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Shortness of breath (Duan Qi) and insufficient breath (Shao Qi) were not strictly distinguished by ancient physicians. For instance, Li Dongyuan considered both to be due to Qi deficiency. Dai Fu'an stated that shortness of breath is characterized by difficulty in breathing and weak voice, and should be treated by tonifying deficiency. In addition to herbal medicine, one could select a robust person to inhale and exhale into the patient's mouth to assist the Zheng Qi (Upright Qi). Does this differ from what *Su Wen* describes as "timid insufficient breath" (Qie Ran Shao Qi), where speech is faint and can only resume after a whole day, indicating that Qi has been depleted, resulting in insufficient breath to speak? Thus, both belong to deficiency syndromes. However, some classify shortness of breath as excess. For example, Zhang Zhongjing discussed shortness of breath in Chest Bi (Xiong Bi) as an excess syndrome (see Pi Man chapter), and also stated that shortness of breath often belongs to fluid retention (see Tan Yin chapter), thus treating shortness of breath as excess. This is because pathogens such as water-fluids, phlegm, and food stagnation can obstruct Zheng Qi. The Qi itself is not deficient, but due to obstruction and upward congestion by pathogens, respiration becomes panting (ancients often equated shortness of breath with panting), preventing it from being smooth and prolonged like normal Qi; hence it is called "short." In such cases, once the pathogen is removed, the Qi naturally relaxes; therefore, they must be distinguished.

This refers to Yiqi (belching) mentioned in the *Jing* (*Neijing*), where Qi fails to diffuse smoothly and is expelled via belching. Its mechanism is similar to Hui Ni (hiccups). In hiccups, Qi is blocked and rushes upward, producing sound naturally; in belching, Qi is stagnant without rushing, so it is expelled through belching. The *Jing* associates belching with the Heart. The *Bi Lun* states that in Heart Bi, the vessels are obstructed; when vexed, there is palpitation under the heart, sudden upward Qi rush with panting, dry throat, and frequent belching. It also states that puncturing the Heart leads to death within one day, with the manifestation being belching. Wang Bing explained that the Heart governs belching because it resembles fire flaming upward, with smoke following the flame. Additionally, belching is associated with Spleen Qi stagnation; the *Jing* mentions that Taiyin disease involves abdominal fullness and frequent belching, which can be observed after overeating.

This refers to Yue (hiccups) in the *Neijing*, where Qi rushes upward from below, producing a "he-he" sound. The *Jing* states: "All rebellious Qi rushing upward belongs to Fire." However, there must be obstruction for this to occur. Obstruction may be caused by Cold-Heat, or by tangible substances such as water-fluids, phlegm, food, and blood. Zhang Jingyue compared it to thunder in rain (Yang obscured by Yin, struggling out of the earth to make sound) or bubbles in water (Qi covered by water, rising up to form bubbles and making sound), capturing the essence well. I once inhaled smoke into my throat, causing sudden closure of the Stomach gate, leading to frequent hiccups; thus, I know that Heat can also cause obstruction. Danxi treated Chen Chaoyue, who developed hiccups after running following a heavy meal (damaging collaterals and causing internal bleeding). Every time he ate, he hiccuped over a hundred times (food is turbid, belonging to Blood); it lasted half a day without stopping. However, drinking wine or soup did not trigger hiccups (wine and water are clear, belonging to Qi). By evening, he had a fever (Blood is Yin, so Blood pathology manifests at night), with a choppy and rapid pulse. Treating it as Blood invading Qi (Blood covering Qi), he used Taoren Chengqi Tang (see Blood) with Honghua (Safflower), decocted and administered. After passing foul blood several times, he recovered. He also cured a young woman by expelling stubborn phlegm. Thus, Blood, Food, and Phlegm can all cause obstruction. Hiccups may originate in the Middle Jiao, where Spleen and Stomach Qi are obstructed; or in the Lower Jiao, where Liver and Kidney Qi are obstructed. Qi is Yang, and Yang belongs to Fire. Treatment requires removing obstruction and dispersing Fire, distinguishing between Excess Fire and Deficiency Fire. Excess is treated with purgation, clearing, and dispersing; Deficiency is treated with tonification. Hiccups occurring without disease require no treatment. Even if treated, methods from the *Neijing* such as stimulating sneezing by poking the nose, holding breath, or startling the patient can stop it immediately. If hiccups occur with disease, and the constitution is strong without other ominous signs, identifying and removing the obstructing pathogen will stop it. However, in severe illness, hiccups often indicate Qi collapse. If hiccups rise from the Dantian and occur infrequently (frequent and connected indicates Excess; infrequent indicates Deficiency), accompanied by whole-body tremors, it is a critical sign, likely untreatable (indicating collapse of the primordial Fire of the Mingmen, usually fatal). Administer Heixi Dan and moxa Guanyuan. After Han Syndrome treatments involving vomiting, sweating, or purging, or after prolonged diarrhea due to misusing cold herbs, use Lizhong Tang (see Cold Syndrome). Postpartum hiccups are treated with Dingxiang San. In Han Syndrome heat diseases with dry stool and rapid pulse, use Chengqi Tang (see Constipation). If Qi is closed by Cold without transforming into Heat, use Shiqian San, Dingxiang Shidi San, or Qianghuo Fuzi Tang. For rebellious Qi with deficiency, use Chenpi Zhuru Tang. For Phlegm-Fluids, use Erchen Tang or Daotan Tang (see Phlegm) with Jiangzhi (Ginger Juice) and Zhuli (Bamboo Sap). For Yang deficiency with spontaneous sweating, use Shenfu Tang. For Yin deficiency with flaming Fire, use Shenfu decoction to swallow Dabu Yin Wan. For occasional hiccups lasting one or two days, use Muxiang Tiaoqi San (see Middle Qi). Acupuncture/Moxibustion method: For men, treat the left side; for women, the right side. Moxa an area the size of a leek leaf at the point where black hair ends below the nipple. Three moxa cones for mild cases, fourteen for severe cases.