呃，即哕也。有火、有痰饮、有寒、有虫、有食、有胃虚、有肾虚。种种不同，
但虚寒者十九。然必细察得之久暴，声之远近，形之盛衰，及病之所由起，则施治
自多效也。盖潜行默运，无声无臭者，中气之常也。若有所激，气即为火，易其常
性，卒暴上冲。仍欲其潜行默运，无臭无声，安可得乎？至若痰饮停中，碍其清道。
阴寒迫里，遏其阳升。或蛔卒动而气阻，或食暴入而气壅，或胃气虚于上而气不舒，
或肾气虚于下而气不续，皆能挠挫运机，行不顺利，而呃呃之声，有自来矣。故因
于火者，其声频以促，兼面赤而脉数。（宜二陈汤加山栀、黄连之类。）因于痰饮者，其声缓匀，
兼吞酸面泽而脉滑。（宜二陈汤、温胆汤、导痰汤之类。）因于阴寒者，其声短，而声扼扼不扬，
兼面色青白，恶寒而脉紧。（宜二陈汤加干姜、丁桂之类。）因于虫者，其声或作或止，或缓或
促，兼面色不一，胃中或痛、或吐清水冷涎，或心中嘈杂，脉迟数大小不定。（宜二陈
汤去甘草加吴茱萸、制黄连、干姜、细辛之类。）因于食者，其声浊而类呕，兼嗳逆酸腐，恶食，面
黄，脉紧滑。（宜和剂枳实半夏汤、曲 枳术丸、法制陈皮、法制槟榔之类。）因胃气虚寒者，其
声促而无力，或得食少止，面青白，畏寒，脉缓弱无力。（宜六君子汤、四君子汤、橘皮竹茹汤、
理中汤、洁古柿钱散之类。）因肾气虚寒者，其声远而长，或作或止，半刻一声，脐下或动筑，面黑，
腰疼，或足冷恶寒，脉沉微。（宜金匮肾气丸、良方参附汤之类。）
Hiccups (E), also known as "yue" (Yue), can be caused by fire pathogen, phlegm-fluid retention, cold pathogen, intestinal parasites, food stagnation, deficiency of stomach Qi, and deficiency of kidney Qi. Although the causes are diverse, the majority belong to deficiency-cold patterns. However, one must carefully distinguish the duration of the disease, the distance and pitch of the sound, the fullness or emaciation of the body, and the etiology of the illness; only then can treatment be effective in most cases.
The normal function of Middle Qi (Zhong Qi) operates silently and invisibly without sound or odor. If provoked, Qi transforms into fire, altering its normal nature and rushing upward suddenly and violently. Under such circumstances, how can it be expected to continue operating silently and invisibly? As for phlegm-fluid retention stagnating in the middle jiao, it obstructs the clear pathways. Yin-cold forcing inward suppresses the ascending of Yang. Alternatively, sudden movement of roundworms may block Qi mechanism, or excessive intake of food may cause Qi congestion. Deficiency of Stomach Qi in the upper part may lead to unsmooth Qi distribution, while deficiency of Kidney Qi in the lower part may result in discontinuous Qi flow. All these factors can disrupt the machinery of Qi transformation and movement, causing unsmooth operation, thereby giving rise to the sound of hiccups.
Therefore, when caused by fire, the sound is frequent and rapid, accompanied by a red face and rapid pulse. (Suitable formulas include Er Chen Tang [Two-Cured Decoction] with added Gardeniae Fructus [Shanzhi] and Coptidis Rhizoma [Huanglian].) When caused by phlegm-fluid, the sound is slow and even, accompanied by acid regurgitation, lustrous complexion, and slippery pulse. (Suitable formulas include Er Chen Tang [Two-Cured Decoction], Wendan Tang [Gallbladder-Warming Decoction], and Daotan Tang [Phlegm-Expelling Decoction].) When caused by Yin-cold, the sound is short, harsh, and not resonant, accompanied by a cyan-white complexion, aversion to cold, and tight pulse. (Suitable formulas include Er Chen Tang [Two-Cured Decoction] with added Dried Ginger [Ganjiang], Clove Flower [Dingxiang], and Cinnamon Bark [Rougui].) When caused by parasites, the sound starts and stops intermittently, varying between slow and rapid, accompanied by inconsistent facial complexion, epigastric pain or vomiting of clear cold saliva, cardiac discomfort, and irregular pulse varying in rate and size. (Suitable formula includes Er Chen Tang [Two-Cured Decoction] with Glycyrrhizae Radix [Gancao] removed, plus Evodiae Fructus [Wuzhuyu], processed Coptidis Rhizoma [Zhi Huanglian], Dried Ginger [Ganjiang], and Asari Radix et Rhizoma [Xixin].) When caused by food stagnation, the sound is turbid and resembles vomiting, accompanied by belching with sour-rotten odor, anorexia, yellowish complexion, and tight-slippery pulse. (Suitable preparations include Zhishi Banxia Tang [Immature Bitter Orange and Pinellia Decoction] from Heji Ju Fang, Qu Zhizhu Wan [Qu and Atractylodes Pill], processed Tangerine Peel [Fazhi Chenpi], and processed Areca Seed [Fazhi Binglang].) When caused by deficiency-cold of Stomach Qi, the sound is rapid yet weak, sometimes slightly relieved after eating, accompanied by a cyan-white complexion, fear of cold, and weak-slow pulse. (Suitable formulas include Liu Junzi Tang [Six-Gentlemen Decoction], Sijunzi Tang [Four-Gentlemen Decoction], Jupi Zhuru Tang [Tangerine Peel and Bamboo Shavings Decoction], Lizhong Tang [Regulate-the-Middle Decoction], and Jiegu Shi Qian San [Jiegu Persimmon Cap Powder].) When caused by deficiency-cold of Kidney Qi, the sound is distant and long, intermittent, occurring once every half minute, accompanied by pulsation below the umbilicus, blackish complexion, lumbar pain, cold feet, aversion to cold, and deep-micro pulse. (Suitable formulas include Jin Gui Shenqi Wan [Golden Cabinet Kidney-Energy Pill] and Liangfang Shenfu Tang [Effective Formula Ginseng and Aconite Decoction].)