朱丹溪治超越陈氏，二十余岁，因饱后奔走数里，遂患哕病。但食物连哕百余声，半日不止，饮酒与汤则
不作，至晚发热，如此者三月。脉涩数，以血入气中治之，用桃仁承气汤加红花煎服，下污血数次即减。再用
木香和中丸加丁香服之，十月而愈。
一人病后呃逆不止，声闻邻家，或令取刀豆子烧存性，白汤调服二钱，即瘥，盖取其下气归元而逆自止也。
（《本草纲目》。）
邃 治一人伤寒，阳明内实，地道不通发呃，其脉长而实，以大承气汤下之而愈。
一人伤寒，七日热退而呃声不绝，六脉沉细无力，倦甚，以补中益气汤加附子，日进三服而安。
一人酒色过伤，医作外感治，发汗过多，绝食日久，致血气两虚，相火冲上，呃逆五六日不止。治以半夏、
黄连以泻逆气，归、芍、生地、知母以养阴，炒柏以泻冲火，二三剂而愈。
陈三农治一人，患温热病十余日，身热面红，舌燥黑，呃逆日夜不止者三日。众医以脉迟无力，欲用丁
附回阳热剂。陈以手按其胸腹，痛不可近，曰∶脉微迟非元气虚，由邪热内实，壅滞其脉而然也。用解毒承气
汤，入甘遂末三分，下咽而燥热，片时去黑粪三四升，热退呃止而安。
一人患温热病，大便不通，用下药粪去而呃大作。众尤下药之过。曰∶此燥粪在肠胃，遏气于下，粪去而
郁气暴升，故奔迫而作呃耳。以枳壳饮之而安。
一人呃逆连声，脉来有力。正邪相争，肝木受邪。自思金能克木，用铁二斤，烧红水淬饮之即愈。
一妇患时疫，饮水过多，心下坚痞，咳逆倚息，短气不卧，诸药无效。作停饮治之，进以五苓散一剂而安。
（以上皆《大还》。）
卢不远治陈孟抒室人，因怒发呃三日夜。召诊，以来迟意甚不怿。脉之曰∶固来迟，然效极速。果一剂而
愈。此盖肝郁甚怒弗畅，气将入胃而不能，故发呃。今不治呃，用柴胡等条达木郁，郁解即止，暴病气全，故易愈也。
吴孚先治袁氏女，陡发呃症。有用丁香、柿蒂者，有补之泻之，有灸之者，俱不效。乃与柴胡、桔梗等味
开提之，不三剂而愈。良由郁怒，肝木不舒，上乘于胃，故作呃，经曰木郁则达之谓也。
喻嘉言治王岵翁，有脾约症，得苁蓉、胡麻、首乌、山药等润剂即解。冬尽偶饱食，当风而吐，胃气大伤，
微似发热，左关脉甚大。自云初觉中脘不舒，今则气反攻左，初饮梨汁不投，今服蔗汁稍定。喻曰∶此虚风之
候也，以胃中空虚若谷，风自内生，左投肝木，而从其类，是以气攻左，而左脉即为之大且劲。经云∶风淫于
内，治以甘寒。梨蔗皆甘寒，而一效一不效者，乃胃中气虚已极，不奈梨性之达下，而喜蔗性之和中也。遂以
甘寒定方，人参、竹沥、麦冬、生地之属。众议除参不用，服后腹内呱呱有声，呕出黄痰少许，胸中遂快，次
早大便亦通，症似向安。然本胃经受病，而胃脉反和，惟心肾肝肺之脉不安，其故口中味淡，汤饮不肯下行。
此中央气弱，不能四迄转达也。宜急用四君子汤之理胃气，则中央之枢转有力，而四畔之机关尽利，喉管之水
气不逆，而口中之淡味亦除矣。不信，别召二医，一谓中风，一谓伤寒。微用表剂，即汗出沾濡，气高神荡，
呃逆不休矣。再投黄连一剂，则脉乱如沸羹，频转频歇，神昏身强，年寿黑滞，气出顺而入必哕，昼夜万三千
五百息，即哕亦如之。二医卸祸，谓喻前议四君，今始可用。喻曰∶气已出而不入，再加参、术之腻阻，气立
断矣，惟仲景旋复代赭一方，可收神功于百一。进一剂而哕势稍减，二剂加代赭至五钱，哕遂大减，连连进粥，
神清色亮，脉复体轻。再用参、苓、麦冬、木瓜、甘草，平调二日，康复如初。
张三锡治一老人，偶伤饮食，消导未减。或误与润肠丸，二服下清水，胀痛转甚。或复投巴豆丸，二服至
呃逆不止。用大剂六君子汤二帖，至五帖全止，补养而愈。
一老人深秋患痢，发呃逆呕吐。黄柏炒燥研末，陈米饭为丸小菀豆大，每服三十丸，人参、白术、茯苓三
味浓煎汤下，连服三剂即愈。切不可下丁香等热药。
陈良甫治一人痢疾，呃逆不止，六脉沉弱。诸医药灼艾皆无效，乃投退阴散两服愈。又尝治许主簿，痢疾
呃逆不止，诸药无效。灸期门穴，不三壮而愈。（《良方》。）
王叔权治一男子，忽气出不绝声，病数日矣。以手按其膻中而应微，以冷针频频刺之而愈。初不之灸，何
其神也。（《资生经》。）
陈霞山治一人，咳逆上气，体重气短，胀满坐不得卧，常作水鸡声。用白前汤∶白前二两，紫菀、半夏各
三两，大戟一两，水一斗，煮三升，分三服。（水肿大实之治。）
薛立斋治一妇人痢后呕哕，（即呃逆也。）服降火化痰等剂愈甚，脉洪大，按之虚细，作渴饮汤，诸药到口即
呕。此脾胃虚寒，不能司纳，以参、术、炮姜末各一钱，以饭作丸，米饮不时送三五粒，至三两余，闻药不呕。
乃以六君加炮姜，三十余剂。
一妇人患症同前，饮食少思，胸腹膨胀，大便不实。所见之症，悉属虚寒假实，遂朝用补中益气汤加炮姜、
木香，夕用六君子汤送四神丸，渐愈。又用八味丸料，煎送四神丸而痊。
一妇人因怒呕哕，时或昏愦口噤，时或举体内动，其面色或青或赤。此肝火炽甚，脾土受侮，用小柴胡汤
加山栀、钩藤治之渐愈。又用加味归脾、逍遥二药，调理而痊。
缪仲淳治高存之邻人卖腐者，伤寒微哕，两日夜不省人事。其子乞方，问之曰∶汝父当时曾头身热乎？曰∶
然。曰∶曾服汗药乎？曰∶未也。曾吐下乎？ 曰∶未也。因索伤寒书检之，其方类用干姜、柿蒂、丁香及附子
等温热之药，（检方云云者，盖示人以病系阳明热呕，以上诸药均不可用，非临阵看兵书也。）末条仅载白虎汤
一方。缪思之，曰∶伤寒头痛口渴身热，本属阳明热邪传里，故身凉发哕，（传里身凉，亦是金针。）未经汗
吐下，邪何从而出？但其人年老多
作劳，故于白虎汤中加人参三钱，二剂立愈。
马元仪治葛怀，年六旬外，下痢呃逆，两足微冷，或以痢治之转剧。诊之，两脉虚微，此中气挟寒下痢，
当大剂温补，以恢复元气。时有言下痢多由湿热在胃，不行清理，而反温补恐未合。曰∶湿热伤者，其脉必实，
其腹结痛，且无呃逆足冷之症。此由年高气弱，火衰于下，气虚于中，因之升降失常，而输泄无度。温补非治
痢也，阳回则痢自止耳，若必俟痢止而后补之晚矣。遂与人参四两，合附桂理中汤，连投四大剂而瘥。
陆圣修年逾六旬，呃逆泄泻，面赤如妆，足冷如冰，两脉沉微。曰∶人身之中，赖元气以充养，今因泄泻
而气衰于下，复因呃逆而气伤于上，上下交征，年高气弱，何以当此？所幸者犹未喘与汗，尚可挽也。与
附子理中汤，大培火土，加丁香以暖胃止呃，盖一法而升降之道备焉。降者以肾中阳旺，则气不上僭，而
下收崇土之功，升者以脾中阳旺，则气不下陷，而中守之营运有职，则饮食自然变化精液，而泄泻安有不愈乎？
朱氏子未第时，患腹胀食少，倦怠自汗，呃逆口干。脉之，左得弦急，右见虚微，此中虚肝盛，得之烦劳
且怒也。烦劳则气分驰而脾胃损，郁怒则肝木横肆而脾胃伤，由是汗出不止，脾虚而腠理不固也。口中干燥者，
脾虚而精液不升也；腹胀者，气虚而传化失常也；食少者，胃阳不化，健运失职也；呃逆者，五阳不布，阴气
用事也。当用桂附理中汤，大培中土，土旺则不受制于木，且能生肺以制木也。服四剂，脉渐起，胀渐平。因
停药数日，胀如故，与大剂桂附理中汤，少加沉香以和胃气而行肝气，调理一月而安。（病本多项，因呃逆为
病之最，故入此。）
老仆王忠妇呕逆呃气，几无宁刻。脉之，右寸独大，余脉虚微。此中州土败，水气不行，五阳不布，浊阴
上逆也。与五苓散一剂。此肝邪挟水气上逆也，五苓利水，中有桂以制肝，故速愈。服后一时许吐逆顿止，再
与附桂理中汤连服之，明日两脉向和，呃逆亦止。微觉倦怠，与加桂理中汤，四五剂而安。
张意田治董友之母，年将七旬，病已八日。脉之，软缓而迟滞，发热日晡益甚，舌苔黄浓，大便不行，（便
知非丁香、柿蒂症。）畏寒呃逆。阅诸方咸以老年正气虚，用丁香柿蒂与补阴之剂。夫脉来迟滞，畏寒，阳邪入
里也；舌苔黄浓，日晡热盛，阳明实也。此乃表症未解，而陷里之热急，致气机逆窒而发呃，法当下之，毋以年
高为虚也。与小承气，服后大便转矢气，兼有心烦不宁之状。与一剂，临晚下黑屎数枚，二更战栗壮热，四更
大汗，天明又便黑矢，然后呃止神清而睡。此实呃之症也，宜审之。
朱丹溪治一中年妇人病哕，以四物汤加和白陈皮、留尖桃仁、生甘草、酒红花，浓煎入驴尿饮，以防其或
生虫也。与数十帖而呃逆除矣。
楼全善治其兄，九月得滞下，每夜五十余行，呕逆食不下，五六日后加呃逆，与丁香一粒，噙之立止。但
少时又至，遂用黄连泻心汤加竹沥引之。此实中挟虚之症，得黄连泻心，实症除而虚症未已，故得补敛而安。
若施之纯实之症则危矣。呃虽少止，滞下未安，若此十余日，（痢久故可用涩。）遂空心用御米壳些少涩其滑，
日间用参、术、陈皮之类补其虚。自服御米壳之后，呃声渐轻，滞下亦收而安。
沈明生治唐玉如，夏间患血淋，数日淋止发呃，举体振动，声大且长。或与开胃消痰益剧，勺粒不入，
已两日夕。又欲进丁香、柿蒂且加姜、桂、参、 。诊之，乃阴衰火炎症也。盖劳役而兼房帏，时际炎敲，水
不制火，血虚而气上冲，是以胀满不食，呃逆不已。今六部脉洪数，颜如煤 ，大便六七日不行，小水滴沥不
快。经云∶诸逆冲上，皆属于火。先哲云∶呃满须看前后部。肾虚不能纳气归元，故呃声长大从丹田出，丁香、
柿蒂可妄投耶？乃先用胆导得垢数枚，觉两足微暖，此逆气下达也。即以六味汤料稍减山药、萸肉，入黄连、
栀子、车前、牛膝，薄暮煎服，不夜分呃全愈矣。明晨进粥，滞色渐清。夫呃症有寒热之分，呃声有上下之别。
今以劳剧之体，血淋后见之，是不由胃而由于肾也。六脉洪数，大小便不利，是不由于寒而由于热也。真水耗
于平日，火症萃于一时，虚则肝肾不能纳气，自下焦上逆为声，非中焦热邪之比。其腰疼颜黑俱属可虞，幸得
两足温，得补而哕止，乃壮水制阳光之明验，亦坎离既济之隹征也。根据方调理半月全瘳。
娄东吴大令梅顿先生弟也，丁未夏，归自烟台，炎风烈日不无感受，萑符不靖不无惊恐。舟中兼有当夕
者，至中途疲 殊甚，急棹抵吴门。或谓憔悴之体，竟应投补。沈见脉数未平，气口独盛，以为虚中有实热，
初用薷、芩等剂，溯其源也。继用劫利等剂，导其流也。宿垢既除，旋培元气，元气渐复，行且勿药矣。因
设酬劳之宴，劳倦惫甚，其夕神昏肢倦，俄而发呃。沈曰∶劳复发呃，当施温补无疑，第虚气上逆，其势方张，
恐汤药未能即降，须艾 佐之为妙。一友于期门穴一壮即缓，三壮全除，调补而瘥。
魏玉横曰∶祖姓人年近七旬，素有胃痛病。于二月间忽发呃，昼夜不绝声者十余日，胃亦痛，食入即呕。
或与二陈汤加丁香、藿香等，病转剧。脉之，两手皆洪数，两寸溢而鼓，时见歇止，乃厥阴之火上冲而然。与
杞子、米仁各一两，沙参五钱，麦冬三钱，酒连四分，二剂而愈。后半年病复作，以贫乏无力再药而死。此贫
亦为不治之一也，哀哉！
Zhu Danxi treated a patient surnamed Chen (Chao Yue Chen), who was in his twenties. After running for several miles on a full stomach, he developed hiccups (hiccough). Food intake triggered over a hundred hiccups continuously for half a day without relief; however, drinking alcohol or soup prevented the hiccups. He experienced fever in the evenings, a condition that persisted for three months. The pulse was choppy and rapid. Zhu diagnosed this as blood entering the qi mechanism. He prescribed Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Drain the Extremities) with added Hong Hua (Safflower) decocted and taken orally. After expelling foul blood several times, the symptoms subsided. Subsequently, Mu Xiang He Zhong Wan (Aucklandia Pill to Harmonize the Middle) with Ding Xiang (Clove) was administered, leading to recovery after ten months.
Another patient suffered from persistent hiccups following an illness, audible to neighbors. Someone advised him to take Dou Zi (Cardamom Seed) charred but preserved in its nature, mixed with warm water and taken in a dose of two qian. The hiccups ceased immediately, likely due to the herb's ability to direct qi downward to its origin, thereby stopping the rebellious qi. (From *Ben Cao Gang Mu*.)
Sui treated a patient with Shang Han (Cold Damage) presenting with Yang Ming internal excess and intestinal obstruction causing hiccups. The pulse was long and forceful. Sui used Da Cheng Qi Tang (Major Order the Qi Decoction) to purge the bowels, resulting in recovery.
Another patient with Shang Han had fever subside after seven days, yet hiccups persisted. The six pulses were deep, fine, and weak, accompanied by extreme fatigue. Bu Zhong Yi Qi Tang (Decoction to Supplement the Middle and Augment the Qi) with Fu Zi (Prepared Aconite Root) was administered, three doses daily, bringing stability.
A patient injured himself through excessive alcohol and sexual activity. Physicians mistakenly treated it as an exterior contraction, inducing excessive sweating. Prolonged fasting led to deficiency of both qi and blood, with ministerial fire rushing upward, causing hiccups for five to six days. Treatment involved Ban Xia (Pinellia Tuber) and Huang Lian (Coptis Rhizome) to drain rebellious qi; Dang Gui (Angelica Sinensis), Bai Shao (White Peony Root), Sheng Di Huang (Rehmannia Root), and Zhi Mu (Anemarrhena Rhizome) to nourish yin; and Chao Bai Zhu (Fried Phellodendron Bark, note: text says Bai, usually Huang Bai/Phellodendron for fire, here interpreted as such contextually or potentially a typo for Huang Bai, but strictly translating "Bai" implies White, however "Xie Chong Huo" suggests clearing heat/fire, typically Huang Bai. Given standard TCM, "Bai" alone is rare for this purpose, likely Huang Bai. I will translate as Phellodendron Bark assuming clinical intent, or stick to literal if ambiguous. Text says "Chao Bai", likely short for Huang Bai or a specific preparation. I will use Phellodendron Bark/Pseudobletia? No, context is clearing fire. I will use Phellodendron Bark (Huang Bai) noting the text says Bai, but clinically it fits Huang Bai. Actually, let's look at "Chao Bai". It might be a typo for Huang Bai. I will translate as Fried Phellodendron Bark.) to drain the rushing fire. Recovery occurred within two to three doses.
Chen San Nong treated a patient suffering from Wen Re Bing (Warm-Heat Disease) for over ten days, presenting with fever, red face, dry black tongue coating, and incessant hiccups day and night for three days. Other physicians, noting a slow and weak pulse, intended to use Ding Fu Hui Yang Re Ji (Ding Xiang and Fu Zi warming yang hot agents). Chen pressed the chest and abdomen, finding tenderness preventing touch, and stated: "The micro-slow pulse is not due to yuan qi deficiency, but rather due to pathogenic heat being internally excess and obstructing the pulse channels." He prescribed Jie Du Cheng Qi Tang (Detoxifying Order the Qi Decoction) with Gan Sui (Kansui Root) powder added. Upon ingestion, the dryness and heat dissipated, and within moments, three to four sheng of black stool were expelled. Fever subsided, hiccups stopped, and the patient stabilized.
Another patient with Wen Re Bing had constipation. After using purgatives, stool was passed, but hiccups intensified. Others blamed the purgatives. Chen explained: "Dry feces were in the intestines and stomach, obstructing qi downward. Once the feces were removed, stagnant qi surged violently, causing the hiccups." He treated with Zhi Ke Yin (Citrus Aurantium Decoction), resulting in recovery.
A patient with continuous hiccups had a forceful pulse. This indicated struggle between righteous qi and pathogenic factors, with Liver Wood affected. Thinking that Metal controls Wood, he used two jin of iron, heated red-hot and quenched in water, which the patient drank, leading to immediate cure.
A woman with Shi Yi (Epidemic Disease) drank too much water, resulting in hardness and distension below the heart, coughing with inability to lie flat, shortness of breath, and failure of various medicines. Diagnosed as retained fluid, Wu Ling San (Five-Ingredient Powder with Poria) was administered, one dose, leading to recovery. (All above from *Da Huan*.)
Lu Bu Yuan treated the wife of Chen Mengshu, who developed hiccups for three days and nights due to anger. Upon consultation, she was displeased with the slow pulse. Lu diagnosed: "Indeed the pulse is slow, but the effect will be rapid." One dose resulted in cure. This was due to severe Liver depression from unexpressed anger, where qi attempted to enter the Stomach but could not, thus causing hiccups. Instead of treating the hiccups directly, he used Chai Hu (Bupleurum Root) etc. to soothe Liver depression. Once depression resolved, hiccups stopped. In acute disease with intact qi, recovery is easy.
Wu Fuxian treated Miss Yuan, who suddenly developed hiccups. Treatments with Ding Xiang (Clove) and Shi Di (Persimmon Calyx), tonification, purgation, and moxibustion all failed. He prescribed Chai Hu (Bupleurum Root) and Jie Geng (Platycodon Root) to lift and open. Within three doses, she recovered. This was due to depression and anger causing Liver Wood stagnation, attacking the Stomach. As the Classics state: "When Wood is depressed, it should be dispersed."
Yu Jiayan treated Wang Hu Weng, who had Pi Yue Zheng (Spleen Confinement Syndrome), resolving with moistening agents like Rong Ren (Cistanche), Hu Ma (Hemp Seed), Shou Wu (Polygonum Multiflorum), and Shan Yao (Dioscorea). At the end of winter, after overeating and vomiting in the wind, Stomach qi was severely damaged, with slight fever and a very large left Guan pulse. He reported initial discomfort in the middle jiao, now qi attacking the left side. Pear juice did not help, but sugarcane juice provided slight relief. Yu said: "This is a sign of deficient wind. With the Stomach empty like a valley, wind generates internally. Attacking the Liver Wood, qi attacks the left, making the left pulse large and tense. The Classics say: 'Wind rampant inside, treat with sweet-cold.' Both pear and sugarcane are sweet-cold. The difference in efficacy is because Stomach qi is extremely deficient; it cannot tolerate pear's descending nature but prefers sugarcane's harmonizing nature." He prescribed a sweet-cold formula including Ren Shen (Ginseng), Zhu Li (Bamboo Sap), Mai Dong (Ophiopogon Tuber), and Sheng Di Huang (Rehmannia Root). Others advised excluding Ren Shen. After taking it, abdominal sounds were heard, some yellow phlegm vomited, chest felt relieved, and bowel movement occurred next morning. Symptoms seemed to improve. However, the Stomach channel was diseased, yet the Stomach pulse appeared harmonious, while Heart, Kidney, Liver, and Lung pulses were unsettled. The cause was bland taste in mouth and refusal of fluids to descend. This indicated weak central qi failing to circulate to all directions. Urgent use of Si Jun Zi Tang (Four Gentlemen Decoction) to regulate Stomach qi would strengthen the central pivot, benefiting all extremities, stopping rebellious qi in the throat, and removing bland taste. Disbelieving, he summoned two other doctors: one diagnosed Stroke Wind, the other Shang Han. Mild exterior-releasing agents caused profuse sweating, floating qi, scattered spirit, and incessant hiccups. Another dose of Huang Lian (Coptis) made the pulse chaotic like boiling soup, frequent turning and pausing, coma, stiff body, dark complexion, smooth exhalation but forced inhalation with hiccups, thousands of breaths per day with constant hiccups. The two doctors shifted blame, suggesting Yu's previous Si Jun Zi prescription was now usable. Yu said: "Qi exits but does not enter. Adding cloying and obstructing Ren Shen and Bai Zhu would cut off qi completely. Only Zhang Zhongjing's Xuan Fu Dai Zhe Tang (Inula and Hematitum Decoction) can achieve miraculous results." One dose reduced hiccups slightly; two doses with increased Dai Zhe (Hematitum) to five qian greatly reduced hiccups. Porridge was consumed continuously, spirit cleared, color brightened, pulse returned, body lightened. Further treatment with Ren Shen, Fu Ling (Poria), Mai Dong, Mu Gua (Chaenomeles), and Gan Cao (Licorice) harmonized for two days, leading to full recovery.
Zhang San Xi treated an elderly man who accidentally injured his diet. Digestive aids did not reduce symptoms. Mistakenly given Run Chang Wan (Moisten Intestines Pills), two doses produced clear water, worsening pain and distension. Then Ba Dou (Croton Seed) pills were given, two doses leading to incessant hiccups. Large doses of Liu Jun Zi Tang (Six-Gentlemen Decoction) for two doses, up to five doses, stopped hiccups completely, cured by tonification and nourishment.
An elderly man developed dysentery in late autumn, with hiccups and vomiting. Huang Bo (Phellodendron Bark) fried and powdered, formed into pills the size of small beans with aged rice paste. Thirty pills per dose, taken with strong decoction of Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala), and Fu Ling (Poria). Three doses led to cure. Hot herbs like Ding Xiang must absolutely be avoided.
Chen Liang Fu treated a man with dysentery and incessant hiccups, six pulses deep and weak. Moxibustion by various physicians failed. Tui Yin San (Retain Yin Powder) for two doses cured him. He also treated Magistrate Xu with dysentery and incessant hiccups, unresponsive to drugs. Moxibustion on Qi Men (Liver 14) for less than three cones cured him. (*Liang Fang*.)
Wang Shu Quan treated a man whose breath emitted continuous sound for several days. Pressing Dan Zhong (Conception Vessel 17) yielded a slight response. Frequent needling with cold needles cured him. Initially no moxibustion was used; how miraculous! (*Zi Sheng Jing*.)
Chen Xia Shan treated a person with coughing rebellion of qi, heavy body, shortness of breath, distension unable to lie down, often making sounds like a water fowl. Bai Qian Tang (Cynanchum Decoction): Bai Qian 2 liang, Zi Wan (Aster Root) and Ban Xia (Pinellia) 3 liang each, Da Ji (Euphorbia Lathyris) 1 liang. Water 1 dou, boiled to 3 sheng, divided into three doses. (Treatment for severe edema excess.)
Xue Li Zhai treated a woman with vomiting and hiccups after dysentery. Medicines for descending fire and resolving phlegm worsened symptoms. Pulse was flooding and large, but empty and fine upon pressure. Thirsty for drinking, all medicines caused immediate vomiting. This was Spleen-Stomach deficient cold, unable to receive and hold. Ren Shen (Ginseng), Bai Zhu (Atractylodes), and Pao Jiang (Roasted Ginger) powder, 1 qian each, formed into pills with rice, taken with rice drink, 3-5 pills occasionally. After consuming over 2 liang, vomiting ceased when smelling medicine. Then Liu Jun Zi Tang (Six-Gentlemen Decoction) with Pao Jiang was used for over 30 doses.
Another woman had similar symptoms: poor appetite, chest-abdominal distension, loose stools. All symptoms belonged to deficiency-cold mimicking excess. Morning: Bu Zhong Yi Qi Tang (Decoction to Supplement the Middle and Augment the Qi) with Pao Jiang and Mu Xiang (Aucklandia); Evening: Liu Jun Zi Tang (Six-Gentlemen Decoction) delivering Si Shen Wan (Four Spirits Pill). Gradual recovery. Later, Ba Wei Wan (Eight-Ingredient Pill) decoction delivered Si Shen Wan, leading to cure.
A woman developed vomiting and hiccups due to anger, sometimes fainting with clenched jaws, sometimes limb tremors, face alternating green and red. This was intense Liver fire insulting Spleen Earth. Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Shan Zhi (Gardenia) and Gou Teng (Uncaria) gradually improved her. Then Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction) and Xiao Yao San (Free Wanderer Powder) regulated her to cure.
Miao Zhong Chun treated a tofu seller, neighbor of Gao Cunzhi, with mild hiccups from Shang Han, unconscious for two days and nights. His son asked for a prescription. Miao asked: "Did your father have head and body heat?" Son: "Yes." "Did he take diaphoretic medicine?" Son: "No." "Vomit or purge?" Son: "No." Miao requested Shang Han books to check formulas. Most used Gan Jiang (Dried Ginger), Shi Di (Persimmon Calyx), Ding Xiang (Clove), and Fu Zi (Aconite) – warm-hot herbs. (Checking formulas shows the disease is Yang Ming heat vomiting; above herbs are contraindicated, not reading military books before battle.) Only Bai Hu Tang (White Tiger Decoction) was listed at the end. Miao thought: "Shang Han with headache, thirst, and fever belongs to Yang Ming heat transmitting inward, hence cool body and hiccups. Without sweat, vomit, or purge, how does pathogen exit? But the patient is old and overworked." Thus, he added Ren Shen (Ginseng) 3 qian to Bai Hu Tang. Two doses led to immediate cure.
Ma Yuan Yi treated Ge Huai, over sixty, with dysentery and hiccups, slightly cold feet. Treating dysentery made it worse. Pulse was empty and minute. This was Middle Qi carrying cold dysentery. Large dose warming and tonifying was needed to restore yuan qi. Some argued dysentery is mostly damp-heat in Stomach, requiring clearing, not warming. Ma said: "Damp-heat injury has solid pulse, abdominal knotting pain, and no hiccups/cold feet. This is due to age, weak qi, declining fire below, deficient qi in middle, leading to abnormal ascending/descending and uncontrolled discharge. Warming tonification is not treating dysentery per se; returning yang stops dysentery naturally. Waiting for dysentery to stop before tonifying is too late." He gave 4 liang of Ren Shen combined with Fu Gui Li Zhong Tang (Aconito-Cinnamon Regulate the Middle Decoction), four large doses consecutively, leading to recovery.
Lu Sheng Xiu, over sixty, had hiccups and diarrhea, face red like makeup, feet cold as ice, pulses deep and minute. He said: "Human body relies on yuan qi for nourishment. Now, diarrhea depletes qi below, hiccups injure qi above. Upper and lower conflict, age high, qi weak, how to bear this? Fortunately, no panting or sweating, still salvageable." He prescribed Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) to strongly cultivate Fire and Earth, adding Ding Xiang (Clove) to warm Stomach and stop hiccups. One method prepares ascending/descending pathways. Descending: Kidney yang vigorous prevents qi from usurping upward, gathering earth-conquering power. Ascending: Spleen yang vigorous prevents qi from sinking, maintaining middle operations, transforming food into essence, so diarrhea heals.
Son of Mr. Zhu, before passing exams, had abdominal distension, poor appetite, fatigue, spontaneous sweating, hiccups, dry mouth. Pulse: Left wiry and urgent, Right empty and minute. This was Middle deficiency with Liver excess, caused by mental toil and anger. Toil relaxes qi and damages Spleen-Stomach; anger causes Liver Wood to invade and damage Spleen-Stomach. Hence sweating, Spleen deficiency, insecure pores. Dry mouth: Spleen deficiency, essence fluids not ascending. Distension: Qi deficiency, transmission dysfunction. Poor appetite: Stomach Yang not transforming, transportation failure. Hiccups: Five Yang not distributing, Yin Qi acting. Use Gui Fu Li Zhong Tang (Cinnamon-Aconite Regulate the Middle Decoction) to strongly cultivate Middle Earth. Earth prosperous resists Wood and generates Lung to control Wood. Four doses: pulse rose, distension flattened. Stopped medicine for days, distension returned. Large dose Gui Fu Li Zhong Tang with small amount Chen Xiang (Aquilaria) to harmonize Stomach qi and move Liver qi. Regulated for one month, stable. (Many diseases present, but hiccups most prominent, hence included.)
Old servant Wang Zhong's wife had vomiting and hiccups, no peace. Pulse: Right Cun only large, others empty and minute. This was Central Earth collapse, water qi not moving, Five Yang not distributing, turbid Yin rebelling upward. Wu Ling San (Five-Ingredient Powder with Poria) one dose. This was Liver pathogen carrying water qi rebelling upward. Wu Ling drains water, contains Gui Zhi (Cinnamon Twig) to control Liver, hence quick cure. After one hour, vomiting/hiccups stopped. Continued Fu Gui Li Zhong Tang. Next day pulses harmonized, hiccups stopped. Slight fatigue: Jia Gui Li Zhong Tang (Augmented Cinnamon Regulate the Middle Decoction) 4-5 doses, stable.
Zhang Yi Tian treated Mother of Dong You, nearly seventy, ill eight days. Pulse: Soft, slow, sluggish. Fever worse in afternoon, thick yellow tongue coating, no bowel movement. Fear of cold, hiccups. Prescriptions all assumed elderly righteous qi deficiency, using Ding Xiang Shi Di Wan (Clove and Persimmon Calyx Pill) and yin tonics. Zhang said: "Sluggish pulse, fear of cold, Yang pathogen enters interior. Thick yellow coating, afternoon fever, Yang Ming excess. Exterior syndrome unresolved, heat trapped interior urgently, causing qi mechanism reversal and hiccups. Method: Purge. Do not consider age as deficiency." Small Cheng Qi Tang given. Bowel movement passed gas, irritability. One dose more. Late evening passed black stool. Second watch: chills, high fever. Fourth watch: profuse sweat. Dawn: black stool again. Then hiccups stopped, spirit clear, slept. This is Excess Hiccups. Must examine carefully.
Zhu Danxi treated a middle-aged woman with hiccups. Si Wu Tang (Four Substance Decoction) plus He Bai Chen Pi (Harmonized Tangerina Peel), Liu Jian Tao Ren (Tip-retained Peach Kernel), Sheng Gan Cao (Raw Licorice), Jiu Hong Hua (Wine-treated Safflower). Strong decoction with Donkey Urine drunk to prevent worms. Dozens of doses removed hiccups.
Lou Quan Shan treated his brother, September dysentery, 50+ movements nightly, vomiting, inability to eat. After 5-6 days, hiccups added. One Ding Xiang (Clove) held in mouth stopped hiccups immediately. But returned shortly. Then Huang Lian Xie Xin Tang (Coptis Decoction to Drain the Epigastrium) with Zhu Li (Bamboo Sap) guided it. This was Excess containing Deficiency. Huang Lian Xie Xin removed excess, but deficiency remained, so tonification/astringency brought stability. Applied to pure excess would be dangerous. Hiccups slightly stopped, dysentery unstable. Over ten days (long dysentery allows astringents). Empty stomach: small amount Yu Mi Ke (Poppy Shell) astringed sliding. Daytime: Ren Shen, Bai Zhu, Chen Pi tonified deficiency. After Yu Mi Ke, hiccups lightened, dysentery收了 (collected/stabilized).
Shen Ming Sheng treated Tang Yuru, summer hematuria. After days urine stopped, hiccups started, whole body vibration, loud long sound. Open Stomach resolve phlegm worsened. Spoonful not entered, two days/nights. Wanted Ding Xiang, Shi Di, Ginger, Cinnamon, Ren Shen... Diagnosis: Yin decline, Fire inflammation. Labor and sex, hot season, water fails to control fire, blood deficiency, qi rushes up. Hence distension, anorexia, incessant hiccups. Six pulses flooding and rapid, face like coal, stool 6-7 days no movement, urine drops difficult. Classics: "All rebellious rushing upward belong to Fire." Ancients: "Check front/back parts for hiccups." Kidney deficiency fails to grasp qi to origin, so hiccups large from Dantian. Can Ding Xiang/Shi Di be recklessly given? First used Gallbladder suppository, got dirt pieces, feet slightly warm, rebellious qi descended. Then Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) material, reduced Shan Yao and Yu Rou, added Huang Lian, Zhi Zi (Gardenia), Che Qian (Plantago), Niu Xi (Achyranthes). Decocted at dusk. By night, hiccups fully cured. Next morning porridge, dysentery color cleared. Hiccups have Cold/Heat distinction, sound has Up/Down difference. Here, labor body, post-hematuria, not from Stomach but Kidney. Six pulses flooding/rapid, urination/defecation difficult, not Cold but Heat. True water exhausted normally, Fire symptoms gathered momentarily. Deficiency: Liver/Kidney fail to grasp qi, reverses from Lower Jiao as sound, not comparable to Middle Jiao heat pathogen. Waist pain, black face concerning. Fortunately feet warm, tonification stopped hiccups. Clear proof of strengthening Water to control Sunlight, good omen of Kan-Li intersection. Regulated according to formula half month, fully healed.
Lou Dongwu, Prefect Meidun's younger brother. Ding Wei Summer, returned from Yantai, felt hot wind/sun, not free from fright due to unrest. On boat, had night watch, midway exhaustion severe, rowed fast to Wu Gate. Some said emaciated body should tonify. Shen saw rapid pulse not calm, Qi Kou (Radial artery) only flourishing, thought deficiency with real heat. First used Ru (Perilla Leaf) and Qin (Scutellaria) to trace source. Then used Jie Li (Draining) to guide flow. Old filth removed, then cultivated yuan qi. Yuan qi gradually restored, soon no medicine needed. Held banquet for reward, labor/fatigue extreme. That night coma, limb fatigue, suddenly hiccups. Shen said: Labor recurrence hiccups, must apply warming tonification. But deficient qi rebels upward, momentum rising, fear decoction cannot descend quickly. Must assist with Moxibustion. Friend: one cone on Qi Men (Liver 14) eased, three cones removed all. Tonified/regulation, healed.
Wei Yu Heng said: Ancestor surname person near seventy, chronic stomach pain. February suddenly hiccups, day/night incessant ten days, stomach pain, vomit after eating. Given Er Chen Tang (Two-Aged Decoction) plus Ding Xiang, Huo Xiang (Patchouli), disease worsened. Pulse: Both hands flooding/rapid, both Cun overflowing/beating, occasional pauses. Jue Yin fire rushing upward. Given Qi Zi (Goji), Mi Ren (Coix Seed) 1 liang each, Sha Shen (Glehnia) 5 qian, Mai Dong 3 qian, Jiu Lian (Wine-processed Coptis) 4 fen. Two doses cured. Half year later disease recurred, died of poverty/inability to medicate. Poverty is also one untreatable cause. Alas!