大全云∶饮食过度，触冒风冷，阴阳不和，清浊相干，谓之霍乱（论霍乱详明，杂症亦不
外此）。其间或先吐，或腹痛吐利，是因于热也；若头痛体疼发热，是挟风邪也。若风折皮
肤，则气不宣通，而风热上冲为头痛；若风入肠胃，则泄利呕吐，甚则手足逆冷，此阳气暴
竭，谓之四逆。妊娠患之，多致伤胎也。
薛氏曰∶前证若因内伤饮食，外感风寒，用藿香正气散；若因饮食停滞，用平胃散；若
果脾胃顿伤，阳气虚寒，手足逆冷者，须用温补之剂。治当详审，毋使动胎也。
万密斋曰∶霍乱者，阳明胃经之病名也。盖因平日五味肥酿，腐积成痰，七情郁结，气
盛为火，停蓄胃中，乍因寒热之感，邪正交争，阴阳相混，故令心腹绞痛，吐利并作，挥霍变
乱，故名霍乱。如邪在上胃脘，则当心而痛，其吐多；邪在下胃脘，则当脐而痛，其利多；邪在
中脘，其腹中痛，吐利俱多。吐多则伤气，利多则伤血，血气受伤，不能护养其胎，况邪气鼓
击胎元，母寿未有不殒者矣。此危恶之证，不可不亟治也，宜香苏散加藿香叶主之。
香苏散加藿香方 治妊娠霍乱。（此方平正可法）
香附（炒） 紫苏（各二钱） 陈皮（一钱） 甘草（炙） 藿香叶 缩砂（各五分）
上锉，水煎服、如转筋，加木瓜一钱。胎动不安，加白术一钱半。如夏月得之，加
黄芩一钱半，黄连一钱，香薷二钱。如冬月得之，加人参、白术各一钱，干姜炮五分。
回生散 治中气不和，霍乱吐泻，但一点胃气存者，服之回生，（此方甚良）
陈皮（去白） 藿香（各五分）
上为末，水煎，温服。
七味白术散 治脾胃虚弱，吐泻作渴不食。
白术 人参 茯苓 甘草（炙） 木香 藿
香（各半两） 干葛（一两）
上为末，沸汤调服二钱。吐甚者，加生姜汁频频服之。
理中汤 治妊娠霍乱腹痛，四肢逆冷，汗出脉虚弱者。
白术 人参 干姜（炮） 甘草（炙，各一钱）
上锉，水煎服。甚者，加熟附子五分。
人参散 治妊娠霍乱吐泻，心烦腹痛，饮食不入。（心烦腹痛而用人参、炮姜，岂烦非
热，而痛属虚乎，虚实寒热，用者须斟酌之）
人参 浓朴（姜制） 橘红（各二钱） 当归（炒） 干姜（炮） 甘草（炙，各一钱）
上作一服，加生姜三片，枣一枚，水煎服。
白术散 治妊娠霍乱腹痛，吐利不止。（此真虚寒腹痛吐利方也，勿妄用）
白术（炒） 益智仁 枳壳（麸炒） 橘红（各七钱半） 草豆蔻（煨去皮） 良姜（炒，各半两）
上为散，每服五钱，入生姜半分，水煎，去滓，温服。
木瓜煎 治妊娠霍乱吐泻，转筋闷绝。（此方可常用）
吴茱萸（汤洗七次） 生姜（切，各七钱半） 木瓜（竹刀切，一两半）
上细锉，水二盏煎一盏二分，去滓，分三服，热服。
一方有 香七钱半，甘草一钱，茱萸半两加紫苏煎。
上四方，用干姜、豆蔻、茱萸，俱大温之剂（霍乱切忌温药，犹者必死，即不发热烦渴者，
亦不可轻用，慎之慎之）。若发热烦渴，脉数阳证者，服之即死，宜用后方。
竹茹汤（方见胎前门恶阻）
益元散 桂苓甘露饮 冬葵子汤（并治霍乱，方见胎前门子淋）
《大全》记载：饮食过量，感受风冷邪气，导致阴阳失调，清浊之气相互干扰，这就称为霍乱（关于霍乱的论述非常详尽，其他杂病也不外乎此理）。其中有的先出现呕吐，或者腹痛并伴有吐泻，这是因热邪所致；如果伴有头痛、身体疼痛、发热，则是兼夹风邪。如果风寒束缚皮肤，则气机不能宣通，风热上冲头部导致头痛；如果风邪侵入肠胃，则出现泄泻、呕吐，严重时手足逆冷，这是阳气突然衰竭的表现，称为四逆证。孕妇患此病，多会导致伤胎。
薛己认为：上述病症如果是由于内伤饮食、外感风寒引起，应使用藿香正气散；如果是由于饮食停滞引起，应使用平胃散；如果确实是脾胃骤然受损，阳气虚寒，出现手足逆冷的情况，必须使用温补的方剂。治疗应当详细审察，不要使胎儿受到惊动。
万密斋说：霍乱，是阳明胃经的病名。大概是因为平日食用五味肥腻酿制之物，腐败积滞形成痰饮，加上七情郁结，气盛化为火邪，停蓄在胃中，忽然因为寒热之感，邪气与正气交争，阴阳混淆，所以导致心腹绞痛，呕吐和泄泻同时发作，挥霍变乱，因此命名为霍乱。如果邪气在上焦胃脘，则心痛明显，呕吐较多；邪气在下焦胃脘，则脐部疼痛明显，泄泻较多；邪气在中焦胃脘，则腹部疼痛，呕吐和泄泻都很多。呕吐多会损伤气，泄泻多会损伤血，气血受伤，不能护养胎儿，何况邪气鼓动冲击胎元，母亲性命没有不丧失的。这是危急恶毒的证候，不可不紧急治疗，适宜用香苏散加藿香叶主治。
香苏散加藿香方 治疗妊娠霍乱。（此方平和端正，值得效法）
香附（炒制） 紫苏（各二钱） 陈皮（一钱） 甘草（炙烤） 藿香叶 缩砂仁（各五分）
以上药材切碎，用水煎服。如果出现转筋，加木瓜一钱。胎动不安，加白术一钱半。如果在夏季得此病，加黄芩一钱半，黄连一钱，香薷二钱。如果在冬季得此病，加人参、白术各一钱，干姜炮制五分。
回生散 治疗中气不和，霍乱吐泻，只要还有一点点胃气存在，服用后能起死回生。（此方非常好）
陈皮（去白） 藿香（各五分）
以上研为细末，用水煎煮，温服。
七味白术散 治疗脾胃虚弱，吐泻并作且口渴不想进食。
白术 人参 茯苓 甘草（炙烤） 木香 藿香（各半两） 干葛根（一两）
以上研为细末，用沸水调服二钱。呕吐严重的，加生姜汁频频服用。
理中汤 治疗妊娠霍乱腹痛，四肢逆冷，出汗脉象虚弱者。
白术 人参 干姜（炮制） 甘草（炙烤，各一钱）
以上切碎，用水煎服。病情严重的，加熟附子五分。
人参散 治疗妊娠霍乱吐泻，心烦腹痛，饮食无法进入。（心烦腹痛而用人参、炮姜，难道心烦不是热证，而腹痛属于虚证吗？虚实寒热，使用者必须斟酌。）
人参 浓朴（姜汁制） 橘红（各二钱） 当归（炒制） 干姜（炮制） 甘草（炙烤，各一钱）
以上为一服的量，加生姜三片，大枣一枚，用水煎服。
白术散 治疗妊娠霍乱腹痛，吐泻不止。（这是真正的虚寒腹痛吐泻方，不要随意使用）
白术（炒制） 益智仁 枳壳（麸皮炒） 橘红（各七钱半） 草豆蔻（煨制去皮） 良姜（炒制，各半两）
以上研为散剂，每次服用五钱，加入生姜半分，用水煎煮，去渣，温服。
木瓜煎 治疗妊娠霍乱吐泻，转筋闷绝。（此方可以常用）
吴茱萸（汤洗七次） 生姜（切片，各七钱半） 木瓜（用竹刀切，一两半）
以上细细切碎，用水二盏煎至一盏二分，去渣，分三次服用，热服。
另一配方有沉香七钱半，甘草一钱，吴茱萸半两，加紫苏煎煮。
以上四方，使用了干姜、豆蔻、吴茱萸，都是大温热的方剂（霍乱切忌使用温药，否则必然死亡，即使是不发热烦渴的患者，也不可轻易使用，务必谨慎）。如果患者发热烦渴，脉数属阳证，服用这些温药就会致死，适宜使用后面的方剂。
The *Daquan* records: Overeating and exposure to wind-cold pathogens cause disharmony of Yin and Yang, with turbid and clear qi interfering with each other; this is called Huoluan (Vomiting and Diarrhea Syndrome) (Discussions on Huoluan are detailed, and other miscellaneous diseases do not deviate from this principle). Among these cases, if vomiting occurs first, or abdominal pain accompanies vomiting and diarrhea, it is due to heat pathogen. If accompanied by headache, body ache, and fever, it involves an external wind pathogen. If wind-cold constricts the skin, Qi mechanism fails to circulate freely, and wind-heat rushes upward causing headache; if wind enters the intestines and stomach, it results in diarrhea and vomiting. In severe cases, cold extremities occur, indicating sudden exhaustion of Yang Qi, termed Sini (Four Reversals) syndrome. Pregnant women suffering from this condition often experience fetal injury.
Xue Ji stated: For the aforementioned symptoms caused by internal dietary injury and external wind-cold invasion, use Huoxiang Zhengqi San (Patchouli Powder to Rectify the Qi); if caused by food stagnation, use Pingwei San (Calm the Stomach Powder); if the Spleen and Stomach are suddenly damaged, leading to deficiency-cold of Yang Qi and cold extremities, warming and tonifying formulas must be used. Treatment requires careful examination to avoid disturbing the fetus.
Wan Mizhai said: Huoluan is a disease name of the Yangming Stomach Meridian. It generally arises because daily consumption of rich, greasy, and fermented foods leads to rotting accumulation forming phlegm-dampness, combined with emotional depression causing Qi stagnation transforming into fire, which accumulates in the Stomach. Suddenly triggered by cold or heat sensations, evil qi and righteous qi contend, and Yin and Yang mix chaotically, causing severe heart and abdominal colic with simultaneous vomiting and diarrhea, creating chaotic turmoil; hence named Huoluan. If the pathogen is in the upper Jiao epigastrium, pain centers around the heart with predominant vomiting; if in the lower Jiao epigastrium, pain centers around the umbilicus with predominant diarrhea; if in the middle Jiao epigastrium, abdominal pain occurs with both significant vomiting and diarrhea. Excessive vomiting damages Qi, excessive diarrhea damages Blood. When Qi and Blood are injured, they cannot nourish the fetus. Moreover, as the pathogen agitates and strikes the fetal origin, the mother’s life is invariably lost. This is a critical and malignant syndrome requiring urgent treatment. Xiangsu San (Elsholtzia and Cyperus Powder) added with Huoxiang Ye (Patchouli Leaf) is appropriate.
**Xiangsu San Added with Huoxiang Formula**: Treats Huoluan during pregnancy. (This formula is balanced and standard.)
Cyperus Rhizome (Chao/Fried), Perilla Leaf (each 2 qian), Tangerine Peel (1 qian), Licorice Root (Zhi/Roasted), Patchouli Leaf, Amomum Fruit (each 5 fen).
Crush the herbs, decoct in water, and take orally. If muscle cramps (Zhuanjin) occur, add Quince Fruit (Mugua) 1 qian. For restless fetus, add Atractylodes Macrocephala Rhizome (Baizhu) 1.5 qian. If contracted in summer, add Scutellaria Root (Huangqin) 1.5 qian, Coptis Rhizome (Huanglian) 1 qian, Mosla Herb (Xiangru) 2 qian. If contracted in winter, add Ginseng Radix (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu) each 1 qian, Ginger Rhizome (Ganjiang) processed 5 fen.
**Huisheng San (Life-Restoring Powder)**: Treats Disharmony of Middle Qi, Huoluan with vomiting and diarrhea. Effective for restoring life provided even a trace of Stomach Qi remains. (This formula is excellent.)
Tangerine Peel (deprived of white pith), Patchouli (each 5 fen).
Grind into powder, decoct in water, and take warm.
**Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder)**: Treats Spleen-Stomach deficiency with vomiting, diarrhea, thirst, and anorexia.
Atractylodes Macrocephala Rhizome (Baizhu), Ginseng Radix (Renshen), Poria (Fuling), Licorice Root (Zhi/Roasted), Aucklandia Root (Muxiang), Patchouli (each half liang), Kudzu Root (Gegen) (1 liang).
Grind into powder, mix with boiling water, and take 2 qian. For severe vomiting, add Ginger Juice and take frequently.
**Lizhong Tang (Regulate the Middle Decoction)**: Treats Huoluan during pregnancy with abdominal pain, cold extremities, sweating, and weak pulse.
Atractylodes Macrocephala Rhizome (Baizhu), Ginseng Radix (Renshen), Ginger Rhizome (Pao/Processed), Licorice Root (Zhi/Roasted, each 1 qian).
Crush, decoct in water, and take orally. For severe cases, add Prepared Aconite Lateral Root (Shu Fuzi) 5 fen.
**Renshen San (Ginseng Powder)**: Treats Huoluan during pregnancy with vomiting, diarrhea, restlessness, abdominal pain, and inability to retain food. (Note: Using Renshen and Pao Jiang for restlessness and abdominal pain implies that the restlessness is not due to heat, and the pain is due to deficiency. Practitioners must carefully consider patterns of deficiency/excess and cold/heat.)
Ginseng Radix (Renshen), Magnolia Bark (Zhi/Ginger-processed), Tangerine Peel (Ju Hong), Angelica Sinensis Radix (Chao/Fried), Ginger Rhizome (Pao/Processed), Licorice Root (Zhi/Roasted, each 1 qian).
Take as one dose, add 3 slices of Fresh Ginger and 1 Jujube, decoct in water, and take orally.
**Baizhu San (Atractylodes Macrocephala Powder)**: Treats Huoluan during pregnancy with abdominal pain and unceasing vomiting/diarrhea. (This is a true formula for deficiency-cold abdominal pain and diarrhea; do not use indiscriminately.)
Atractylodes Macrocephala Rhizome (Chao/Fried), Alpinia Oxyphylla Fruit (Yizhiren), Bitter Orange (Fu Chao/Wheat-bran fried), Tangerine Peel (each 7.5 qian), Cardamom Seed (Wei/Roasted and peeled), Galangal Root (Chao/Fried, each half liang).
Grind into powder. Take 5 qian per dose, add 0.5 qian of Fresh Ginger, decoct in water, strain, and take warm.
**Mugua Jian (Quince Decoction)**: Treats Huoluan during pregnancy with vomiting, diarrhea, and severe muscle cramps leading to fainting. (This formula can be commonly used.)
Evodia Fruit (Xi/Twice-washed in hot water seven times), Fresh Ginger (sliced, each 7.5 qian), Quince Fruit (Cut with bamboo knife, 1.5 liang).
Finely crush, decoct in 2 zhan of water until 1.2 zhan remain, strain, divide into three doses, and take hot.
Alternative prescription: adds Agarwood (Chenxiang) 7.5 qian, Licorice Root 1 qian, Evodia Fruit half liang, and Perilla Leaf for decoction.
The above four formulas all contain Ganjiang (Dried Ginger), Doukou (Cardamom), and Zhuyu (Evodia), which are strongly warming agents. (Huoluan strictly contraindicates warming medicines; using them will certainly lead to death. Even if the patient does not present with fever, restlessness, or thirst, they should not be lightly employed. Exercise extreme caution.) If the patient presents with fever, restlessness, thirst, and rapid pulse (Yang syndrome), taking these warming formulas will cause death. Instead, use the following formulas.
**Zhuru Tang (Bamboo Shave Decoction)** (See Fangji under Taiqian Men - Emetic Syndrome).
**Yiyuan San (Benefit Primordial Powder)**, **Guiling Ganlu Yin (Cassia and Poria Sweet Dew Decoction)**, **Dongkuizi Tang (Abelmoschus Manihot Seed Decoction)** (All treat Huoluan; see Fangji under Taiqian Men - Dysuria during Pregnancy).