Source 出处 · Jingui Yaolüe · Doses are not given here: they are set by a licensed practitioner for the individual.
Safety. Ju Pi Zhu Ru Tang is among the shortest formulas in this library — six ingredients, no minerals, no toxic herbs — and it comes from Jingui Yaolüe, in the chapter dealing with vomiting, hiccup and diarrhoea. Its line is a single clause: for hiccup and counterflow, Ju Pi Zhu Ru Tang governs. The classical word being treated, yue, covered hiccup and dry retching in Han-dynasty usage, and later commentators argued over the reading for centuries. That ambiguity is worth keeping rather than resolving, because the symptom this formula addresses is one that modern medicine also treats as trivial until it is not.
In composition, aged citrus peel leads, bamboo shavings clear, fresh ginger is the ingredient that would actually settle the diaphragmatic spasm in most modern eyes, and ginseng, jujube and honey-fried licorice rebuild the middle. It is a gentle formula by any standard, and the reason for including it here is not its gentleness but what hiccup can signify.
Hiccup lasting more than forty-eight hours is called persistent, and beyond a month intractable, and at that point it is a symptom with a long differential rather than an annoyance. It can arise from the stomach and oesophagus — reflux, hiatus hernia, gastric distension, candidal oesophagitis. It can arise from the chest and diaphragm — pneumonia, empyema, subphrenic abscess, anything irritating the phrenic nerve, and post-operative or post-anaesthetic states. It can be central: stroke, tumour, meningitis, demyelinating disease. It can be metabolic — renal failure, hyponatraemia, hypocalcaemia, diabetes. And it can be drug-induced, with digoxin, benzodiazepines, corticosteroids, dopamine agonists and several chemotherapy agents on the list. Intractable hiccup has been reported as the presenting feature of myocardial infarction and of aortic aneurysm. None of that is answered by six herbs; all of it is the reason a hiccup that will not stop belongs in front of a clinician.
Safety notes, proportionate to a formula this mild. Citrus peel is an agricultural product, and the practical concerns are pesticide residue and, where drying and storage have been poor, mould and aflatoxin; it is not in the same risk class as grapefruit, whose furanocoumarin burden is far higher. Bamboo shavings are the dried middle layer of the culm of Bambusa and related genera — the species is not fixed, and processed material is sometimes sulphured or bleached, which is a question to put to a supplier rather than a reason for alarm. Ginger in food amounts is unremarkable; concentrated ginger products carry antiplatelet reports and mixed warfarin evidence. Ginseng brings the same mixed anticoagulant and glucose-lowering cautions noted elsewhere. Honey-fried licorice, even in a small formula, is the ingredient with the real long-course issue: glycyrrhizin can produce low potassium, raised blood pressure and oedema, and that risk rises alongside diuretics, digoxin and corticosteroids. Jujube is a sugar-containing fruit, which is useful to know for anyone counting carbohydrate. This library does not present this formula as a treatment for hiccup of any named cause.
橘皮竹茹汤是本库最短的方剂之一 —— 六味药，无矿物，无毒药 —— 出自《金匮要略》「呕吐哕下利病脉证治」篇。它的原文只有一句：哕逆者，橘皮竹茹汤主之。所治的「哕」在汉代的用法里同时覆盖呃逆与干呕，后世注家为此争了上千年。这个歧义值得保留而不是替它裁断，因为这首方所对的那个症状，在现代医学里同样「小事一桩，直到不是」。
组成上，陈皮为君，竹茹清热，生姜才是今天多数人眼里真正止住膈肌痉挛的那一味，人参、大枣、炙甘草补中。按任何标准它都是一首温和的方。把它收进本库的理由不是温和，而是呃逆可能意味着什么。
持续超过四十八小时的呃逆称为持续性，超过一个月为顽固性；到这时它是一个鉴别清单很长的症状，而不是一件麻烦事。它可以来自胃与食管 —— 反流、食管裂孔疝、胃扩张、念珠菌性食管炎；可以来自胸与膈 —— 肺炎、脓胸、膈下脓肿、任何刺激膈神经的情况、术后与麻醉后状态；可以是中枢的 —— 卒中、肿瘤、脑膜炎、脱髓鞘疾病；可以是代谢性的 —— 肾衰竭、低钠、低钙、糖尿病；也可以是药物性的，地高辛、苯二氮卓类、糖皮质激素、多巴胺激动剂与若干化疗药都在名单上。顽固性呃逆曾被报道为心肌梗死与主动脉瘤的首发表现。这些没有一样是靠六味药回答的，而全部都是「止不住的呃逆该去见医生」的理由。
安全提示，与这首方的温和程度成比例地写。陈皮是农产品，实际顾虑是农药残留，以及干燥储存不良时的霉变与黄曲霉毒素；它不属于柚汁那一类风险，后者的呋喃香豆素负担高得多。竹茹是竹属及近缘属竹秆的干燥中间层，原植物并不固定，加工品有时经硫熏或漂白 —— 这是该向供应商提的问题，不是该惊慌的理由。食物量的生姜不算什么，浓缩姜制品有抗血小板作用的报告与混杂的华法林证据。人参带着同样的抗凝与降糖谨慎。炙甘草即使在小方里也是长期服用真正要紧的那一味：甘草酸可致低钾、血压升高与水肿，与利尿剂、地高辛、糖皮质激素同用风险更高。大枣是含糖果实，需要计算碳水化合物的人知道这一点有用。本库不声称此方治疗任何特定病因引起的呃逆。