〔《活》〕哕，胃寒所生，橘皮干姜汤、羌活附子散、半夏生姜汤、退阴散主之。若服药不瘥者，灸乳直
下一指许三壮，若妇人则屈乳头下尽处是穴。亦有阳症者，小柴胡汤、橘皮竹茹汤。（方见杂病哕。）
橘皮干姜汤
橘皮 通草 干姜 桂心 甘草（各三两） 人参（二两）
上 咀，每服四钱，水一盏，煎至六分，去渣温服，日三。
羌活附子散（方见杂病哕。）
半夏生姜汤 治哕欲死。
半夏（一两） 生姜（二两，切）
上水二盏，煎至八分，去渣温服。
〔海〕伤寒咳逆脉散死，仲景之言不虚伪。大抵原因失下生，咳逆喉中阴不内。便软惟宜用泻心，便硬尤
宜大承气。二药神任务者谁，东垣洁古为良剂。
〔洁〕咳逆者，火热奔急上行，而肺阴不内，何其当哉？故便秘者，宜大承气下之；便软者，泻心汤主之。
〔海〕少阴咳逆者，此失下也，阴消将尽，阳逆上行，使阴不内也。然阴既尽，阳亦将尽也。吸入肾与肝，
阳逆上行，阴入不内，故为阳极。脉微将尽者，不宜下，宜服泻心汤，养阴退阳而已。如不用泻心汤，凉膈散
去硝黄，清肺散亦可。若脉左浮右沉实，非表也，里极则反出于表也。何以然？咳逆舌强，右脉实者，知少阴
里也。饮水过多，心下痞而渴逆者，五苓散主之，别无恶候是也。恶候生，或兼以舌挛，语言不正，而反昏冒
与咽痛者，少阴也，速下之，宜大承气汤也。何以脉浮为表？浮之实大，沉之损小，是为表也；浮之实大，沉
之亦然，即非表也，邪入已深矣。内热当沉反浮，阳极复之表也。阴症者，内已伏阴，阴气太甚，肾水擅权，
肝气不生，胃火已病，丁火又消，所以游行相火，寒邪迫而萃集于胸中，亦欲尽也，故令人发热，大渴引饮，
欲去盖覆，病患独觉热，他人按执之，身体肌肉骨髓血脉俱寒，此火即无根之火也，宜用丁香、干姜之类，热
药温胃，其火自下。
匀气散
川乌头（大者三个，炮裂，去皮脐）
上为细末，每服三钱，用黑豆二十一粒，砂糖同泡汤调，乘热细细饮之。
〔《本》〕治阴毒呃逆方
川乌头 干姜 附子（以上俱炮） 肉桂 芍药 半夏 炙甘草 吴茱萸 陈皮 大黄（各等分）
上为细末，每服一钱，水一盏，生姜三五片，煎至七分，去渣温服。
肉豆蔻汤 治伤寒汗后，呃逆噫气。
肉豆蔻（一个） 石莲肉（炒） 茴香（各一两） 人参 丁香（各半两） 枇杷叶（五片，拭去毛炙）
上锉细，用水四盏，生姜十片，煎二盏，去渣，空心温服，分二服。
良姜汤
橘皮 良姜 桂枝 当归（各一两） 麻黄（半两） 杏仁（二十个） 甘草（半两） 槟榔（三个，另为末）
上 咀，用水四盏，姜十片，枣三枚，同煎至二盏，去渣，下槟榔末再煎三沸，通口服一盏。未已，再服，
庞老云；伤寒呃逆不止，是阴阳气升降欲作汗，升之不下，故胃气上逆，为呃逆无休止，宜服此方。
【《活人书》】呃逆，是由胃寒引起的，可用橘皮干姜汤、羌活附子散、半夏生姜汤、退阴散来主治。如果服药后病情没有好转，可以灸乳头直下一指许处三壮，如果是女性，则取乳头下尽处的穴位。也有属于阳证的患者，可用小柴胡汤、橘皮竹茹汤治疗。（方剂见杂病篇的呃逆条）
橘皮干姜汤
橘皮 通草 干姜 桂心 甘草（各三两） 人参（二两）
以上药材切碎，每次服用四钱，加水一盏，煎至六分，去渣温服，每日三次。
半夏生姜汤 治疗呃逆剧烈欲死之症。
半夏（一两） 生姜（二两，切片）
以上加水二盏，煎至八分，去渣温服。
【李东垣】伤寒导致的咳逆（此处指呃逆或气逆），若脉象散乱则为死证，张仲景的话是不虚假的。大抵是因为失于攻下所致，咳逆时喉中阴气不能内守。大便软者适宜用泻心汤，大便硬者尤其适宜用大承气汤。这两味药的神妙作用，以李东垣和洁古先生推荐的良剂最为有效。
【张洁古】咳逆（此处指呃逆或气逆），是火热之气奔急上行，导致肺阴不能内守，这种说法难道不对吗？所以便秘者，适宜用大承气汤攻下；大便软者，适宜用泻心汤主治。
【李东垣】少阴病出现的咳逆，这是失于攻下的结果，阴液消亡将尽，阳气上逆，使得阴气不能内入。然而阴既已尽，阳也将要耗尽。吸气本应归于肾与肝，但因阳气上逆，阴气无法内入，故表现为阳极。脉象微细将绝者，不宜攻下，适宜服用泻心汤，以养阴退阳为主。如果不使用泻心汤，凉膈散去掉芒硝和大黄，或者清肺散也可以使用。如果脉象左浮右沉实，这不是表证，而是里极盛反而外达于表的表现。为什么这样说呢？咳逆伴舌强，右脉实，可知病在少阴里。饮水过多，心下痞满且口渴气逆者，适宜用五苓散主治，只要没有其他恶候即可。如果出现恶候，或者兼有舌体挛缩、言语不正，反而昏冒及咽痛者，属于少阴病，需迅速攻下，适宜用大承气汤。为什么说脉浮为表证呢？轻取脉实大，重按脉损小，这才是表证；如果轻取实大，重按也如此，那就不是表证，邪气已经深入了。内热当见沉脉却反见浮脉，这是阳极复返于表的表现。阴证患者，体内已潜伏阴寒，阴气太盛，肾水擅权，肝气不生发，胃火已病，丁火（心火）又消亡，所以游行相火，寒邪逼迫而聚集于胸中，阳气也将耗尽，因此让人发热，大渴引饮，想要去除盖被，病人自己觉得热，但他人触摸其身体肌肉骨髓血脉都感到寒冷，这就是无根之火，适宜用丁香、干姜之类的热药温胃，这股火自然下行。
匀气散
川乌头（大的三个，炮裂，去皮脐）
以上研为细末，每次服用三钱，用黑豆二十一粒，加砂糖同泡汤调匀，趁热细细饮用。
【《本草衍义》等】治疗阴毒呃逆的方剂
川乌头 干姜 附子（以上均炮制） 肉桂 芍药 半夏 炙甘草 吴茱萸 陈皮 大黄（各等分）
以上研为细末，每次服用一钱，加水一盏，生姜三五片，煎至七分，去渣温服。
肉豆蔻汤 治疗伤寒发汗后，呃逆嗳气。
肉豆蔻（一个） 石莲肉（炒） 茴香（各一两） 人参 丁香（各半两） 枇杷叶（五片，拭去毛并炙）
以上锉细，用水四盏，生姜十片，煎至二盏，去渣，空腹温服，分两次服用。
良姜汤
橘皮 高良姜 桂枝 当归（各一两） 麻黄（半两） 杏仁（二十个） 甘草（半两） 槟榔（三个，另研为末）
以上切碎，用水四盏，生姜十片，大枣三枚，同煎至二盏，去渣，加入槟榔末再煎三沸，一次口服一盏。如果未止，再服用。庞老说：伤寒呃逆不止，是阴阳之气升降欲作汗出，升而不降，导致胃气上逆，造成呃逆无休止，适宜服用此方。
[From *Huoren Shu*] Hiccups (Yue) are caused by stomach cold. They should be primarily treated with Jupi Ganjiang Tang (Tangerine Peel and Dried Ginger Decoction), Qianghuo Fuzi San (Notopterygium and Aconite Powder), Banxia Shengjiang Tang (Pinellia and Fresh Ginger Decoction), or Tuiyin San (Eliminating Yin Powder). If the condition does not improve after taking medicine, moxibustion should be applied to the point located approximately one finger-width directly below the nipple, three moxa cones. For women, this point is at the very bottom of the nipple. There are also cases belonging to Yang syndromes, which can be treated with Xiaochaihu Tang (Minor Bupleurum Decoction) or Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction). (Formulas see Hiccups in Miscellaneous Diseases.)
Jupi Ganjiang Tang (Tangerine Peel and Dried Ginger Decoction)
Chenpi (Citri Reticulatae Pericarpium), Tongcao (Tetrapanacis Medulla), Ganjiang (Zingiberis Rhizoma Recens dried), Guixin (Cinnamomi Cortex), Gancao (Glycyrrhizae Radix et Rhizoma) (each 3 liang); Renshen (Ginseng Radix) (2 liang).
Crush the herbs. Take 4 qian per dose, add 1 sheng of water, decoct until 0.6 sheng remains, remove dregs, and take warm. Three times daily.
Qianghuo Fuzi San (Notopterygium and Aconite Powder) (Formula see Hiccups in Miscellaneous Diseases.)
Banxia Shengjiang Tang (Pinellia and Fresh Ginger Decoction) Treats severe hiccups nearing death.
Banxia (Pinelliae Rhizoma Preparatum) (1 liang); Shengjiang (Zingiberis Rhizoma Recens) (2 liang, sliced).
Add 2 sheng of water, decoct until 0.8 sheng remains, remove dregs, and take warm.
[Li Dongyuan] In Shanghan (Cold Damage), cough with upward rushing qi (Ke Ni, here referring to hiccups or rebellious Qi) accompanied by a scattered pulse indicates death; Zhang Zhongjing's words are not false. Generally, this arises from failure to purge earlier. The rebellious Qi in the throat prevents Yin from being retained internally. If stools are soft, Xiexin Tang (Gallbladder-Draining Decoction) is suitable; if stools are hard, Dachengqi Tang (Major Order the Qi Decoction) is especially suitable. Among these two medicines, the divine efficacy is best represented by the excellent prescriptions of Dongyuan and Jiegu.
[Zhang Congzheng/Jiegu] Ke Ni (rebellious Qi/hiccups) occurs when fire-heat rushes upward urgently, preventing Lung Yin from being retained internally. Is this not accurate? Therefore, for those with constipation, Dachengqi Tang (Major Order the Qi Decoction) should be used to purge; for those with soft stools, Xiexin Tang (Gallbladder-Draining Decoction) should be primarily used.
[Li Dongyuan] Shaoyin syndrome presenting with Ke Ni (rebellious Qi/hiccups) results from failure to purge earlier. Yin fluids are nearly exhausted, Yang Qi rebels upward, preventing Yin from entering internally. However, once Yin is exhausted, Yang will also soon be exhausted. Inhalation should belong to Kidney and Liver, but due to Yang rebellion, Yin cannot enter, thus manifesting as extreme Yang. If the pulse is minute and near exhaustion, purging is contraindicated; instead, Xiexin Tang (Gallbladder-Draining Decoction) should be taken to nourish Yin and retreat Yang. If Xiexin Tang is not used, Liangge San (Cool the Chest Powder) with Mangxiao (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma) removed, or Qingfei San (Clear Lung Powder) may also be used. If the left pulse is floating and the right pulse is deep and excess, this is not a Exterior syndrome, but rather Interior extremity manifesting outwardly. Why is this so? Hiccups with tongue stiffness and an excess Right pulse indicate Shaoyin Interior syndrome. If excessive drinking leads to epigastric fullness, thirst, and rebellious Qi, Wuling San (Five-Ling Powder) should be primarily used, provided there are no other ominous signs. If ominous signs arise, or if accompanied by tongue spasm, abnormal speech, sudden dizziness/confusion, and sore throat, it belongs to Shaoyin syndrome; rapid purging is required, and Dachengqi Tang (Major Order the Qi Decoction) is suitable. Why is a floating pulse considered Exterior? If the pulse is solid and large on light pressure but diminished on heavy pressure, it is Exterior; if it is solid and large on both light and heavy pressure, it is not Exterior, but Deep Pathogen. Internal heat should present as Deep but floats; this is Extreme Yang returning to the Exterior. In Yin syndromes, Yin cold has潜伏 (latent) internally. Yin Qi is too excessive, Kidney Water dominates, Liver Qi fails to generate, Stomach Fire is diseased, Ding Fire (Heart Fire) declines. Thus, Ministerial Fire wanders, cold pathogen forces its way and gathers in the chest, and Yang Qi is also about to exhaust. This causes fever, extreme thirst with desire to drink, desire to remove covers, the patient feels hot, but others touching their body, muscles, bones, marrow, and blood vessels feel cold. This is Rootless Fire. It is suitable to use hot medicines like Dingxiang (Caryophylli Flos) and Ganjiang (Zingiberis Rhizoma) to warm the Stomach, and the fire will naturally descend.
Yunqi San (Harmonizing Qi Powder)
Chuanwutou (Aconiti Lateralis Radix Preparata) (3 large ones, processed until cracked, skin and root removed).
Grind into fine powder. Take 3 qian per dose. Soak 21 black soybeans (Heidou, Glycines Max Semen Nigrum) with brown sugar in water, mix well, and drink slowly while hot.
[Ben Cao Yan Yi etc.] Formula for treating Yin Toxin Hiccups
Chuanwutou (Aconiti Lateralis Radix Preparata), Ganjiang (Zingiberis Rhizoma Recens dried), Fuzi (Aconiti Lateralis Radix Preparata) (all above processed); Rougui (Cinnamomi Cortex), Shaoyao (Paeoniae Radix Alba), Banxia (Pinelliae Rhizoma Preparatum), Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparata), Wuzhuyu (Evodiae Fructus), Chenpi (Citri Reticulatae Pericarpium), Dahuang (Rhei Radix et Rhizoma) (equal parts).
Grind into fine powder. Take 1 qian per dose. Add 1 sheng of water, 3-5 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct until 0.7 sheng remains, remove dregs, and take warm.
Roudoukou Tang (Myristica Decoction) Treats hiccups and belching after sweating in Shanghan (Cold Damage).
Roudoukou (Myristicae Semen), Shilianrou (Nelumbinis Plumula stir-fried), Huixiang (Foeniculi Fructus) (each 1 liang); Renshen (Ginseng Radix), Dingxiang (Caryophylli Flos) (each 0.5 liang); Pipaye (Eriobotryae Folium) (5 leaves, brushed clean of hairs and roasted).
Cut finely. Add 4 sheng of water, 10 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct until 2 sheng remains, remove dregs, and take warm on an empty stomach. Divide into two doses.
Liangjiang Tang (Galangal Decoction)
Chenpi (Citri Reticulatae Pericarpium), Liangjiang (Alpiniae Officinarum Rhizoma), Guizhi (Cinnamomi Ramulus), Danggui (Angelicae Sinensis Radix) (each 1 liang); Mahuang (Ephedrae Herba) (0.5 liang); Xingren (Armeniacae Semen Amarum) (20 pieces); Gancao (Glycyrrhizae Radix et Rhizoma) (0.5 liang); Binglang (Arecae Semen) (3 pieces, ground separately into powder).
Cut finely. Add 4 sheng of water, 10 slices of Shengjiang (Zingiberis Rhizoma Recens), 3 dates (Dazao, Ziziphi Jujubae Fructus), decoct together until 2 sheng remains. Remove dregs, add the Binglang (Arecae Semen) powder, boil three more times, and drink one sheng all at once. If not stopped, take another dose. Elder Pang said: Unceasing hiccups in Shanghan (Cold Damage) indicate that the ascending and descending of Yin and Yang Qi are attempting to produce sweat. Ascending without descending causes Stomach Qi to rebel upward, resulting in unceasing hiccups. It is suitable to take this formula.