经曰∶太阳所谓上走心为噫者（嗳气也），阴盛而上走阳明，阳明络属心为噫。又曰∶胃中伏火
，膈上停痰，令人嗳气。是证多因胃气不和，窒塞不通。脉右关弱短，左关弦大，肝盛脾虚，治
宜健胃消滞，清痰降火。
主方 陈皮 半夏 茯苓 白术 香附（各一钱） 藿香 黄连（姜炒） 砂仁（各六分）
木香 炙草（各三分） 加姜、枣煎。
寒加白蔻、益智、浓朴；热加栀子（炒）、石膏（ ）；虚，人参；气实，枳实、槟榔。
半夏丸 治痰火嗳气。
半夏 南星（并姜制） 软石膏 香附子 栀子（等分）
上为末，神曲糊和丸桐子大，每服七十丸，食远，白汤送下。
经曰∶岁金太过咳逆；余郁之发咳逆。若胃火上冲而逆随口应。起于上膈者易治；若脐下上
冲直出于口者，阴火上冲难治。俗名打呃是也。脉浮缓者顺，弦急者逆。治宜顺气为先，久者清
火。
主方 冷呃 丁香 柿蒂 良姜 官桂 半夏（姜炒） 陈皮 木香（磨） 藿香 沉香（
磨） 茴香 浓朴（姜汁炒） 砂
仁乳香（另研，等分） 甘草（减半） 上加枇杷叶三片，姜三片，水煎成。调木、沉、乳香
服。
寒极脉沉肢冷，加附子、干姜，去良姜、官桂。
热逆汤 治发热、烦渴、便秘、脉数、热呃。
黄芩 栀子 柿蒂 陈皮 香附（盐水炒） 连翘 白芍药 半夏（各一钱） 砂仁 藿香（
各六分） 甘草（三分） 加莲肉七个，乌梅一个，竹茹一团，水煎服。痰加茯苓、贝
母；气虚并久痢，加人参、白术、茯苓；阴火，黄连、黄柏、滑石。
蓝玉散 治火邪上炎，肺金受克，欲悲而呃。
六一散（方见暑门） 加青黛、薄荷末，灯心汤调下。或黄连解毒汤（方见火门）。
简便方 雄黄末（一钱），温水服即止。或柿蒂（十五个）、白盐梅（半个），水煎服。
寒呃∶丁香、柿蒂（各二钱），煎服。呃、呕、哕，半夏（半两）、生姜（一两），水煎作
二服。
又 吴萸（泡）、青橘叶（各二钱），姜三片，煎服。或陈皮、枳壳、半夏煎服。
又 川椒末，面糊丸，桐子大，二十丸白汤下。
伤寒呃（见本门）。
痰呃∶半夏（十四枚） 猪牙皂角（一条，炙，研） 姜五片煎服，得吐痰出妙。
又 食盐（一两） 湿草纸包，煨红去纸，以河水三碗，入盐滚数沸，温饮探吐。
灸法 男左乳下（一寸余动处灸），女右乳下起肉处。艾炷麦大，三壮。气海，脐下寸半。
《黄帝内经》中说：太阳经的病邪向上走于心，表现为嗳气（即打嗝、胃气上逆），这是因为阴寒之气过盛，向上侵犯阳明经，而阳明经的络脉归属于心，从而引发嗳气。又说：胃中有潜伏的火邪，膈间有停聚的痰饮，会导致人出现嗳气。这种病症多因胃气不和，气机阻滞不通所致。诊察时，右手关脉弱而短，左手关脉弦而大，这是肝气旺盛而脾气虚弱的表现，治疗应当以健运脾胃、消食导滞、清化痰热、降火为主。
主方：陈皮、半夏、茯苓、白术、香附（各一钱），藿香、黄连（用姜汁炒）、砂仁（各六分），木香、炙甘草（各三分）。加入生姜、大枣煎服。
若属寒证，加白豆蔻、益智仁、厚朴；若属热证，加栀子（炒）、石膏；若属虚证，加人参；若气实（气滞严重），加枳实、槟榔。
半夏丸：治疗痰火引起的嗳气。
组成：半夏、天南星（均用姜汁炮制）、软石膏、香附子、栀子（等量）。
以上药物研为细末，用神曲糊制成梧桐子大小的丸剂，每次服用七十丸，饭后不久，用白开水送服。
《黄帝内经》又说：岁金太过之年，易发咳逆；其余气郁发作之时也会咳逆。如果是胃火上冲，气逆随口而出。病势起于上膈部的容易治疗；如果气从脐下上冲，直出于口，这是阴火上冲，难以治疗。这就是俗称的“打呃”（呃逆）。脉象浮缓者为顺证，脉象弦急者为逆证。治疗应以顺气为先，病程久者需清火。
主方 冷呃方：丁香、柿蒂、高良姜、官桂、半夏（姜汁炒）、陈皮、木香（磨汁）、藿香、沉香（磨汁）、小茴香、厚朴（姜汁炒）、砂仁、乳香（另研，以上等分）、甘草（减半）。上加枇杷叶三片、生姜三片，水煎成汤。调入木香、沉香、乳香的药末服用。
若寒极，脉沉肢冷，加附子、干姜，去掉高良姜、官桂。
热逆汤：治疗发热、烦渴、便秘、脉数、热性呃逆。
组成：黄芩、栀子、柿蒂、陈皮、香附（盐水炒）、连翘、白芍药、半夏（各一钱），砂仁、藿香（各六分），甘草（三分）。加莲子肉七个、乌梅一个、竹茹一团，水煎服。若有痰，加茯苓、贝母；若气虚并伴有久痢，加人参、白术、茯苓；若是阴火，加黄连、黄柏、滑石。
蓝玉散：治疗火邪上炎，肺金受克，想哭却发出呃逆声。
组成：六一散（方见暑门章节），加青黛、薄荷末，用灯心草汤调服。或者使用黄连解毒汤（方见火门章节）。
简便方：雄黄末（一钱），温水送服即可止住。或者用柿蒂（十五个）、白盐梅（半个），水煎服。
寒性呃逆：丁香、柿蒂（各二钱），煎服。呃逆、呕吐、哕逆，用半夏（半两）、生姜（一两），水煎分两次服。
又方：吴茱萸（浸泡）、青橘叶（各二钱），生姜三片，煎服。或者用陈皮、枳壳、半夏煎服。
又方：川椒末，用面糊制成梧桐子大小的丸剂，每次二十丸，白开水送服。
伤寒引起的呃逆（见本门章节）。
痰性呃逆：半夏（十四枚）、猪牙皂角（一条，炙后研末）、生姜五片，煎服，若能吐出痰液则疗效更佳。
又方：食盐（一两），用湿草纸包裹，煨至发红后去掉纸，用三碗河水，放入盐煮沸数次，温饮以催吐。
灸法：男性在左乳下一寸余跳动处施灸，女性在右乳下隆起处施灸。艾炷如麦粒大小，灸三壮。穴位也可选气海穴，位于脐下寸半处。
The *Classic of Difficult Issues* (Jing Yue) states: When the pathogen of the Taiyang (Greater Yang) channel ascends to the Heart, it manifests as Yi (belching/stomach qi rebelling). This occurs because Yin-cold excess ascends to invade the Yangming (Yang Brightness) channel; since the Yangming collaterals connect to the Heart, belching ensues. It is also stated: latent fire in the Stomach and retained phlegm above the Diaphragm cause individuals to belch. This syndrome is mostly due to disharmony of Stomach Qi, with obstruction and blockage preventing smooth flow. Pulse examination reveals a weak and short pulse at the Right Guan position, and a wiry and large pulse at the Left Guan position, indicating Liver excess and Spleen deficiency. Treatment should focus on strengthening the Stomach, resolving stagnation, clearing phlegm, and descending fire.
Main Formula: Chenpi (Tangerine Peel), Banxia (Pinellia Rhizome), Fuling (Poria), Baizhu (Atractylodes Macrocephala Rhizome), Xiangfu (Cyperus Rhizome) (each 1 qian); Huoxiang (Patchouli Herb), Huanglian (Coptis Rhizome, stir-fried with ginger juice), Sharen (Amomum Fruit) (each 6 fen); Muxiang (Costus Root), Zhigancao (Prepared Licorice Root) (each 3 fen). Add Shengjiang (Fresh Ginger) and Dazao (Jujube), decoct and take.
If cold predominates, add Baixiaren (White Cardamom Seed), Yizhiren (Alpinia Oxyphylla Fruit), Houpo (Magnolia Bark); if heat predominates, add Zhizi (Gardenia Fruit, stir-fried), Shigao (Gypsum Fibrosum); if deficiency, add Renshen (Ginseng Root); if Qi excess (stagnation), add Zhishi (Immature Bitter Orange), Binglang (Areca Seed).
Banxia Wan (Pinellia Pill): Treats belching caused by Phlegm-Fire.
Ingredients: Banxia (Pinellia Rhizome), Nanting (Arisaema Cum Bile, both processed with ginger juice), Ruangao (Soft Gypsum), Xiangfuzi (Cyperus Rhizome), Zhizi (Gardenia Fruit) (equal parts).
Grind the above into powder, mix with paste made from Shenqu (Medicated Leaven) to form pills the size of paulownia seeds. Take 70 pills per dose, shortly after meals, washed down with warm water.
The *Classic* also states: In years of excessive Metal Qi, Ke Ni (cough/rebellious Qi) occurs; during outbreaks of pent-up Qi, Ke Ni also occurs. If Stomach Fire rushes upward, rebellious Qi follows the mouth's opening. If the rebellion originates from the Upper Diaphragm, it is easy to treat; if Qi rushes up from below the navel directly out of the mouth, this is Yin Fire rushing upward, which is difficult to treat. This is commonly known as "Da E" (hiccups). A floating and moderate pulse indicates a favorable prognosis, while a wiry and rapid pulse indicates an unfavorable one. Treatment should prioritize smoothing Qi; for chronic cases, clear Fire.
Main Formula for Cold Hiccups: Dingxiang (Caryophylli Flos), Shidi (Diospyri Fructus), Liangjiang (Galangal Rhizome), Guongui (Cinnamon Twig), Banxia (Pinellia Rhizome, stir-fried with ginger juice), Chenpi (Tangerine Peel), Muxiang (Costus Root, grated juice), Huoxiang (Patchouli Herb), Chenxiang (Aquilaria Lignum), Huixiang (Foeniculum Fructus), Houpo (Magnolia Bark, stir-fried with ginger juice), Sharen (Amomum Fruit), Ruxiang (Olibanum, separately ground, all equal parts), Gancao (Licorice Root, halved amount). Add three leaves of Pipaye (Loquat Leaf) and three slices of Shengjiang (Fresh Ginger), decoct in water. Mix in the powders of Muxiang, Chenxiang, and Ruxiang before taking.
If extreme cold with deep pulse and cold limbs, add Fuzi (Aconite Lateral Root Preparata) and Ganjiang (Dried Ginger), remove Liangjiang and Guongui.
Rebellious Heat Decoction (Niyi Tang): Treats fever, irritability and thirst, constipation, rapid pulse, and heat-type hiccups.
Ingredients: Huangqin (Scutellaria Root), Zhizi (Gardenia Fruit), Shidi (Diospyri Fructus), Chenpi (Tangerine Peel), Xiangfu (Cyperus Rhizome, stir-fried with salt water), Lianqiao (Forsythia Fruit), Shaoyao (White Peony Root), Banxia (Pinellia Rhizome) (each 1 qian); Sharen (Amomum Fruit), Huoxiang (Patchouli Herb) (each 6 fen); Gancao (Licorice Root) (3 fen). Add seven Lotus Seeds (Lianrou), one Smoked Plum (Wumei), and a ball of Zhuru (Bamboo Shavings), decoct in water and take. If phlegm is present, add Fuling (Poria) and Beimu (Fritillaria Bulb); if Qi deficiency with chronic dysentery, add Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria); if Yin Fire, add Huanglian (Coptis Rhizome), Huangbai (Phellodendron Bark), Huashi (Talcum).
Lan Yu San (Blue Jade Powder): Treats Fire Evil rising upward, suppressing Lung Metal, causing hiccups accompanied by a desire to weep.
Ingredients: Liuyi San (Six-to-One Powder, formula seen in Summer-heat section), add Qingdai (Indigo Naturalis) and Bohe (Mint Leaf) powder, taken with Dengxin Tang (Juncus Decoction). Alternatively, use Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity, formula seen in Fire section).
Simple Prescription: Xionghuang (Realgar) powder (1 qian), taken with warm water stops hiccups immediately. Or use Shidi (Diospyri Fructus) (15 pieces), Baiyanmei (White Salted Plum) (half piece), decoct in water and take.
Cold Hiccups: Dingxiang (Caryophylli Flos), Shidi (Diospyri Fructus) (each 2 qian), decoct and take. For hiccups, vomiting, and yue (dry heaving), use Banxia (Pinellia Rhizome) (0.5 liang), Shengjiang (Fresh Ginger) (1 liang), decoct in water and divide into two doses.
Another prescription: Wuyu (Evodia Fruit, soaked), Qingjuye (Green Tangerine Leaf) (each 2 qian), Shengjiang (Fresh Ginger) (3 slices), decoct and take. Or use Chenpi (Tangerine Peel), Zhiqiao (Bitter Orange Fruit), Banxia (Pinellia Rhizome), decoct and take.
Another prescription: Chuanjiao (Sichuan Pepper) powder, made into pills with flour paste the size of paulownia seeds. Take 20 pills with warm water.
Hiccups due to Cold Damage (see this section).
Phlegm Hiccups: Banxia (Pinellia Rhizome) (14 pieces), Zhuya Zaojiao (Gleditsia Sinensis Fruit, roasted and ground) (one strip), Shengjiang (Fresh Ginger) (5 slices), decoct and take. It is beneficial if phlegm is vomited out.
Another prescription: Yan (Salt) (1 liang), wrapped in wet straw paper, roasted until red, then remove paper. Add to three bowls of river water, boil with salt for several boils, drink warm to induce vomiting.
Moxibustion Method: For males, moxa on the moving point approximately 1 cun below the left nipple; for females, on the raised area below the right nipple. Use wheat-sized moxa cones, three moxibustions. Acupoint Qihai (Sea of Qi), located 1.5 cun below the umbilicus.