二者古人不甚分别。如东垣谓二者皆气不足。戴复庵谓短气者，呼吸不来，
语言无力，宜补虚。于进药外，选壮盛人，吸气嘘其口中以助之。此与《素问》
谓怯然少气者，言而微，终日乃复言，此气夺也，乃少气不足以言，有以异乎？是
以二者同属之虚也。亦有分短气为实者，如仲景论胸痹短气为实，（是痞满篇。）又论短
气皆属于饮，（见痰饮篇。）是以短气为实也。盖水饮痰食诸实邪，足以阻碍正气，气本
不少，因为邪阻上壅而呼吸喘急，（古人多以短气为喘可见。）不得如平气之舒和悠长，故谓
之短耳。此但去其邪，邪去气自舒矣，须分别观之。
即《经》所云噫气，由气不得舒，故嗳以出之，理与呃逆通。彼则气闭而逆冲，
自作响以出；此则气滞而不冲，故藉噫以出之也。《经》以心为噫。《痹论》所谓心
痹者，脉不通，烦则心下鼓，暴上气而喘，嗌干善噫。又谓刺中心一日死，其动为
噫者，是也。（王太仆解心噫之义，谓象火炎上，烟随焰出。）又属脾气不舒，《经》所谓太阴腹胀
善噫者是也，观饱食则嗳可见。
即《内经》所谓哕，气自下冲上而呃呃作声也。《经》谓∶诸逆冲上，皆属于
火。然必有所闭遏乃然，有为寒气所闭者，有为热气所闭者，有为水饮痰食及血，
诸有形之物所闭者。景岳譬之雨中之雷，（阳为阴蔽，奋出于地而有声也。）水中之 ，（气为水覆，
上出为 ， 作声。）深得其理。予尝吸烟入喉，胃口乍闭，每每作呃，故知热气亦能闭
也。丹溪治陈超越，因饱食后奔走，（络伤血内溢矣。）患呃逆。但食物则呃百余声，（食物质
浊，血之属也。）半日不止，饮酒与汤则不作，（酒、水质清，气之属也。）至晚发热，（血属阴，血病故
夜发。）脉涩数。以血入气中治之，（犹云血覆气上。）用桃仁承气汤（见血）加红花煎服，下污血
数次而愈。又治一女子，大吐顽痰而愈。故知血食痰，皆能闭也。有发于中焦者，
脾胃之气被闭也；有发于下焦者，肝肾之气被闭也。气为阳，阳属火，治须撤闭散
火，而有实火虚火之分。实者利之、清之、散之；虚者补之。无病而呃者，不必治
也。即治不过用《内经》刺鼻取嚏，或闭息不令出入，或惊之之法，皆可立已。若
有病而呃者，形气壮实，别无恶候，审其致闭之邪去之，亦即已。惟病重得此，多
为气脱。凡见其呃自丹田而上，久久乃一声，（密频相连者为实，久久一声者为虚。）通身
振动者，即是危候，恐难治矣。（此先天命门真火欲脱，多不救。）与黑锡丹，灸关元。伤寒吐
汗下后，与泻利日久误服寒凉者，理中汤（见中寒。）产后，丁香散。伤寒热病，便燥脉
数，承气汤（见大便不通。）气为寒闭，未郁成热者，柿钱散、丁香柿蒂散、羌活附子汤。
气逆而虚者，陈皮竹茹汤。痰饮者，二陈汤、导痰汤（并见痰）加姜汁、竹沥。阳虚自汗
者，参附汤。阴虚火炎者，参附煎汤，下大补阴丸。偶然呃一二日不止者，木香调
气散（见中气）。灸法∶男左女右，乳下黑尽处一韭叶许，灸三壮，甚者二七壮。
短气与少气，古人在概念上并未严格区分。例如李东垣认为二者皆属于气虚。戴复庵认为短气的表现是呼吸不畅、语言无力，治疗应当补益虚损。除了用药之外，还可以选择身体强壮的人，让其对着患者的口中吸气并吹嘘，以此来辅助正气。这与《素问》中提到的“怯然少气”，表现为说话声音微弱，整天才能再说几句话，这是气被夺失的表现，即少气导致不足以言语，这二者有区别吗？因此，二者同属于虚证。也有将短气归为实证的，如张仲景论述胸痹引起的短气属于实证（见于痞满篇），又论述短气多由饮邪引起（见于痰饮篇），因此将短气视为实证。大概是因为水饮、痰浊、食积等实邪，足以阻碍正气，正气本身并不虚弱，只是因为邪气阻滞、上壅而导致呼吸喘急（古人常将短气等同于喘证），不能像正常气息那样舒缓悠长，所以称之为短。这种情况只需去除邪气，邪去则气自舒展，必须分别看待。
这就是《内经》所说的噫气，由于气机不得舒展，所以通过嗳气将其排出，其机理与呃逆相通。呃逆则是气机闭塞而逆冲向上，自然发出声响；而噫气则是气机郁滞而不逆冲，所以借助嗳气将其排出。《内经》认为心主噫气。《痹论》中说心痹的症状是脉道不通，心烦时感到心下悸动，突然气逆而上喘，咽喉干燥，容易嗳气。又说针刺中心脏一天会死亡，其动的表现为嗳气，指的就是这种情况。（王冰注解心主噫气的含义，认为是象火炎上，烟雾随火焰冒出。）另外，噫气也属于脾气不舒，《内经》所说太阴病腹胀且容易嗳气就是这种情况，观察饱食后容易嗳气即可明白。
这就是《内经》所说的哕（呃逆），气从下向上冲逆而发出呃呃的声音。《内经》说：各种气逆冲上的病症，都属于火。但是必须有闭遏的因素才会如此，有的是被寒气闭遏，有的是被热气闭遏，有的是被水饮、痰浊、食积及瘀血等有形之物闭遏。张景岳比喻为雨中的雷声（阳气被阴气遮蔽，奋力冲出地面而发出声音），水中的气泡（气被水覆盖，向上冒出形成气泡并发出声音），深得其中道理。我曾经吸烟入喉，胃口突然闭塞，常常发生呃逆，所以知道热气也能导致闭遏。朱丹溪治疗陈超越，因为饱食后奔走（导致络脉损伤，血液内溢），患上呃逆。只要进食就会呃逆百余声（食物性质浊重，属于血的范畴），半天不止，但饮酒或喝汤就不会呃逆（酒和水性质清轻，属于气的范畴），到了晚上发热（血属阴，血病故夜间发作），脉象涩而数。用治血入气中的方法（意为血覆于气之上），使用桃仁承气汤（见血证）加入红花煎服，排出污血数次后痊愈。又治疗一名女子，因吐出顽固痰涎而痊愈。所以知道血、食、痰都能导致闭遏。呃逆有发于中焦的，是脾胃之气被闭遏；有发于下焦的，是肝肾之气被闭遏。气属阳，阳属火，治疗需要撤除闭遏、疏散火邪，而有实火和虚火之分。实证采用通利、清热、发散的方法；虚证采用补益的方法。没有疾病而偶尔呃逆的，不必治疗。即使治疗，也不过是用《内经》的方法刺鼻取嚏，或者屏住呼吸不让气出入，或者惊吓患者的方法，都可以立即停止。如果有病而呃逆，形体和气机壮实，没有其他恶候，审察导致闭遏的邪气并去除它，也会立即停止。只有在重病中出现此症，多为气脱。凡是看到呃逆从丹田向上发起，很久才发出一声（密集频繁相连的为实证，很久才发出一声的为虚证），全身振动的，就是危重征候，恐怕难以治愈了。（这是先天命门真火欲脱，大多无法救治）。给予黑锡丹，灸关元穴。伤寒经过吐、汗、下法治疗后，或者泻利日久误服寒凉药的，使用理中汤（见中寒证）。产后呃逆，使用丁香散。伤寒热病，大便干燥脉数的，使用承气汤（见大便不通）。气被寒邪闭遏，尚未郁结成热的，使用柿钱散、丁香柿蒂散、羌活附子汤。气逆且虚的，使用陈皮竹茹汤。痰饮导致的，使用二陈汤、导痰汤（并见痰饮证）加入姜汁、竹沥。阳虚自汗的，使用参附汤。阴虚火炎的，用参附煎汤送服大补阴丸。偶然呃逆一二日不止的，使用木香调气散（见中气证）。灸法：男性灸左侧，女性灸右侧，乳头下方黑色毛发尽处，约一韭菜叶大小的范围，灸三壮，严重的灸十四壮。
Shortness of breath (Duan Qi) and insufficient breath (Shao Qi) were not strictly distinguished by ancient physicians. For instance, Li Dongyuan considered both to be due to Qi deficiency. Dai Fu'an stated that shortness of breath is characterized by difficulty in breathing and weak voice, and should be treated by tonifying deficiency. In addition to herbal medicine, one could select a robust person to inhale and exhale into the patient's mouth to assist the Zheng Qi (Upright Qi). Does this differ from what *Su Wen* describes as "timid insufficient breath" (Qie Ran Shao Qi), where speech is faint and can only resume after a whole day, indicating that Qi has been depleted, resulting in insufficient breath to speak? Thus, both belong to deficiency syndromes. However, some classify shortness of breath as excess. For example, Zhang Zhongjing discussed shortness of breath in Chest Bi (Xiong Bi) as an excess syndrome (see Pi Man chapter), and also stated that shortness of breath often belongs to fluid retention (see Tan Yin chapter), thus treating shortness of breath as excess. This is because pathogens such as water-fluids, phlegm, and food stagnation can obstruct Zheng Qi. The Qi itself is not deficient, but due to obstruction and upward congestion by pathogens, respiration becomes panting (ancients often equated shortness of breath with panting), preventing it from being smooth and prolonged like normal Qi; hence it is called "short." In such cases, once the pathogen is removed, the Qi naturally relaxes; therefore, they must be distinguished.
This refers to Yiqi (belching) mentioned in the *Jing* (*Neijing*), where Qi fails to diffuse smoothly and is expelled via belching. Its mechanism is similar to Hui Ni (hiccups). In hiccups, Qi is blocked and rushes upward, producing sound naturally; in belching, Qi is stagnant without rushing, so it is expelled through belching. The *Jing* associates belching with the Heart. The *Bi Lun* states that in Heart Bi, the vessels are obstructed; when vexed, there is palpitation under the heart, sudden upward Qi rush with panting, dry throat, and frequent belching. It also states that puncturing the Heart leads to death within one day, with the manifestation being belching. Wang Bing explained that the Heart governs belching because it resembles fire flaming upward, with smoke following the flame. Additionally, belching is associated with Spleen Qi stagnation; the *Jing* mentions that Taiyin disease involves abdominal fullness and frequent belching, which can be observed after overeating.
This refers to Yue (hiccups) in the *Neijing*, where Qi rushes upward from below, producing a "he-he" sound. The *Jing* states: "All rebellious Qi rushing upward belongs to Fire." However, there must be obstruction for this to occur. Obstruction may be caused by Cold-Heat, or by tangible substances such as water-fluids, phlegm, food, and blood. Zhang Jingyue compared it to thunder in rain (Yang obscured by Yin, struggling out of the earth to make sound) or bubbles in water (Qi covered by water, rising up to form bubbles and making sound), capturing the essence well. I once inhaled smoke into my throat, causing sudden closure of the Stomach gate, leading to frequent hiccups; thus, I know that Heat can also cause obstruction. Danxi treated Chen Chaoyue, who developed hiccups after running following a heavy meal (damaging collaterals and causing internal bleeding). Every time he ate, he hiccuped over a hundred times (food is turbid, belonging to Blood); it lasted half a day without stopping. However, drinking wine or soup did not trigger hiccups (wine and water are clear, belonging to Qi). By evening, he had a fever (Blood is Yin, so Blood pathology manifests at night), with a choppy and rapid pulse. Treating it as Blood invading Qi (Blood covering Qi), he used Taoren Chengqi Tang (see Blood) with Honghua (Safflower), decocted and administered. After passing foul blood several times, he recovered. He also cured a young woman by expelling stubborn phlegm. Thus, Blood, Food, and Phlegm can all cause obstruction. Hiccups may originate in the Middle Jiao, where Spleen and Stomach Qi are obstructed; or in the Lower Jiao, where Liver and Kidney Qi are obstructed. Qi is Yang, and Yang belongs to Fire. Treatment requires removing obstruction and dispersing Fire, distinguishing between Excess Fire and Deficiency Fire. Excess is treated with purgation, clearing, and dispersing; Deficiency is treated with tonification. Hiccups occurring without disease require no treatment. Even if treated, methods from the *Neijing* such as stimulating sneezing by poking the nose, holding breath, or startling the patient can stop it immediately. If hiccups occur with disease, and the constitution is strong without other ominous signs, identifying and removing the obstructing pathogen will stop it. However, in severe illness, hiccups often indicate Qi collapse. If hiccups rise from the Dantian and occur infrequently (frequent and connected indicates Excess; infrequent indicates Deficiency), accompanied by whole-body tremors, it is a critical sign, likely untreatable (indicating collapse of the primordial Fire of the Mingmen, usually fatal). Administer Heixi Dan and moxa Guanyuan. After Han Syndrome treatments involving vomiting, sweating, or purging, or after prolonged diarrhea due to misusing cold herbs, use Lizhong Tang (see Cold Syndrome). Postpartum hiccups are treated with Dingxiang San. In Han Syndrome heat diseases with dry stool and rapid pulse, use Chengqi Tang (see Constipation). If Qi is closed by Cold without transforming into Heat, use Shiqian San, Dingxiang Shidi San, or Qianghuo Fuzi Tang. For rebellious Qi with deficiency, use Chenpi Zhuru Tang. For Phlegm-Fluids, use Erchen Tang or Daotan Tang (see Phlegm) with Jiangzhi (Ginger Juice) and Zhuli (Bamboo Sap). For Yang deficiency with spontaneous sweating, use Shenfu Tang. For Yin deficiency with flaming Fire, use Shenfu decoction to swallow Dabu Yin Wan. For occasional hiccups lasting one or two days, use Muxiang Tiaoqi San (see Middle Qi). Acupuncture/Moxibustion method: For men, treat the left side; for women, the right side. Moxa an area the size of a leek leaf at the point where black hair ends below the nipple. Three moxa cones for mild cases, fourteen for severe cases.