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Gan Ou (Dry Retching) refers to the sensation of vomiting without any substance being expelled. Generally, this occurs due to heat in the epigastrium combining with grain qi, where rising heat steams upward, causing stagnation and knotting below the heart, resulting in this syndrome. For Taiyang disease presenting with sweating and gan ou, Guizhi Tang (Cinnamon Twig Decoction) is indicated to treat spontaneous sweating. For Shaoyin disease presenting with diarrhea and gan ou, Jiang Fu Tang (Ginger and Aconite Decoction) is indicated to treat diarrhea. For Jueyin disease presenting with salivation and gan ou, Wuzhuyu Tang (Evodia Decoction) is indicated to treat saliva and froth. Once the pathogenic factor is eliminated, vomiting will cease naturally. If there are two types of water-fluid retention syndromes, differentiation should be made based on exterior and interior patterns.

In Shanghan (Cold Damage) where the exterior pattern is unresolved and there is fluid retention in the epigastrium, manifesting as gan ou, slight fever, mild wheezing, or spontaneous diarrhea, Xiao Qinglong Tang (Minor Green Dragon Decoction) is indicated.

If there is no fever, no aversion to cold, hypochondriac pain, cough accompanied by diarrhea, and gan ou, Shizao Tang (Ten Jujube Decoction) is used for purgation.

For spontaneous sweating, headache, and gan ou, Guizhi Tang (Cinnamon Twig Decoction) is indicated.

For Shaoyin disease with diarrhea and gan ou, if the pulse is faint, Baitong Tang (White Passage Decoction) is indicated; if diarrhea persists, gan ou is accompanied by irritability, and there is cold extremities with no palpable pulse, Baitong Jia Zhuhuangdan Tang (White Passage Decoction with Pig Gallbladder Bile) is indicated.

For aversion to cold with external false heat, a pulse that is faint and nearly imperceptible, and gan ou, Tongmai Sini Tang (Pulse-Restoring Four Reversal Decoction) is indicated.

For cold-fluid retention above the diaphragm causing gan ou, which also belongs to Shaoyin disease, Sini Tang (Four Reversal Decoction) is indicated.

For gan ou, expectoration of phlegm and froth, and headache, Wuzhuyu Tang (Evodia Decoction) is indicated. If the condition worsens after taking this decoction, Xiaochaihu Tang (Minor Bupleurum Decoction) should be given. For gan ou accompanied by spontaneous diarrhea, Huangqin Tang (Scutellaria Decoction) or Banxia Shengjiang Tang (Pinellia and Fresh Ginger Decoction) are indicated.

For Taiyang Wind Strike, characterized by floating yang and weak yin pulses, spontaneous sweating, aversion to wind and cold, fever, nasal congestion, and gan ou, Guizhi Tang (Cinnamon Twig Decoction) is indicated. For gan ou, Yue (Hiccups), and cold extremities, Jupi Tang (Tangerine Peel Decoction) is indicated.

Yue (Hiccups), commonly known as "Chi Te" (hiccuping), is described as sound emerging from the throat and stopping abruptly, producing continuous short sounds ("HT HT") that are brief rather than prolonged. It was incorrect for ancient authors to call this "Yue". True Yue is similar to Gan Ou but involves a turbid, foul, and prolonged sound, yet still有声无物 (sound without substance). When a disease progresses to Yue, it is critical and difficult to treat. Da Di (Belching/Eructation) is close to Yue. Da Di merely involves qi stagnation in the chest preventing downward flow, whereas Yue involves foul sounds reaching the exterior. This typically arises because stomach qi is originally deficient; excessive sweating or purging, followed by drinking water, causes water and cold to clash, leading to deficiency-induced rebellion. The classics state: "Floating yang pulse indicates qi belching." And: "Slippery pulse indicates hiccups." This is a medical error, resulting from treating deficiency as excess. Alternatively, hiccups can result from heat oppression blocking upper and lower qi circulation; mild cases are treated with harmonizing and unblocking methods, severe cases with warming and dispersing. If there is anuria, abdominal fullness, and hiccups, or if hiccups are accompanied by a scattered and chaotic pulse, even a divine physician cannot intervene; this differs from Shanghan cough with rebellious qi. Confusing hiccuping with Yue and cough with rebellious qi leads to many errors. Clinicians must distinguish them clearly.

For cough with scanty stools, Dachengqi Tang (Major Order the Qi Decoction) is used for purgation, as this is caused by heat rushing against the diaphragm, liver, and lungs. If stools are soft, Xiexin Tang (Drain the Epigastrium Decoction) is used, indicating stomach qi deficiency with Chong Mai (Penetrating Vessel) rebellion. If the pulse is scattered, it is untreatable. For hiccups with tidal fever, Xiaochaihu Tang (Minor Bupleurum Decoction) added with Jupi (Tangerine Peel) and Shengjiang (Fresh Ginger) is indicated.

For persistent cold extremities, Wuling Tang (Black Bean and Polyporus Decoction) is used; if there is cold pathogen, Qianghuo Fuzi San (Notopterygium and Aconite Powder) is used.

In Shanghan where the exterior pattern is unresolved and there is fluid retention in the epigastrium, presenting with gan ou, fever, cough, or belching, Xiao Qinglong Tang (Minor Green Dragon Decoction) with Mahuang (Ephedra) removed and Fuzi (Aconite) added is indicated.

If the cunkou pulse is floating and large, and the doctor erroneously uses purgation, creating a counter-indication, and then gives cold water causing profuse sweating, the water meets cold qi, clashing together, causing the patient to belch; Doukou Tang (Cardamom Decoction) is indicated.

For hiccups with abdominal fullness and difficulty passing stool, first use Banxia Shengjiang Tang (Pinellia and Fresh Ginger Decoction), then Chengqi Tang (Order the Qi Decoction); for difficulty urinating, Zhuling Tang (Polyporus Decoction) is indicated.

For Yangming Wind Strike, with floating and wiry pulses, difficulty urinating, tidal fever, and hiccups, Xiaochaihu Tang (Minor Bupleurum Decoction) added with Fuling (Poria) is indicated.

For vomiting and hiccups with cold extremities, Xiao Jupi Tang (Minor Tangerine Peel Decoction) is used. If there is chest fullness and empty irritability, Da Jupi Tang (Major Tangerine Peel Decoction) is used; for cold stomach qi, Wuzhuyu Lizhong Tang (Evodia and Middle-Warming Decoction) or Wenzhong Tang (Warm the Middle Decoction) is used.

The *Jingui Yaolue* states: For hiccups and reversal, Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction) is indicated. For persistent hiccups, Jupi Ganjiang Tang (Tangerine Peel and Dried Ginger Decoction), Banxia Shengjiang Tang (Pinellia and Fresh Ginger Decoction), or Tuiyin San (Remove Yin Powder) may be used according to circumstances.

For Warm Disease where heat is not cleared, heavy quilts allow sudden cold to enter the stomach, accumulating and failing to dissipate, transforming into hiccups; Zipi Yinzi (Bark Decoction) is used. For Warm Disease with heat, drinking sudden cold water causes hiccups; Maogen Gengen Tang (Reed Rhizome and Kudzu Root Decoction) is used. For Warm Disease with cold stomach transforming into hiccups, Maogen Jupi Tang (Reed Rhizome and Tangerine Peel Decoction) is used. For Warm Disease with heat, drinking sudden cold water, Pipa Maogen Tang (Loquat Leaf and Reed Rhizome Decoction) is used.