Dingxiang Shidi Zhuru Tang for Intractable Hiccups After a Serious Illness
After a serious illness, many people are left with the after-effect of hiccups (belching). For example, after COVID, some patients develop stubborn hiccup symptoms, for which modern medicine has no corresponding management method. But this human reaction has existed since ancient times; in the Yifang Kaoyao (Examination of Medical Formulas) written by the Ming-dynasty physician Wu Kun, there is recorded a formula specifically for treating, after a serious illness, blockage of qi in the middle jiao with hiccups in the lower jiao. This formula is called Dingxiang Shidi Zhuru Tang.Dingxiang Shidi Zhuru Tang consists of Dingxiang (Clove) three grains, Shidi (persimmon calyx) and Zhuru (Bamboo shavings) each three qian (9 g), and Chenpi (aged tangerine peel) one qian (3 g). Method: decoct in water, strain off the dregs, and take warm twice daily.The TCM decoction-rhyme literature has a rhyme for this formula: Dingxiang shidi rensheng jiang, ehni yin han zhong qi shang. Jisheng xiang di jin er wei, huo jia zhu ju yong jie liang. This rhyme summarizes the indications and the modified variants of Dingxiang Shidi Zhuru Tang.The formula may consist of Dingxiang, Shidi, Renshen (Ginseng) and Shengjiang (Fresh Ginger), treating hiccups caused by stomach cold. The Dingxiang Shidi San in the Jisheng Fang uses only Dingxiang and Shidi to treat hiccups; on this basis, adding Zhu (Zhuru, bamboo shavings) and Ju (Jupi, tangerine peel, i.e. Chenpi) gives Dingxiang Shidi Zhuru Tang, which treats hiccups better than Dingxiang Shidi San alone.In this formula Dingxiang warms the middle and lowers counterflow, and supplements the kidney and assists yang; it is used for spleen-stomach deficiency-cold, hiccup and vomiting, poor appetite with vomiting and diarrhea, cold pain in the heart and abdomen, and kidney deficiency impotence. Shidi is the persimmon calyx, a specific herb for lowering counterflow and stopping hiccups. Zhuru clears heat and resolves phlegm, eliminates vexation and stops vomiting, and is a common herb for hiccups and vomiting. Chenpi is aged tangerine peel, which moves qi and fortifies the spleen, and dries dampness and resolves phlegm. The four herbs used together make the action of lowering counterflow and stopping vomiting even stronger. For those with spleen-stomach deficiency, Renshen can be added to supplement the spleen and stomach, and Shengjiang to warm and transform cold-phlegm.The specific cause of hiccups may be hard to pin down, but traditional medicine, which emphasizes symptomatic treatment, has a way to solve this problem. When we follow this method to relieve the patient suffering, the patient disease no longer exists.