《金匮》痰饮篇曰∶水在肝，胁下支满，嚏而痛。徐注曰∶肝与少阳胆为表里，所以主
半表
半里者，水气乘之，阴寒内束，故少阳气上出，冲击而嚏，如伤风然。喻注曰∶火气冲鼻，
故嚏也。按《内经》肾主嚏，故凡太阳伤寒，寒气深入，随督入脑，为热所击，则嚏矣。太
阳与督，即少阴之部也，其脉皆与脑通。嚏者，寒热相激，逐于脉中，致脉内作痒，痒即突
出。徐曰寒束，喻曰火冲，其义一也，惟不言肝肾相通，而牵说少阳，殊属无稽。夫肝水见
嚏者，肝寒感于肾也。且嚏之来路有二∶因寒束肺窍，热气撩于肺中而上冲者，其气发于胸
中，上过上 之内，而下出于鼻也；因寒束督脉，热气激于脊膂而上冲者，其气起于腰俞，
循脊上出脑顶之巅，而下出于鼻也。一缕寒邪，孤行气脉，而不为正气所容，故冲击而出也
。本属微邪，不足为病，然见有早起，必嚏数十次，无间寒暑，而寒天较甚，妇人妊娠尤为
有碍，此不得为微邪矣。治法宜仿肝水例，宣达肝与膀胱之阳，与肺气相接，使水邪下伏，
宿寒外攘，即止。
《伤寒论》湿病篇，湿家下之早，则哕。此丹田有热，胸上有寒。又太阳篇，邪高痛下
，故
使其呕，小柴胡汤主之。邪者，伤寒之邪也；痛者，热之所郁而激也。又云∶伤寒胸中有热
，
胃中有邪气，腹中痛，欲呕吐，黄连汤主之。《脉经》平呕吐哕篇曰∶寒气在上，暖气在下
，二气相争，但出不入，其人即呕而不得食，恐怖即死，宽缓即瘥。朱丹溪曰∶呃逆，有痰
闭于上，火起于下，而不得伸越者。大凡人身四维有寒束之，气行横窍之出入不利，遂从直
窍上冲；又或寒压于上，热郁于下，气上升道狭，不如其常，则升气冲激，此皆作呕哕也。
若肠胃秘结，浊气上蒸，肝肾血热，火气上浮，而无寒遏于上者，不过愠愠欲吐，不至冲激
也。干呕与哕，证有轻重，而因无异同，前人剖析太过，转乱人意。(按∶上论呕哕，非论
吐也。吐之病，有因寒气从下上冲而然者，有因中焦胃热、肝热而然者，有因外风袭胃者。
)
《金匮要略》痰饮篇中说：水气停留在肝脏，胁肋下支撑胀满，打喷嚏时感到疼痛。徐忠可注解道：肝与少阳胆互为表里，所以主管半表半里部位的是胆经；水气侵袭了它，阴寒之气在内部束缚，导致少阳之气向上冲出，冲击而引发喷嚏，就像伤风一样。喻嘉言注解道：火气冲撞鼻腔，所以引发喷嚏。按《内经》所说，肾主司喷嚏，所以凡是太阳伤寒证，寒气深入体内，随着督脉进入脑部，被热邪所击，就会打喷嚏。太阳经与督脉，都属于少阴经的范畴，它们的经脉都与脑相通。打喷嚏，是寒热相互激荡，追逐于脉管之中，致使脉管内产生痒感，痒感强烈就突然喷出。徐氏说是寒邪束缚，喻氏说是火气冲撞，其道理是一样的，只是他们没有提到肝肾相通，反而牵强地解说少阳经，确实属于无稽之谈。肝经有水气而见打喷嚏的，是因为肝寒感应到了肾。况且打喷嚏的来源有两条路径：因寒邪束缚肺窍，热气撩动于肺中而上冲的，这股气发源于胸中，向上经过上脘穴所在区域，然后向下从鼻子出来；因寒邪束缚督脉，热气激惹于脊背而上冲的，这股气起于腰俞穴，沿着脊柱向上出于头顶百会穴处，然后向下从鼻子出来。一缕寒邪，独自在气脉中运行，不被正气所容纳，所以冲击而出。这本来属于轻微的邪气，不足以成为疾病，然而有的人早起必定要打几十个喷嚏，无论寒冬酷暑都不间断，而且寒冷天气时症状更重，妇女妊娠期间尤其受影响，这就不能算是轻微邪气了。治疗方法应当仿照治疗肝水的例子，宣通达散肝与膀胱的阳气，使其与肺气相接，使水邪向下潜伏，宿寒向外驱除，喷嚏自然停止。
《伤寒论》湿病篇说，湿病患者过早使用攻下法，就会出现呃逆（哕）。这是因为丹田有热，胸中有寒。又在太阳病篇中提到，病邪位置高而疼痛位置低，所以导致呕吐，用小柴胡汤主治。所谓“邪”，是指伤寒的病邪；所谓“痛”，是热邪郁结而激惹所致。又说：伤寒导致胸中有热，胃中有邪气，腹部疼痛，想要呕吐，用黄连汤主治。《脉经》平呕吐哕篇说：寒气在上部，暖气在下部，二气相互争斗，只有气出不进，病人就会呕吐且无法进食，如果惊恐就会死亡，情绪宽缓平和就会痊愈。朱丹溪说：呃逆，是有痰浊闭塞于上部，火气兴起于下部，而不能舒展越出的缘故。大凡人体四肢受寒邪束缚，气机在横向孔窍的出入不利，于是从直行的孔窍向上冲逆；或者又或寒邪压制于上部，热邪郁结于下部，气上升的道路狭窄，不如平常通畅，那么上升的气机冲激，这些都是造成呕吐和呃逆的原因。如果是肠胃秘结不通，浊气向上蒸腾，肝肾血分有热，火气上浮，而没有寒邪遏制于上方的，不过是心中烦闷想吐，不至于剧烈冲激。干呕与呃逆，病症有轻重的区别，但病因没有不同，前人分析得太过繁琐，反而扰乱了人们的理解。（按：以上论述呕吐和呃逆，并非论述吐症。吐症的病因，有因寒气从下向上冲逆而导致的，有因中焦胃热、肝热而导致的，有因外感风邪袭击胃腑而导致的。）
In the "Phlegm-Fluids" chapter of *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), it is stated: When water retention resides in the Liver, there is distending fullness under the hypochondrium, and sneezing causes pain. Xu Zhongke annotated: The Liver and Shaoyang Gallbladder are interior-exteriorly related; thus, the Gallbladder governs the half-interior and half-exterior aspect. When water qi invades it, Yin-cold binds internally, causing Shaoyang Yang to rush upward, striking and inducing a sneeze, similar to wind-cold injury. Yu Jiayan annotated: Fire qi rushes into the nasal cavity, hence the sneeze. According to the *Neijing*, the Kidney governs sneezing; therefore, in cases of Taiyang Cold Damage, when cold pathogen penetrates deeply, following the Du Mai (Governing Vessel) into the brain, and is struck by heat, sneezing occurs. The Taiyang Meridian and the Du Mai belong to the domain of the Shaoyin system, and their pulses all connect with the brain. Sneezing results from the mutual agitation of cold and heat, chasing within the vessels, causing an itching sensation inside the vessels; intense itching leads to sudden expulsion. Xu attributed it to cold binding, while Yu attributed it to fire rushing; their meanings are identical. However, they failed to mention the connection between the Liver and Kidney, instead forcing an explanation involving the Shaoyang, which is indeed baseless. When Liver-water manifests as sneezing, it is because Liver-cold responds to the Kidney. Furthermore, there are two pathways for sneezing: one where cold binds the Lung orifices, and hot qi agitates within the Lungs to rush upward; this qi originates in the chest, passes above the upper epigastrium, and exits downward through the nose. The other where cold binds the Du Mai, and hot qi agitates along the spine to rush upward; this qi arises at Yaoshu (BL23), follows the spine upward to the vertex of the head, and exits downward through the nose. A wisp of cold pathogen travels alone within the Qi vessels, not tolerated by healthy Qi, hence it strikes out. This originally belongs to minor pathogens, insufficient to cause disease. However, some individuals must sneeze dozens of times every morning, regardless of cold or heat, with symptoms worsening in cold weather, especially affecting pregnant women; this cannot be considered a minor pathogen. The treatment method should imitate that for Liver-water: diffuse and unblock the Yang of the Liver and Bladder, allowing them to connect with Lung Qi, so that water pathogens subside downward and old cold is expelled outward, thereby stopping the sneeze.
In the "Dampness Disease" chapter of *Shanghan Lun* (Treatise on Cold Damage Disorders), it states: If a dampness patient is purged too early, hiccups (Yue) will occur. This indicates heat in the Dantian and cold in the chest. In the Taiyang chapter, it says: The pathogen is high, pain is low, thus causing vomiting; Xiao Chai Hu Tang (Minor Bupleurum Decoction) is the primary formula. "Pathogen" refers to the cold damage pathogen; "pain" refers to heat stagnating and agitating. It also states: Cold damage causing heat in the chest and pathogenic factors in the stomach, abdominal pain, and desire to vomit; Huanglian Tang (Coptis Decoction) is the primary formula. In the "Ping Ou Tu Yue" chapter of *Maijing* (Pulse Classic), it says: Cold qi is above, warm qi is below; the two qi contend, only exiting without entering, the person vomits and cannot eat; if terrified, death ensues; if relaxed and calm, recovery occurs. Zhu Danxi said: Hiccups result from phlegm blocking the upper part and fire rising from the lower part, unable to extend and transcend. Generally, when the four extremities of the human body are bound by cold, the movement of Qi in the transverse orifices becomes unfavorable, so it rushes upward through the straight orifices; or again, if cold suppresses the upper part and heat stagnates in the lower part, the ascending pathway becomes narrow, less smooth than usual, causing the ascending Qi to strike; these are all causes of vomiting and hiccups. If intestinal and gastric constipation occurs, turbid Qi steams upward, Liver and Kidney blood heat causes fire Qi to float upward, without cold suppressing the upper part, there is merely a mild desire to vomit, not violent striking. Dry retching and hiccups differ in severity but share the same etiology; predecessors analyzed them too excessively, confusing people's understanding. (Note: The above discussion on vomiting and hiccups does not discuss spitting/vomiting food. The etiology of vomiting includes: cold Qi rushing up from below; middle Jiao Stomach heat and Liver heat; external Wind attacking the Stomach.)