胃虚为哕名吃噫。（吃、声哑语难也。噫胸气饱。出息。）多因吐下缘虚极。（古人方书无吃字。惟有哕。朱肱以哕
者吃气也。）橘皮干姜退阴散。或灸乳下皆得力。（灸法见活人书。并良方中。）又有阳明小柴胡。视其前后部何如。（仲
景云。伤寒。哕而渴者。视其前后。知何部不利。利之则愈。）因虚攻热必生哕。仲景言之岂妄欤。（仲景云。其人本虚。
攻其热必哕。哕火外切。又于月切。逆气也。）更有一证欲作汗。阴阳升降致屯如。胃气上逆无休止。逡巡中汗自然除。
（庞安常说。）
实则谵语虚郑声。两般相似最难明。（仲景云。实则谵语。虚则郑声。郑声者重语也。直视谵语而喘满者死。下利不
止亦死矣。）大小便利手足冷。更兼脉细是虚形。（此郑声之证也。）脉来洪数二便秘。谵语为因实得名。谵语证。本非一。
或因下利或胃实。（仲景云。下利而谵语为有燥屎。承气汤主之。又云。阳明病。其人多汗。津液外出。胃中燥。大便必
坚。坚者谵语。承气汤主之。）三阳合病或瘀血。或者热入于血室。（仲景云。三阳合病。腹满身重。难以转侧。口中不
仁。谵语又云。胁下满如结胸状。其人谵语。此皆热入血室。）大抵发热阳脉生。反见阴脉斯为逆。（谵语发热。见阳脉
者生。见阴脉者死。）
胃气虚弱导致的呃逆称为“吃噫”。（“吃”指声音嘶哑、言语困难；“噫”指胸中饱胀之气向外排出。）这多是因为剧烈呕吐或腹泻导致正气极度虚弱所致。（古人的医方书籍中没有“吃”这个字，只有“哕”。朱肱认为“哕”就是吃气的表现。）橘皮干姜汤可以驱散阴寒。或者艾灸乳下的穴位也都能见效。（艾灸的方法见《活人书》，以及《良方》中也有记载。）还有阳明病或少阳病的小柴胡汤证，需要观察患者前后二便的情况如何。（张仲景说：伤寒病中，出现呃逆且口渴的，要观察其前阴和后阴，知道哪一部分不通利，通利它就能痊愈。）因为正气虚弱而误用攻下热邪的方法，必然会导致呃逆。张仲景这样说是不会错的。（张仲景说：病人本来体质虚弱，如果攻伐其热邪，必然会导致呃逆。“哕”音huì，又音yue，指气逆上冲。）另外还有一种情况是想要出汗，由于阴阳升降失调导致气机阻滞。胃气上逆没有停止的时候，不久之后自然会通过出汗而解除。（庞安常这样说。）
实证表现为谵语，虚证表现为郑声。这两种症状相似，最难分辨清楚。（张仲景说：实证则谵语，虚证则郑声。郑声是指语言重复啰嗦。如果眼睛直视、谵语并且伴有气喘胸闷的是死证；如果伴有腹泻不止也是死证。）大小便通畅但手足冰冷，再加上脉象细微，这是虚证的征象。（这是郑声的证候。）脉象来势洪大快速，且大小便闭塞不通，谵语是因为实证而得名。谵语的证候，本就不止一种，有的因为腹泻（伴燥屎），有的因为胃腑实热。（张仲景说：腹泻却出现谵语，说明体内有燥屎，用承气汤主治。又说：阳明病，病人汗出多，津液外泄，胃中干燥，大便必然坚硬，大便坚硬的会出现谵语，用承气汤主治。）三阳合病或者有瘀血，或者是热邪侵入血室。（张仲景说：三阳合病，腹部胀满、身体沉重，难以翻身转侧，口中感觉麻木不仁，出现谵语。又说：胁下胀满像结胸的样子，病人谵语，这都是热邪侵入血室的表现。）大体上说，发热且脉象为阳脉者预后良好，反而见到阴脉则是逆证。（谵语伴发热，见到阳脉者生，见到阴脉者死。）
Hiccups caused by Stomach deficiency are named "Chi Yi" (stuttering and belching). ("Chi" refers to hoarseness and difficulty in speaking; "Yi" refers to the expulsion of fullness from the chest.) This is mostly due to extreme deficiency resulting from severe vomiting or purging. (Ancient medical texts do not contain the character "Chi," only "Yue." Zhu Gong considered "Yue" as the sound of eating air.) Juhui Ganjiang Tang (Tangerine Peel and Dried Ginger Decoction) can dispel Yin cold. Alternatively, moxibustion on acupoints below the nipple is also effective. (Moxibustion methods are seen in *Huoren Shu* and *Liang Fang*.) There is also the Shaoyang disease pattern treated with Xiaochaihu Tang (Minor Bupleurum Decoction); one must observe the condition of the anterior and posterior orifices. (Zhang Zhongjing said: In Shanghan disease, if hiccups occur with thirst, observe the anterior and posterior orifices to determine which part is obstructed; unblocking it will lead to recovery.) If heat is attacked while the body is deficient, hiccups will inevitably arise. Zhang Zhongjing's words are not baseless. (Zhang Zhongjing said: If a person is originally deficient and their heat is aggressively cleared, hiccups will result. "Yue" implies rebellious Qi moving upward.) Furthermore, there is a syndrome where sweat is about to emerge, but the ascent and descent of Yin and Yang cause stagnation. When Stomach Qi rebels without cessation, sweat will naturally appear after a short while to resolve the issue. (As Pang Anchang stated.)
Excess patterns manifest as Dan Yu (delirious speech), while deficiency patterns manifest as Zheng Sheng (murmuring speech). The two are similar and hardest to distinguish. (Zhang Zhongjing said: Excess leads to delirious speech; deficiency leads to murmuring speech. Murmuring speech involves repetitive utterances. Fixed staring with delirious speech accompanied by asthma and chest fullness indicates death; persistent diarrhea also indicates death.) If urination and defecation are normal but hands and feet are cold, combined with a fine pulse, this is a sign of deficiency. (This is the presentation of Zheng Sheng.) If the pulse comes in a surging and rapid manner, accompanied by constipation of both bowels and bladder, delirious speech is named for its excess etiology. Delirious speech syndromes are not uniform; they may arise from diarrhea (with dry stool) or Stomach excess. (Zhang Zhongjing said: Diarrhea with delirious speech indicates the presence of dry fecal matter, treated with Chengqi Tang. He also said: In Yangming disease, excessive sweating causes fluid loss, leading to dryness in the Stomach and hard stools; hardness results in delirious speech, treated with Chengqi Tang.) It may also occur in concurrent diseases of the Three Yang, or due to blood stasis, or when heat enters the Blood Chamber. (Zhang Zhongjing said: Concurrent disease of the Three Yang presents with abdominal fullness, body heaviness, difficulty turning over, insensitivity in the mouth, and delirious speech. He also said: Fullness under the ribs resembling Jie Xiong syndrome, with delirious speech, all indicate heat entering the Blood Chamber.) Generally, fever with Yang pulses indicates survival; conversely, seeing Yin pulses is an adverse sign. (Delirious speech with fever: seeing Yang pulses indicates life, seeing Yin pulses indicates death.)