干呕者，呕而无物出也。大抵热在胃脘，与谷气并，热气上熏，心下痞结，则有此证。太阳汗
出干呕，桂枝汤，主自汗也。少阴下利干呕，姜附汤，主下利也。厥阴吐沫干呕，吴茱萸汤，主涎
沫也。邪去，则吐自止矣。若有水气二证，又当以
表里别之。
伤寒表不解而心下有水气，干呕，身热微喘，或自利，小青龙汤主之。
不发热，不恶寒，肋痛，咳而利，干呕者，十枣汤下之。
自汗头痛，干呕，桂枝汤。
少阴下利干呕，脉微，白通汤；下利不止，干呕而烦，厥逆无脉，白通加猪胆汁汤。
恶寒外热，脉微欲绝，干呕，通脉四逆汤。
膈上有寒饮，干呕，亦属少阴，四逆汤。
干呕，吐痰沫，头痛，吴茱萸汤。得此汤反剧者，与小柴胡汤。干呕自利，黄芩汤、半夏生姜
汤。
太阳中风，阳浮阴弱，自汗恶风寒，发热鼻鸣，干呕者，桂枝汤。干呕，哕，若手足厥者，橘
皮汤。
夫咳逆者，俗谓之吃忒是也。才发声于喉间则遽止，HT HT 然连续数声，然而短
促不长。古人谓之哕者，非也。哕与干呕无异，但其声浊恶而长，然皆有声而无物。病至于哕，则
危，难治矣。大抵KT 近于哕。KT 者，但胸间气塞不得下通，哕则恶浊之声达于外矣。盖因胃气本虚，
汗下太过，或复饮水，水寒相搏，虚逆而成。经曰∶阳脉浮，则为气KT 。又曰∶脉滑，则为哕。此
为医咎，责虚取实之过也。又有热气拥郁，上下气不得通而哕者，轻则和解之，通利之，甚则温散
之。设若不尿，腹满而哕者，咳逆、脉散而无伦者，虽神医不能措手，与伤寒咳而气逆者又不同也。
若将吃忒紊于哕与咳而气逆，则误人多矣。临病之际，宜明辩之。
咳嗽，大便少，与大承气汤下之。盖由热气冲膈肝肺故耳。若便软，泻心汤，胃气虚而冲脉逆
也。若脉散者，不治。咳逆潮热，小柴胡加橘皮生姜汤。
厥逆不止，乌苓汤；有寒者，羌活附子散。
伤寒表不解，心下有水气，干呕，发热而咳，或KT ，小青龙汤去麻黄，加附子。
寸口脉浮大，医反下之，为逆，又饮冷水，令汗大出，水得寒气，冷必相搏，其人即KT ，豆蔻
汤。
哕而腹满，大便不利，先宜半夏生姜汤，次用承气汤；小便不利，猪苓汤。
阳明中风，脉浮弦，小便难，潮热而哕，小柴胡汤加茯苓。
呕哕，手足冷逆，小橘皮汤。若胸满虚烦，大橘皮汤；胃气寒者，吴茱萸理中汤、温中汤。
《金匮要略》曰∶哕逆者，橘皮竹茹汤主之。哕不止者，橘皮干姜汤、半夏生姜汤、退阴散子，
宜消息用之。
温病热未除，重被暴寒入胃，蕴结不散，变哕，梓皮饮子。温病有热，饮水暴冷，作哕，茅根
葛根汤。温病胃冷，变哕，茅根橘皮汤。温病有热，饮水暴冷，枇杷茅根汤。
干呕，是指想要呕吐但没有实物吐出。大抵是因为热邪在胃脘部，与谷气相搏结，热气向上熏蒸，导致心下痞塞结聚，从而出现这种证候。太阳病汗出而干呕，用桂枝汤主治，以治疗自汗；少阴病下利而干呕，用姜附汤主治，以治疗下利；厥阴病吐涎沫而干呕，用吴茱萸汤主治，以治疗涎沫。邪气去除，呕吐自然停止。如果有水气相关的两种证候，又应当根据表里分别辨证施治。
伤寒表证未解且心下有停饮，表现为干呕、身热微喘，或者自利，用小青龙汤主治。
少阴病下利干呕，脉象微弱的，用白通汤；下利不止，干呕且心烦，四肢厥冷无脉的，用白通加猪胆汁汤。
干呕，吐痰沫，头痛的，用吴茱萸汤。服用此汤后病情反而加剧的，改用小柴胡汤。干呕伴自利的，用黄芩汤或半夏生姜汤。
太阳中风，脉象阳浮阴弱，自汗恶风寒，发热鼻鸣，干呕的，用桂枝汤。干呕，呃逆（哕），如果手足厥冷的，用橘皮汤。
所谓咳逆，就是俗称的“打嗝”（吃忒）。刚发出声音于喉间就立刻停止，发出“HT HT”的声音连续数声，但是短促而不长。古人称之为“哕”是不对的。“哕”与干呕没有区别，只是声音浑浊恶劣且长，但都是有声而无物吐出。疾病发展到“哕”，则情况危急，难以治疗。大抵“噫”（KT，即嗳气）接近于“哕”。“噫”仅仅是胸中气机堵塞不得下行，“哕”则是恶浊之声达于体外。这大概是因为胃气本虚，发汗或攻下太过，或者又饮水，水寒相互搏结，因虚致逆而成。医经说：“阳脉浮，则为气噫。”又说：“脉滑，则为哕。”这是医生的过错，在于责备虚证却误用攻实的方法。又有因热气拥郁，上下气机不通而导致哕的，轻则和解、通利，重则温散。假设如果不排尿，腹部胀满而哕的，咳逆、脉象散乱无伦次的，即使是神医也无法措手，这与伤寒咳嗽而气逆是不同的。如果把打嗝混淆于哕和咳而气逆，就会误导很多人。临证时，应当明辨清楚。
咳嗽，大便量少，用大承气汤攻下。这是因为热气冲犯膈肝肺的缘故。如果大便软，用泻心汤，这是胃气虚而冲脉气逆。如果脉象散的，无法治疗。咳逆伴潮热的，用小柴胡汤加橘皮生姜汤。
伤寒表证未解，心下有停饮，干呕，发热而咳，或者有噫气的，用小青龙汤去掉麻黄，加入附子。
寸口脉浮大，医生反而使用攻下法，这是逆治，又饮用冷水，导致大汗出，水遇到寒气，寒冷必然相互搏结，病人随即出现噫气，用豆蔻汤。
哕而腹部胀满，大便不通利，先用半夏生姜汤，再用承气汤；小便不利，用猪苓汤。
呕哕，手足冷逆，用小橘皮汤。如果胸满虚烦，用大橘皮汤；胃气寒的，用吴茱萸理中汤或温中汤。
《金匮要略》说：哕逆的，用橘皮竹茹汤主治。哕不止的，用橘皮干姜汤、半夏生姜汤、退阴散子，宜斟酌使用。
温病热邪未除，厚被暴寒入胃，蕴结不散，变为哕，用梓皮饮子。温病有热，饮水过冷，导致哕，用茅根葛根汤。温病胃冷，变为哕，用茅根橘皮汤。温病有热，饮水过冷，用枇杷茅根汤。
Gan Ou (Dry Retching) refers to the sensation of vomiting without any substance being expelled. Generally, this occurs due to heat in the epigastrium combining with grain qi, where rising heat steams upward, causing stagnation and knotting below the heart, resulting in this syndrome. For Taiyang disease presenting with sweating and gan ou, Guizhi Tang (Cinnamon Twig Decoction) is indicated to treat spontaneous sweating. For Shaoyin disease presenting with diarrhea and gan ou, Jiang Fu Tang (Ginger and Aconite Decoction) is indicated to treat diarrhea. For Jueyin disease presenting with salivation and gan ou, Wuzhuyu Tang (Evodia Decoction) is indicated to treat saliva and froth. Once the pathogenic factor is eliminated, vomiting will cease naturally. If there are two types of water-fluid retention syndromes, differentiation should be made based on exterior and interior patterns.
In Shanghan (Cold Damage) where the exterior pattern is unresolved and there is fluid retention in the epigastrium, manifesting as gan ou, slight fever, mild wheezing, or spontaneous diarrhea, Xiao Qinglong Tang (Minor Green Dragon Decoction) is indicated.
If there is no fever, no aversion to cold, hypochondriac pain, cough accompanied by diarrhea, and gan ou, Shizao Tang (Ten Jujube Decoction) is used for purgation.
For spontaneous sweating, headache, and gan ou, Guizhi Tang (Cinnamon Twig Decoction) is indicated.
For Shaoyin disease with diarrhea and gan ou, if the pulse is faint, Baitong Tang (White Passage Decoction) is indicated; if diarrhea persists, gan ou is accompanied by irritability, and there is cold extremities with no palpable pulse, Baitong Jia Zhuhuangdan Tang (White Passage Decoction with Pig Gallbladder Bile) is indicated.
For aversion to cold with external false heat, a pulse that is faint and nearly imperceptible, and gan ou, Tongmai Sini Tang (Pulse-Restoring Four Reversal Decoction) is indicated.
For cold-fluid retention above the diaphragm causing gan ou, which also belongs to Shaoyin disease, Sini Tang (Four Reversal Decoction) is indicated.
For gan ou, expectoration of phlegm and froth, and headache, Wuzhuyu Tang (Evodia Decoction) is indicated. If the condition worsens after taking this decoction, Xiaochaihu Tang (Minor Bupleurum Decoction) should be given. For gan ou accompanied by spontaneous diarrhea, Huangqin Tang (Scutellaria Decoction) or Banxia Shengjiang Tang (Pinellia and Fresh Ginger Decoction) are indicated.
For Taiyang Wind Strike, characterized by floating yang and weak yin pulses, spontaneous sweating, aversion to wind and cold, fever, nasal congestion, and gan ou, Guizhi Tang (Cinnamon Twig Decoction) is indicated. For gan ou, Yue (Hiccups), and cold extremities, Jupi Tang (Tangerine Peel Decoction) is indicated.
Yue (Hiccups), commonly known as "Chi Te" (hiccuping), is described as sound emerging from the throat and stopping abruptly, producing continuous short sounds ("HT HT") that are brief rather than prolonged. It was incorrect for ancient authors to call this "Yue". True Yue is similar to Gan Ou but involves a turbid, foul, and prolonged sound, yet still有声无物 (sound without substance). When a disease progresses to Yue, it is critical and difficult to treat. Da Di (Belching/Eructation) is close to Yue. Da Di merely involves qi stagnation in the chest preventing downward flow, whereas Yue involves foul sounds reaching the exterior. This typically arises because stomach qi is originally deficient; excessive sweating or purging, followed by drinking water, causes water and cold to clash, leading to deficiency-induced rebellion. The classics state: "Floating yang pulse indicates qi belching." And: "Slippery pulse indicates hiccups." This is a medical error, resulting from treating deficiency as excess. Alternatively, hiccups can result from heat oppression blocking upper and lower qi circulation; mild cases are treated with harmonizing and unblocking methods, severe cases with warming and dispersing. If there is anuria, abdominal fullness, and hiccups, or if hiccups are accompanied by a scattered and chaotic pulse, even a divine physician cannot intervene; this differs from Shanghan cough with rebellious qi. Confusing hiccuping with Yue and cough with rebellious qi leads to many errors. Clinicians must distinguish them clearly.
For cough with scanty stools, Dachengqi Tang (Major Order the Qi Decoction) is used for purgation, as this is caused by heat rushing against the diaphragm, liver, and lungs. If stools are soft, Xiexin Tang (Drain the Epigastrium Decoction) is used, indicating stomach qi deficiency with Chong Mai (Penetrating Vessel) rebellion. If the pulse is scattered, it is untreatable. For hiccups with tidal fever, Xiaochaihu Tang (Minor Bupleurum Decoction) added with Jupi (Tangerine Peel) and Shengjiang (Fresh Ginger) is indicated.
For persistent cold extremities, Wuling Tang (Black Bean and Polyporus Decoction) is used; if there is cold pathogen, Qianghuo Fuzi San (Notopterygium and Aconite Powder) is used.
In Shanghan where the exterior pattern is unresolved and there is fluid retention in the epigastrium, presenting with gan ou, fever, cough, or belching, Xiao Qinglong Tang (Minor Green Dragon Decoction) with Mahuang (Ephedra) removed and Fuzi (Aconite) added is indicated.
If the cunkou pulse is floating and large, and the doctor erroneously uses purgation, creating a counter-indication, and then gives cold water causing profuse sweating, the water meets cold qi, clashing together, causing the patient to belch; Doukou Tang (Cardamom Decoction) is indicated.
For hiccups with abdominal fullness and difficulty passing stool, first use Banxia Shengjiang Tang (Pinellia and Fresh Ginger Decoction), then Chengqi Tang (Order the Qi Decoction); for difficulty urinating, Zhuling Tang (Polyporus Decoction) is indicated.
For Yangming Wind Strike, with floating and wiry pulses, difficulty urinating, tidal fever, and hiccups, Xiaochaihu Tang (Minor Bupleurum Decoction) added with Fuling (Poria) is indicated.
For vomiting and hiccups with cold extremities, Xiao Jupi Tang (Minor Tangerine Peel Decoction) is used. If there is chest fullness and empty irritability, Da Jupi Tang (Major Tangerine Peel Decoction) is used; for cold stomach qi, Wuzhuyu Lizhong Tang (Evodia and Middle-Warming Decoction) or Wenzhong Tang (Warm the Middle Decoction) is used.
The *Jingui Yaolue* states: For hiccups and reversal, Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction) is indicated. For persistent hiccups, Jupi Ganjiang Tang (Tangerine Peel and Dried Ginger Decoction), Banxia Shengjiang Tang (Pinellia and Fresh Ginger Decoction), or Tuiyin San (Remove Yin Powder) may be used according to circumstances.
For Warm Disease where heat is not cleared, heavy quilts allow sudden cold to enter the stomach, accumulating and failing to dissipate, transforming into hiccups; Zipi Yinzi (Bark Decoction) is used. For Warm Disease with heat, drinking sudden cold water causes hiccups; Maogen Gengen Tang (Reed Rhizome and Kudzu Root Decoction) is used. For Warm Disease with cold stomach transforming into hiccups, Maogen Jupi Tang (Reed Rhizome and Tangerine Peel Decoction) is used. For Warm Disease with heat, drinking sudden cold water, Pipa Maogen Tang (Loquat Leaf and Reed Rhizome Decoction) is used.