芍药汤加减 兼治赤白痢。
白芍药（一钱） 黄连（一钱） 枳实（一钱） 白茯苓（一钱） 槟榔（七分） 当归（八分） 黄芩
（一钱） 川芎（五分） 大黄（二钱） 加滑石（二钱）
大黄，初痢二三日内用一帖，动后即去之，痢日久者不可用，水一盅半，煎至八分，和木香末三分温服，日
夜三服方效。
香连丸 方伯王嵩淮传自楚府。
木香（二两） 黄连（茱萸炒，八两） 广陈皮（二两） 槐角子（一两五钱） 地榆（一两） 枳壳（麸炒，
二两） 枳实（麸炒，一两） 槟榔（二两） 益元散（二两）
醋糊为丸，每服一钱，红痢、米汤下，白痢、姜汤滚白水送下，亦每日三服，或汤一丸二丸亦可。老弱数服后，
即当温补。
清脾饮加减
青皮 浓朴 白茯苓 柴胡 半夏 黄芩（各一钱） 白术（八分） 甘草 草果仁 砂仁（各五分） 滑石
（二钱）
渴加麦门冬一钱，乌梅一个，水一盅半，煎至八分，和姜汁二匙温服，疟发过两个时辰服一帖，到疟临来前一
个时辰，再服一帖方效。二日一发者，先于空日早晚服二帖，至临发日前一个时辰，又服一帖方效。
如服前药后，尚未痊愈，即服后剂。
胃苓汤
浓朴（姜制，炒） 苍术（泔水浸，炒） 陈皮（一钱） 甘草（炙，五分） 泽泻 云茯苓 猪苓
（各八分） 白术（一钱） 官桂（三分）
上水二盅，煎至八分温服。
霖按∶干霍乱欲吐不得，欲泻不得，顷刻危亡，恐非二陈汤探吐可通，当以屋角结网之大蜘蛛一枚捣烂，
水冲服，即可痛止便通。盖暑湿伏郁之邪，贼及太阴湿土，非风木之相克则不剧，邪秽深伏，上下为之不通，
风邪肆虐，故心腹为之绞痛，蜘蛛善能定风，风平则土气得伸，而上下皆通矣。通后再议进药，若夫霍乱之治
，虽载方书，可不具录，然既云附列主方，若不辨其寒热纲领，诚恐贻误来兹。凡霍乱吐泻，吐出澄澈而不酸
浊，泻出而不臭秽，口不渴，小溲利，此寒证。即《素问·至真要大论》，诸病水液，澄澈清冷，皆属于寒者
是也。若吐出酸浊，泻出臭秽，溲浑口渴，此热证，即诸转反戾，水液混浊，诸呕吐酸，暴注下迫，皆属于热
是也。转筋者，感风木之变，土为木克也。夫霍乱吐泻后，每多肢冷如冰，脉伏欲绝，口渴甚，以凉水与之即
止。若验其所吐酸臭，所下秽恶，小溲赤涩，此假寒真热证也。口渴喜冷冻饮料，却不多，手足逆冷，面赤戴阳，
烦热发躁，揭去衣被，若察其泻出不臭恶，吐出不酸秽者，阴盛格阳之假热真寒证也。如烦渴躁扰，口干恣饮
，舌本不冷者，乃气液告竭之候，宜兼救阴。如吐利止而身痛不休，宜兼达表，此寒热之略也。然易之山风蛊
卦，艮上巽下，蛊者虫类也，风木之邪，克制湿上，则虫生，霍乱之重者，杀虫又不可缓也。此义仲景以后，
未有知者，近西士言之，司命者亦不可忽。
又按∶痢疟各有专书，原不须缕述，但清脾饮治少阳正疟之方，胃苓汤治太阴寒湿之疟，温瘅等疟，若误用
，祸尚不测，况暑疟乎？此书专言伤暑，而舍暑疟不论，殊觉未备，夫微寒壮热，心烦多汗，口渴引饮，脉或虚
或濡，或洪或弦，或一日一发，或间日一发者，即所谓阴气先伤，阳气独发之暑疟也。当与《内经》、《金匮》
瘅疟治法相仿，然有微甚之不同。若因外感触发伏气，宜清凉涤暑，如滑石、青蒿、生草、连翘、茯苓、竹茹、
枳实。暑热甚者，黄芩、黄连皆可加入。外邪甚者，可加豆豉、葱、藿香、薄荷之属。若暑热内动者，宜甘寒生
津，如鲜生地、麦冬、沙参、花粉、知母、石膏、鲜石斛、梨汁、蔗浆。夹湿者，可加入芦根、通草、六一散。
热湿两重，日晡烦痞昏谵，而阴气
未见大伤者，半夏泻心，合小陷胸，去参枣，稍挟表邪，可佐以豉、薄、苏、藿、葱白等两三味是矣。若夫十二
经之疟，风寒湿及痰食疫瘴诸疟，仍当考之专书，兹不载。
芍药汤加减方，兼治赤白痢疾。
白芍药（一钱） 黄连（一钱） 枳实（一钱） 白茯苓（一钱） 槟榔（七分） 当归（八分） 黄芩（一钱） 川芎（五分） 大黄（二钱） 加滑石（二钱）。
大黄，在痢疾初起二三日内使用一帖，大便通畅后即去除大黄；痢疾日久者不可使用。用水一盅半，煎至八分，混合木香末三分，温服，日夜服用三次才见效。
香连丸，由王嵩淮从楚王府传来。
木香（二两） 黄连（吴茱萸炒制，八两） 广陈皮（二两） 槐角子（一两五钱） 地榆（一两） 枳壳（麸皮炒制，二两） 枳实（麸皮炒制，一两） 槟榔（二两） 益元散（二两）。
用醋糊制作成丸药，每次服用一钱，红痢用米汤送服，白痢用姜汤滚开的白水送服，也是每日服用三次，或者将汤剂与丸药配合服用也可。年老体弱者服用几剂后，就应当进行温补。
清脾饮加减方
青皮 厚朴 白茯苓 柴胡 半夏 黄芩（各一钱） 白术（八分） 甘草 草果仁 砂仁（各五分） 滑石（二钱）。
口渴加麦门冬一钱、乌梅一个，用水一盅半，煎至八分，混合姜汁两匙温服。疟疾发作过两个时辰后服用一帖，到疟疾来临前一个时辰，再服用一帖才见效。如果是隔日发作的疟疾，先在非发作日的早晚各服用两帖，到了发作日前一个时辰，再服用一帖才见效。
如果服用前面的药物后，尚未痊愈，就服用后面的方剂。
胃苓汤
厚朴（姜汁制，炒） 苍术（淘米水浸泡，炒） 陈皮（一钱） 甘草（蜜炙，五分） 泽泻 云茯苓 猪苓（各八分） 白术（一钱） 官桂（三分）。
以上药材用水二盅，煎至八分，温服。
霖按：干霍乱想要呕吐却吐不出来，想要腹泻却拉不出来，片刻间就有生命危险，恐怕不是二陈汤探吐就能疏通的，应当取屋檐角落结网的大蜘蛛一只捣烂，用水冲服，即可疼痛停止、大小便通畅。这是因为暑湿郁伏之邪，侵害太阴湿土，如果不是风木之气相克则病情不会剧烈，邪气秽浊深伏，导致上下不通，风邪肆虐，所以心腹绞痛，蜘蛛善于平息风邪，风平则土气得以舒展，上下自然通畅。通利之后再议进药。至于霍乱的治疗，虽然记载在医书中，可以不全部列出，但既然附录了主方，如果不辨别寒热纲领，确实恐怕会贻误后人。凡是霍乱吐泻，吐出物清澈而不酸浊，泻出物不臭秽，口不渴，小便通利，这是寒证。即《素问·至真要大论》所说：“诸病水液，澄澈清冷，皆属于寒”就是这个意思。如果吐出物酸浊，泻出物臭秽，小便浑浊且口渴，这是热证，即“诸转反戾，水液混浊，诸呕吐酸，暴注下迫，皆属于热”就是这个意思。转筋，是感受风木之变，土被木克制所致。霍乱吐泻之后，往往出现四肢冰冷如冰，脉象潜伏欲绝，极度口渴，如果用凉水给他喝就会停止（指口渴缓解或症状暂时抑制）。如果验证其吐出物酸臭，排泄物秽恶，小便赤涩，这是假寒真热的证候。口渴喜欢喝冷冻饮料，但不多喝，手足逆冷，面赤戴阳（虚阳上浮），烦热发躁，掀去衣被，如果观察其泻出不臭恶，吐出不酸秽，这是阴盛格阳的假热真寒证候。如果烦渴躁扰，口干恣意饮水，舌根不冷，这是气液枯竭的征候，应当兼顾救阴。如果吐利停止而身体疼痛不止，应当兼顾解表，这是寒热的大略区分。然而《易经》山风蛊卦，艮上巽下，蛊字意为虫类，风木之邪克制湿气，则生虫，霍乱重症，杀虫也不可迟缓。这一义理在张仲景之后，无人知晓，近代西方医生有所论述，治病救人者也不可忽视。
又按：痢疾和疟疾各有专门著作，原本不需要详细叙述，但清脾饮是治疗少阳正疟的方剂，胃苓汤是治疗太阴寒湿之疟的方剂，温瘅等疟疾，如果误用，祸患尚不可测，何况是暑疟呢？这本书专门讲述伤暑，而舍弃暑疟不论，觉得很不完备。微寒壮热，心烦多汗，口渴引饮，脉象或虚或濡，或洪或弦，或一日一发，或间日一发，这就是所谓“阴气先伤，阳气独发”的暑疟。应当与《内经》、《金匮要略》中瘅疟的治法相似，但有轻重程度的不同。如果是因外感触发伏气，宜清凉涤暑，如滑石、青蒿、生甘草、连翘、茯苓、竹茹、枳实。暑热甚者，黄芩、黄连都可以加入。外邪甚者，可加豆豉、葱、藿香、薄荷之类。若暑热内动者，宜甘寒生津，如鲜生地、麦冬、沙参、花粉、知母、石膏、鲜石斛、梨汁、蔗浆。夹湿者，可加入芦根、通草、六一散。热湿两重，傍晚时分烦闷痞塞、昏谵，而阴气未见大伤者，可用半夏泻心汤合小陷胸汤，去掉人参、大枣，稍挟表邪，可佐以豆豉、薄荷、苏叶、藿香、葱白等两三味就可以了。至于十二经的疟疾，风寒湿及痰食疫瘴等各种疟疾，仍当查阅专门书籍，此处不载。
Shao Yao Tang (Peony Decoction) modified, also treats bloody and white dysentery.
Bai Shao Yao (White Peony Root, 1 qian), Huang Lian (Coptis Rhizome, 1 qian), Zhi Shi (Immature Bitter Orange, 1 qian), Bai Fu Ling (Poria with Hostwood, 1 qian), Bing Lang (Areca Seed, 0.7 qian), Dang Gui (Chinese Angelica Root, 0.8 qian), Huang Qin (Scutellaria Root, 1 qian), Chuan Xiong (Sichuan Lovage Rhizome, 0.5 qian), Da Huang (Rhubarb Root and Rhizome, 2 qian), plus Hua Shi (Talcum, 2 qian).
Da Huang (Rhubarb Root and Rhizome): Use one dose in the first two to three days of acute dysentery; remove it once bowel movements are unblocked. It should not be used for chronic dysentery. Decoct with 1.5 zhong of water until reduced to 0.8 zhong, mix with 0.3 qian of Mu Xiang powder (Aucklandia Root), and take warm. Take three times a day for efficacy.
Xiang Lian Wan (Costus and Coptis Pill), transmitted by Wang Songhuai from the Chu Prince's mansion.
Mu Xiang (Aucklandia Root, 2 liang), Huang Lian (Coptis Rhizome stir-fried with Evodia Fruit, 8 liang), Guang Chen Pi (Tangerine Peel, 2 liang), Huai Jiao Zi (Sophora Fruit, 1.5 liang), Di Yu (Sanguisorba Root, 1 liang), Zhi Ke (Aurantium Fruit, stir-fried with bran, 2 liang), Zhi Shi (Immature Bitter Orange, stir-fried with bran, 1 liang), Bing Lang (Areca Seed, 2 liang), Yi Yuan San (Benefit the Origin Powder, 2 liang).
Make pills using vinegar paste. Take 1 qian per dose. For bloody dysentery, swallow with rice soup; for white dysentery, swallow with ginger soup boiled in plain water. Take three times daily. Alternatively, take decoction along with one or two pills. After taking several doses, elderly and weak patients should receive warming tonification.
Qing Pi Yin (Clear Spleen Decoction) modified
Qing Pi (Green Tangerine Peel), Hou Po (Magnolia Bark), Bai Fu Ling (Poria with Hostwood), Chai Hu (Bupleurum Root), Ban Xia (Pinellia Tuber), Huang Qin (Scutellaria Root) (each 1 qian), Bai Zhu (Atractylodes Macrocephala Rhizome, 0.8 qian), Gan Cao (Licorice Root), Cao Guo Ren (Black Cardamom Seed), Sha Ren (Amomum Fruit) (each 0.5 qian), Hua Shi (Talcum, 2 qian).
For thirst, add Mai Dong (Ophiopogon Tuber, 1 qian) and Wu Mei (Mume Fruit, 1 piece). Decoct with 1.5 zhong of water until reduced to 0.8 zhong, mix with two spoons of Jiang Zhi (Ginger Juice), and take warm. Take one dose two hours after the malaria paroxysm ends. Take another dose one hour before the next expected onset for efficacy. For tertian malaria (occurring every other day), take two doses on non-paroxysmal days (morning and evening), and one dose one hour before the expected onset day for efficacy.
If the previous medication does not cure the condition, proceed to the following prescription.
Wei Ling Tang (Stomach and Poria Decoction)
Hou Po (Magnolia Bark, processed with ginger juice and stir-fried), Cang Zhu (Atractylodes Lancea Rhizome, soaked in rice water and stir-fried), Chen Pi (Tangerine Peel, 1 qian), Gan Cao (Licorice Root, honey-roasted, 0.5 qian), Ze Xie (Alisma Rhizome), Yun Fu Ling (Poria), Zhu Ling (Polyporus) (each 0.8 qian), Bai Zhu (Atractylodes Macrocephala Rhizome, 1 qian), Guan Gui (Cinnamon Twig, 0.3 qian).
Decoct the above ingredients with 2 zhong of water until reduced to 0.8 zhong, and take warm.
Lin’s Note: In Gan Huo Luan (Dry Cholera), where there is an urge to vomit but inability to do so, and an urge to defecate but inability to do so, death can occur within moments. It is feared that Tan Tu (Probe Vomiting) using Er Chen Tang (Two-Cured Decoction) may not suffice to clear the blockage. One should crush one large spider from a web in the corner of a roof, mix with water, and administer orally. This will stop pain and restore bowel/bladder function. This is because summer-heat and dampness stagnating pathogens invade the Taiyin Damp Earth. Without the counteracting force of Wind-Wood, the condition would not be severe. The pathogenic filth lies deep, causing obstruction above and below. The rampant Wind evil causes severe heart and abdominal colic. Spiders are good at calming Wind; when Wind calms, Earth Qi extends, and upper and lower passages open. After clearing, discuss further medication. Regarding the treatment of Huo Luan (Cholera), although prescriptions are recorded in medical books, they need not be fully listed here. However, since main formulas are appended, if one does not distinguish between Cold and Heat patterns, it is feared this will mislead future practitioners. Generally, in Huo Luan vomiting and diarrhea, if the vomitus is clear and not sour/turbid, and the stool is not foul-smelling, with no thirst and free urination, this is a Cold pattern. This corresponds to *Su Wen · Zhi Zhen Yao Lun*: "All diseases involving body fluids that are clear and cold belong to Cold." If the vomitus is sour and turbid, the stool is foul-smelling, urine is turbid and there is thirst, this is a Heat pattern. This corresponds to: "All spasms, convulsions, turbid fluids, vomiting of acid, sudden violent diarrhea, and tenesmus belong to Heat." Muscle cramps (Zhuan Jin) result from Wind-Wood changes, where Wood overacts on Earth. After Huo Luan vomiting and diarrhea, limbs often become ice-cold, pulse becomes hidden and nearly imperceptible, and there is extreme thirst. Giving cool water may temporarily relieve thirst. If the vomitus is sour/foul and stool is filthy, with red/scanty urine, this is a False Cold, True Heat pattern. Thirst prefers cold drinks but intake is small; limbs are cold, face is red (floating Yang), restlessness and heat sensation cause removal of clothes/blankets. If stool is not foul and vomitus not sour, this is False Heat, True Cold due to Yin Excess repelling Yang. If there is irritability, thirst, dry mouth with excessive drinking, and the tongue root is not cold, this indicates exhaustion of Qi and Fluids; treat by simultaneously nourishing Yin. If vomiting/diarrhea stop but body pain persists, treat by simultaneously releasing the exterior. This is a brief overview of Cold and Heat. However, the *I Ching* hexagram Mountain over Wind (Gu), where Gu means insects, suggests that Wind-Wood evil overcoming Dampness generates insects. In severe Huo Luan, antiparasitic treatment cannot be delayed. This principle was unknown after Zhang Zhongjing, but discussed by modern Western physicians; healers must not ignore it.
Another Note: Dysentery and Malaria each have dedicated texts, so detailed description is unnecessary. However, Qing Pi Yin is the formula for Shaoyang Zheng Nue (Regular Malaria of Shaoyang), and Wei Ling Tang is for Taiyin Cold-Damp Malaria. Misusing them for Wendan Malaria etc. could lead to unpredictable disasters, let alone Shu Nue (Summerheat Malaria). This book focuses on Shang Shu (Summerheat Injury) but omits Shu Nue, which seems incomplete. Symptoms such as slight chills with high fever, vexation, profuse sweating, thirst with desire to drink, pulse being deficient or soggy, or surging or wiry, occurring daily or every other day, constitute what is called "Yin Qi injured first, Yang Qi acting alone" Shu Nue. Treatment should resemble that for Dan Nue (Hot Malaria) in *Nei Jing* and *Jin Gui Yao Lue*, though with differences in severity. If triggered by external contraction activating latent qi, use Cooling and Clearing Summerheat methods, such as Hua Shi (Talcum), Qing Hao (Artemisia Annua Herba), Sheng Gan Cao (Raw Licorice Root), Lian Qiao (Forsythia Fruit), Fu Ling (Poria), Zhu Ru (Bamboo Shavings), Zhi Shi (Immature Bitter Orange). For severe summerheat, add Huang Qin (Scutellaria Root) and Huang Lian (Coptis Rhizome). For severe external pathogens, add Dou Chi (Prepared Soybean), Cong Bai (Scallion White), Huo Xiang (Patchouli Herb), Bo He (Mint Herb). If summerheat moves internally, use Sweet-Cold methods to generate fluids, such as Xian Sheng Di Huang (Fresh Rehmannia Root), Mai Dong (Ophiopogon Tuber), Sha Shen (Glehnia Root), Hua Fen (Angelica Dahurica Root), Zhi Mu (Anemarrhena Rhizome), Shi Gao (Gypsum Fibrosum), Xian Shi Hu (Dendrobium Stem), Li Zhi (Pear Juice), Zhe Jiang (Sugarcane Juice). For cases with dampness, add Lu Gen (Reed Rhizome), Tong Cao (Tetrapanax Pith), Liu Yi San (Six-to-One Powder). For heavy heat and dampness with evening vexation, fullness, confusion, and delirium, without major Yin injury, use Ban Xia Xie Xin Tang (Pinellia Heart-Draining Decoction) combined with Xiao Xian Xiong Tang (Minor Trap-the-Chest Decoction), removing Ren Shen (Ginseng Root) and Da Zao (Jujube Fruit). If slightly accompanied by exterior pathogens, assist with Dou Chi (Prepared Soybean), Bo He (Mint Herb), Su Ye (Perilla Leaf), Huo Xiang (Patchouli Herb), Cong Bai (Scallion White), two or three herbs. As for Malaria of the Twelve Meridians, and various Malaria types caused by Wind-Cold-Damp, Phlegm-Food, or Epidemic Miasma, consult specialized texts; these are not recorded here.