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All cases of *zaocha* (a sensation of hunger mixed with discomfort, neither true hunger nor pain, accompanied by a feeling of restlessness) are caused by the activation of deficient fire in the Heart and Spleen meridians. This is indicated by a wiry and slippery pulse at the Cun (inch) and Guan (middle) positions on both wrists.

**Tiaopi Huohuo Tang (Spleen-Regulating and Fire-Suppressing Decoction)**: Treats insufficient Spleen Qi, characterized by intermittent sensations of *zaocha* in the chest/heart area.
Ingredients: Bai Fuling (Poria), Huanglian (Coptis Rhizome), Shanzhiren (Gardenia Seed), Baizhu (Atractylodes Macrocephala Rhizome) [each 2 qian]; Chenpi (Citrus Reticulata Peel), Huangqin (Scutellaria Root), Gancao (Licorice Root) [each 1 qian]. Decoct in water and take at any time.

Another prescription: Treats insufficient Heart Blood, characterized by gastric *zaocha* and frequent cravings for food.
Ingredients: Huanglian (Coptis Rhizome, stir-fried with ginger juice), Danggui (Angelica Sinensis Root), Renshen (Ginseng Radix), Baizhu (Atractylodes Macrocephala Rhizome, soil-stir-fried) [each 2 qian]; Longyanrou (Longan Aril) [5 pieces]. Decoct and take.

All conditions involving rebellious Qi rushing upward belong to Fire. The ancients considered them Cold patterns, which is likely incorrect. Treatment methods must distinguish between excess and deficiency before applying therapy.

If the pulse is floating and moderate, it is easy to treat; if the pulse is rapid/tense, it is difficult to treat.

**Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction)**: Treats persistent hiccups due to insufficient Middle Qi after a severe illness, with a deficient and fine pulse.
Ingredients: Renshen (Ginseng Radix), Chenpi (Citrus Reticulata Peel), Zhuru (Bamboo Shavings), Gancao (Licorice Root) [each 2 qian]; Jujube (Chinese Date) [5 pieces], Shengjiang (Fresh Ginger Slice) [10 slices]. Decoct and take.

**Jiedu Tang (Detoxifying Decoction)**: Treats persistent hiccups caused by the interaction of Phlegm and Fire. (See the *Shanghan Men* chapter for the formula details).

**Dingxiang Zhuru Tang (Clove and Bamboo Shavings Decoction)**: Treats hiccups originating from the Lower Jiao due to Qi blockage in the Middle Jiao.
Ingredients: Shidi (Persimmon Calyx), Chenpi (Citrus Reticulata Peel), Shengzhuru (Raw Bamboo Shavings) [each 2 qian]; Dingxiang (Caryophylli Flos) [5 pieces], Shengjiang (Fresh Ginger Slice) [5 slices]. Decoct and take.

Another prescription: Treats hiccups occurring postpartum in women.
Ingredients: Huangbai (Phellodendron Bark), Danggui (Angelica Sinensis Root), Zhimu (Anemarrhena Rhizome), Chenpi (Citrus Reticulata Peel) [each 2 qian]; Shengdi (Rehmannia Root), Chuanxiong (Ligusticum Chuanxiong Rhizome), Zhuru (Bamboo Shavings), Baishao (White Peony Root) [each 1.2 qian], Shengjiang (Fresh Ginger Slice) [3 slices].

The Abdomen is located in the center of the human body and is governed by the Spleen and Stomach; it is the residence of water and grain. If Cold pathogens invade, they obstruct circulation; if Heat arises internally, it stagnates without dispersing.
Food retention
can all cause pain. There are also worm pain, summerheat pain, hernia pain, accumulation/mass pain, intestinal cramping pain, dysentery pain, and appendicitis pain, among many others. All require differentiation.

Continuous dull pain without sharp piercing sensations, which alleviates slightly with hot compresses, accompanied by a fine, deep, and slow pulse, clear and profuse urination, indicates a Cold pattern. Intermittent pain where the painful area cannot tolerate heat, dry mouth and tongue, dark and scanty urination, constipation, or a burning sensation in the anus, indicates a Fire pattern. Chest and epigastric fullness and oppression, where pain worsens with heavy pressure, and pain alleviates after defecation or urination, indicates Food retention. Pain localized to a specific area, worsening at night, with abdominal distension but normal urination, and a choppy pulse, indicates Blood stasis. Obstruction of Qi mechanism leading to difficult urination, with a slippery pulse, indicates Phlegm. Pain radiating to both hypochondriac regions or shooting into the lower back, with a wiry pulse, indicates emotional anger. If one usually eats cautiously, yet the limbs are emaciated, without fullness or oppression, but experiencing only lingering pain as if pulled by fine threads, this indicates Blood deficiency. If the abdomen constantly feels empty, resembling hunger but not quite, with lingering pain and weak respiration, this indicates Qi deficiency. Yellowish complexion with emaciation, large abdomen with visible blue veins, alternating colicky pain, ability to eat when pain subsides, white spots on the face, pale lips, erect hair, and vomiting of clear fluid indicate Worm infestation. Summerheat pain results from Summerheat injury; accumulation/mass pain presents as palpable masses; hernia pain radiates to the testicles; intestinal cramping pain occurs without vomiting or diarrhea; dysentery pain is accompanied by tenesmus; appendicitis pain involves sores around the umbilicus and urinary symptoms resembling strangury. Generally, upper abdominal pain belongs to the Taiyin stage, often due to food retention and external contraction; periumbilical pain belongs to the Shaoyin stage, often due to accumulated heat and phlegm-fire; lower abdominal pain belongs to the Jueyin stage, often due to blood stasis, phlegm, and difficult urination. By reasoning in this manner, the patterns of Cold, Heat, Deficiency, and Excess become clear.