典藏书目

Ju Pi (Exocarpium Citri Reticulatae) two jin, Zhu Ru (Bambusa Textilis Caulis in Succo) two sheng, Da Zao (Fructus Jujubae) thirty pieces, Sheng Jiang (Rhizoma Zingiberis Recens) half a jin, Gan Cao (Radix Glycyrrhizae Preparata) five liang, Ren Shen (Radix Ginseng) one liang.
The above six ingredients are decocted with ten dou of water until three sheng remain. Take one sheng warm, three times daily.

[Collected Explanations]
Li [Name obscured] stated: Hiccups (Yue, 哕) may belong to stomach cold or stomach heat. This type of hiccup is caused by deficiency-heat in the stomach and rebellious qi. Therefore, Ren Shen (Radix Ginseng), Gan Cao (Radix Glycyrrhizae Preparata), and Da Zao (Fructus Jujubae) are used to tonify deficiency; Ju Pi (Exocarpium Citri Reticulatae) and Sheng Jiang (Rhizoma Zingiberis Recens) are used to scatter rebellious qi; Zhu Ru (Bambusa Textilis Caulis in Succo) is sweet and cold, capable of dispersing rebellious qi and clearing stomach heat, thus serving as the sovereign herb.
You Yi stated: When stomach deficiency allows heat to invade, hiccups occur. Ju Pi (Exocarpium Citri Reticulatae) and Sheng Jiang (Rhizoma Zingiberis Recens) harmonize the stomach and scatter rebellious qi; Zhu Ru (Bambusa Textilis Caulis in Succo) eliminates heat and stops vomiting and hiccups; Ren Shen (Radix Ginseng), Gan Cao (Radix Glycyrrhizae Preparata), and Da Zao (Fructus Jujubae) benefit deficiency and stabilize the middle jiao.

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For dry retching or hiccups accompanied by coldness of the hands and feet, Ju Pi Tang (Orange Peel Decoction) is the primary treatment.

[Annotation]
"Dry retching and hiccups" implies that dry retching here refers to hiccups. Dong Yuan considered dry retching mild and hiccups severe, recognizing Zhang Zhongjing's precise wording. Hiccups with cold extremities indicate stomach yang deficiency, which is the indication for Wu Zhu Yu Tang (Evodia Decoction). However, if it is an initial illness where both form and qi are excess, even with cold extremities, it differs from yin excess due to yang deficiency; rather, it is caused by qi closure preventing circulation to the four limbs. Therefore, only Ju Pi (Exocarpium Citri Reticulatae) is used to unblock qi, and Sheng Jiang (Rhizoma Zingiberis Recens) to stop hiccups.

[Collected Annotations]
Cheng Lin stated: Dry retching and hiccups indicate rebellious qi stagnating in the chest and diaphragm, failing to reach the extremities, hence the coldness of the hands and feet. Ju Pi (Exocarpium Citri Reticulatae) can descend rebellious qi, and Sheng Jiang (Rhizoma Zingiberis Recens) is the sage medicine for vomiting. A small dose is used to harmonize. However, dry retching is not regurgitation, and coldness does not imply loss of yang; thus, upon swallowing, qi flows and recovery occurs.

Ju Pi (Exocarpium Citri Reticulatae) four liang, Sheng Jiang (Rhizoma Zingiberis Recens) half a jin.
The above two ingredients are decocted with seven sheng of water until three sheng remain. Take one sheng warm; recovery follows immediately upon swallowing.

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In cases of hiccups accompanied by abdominal fullness, observe the anterior and posterior orifices to determine which part is obstructed; unblocking it will lead to recovery.

[Annotation]
Hiccups generally belong to deficiency pathogens. Hiccups without abdominal fullness indicate righteous qi deficiency; if accompanied by heat, Ju Pi Zhu Ru Tang (Orange Peel and Bamboo Sheath Decoction) is indicated; if accompanied by cold, Wu Zhu Yu Tang (Evodia Decoction) is indicated. Hiccups with abdominal fullness indicate excess pathogens. One must examine the bowel and urinary movements: if stool is difficult, purgation is used; if urination is difficult, diuresis is used, leading to recovery.

[Collected Annotations]
Zhu Gong stated: Obstruction in the anterior part (urine) is treated with Zhu Ling Tang (Polyporus Decoction); obstruction in the posterior part (stool) is treated with Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct Downward Decoction).
Zhao Liang stated: Abdominal fullness indicates excess; excess causes qi to rebel upward resulting in hiccups. Therefore, one must identify which of the anterior or posterior orifices is obstructed and unblock it, thereby removing fullness and stopping hiccups.
Wei Litong stated: Rebellious stomach qi surges upward causing hiccups; the treatment method requires observing the anterior and posterior orifices to assess whether urination and defecation are smooth. Obstruction in the anterior part (urine) indicates water pathogen rebellion; promoting urination cures the hiccups. Obstruction in the posterior part (stool) indicates heat pathogen excess; promoting defecation cures the hiccups.

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When the qi of the six fu organs fails externally, there is coldness of the hands and feet, rebellious qi ascending, and retraction of the legs; when the qi of the five zang organs fails internally, there is uncontrollable diarrhea; in severe cases, there is numbness of the hands and feet.

[Annotation]
"Qi failure" does not mean complete extinction, but extreme deficiency. The qi of the six fu organs is yang; when yang qi is deficient and cannot warm the exterior, the hands and feet become cold and retracted. Yang deficiency leads to yin excess and rebellion, causing vomiting and hiccups. The qi of the five zang organs is yin; when yin qi is deficient and cannot secure the interior, uncontrollable diarrhea occurs. Severe diarrhea leads to central collapse and physical decline, resulting in numbness of the hands and feet. This section elucidates the origins of vomiting and diarrhea.

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In cases of diarrhea with undigested food, internal cold with external heat, sweating, and cold extremities, Tong Mai Si Ni Tang (Pulse-Unblocking Four Reversal Decoction) is the primary treatment.

[Annotation]
Diarrhea with undigested food indicates internal cold. External heat, sweating, and cold extremities indicate the collapse of yang qi. Tong Mai Si Ning Tang (Pulse-Unblocking Four Reversal Decoction) is used to restore yang and overcome cold, thereby stopping the diarrhea.