进前剂，麻痹得和，四肢亦缓，且得吐出陈腐酸苦，其色若尘，此皆得温而通也。然呃
忒频频，气自短促，呻吟不绝，哕逆呕恶之象仍不陡除。神情困倦，左脉细空，右脉弦急，大
便溏黑，喜饮热汤，湿痰邪滞之外，更有瘀血在里。邪从上出，不自下行，已为逆症，而况呕
吐之时，曾经额汗，能不虑其虚波暗起而胱乎？哕逆吐逆无不由乎气之所载，气若不平，
诸症何从化解？前方加减，先使气平为要。
复花 赭石 半夏 洋参 牛膝 槟榔 沉香 杏仁 刀豆子 乌药 柿蒂 大补阴丸
呃忒日轻，呕恶日重，此即陈腐之邪内阻气机，为呃者都从呕出。所以一则见轻，一则
见重也。然病根欲拔，而其所出之路逆而不顺，上而不下。失胃气下行为顺之理，却为累
事。昨夜额虽无汗，今朝脉尚弦急，呻吟未绝，所留陈腐之邪尚在中宫。犯肺为咳，犯胃为
呕，直从中道而出，又带呃逆。必须去尽宿邪，庶几有望。
指迷茯苓 苏子 白芥子 刀豆子 浓朴 茅根 枇杷叶 竹茹 洋参
荡涤宿邪之下，呕恶大减，呃忒更缓，脉象稍和，呻吟渐除，大便叠通。无乃胃有下行
为顺之兆乎？去痰莫如尽，尚须磨荡下行，继之于后，可卜其旋元吉。
二蚕绵 当归 川芎（各三两，水五大碗煮至烂，晒干， 存性入后药） 卷心荷叶（四两四钱，取）
阿胶（一两五钱，酒浸拌蒸晒七次者佳） 大熟地（三两） 砂仁末（四钱，酒煮） 香附（四两，盐水浸三
夜，童便浸五宿，
日夜各拌晒，酒炒） 杜仲（三两，盐水炒） 真于术（二两，米泔浸一宿，土炒） 川断（一两六钱，酒炒）
细子芩（一两六钱，酒炒） 归身（二两，酒炒） 奎白芍（一两六钱，酒炒） 甘草（六钱，蜜炙）
为末，蜜丸，每用二钱。朝晚两服，砂仁汤送下，至七个月不必服。
After taking the previous prescription, the numbness and stiffness of the limbs were relieved, and the four extremities became relaxed. Furthermore, old, putrid, sour, and bitter phlegm was vomited out, with a color resembling dust; this is all due to the warming and unblocking action. However, hiccups are frequent, breath is short, groaning is incessant, and the manifestations of belching, vomiting, and nausea have not abruptly disappeared. The patient's spirit is listless, the left pulse is fine and empty, the right pulse is wiry and rapid, stools are loose and black, and there is a preference for drinking hot soup. Besides damp-phlegm and pathogenic stagnation, there is also blood stasis in the interior. Since the pathogen exits from above rather than descending from below, it has already become an adverse syndrome. Moreover, during vomiting, sweat appeared on the forehead; how can one not worry about hidden deficiency waves arising and becoming dangerous? Belching and vomiting invariably stem from the carriage of Qi. If Qi is not balanced, how can various symptoms be resolved? Modifications to the previous formula should prioritize first making the Qi smooth.
*Inula Flower (Xuanfuhua), Hematitum (Heshi), Pinellia Rhizoma (Banxia), American Ginseng Radix et Cortex (Yangshen), Achyranthes Bidentatae Radix (Niuxi), Areca Seed (Binglang), Aquilariae Lignum Resinatum (Chenxiang), Apricot Seed (Xingren), Diocoreae Stolonis Fructus (Daodouzi), Lindera Root (Wuyao), Persimmon Calyx (Shidi), Da Bu Yin Wan.*
Hiccups lighten day by day, while vomiting and nausea worsen day by day. This indicates that old, putrid pathogens obstruct the Qi mechanism internally, causing hiccups to emerge from vomiting. Thus, one aspect lightens while the other worsens. However, to eradicate the root of the disease, the pathway of expulsion is reversed and unsmooth, going up but not down. This violates the principle that stomach Qi descending is favorable, leading to recurring issues. Although there was no sweat on the forehead last night, the morning pulse remains wiry and rapid, groaning has not ceased, and the remaining old, putrid pathogens are still in the Middle Jiao (Central Palace). Invading the Lung causes cough; invading the Stomach causes vomiting. They exit directly through the middle pathway, accompanied by hiccups. It is necessary to completely eliminate the stored pathogens to have hope for recovery.
*Zhi Mi Fu Ling Wan, Perilla Fructus (Suzi), White Mustard Seed (Baijiezi), Diocoreae Stolonis Fructus (Daodouzi), Magnolia Bark (Mudou), Imperata Rhizome (Maogen), Loquat Leaf (Pipaye), Bamboo Shavings (Zhuru), American Ginseng Radix et Cortex (Yangshen).*
After sweeping away the stored pathogens, vomiting and nausea are greatly reduced, hiccups are even slower, the pulse image is slightly harmonious, groaning gradually ceases, and bowel movements pass multiple times. Is this not a sign that stomach Qi descending is favorable? To remove phlegm, one must strive for completeness; further grinding and downward movement are needed subsequently, from which one can predict a return to auspicious health.
*Bombyx Batryticatus (Er Can Mian), Angelica Sinensis Radix (Danggui), Ligusticum Chuanxiong Rhizoma (Chuanxiong) [each 3 liang, boiled in 5 large bowls of water until soft, dried, retaining medicinal properties for subsequent use], Heart of Lotus Leaf (Juanxin Heye) [4 liang 4 qian, taken], Donkey-hide Gelatin (Ejiao) [1 liang 5 qian, preferably soaked in wine, mixed, steamed, and sun-dried seven times], Prepared Rehmannia Root (Dashudi) [3 liang], Powdered Amomum Fruit (Sharen Mo) [4 qian, boiled in wine], Cyperi Rhizoma (Xiangfu) [4 liang, soaked in salt water for three nights, soaked in children's urine for five nights, mixed and sun-dried day and night, stir-fried with wine], Eucommia Bark (Duzhong) [3 liang, stir-fried with salt water], Dried Atractylodes Macrocephala Rhizoma (Zhen Yuzhu) [2 liang, soaked in rice wash water overnight, stir-fried with soil], Dried Silybum Marginatum Fruit (Chuanduan) [1 liang 6 qian, stir-fried with wine], Scutellaria Baicalensis Radix (Xizi Qin) [1 liang 6 qian, stir-fried with wine], Angelica Sinensis Radix Section (Guishen) [2 liang, stir-fried with wine], White Peony Root (Kui Baishao) [1 liang 6 qian, stir-fried with wine], Licorice Root (Gancao) [6 qian, honey-roasted].
Grind into fine powder, form pills with honey. Take 2 qian each time. Take twice daily, morning and evening, delivered with Amomum decoction. Discontinue use by the seventh month of pregnancy.