经曰∶足太阴厥气上逆则霍乱。又曰∶不远热则热至，热至则身热，吐下霍乱。夫霍乱之病，起于仓卒，其
证挥霍扰乱，无有宁止，故名霍乱。多因夹食伤寒，阴阳乖隔，上吐下泻，而烦躁闷乱者是也。盖人有三焦∶
上焦受纳水谷，主入而不主出；中焦腐化水谷，流行于五脏六腑；下焦分别水谷，主出而不主纳。故邪在上焦
则吐，邪在下焦则泻，邪在中焦则上吐下泻。凡霍乱得吐泻，则邪气上下得出，斯无苦也；陈 出尽，而吐泻
自止。乃有上不得吐，下不得泻，为干霍乱，又名绞肠痧。其病因脾胃之邪无从而出，若加喘满作搐者，十不救
一。其有上吐下泻者，当分寒热而治之，亦宜止其乳食，恐其增痰也。故霍乱饮米汤必死，以其助胃邪故也，
宜藿香正气散。
有先泻后吐者，乃脾胃虚寒，故先泻白水，而吐亦不多，口气缓而神色慢，额上有汗，六脉沉细，此为虚
冷，宜温之，六君子汤。不愈，则理中汤加藿香、木瓜各一钱。
有先吐后泻者，乃脾胃有热，故喘促唇红，吐多面赤，渴饮水浆，脉洪而数。此为热也，宜和解之，五苓
散加藿香。
其干霍乱上不得吐，下不得泻，最为危迫，速用盐汤探吐之，必待其吐出宿食积痰，然后用药，或以针刺
十指甲边令血出，或刺膝湾名委中穴，出血即解，后用藿香正气散。
《黄帝内经》说：足太阴脾经的厥逆之气上冲，就会引发霍乱。又说：如果不远离热邪，热邪就会侵袭人体；热邪侵袭，身体就会发热，出现呕吐、腹泻和霍乱的症状。所谓霍乱这种病，起病突然，症状表现为挥霍撩乱，没有片刻安宁，因此命名为“霍乱”。这多是因为夹带饮食停滞而感受伤寒，导致阴阳之气乖违阻隔，出现上部呕吐、下部腹泻，并伴有烦躁闷乱的症状。
大概人有上、中、下三焦：上焦接受容纳水谷，主要功能是受纳而不主排泄；中焦腐熟消化水谷，其精气流行输布于五脏六腑；下焦分别清浊水谷，主要功能是排泄而不主受纳。所以，邪气侵犯上焦则发生呕吐，邪气侵犯下焦则发生腹泻，邪气侵犯中焦则既呕吐又腹泻。凡是霍乱患者能够呕吐和腹泻，那么邪气就能从上下的途径排出体外，这样痛苦也就消除了；陈旧的积滞排尽后，呕吐和腹泻自然停止。然而，有的人上不能吐，下不能泻，称为“干霍乱”，又名“绞肠痧”。这是因为脾胃中的邪气无法排出，如果再加上气喘胸闷、抽搐等症状，十个人中救不活一个。那些既有上吐又有下泻的患者，应当分辨寒热证型进行治疗，同时也应该暂停乳食，恐怕会增加痰湿。所以霍乱患者喝米汤必死无疑，因为米汤会助长胃中的邪气，适宜使用藿香正气散（Huo Xiang Zheng Qi San）。
有先腹泻后呕吐的，这是脾胃虚寒所致，所以先排出白色清水样便，呕吐量也不多，气息微弱且神色倦怠，额头出汗，六脉沉细，这属于虚冷证，适宜温补治疗，用六君子汤（Liu Jun Zi Tang）。如果不见效，则在理中汤（Li Zhong Tang）中加入藿香、木瓜各一钱。
有先呕吐后腹泻的，这是脾胃有热所致，所以气喘急促、嘴唇发红，呕吐量大且面色潮红，口渴想喝水浆，脉象洪大而数。这属于热证，适宜和解治疗，用五苓散（Wu Ling San）加入藿香。
那种干霍乱，上不能吐，下不能泻，最为危急紧迫，必须迅速用盐汤催吐，一定要等到吐出宿食和积痰之后，再用药治疗。或者针刺十个指甲边缘（十宣穴区域）令其出血，或者针刺膝弯处的委中穴（Weizhong, BL40），放出血液即可缓解，之后再服用藿香正气散。
The *Yellow Emperor's Inner Classic* states: "When the rebellious qi of the Foot-Taiyin [Spleen] channel ascends, Huoluan occurs." It also states: "If one does not keep away from heat, heat will arrive; when heat arrives, the body becomes hot, accompanied by vomiting, diarrhea, and Huoluan." The disease known as Huoluan arises suddenly. Its symptoms are characterized by chaotic turmoil without cessation, hence the name "Huoluan" (sudden chaos). This condition is often caused by cold damage complicated by food stagnation, leading to a discordance and separation of Yin and Yang, resulting in upper vomiting, lower diarrhea, and irritability with mental confusion.
Generally, the human body possesses three Jiao (Triple Burners): The Upper Jiao receives and accepts water and grain, primarily governing intake rather than excretion; the Middle Jiao rots and ferments water and grain, circulating its essence to the five zang organs and six fu organs; the Lower Jiao separates water and grain, primarily governing excretion rather than acceptance. Therefore, if pathogenic factors affect the Upper Jiao, vomiting occurs; if they affect the Lower Jiao, diarrhea occurs; if they affect the Middle Jiao, both vomiting and diarrhea occur. In cases of Huoluan where vomiting and diarrhea are present, the pathogenic factors can be expelled from above and below, thus relieving suffering; once the accumulated pathogens are exhausted, vomiting and diarrhea cease naturally. However, in cases where there is neither vomiting nor defecation, it is called "Dry Huoluan," also known as "Intestinal Colic Sha" (Jiao Chang Sha). This occurs because the pathogens in the Spleen and Stomach have no outlet to exit. If accompanied by wheezing, chest fullness, and convulsions, fewer than one in ten patients can be saved. For those presenting with both vomiting and diarrhea, treatment must differentiate between cold and heat patterns. One should also suspend milk and solid food intake to prevent increasing phlegm. Therefore, drinking rice soup for Huoluan leads to death, as it aids the stomach pathogens; instead, Huo Xiang Zheng Qi San (Agaricus Powder for Rectifying the Qi) is indicated.
In cases where diarrhea precedes vomiting, this indicates deficiency-cold of the Spleen and Stomach. Consequently, white watery stools appear first, followed by minimal vomiting. The breath is weak, the spirit is lethargic, sweat appears on the forehead, and the six pulses are deep and fine. This is a deficiency-cold pattern, suitable for warming treatment using Liu Jun Zi Tang (Six Gentlemen Decoction). If ineffective, add Huo Xiang (Patchouli Herb) and Mu Gua (Papaya Fruit), each 1 qian, to Li Zhong Tang (Regulate the Middle Decoction).
In cases where vomiting precedes diarrhea, this indicates heat in the Spleen and Stomach. Symptoms include rapid breathing, red lips, profuse vomiting, flushed face, thirst for fluids, and a flooding and rapid pulse. This is a heat pattern, suitable for harmonizing treatment using Wu Ling San (Five-Ingredient Powder with Poria) added with Huo Xiang (Patchouli Herb).
Dry Huoluan, characterized by the inability to vomit or defecate, is the most critical and urgent condition. Immediately induce vomiting using salt water solution. Only after the retained food and accumulated phlegm are expelled should medication be administered. Alternatively, prick the sides of the ten fingernails (Shi Xuan points area) to allow blood to flow, or prick the Weizhong point (BL40, located at the popliteal crease) to release blood, which provides immediate relief. Subsequently, administer Huo Xiang Zheng Qi San (Agaricus Powder for Rectifying the Qi).