橘皮（二两） 竹茹（一升） 甘草（三两炙） 人参（半两） 半夏（一两汤浸） 上
锉如麻豆
大。每服五钱。生姜六片。枣一枚。以水二大盏。煎至一盏。去滓。温服。日三服。金匮方。
无
橘皮干姜汤（出活人书）治哕。
橘皮 通草 干姜（炮） 桂心（各二两） 人参（一两） 甘草（半两） 上锉如麻
豆。每服
四钱。水一盏。煎至六分。去滓。温服。日三服。
夺命沉香散（出王氏博济方）治伤寒呕逆。结痞心胸。真气虚弱。脉息沉细。
正气补充。
沉香（一两） 舶上茴香 青橘皮（去瓤） 胡椒 荜澄茄 川楝子 陈橘皮（去瓤各
一两）
上为细末。如患者。但得心头有气未断。亦可服之二钱。葱白三寸。擘破。入酒并童子小便。
各半盏。同煎至六分。放温。和滓服。患沉重者。不过三服。气正脉生。
夫咳逆者多种。或水渍于肺而心痞。或连咳不已而气逆。或喜笑过多而气逆。或咽饮错
候而气KT 。或急食干物而气塞。皆能作咳逆之声也。俗呼谓之吃忒是也。皆气不得下。
为火热托之。而使上至咽喉中。噎而止也。人或以纸捻鼻。因叹而止。或诈冤盗物。因恐而
止。或鼻闻香。调气而止。皆抑之骇之调之。而使气下也。千金以喘嗽咳逆上气者。为病肺。
脉散者。是心火形于肺金也。心之肺。谓之死阴。死阴之属。不过三日死。以其形见乎损伤
故也。此说甚优。易老谓渴逆者。火热奔急上行。而肺阴不内。何其当哉。故便闭者。大承
气汤下之。便软者。泻心汤主之也。又论阴证咳逆云。且阳证咳逆者。胃热失下也。阴气先
绝。阳气后亦将竭。火独炎上逆出阴气而为咳逆。阴证者。内已伏阴。阴气太甚。肾水擅权。
肝气不生。胃已大病。丁火又消。所有游行相火。寒邪迫而萃集于胸中。亦欲尽矣。故令人
发热。大渴引饮。并去盖覆。病患独热。他人按执之。身体肌肉骨髓血脉皆寒。此火即无
根火也。故用丁香、干姜之类热药。温服。其火自下。咳逆方止。非若凉膈泻心以治阳证。
自上而下。泻退心火。阴气乃生。阴证咳逆。从呕哕而生。胃寒呕哕不已。咳逆继之。仲景
有伤寒咳逆上气。脉散者死。谓其形损故也。少阴咳逆者。失下也。阴消将尽。阳逆上行。
使阴不内也。谓之恶候。或兼以舌弯。语言不正而反昏冒。咽喉痛者。少阴也。速下之。宜
大承气汤。若阳极。脉微将尽者。不宜下。宜泻心汤。养阴退阳而已。不如用泻心汤。凉膈
去硝。清肺亦可。若饮水过多。心下痞而渴逆者。五苓散主之。别无恶物是也。
歌曰。咳逆皆因胃有寒。此名恶候古今传。橘皮半夏并姜附。不瘥根据方灸乳边。
橘皮干姜汤。半夏生姜汤。羌活附子散是也。不瘥即灸之。妇人屈乳头向下尽处骨间。
丈夫及乳小者。以一指为率。男左女右。艾炷如小豆许三壮。陷中有动脉是穴。证治论云。
呕哕手足逆冷者。乃小橘皮汤。呕哕胸满。虚烦不安。大橘皮汤。
又歌曰。小柴胡主阳家哕或用陈皮与竹茹。腹满须看前后部。猪苓承气莫相拘。
有阳证咳逆者。小柴胡汤。橘皮竹茹主之。前后部。乃大小便也。前部不利。调胃承气。
阳明中风脉弦浮。小便难。潮热而哕者。小柴胡加茯苓汤。咳逆。俗为之噫。古人谓之哕。
盖胃气本虚。吐下大过。或复与之水。发其汗。胃气虚逆。噫哕生。为病势至此极矣。虽然。
咳逆出于哕。寒固也。其有水挟寒气击搏而成者。则茯苓、半夏。逐水主噫。官桂、丁香。
下气御寒。又有热气拥郁。气不得通者。小柴胡汤加生姜。自有条例。惟有哕而腹满。不得
小便。或后部不通。此为真病。虽有神医。未知之何矣。易简论。伤寒咳逆。为笃证也。他
病见之亦然。以半夏生姜汤主之。又方。丁香、柿蒂煎汤。调苏合香丸。大抵咳逆不可不速
救药。是水气乘肺。亦主噫逆为咳。当以表水治之。
方
匀气散（出济生拔粹方）治阴证咳逆。
川乌头（大者三个炮裂去皮脐） 上为细末。每服二钱。黑豆二十一粒。沙糖鸡头子大。
水煎成熟。细细饮之。
治伤寒心下虚噎不下。服诸药不效者。
用石莲子肉一两。为末。每服二钱。白汤下。
治伤寒塞噎不住。
枳壳 陈皮（各等分） 上锉。水一大碗。煎至七分。温服。
肉豆蔻汤（出本事方）治伤寒汗后吃噎。
肉豆蔻（一个） 石莲肉（炒） 茴香（各一分） 丁香（半分） 人参（半两） 枇
杷叶（五片
拭去毛炙） 上锉细。用水四盏。生姜十片。煎二盏。去滓。空心。温分二服。
良姜汤（出本事方）
橘皮 良姜 桂枝 当归（各一两） 麻黄（半两） 杏仁（二十个） 甘草（一分） 槟
榔
（三个别末） 上粗末。用水四盏。姜十片。枣十个。同煎至二盏。去滓。下槟榔末。更煎。
至一盏三服。未已再作一剂。庞老云。伤寒吃噎不止。是阴阳气升降欲作汗。升之不下。故
胃气上逆。为吃噎无休止。宜此方。
又方（出本事方）
枳壳（半两） 木香（一钱） 上为细末。每服一钱。白汤调。未知再与。
一方（出肘后方）治伤寒咳噫不止。呕逆不定。
丁香（一两） 柿蒂（一两） 上焙干。捣末。人参煎汤下数升。无时服。
加味柿蒂汤（出德生堂）治伤寒发热。噫逆气噎。虚烦不得睡卧。
热多小柴胡汤。加干柿蒂七个。煎。根据柴胡汤饮子为妙。渴热。生料五苓散。加干柿蒂
七个。柴胡一钱。同煎。无大热。体虚。气不调。噫逆者。只用人参半两。加柿蒂十五个。
水一盏半。煎至一盏。去渣服之。不计时候。无热不渴。宜服五膈宽中散。加柿蒂煎服。
调胃散（出儒门事亲）治伤寒吐逆。四肢逆冷。
水银 舶上硫黄（各半两） 上先研硫黄极细。次入水银。同研至深黑。每服一钱。病
重
者二钱。温米饮调服。不拘时。
治伤寒咳逆噎汗。寻常亦可服。（出本草）
丁香 柿蒂（各一钱） 甘草 良姜（各半钱） 上为末。用热沸汤猛点。乘热一服。
治伤寒后咳逆。其证最危。宜用。（出澹寮方）
半夏（一两） 生姜（两半） 上白水煎服。其它病亦恶咳逆。当用丁香十五枚。干柿
蒂十
五枚。煎汤半盏。乘热顿服。或用丁香、柿蒂煎汤。调下苏合香丸。
羌活附子散（出活人书）治咳逆。
羌活 附子 茴香（微炒各半两） 木香 干姜（各一枣许大） 上为细末。每服二钱。
水
一盏。盐一捻。同煎二十沸。热服。一服止。
硫黄嗅法（出活人书）治咳逆。服药无效者。
硫黄 乳香（各等分） 上为细末。以酒煎。急令患人嗅之。
又方（出活人书）
用雄黄二钱。酒一盏。煎七分。急令患人嗅。其热气即止。
治伤寒清涕。咳逆上气（出本草）
以都咸子。煎汁服食之。
Tangerine Peel (Chenpi, 2 liang) Bamboo Shavings (Zhuru, 1 sheng) Licorice Root (Gancao, 3 liang, honey-fried) Ginseng Root (Renshen, 0.5 liang) Pinellia Tuber (Banxia, 1 liang, soaked in decoction) The above herbs are cut into pieces the size of hemp seeds. Take 5 qian per dose. Add 6 slices of Fresh Ginger (Shengjiang), 1 Jujube (Dazao). Decoct with 2 large jin of water until 1 jin remains. Strain. Take warm. Three times a day. From *Jingui Yaolue* formula.
None
Dried Ginger Decoction (Ganjiang Tang, from *Heren Shu*) treats hiccups.
Tangerine Peel (Chenpi) Tetrapanax Pith (Tongcao) Dried Ginger (Ganjiang, processed) Cinnamon Twig (Guixin, each 2 liang) Ginseng Root (Renshen, 1 liang) Licorice Root (Gancao, 0.5 liang) The above herbs are cut into pieces the size of hemp seeds. Take 4 qian per dose. Decoct with 1 jin of water until 0.6 jin remains. Strain. Take warm. Three times a day.
Life-Restoring Agastache Powder (Duoming Chenxiang San, from *Wangshi Boji Fang*) treats cold damage vomiting and counterflow qi. Chest obstruction and fullness. True qi deficiency. Pulse deep and fine. Righteous qi is replenished.
Agastache Rhizome (Chenxiang, 1 liang) Fennel Fruit (Boshang Huixiang) Green Tangerine Peel (Qingjupi, pith removed) Pepper (Hujiao) Galangal Fruit (Bichengqie) Toosendan Fruit (Chuanlianzi) Aged Tangerine Peel (Chenjupi, pith removed, each 1 liang) The above herbs are ground into fine powder. If the patient only feels that qi in the heart region has not ceased, 2 qian can also be taken. Break 3 cun of Scallion White (Congbai). Add wine and urine of a young boy, half jin each. Decoct together until 0.6 jin remains. Let cool to warm. Take with the dregs. For severe cases, no more than three doses. Qi returns, pulse generates.
Counterflow cough (Ke Ni) has various causes. Some are due to fluid retention in the Lung causing chest oppression. Some are due to continuous coughing leading to counterflow qi. Some are due to excessive laughter leading to counterflow qi. Some are due to improper swallowing leading to qi stagnation. Some are due to eating dry food hastily leading to qi blockage. All these can produce the sound of counterflow cough. Commonly called "chi te". It is because qi cannot descend, pushed up by fire-heat, causing qi to rush to the throat, choking and stopping. Some use paper twists to stimulate the nose, stopping due to sneezing. Some pretend injustice or theft, stopping due to fear. Some smell fragrant substances, regulating qi to stop it. These are all methods of suppressing, startling, and regulating to make qi descend. *Qianjin Fang* considers wheezing, coughing, and counterflow upper qi as Lung diseases. A scattered pulse indicates Heart Fire manifesting on Lung Metal. The relationship between Heart and Lung is called Dead Yin. Those belonging to Dead Yin will die within three days. Because the form has already been damaged. This theory is excellent. Yilao (Li Dongyuan) said that thirst-counterflow is due to fire-heat rushing upward, while Lung Yin cannot remain internal. How appropriate! Therefore, for constipation, use Da Chengqi Tang to purge. For soft stools, Xixin Tang is the main treatment. Also discussed Yin syndrome counterflow cough: Yang syndrome counterflow cough is due to Stomach heat failing to be purged. Yin qi first exhausts, Yang qi will also soon exhaust. Fire flares up alone, counterflows out of Yin qi to cause counterflow cough. Yin syndrome, internal latent Yin-cold. Yin qi is too excessive. Kidney Water dominates. Liver Qi does not generate. Stomach is severely ill. Ding Fire (Heart/Small Intestine Fire) is also diminished. All wandering Ministerial Fire is forced by cold pathogens to gather in the chest, also wanting to exhaust. Thus causing fever. Great thirst craving drink. And removing covers. The patient is uniquely hot. When touched by others, body muscles, bone marrow, blood vessels are all cold. This is rootless fire. Therefore, use hot medicines like Clove (Dingxiang) and Dried Ginger (Ganjiang). Take warm. The fire naturally descends. Counterflow cough stops. Unlike Liangge San or Xixin Tang treating Yang syndrome. From top to bottom. Purging Heart Fire. Yin qi then generates. Yin syndrome counterflow cough arises from vomiting and hiccups. Stomach cold vomiting and hiccups do not cease, counterflow cough follows. Zhang Zhongjing stated in cold damage counterflow upper qi, if pulse is scattered, death ensues. Due to form damage. Shaoyin counterflow cough is due to failure to purge. Yin consumption nearly exhausted. Yang counterflows upward. Preventing Yin from remaining internal. Called evil prognosis. Or accompanied by tongue curling. Abnormal speech and sudden dizziness. Sore throat is Shaoyin disease. Purge quickly. Use Da Chengqi Tang. If Yang extremity, pulse faint nearly exhausted. Do not purge. Use Xixin Tang. Nourish Yin, retreat Yang. Better to use Xixin Tang. Liangge San remove Niter. Clear Lung is also acceptable. If drinking too much water. Chest oppression and thirst-counterflow. Use Wuling San. No other evil matter discharged.
Song says: Counterflow cough all due to Stomach cold. This name evil prognosis passed through ancient and modern. Tangerine Peel, Pinellia, Ginger, and Aconite. If not cured, according to prescription moxa breast side.
Tangerine Peel Dried Ginger Decoction. Pinellia Fresh Ginger Decoction. Qianghuo Aconite Powder are so. If not cured, moxa immediately. For women, at the end of the bent nipple downwards to the bone gap. For men and those with small breasts, use one finger width as standard. Men left, women right. Moxa cone size of small bean, three moxibustions. Where there is a pulsating artery is the acupoint. *Zhengzhi Lun* says: Vomiting and hiccups with cold limbs, use Xiao Jupi Tang. Vomiting and hiccups with chest fullness, empty vexation and unrest, use Da Jupi Tang.
Another song says: Xiao Chaihu Tang governs Yang family hiccups, or use Tangerine Peel and Bamboo Shavings. Abdominal fullness must look at anterior and posterior parts. Zhu Ling Chengqi Tang do not be restricted.
For Yang syndrome counterflow cough, use Xiao Chaihu Tang. Jupi Zhuru Tang governs. Anterior and posterior parts refer to urination and defecation. Anterior part unfavorable, Tiaowei Chengqi Tang. Yangming wind-stroke pulse string-floating. Difficult urination. tidal fever and hiccups, use Xiao Chaihu plus Poria Decoction. Counterflow cough. Commonly called yi. Ancients called huo. Because Stomach qi originally deficient. Vomiting and purging excessive. Or again giving water. Inducing sweat. Stomach qi deficient and counterflow. Yi and huo arise. Disease progression reaches extreme. Although. Counterflow cough arises from huo. Cold is solid. There are cases where water carries cold qi striking and forming. Then Poria (Fuling) and Pinellia (Banxia). Expelling water governing yi. Guigui (Cinnamon Bark) and Clove (Dingxiang). Descending qi resisting cold. Again there is heat qi congestion. Qi cannot pass. Xiao Chaihu Tang add Fresh Ginger. Has its own rules. Only huo with abdominal fullness. Cannot urinate. Or posterior part blocked. This is true disease. Even with divine doctors, do not know what to do. *Yijian Lun*. Cold damage counterflow cough is a serious syndrome. Other diseases seeing it are also so. Govern with Pinellia Fresh Ginger Decoction. Another formula. Clove (Dingxiang) and Persimmon Calyx (Shidi) decoct soup. Mix Suhexiang Wan. Generally counterflow cough cannot but save medicine quickly. This is water qi attacking Lung. Also governs yi counterflow as cough. Should treat with exteriorizing water.
Formula
Qi-Regulating Powder (Yunqi San, from *Jisheng Bacuifang*) treats Yin syndrome counterflow cough.
Aconite Mother Root (Chuanwutou, three large ones, processed cracked, peel and umbilicus removed) The above herbs are ground into fine powder. Take 2 qian per dose. Black soybeans 21 grains. Rock sugar size of a chestnut. Decoct with water until cooked. Drink slowly.
Treating cold damage chest deficiency obstruction unable to swallow. Taking various herbs ineffective.
Use Stone Lotus Seed Flesh (Shilianzirou) 1 liang. Grind into powder. Take 2 qian per dose. Down with white water.
Treating cold damage obstruction unable to stop.
Immature Bitter Orange (Zhiqiao) Tangerine Peel (Chenpi, equal parts) The above herbs are cut. One large bowl of water. Decoct until 0.7 jin remains. Take warm.
Myristica Decoction (Roudoukou Tang, from *Ben Shi Fang*) treats cold damage post-sweat hiccup.
Nutmeg (Roudoukou, one) Stone Lotus Seed Flesh (Shilianrou, stir-fried) Fennel Fruit (Huixiang, each 1 fen) Clove (Dingxiang, 0.5 fen) Ginseng Root (Renshen, 0.5 liang) Loquat Leaf (Pipaye, five leaves, wipe off hairs, roast) The above herbs are cut finely. Use four jin of water. Ten slices of ginger. Decoct two jin. Strain. Empty stomach. Warmly divide into two doses.
Galangal Decoction (Liangjiang Tang, from *Ben Shi Fang*)
Tangerine Peel (Chenpi) Galangal Rhizome (Liangjiang) Cinnamon Twig (Guizhi) Angelica Root (Danggui, each 1 liang) Ephedra Stem (Mahuang, 0.5 liang) Apricot Seed (Xingren, twenty) Licorice Root (Gancao, 1 fen) Areca Nut (Binglang, three, separately powdered) The above coarse powder. Use four jin of water. Ten slices of ginger. Ten jujubes. Decoct together to two jin. Strain. Add Areca Nut powder. Decoct further. Until one jin. Three doses. If not finished, make another batch. Old Pang said. Cold damage hiccup unceasing. Is Yin-Yang qi ascending and descending wanting to produce sweat. Ascending not descending. Thus Stomach qi counterflows. Causing hiccup without cessation. Suitable for this formula.
Another formula (from *Ben Shi Fang*)
Immature Bitter Orange (Zhiqiao, 0.5 liang) Costus Root (Muxiang, 1 qian) The above herbs are ground into fine powder. Take 1 qian per dose. Mixed with white water. If unknown, give again.
One formula (from *Zhouhou Fang*) treats cold damage cough-yi unceasing. Vomiting counterflow uncertain.
Clove (Dingxiang, 1 liang) Persimmon Calyx (Shidi, 1 liang) The above bake dry. Pound into powder. Ginseng decocted soup down several sheng. Take at any time.
Modified Persimmon Calyx Decoction (Jiawei Shidi Tang, from *Deshengtang*) treats cold damage fever. Yi counterflow qi obstruction. Empty vexation unable to sleep.
Heat many Xiao Chaihu Tang. Add seven dried persimmon calyces. Decoct. According to Chaihu Tang infusion is wonderful. Thirst heat. Raw material Wuling San. Add seven dried persimmon calyces. Bupleurum Root (Chaihu) 1 qian. Decoct together. No great heat. Body weak. Qi not regulated. Yi counterflow. Only use Ginseng Root (Renshen) 0.5 liang. Add fifteen persimmon calyces. Water one jin and half. Decoct to one jin. Strain dregs and take. Regardless of time. No heat no thirst. Suitable to take Wuge Kuanzhong San. Add persimmon calyx decoct and take.
Stomach-Regulating Powder (Tiaowei San, from *Rumen Shiqin*) treats cold damage vomiting counterflow. Four limbs cold reversal.
Mercury (Shuiyin)舶上 Sulfur (Boshang Liuhuang, each 0.5 liang) The above first grind sulfur extremely fine. Then add mercury. Grind together until deep black. Take 1 qian per dose. Severe illness 2 qian. Warm rice drink mixed take. Regardless of time.
Treating cold damage counterflow obstruction sweat. Ordinary can also take. (From *Bencao*)
Clove (Dingxiang) Persimmon Calyx (Shidi, each 1 qian) Licorice Root (Gancao) Galangal Rhizome (Liangjiang, each 0.5 qian) The above into powder. Use hot boiling water strong point. Take warm in one dose.
Treating cold damage after counterflow. Its syndrome most critical. Suitable to use. (From *Danliao Fang*)
Pinellia Tuber (Banxia, 1 liang) Fresh Ginger (Shengjiang, 1.5 liang) The above white water decoct and take. Other diseases also dislike counterflow cough. Should use fifteen cloves. Fifteen dried persimmon calyces. Decoct soup half jin. Take warm in one gulp. Or use Clove, Persimmon Calyx decoct soup. Mix down Suhexiang Wan.
Qianghuo Aconite Powder (Qianghuo Fuzi San, from *Heren Shu*) treats counterflow cough.
Notopterygium Rhizome (Qianghuo) Prepared Aconite Child Root (Fuzi) Fennel Fruit (Huixiang, slightly stir-fried each 0.5 liang) Costus Root (Muxiang) Dried Ginger (Ganjiang, each size of a date pit) The above herbs are ground into fine powder. Take 2 qian per dose. Water one jin. Pinch of salt. Decoct together twenty boils. Take hot. One dose stops.
Sulfur Sniffing Method (Liuhuang Xiu Fa, from *Heren Shu*) treats counterflow cough. Medication ineffective.
Sulfur (Liuhuang) Frankincense (Ruxiang, equal parts) The above into fine powder. Decoct with wine. Urgently let patient sniff it.
Another formula (from *Heren Shu*)
Use Realgar (Xionghuang) 2 qian. Wine one jin. Decoct 0.7 jin. Urgently let patient sniff. The hot qi stops immediately.
Treating cold damage clear nasal discharge. Counterflow upper qi (From *Bencao*)
Use Du Xianzi. Decoct juice and eat.