呃逆症，气逆于下，直冲于上，作呃忒声，由肺胃气不主降，
肝肾气不主吸故也。《内经》谓之哕。《内经》治哕之法，以草刺鼻嚏而已，无息而疾引之，立已。大惊之，
亦可已。今谓之呃，其症因寒火痰食，以及伤寒、吐利、病后、产后多有之。举其纲，则寒呃、热呃、虚脱呃，
三者括之而已。寒呃宜温宜散，寒去而气自舒；热呃宜降宜清，火静而气自平；古方用柿蒂，取其苦温降逆。
济生加丁香、生姜，取其开郁散痰，乃从治之法。虚脱呃则非大补真元，必难镇摄也。其寒滞为呃者，阴凝
浊逆。丁香散、二陈汤、橘皮干姜汤。其肺痹为呃者，咽阻胸闷。枇杷叶、川贝母、郁金、白通草、杏仁、
淡豆豉。其胃火为呃者，脉实便坚。安胃饮。其胃虚为呃者，虚阳上逆。橘皮竹茹汤、旋复代赭汤。其怒动
肝火者，胁痛吐酸。佐金汤加白芍、山栀、金器。金器取镇逆以平肝，其气逆作呃者，肝邪乘胃。旋复代赭汤
加降香。其痰滞为呃者，饮停气阻。丁香二陈汤。其食滞为呃者，腹痛嗳腐。养胃汤去蔻、附、肉果，或大和
中饮去干姜、泽泻。伤寒少阳症哕逆者，半表半里，气为邪抑。小柴胡汤，或柴陈煎。寒加丁香，火加黄芩。
伤寒阳明症失下内热，三焦干格，阴道不行，气冲作呃者，宜去火，白虎汤，竹叶石膏汤加减；去闭，承气汤。
逆气降，哕自止。其吐利后，胃虚膈热而呃者，橘皮竹茹汤加川贝。其病后发呃者，察其中虚，必补脾；察
其阴虚，必补肾。大补元煎，右归饮。其中焦脾胃虚寒，气滞为呃者，丁香柿蒂散，或理中汤、温胃饮，
俱加丁香。其下焦虚寒，肝肾不能畅达，或虚人元阳无力，易为遏抑而致呃者，归气饮，或理阴煎加丁香。
丹溪谓呃逆因肝肾阴虚，气从脐下直冲于口，由相火挟冲气上逆者。用大补阴丸，峻补真阴，承制相火。
东垣谓阴火上冲，吸气不得入，胃脉反逆，阴中伏阳，即为呃。用滋肾丸，壮水制火，引以归源，以泻阴中伏
热。此阳虚阴虚之辨，所当详审施治者也。产后呃逆，最危，四逆汤加人参，羌活附子汤，或桂心五钱，
姜汁三合水煎。急灸期门左穴，艾柱如豆大。《医通》曰∶平人饮热汤，及食椒姜即呃者，此胃有寒痰死血也。
死血，用韭汁、童便、下越鞠丸。虚人，用理中汤加蓬术、桃仁，痰加茯苓、半夏。盖呃逆皆是寒热错杂，
二气相搏，故治之亦多寒热相兼之剂，如丁
香柿蒂并投之类。试观平人冷呃，令其思想则止，思则脾火气乘而胃和矣。
Ehicus (hiccup) is a condition where Qi rebels from the lower body and rushes directly upward, producing hiccuping sounds. This occurs because the Qi of the Lung and Stomach fails to descend, and the Qi of the Liver and Kidney fails to inhale. The *Neijing* refers to this as Yue (hiccups). The treatment method for Yue in the *Neijing* involves using grass to stimulate the nasal cavity to induce sneezing, or rapidly guiding the breath when it stops, which leads to immediate cessation; alternatively, startling the patient can also cure it. It is now called Ehicus. The etiology includes Cold, Fire (Heat), Phlegm, and Food Stagnation, and it frequently occurs in cases of Shaoyang Disease (Taiyang disease affecting the half-exterior and half-interior), vomiting and diarrhea, post-illness recovery, and postpartum conditions. Summarizing the main categories, there are only three: Cold Ehicus, Heat Ehicus, and Collapse Ehicus. For Cold Ehicus, warming and dispersing methods are suitable; once the Cold is removed, the Qi naturally relaxes. For Heat Ehicus, descending and clearing methods are suitable; once the Fire is quieted, the Qi naturally levels out. Ancient formulas use Persimmon Calyx (Shi Di), taking advantage of its bitter-warm property to direct rebellious Qi downward. The *Jisheng Fang* adds Clove (Ding Xiang) and Fresh Ginger (Sheng Jiang) to open depression and disperse Phlegm, representing a "following treatment" method (treating by following the nature of the pathogen). Collapse Ehicus cannot be controlled without major tonification of True Yuan (True Origin/Essence). If Ehicus is caused by Cold stagnation, it involves Yin coagulation and turbid rebellion. Formulas include Ding Xiang San (Clove Powder), Er Chen Tang (Two-Cured Decoction), and Ju Pi Gan Jiang Tang (Tangerine Peel and Dried Ginger Decoction). If Ehicus is caused by Lung Bi (Lung Obstruction), accompanied by throat obstruction and chest tightness, use Loquat Leaf (Pi Pa Ye), Fritillaria Bulb (Chuan Bei Mu), Curcuma Tuber (Yu Jin), White Akebia Stem (Bai Tong Cao), Apricot Seed (Xing Ren), and Fermented Soybean (Dan Dou Chi). If Ehicus is caused by Stomach Fire, with a surging pulse and hard stool, use An Wei Yin (Stomach-Calming Drink). If Ehicus is caused by Stomach Deficiency, involving floating Yang rebelling upward, use Ju Pi Zhu Ru Tang (Tangerine Peel and Bamboo Shaving Decoction) or Xuan Fu Dai Zhe Tang (Inula and Hematite Decoction). If Ehicus is triggered by anger stirring up Liver Fire, accompanied by hypochondriac pain and sour regurgitation, use Jia Jin Tang (Metal-Assisting Decoction) added with White Peony Root (Bai Shao), Gardenia Fruit (Shan Zhi), and Metal Objects (Jin Qi). Metal objects are used to suppress rebellion and calm the Liver; this addresses Qi rebellion causing Ehicus due to Liver Pathogen invading the Stomach. Use Xuan Fu Dai Zhe Tang added with Agarwood (Xiang). If Ehicus is caused by Phlegm stagnation, involving fluid retention and Qi obstruction, use Ding Xiang Er Chen Tang (Clove Two-Cured Decoction). If Ehicus is caused by Food stagnation, accompanied by abdominal pain and putrid belching, use Yang Wei Tang (Nourishing Stomach Decoction) removing Cardamom (Dou Kou), Aconite (Fu Zi), and Myrobalan (Rou Guo), or Da He Zhong Yin (Great Harmonizing Middle Drink) removing Dried Ginger (Gan Jiang) and Alisma (Ze Xie). In Shaoyang Disease of Cold Damage presenting with Yue and Ehicus, the pathogen is at the half-exterior and half-interior, suppressing Qi. Use Xiao Chai Hu Tang (Minor Bupleurum Decoction) or Chai Chen Jian (Bupleurum and Two-Cured Decoction). Add Clove for Cold, add Scutellaria Root (Huang Qin) for Fire. In Yangming Disease of Cold Damage, if failure to purge leads to internal heat, drying and blocking the Triple Burner, obstructing the Yin pathways, and causing Qi rushing upward to produce Ehicus, one should clear Fire using Bai Hu Tang (White Tiger Decoction) or Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) with modifications; or clear blockage using Cheng Qi Tang (Order the Qi Decoction). Once rebellious Qi descends, Yue ceases spontaneously. If Ehicus occurs after vomiting and diarrhea due to Stomach Deficiency and Diaphragmatic Heat, use Ju Pi Zhu Ru Tang added with Fritillaria Bulb (Chuan Bei). If Ehicus occurs after illness, observe if Spleen Qi is deficient and must be tonified, or if Yin is deficient and must be nourished. Use Da Bu Yuan Jian (Great Tonifying Original Decoction) or You Gui Yin (Right Restoring Drink). If Middle Jiao Spleen and Stomach are deficient and cold, with Qi stagnation causing Ehicus, use Ding Xiang Shi Di San (Clove and Persimmon Calyx Powder), Li Zhong Tang (Regulate the Middle Decoction), or Wen Wei Yin (Warm the Stomach Drink), all added with Clove. If Lower Jiao is deficient and cold, with Liver and Kidney Qi unable to flow freely, or in deficient individuals with weak Yuan Yang prone to suppression causing Ehicus, use Gui Qi Yin (Returning Qi Drink) or Li Yin Jian (Regulating Yin Decoction) added with Clove. Zhu Danxi stated that Ehicus is due to Liver and Kidney Yin Deficiency, with Qi rushing straight from below the umbilicus to the mouth, driven by Ministerial Fire carrying Chong Qi upward. Use Da Bu Yin Wan (Great Tonifying Yin Pill) to vigorously tonify True Yin and control Ministerial Fire. Li Dongyuan stated that Yin Fire rushing upward prevents inhalation, causing Stomach Meridian Qi to rebel inversely; hidden Yang within Yin results in Ehicus. Use Zi Shen Wan (Kidney-Nourishing Pill) to strengthen Water to control Fire, guide Fire back to its source, and drain hidden heat within Yin. This distinction between Yang Deficiency and Yin Deficiency requires detailed examination for treatment. Postpartum Ehicus is most critical; use Si Ni Tang (Frigid Extremities Decoction) added with Ginseng, Qiang Huo Fu Zi Tang (Notopterygium and Aconite Decoction), or Cinnamon Heart (Gui Xin) 5 qian and Ginger Juice 3 he, decocted in water. Urgently moxa the Left Qimen Acupoint (LR14) with moxa cones the size of beans. The *YiTong* states: If a healthy person hiccups after drinking hot soup or eating pepper and ginger, this indicates Cold Phlegm and Dead Blood in the Stomach. For Dead Blood, use Leek Juice and Child's Urine, combined with Yue Ju Wan (Sorrow-Pill). For deficient persons, use Li Zhong Tang added with Curcuma Rhizome (Peng Zhu) and Peach Kernel (Tao Ren); for Phlegm, add Poria (Fu Ling) and Pinellia Tuber (Ban Xia). Generally, Ehicus involves mixed Cold and Heat, with Yin and Yang Qi clashing; thus, treatments often combine Cold and Heat herbs, such as using Clove and Persimmon Calyx together. Consider that for ordinary people with Cold Ehicus, making them think can stop it, because thought engages Spleen Fire to overcome Stomach Qi, thereby harmonizing the Stomach.