脉浮而缓者。易治。弦急。按之而不鼓者。难治。脉急。或促或微。皆可治。脉代者危
右关脉弦者。木乘土位。难治。发呃者。气逆上冲而作声也。一名呃逆。因气逆奔急上行
作呃发声。有数者不同。不可不辨。有胃虚膈热者。宜桔皮竹茹汤。有胃虚寒者。宜丁香
柿蒂汤。有肾气虚损。阴火上冲者。宜六味地黄丸。有中气不足者。脉虚数。气不相续而发
呃者。宜补中益气汤加生姜、炒黄柏以降虚火。或少加附子。服之立愈。有阳明内实。失下
而发呃者。宜六一顺气汤下之。有渴而饮水太过。成水结胸而又发呃者。宜小陷胸汤。或用
小青龙汤去麻黄。加附子。治水寒相搏发呃。大妙。有传经伤寒热症。误用姜、桂等药料。
助起火邪。痰火相搏而呃逆者。黄连解毒汤、白虎汤。及竹沥之类治之。
一论呃逆。因吐利后。胃虚膈热而呃逆者。
橘皮竹茹汤
陈皮（去白三分） 人参（二钱） 甘草（一钱炙） 竹茹（一钱） 柿蒂（一钱） 丁香（五分）
上锉一剂。生姜五片。枣二枚。水煎。温服。身热发渴。加柴胡、黄芩。去丁香。
一论吐利后大病后。胃中虚寒。呃逆至七八声相连。收气不回者。难治。
丁香柿蒂汤
人参（二钱） 白茯苓（二钱） 陈皮（二钱） 良姜（二钱） 丁香（二钱） 柿蒂（二钱） 甘
草（五分）
上锉。生姜五片。水煎服。
一论呃逆而无脉者。用
人参复脉汤
人参（二钱） 白术（一钱五分去芦） 麦门冬（去心二钱） 白茯苓（去皮三钱） 五味子（
四分） 陈皮（二钱） 半夏（姜炒二钱） 竹茹（四钱） 甘草（八分）
上锉。生姜五片。水煎服。
一论人因饱食后得气。发呃逆。连声不止者。宜
顺气消滞汤
陈皮（二钱） 半夏（姜炒二钱） 白茯苓（去皮三钱） 丁香（三分） 柿蒂（二个） 黄连（
姜炒二分） 神曲（炒二钱） 香附（二钱） 白术（一钱五分） 竹茹（四钱） 甘草（八分）
上锉。生姜五片。水煎服。
一论肾气虚损。虚火上冲而作呃逆者。（自脐下上冲直出于口者难治）六味地黄丸。（方
见补益）根据本方作汤。加柿蒂二个。沉香八分。木香一钱。砂仁八分。
一论中气不足。脉虚微。气不相接续而作呃逆者。宜补中益气汤。（方见内伤）根据本方加
麦门冬二钱。五味子四分。黄柏酒炒三钱。少加附子六分制。
一论伤寒阳明内实失下。而作呃逆者。用六一顺气汤。（方见伤寒）
一论伤寒发热而作呃逆者。用蔓荆子炒。不拘多少。水煎服。
一论伤寒发渴。而饮水太过。成水结胸而发呃者。用
小陷胸汤
黄连（三钱） 半夏（姜炒二钱） 栝蒌实（三钱）
上锉一剂。生姜三片。水煎服。
一论伤寒表证未解。心下有水气。干呕咳逆。又治受寒喘嗽。宜以
小青龙汤
桂枝（八分） 干姜（八分） 细辛（八分） 半夏（二钱） 芍药（二钱） 五味子（四分） 麻
黄（八分） 甘草（八分） 上锉。水煎服。
一论伤寒阳症呃逆。潮热。小柴胡汤加生姜二片。竹茹四钱。橘皮二钱。
一论有传经伤寒。误用姜、桂等热药。助起痰火。而作呃逆者。用黄连解毒汤。（方见
感冒
）白虎汤。（方见伤寒）
一论因服攻病药。致伤胃气。下陷而元气将离。以致胃气共丹田之气疲敝。或久病患而
至于呃者。乃三焦元气。与胃气惫矣。乃危急之兆也。宜用
大补元汤
嫩黄 （蜜水炒一钱半） 参（去芦一钱五分） 白术（炒二钱） 怀山药（一钱） 广陈皮
（七
分） 石斛（七分） 白豆蔻（研六分） 沉香（二分） 广木香（三分） 甘草（炙七分）
上锉一剂。生姜三片。红枣二枚。粳米一撮。水煎。不拘时温服。
一论一切呃逆。用柿蒂烧存性为末。酒调服。立止。一方。每服用柿蒂七个。焙为末。
用黄酒调下。
一 法。治呃逆服药无效者。用硫黄、乳香各等分为末。以酒煎。急令患人 之。
一方。用雄黄二钱。酒一盏。煎七分。急令患人 其热气。即止。
一灸呃逆法（见灸法）
一治哕逆欲死者。其肺脉弱者不治。用半夏、生姜各一两。每服五钱。水煎服。
一治咳逆。连咳四五十声者。用姜汁半合。蜜一匙。共煎令熟。温服。如此三服瘥。
Pulse floating and slow indicates a condition that is easy to treat. Pulse wiry and rapid, which feels non-pulsating upon pressure, indicates a difficult-to-treat condition. Pulse rapid, or either surging (Cu Mai) or faint, are all treatable. The appearance of a intermittent pulse (Dai Mai) indicates a critical condition.
A wiry pulse at the Right Guan position (corresponding to Spleen and Stomach) suggests Liver Wood overacting on Spleen Earth, indicating a difficult-to-treat condition. "E" (hiccup) refers to the sound produced by rebellious Qi rushing upward. It is also known as hiccup, caused by rebellious Qi surging upward rapidly. There are several different patterns, which must be distinguished.
For Stomach deficiency with Diaphragm heat, Jie Pi Zhu Ru Tang (Tangerine Peel and Bamboo Shavings Decoction) is indicated.
For Stomach deficiency with cold, Ding Xiang Shi Di Tang (Clove and Persimmon Calyx Decoction) is indicated.
For Kidney Qi deficiency with Yin fire rushing upward, Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) is indicated.
For Middle Qi deficiency, with a deficient-rapid pulse and Qi failing to connect, causing hiccup, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Sheng Jiang (Fresh Ginger) and Chao Huang Bo (Fried Phellodendron Bark) to descend deficient fire is indicated; a small amount of Fu Zi (Prepared Aconite Root) may be added, and recovery will be immediate.
For Yangming interior excess, where hiccup arises from failure to purge earlier, Liu Yi Shun Qi Tang (Six-One Regulating Qi Decoction) for purgation is indicated.
For excessive thirst leading to excessive water intake, resulting in Water Accumulation in the Chest (Shui Jie Xiong) and subsequent hiccup, Xiao Xian Xiong Tang (Minor Intra-Chest Purgative Decoction) is indicated. Alternatively, Xiao Qing Long Tang (Minor Green Dragon Decoction) with Ma Huang (Ephedra Stem) removed and Fu Zi (Prepared Aconite Root) added can be used to treat hiccup caused by the struggle between water and cold, which is highly effective.
For transmitted Cold Damage (Shang Han) heat syndromes, where mistaken use of warming herbs like Sheng Jiang (Fresh Ginger) and Gui Zhi (Cinnamon Twig) has aggravated fire pathogens, leading to hiccup due to the struggle between phlegm and fire, Huang Lian Jie Du Tang (Coptis Decoction for Relieving Toxicity), Bai Hu Tang (White Tiger Decoction), and Zhu Li (Bamboo Sap) are indicated.
First discussion: Hiccup occurring after vomiting and diarrhea, caused by Stomach deficiency and Diaphragm heat.
[Formula] Ju Pi Zhu Ru Tang (Tangerine Peel and Bamboo Shavings Decoction)
Chen Pi (Exocarpium Citri Reticulatae, peeled white part, 3 fen) Ren Shen (Radix Ginseng, 2 qian) Gan Cao (Radix Glycyrrhizae, 1 qian, honey-fried) Zhu Ru (Caulis Bambusae in Taeniam, 1 qian) Shi Di (Calyx Diospygi, 1 qian) Ding Xiang (Flos Caryophylli, 5 fen)
Crush these ingredients into one dose. Add Sheng Jiang (Fresh Ginger, 5 slices) and Da Zao (Fructus Jujubae, 2 pieces). Decoct in water and take warm. If there is body heat and thirst, add Chai Hu (Radix Bupleuri) and Huang Qin (Scutellaria Root), and remove Ding Xiang (Clove).
Second discussion: After vomiting, diarrhea, or severe illness, if Stomach deficiency-cold causes hiccup continuing for seven or eight sounds without inhalation returning, it is difficult to treat.
[Formula] Ding Xiang Shi Di Tang (Clove and Persimmon Calyx Decoction)
Ren Shen (Radix Ginseng, 2 qian) Bai Fu Ling (Poria, 2 qian) Chen Pi (Exocarpium Citri Reticulatae, 2 qian) Liang Jiang (Rhizoma Alpiniae Officinarum, 2 qian) Ding Xiang (Flos Caryophylli, 2 qian) Shi Di (Calyx Diospygi, 2 qian) Gan Cao (Radix Glycyrrhizae, 5 fen)
Crush these ingredients. Add Sheng Jiang (Fresh Ginger, 5 slices). Decoct in water and take.
Third discussion: For hiccup without a palpable pulse, use
[Formula] Ren Shen Fu Mai Tang (Ginseng Reviving the Pulse Decoction)
Ren Shen (Radix Ginseng, 2 qian) Bai Zhu (Rhizoma Atractylodis Macrocephalae, 1.5 qian, radix tip removed) Mai Men Dong (Radix Ophiopogonis, 2 qian, heart removed) Bai Fu Ling (Poria, 3 qian, peel removed) Wu Wei Zi (Fructus Schisandrae, 4 fen) Chen Pi (Exocarpium Citri Reticulatae, 2 qian) Ban Xia (Rhizoma Pinelliae, 2 qian, ginger-fried) Zhu Ru (Caulis Bambusae in Taeniam, 4 qian) Gan Cao (Radix Glycyrrhizae, 8 fen)
Crush these ingredients. Add Sheng Jiang (Fresh Ginger, 5 slices). Decoct in water and take.
Fourth discussion: For hiccup arising after overeating, characterized by continuous sounds, Shun Qi Xiao Zhi Tang (Regulate Qi and Reduce Stagnation Decoction) is indicated.
[Formula] Shun Qi Xiao Zhi Tang (Regulate Qi and Reduce Stagnation Decoction)
Chen Pi (Exocarpium Citri Reticulatae, 2 qian) Ban Xia (Rhizoma Pinelliae, 2 qian, ginger-fried) Bai Fu Ling (Poria, 3 qian, peel removed) Ding Xiang (Flos Caryophylli, 3 fen) Shi Di (Calyx Diospygi, 2 pieces) Huang Lian (Rhizoma Coptidis, 2 fen, ginger-fried) Shen Qu (Massa Medicata Fermentata, 2 qian, fried) Xiang Fu (Rhizoma Cyperi, 2 qian) Bai Zhu (Rhizoma Atractylodis Macrocephalae, 1.5 qian) Zhu Ru (Caulis Bambusae in Taeniam, 4 qian) Gan Cao (Radix Glycyrrhizae, 8 fen)
Crush these ingredients. Add Sheng Jiang (Fresh Ginger, 5 slices). Decoct in water and take.
Fifth discussion: For hiccup caused by Kidney Qi deficiency and deficiency fire rushing upward. (If the sensation rushes directly from below the navel to the mouth, it is difficult to treat.) Use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia). (See Tonification section for formula). Modify this formula into a decoction, adding Shi Di (Persimmon Calyx, 2 pieces), Chen Xiang (Aquilaria Wood, 8 fen), Mu Xiang (Costus Root, 1 qian), and Sha Ren (Amomum Fruit, 8 fen).
Sixth discussion: For hiccup caused by Middle Qi deficiency, with a deficient-faint pulse and disconnected Qi, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is indicated. (See Internal Injury section for formula). Modify this formula by adding Mai Men Dong (Ophiopogon Root, 2 qian), Wu Wei Zi (Schisandra Berry, 4 fen), Jiu Chao Huang Bo (Wine-fried Phellodendron Bark, 3 qian), and a small amount of Zhi Fu Zi (Prepared Aconite Root, 6 fen).
Seventh discussion: For hiccup caused by Yangming interior excess in Cold Damage due to failure to purge, use Liu Yi Shun Qi Tang (Six-One Regulating Qi Decoction). (See Cold Damage section for formula).
Eighth discussion: For hiccup accompanied by fever in Cold Damage, use Chao Man Jing Zi (Fried Vitex Fruit), in any quantity, decocted in water and taken.
Ninth discussion: For thirst in Cold Damage where excessive water intake leads to Water Accumulation in the Chest and hiccup, use
[Formula] Xiao Xian Xiong Tang (Minor Intra-Chest Purgative Decoction)
Huang Lian (Rhizoma Coptidis, 3 qian) Ban Xia (Rhizoma Pinelliae, 2 qian, ginger-fried) Gua Lou Shi (Fructus Trichosanthis, 3 qian)
Crush these ingredients into one dose. Add Sheng Jiang (Fresh Ginger, 3 slices). Decoct in water and take.
Tenth discussion: For Cold Damage where the exterior syndrome is unresolved, with fluid retention in the Heart region, dry heaving, coughing, and wheezing, and for treating cold-induced asthma and cough, Xiao Qing Long Tang (Minor Green Dragon Decoction) is indicated.
[Formula] Xiao Qing Long Tang (Minor Green Dragon Decoction)
Gui Zhi (Ramulus Cinnamomi, 8 fen) Gan Jiang (Rhizoma Zingiberis Recens, 8 fen) Xi Xin (Herba Asari, 8 fen) Ban Xia (Rhizoma Pinelliae, 2 qian) Shao Yao (Radix Paeoniae Alba, 2 qian) Wu Wei Zi (Fructus Schisandrae, 4 fen) Ma Huang (Herba Ephedrae, 8 fen) Gan Cao (Radix Glycyrrhizae, 8 fen)
Crush these ingredients. Decoct in water and take.
Eleventh discussion: For Yang syndrome hiccup in Cold Damage with tidal fever, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Sheng Jiang (Fresh Ginger, 2 slices), Zhu Ru (Bamboo Shavings, 4 qian), and Ju Pi (Tangerine Peel, 2 qian).
Twelfth discussion: For transmitted Cold Damage where mistaken use of hot herbs like Sheng Jiang (Fresh Ginger) and Gui Zhi (Cinnamon Twig) has aggravated phlegm-fire, causing hiccup, use Huang Lian Jie Du Tang (Coptis Decoction for Relieving Toxicity). (See Common Cold section for formula) and Bai Hu Tang (White Tiger Decoction). (See Cold Damage section for formula).
Thirteenth discussion: Due to taking purgative drugs damaging Stomach Qi, causing Qi sinking and impending dispersion of Yuan Qi, leading to exhaustion of Stomach Qi and Dantian Qi, or hiccup in chronic patients, this indicates exhaustion of San Jiao Yuan Qi and Stomach Qi, a critical sign. Da Bu Yuan Tang (Great Tonifying Source Decoction) is indicated.
[Formula] Da Bu Yuan Tang (Great Tonifying Source Decoction)
Huang Qi (Radix Astragali, tender stem, honey-fried 1.5 qian) Ren Shen (Radix Ginseng, 1.5 qian, radix tip removed) Bai Zhu (Rhizoma Atractylodis Macrocephalae, 2 qian, stir-fried) Huai Shan Yao (Rhizoma Dioscoreae, 1 qian) Guang Chen Pi (Exocarpium Citri Reticulatae, 7 fen) Shi Hu (Caulis Dendrobii, 7 fen) Bai Dou Kou (Fructus Amomi Rotundus, 6 fen, ground) Chen Xiang (Lignum Aquilariae Resinatum, 2 fen) Guang Mu Xiang (Radix Aucklandiae, 3 fen) Gan Cao (Radix Glycyrrhizae, 7 fen, honey-fried)
Crush these ingredients into one dose. Add Sheng Jiang (Fresh Ginger, 3 slices), Hong Zao (Fructus Jujubae, 2 pieces), and Geng Mi (Oryza Sativa, a pinch). Decoct in water and take warm at any time.
Fourteenth discussion: For all types of hiccup, burn Shi Di (Persimmon Calyx) until carbonized but retaining its nature, grind into powder, and take with wine for immediate cessation. Another method: take 7 Shi Di (Persimmon Calyx), bake into powder, and take with yellow wine.
Fifteenth method: For hiccup unresponsive to medication, equal parts of Huang Dan (Realgar) and Ru Xiang (Olibanum) are ground into powder, decocted in wine, and the patient is instructed to inhale the steam urgently.
Sixteenth method: Use Xiong Huang (Realgar, 2 qian) and one cup of wine, decoct to three-quarters, and instruct the patient to inhale the steam urgently to stop the hiccup.
Seventeenth: Moxibustion method for hiccup (see Moxibustion section).
Eighteenth: For severe hiccup threatening death, if the Lung pulse is weak, it is untreatable. Use Ban Xia (Pinellia Rhizome) and Sheng Jiang (Fresh Ginger), each 1 liang. Take 5 qian per dose, decocted in water.
Nineteenth: For coughing with reversal (Ke Ni), characterized by forty to fifty consecutive coughs, use half he of Jiang Zhi (Ginger Juice) and one spoonful of Honey, decoct together until cooked, and take warm. Three doses will result in recovery.