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Huxian Weng treated the country jinshi (scholar-official) Xu Chongzhi, who suffered from hiccups. A physician used realgar smoke to fumigate his nose. Suddenly, he became blind, and the heat intensified severely. Huxian Weng examined him and said, "This is caused by anger injuring the Liver, leading to rebellious Liver Qi ascending and causing hiccups. The Classics state: 'When Wood is stagnant, unblock it.'" Therefore, he administered an emetic agent and also prescribed herbs to soothe the Liver and regulate Qi. After taking a few doses, he recovered. The reason for diagnosing Xu Chongzhi's condition was that his pulse at the left Guan position was deep and wiry, while the right Cun position was faint and rapid. Deep and wiry indicates stagnation; faint and rapid indicates heat. Due to the stagnation of Qi not flowing freely, it was inferred to be caused by anger.

Zhu Danxi treated a young woman over fifteen years old (of age to wear her hairpin), who had an irritable temperament and preferred rich flavors. In midsummer, she developed hiccups due to a fit of rage. Each time a hiccup occurred, her whole body would tremble, and she lost consciousness. This happened once every three or five breaths, making the pulse impossible to palpate. Observing that her physical constitution and Qi were robust, Zhu administered two liang of Ren Shen Lu (Ginseng Stalk) decoction orally, which induced vomiting of several bowls of stubborn phlegm, profuse sweating, and a brief period of unconsciousness before she regained consciousness.

Another case involved an elderly man who usually consumed rich foods and suffered from chronic asthma with irregular episodes. In early autumn, he contracted dysentery, leading to a significant loss of appetite. Several days later, hiccups appeared, and his pulse was vast and empty. Zhu Danxi considered him treatable despite his thin physique and used Shen Zhu Tang (Ginseng and Atractylodes Decoction) to administer Da Bu Wan (Great Tonifying Pill). By the seventh day, he stabilized.

Yu Tianmin treated a patient with Shanghan (Cold Damage) whose previous physician had used tonifying medicines, thereby inducing hiccups. Ten days later, Yu was invited to examine the patient. The pulse was long and full-large, indicating Yangming Fu Excess (internal accumulation in the stomach/intestines) caused by erroneous tonification. Yu administered Da Cheng Qi Tang (Major Order the Qi Decoction) to purge the bowels. The heat subsided, and the hiccups stopped.

Commentary by Zhen: In this case, the hiccups had persisted for ten days, and the pulse was long, full, and large, making it relatively easy to distinguish. In the previous case, the pulse was vast and empty, yet Ginseng and Atractylodes were used. Why was Huang Bai (Phellodendron Bark) added? Was it because of his thin physique and rich dietary habits suggesting latent heat? Regarding the young woman whose hiccups were triggered by anger, with an unpalpable pulse, treatment was based solely on the robustness of her form and Qi. Why were other emetics not used, but instead two liang of Ren Shen Lu? Was it because the pulse could not be obtained, so a tonifying agent within the category of emetics was chosen as a safer approach?

In another case, a patient with Shanghan syndrome experienced a cessation of fever after seven days, followed by severe hiccups. The family was in distress. Yu examined the pulse, finding it deep, fine, and weak. The patient was extremely fatigued. Yu prescribed a large dose of Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) supplemented with Gan Jiang (Dried Ginger) and Fu Zi (Aconite Root). The patient took three doses per day, combined with moxibustion on Qihai (CV6) and Rugen (ST18). On the same day, the hiccups ceased, the pulse became full, and the patient recovered safely.

Lu Yuanying treated Guo Wenyu, the prefect of Yuyao, who had suffered from hiccups for over ten days. Physicians had treated him with Ding Xiang (Clove) and Fu Zi, which worsened the condition. Lu palpated the pulse, noting it was large and long at the Yangming position, and the Yang pulse on the right side was rapid and restless. He stated, "This hiccups are caused by Stomach Heat. Using hot medicines to assist the heat was a mistake." He prescribed Zhu Ru Tang (Bamboo Shavings Decoction), and the patient recovered quickly.

Commentary by Zhen: The previous case suitable for warm tonification and moxibustion is well-known. In the next case, where hot medicines worsened the condition, combined with the large, long, rapid, and restless pulse, a large dose of Bai Hu Tang (White Tiger Decoction) should have been used; if there were signs of excess requiring purgation, Cheng Qi Tang should have been added. It seems Zhu Ru Tang might have been insufficient.

Dai Tongfu treated a man whose primordial Qi was inherently deficient and who had blood stasis accumulating in the stomach area. Whenever he consumed hot soups containing Sichuan pepper and ginger, he would hiccup one or two times. Dai prescribed one liang each of Ren Shen (Ginseng) and Sheng Bai Zhu (Raw Atractylodes Macrocephala Rhizome), sliced them, and mixed them with powder made from crushed earthworms (Di Long) drowned in wine. Seven fen of dry lac ash was added. The mixture was formed into pills the size of bullet seeds using rice water. The patient chewed one pill slowly with aged wine in the morning and evening.

Commentary by Zhen: This syndrome is more difficult to differentiate than the previous ones. This prescription is superior to the previous formulas.