Hiccup is an involuntary spasm of the glottis and diaphragm, causing thecharacteristic sound. Occasional attack of hiccup suggests a mild case and canbe removed without medication, but if it persists, treatment is required. Hiccup is mostly caused by irregular diet, stagnation of the liver qi and presence of cold in the stomach, leading to upward perversion of the stomach qi instead of descending.

Etiology and Pathogenesis

Irregular food intake causes failure of the stomach qi to descend, or emotional frustration stagnates the liver qi, leading to upward perversion of the stomach qi.

The attack of the stomach by cold, overeating of raw and cold food, or taking drugs of cold nature gives rise to retaining of the stomach yang and upward perversion of qi.


Retention of food:

Main manifestations: Loud hiccups, epigastric and abdominal distension, anorexia, thick, sticky tongue coating, rolling and forceful pulse.

Analysis: Retention of food in the stomach disturbs the function of the spleen and stomach in transportation and transformation and impedes the qi activities in the middle jiao. The stomach is in normal function when its qi descends. Failure of its qi to descend may lead to loud hiccups, epigastric and abdominal distension, and anorexia. Thick, sticky tongue coating, and rolling, forceful pulse are the signs of retention of food.

Stagnation of qi:

Main manifestations: Continual hiccups, distending pain and feeling of oppression in the chest and hypochondrium, thin tongue coating, string - taut and forceful pulse.

Analysis: The liver qi, if stagnated, will attack the stomach, causing upward perversion of stomach qi, therefore, hiccup, distending pain in the chest and hypochondrium, and feeling of oppression appear. String - taut and forceful pulse is a sign of stagnation of qi due to depression of the liver.

Cold in the stomach:

Main manifestations: Slow and forceful hiccups which may be relieved by heat and aggravated by cold, discomfort in the epigastria, white, moist tongue coating, slow pulse.

Analysis: The stomach qi fails to descend because of stagnated cold, so hiccup is forceful. In case of disturbance of the stomach qi, discomfort in the epigastria occurs. If cold gets heat, smooth circulation of qi results, and then hiccup is relieved ; but if cold gets worse, hiccup is aggravated. White, moist tongue coating and slow pulse indicate the presence of cold in the stomach.



Accumulation of Cold in Stomach

Deep long forceful hiccup, pain in Stomach (discomfort) is relieved by warmth and induced by cold, T- white moist coat, P- slow

P/T – warm mid Jiao, expel Cold, descend Stomach Qi


  • Rx – sedate, moxa, foot yangming, hand jueyin
  • *RN22 - *MH6 - *BL17 - *ST36 - RN12 - LR 13 - BL20 - BL21 - RN4
  • nausea, vomit, acid reflux: ST21

Explanation.  RN22 descends Qi.  MH6 is connected to yinwei which opens the chest and diaphragm.  BL17 is the ge shu.

Stomach Fire up-surging

Loud clear forceful hiccups, bad breath, thirst for cold drinks, dry stools and/or constipation, P- slippery rapid, T- red, with yellow coat

P/T – clear and purge Stomach Fire, descend Stomach Qi


  • Rx – foot yangming, hand jueyin
  • *RN22, *BL17, *ST36, *MH6, ST25, ST44, LI4, SP4 & MH4 (nausea- Chong)
  • bitter taste or dry mouth: ST43


Qi and Phlegm stagnation

Continuous hard to stop hiccups (can sometimes lead to vomiting), induced by emotional stress, poor appetite, nausea, gas, belching, chest fullness, T- thin greasy coat, P- wiry slippery
Liver attack Spleen that causes Phlegm.

P/T – regulate Qi, transform Phlegm, harmonize Stomach Qi


  • *RN22, *MH6, *ST36, *BL17, LR14, GB43, ST40, GB34
  • Dizziness: DU20, GB20


Spleen Stomach Yang deficiency

Deep weak low tone hiccup, pale face, cold limbs, poor appetite, fatigue, cold body, P- deep thin, T- white coat

P/T – warm mid Jiao, harmonize Stomach Qi


  • Rx – tonify, moxa, foot yangming, hand jueyin
  • *RN22, *MH6, *ST36, * BL17, RN12, BL20, BL21, RN6
  • Cold lower back: RN4 & RN8 (moxa and needle)


Stomach Yin deficiency

short intermittent quick hiccups, dry mouth and tongue, irritable, dry stool, T- red, cracked, scanty dry coat, P- thin rapid

P/T – nourish Stomach Yin and fluids, descend Stomach Qi

Acupuncture Rx – tonify,

  • *RN 22, *MH 6, *ST 36, *BL 17, 21, RN 12, KI 3 or 6
  • poor appetite – RN 10, SP 3


Alternative treatment methods

  • Auricular – mid ear, shenmen, subcortex, ST LR SP
  • Tricks – try to make person sneeze, shock them, hold breath, drink appropriate temperature water, push on eyeball, push with thumb on BL 2 for 5 minutes, SI 11 for 5 minutes, push down on RN 22 for 1 minute while person holds breath, push TH 17 until it hurts
  • Scalp acupuncture – St region, chest region electro – RN 12, ST 36 moxa – direct
  • Injection – vitamin B1 in Hua tou from T5-T7, BL 17, RN 12, ST 36, MH 6, RN 22
  • Always perform treatment from head to toe (top to bottom) to bring down Qi