〔大〕凡滞下病之稍久或欲愈之时，多有咳逆及呕逆之证。然咳逆者，古人之所谓
哕是也。哕者肾寒所生，此证最危，其他病亦恶咳逆，如见此证，宜用橘皮干姜汤、半
夏生姜汤、丁香柿蒂汤。若阳证咳逆者，小柴胡汤、橘皮竹茹汤。予尝治一痢疾咳逆不
止，六脉沉弱，诸医用药灼艾皆无效，仆投退阴散两服愈。又尝治许主簿痢疾愈后咳逆
不止，服诸药无效，遂灸期门穴，不三壮而愈。（穴见《针灸准绳》。）如有呕逆之证，《难经》
云∶无阴则呕。然多有胃热而呕，亦有胃寒而生，亦有暑毒而生，如胃热而呕，宜服小
柴胡汤、孙兆竹茹汤、芦根汤、官局桔梗汤、竹叶石膏汤加生姜主之。呕而发渴者，猪
苓汤，又尝治一痢后呕不止，六脉虚弱，此胃寒而呕，又似暑毒凝于胃脘，投《局方》香
薷丸而愈。
橘皮干姜汤 治哕。
橘皮 通草 干姜 桂心 甘草（各四钱） 人参（二钱）
上 咀，每服四钱，水一盏，煎至七分，去滓温服。
半夏生姜汤 治哕欲死。
半夏（一两一分，洗） 生姜（二两，切）
上以水二盏，煎至八分，去滓分为二服。
丁香柿蒂汤 治咳逆。
丁香（十粒） 柿蒂（十五枚）
上 咀，用水一盏半，煎至八分，去滓热服。
橘皮竹茹汤 治哕逆。
橘皮 甘草（各二两） 半夏（一两，汤洗） 人参（半两） 竹茹（一升）
上 咀，每服四钱，水二盏，生姜六片，枣一枚，煎至七分，去滓温服。
生姜橘皮汤 治干呕哕，若手足厥冷者。
橘皮（四两） 生姜（半斤）
上 咀，每服半两，水一盏，煎至七分，去滓温服。
退阴散 本治阴毒伤寒，手足逆冷，脉沉细，头痛腰重连进三服。小小伤冷，每服
一字，入正元散内同煎，加盐少许。阴毒伤寒咳逆，煎一服，细细热呷即止。
干姜 川乌头（各等分）
上为粗末，炒令黄色，候冷捣为末，每服一钱，水一盏，盐一捻，煎至半盏服。
猪苓汤 治咳而呕渴，心烦不得眠。
猪苓 赤茯苓 泽泻 阿胶（炒） 滑石（各半两）
上 咀，每服三钱，水一盏，煎候胶消尽服。
补遗仓廪汤 治痢疾心烦，手足温，头痛。如脾胃脉不弱，此乃毒瓦斯上冲心肺，所
呕哕而不食，宜仓廪汤。（即败毒散是。）
每服四钱，入陈仓米百粒，姜五片，枣一枚，煎温服。若脉微弱，或心腹虚胀，手
足厥逆，初病则不呕，因服罂粟、乌梅，苦涩过多，以致闻食先呕，此乃脾胃虚弱，用
山药一味，锉小豆大，一半生用，一半银瓦铫内炒熟，同为末，米饮调下。
又治噤口痢。以石莲子去壳留心并肉，为末，每二钱，陈米饮调下。此疾盖毒上冲心
肺，借此以通心气，便思食。
【大】凡是痢疾（滞下病）病程较长或即将痊愈的时候，常常会出现咳嗽气逆和呕吐气逆的症状。然而，这里的“咳逆”，就是古人所说的“哕”（呃逆）。哕是由于肾寒引起的，这种证候最为危重，其他疾病如果出现咳逆也属恶候，如见到此证，适宜使用橘皮干姜汤、半夏生姜汤、丁香柿蒂汤。如果是阳证引起的咳逆，则用小柴胡汤、橘皮竹茹汤。我曾经治疗过一个痢疾导致咳逆不止的患者，六脉沉弱，各位医生用药并施以艾灸都无效，我投用退阴散，服用两剂后痊愈。又曾治疗许主簿在痢疾痊愈后咳逆不止，服用各种药物无效，于是灸期门穴，不到三壮就痊愈了。（穴位详见《针灸准绳》）。如果有呕吐气逆的症状，《难经》说：“无阴则呕”。然而大多是因为胃热而呕吐，也有因胃寒而生，也有因暑毒而生。如果是胃热而呕吐，适宜服用小柴胡汤、孙兆竹茹汤、芦根汤、官局桔梗汤、竹叶石膏汤加生姜主治。呕吐且伴有口渴的，用猪苓汤。又曾治疗一个痢疾后呕吐不止的患者，六脉虚弱，这是胃寒导致的呕吐，又似乎有暑毒凝结在胃脘，投用《局方》香薷丸而痊愈。
橘皮干姜汤 治疗哕。
橘皮、通草、干姜、桂心、甘草（各四钱），人参（二钱）。
以上药材切碎，每次服用四钱，用水一盏，煎至七分，去渣温服。
半夏生姜汤 治疗哕欲死（剧烈呃逆）。
半夏（一两一分，洗净），生姜（二两，切片）。
以上用水二盏，煎至八分，去渣分为两次服用。
丁香柿蒂汤 治疗咳逆（呃逆）。
丁香（十粒），柿蒂（十五枚）。
以上切碎，用水一盏半，煎至八分，去渣热服。
橘皮竹茹汤 治疗哕逆。
橘皮、甘草（各二两），半夏（一两，热水洗），人参（半两），竹茹（一升）。
以上切碎，每次服用四钱，用水二盏，生姜六片，枣一枚，煎至七分，去渣温服。
生姜橘皮汤 治疗干呕哕，如果伴有手足厥冷者。
橘皮（四两），生姜（半斤）。
以上切碎，每次服用半两，用水一盏，煎至七分，去渣温服。
退阴散 原本治疗阴毒伤寒，手足逆冷，脉沉细，头痛腰重，连进三服。轻微受寒，每次服用一字，加入正元散内同煎，加少许盐。阴毒伤寒引起的咳逆，煎一服，细细热饮即止。
干姜、川乌头（各等分）。
以上研为粗末，炒至黄色，待冷捣为粉末，每次服用一钱，用水一盏，盐一捻，煎至半盏服用。
猪苓汤 治疗咳而呕渴，心烦不得眠。
猪苓、赤茯苓、泽泻、阿胶（炒）、滑石（各半两）。
以上切碎，每次服用三钱，用水一盏，煎至胶完全溶解后服用。
补遗仓廪汤 治疗痢疾心烦，手足温，头痛。如果脾胃脉不弱，这是毒瓦斯上冲心肺，所致的呕吐呃逆且不进食，适宜用仓廪汤。（即败毒散。）
每次服用四钱，加入陈仓米百粒，姜五片，枣一枚，煎温服。如果脉微弱，或心腹虚胀，手足厥逆，初病时不呕吐，因为服用罂粟、乌梅过多苦涩之品，以致闻到食物就先呕吐，这是脾胃虚弱，用山药一味药，锉成小豆大小，一半生用，一半在银瓦铫内炒熟，同为粉末，用米饮调下。
[Da] Generally, when dysentery (Zhi Xia Bing) has persisted for a long time or is approaching resolution, symptoms of coughing with reverse flow of Qi (Ke Ni) and vomiting with reverse flow of Qi often occur. However, "Ke Ni" here refers to what the ancients called "Yue" (Hiccup). Yue is caused by Kidney Cold; this syndrome is extremely critical, and even in other diseases, the appearance of Ke Ni is considered a malignant sign. If such a syndrome is observed, it is appropriate to use Jupi Ganjiang Tang (Tangerine Peel and Dried Ginger Decoction), Banxia Shengjiang Tang (Pinellia and Fresh Ginger Decoction), or Dingxiang Shidi Tang (Clove and Persimmon Calyx Decoction). For Ke Ni arising from Yang syndromes, Xiao Chaihu Tang (Minor Bupleurum Decoction) or Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction) should be used. I once treated a patient whose dysentery led to incessant hiccupping; his six pulses were deep and weak, and treatments by other physicians involving herbs and moxibustion were ineffective. I administered Tu Yin San (Retreat Yin Powder), and he recovered after two doses. I also treated Magistrate Xu, who suffered from incessant hiccupping after recovering from dysentery; various medications had failed. I then applied moxibustion to Qimen (LR14), and he was cured in less than three moxa cones. (See *Zhenjiu Zhunsheng* for acupoint details.) Regarding vomiting with reverse flow of Qi, the *Nan Jing* states: "Without Yin, there is vomiting." However, vomiting is mostly due to Stomach Heat, but can also arise from Stomach Cold or Summer-heat Toxin. If vomiting is due to Stomach Heat, it is appropriate to administer Xiao Chaihu Tang (Minor Bupleurum Decoction), Sun Zhao Zhuru Tang (Sun Zhao's Bamboo Shavings Decoction), Lugen Tang (Reed Rhizome Decoction), Guanju Jiegeng Tang (Official Bureau Platycodon Decoction), or Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) added with Fresh Ginger as the chief agent. If vomiting is accompanied by thirst, Zhuling Tang (Polyporus Decoction) should be used. I once treated a patient with incessant vomiting following dysentery; his six pulses were weak and deficient, indicating vomiting due to Stomach Cold, seemingly compounded by Summer-heat Toxin congealing in the Epigastrium. I administered Xiangru Wan (Mosla Pill) from the *Ju Fang*, and he recovered.
Jupi Ganjiang Tang (Tangerine Peel and Dried Ginger Decoction) treats Yue.
Chen Pi (Pericarpium Citri Reticulatae), Tongcao (Tetrapanacis Medulla), Gan Jiang (Rhizoma Zingiberis Preparatum), Guixin (Cortex Cinnamomi), Gancao (Radix Glycyrrhizae) [each 4 qian], Renshen (Radix Ginseng) [2 qian].
Crush the ingredients. Take 4 qian per dose, decoct in one sheng of water until reduced to 0.7 sheng, strain, and take warm.
Banxia Shengjiang Tang (Pinellia and Fresh Ginger Decoction) treats severe Yue.
Banxia (Rhizoma Pinelliae Preparatum) [1 liang 1 fen, washed], Shengjiang (Rhizoma Zingiberis Recens) [2 liang, sliced].
Decoct in two sheng of water until reduced to 0.8 sheng, strain, and divide into two doses.
Dingxiang Shidi Tang (Clove and Persimmon Calyx Decoction) treats Ke Ni (Hiccup).
Dingxiang (Flos Caryophylli) [10 pieces], Shidi (Calyx Diospyri) [15 pieces].
Crush the ingredients, decoct in 1.5 sheng of water until reduced to 0.8 sheng, strain, and take hot.
Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction) treats Yue Ni.
Chen Pi (Pericarpium Citri Reticulatae), Gancao (Radix Glycyrrhizae) [each 2 liang], Banxia (Rhizoma Pinelliae Preparatum) [1 liang, washed with boiling water], Renshen (Radix Ginseng) [0.5 liang], Zhuru (Spiritus Bambusae in Taenia) [1 sheng].
Crush the ingredients. Take 4 qian per dose, decoct with two sheng of water, 6 slices of Shengjiang (Rhizoma Zingiberis Recens), and one Jujuba (Fructus Ziziphi Jujubae) until reduced to 0.7 sheng, strain, and take warm.
Shengjiang Jupi Tang (Fresh Ginger and Tangerine Peel Decoction) treats Gan Ou (Dry Heaving) and Yue, especially when accompanied by cold extremities.
Chen Pi (Pericarpium Citri Reticulatae) [4 liang], Shengjiang (Rhizoma Zingiberis Recens) [0.5 jin].
Crush the ingredients. Take 0.5 liang per dose, decoct in one sheng of water until reduced to 0.7 sheng, strain, and take warm.
Tu Yin San (Retreat Yin Powder) originally treats Yin Du Shang Han (Yin-Toxic Cold Damage), characterized by cold extremities, deep and fine pulses, headache, and heavy sensation in the lower back. Administer three consecutive doses. For minor cold injuries, take one zi per dose, decoct together with Zhengyuan San (Zhengyuan Powder), adding a little salt. For Ke Ni caused by Yin-Du Shang Han, decoct one dose and sip slowly while hot to stop the symptom.
Gan Jiang (Rhizoma Zingiberis Preparatum), Chuan Wutou (Radix Aconiti Kusnezoffii Preparatum) [equal parts].
Grind into a coarse powder, stir-fry until yellow, cool, and grind into a fine powder. Take 1 qian per dose, decoct in one sheng of water with a pinch of salt until reduced to half a sheng, and take.
Zhuling Tang (Polyporus Decoction) treats cough with vomiting and thirst, restlessness, and inability to sleep.
Zhuling (Sclerotium Polypori), Chi Fuling (Poria cum Radice et Mycelium Rubrum), Zexie (Rhizoma Alismatis), Ejiao (Colla Corii Asini) [stir-fried], Huashi (Talcum) [each 0.5 liang].
Crush the ingredients. Take 3 qian per dose, decoct in one sheng of water until the Ejiao is completely dissolved, and take.
Buyi Canglin Tang (Supplement to Canglin Decoction) treats dysentery with restlessness, warm extremities, and headache. If the Spleen/Stomach pulse is not weak, this indicates Toxic Qi rushing upward to the Heart and Lungs, causing vomiting, hiccupping, and anorexia. It is appropriate to use Canglin Tang (which is Baidu San/Deficiency-Dispelling Powder).
Take 4 qian per dose, add 100 grains of Chen Cang Mi (Old Rice), 5 slices of Ginger, and one Jujuba. Decoct and take warm. If the pulse is weak and minute, or if there is empty distension in the heart and abdomen, and cold extremities, and initially no vomiting occurs, but later vomiting arises upon smelling food due to excessive consumption of astringent substances like Yingsu (Poppy Shell) and Wumei (Fructus Mume), this indicates Spleen/Stomach deficiency. Use Shan Yao (Rhizoma Dioscoreae) alone, cut into pieces the size of adzuki beans. Half raw, half stir-fried in a silver pot until cooked. Grind into powder and take mixed with Rice Drink.
It also treats Jin Kou Li (Anorexic Dysentery). Use Shi Lian Zi (Fructus Nelumbinis Cum Plumula) with shell removed, keeping the plumule and flesh, grind into powder. Take 2 qian per dose, mixed with Old Rice Drink. This disease is generally caused by toxic Qi rushing upward to the Heart and Lungs; this remedy helps unblock Heart Qi, thereby restoring appetite.