经曰∶岁土不及,风乃大行,民病飧泄、霍乱,体重腹痛,筋骨繇并。是证虽因饮食过度,七
情内伤,风寒湿热外感,诚因暑火所致,发必夏秋(口大渴,转筋,反戾,火也,病感于火,治从温
散。)盖夏时腠理开豁,暑气易入,或坐卧阴湿,当风取凉,风寒之邪,客于三焦,传于脾胃,更伤
饮食劳役。复感风寒外束,则内邪杂揉,
阳气不能外舒,变为郁热,致阴阳反戾,清浊相干。阳气暴升,阴气顿坠,上下痞膈,邪客胃多吐
,邪客脾多泻。受邪浅乃得上下分为易治;若深者,邪恣中焦,上不得吐,下不得泻,搅腹颠倒,
挥霍撩乱,大痛危甚,此干霍乱也(俗名绞肠沙。)急治则生,失治则死。多饮淡盐汤(水二钟,
烧百沸,入盐一撮,和河水二钟,加生姜及皂角末少许,尤佳。)患人频饮,必得吐或泻,便是生
机。次服煎药。切戒米汤,一口入胃立死。转筋者,手足挛缩,筋收入心腹者,死。男子急挽其阴
囊,女子挽定两乳,用鲜蓼一束煎;或盐煎热汤,淋渍腿足,筋挛处可舒;或以绵絮裹暖,饮温姜
汤,过一时与米汤。脉宜洪大,忌虚细。如大痛时,脉多伏,不宜渐迟(盐汤吐泻,不药亦安。)
主方 半夏 茯苓 苍术 陈皮 浓朴 猪苓 藿香 泽泻 炙草 上姜、枣、枇杷叶
煎服。
手足厥冷加干姜、官桂、良姜;冷极脉欲脱加人参、附子;怕寒加紫苏、白芷;吐甚去藿香;
腹痛加炒芍药;少腹痛加吴茱萸(泡);心腹胀加木香、砂仁、大腹皮;转筋加牛膝、木瓜、火
石膏;食积加山楂、神曲、麦芽;心下痞加枳实、青皮;暑加香藿、扁豆;大渴欲水,水调六一散
,微渴汤调;烦渴加麦冬、葛根;胃寒发呃加丁香、香附、茴香、良姜,去甘草;远至他乡、不伏
水土而作,加木香、砂仁;泻加白术、山药、乌梅;喘加苏子、桑皮,去甘草。
藿香正气散 (方见卷末)
针刺十指甲尽处出血。先从臂复下,绳扎十指乃刺。及两委中(穴在膝后腕中横纹处。)先以
冷水,从腿肚搭上,见紫点起针,或用瓷锋刺出紫血。腹痛不止,炒盐麸或灰砂包熨。痛甚,将面
或布条作圈,放脐上,
圆圈中放炒盐,上以大艾炷三个,灸多壮,痛止为度。痛在上下对痛灸。
六和半夏汤 治霍乱吐泻。
白术 甘草 砂仁 杏仁 人参 半夏(制。各五分) 藿香 赤茯苓 白扁豆(姜汁炒)
木瓜(各一钱) 香薷(二钱) 浓朴(姜制,二钱)
上咀,作一服。姜三片,枣一枚,水二盏煎至一盏,温服。
木瓜汤 治霍乱吐泻,举身转筋,入腹则闷绝。
紫苏叶(十片) 干木瓜(一两) 吴茱萸(半两) 小茴香(炒) 甘草(炙。各一钱)
上加姜、枣,水煎服。更用丝瓜叶捣,绞汁,河、井水和服。
藿苓汤 治外感风寒,内伤饮食,霍乱转筋,呕吐泻泄等证。
藿香 浓朴 白术 茯苓(各一钱) 甘草(炙,五分) 紫苏 白芷 大腹皮 桔梗 半夏
陈皮(各八分) 肉桂 猪苓 泽泻(各七分)
上咀,一服。水二钟,姜五片,煎八分,食远服。
简便方 用良姜(半两,)煎服。
又 枇杷叶(刷去毛) 橘皮 枣、姜煎服。
又 桑叶捣汁一盏服(冬月煎汤。)
又 浓朴(姜汁浸,炒)为末,(二钱,)汲新水服。
又 丁香十四枚为末,服。或白羊眼豆为末,醋调服。垂死者,用生姜三两,捣烂,煎汤一碗
温服。吐不止,梨枝叶一握煎服。
又 胡椒四十粒,滚白汤吞下。或枯矾一钱,白汤服。
又 胡椒 绿豆(各四十九粒),研细,水煎服。口渴,为末,水调下。
大泻肢冷∶附子炮为末四钱,盐三钱,水二钟,煎温服。
吐泻不止∶艾一把,水煎服。
干呕不息∶用薤叶煎服。
转筋∶赤蓼(切,)三合,水煎服。或皂角末吹入鼻,取嚏。
筋挛∶薏苡仁为末,连进数服。
筋痛∶生姜或葱(捣,炒),贴患处。
痢后转筋∶用羊眼豆叶一握,捣,醋煎服。
干霍乱不得吐泻∶盐汤未通,用小蒜一碗,水三碗,煮汁碗半服。
烦躁∶葱白(二十茎) 大枣(二十枚),水煎汁服。
沙病∶水红花根,水煎服。
吐泻后大渴∶饮童便妙,渐少与黄米汤。
《黄帝内经》说:如果岁运土气不足,风气就会大行,百姓容易患完谷不化的泄泻、霍乱,身体沉重腹痛,筋骨拘急挛缩。这种病证虽然是因为饮食过度、七情内伤,以及风寒湿热外感所致,但确实是由暑火引起的,发病多在夏秋季节(口大渴,转筋,反戾,这是火邪的表现,病感于火,治疗应从温散入手。)因为夏季腠理开豁,暑气容易侵入,或者坐卧在阴湿之处,对着风取凉,导致风寒之邪客居于三焦,传入脾胃,再加上饮食和劳役损伤。又感受风寒外束,则内邪混杂,阳气不能向外舒展,变为郁热,导致阴阳逆乱,清浊之气相互干扰。阳气突然上升,阴气骤然下降,上下痞塞阻隔,邪气客于胃多表现为呕吐,邪气客于脾多表现为腹泻。受邪浅的,上下分开,容易治疗;如果受邪深重,邪气恣肆于中焦,上不能吐,下不能泻,搅动腹部,颠倒混乱,挥霍撩乱,剧烈疼痛且病情危重,这就是干霍乱(俗称绞肠沙。)紧急治疗可以生还,失治则会死亡。多喝淡盐汤(水两钟,烧至沸腾百次,加入一撮盐,混合河水两钟,再加少许生姜及皂角末,尤其好。)让患者频频饮用,必定会吐或泻,这就是生机。随后再服用煎药。切记禁止喝米汤,一口入胃立即致死。出现转筋的,手足挛缩,筋脉收缩进入心腹的,预后不良属死证。男子要急忙挽住其阴囊,女子要按住两乳,用鲜蓼一束煎煮;或者用盐水煎热汤,淋渍腿足,筋挛处可以舒缓;或者用绵絮包裹保暖,饮用温姜汤,过一个时辰后再给米汤。脉象宜洪大,忌虚细。如在大痛时,脉象多伏,不宜逐渐变迟(通过盐汤催吐泻下,不吃药也能安宁。)主方:半夏、茯苓、苍术、陈皮、浓朴、猪苓、藿香、泽泻、炙甘草。以上药材加生姜、大枣、枇杷叶煎服。
手足厥冷加干姜、官桂、良姜;冷极且脉象欲脱加人参、附子;怕寒加紫苏、白芷;呕吐严重去藿香;腹痛加炒芍药;小腹痛加吴茱萸(泡过);心腹胀加木香、砂仁、大腹皮;转筋加牛膝、木瓜、火石膏;食积加山楂、神曲、麦芽;心下痞加枳实、青皮;暑邪加香藿、扁豆;大渴想喝水,用水调服六一散,微渴用汤调服;烦渴加麦冬、葛根;胃寒发呃逆加丁香、香附、茴香、良姜,去甘草;远行至他乡、不服水土而发病,加木香、砂仁;腹泻加白术、山药、乌梅;气喘加苏子、桑白皮,去甘草。
藿香正气散(方剂见卷末)
针刺十指甲尽头处出血。先从手臂开始向下,用绳子扎紧十个手指然后针刺。以及两委中穴(穴位在膝后腘窝横纹处。)先用冷水,从腿肚搭上,看到紫点起针,或者用瓷锋刺出紫血。腹痛不止,用炒盐麸或灰砂包熨烫。疼痛剧烈,将面粉或布条做成圈,放在脐上,圆圈中放炒盐,上面用大艾炷灸三个,灸多壮数,以疼痛停止为度。疼痛在上方或下方,就对着疼痛部位施灸。
六和半夏汤 治疗霍乱吐泻。
白术、甘草、砂仁、杏仁、人参、半夏(制,各五分)、藿香、赤茯苓、白扁豆(姜汁炒)、木瓜(各一钱)、香薷(二钱)、浓朴(姜制,二钱)。
以上切碎,作一服。加生姜三片,大枣一枚,水两盏煎至一盏,温服。
木瓜汤 治疗霍乱吐泻,全身转筋,筋脉入腹则闷绝。
紫苏叶(十片)、干木瓜(一两)、吴茱萸(半两)、小茴香(炒)、甘草(炙,各一钱)。
上加生姜、大枣,水煎服。另外用丝瓜叶捣烂,绞汁,用河水、井水调和服用。
藿苓汤 治疗外感风寒,内伤饮食,霍乱转筋,呕吐泻泄等证。
藿香、浓朴、白术、茯苓(各一钱)、甘草(炙,五分)、紫苏、白芷、大腹皮、桔梗、半夏、陈皮(各八分)、肉桂、猪苓、泽泻(各七分)。
以上切碎,作一服。水两钟,生姜五片,煎至八分,饭后服用。
简便方 用良姜(半两),煎服。
又方 枇杷叶(刷去毛)、橘皮、枣、姜煎服。
又方 桑叶捣汁一盏服用(冬季煎汤。)
又方 浓朴(姜汁浸,炒)研为末(二钱),汲新水送服。
又方 丁香十四枚研为末,服用。或者白羊眼豆研为末,醋调服。垂死者,用生姜三两,捣烂,煎汤一碗温服。呕吐不止,梨枝叶一握煎服。
又方 胡椒四十粒,滚开的白水吞下。或者枯矾一钱,白水送服。
又方 胡椒、绿豆(各四十九粒),研细,水煎服。口渴,研为末,水调下。
大泻肢冷:附子炮制为末四钱,盐三钱,水两钟,煎温服。
吐泻不止:艾一把,水煎服。
干呕不息:用薤叶煎服。
转筋:赤蓼(切),三合,水煎服。或者皂角末吹入鼻中,取嚏。
筋挛:薏苡仁为末,连续服用几服。
筋痛:生姜或葱(捣,炒),贴敷患处。
痢后转筋:用羊眼豆叶一握,捣,醋煎服。
干霍乱不得吐泻:盐汤未通,用小蒜一碗,水三碗,煮汁碗半服用。
烦躁:葱白(二十茎)、大枣(二十枚),水煎汁服。
沙病:水红花根,水煎服。
吐泻后大渴:饮童便妙,逐渐少量给予黄米汤。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: If the Earth Qi of the year is insufficient, Wind will prevail greatly, and the people will suffer from undigested diarrhea (Sun Xie), cholera-like disease (Huo Luan), heavy body with abdominal pain, and spasms of sinews and bones. Although this syndrome is caused by overeating, internal injury from the Seven Emotions, and external contraction of Wind-Cold-Damp-Heat, it is indeed caused by Summer-Heat and Fire, occurring necessarily in summer and autumn (Mouth greatly thirsty, tendon cramping, reversal of limbs, indicates Fire; when the pathogen is Fire, treatment should follow warming and dispersing.) Because in summer, the interstices are open, and Summer-Heat easily enters; or if sitting and lying in damp and cold places, seeking coolness facing the wind, the Wind-Cold pathogen lodges in the San Jiao (Triple Burner), transmits to the Spleen and Stomach, further injuring due to diet and labor. Additionally contracting Wind-Cold externally constraining the exterior, the internal pathogens mix turbidly, Yang Qi cannot extend outward, transforming into constrained Heat, causing Yin and Yang to reverse, Clear and Turbid Qi to interfere with each other. Yang Qi rises suddenly, Yin Qi drops abruptly, causing upper and lower obstruction and blockage. Pathogen lodging in the Stomach leads mostly to vomiting; pathogen lodging in the Spleen leads mostly to diarrhea. If the pathogen is shallow, upper and lower separation makes it easy to treat; if deep, the pathogen肆s in the Middle Jiao, unable to vomit above or defecate below, churning the abdomen, chaotic and tumultuous, severe pain and critical condition, this is Dry Cholera (commonly known as Intestinal Colic Sha). Urgent treatment leads to survival, neglect leads to death. Drink plenty of light salt water (Two cups of water, boiled vigorously one hundred times, add a pinch of salt, mix with two cups of river water, add a little ginger and powdered Gleditsia Sinensis [Zao Jiao], which is especially good.) Let the patient drink frequently; once vomiting or diarrhea occurs, this is the sign of life. Then administer decocted medicine. Strictly forbid rice soup; one mouthful entering the stomach causes immediate death. For tendon cramping, where hands and feet contract, and sinews retract into the heart and abdomen, it is a fatal prognosis. For men, urgently pull their scrotum; for women, press firmly on both breasts, decoct a bundle of fresh Polygonum orientale (Liao); or use hot water decocted with salt, pour and soak legs and feet, so that cramped sinews can relax; or wrap with cotton wadding to keep warm, drink warm Ginger Decoction, and after an hour give rice soup. The pulse should be洪大 (Hong Da, surging and large); deficiency and fine pulses are contraindicated. During severe pain, the pulse is often hidden (Fu); it should not gradually become slow (Using salt water to induce vomiting and diarrhea, peace can be achieved without medicine.) Main Formula: Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Cang Zhu (Atractylodis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Hou Po (Magnoliae Officinalis Cortex), Zhu Ling (Polyporus), Huo Xiang (Agastaches Herba), Ze Xie (Alismatis Rhizoma), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma). Decoct these with Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus), and Pi Pa Ye (Loquats Leaf) for administration.
For cold hands and feet, add Gan Jiang (Zingiberis Rhizoma), Guan Gui (Cinnamomi Cortex), and Liang Jiang (Galangal Rhizoma); for extreme cold with pulse about to collapse, add Ren Shen (Ginseng Radix) and Fu Zi (Aconiti Lateralis Radix Praeparata); for aversion to cold, add Zi Su (Perillae Folium) and Bai Zhi (Angelicae Dahuricae Radix); for severe vomiting, remove Huo Xiang; for abdominal pain, add Chao Shao Yao (Fried Paeoniae Radix Alba); for lower abdominal pain, add Wu Zhu Yu (Evodiae Fructus) (soaked); for epigastric and abdominal fullness, add Mu Xiang (Aucklandiae Radix), Sha Ren (Amomi Fructus), and Da Fu Pi (Arecae Pericarpium); for tendon cramping, add Niu Xi (Achyranthis Bidentatae Radix), Mu Gua (Chaenomelis Fructus), and Huo Shi Gao (Calcitum); for food stagnation, add Shan Zha (Crataegi Fructus), Shen Qu (Massa Medicata Fermentata), and Mai Ya (Hordei Fructus Germinatus); for epigastric stuffiness, add Zhi Shi (Aurantii Fructus Immaturus) and Qing Pi (Citri Reticulatae Pericarpium Viride); for Summer-Heat, add Xiang Huo (Agastache) and Bian Dou (Dolichos Lablab Seed); for great thirst desiring water, take Liu Yi San (Six-to-One Powder) mixed with water; for slight thirst, take with decoction fluid; for vexatious thirst, add Mai Dong (Ophiopogonis Radix) and Ge Gen (Puerariae Lobatae Radix); for stomach Cold with hiccups, add Ding Xiang (Caryophylli Flos), Xiang Fu (Cyperi Rhizoma), Hui Xiang (Foeniculi Fructus), and Liang Jiang, remove Gan Cao; for illness arising from traveling far away and acclimatization issues, add Mu Xiang and Sha Ren; for diarrhea, add Bai Zhu (Atractylodis Macrocephalae Rhizoma), Shan Yao (Dioscoreae Rhizoma), and Wu Mei (Mume Fructus); for wheezing, add Su Zi (Perillae Fructus) and Sang Bai Pi (Mori Cortex), remove Gan Cao.
Huo Xiang Zheng Qi San (See formula at the end of the volume)
Prick the ends of the ten fingernails to bleed. Start from the arms downwards, tie the ten fingers tightly with a rope before pricking. Also prick Li Zhong (Weizhong BL-40) (located at the midpoint of the popliteal crease). First apply cold water from the calf upwards; when purple spots appear, remove the needle, or use a porcelain blade to prick out purple blood. For unceasing abdominal pain, apply a pack of fried salt bran or ash-sand for moxibustion/warming. For severe pain, make a circle from flour or cloth strips, place it on the navel, put fried salt inside the circle, and apply three large moxa cones on top, burning many moxibustions until the pain stops. If pain is above or below, apply moxibustion opposite to the painful area.
Liu He Ban Xia Tang (Six Harmonies Pinellia Decoction) treats Cholera with vomiting and diarrhea.
Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Sha Ren (Amomi Fructus), Xing Ren (Armeniacae Semen Amarum), Ren Shen (Ginseng Radix), Ban Xia (Pinelliae Rhizoma) (processed, each 5 fen), Huo Xiang (Agastaches Herba), Chi Fu Ling (Poria cum Risus), Bai Bian Dou (Dolichos Lablab Seed) (fried with ginger juice), Mu Gua (Chaenomelis Fructus) (each 1 qian), Xiang Ru (Elsholtziae Herba) (2 qian), Hou Po (Magnoliae Officinalis Cortex) (processed with ginger juice, 2 qian).
Cut into pieces, make one dose. Add three slices of ginger and one jujube, decoct two cups of water to one cup, take warm.
Mu Gua Tang (Chaenomelis Decoction) treats Cholera with vomiting and diarrhea, whole-body tendon cramping, and retraction into the abdomen causing suffocation.
Zi Su Ye (Perillae Folium) (10 leaves), Gan Mu Gua (Chaenomelis Fructus) (1 liang), Wu Zhu Yu (Evodiae Fructus) (half liang), Xiao Hui Xiang (Foeniculi Fructus) (fried), Gan Cao (Glycyrrhizae Radix et Rhizoma) (prepared, each 1 qian).
Add ginger and jujube, decoct in water and take. Additionally, crush Loofah leaves, wring out the juice, and take mixed with river or well water.
Huo Ling Tang (Agastache and Poria Decoction) treats external contraction of Wind-Cold, internal injury from diet, Cholera with tendon cramping, vomiting and diarrhea, etc.
Huo Xiang (Agastaches Herba), Hou Po (Magnoliae Officinalis Cortex), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria) (each 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (prepared, 5 fen), Zi Su (Perillae Folium), Bai Zhi (Angelicae Dahuricae Radix), Da Fu Pi (Arecae Pericarpium), Jie Geng (Platycodonis Radix), Ban Xia (Pinelliae Rhizoma), Chen Pi (Citri Reticulatae Pericarpium) (each 8 fen), Rou Gui (Cinnamomi Cortex), Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma) (each 7 fen).
Cut into pieces, make one dose. Two cups of water, five slices of ginger, decoct to eight parts, take long after meals.
Simple Prescriptions: Use Liang Jiang (Galangal Rhizoma) (half liang), decoct and take.
Another: Pi Pa Ye (Loquats Leaf) (brush off hairs), Ju Pi (Citri Reticulatae Pericarpium), Zao (Jujube), Jiang (Ginger), decoct and take.
Another: Crush Sang Ye (Mori Folium) to get one cup of juice to take (decoct in winter).
Another: Hou Po (Magnoliae Officinalis Cortex) (soaked in ginger juice, fried) powder, (2 qian), take with fresh water drawn from a well.
Another: Ding Xiang (Caryophylli Flos) fourteen pieces powder, take. Or Bai Yang Yan Dou (Goat-eye Bean) powder, take mixed with vinegar. For those near death, use three liang of Sheng Jiang (Zingiberis Rhizoma Recens), crush, decoct one bowl of soup, take warm. For unceasing vomiting, decoct one handful of Li Zhi Ye (Pear Branches and Leaves) and take.
Another: Swallow forty grains of Hu Jiao (Piperis Longi Fructus) with boiling white water. Or take one qian of Ku Fan (Alumen Exsiccatum) with white water.
Another: Hu Jiao (Piperis Longi Fructus) and Lu Dou (Vigna Radiata Seed) (each 49 grains), grind finely, decoct in water and take. For thirst, take as powder mixed with water.
Profuse diarrhea with cold limbs: Si Pian Zi (Aconiti Radix Praeparata) processed into powder 4 qian, salt 3 qian, two cups of water, decoct warm and take.
Unceasing vomiting and diarrhea: One handful of Ai Ye (Artemisiae Argyi Folium), decoct in water and take.
Unceasing dry retching: Decoct Xie Ye (Allii Macrostemonis Folium) and take.
Tendon cramping: Chi Liao (Polygoni Orientalis Herba) (cut), three he, decoct in water and take. Or blow powdered Zao Jiao (Gleditsiae Sinensis Fructus) into the nose to induce sneezing.
Sinew spasm: Yi Yi Ren (Coicis Semen) powder, take continuously for several doses.
Sinew pain: Sheng Jiang (Zingiberis Rhizoma Recens) or Cong Bai (Allii Fistulosi Bulbus) (crush, fry), apply to the affected area.
Tendon cramping after dysentery: Take one handful of Yang Yan Dou Ye (Goat-eye Bean Leaf), crush, decoct with vinegar and take.
Dry Cholera unable to vomit or defecate: If salt water has not passed, take one bowl of Xiao Suan (Allii Macrostemonis Bulbus), three bowls of water, boil to half a bowl of juice and take.
Vexation and restlessness: Cong Bai (Allii Fistulosi Bulbus) (twenty stalks), Da Zao (Jujubae Fructus) (twenty pieces), decoct in water, take the juice.
Sha Disease: Shui Hong Hua Gen (Alternantherae Philoxeroidis Radix), decoct in water and take.
Great thirst after vomiting and diarrhea: Drinking Tong Bian (Child Urine) is excellent; gradually give small amounts of Huang Mi Tang (Yellow Millet Soup).