病源霍乱而气筑悸者，由吐下之后三焦五脏，不和而水气上乘于心故也，肾主水，其气
通于阴，若吐下则三焦五脏不和，故脾气亦虚不能制水水不下宣，与气俱上乘心其状起脐下，
上
仲景论霍乱脐上筑者，肾气动也，先疗气，理中汤去术加桂，凡方加术者，以内虚也，
加桂者，恐作奔豚也，理中汤方。
人参（二两） 甘草（三两炙） 白术（三两） 干姜（三两炮）
上四味切，以水八升，煮取三升，去滓，温服一升，日三夜一，若脐上筑者，肾气动也
，去术加桂心四两，吐多者，去术，加生姜三两，若下多者复用术，悸者加茯苓二两，若先
时渴喜得水者，加术合前成四两半，若腹中痛者，加人参，合前成四两半，若恶寒者，加干
姜，合前成四两半，若腹满者，去术加附子一枚炮去皮，破六片，服汤后一食项，饮热粥一
升许，汗微出自温，勿发揭衣被也。忌海藻菘菜桃李雀肉等。（千金备急文仲崔氏集验必效
短剧古今录验并同）
又霍乱脐上筑者，以吐多故也，若吐多者，理中汤主之，方如前法加减，霍乱四逆吐少
呕多者，附子粳米汤主之方。
附子（一枚炮） 半夏（半升洗） 甘草（一两炙） 大枣（十枚） 粳米（半升）
上五味切，以水八升，煮米熟，去滓，温服一升，日三。忌羊肉猪肉海藻菘菜饧。（一
方有干姜一两短剧千金同出第十七卷中）
范汪疗霍乱脐上筑而悸，茯苓理中汤方。
茯苓（二两） 甘草（三两炙） 干姜（一两炮） 人参（三两） 木瓜（三两）
上五味 咀，以水六升，煮取三升，去滓，适寒温，分为四服。忌海藻菜酢物。（出第
四卷中）
【病源】霍乱且伴有脐上悸动筑筑感的病症，是由于呕吐腹泻之后，三焦与五脏功能失调，导致水气上乘侵犯心脏的缘故。肾主水，其气通于阴经；如果发生呕吐腹泻，会导致三焦和五脏不和，因此脾气也会虚弱，不能制约水液，使水液不能向下宣通，反而伴随气机上逆侵犯心脏。其症状表现为从脐下起始，向上冲击。
张仲景论述霍乱中脐上筑动感的情况，认为是肾气动扰所致，治疗应先调理气机，使用理中汤去掉白术加上桂枝。凡是方剂中加入白术的，是因为体内虚损；加入桂枝的，是担心出现奔豚病（一种自觉有气从少腹上冲心胸的病症）。理中汤的配方如下：
人参（二两） 甘草（三两，炙） 白术（三两） 干姜（三两，炮制）
将以上四味药切碎，用水八升，煮取三升药液，滤去药渣，每次温服一升，白天服三次，夜间服一次。如果出现脐上筑动感，说明肾气动，应去掉白术，加入桂心四两；如果呕吐多者，去掉白术，加入生姜三两；如果腹泻多者，重新使用白术；如果心悸者，加入茯苓二两；如果先前口渴喜欢喝水的，增加白术至共四两半；如果腹中疼痛的，增加人参至共四两半；如果恶寒的，增加干姜至共四两半；如果腹部胀满的，去掉白术，加入一枚炮制去皮并破成六片的附子。服用汤药后一顿饭的时间里，喝热粥约一升，使身体微微出汗以保暖，不要掀开衣被。忌食海藻、菘菜（白菜类）、桃李、雀肉等。（《千金方》、《备急方》、《文仲方》、《崔氏集验方》、《必效方》、《短剧方》、《古今录验方》均与此相同）
另外，霍乱伴有脐上筑动感，是因为呕吐过多所致。如果呕吐多者，主治用理中汤，方剂用法如前所述进行加减。对于霍乱四肢厥逆、呕吐少而呕逆多的情况，主治用附子粳米汤。配方如下：
附子（一枚，炮制） 半夏（半升，洗） 甘草（一两，炙） 大枣（十枚） 粳米（半升）
将以上五味药切碎，用水八升，煮至米熟，滤去药渣，每次温服一升，每日三次。忌食羊肉、猪肉、海藻、菘菜、饴糖。（一方中有干姜一两，《短剧方》、《千金方》同出第十七卷中）
范汪治疗霍乱伴有脐上筑动感且心悸的方剂：茯苓理中汤。
茯苓（二两） 甘草（三两，炙） 干姜（一两，炮制） 人参（三两） 木瓜（三两）
将以上五味药捣碎，用水六升，煮取三升药液，滤去药渣，根据冷热适宜程度，分为四次服用。忌食海藻、蔬菜、醋制品。（出自第四卷中）
[Pathogenesis] In cases of cholera accompanied by a throbbing sensation (Zhu Ji) above the navel, this is caused by dysfunction of the Sanjiao (Triple Burner) and the five Zang organs following vomiting and purging, leading to water qi ascending to invade the Heart. The Kidney governs water, and its qi connects with the Yin channels. If vomiting and purging occur, it causes disharmony in the Sanjiao and the five Zang organs; consequently, Spleen Qi becomes deficient and fails to control water, preventing water from descending and dispersing properly. Instead, water accompanies rebellious Qi to ascend and invade the Heart. The manifestation begins below the navel and moves upward.
In Zhang Zhongjing's discussion on cholera with a throbbing sensation above the navel, it is attributed to the movement of Kidney Qi. Treatment should first regulate Qi using Lizhong Tang (Regulate the Middle Decoction) with Baizhu (Atractylodis Rhizoma) removed and Guizhi (Cinnamon Twig) added. Whenever Baizhu is added to a formula, it is due to internal deficiency; when Guizhi is added, it is to prevent the occurrence of Ben Tun (Rushing Pig), a condition characterized by a sensation of Qi rushing from the lower abdomen to the chest. The prescription for Lizhong Tang is as follows:
Renshen (Ginseng Radix et Rhizoma, 2 liang) Gancao (Licorice Root, 3 liang, honey-fried) Baizhu (Atractylodis Rhizoma, 3 liang) Ganjiang (Dried Ginger, 3 liang, processed)
Cut the four herbs, add eight sheng of water, and decoct to obtain three sheng of liquid. Remove the dregs, and take one sheng warm each time. Administer three times during the day and once at night. If there is a throbbing sensation above the navel, indicating Kidney Qi movement, remove Baizhu and add Guixin (Cinnamon Heart) 4 liang. If vomiting is excessive, remove Baizhu and add Shengjiang (Fresh Ginger, 3 liang). If diarrhea is excessive, resume use of Baizhu. If palpitations are present, add Fuling (Poria, 2 liang). If there was prior thirst and desire for water, increase Baizhu to a total of 4.5 liang. If there is abdominal pain, increase Renshen to a total of 4.5 liang. If there is aversion to cold, increase Ganjiang to a total of 4.5 liang. If there is abdominal fullness, remove Baizhu and add one Fuzi (Aconiti Lateralis Radix Praeparata, processed, peeled, broken into six pieces). After taking the decoction, within the time of one meal, drink approximately one sheng of hot porridge to induce slight sweating and maintain warmth; do not uncover clothes or blankets. Avoid consuming Haizao (Sargassum), Songcai (Brassica vegetables), Taoli (peaches and plums), and Que Rou (sparrow meat). (The prescriptions in Qianjin Fang, Beiji Wenzhong Fang, Cui Shi Jiyan Fang, Bixiao Fang, Duanju Fang, and Jinlu Yan Fang are identical.)
Furthermore, cholera with a throbbing sensation above the navel is caused by excessive vomiting. If vomiting is excessive, treat with Lizhong Tang, adjusting the prescription as described previously. For cholera with cold limbs, scanty vomiting but frequent retching, treat with Fuzi Jingmi Tang (Aconite and Rice Decoction). The prescription is as follows:
Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece, processed) Banxia (Pinelliae Tuber, 0.5 sheng, washed) Gancao (Licorice Root, 1 liang, honey-fried) Dazao (Jujubae Fructus, 10 pieces) Jingmi (Oryza Sativa var. Japonica, 0.5 sheng)
Cut the five herbs, add eight sheng of water, and decoct until the rice is cooked. Remove the dregs, and take one sheng warm each time, three times daily. Avoid consuming mutton, pork, Haizao (Sargassum), Songcai (Brassica vegetables), and Yi (Maltose). (One version contains Ganjiang 1 liang; Duanju Fang and Qianjin Fang are cited from Volume 17.)
Fan Wang’s prescription for treating cholera with throbbing sensation above the navel and palpitations: Fuling Lizhong Tang (Poria Regulating the Middle Decoction).
Fuling (Poria, 2 liang) Gancao (Licorice Root, 3 liang, honey-fried) Ganjiang (Dried Ginger, 1 liang, processed) Renshen (Ginseng Radix et Rhizoma, 3 liang) Mugua (Chaenomelis Fructus, 3 liang)
Crush the five herbs, add six sheng of water, and decoct to obtain three sheng of liquid. Remove the dregs, adjust to a suitable temperature, and divide into four doses. Avoid consuming Haizao (Sargassum), vegetables, and vinegar products. (Cited from Volume 4.)