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Prepared Rehmanniae Radix (Shu Dihuang, Prepared Rehmannia Root) (eight liang), Cornus Officinalis Fructus (Shanzhuyu, Dogwood Fruit), Dioscoreae Rhizoma (Shanyao, Yam Rhizome) (each four liang), Moutan Cortex (Mudanpi, Tree Peony Bark), Poria (Baifuling, White Poria), Alisma Rhizoma (Zexie, Water Plantain Rhizome) (each three liang). Formed into pills with honey.
For deficiency of Yin in the lower jiao causing frequent vomiting, this formula is indicated; it should be taken with salt water.
The *Maijie Pian* (Chapter on Pulse Explanation) states: "When various Yang qi floats upward without a root to rely upon, vomiting, coughing, and wheezing occur." This is due to Yin deficiency in the lower jiao, causing isolated Yang qi to float upward. In this formula, Shudi and Shanzhuyu have moist textures and rich flavors, enabling them to nourish Yin. Mudanpi and Zexie have salty and cold properties, capable of restraining hyperactive Yang. Shanyao and Fuling...

Narration states: Hiccups are categorized by location into the middle and lower jiao. Hiccups originating from the middle jiao have short sounds and are caused by disorders of food and water. Hiccups originating from the lower jiao have long sounds and result from the struggle between deficiency and pathogenic factors. By examining ancient formulas, distinguishing between upper and lower locations, and assessing deficiency or excess, one can become an excellent physician. If hiccups persist for a long time accompanied by acid regurgitation, it is a precursor to Fanwei (Regurgitation); treatment should address Fire.

Citri Reticulatae Pericarpium (Jupi, Tangerine Peel), Bambusae Folium (Zhuru, Bamboo Leaf), each one sheng; Ginseng Radix et Rhizoma (Renshen, Ginseng Root), Zingiberis Rhizoma Recens (Shengjiang, Fresh Ginger Rhizome), each half liang; Glycyrrhizae Radix et Rhizoma (Gancao, Licorice Root) (prepared with honey, two liang); Jujubae Fructus (Dazao, Jujube Fruit) (thirty pieces).
For hiccups persisting after a severe illness, accompanied by a deficient and large pulse, this formula is indicated.
Hiccups refer to the sound produced by Qi reversing from below upwards. After a severe illness, the Middle Qi is entirely deficient; residual pathogens enter the interior taking advantage of the deficiency. The struggle between pathogens and healthy Qi causes Qi to surge upward, resulting in hiccups. A deficient pulse indicates weak healthy Qi, while a large pulse indicates the presence of pathogenic heat. In this formula, Jupi regulates rebellious Qi, Zhuru clears heat, Gancao harmonizes rebellious Qi, Renshen tonifies deficiency, Shengjiang warms the Stomach, and Dazao benefits the Spleen.

Symplocos Fructus (Dingxiang, Clove Bud) (three grains); Diospyroi Fructus (Shidi, Persimmon Calyx); Bambusae Folium (Zhuru, Bamboo Leaf), each three qian; Citri Reticulatae Pericarpium (Chenpi, Aged Tangerine Peel), one qian.
For Qi obstruction in the middle jiao and hiccups in the lower jiao after a severe illness, this formula is indicated.
After a severe illness, the Five Zang organs are injured, and ascending and descending functions are disordered, leading to fullness and obstruction in the middle jiao. Since the Yin of the Five Zang organs is damaged, Shaoyang Ministerial Fire rises vigorously in the lower jiao, causing hiccups that rush directly up the clear pathways. In this formula, Dingxiang and Chenpi are acrid and warm, regulating Qi obstruction in the middle jiao. Zhuru and Shidi are bitter and cold, treating hiccups in the lower jiao. One might ask: Why not use Gardeniae Fructus (Zhizi, Gardenia Fruit) and Phellodendri Cortex (Huangbai, Phellodendron Bark) to direct Qi downward? I reply: This is a deficiency-type pathogen of Shaoyang, not an excess pathogen. Therefore, herbs with lighter flavors like Zhuru and Shidi are used. If heavy-flavored herbs like Zhizi and Huangbai were used, they would further damage Middle Qi, worsening the obstruction, would they not? The ancients indeed weighed these factors deeply.