按：《伤寒论》说：脉数不停止，就会发生恶疮，这与这里的意义相同。）又说：下痢便脓血的，用桃花汤主治。（《伤寒论·少阴篇》相同。）这些《难经》《金匮》，论证和论治，都与痈疡相符合。《北史》记载司马膺之，患痢疾十七年不愈，巢元方论述休息痢的时发时止，肠蛊痢的先红后白，连年不愈，这两条，就是痈疡形成瘘管的类别。
孙思邈说：脏腑积毒导致痢疾。《唐太宗实录》说：太宗苦于气痢，服用乳煎荜茇而痊愈。（牛乳半斤，荜茇三钱煎服。）雷斅说：阳虚久痢，必须假借草零（草零即五倍子，研末调服）。《赵溍养疴谩笔》说：宋孝宗吃湖蟹患痢，用藕节捣烂酒调服而痊愈。
《夷坚志》说：暑毒在脾，湿气连脚，不泄泻则成痢，不痢则成疟，单独炼制雄黄，用蒸饼和药，甘草作汤剂，服用后安乐。寇宗奭说：洛阳女子贪饮，多吃鱼蟹，毒素蓄积在脏腑，大便脓血，各种药物无效，这样过了一年，生命垂危等待死亡，有人教她服用人参散而痊愈。（人参、椿根皮各一两为末，每次服二钱，开水调下。）
刘河间说：下痢赤白，俗话说是寒热兼夹，这种说法尤其错误。比如热邪产生痈疡，而出白色的脓，难道可以因为白色就认为是寒吗？因为毒在皮肤之分，属于肺金，所以色白。其次在血脉之分，属于心火，所以色赤。（这就是痈疡化脓的道理。）李东垣说：肠澼是水谷与血，另外形成一派，像桶里涌出一样。（这就是痈疽溃破流出的意思。）
朱丹溪说：红色属血，白色属气，下利像鱼脑的是半生半死，下利像灰尘腐烂颜色的死，下纯血的是死，下利像屋顶漏水的死。（这与痈疽败症没有不同。）
张景岳说：痢疾的脓垢，不是糟粕，而是附着在肠壁和脏腑上的脂膏，都是精血所属的东西。（这就是痈疽化脓的道理。）
吴又可说：温疫痊愈后，以及战汗之后，反而腹痛里急后重，想要发作滞下痢疾。（这就是余热发病遗留的意思。）又说：下痢脓血，更加发热而口渴，这是疫痢兼症。这就是热极生痈的意思。以上十一条，论述痢疾证治的道理，正与痈疡的机理暗中契合，只是没有直言是痈疖流注疮疡之类，生于膜原连接肠胃之间，脓血内溃，渗入肠中，漂荡而下，成为痢疾的赤白黏液。由此看来，治疗痢疾的方法，应当参入治疗痈义。如痢疾初起用芍药汤等，就是痈疽初起宜攻伐的意思。正气偏虚，用补中益气汤等，就是痈疽托里透脓的意思。旷日持久，用收涩等方法，就是痈疡愈合封口的意思。如痢疾所禁忌的，身体发热脉大，禁口不食，也是痈疡所禁忌的。痈疡所禁忌的，脓色清稀，尘腐如屋漏水，也是痢疾所禁忌的。前贤治疗痢疾的方剂已经完备，现在参入治疗痈的方法，就没有遗漏的意义了。然而治法多种多样，恐怕造成混乱，这里概括三种方法，可以类推。一是攻发，二是托补，三是收涩。如果有表证，用败毒散、小柴胡汤等。无表证，用芍药汤、承气汤等。都是攻发的药剂。气虚用四君子汤、补中益气汤等，血虚用四物汤、六味地黄汤等，都是托补的药剂。滑泄休息痢，用桃花汤、养脏汤、椿根皮、罂粟壳、乌梅、诃子等，都是收涩的药剂。如果医家新制定的痢疾三方，探本穷源，从博返约，更没有超过它们的了。
大致说：道光甲午年，我的祖母杨氏，九十五岁，凉秋九月，患痢疾像鱼肠屋漏水，昼夜无度，颜色气味腐败，脚缩不能伸直，足胫红肿像肠痈的样子，知道她活不了，不敢进药，八天后去世。（从九月初六到十三日亥时结束。）又叔母王氏，六十六岁，在己亥年秋末，生病也是这样而去世。（从九月初十到十八日寅时结束。还有我女儿年仅五岁，也在这个月得此病而去世。）我因此知道痢疾就是内痈，赤白黏液就是脓血，于是写了这篇论述。
痢疾论列方
败毒散（第三十一方） 桃花汤（第五十一方） 芍药汤（第四十七方） 补中益气汤（第四十九方） 小柴胡汤（第三十三方） 大承气汤（第三十四方） 四君子汤（第四十八方） 四物汤（第八方） 六味地黄汤（第五十方） 养脏汤（第五十二方）
霍乱第十一
《椿田医话》说：黄土汤，主治霍乱吐泻。这个病症多在夏秋季节，是暑湿食积郁结在中焦胃腑，传化功能失常，气机紊乱味道改变，正气不容纳邪气，犯上则呕吐，犯下则泄泻。既吐又泻，邪气有出路，所以湿霍乱较轻多能生存。如果上不得吐，下不得泻，邪气没有出路，所以干霍乱较重多死亡。霍乱既然因暑湿而得，而又夹杂寒邪的，是因为夏天贪凉过食瓜果的缘故。夏季加香薷一钱，三秋加蓼花根一两，虚则加冬白术钱半土炒，实则加鸡心槟榔一钱，寒则加理中丸五钱同煎，热则加四苓散五钱同煎。干霍乱本方两剂加炒盐一两，童子小便一小碗多服，用手指按压舌根探吐，得吐即泻，吐泻后去掉炒盐和童便，照常煎服。忌食稠粘粥食，宜喝老米汤及老米粥，三天后方可吃新米，并治疗转筋霍乱。 净黄土（二两） 广藿香（二钱） 生木香（八分） 宣木瓜（二钱） 陈橘皮（一钱） 紫厚朴（八分） 白扁豆（三钱） 活水芦根（二两） 长流水煎。 前哲挖掘墙壁下成坑，灌水搅浑取起，名叫地浆，治疗干湿霍乱，洗尽腹中秽浊，很好。现在用黄土为主，加藿香、木香的芳香以解秽浊，木瓜和胃舒筋，以防止转筋，陈皮调畅气机，厚朴、扁豆消暑去湿，芦根使胃清和，仍然是地浆的意思，而胜过墙阴的不洁远矣。
《春秋考异》邮说：襄公朝见荆国，士卒度过一年，愁悲失时，泥雨暑湿，多患霍乱病。
《汉书》说：淮南王上书说：南方越地多有霍乱病。（见《太平御览》七百四十三卷。）
柳宗元说：元和十一年十月得霍乱，上不能吐，下不能利，出冷汗三大升左右，气即断绝。河南房伟传，此方入口即吐，绝气复通。用盐一大匙，熬令黄色，童子小便一升，混合温服，一会儿，吐下即痊愈。
《九峰医案》说：客忤霍乱，内有所伤，伤了七情，外有所感，感于六气，阴阳乖错，吐泻交作。吐则伤阳伤胃，泻则伤阴伤肾。吐泻时幸好服用理中丸得有转机。现在已经二十天，胸次胀满，口干非渴，脉弦无力，阳不生阴，阴不化气，阴阳俱亏，五液俱耗，乙癸同源是道理，只是肾阴不足以制约肝阳，肝志为怒，怒则气上，气填胸膈，不是食滞可比。肝无补法，补肾即所以补肝。人身之阴阳，阳者亲上而外卫，阴者亲下而内营，难成而易亏，补之非易，无阳则阴无以生，无阴则阳无以化，必得益气生阴，阴从阳化，肾气通于胃，阴精上蒸，清阳开展，自入佳境，二气两协其平，上下互相流贯，自无否象。公议生脉、八味，益火之原，壮水之主，从阴引阳，从阳引阴，是否候酌。 大熟地（八钱） 粉丹皮（三钱） 福泽泻（三钱） 淮山药（四钱） 云茯苓（三钱） 山萸肉（四钱） 制附子（一钱） 油肉桂（八分） 人参（二钱） 大麦冬（三钱） 北五味（一钱） 肝脉渐和，胃脉尚软，夜来半寤半寐，二气渐有和顺之机，素本肾亏，虚寒之体，真阳不健，值大病之后，二气交伤，五液互损，藏府之气，何由骤复，补阴之品，无过熟地，但守补则中枢易钝，得桂附走而不守，达肾火之窟，蕴生中土，方能化液生阴，不独不闷不滞，且于肾胃有赞襄之功，所谓补肾则胃开，补命则脾健。清晨用原方略为加减，培补命肾之阴阳，午后以养胃生阴之品，阴阳交济之法，循理之至，似无背谬，候正诸明哲。 大熟地（八钱） 粉丹皮（三钱） 福泽泻（三钱） 淮山药（四钱） 云茯苓（四钱） 山萸肉（四钱） 制附子（八分） 油肉桂（五分） 人参（一钱） 淡苁蓉（三钱） 福橘皮（一钱） 大麦冬（三钱） 午后服养胃生阴方 南沙参（八钱） 野白术（三钱） 大白芍（三钱） 生甘草（五分） 金钗石斛（五钱） 夜寐初醒，偶虑事情，扰动心火，舌中作燥。照本方去肉桂、茯苓，减附子四分，加酸枣仁、白茯神各三钱，午后仍服养胃生阴方。 立秋后四日，脉神形色俱起，脾胃渐苏，大病新瘥，藏府初和，二气未定，全在静养工夫。当守摇精劳形之戒，澄心息虑，恬憺虚无，乃善后之良谋。五内得太和之气，自臻康豫。拟方仍候酌。 大熟地（八钱） 淮山药（四钱） 山萸肉（四钱） 云茯苓（三钱） 福橘皮（一钱） 人参（一钱） 酸枣仁（三钱） 当归身（三钱） 五味子（一钱） 大病新瘥，藏府初和，脾胃苏而未振，不宜思虑烦劳，七情之伤，虽有五藏之分，不外心肾，天地造化之理，无非静定，静则神藏无为自化，阴平阳秘，精神乃治，食入于阴，长气于阳，阳气者若天与日，失其所，则折寿而不彰，故天运当以日光明。前以从阴引阳，从阳引阴，水升火降，诸恙悉平。兹以黑归脾加减，从心脾肾主治，待中枢大展，饮食加增，再以斑龙丸，培补命肾之元阳，以化素体之沉寒痼冷，乃有层次，然否仍候酌。 大熟地（四两） 人参（五钱） 野白术（二两） 炙甘草（五钱） 当归身（二两） 酸枣仁（二两） 远志肉（一两） 白茯神（二两） 煨木香（三钱） 淮山药（二两） 山萸肉（二两） 为末，龙眼肉三两，煎水叠丸，早晚服二钱，开水下。 蒋宝素说：霍乱者，霍然变乱非常，胸腹互痛，吐泻交作，乃湿郁于中，气机不运，升降道阻，水谷不化，气乱味变于肠胃之间，郁极而发，兼六化之证也。有不得吐泻者，即名干霍乱，乃湿郁之甚也。《灵枢·经脉篇》说：足太阴厥气上逆则霍乱。《素问·气交变大论》说：岁土不及，民病飧泄霍乱。又六元正纪大论说：土郁之发，心痛胁痛，呕吐霍乱。又说：太阴所至为中满，霍乱吐下。又说：不远热则热至，（这就是因热化热的依据。）热至则身热吐下霍乱。这些《内经》各篇，都以太阴湿土动变成霍乱。盖湿从土化，土无成位，湿无专证，而有六化之别焉。遇热化热，遇寒化寒，因表化表，因里化里，因虚化虚，因实化实。所以仲景《伤寒论·辨霍乱条》说：霍乱头痛，发热身疼痛，热多欲饮水者，五苓散主之。这是湿从热化。又说：寒多不欲水，理中丸主之。这是湿从寒化。又说：吐利而身痛不休者，宜桂枝汤小和之。这是因表化表。又说：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。这是因里化里。又说：恶寒脉微而复利，利止亡血也，四逆加人参汤主之。这是因虚化虚。又说：下利后当便硬，硬则能食者愈。这是因实化实。岂可执一乎。《易说》说：谷雨气当至不至，则多霍乱。这也是湿从寒化。《汉书》淮南王上书说：南越多霍乱之病。这也是湿从热化。《春秋考异》邮说：襄公朝见荆国，士卒度过一年，愁悲失时，泥雨暑湿，多患霍乱病。这也是湿从热化而兼七情。葛稚川认为由饮食生冷肥腻酒鲙，而当风履湿，薄衣露坐，或夜卧失覆所致。也从湿食动变而起。巢元方认为温凉不调，阴阳清浊二气有相干乱之时，其乱在于肠胃之间，因遇饮食而变发。又宗仲景之意，以挟风而实者，身发热头痛体疼而复吐利，虚者但吐利心腹刺痛而已。又宗稚川以饮酒食肉腥脍生冷过度，因居处不节，或露卧湿地，或当风取凉，而风冷之气归于三焦，传于脾胃。又以干霍乱是冷气搏于肠胃，又以霍乱转筋，是冷气入筋，大吐下之后，阴阳俱虚，其血气虚极，则手足逆而营卫不理，冷搏于筋，则筋为之转，此湿因风寒之证，乃六化之一也。夫干霍乱不得吐泻者，乃湿郁兼六化之甚也。转筋者在吐泻之前，因实因热也。在吐泻之后，因虚因寒也。柳宗元得干霍乱，用炒盐和童便服之，取吐即泻而愈。此开湿郁之甚，治法精良。陈无择所论与巢元方同。刘河间认为热气甚，则传化失常而吐泻霍乱，火性燥动故也。又说：一切霍乱吐泻，通宜五苓散、益元散。又说转筋吐泻者，其气有三。曰风、火、湿也。又说：此证或先五苓、益元、桂苓甘露饮，乃吐泻之圣药也。慎毋与粟米粥。这是湿因暑热之证，乃六化之一也。易水老人，也以霍乱转筋吐泻，乃阴阳交错不和，不可与分毫粥饮。张子和以风湿暍为主，申明巢氏之非，默契河间之意，伟王冰脾热之语，盖不知霍乱皆以湿为主，而有六化之别。巢氏所论湿，因风寒化也。河间所论湿，因暑热化也。二公俱未悉六化之变。若王冰不过注《素问》经文之一端耳。《丹溪心法》，霍乱吐泻用二陈汤加减作吐，以提其气，切莫与谷食，亦有可下者。转筋不住，男子以手挽其阴，女子以手牵其乳，是皆良法。又说：转筋皆属乎血热，四物汤加酒炒黄芩、红花、苍术、南星，亦未分转筋在吐泻前后有寒热之别。戴复庵言挥霍变乱起于仓卒，宜苏合香丸，继进藿香正气散，加木香五分，论治可采。王肯堂言霍乱转筋，舌卷囊缩，及霍乱后遗尿不语，膏汗如珠，躁欲入水，四肢不收等证皆不治，宜须详审。
The *Suwen: Treatise on the Heavenly Vitality* states: If one becomes overly full from eating, the meridians become loose and scattered, intestinal dysentery (Changpi) develops into hemorrhoids. (This is the meaning that dysentery and external lesions are connected.) Furthermore, the *Maoyao Jingwei Lun* states: A pulse that is rapid, active, and occasionally intermittent indicates disease in the Yang meridians. Symptoms include diarrhea and pus-blood in the stool. (The terms "pus" and "blood" clearly show similarity to carbuncles and sores.) Also, the *Tongping Xushi Lun* states: In intestinal dysentery with blood in the stool, if the body is hot, death ensues; if cold, survival occurs. (This is similar to the adverse and favorable prognoses of carbuncles.) It also states: In intestinal dysentery with pus-blood discharge, a hanging-extreme pulse indicates death, while a slippery and large pulse indicates survival. (This aligns with the concepts of Yang and Yin syndromes in carbuncles.) Additionally, the *Taiyin Yangming Lun* states: Irregular diet and improper daily routine cause pathogenic factors to first affect the Yin channels. Entering the Five Zang organs leads to fullness and obstruction, manifesting downward as undigested diarrhea, which over time becomes intestinal dysentery. (This shows that summer-heat, dampness, and food toxins ferment between the Zang-Fu organs and the membrane source, transforming fatty tissue into pus-blood, thereby forming dysentery.) The *Liuyuan Zhengji Dalun* states: When wind and dampness contend, red and white discharge follows. The *Zhizhen Yao Da Lun* states: When Shaoyang governs the interior, excessive fire causes red and white discharge. (This refers to wind-dampness and ministerial fire damaging the Yin collaterals, transforming blood into red and white discharge, which is the meaning of pus formation in carbuncles.) These chapters in the *Neijing* clearly equate dysentery with carbuncles, stating "intestinal dysentery forms hemorrhoids" and "passing pus-blood," which is particularly evident.
The *Nanjing* states: Passing pus-blood during urination. (Here, the red and white discharge of dysentery is called pus-blood, indicating it belongs to the category of carbuncles.)
The *Jingui Yaolue* states: A rapid pulse with thirst indicates impending recovery. If not recovered, pus-blood in the stool will certainly occur due to heat. (This is consistent with the *Shanghan Lun: Jueyin Chapter*. Note: The *Shanghan Lun* states: A persistent rapid pulse generates malignant sores, which shares the same meaning here.) It also states: For dysentery with pus-blood, Taohua Decoction is the primary treatment. (Consistent with the *Shanghan Lun: Shaoyin Chapter*). The arguments and treatments in the *Nanjing* and *Jingui* align with those for carbuncles. The *Book of Northern History* records Sima Yingzhi suffering from dysentery for seventeen years without cure. Chao Yuanfang discussed the intermittent nature of lingering dysentery and the initial red followed by white discharge of intestinal gu dysentery, lasting years without cure; these two cases belong to the category of carbuncle fistulas.
Sun Simiao stated: Visceral toxicity causes dysentery. The *Veritable Record of Emperor Taizong of Tang* states: Emperor Taizong suffered from Qi dysentery and was cured by taking Pipa decocted in milk. (Half a jin of cow's milk, three qian of Pipa, decocted and taken.) Lei Xiao stated: For chronic dysentery due to Yang deficiency, Cao Ling (Wu Beizi/Galla Chinensis) must be used. (Cao Ling is Wu Beizi, taken as powder mixed with water.) *Zhaomin's Casual Notes on Nursing Illness* states: Emperor Xiaozong of Song developed dysentery after eating lake crabs and was cured by taking crushed lotus rhizome nodes mixed with wine.
*Yijian Zhi* states: Summer-heat toxin resides in the Spleen, dampness connects to the feet; if there is no diarrhea, there is dysentery; if no dysentery, there is malaria. Alone refining Realgar, mixing medicine with steamed dough, and taking Licorice decoction brings peace and comfort. Kou Zongshi stated: A woman from Luoyang who indulged in drinking and ate much fish and crab accumulated toxin in her viscera, resulting in pus-blood in the stool. All medicines failed. After a year, facing death, she was taught to take Rensan Powder and was cured. (One liang each of Ginseng and Toona Root Bark, ground to powder, two qian per dose, taken with boiled water.)
Liu Wansu stated: Red and white dysentery is vulgarly said to be a combination of cold and heat, which is especially erroneous. For instance, when heat generates carbuncles and white pus emerges, how can white be considered cold? Because the toxin is in the skin layer, belonging to Lung Metal, the color is white. Next, in the blood vessel layer, belonging to Heart Fire, the color is red. (This is the principle of pus formation in carbuncles.) Li Dongyuan stated: Intestinal dysentery involves grain and blood forming a separate stream, gushing out like from a bucket. (This is the meaning of carbuncle/ulcer eruption.)
Zhu Danxi stated: Red belongs to Blood, White belongs to Qi. Discharge resembling fish brain indicates half-life half-death; discharge resembling dust or rotting color indicates death; pure blood discharge indicates death; discharge resembling roof leak water indicates death. (This is no different from the defeat syndrome of carbuncles/ulcers.)
Zhang Jingyue stated: The pus and filth of dysentery are not dregs, but the fat and grease attached to the intestines and viscera, all belonging to essence and blood. (This is the principle of pus formation in carbuncles/ulcers.)
Wu Youke stated: After recovery from warm pestilence, or after battle-sweat, abdominal pain and tenesmus may recur, suggesting impending stagnation dysentery. (This is the meaning of residual heat causing disease relapse.) He also stated: Dysentery with pus-blood accompanied by fever and thirst is a concurrent symptom of epidemic dysentery. This is the meaning of extreme heat generating carbuncles. The above eleven points discuss the principles of dysentery diagnosis and treatment, which secretly align with the mechanisms of carbuncles, although they do not explicitly state that carbuncles, boils, flowing abscesses, and sores arise from the membrane source connecting to the intestines and stomach, where internal rupture of pus-blood seeps into the intestines, floats down, and becomes the red and white discharge of dysentery. From this, we see that the method of treating dysentery should incorporate the meaning of treating carbuncles. For example, using Shaoyao Decoction at the onset of dysentery corresponds to the need to attack carbuncles at their onset. Using Buzhong Yiqi Decoction for deficient righteous Qi corresponds to the method of supporting the interior for carbuncles. Using astringent methods for prolonged duration corresponds to the closing of carbuncle wounds. Contraindications for dysentery, such as fever, large pulse, and inability to eat, are also contraindications for carbuncles. Contraindications for carbuncles, such as thin pus and discharge resembling dust or roof leak water, are also contraindications for dysentery. Ancient experts' formulas for dysentery are complete; now incorporating methods for treating carbuncles leaves no aspect unaddressed. However, since treatment methods vary, potentially causing confusion, I summarize three methods for extrapolation: First, attacking and dispersing; Second, supporting and tonifying; Third, astringing. If there is an exterior syndrome, use Baidu San or Xiaochaihu Decoction. Without exterior syndrome, use Shaoyao Tang or Chengqi Tang. These are all attacking agents. For Qi deficiency, use Sijunzi Tang or Buzhong Yiqi Tang; for Blood deficiency, use Siwu Tang or Liuwei Dihuang Tang. These are all supporting and tonifying agents. For slippery diarrhea and lingering dysentery, use Taohua Tang, Yangzang Tang, Chun Gen Pi, Ying Su Ke, Wu Mei, or He Zi. These are all astringent agents. If physicians' new regulations for three dysentery formulas explore the root and source, simplifying from complexity, none surpass them.
Roughly speaking: In the Jiawu year of Daoguang, my grandmother, Lady Yang, aged ninety-five, in early autumn, suffered from dysentery resembling fish intestines and roof leak water, day and night without limit, with foul odor and corrupt appearance. Her legs were curled and could not straighten, and her calves were red and swollen like intestinal abscess. Knowing she would not survive, I dared not administer medicine, and she died eight days later. (From the sixth to the thirteenth day of the ninth month, ending at Hai hour.) My aunt, Lady Wang, aged sixty-six, in late autumn of the Jihai year, also died from similar illness. (From the tenth to the eighteenth day of the ninth month, ending at Yin hour.) My daughter, only five years old, also died from this illness in the same month. Therefore, I know that dysentery is an internal carbuncle, and red and white discharge is pus-blood, hence writing this treatise.
Formulas Listed for Dysentery Treatise
Baidu San (Formula 31) Taohua Tang (Formula 51) Shaoyao Tang (Formula 47) Buzhong Yiqi Tang (Formula 49) Xiaochaihu Tang (Formula 33) Dachengqi Tang (Formula 34) Sijunzi Tang (Formula 48) Siwu Tang (Formula 8) Liuwei Dihuang Tang (Formula 50) Yangzang Tang (Formula 52)
Huoluan (Vomiting and Diarrhea Syndrome) Chapter 11
*Chuntian Yihua* states: Huangtu Tang treats Huoluan vomiting and diarrhea. This syndrome mostly occurs in summer and autumn, caused by summer-heat, dampness, and food stagnation in the middle Jiao stomach, leading to abnormal transmission and transformation, chaotic Qi and altered flavors. When righteous Qi cannot tolerate pathogenic factors, attacking upwards causes vomiting, attacking downwards causes diarrhea. Since both vomiting and diarrhea provide an exit for pathogens, wet Huoluan is lighter and often survivable. If one cannot vomit upwards nor defecate downwards, with no exit for pathogens, dry Huoluan is heavier and often fatal. Huoluan arises from summer-heat and dampness, but may also involve cold due to greed for coolness and excessive consumption of melons and fruits in summer. Add Xiangru one qian in summer, Liaohua Gen one liang in late autumn; for deficiency, add Tu Chao Bai Zhu half a qian; for excess, add Jixin Binglang one qian; for cold, add Lizhong Wan five qian to decoct together; for heat, add Siling San five qian to decoct together. For dry Huoluan, take two doses of the base formula plus one liang of fried salt and one small bowl of child's urine, taken frequently. Use a finger to press the tongue root to induce vomiting; once vomiting occurs, diarrhea follows. After vomiting and diarrhea, remove the fried salt and child's urine, and continue decocting normally. Avoid sticky porridge; prefer old rice soup and old rice porridge. New rice can be eaten after three days. This also treats Huoluan with muscle spasms. Pure Yellow Earth (two liang), Guang Huoxiang (two qian), Sheng Muxiang (eight fen), Xuan Mugua (two qian), Chen Jupi (one qian), Zi Houpo (eight fen), Bai Biandou (three qian), Huoshui Lugeng (two liang). Decoct with long-flowing water. Ancients dug pits under walls, filled with water, stirred until muddy, and took the liquid, named Dijiang (Earth Slurry), to treat wet and dry Huoluan, washing away turbid filth in the abdomen, which is very good. Now using Yellow Earth as the main ingredient, adding the aromatic Huoxiang and Muxiang to resolve turbidity, Mugua to harmonize the stomach and relax sinews to prevent spasms, Jupi to regulate Qi mechanism, Houpo and Biandou to dissipate summer-heat and remove dampness, and Lugeng to clear and harmonize the stomach. This retains the intent of Dijiang but far surpasses the impurity of wall shade.
*Chunqiu Kaoyi* You states: When Duke Xiang visited Jing, soldiers spent the year there, grieving and losing track of time, in mud, rain, summer-heat, and dampness, suffering much from Huoluan.
*Han Shu* states: The King of Huainan submitted a memorial saying: The southern Yue region has many cases of Huoluan. (See *Taiping Yulan*, Volume 743.)
Liu Zongyuan stated: In the tenth month of the eleventh year of Yuanhe, I contracted Huoluan. Unable to vomit or purge, I sweated cold sweat about three sheng, and my breath ceased. Fang Wei from Henan transmitted this formula: upon entering the mouth, it induces vomiting, restoring breath. Use one large spoonful of salt, roasted until yellow, mixed with one sheng of child's urine, taken warm. Soon after, vomiting and purging occur, and one recovers.
*Jiufeng Yi'an* states: Guest-startle Huoluan involves internal injury to the Seven Emotions and external contraction of the Six Qi, causing Yin-Yang disorder and alternating vomiting and diarrhea. Vomiting damages Yang and Stomach; diarrhea damages Yin and Kidney. Fortunately, taking Lizhong Wan during vomiting and diarrhea brought a turning point. Now, after twenty days, there is chest fullness, dry mouth without thirst, string-taut and weak pulse. Yang fails to generate Yin, Yin fails to transform Qi; both Yin and Yang are deficient, and the Five Fluids are exhausted. The theory that Liver and Kidney share the same source holds, but Kidney Yin is insufficient to control Liver Yang. Liver emotion is anger; anger causes Qi to rise, filling the chest and diaphragm, unlike food stagnation. There is no tonification method for the Liver; tonifying the Kidney is the way to tonify the Liver. In the human body, Yang tends upward and guards externally, Yin tends downward and nourishes internally. They are hard to form and easy to lose; tonification is not easy. Without Yang, Yin cannot be generated; without Yin, Yang cannot be transformed. One must benefit Qi and generate Yin, allowing Yin to transform via Yang. Kidney Qi connects to the Stomach; Yin Essence steams upward, Clear Yang expands, naturally entering a good state. The Two Qi balance each other, circulating up and down, eliminating blockage. Public discussion suggests Shengmai and Bawei, benefiting the origin of Fire, strengthening the master of Water, drawing Yang from Yin and Yin from Yang. Whether to adjust according to conditions awaits judgment. Large Shudi (eight qian), Fen Danpi (three qian), Fu Zexie (three qian), Huai Shanyao (four qian), Yun Fuling (three qian), Shan Yurou (four qian), Zhi Fuzi (one qian), You Rougui (eight fen), Renshen (two qian), Da Maidong (three qian), Bei Wuwei (one qian). Liver pulse gradually harmonizes, Stomach pulse remains soft. At night, half-awake half-asleep, the Two Qi show signs of harmony. Originally Kidney deficient, a constitution of deficiency-cold, True Yang is weak. After severe illness, the Two Qi are mutually injured, and the Five Fluids damaged. How can Viscera Qi suddenly recover? Tonifying Yin products, none exceed Shudi. But relying solely on tonification makes the central pivot dull. With Rougui and Fuzi moving without staying, reaching the cave of Kidney Fire, nurturing the Middle Earth, fluid can be transformed into Yin. Not only does it avoid stuffiness and stagnation, but it also assists the Kidney and Stomach. As the saying goes, tonifying the Kidney opens the Stomach; tonifying Mingmen strengthens the Spleen. In the morning, slightly modify the original formula to cultivate the Yin-Yang of Mingmen and Kidney. In the afternoon, use products to nourish the Stomach and generate Yin, applying the method of Yin-Yang mutual assistance. Following reason to the utmost, seemingly without error, awaiting correction by wise men. Large Shudi (eight qian), Fen Danpi (three qian), Fu Zexie (three qian), Huai Shanyao (four qian), Yun Fuling (four qian), Shan Yurou (four qian), Zhi Fuzi (eight fen), You Rougui (five fen), Renshen (one qian), Dan Congrong (three qian), Fu Jupi (one qian), Da Maidong (three qian). Take the Stomach-nourishing and Yin-generating formula in the afternoon. Nan Shashen (eight qian), Ye Baizhu (three qian), Da Baishao (three qian), Sheng Gancao (five fen), Jincha Shihu (five qian). Upon waking from sleep, occasional worry disturbs Heart Fire, causing dryness in the center of the tongue. Follow this formula, remove Rougui and Fuling, reduce Fuzi by four fen, add Suanzaoren and Baifushen three qian each. Continue taking the Stomach-nourishing and Yin-generating formula in the afternoon. Four days after Start of Autumn, pulse, spirit, complexion, and form all improve. Spleen and Stomach gradually revive. After severe illness newly healed, Viscera initially harmonized, the Two Qi not yet settled, entirely depending on quiet rest. Observe warnings against shaking essence and laboring form. Clarify the mind, cease thoughts, remain tranquil and empty, which is the best plan for aftercare. With the Harmonious Qi in the five internal organs, health and wellness will naturally be achieved. Proposed formula still awaits judgment. Large Shudi (eight qian), Huai Shanyao (four qian), Shan Yurou (four qian), Yun Fuling (three qian), Fu Jupi (one qian), Renshen (one qian), Suanzaoren (three qian), Danggui Shen (three qian), Wuweizi (one qian). After severe illness newly healed, Viscera initially harmonized, Spleen and Stomach revived but not vigorous. Avoid mental worry and fatigue. Injury from Seven Emotions, though divided among Five Zang, ultimately concerns Heart and Kidney. The principle of Heaven and Earth creation is nothing but stillness and stability. Stillness allows Spirit to reside and transform spontaneously; Yin and Yang balanced, Spirit is governed. Food enters Yin, grows Qi in Yang. Yang is like Heaven and Sun; losing its place shortens life and obscures brilliance. Thus, heavenly movement relies on sunlight brightness. Previously, drawing Yang from Yin and Yin from Yang, Water rising and Fire descending, all ailments flattened. Now, modifying Hei Guipi San, treating from Heart, Spleen, and Kidney. Wait for the central pivot to expand greatly and diet to increase, then use Banlong Wan to cultivate the Primordial Yang of Mingmen and Kidney, to transform the deep-seated cold of the constitution. This has layers. Whether correct awaits judgment. Large Shudi (four liang), Renshen (five qian), Ye Baizhu (two liang), Zhi Gancao (five qian), Danggui Shen (two liang), Suanzaoren (two liang), Yuanzhi Rou (one liang), Baifushen (two liang), Wei Muxiang (three qian), Huai Shanyao (two liang), Shan Yurou (two liang). Grind to powder, mix with three liang Longyan Rou, decoct water to form pills. Take two qian morning and evening with boiled water. Jiang Baosu stated: Huoluan means sudden and extraordinary disorder, mutual pain in chest and abdomen, alternating vomiting and diarrhea. Dampness stagnates in the middle, Qi mechanism fails to move, ascending and descending pathways blocked, grain and water not transformed. Qi chaos and flavor alteration occur between intestines and stomach, erupting when stagnation reaches extremum, combining with the six transformations. Those unable to vomit or purge are named Dry Huoluan, representing extreme dampness stagnation. The *Lingshu: Jingmai Chapter* states: Rebellious Qi of Foot-Taiyin ascending causes Huoluan. The *Suwen: Qiaobianda Lun* states: When yearly Earth is insufficient, people suffer from undigested diarrhea and Huoluan. The *Liuyuan Zhengji Dalun* also states: When Earth stagnation erupts, heart pain and flank pain occur, vomiting and Huoluan follow. It also states: Where Taiyin arrives, there is middle-fullness, Huoluan with vomiting and purging. It also states: If not distant from heat, heat arrives. (This is the basis for heat transforming into heat.) When heat arrives, body heat, vomiting, purging, and Huoluan occur. These *Neijing* chapters all attribute Huoluan to the dynamic change of Taiyin-Damp-Earth. Dampness transforms from Earth; Earth has no fixed position, Dampness has no specific syndrome, but has distinctions of six transformations. Meeting heat, it transforms into heat; meeting cold, it transforms into cold; due to exterior, it transforms into exterior; due to interior, it transforms into interior; due to deficiency, it transforms into deficiency; due to excess, it transforms into excess. Thus, Zhongjing's *Shanghan Lun: Bian Huoluan Tiao* states: Huoluan with headache, fever, and body pain, with much heat and desire for water, is treated with Wuling San. This is damp transforming into heat. It also states: Much cold, no desire for water, treated with Lizhong Wan. This is damp transforming into cold. It also states: Vomiting and purging with unceasing body pain, treat gently with Guizhi Tang. This is transforming due to exterior. It also states: Both vomiting and purging, frequent urination, profuse sweating, purging of undigested grain, interior cold and exterior heat, pulse faint and near extinction, treated with Sini Tang. This is transforming due to interior. It also states: Aversion to cold, faint pulse, and recurrent purging, purging stops due to blood loss, treated with Sini Jia Renshen Tang. This is transforming due to deficiency. It also states: After purging, stool should become hard; if hard and able to eat, recovery occurs. This is transforming due to excess. How can one adhere to one method? *Yishuo* states: If Grain Rain Qi does not arrive when expected, many Huoluan cases occur. This is also damp transforming into cold. *Han Shu* Huainan King's memorial states: Southern Yue has many Huoluan cases. This is also damp transforming into heat. *Chunqiu Kaoyi* You states: Duke Xiang visiting Jing, soldiers spending the year, grief and lost time, mud, rain, summer-heat, and dampness, causing much Huoluan. This is also damp transforming into heat combined with Seven Emotions. Ge Zhichuan attributed it to consuming raw, cold, fatty, greasy foods, wine, and sashimi, while exposed to wind and dampness, sitting thinly clothed outdoors, or sleeping uncovered at night. It also arises from damp-food dynamic changes. Chao Yuanfang attributed it to imbalance of warmth and coolness, interference between Yin-Yang and Clear-Turbid Qi, chaos occurring between intestines and stomach, triggered by diet. Following Zhongjing's intent, those with Wind-excess present fever, headache, body pain, and vomiting/purging; those with deficiency present only vomiting/purging and stabbing abdominal pain. Following Zhichuan, excessive drinking, meat, raw/fish/cold foods, irregular living, sleeping on damp ground, or seeking coolness in wind causes Cold-Wind Qi to return to the Triple Burner and transmit to Spleen/Stomach. Dry Huoluan is Cold-Qi clashing with intestines/stomach. Huoluan with spasms is Cold-Qi entering sinews. After severe vomiting/purging, Yin-Yang are both deficient, Blood-Qi extremely deficient, hands and feet reverse, Ying-Wei disordered, Cold clashes with sinews causing spasms. This is damp due to Wind-Cold, one of the six transformations. Dry Huoluan unable to vomit/purge is extreme damp stagnation combined with six transformations. Spasms before vomiting/purging are due to excess and heat; after vomiting/purging, due to deficiency and cold. Liu Zongyuan obtained dry Huoluan, treated with fried salt and child's urine, inducing vomiting and purging to cure. This opens extreme damp stagnation, an excellent treatment method. Chen Wuzhe's discussion matches Chao Yuanfang. Liu Hujian attributed it to excessive Heat Qi causing abnormal transmission and Huoluan vomiting/purging due to the drying and moving nature of Fire. He also stated: All Huoluan vomiting/purging generally suit Wuling San and Yiyuan San. For spasms with vomiting/purging, the Qi has three aspects: Wind, Fire, and Dampness. He also stated: This syndrome may first use Wuling, Yiyuan, or Guiling Ganlu Yin, the holy medicine for vomiting/purging. Do not give millet porridge. This is damp due to summer-heat, one of the six transformations. Yishui Laoren also stated that Huoluan spasms/vomiting/purging result from Yin-Yang disorder and incompatibility; do not give any porridge or drink. Zhang Zihe focused on Wind-Damp-Heat, refuting Chao's views, agreeing with Liu Hujian, and praising Wang Bing's Spleen-Heat statement, unaware that Huoluan is primarily damp with six transformations. Chao discussed damp due to Wind-Cold; Liu discussed damp due to Summer-Heat. Neither fully understood the six transformations. Wang Bing merely annotated one aspect of the *Suwen*. *Danxi Xinfa* used Erchen Tang modified to induce vomiting for Huoluan vomiting/purging to lift Qi, strictly avoiding grain food; some cases suitable for purging. For unceasing spasms, pull the male's genitals or female's breasts with hands, both good methods. He also stated: Spasms all belong to Blood-Heat; Siwu Tang added with wine-fried Huangqin, Honghua, Cangzhu, and Nanting. This did not distinguish cold/heat differences of spasms before/after vomiting/purging. Dai Funan stated that sudden Huoluan suits Suhexiang Wan, followed by Huoxiang Zhengqi San plus five fen Muxiang; discussion and treatment are valuable. Wang Kentang stated that Huoluan with spasms, curled tongue and retracted scrotum, post-Huoluan enuresis and aphasia, pearl-like sweat, restlessness desiring water, and flaccid limbs are all untreatable; careful examination is required.