Dr. Xu Fu believes that hiccup is mainly characterized by root deficiency and manifestation excess, and the manifestation excess refers to stomach qi ascending counter flow and disturbing the diaphragm. “Symptomatic treatment in acute condition” is necessary to regulate the counter flow qi and relieve the acute condition, and it is suggested to apply the method of qi ascending and descending by needle twirling and rotating at Zusanli (ST 36). “Descending” is leading yang qi of the superficial layer to go deep, while “ascending” is leading yin qi of the deep layer to go outward. Such combination of reinforcement and reduction can free channels and collaterals, descend qi counter flow to stop hiccup, supplement the deficiency of spleen and stomach, as well as regulate exuberance and debilitation of yin, yang, qi and blood. The disease mainly locates on the Yangming Stomach Channel of Foot, involving the abdomen and thoracic diaphragm. Zusanli (ST 36), Zhongwan (CV 12), Neiguan (PC 6) and Yifeng (TE 17) are the main acupoints for treating the disease, and they should be modified according to syndromes. For up-flaming of stomach fire, Neiting (ST 44) is added. For liver depression and qi stagnation, Taichong (LR 3) is added. For spleen-stomach deficiency, Pishu (BL 20) and Weishu (BL 21) are added. For stomach cold and indigestion, Jianli (CV 11) is added. Pay attention to the order of needling acupoints. Needle Zusanli (ST 36), Zhongwan (CV 12), Neiguan (PC 6) and Yifeng (TE 17) in sequence. For severe symptoms, cupping at back transport points and treatment at auricular acupoints can be applied additionally. The auricular acupoints are mainly Ge (HX 1), Shenmen (TF 4), Pi (CO 13) and Wei (CO 4).

Case: Mr. Li, 76 years old. He underwent gastrectomy for gastric cancer 1 year ago, and has repeated hiccup for one month. Manifestations: short voice hiccup, short of breath, distending pain under the diaphragm, frequent qi counter flow and nausea, red tongue with little coat, thread and weak pulse. It was the syndrome of deficiency of both qi and yin. Treatment was benefiting stomach, engendering fluid and regulating qi to harmonize spleen and stomach. Acupoints: Zhongwan (CV 12), Neiguan (PC 6), Zusanli (ST 36), Yifeng (TE 17) and Sanyinjiao (SP 6). Among them, qi ascending and descending by needle twirling and rotating at Zusanli (ST 36) was applied 3 times, perpendicular insertion of needle at the other acupoints was performed, and the needles were retained for 30 min. After removing the needles, cupping at Geshu (BL 17), Pishu (BL 20) and Weishu (BL 21) was performed, with retaining the cups for 5 min. The patient felt the symptoms were relieved after the treatment. Continuous treatment for 3 days stopped his hiccup, and no recurrence after 10 times of treatment.