【外感呃逆之症】身发寒热，呕逆作呃，此表邪传里之症也。内热口渴，唇焦便赤，上
冲作呃，此积热内冲之症也。或乍发乍止，或连续不已，此痰火攻冲呃逆之症也。
【外感呃逆之因】外受风邪，邪传半表半里，里不受邪，抑遏少阳生升之气，则上冲作
呃。若
【外感呃逆之脉】左脉弦大，少阳有邪。右脉沉数，胃热里实。右关虚涩，胃家虚热。
右脉滑大，胃中痰饮。滑大而数，乃是痰热。
【外感呃逆之治】若表邪入里，小柴胡汤和之。胃热失下者，承气汤下之；胃热便利者
汤；胃热兼虚者，橘皮竹茹汤。若胃中兼痰饮者，橘皮半夏汤加枳、桔；兼热者，栀连二陈汤加葛根、竹茹。
小柴胡汤 治寒热呕苦，呃逆不止。
人参 柴胡 黄芩 广皮 半夏 甘草
承气汤 见食积喘门。
泻心汤 治火逆上冲，呃逆不止。
川黄连 半夏 生姜 甘草
橘皮竹茹汤 消痰止呃方也。
橘皮 半夏 竹茹 人参 生姜 甘草
橘皮半夏汤
半夏 橘皮
有寒加生姜。有热加栀、连。
栀连二陈汤 家秘治痰火呃逆，加葛根、竹茹。
陈皮 半夏 白茯苓 甘草 葛根 山栀 川连 竹茹
【内伤呃逆之症】外无表邪入里，身无寒头痛，惟见呃声发作，或三四声而即止，或
呃数声之外，或连续而不已者，此内伤呃逆之症也。
【内伤呃逆之因】或因中气不足，或因胃气损伤，水谷入胃，难以运化，或膏粱积热，
胃火上冲，或胃寒冷冻饮料，水寒上逆；或脾胃不和，脏腑为病，或怒动肝火，肝气怫逆，或肝肾阴亏
，阴火上冲，此皆内伤呃逆之症也。
【内伤呃逆之脉】脉见微弱，中气不足，或见沉数，膏粱积热，或见促结，脏腑不和，
或见弦数，肝胆有火，左尺数大，真阴不足。
【内伤呃逆之治】若中气不足，六君子汤。痰火上冲，栀连二陈汤、半夏泻心汤。积热
上攻，栀连平胃散，加葛根、竹茹。胃家受寒者，丁香柿蒂汤、理中汤。水停心下，二陈汤，苓桂
术甘汤，食滞中宫者，枳术汤、枳桔、平胃散、苍朴二陈汤。怒动肝火者，加味柴胡汤。阴
血不足，阴火上冲，知柏四物汤。阴精不足，相火上冲者，知柏地黄丸、家秘知柏天地煎加广皮。
若肝肾之精血皆不足，肝肾之阴火合而上冲者，家秘肝肾丸。
六君子汤 见前章。
栀连二陈汤 见前章。
半夏泻心汤 治痰火冲逆。
半夏 川连 甘草 黄芩 人参 干姜
栀连平胃散 加葛根、竹茹，家秘治热积呃逆。
山栀 川黄连 苍术 浓朴 陈皮 甘草 葛根 竹茹
丁香柿蒂汤 治胃寒呃逆脉迟者。
丁香 柿蒂 人参 生姜
二陈汤 见湿痰门。
苓桂术甘汤 见痰饮门。
枳术汤 见食积门。
枳术平胃散 即平胃散加枳实、桔梗。
苍朴二陈汤 即平胃散加苍术、浓朴。
加味柴胡汤 治肝胆之火上冲呃逆。
柴胡 黄芩 陈皮 甘草 山栀 丹皮
知柏四物汤 即四物汤加黄柏、知母。
知柏地黄丸 见前。
家秘天地煎
黄柏 知母 天门冬 地黄 广皮
家秘肝肾丸
天门冬 地黄 当归 白芍药 黄柏 知母
[Symptoms of Exogenous Hiccups] The body presents with aversion to cold and fever, vomiting, regurgitation, and hiccups; this is a syndrome where exterior pathogenic factors have transmitted inward. Internal heat with thirst, dry and cracked lips, and red urine, accompanied by qi rushing upward causing hiccups, indicates the syndrome of accumulated heat surging inward. Sometimes the hiccups start suddenly and stop suddenly, or continue without ceasing; this is the syndrome of hiccups caused by phlegm-fire attacking and surging.
[Etiology of Exogenous Hiccups] Exterior wind-pathogen invades, transmitting to the half-exterior half-interior level. The interior does not directly accept the pathogen, but it suppresses the ascending and generating qi of the Shaoyang channel, leading to upward surging qi that causes hiccups. If... (The original text breaks off here).
[Pulse Signs of Exogenous Hiccups] A wiry and large pulse on the left indicates pathogen in the Shaoyang channel. A deep and rapid pulse on the right indicates stomach heat and interior excess. A deficient and choppy pulse at the right Guan position indicates deficient heat in the stomach. A slippery and large pulse on the right indicates phlegm-fluid retention in the stomach. A slippery, large, and rapid pulse indicates phlegm-heat.
[Treatment of Exogenous Hiccups] If exterior pathogen has entered the interior, use Xiaochaihu Tang (Minor Bupleurum Decoction) to harmonize. For stomach heat due to failure to purge downward, use Chengqi Tang (Gut-Purging Decoction) to purge; for stomach heat with free bowel movement, use [missing formula name] Tang; for stomach heat combined with deficiency, use Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction). If there is phlegm-fluid retention in the stomach along with other conditions, use Jupi Banxia Tang (Tangerine Peel and Pinellia Decoction) plus Zhiqiao (Aurantii Fructus) and Jiegeng (Platycodonis Radix); if combined with heat, use Zhilian Erchen Tang (Gardeniae and Coptis Two-Chen Decoction) plus Gegen (Puerariae Radix) and Zhuru (Bambusae Caulis in Taeniam).
Xiaochaihu Tang (Minor Bupleurum Decoction): Treats alternating chills and fever, bitter taste in mouth, vomiting, and persistent hiccups.
Ingredients: Renshen (Ginseng Radix), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Guangpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma).
Chengqi Tang (Gut-Purging Decoction): See section on Food Stagnation and Wheezing.
Xiexin Tang (Drain the Epigastrium Decoction): Treats fire-ni (rebellious qi) surging upward and persistent hiccups.
Ingredients: Chuanlianhuan (Coptidis Rhizoma), Banxia (Pinelliae Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), Gancao (Glycyrrhizae Radix et Rhizoma).
Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction): A formula to resolve phlegm and stop hiccups.
Ingredients: Jupi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Zhuru (Bambusae Caulis in Taeniam), Renshen (Ginseng Radix), Shengjiang (Zingiberis Rhizoma Recens), Gancao (Glycyrrhizae Radix et Rhizoma).
Jupi Banxia Tang (Tangerine Peel and Pinellia Decoction)
Ingredients: Banxia (Pinelliae Rhizoma), Jupi (Citri Reticulatae Pericarpium).
Add Shengjiang (Zingiberis Rhizoma Recens) if cold is present. Add Zhizi (Gardeniae Fructus) and Lian (Coptidis Rhizoma) if heat is present.
Zhilian Erchen Tang (Gardeniae and Coptis Two-Chen Decoction): Family secret method for treating phlegm-fire hiccups, adds Gegen (Puerariae Radix) and Zhuru (Bambusae Caulis in Taeniam).
Ingredients: Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Baifuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), Gegen (Puerariae Radix), Zhizi (Gardeniae Fructus), Chuanlian (Coptidis Rhizoma), Zhuru (Bambusae Caulis in Taeniam).
[Symptoms of Endogenous Hiccups] There is no exterior pathogen transmitting inward, no aversion to cold or headache; only hiccups are observed. They may occur for three or four sounds and then stop, or occur several times, or continue without ceasing. This is the syndrome of endogenous hiccups.
[Etiology of Endogenous Hiccups] It may be due to insufficiency of Middle Qi, or injury to Stomach Qi, making it difficult to transform food and water entering the stomach. It may be due to accumulation of heat from rich and sweet foods, with Stomach Fire surging upward. It may be due to consumption of cold drinks, with cold water qi reversing upward. It may be due to disharmony between Spleen and Stomach, causing disease in the Zang-Fu organs. It may be due to anger stirring Liver Fire, causing Liver Qi to stagnate and reverse. It may be due to deficiency of Yin in Liver and Kidney, with Deficient Fire surging upward. All these are syndromes of endogenous hiccups.
[Pulse Signs of Endogenous Hiccups] A weak pulse indicates insufficiency of Middle Qi. A deep and rapid pulse indicates accumulation of heat from rich foods. A hurried or knotted pulse indicates disharmony of Zang-Fu organs. A wiry and rapid pulse indicates Fire in Liver and Gallbladder. A large and rapid pulse at the Left Chi position indicates insufficiency of True Yin.
[Treatment of Endogenous Hiccups] For insufficiency of Middle Qi, use Liujunzi Tang (Six-Gentlemen Decoction). For phlegm-fire surging upward, use Zhilian Erchen Tang (Gardeniae and Coptis Two-Chen Decoction) and Banxia Xiexin Tang (Pinellia Drain the Epigastrium Decoction). For accumulation of heat attacking upward, use Zhilian Pingwei San (Gardeniae and Coptis Peace the Stomach Powder) plus Gegen (Puerariae Radix) and Zhuru (Bambusae Caulis in Taeniam). For Stomach Cold, use Dingxiang Shidi Tang (Clove and Persimmon Calyx Decoction) and Lizhong Tang (Regulate the Middle Decoction). For water retention below the heart, use Erchen Tang (Two-Chen Decoction) and Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction). For food stagnation in the Middle Jiao, use Zhizhu Tang (Immature Bitter Orange and Atractylodes Macrocephala Decoction), Zhijie (Aurantii Fructus and Platycodonis Radix), Pingwei San (Peace the Stomach Powder), and Cangpo Erchen Tang (Atractylodes and Magnolia Bark Two-Chen Decoction). For anger stirring Liver Fire, use Jiawei Chaihu Tang (Modified Bupleurum Decoction). For insufficiency of Yin blood with Deficient Fire surging upward, use Zhibo Siwu Tang (Anemarrhena, Phellodendron, and Four-Agent Decoction). For insufficiency of Yin essence with Ministerial Fire surging upward, use Zhibo Dihuang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill) or family secret Zhibi Tiandi Jian (Anemarrhena, Phellodendron, Heaven and Earth Decoction) plus Guangpi (Citri Reticulatae Pericarpium). If both Essence and Blood of Liver and Kidney are insufficient, and Deficient Fire of Liver and Kidney combines and surges upward, use family secret Ganshen Wan (Liver-Kidney Pill).
Liujunzi Tang (Six-Gentlemen Decoction): See previous chapter.
Zhilian Erchen Tang (Gardeniae and Coptis Two-Chen Decoction): See previous chapter.
Banxia Xiexin Tang (Pinellia Drain the Epigastrium Decoction): Treats phlegm-fire rebellious surging.
Ingredients: Banxia (Pinelliae Rhizoma), Chuanlian (Coptidis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqin (Scutellariae Radix), Renshen (Ginseng Radix), Ganjiang (Zingiberis Rhizoma).
Zhilian Pingwei San (Gardeniae and Coptis Peace the Stomach Powder): Adds Gegen (Puerariae Radix) and Zhuru (Bambusae Caulis in Taeniam); family secret method for treating heat-accumulation hiccups.
Ingredients: Zhizi (Gardeniae Fructus), Chuanlian (Coptidis Rhizoma), Cangzhu (Atractylodis Rhizoma), Nongpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Gegen (Puerariae Radix), Zhuru (Bambusae Caulis in Taeniam).
Dingxiang Shidi Tang (Clove and Persimmon Calyx Decoction): Treats Stomach-cold hiccups with a slow pulse.
Ingredients: Dingxiang (Eugeniae Flos), Shidi (Diospyri Fructus Calyx), Renshen (Ginseng Radix), Shengjiang (Zingiberis Rhizoma Recens).
Erchen Tang (Two-Chen Decoction): See Wet-Phlegm section.
Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction): See Phlegm-Fluid section.
Zhizhu Tang (Immature Bitter Orange and Atractylodes Macrocephala Decoction): See Food Stagnation section.
Zhizhu Pingwei San (Immature Bitter Orange and Atractylodes Macrocephala Peace the Stomach Powder): Is Pingwei San (Peace the Stomach Powder) plus Zhishi (Aurantii Fructus Immaturus) and Jiegeng (Platycodonis Radix).
Cangpo Erchen Tang (Atractylodes and Magnolia Bark Two-Chen Decoction): Is Pingwei San (Peace the Stomach Powder) plus Cangzhu (Atractylodis Rhizoma) and Nongpo (Magnoliae Officinalis Cortex).
Jiawei Chaihu Tang (Modified Bupleurum Decoction): Treats hiccups caused by Liver-Gallbladder Fire surging upward.
Ingredients: Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Zhizi (Gardeniae Fructus), Danpi (Moutan Cortex).
Zhibo Siwu Tang (Anemarrhena, Phellodendron, and Four-Agent Decoction): Is Siwu Tang (Four-Agent Decoction) plus Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma).
Zhibo Dihuang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill): See above.
Family Secret Tiandi Jian (Heaven and Earth Decoction)
Ingredients: Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Tianmendong (Asparagi Radix), Dihuang (Rehmanniae Radix), Guangpi (Citri Reticulatae Pericarpium).
Family Secret Ganshen Wan (Liver-Kidney Pill)
Ingredients: Tianmendong (Asparagi Radix), Dihuang (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma).