病
胃中有火有痰。
一云∶噫气吞酸，此系食郁有热，火气冲上，用黄芩为君，南星、半夏、陈皮为佐，热多加青黛。
方
星半汤 治胃中有郁火，膈上有稠痰，故作嗳气。
南星 半夏 石膏 香附 栀子
上锉生姜煎，或作丸亦可。
软石膏丸 治食积痰火，并泻胃火。
软石膏不拘多少，研细。
上用醋糊丸，如绿豆大。每服二十丸，滚汤送下。
脉
右寸关紧而滑，两手弦滑，胸中有留饮；寸脉横者，膈上有横积也；右关弦急甚者，木乘土位，欲作胃反，难治。
病
夫嘈杂者，是痰因火动。其证似饥不饥，似痛非痛，如有懊
不自宁之状者是也。其证或兼嗳气，或兼恶心，渐至胃脘作痛，痰火之为患也。
治
治法以南星、半夏、橘红之类，以消其痰；芩、连、栀子、知母之类，以降其火；苍术、白术、芍药之
类，以健脾行湿，壮其本元；又当节欲，无有不安者也。
一肥人嘈杂，二陈汤加抚芎、苍术、白术、炒栀子。
一湿痰气滞不喜食、用三补丸，加苍术、倍香附。
方
化痰清火汤〔批〕（按此方治痰火嘈杂之剂） 治嘈杂。
南星 半夏 陈皮 苍术 白术 白芍 黄连 黄芩 栀子 知母 石膏 甘草
上锉，生姜三片煎服。
养血四物汤 治血虚嘈杂。
当归 川芎 白芍 熟地黄 人参 茯苓 半夏 黄连 栀子 甘草
上锉，生姜三片，煎服。去人参加香附、贝母，甚效。
茯苓补心汤〔批〕（按此方治血虚嘈杂之剂） 治妇人心胸嘈杂，气盛血衰者。
即参苏饮合四物汤。
[Pathogenesis]
There is fire pathogen and phlegm turbidity in the stomach.
Another view: Belching with acid regurgitation is caused by food stagnation leading to heat retention, with fire qi rushing upward. Treatment uses Huangqin (Scutellariae Radix) as the sovereign drug, Nanxing (Arisaematis Rhizoma), Banxia (Pinelliae Rhizoma), and Chenpi (Citri Reticulatae Pericarpium) as assistant drugs; if heat signs are severe, Qingdai (Indigo Naturalis) is added.
[Formulas]
Xingban Tang (Arisaema and Pinellia Decoction): Treats stagnant fire in the stomach and thick phlegm above the diaphragm, causing belching.
Ingredients: Tian Nansheng (Arisaematis Tuber), Banxia (Pinelliae Rhizoma), Shigao (Gypsum Fibrosum), Xiangfu (Cyperi Rhizoma), Zhizi (Gardeniae Fructus).
Preparation and Administration: The above herbs are cut into small pieces, decocted with fresh ginger, or can be made into pills.
Ruan Shigao Wan (Soft Gypsum Pill): Treats food accumulation with phlegm-fire and clears/stanches stomach fire.
Ingredients: Ruan Shigao (Soft Gypsum Fibrosum), quantity不拘 (unrestricted), ground into fine powder.
Preparation and Administration: Made into pills the size of mung beans using vinegar paste. Take 20 pills each time, washed down with boiling water.
[Pulse Diagnosis]
The right Cun and Guan pulses are tight and slippery; both hands show wiry and slippery pulses, indicating retained fluid (Liuyin, 留饮) in the chest; a horizontal Cun pulse indicates horizontal accumulation above the diaphragm; a severely wiry and urgent Guan pulse on the right indicates Wood overacting on Earth position, suggesting impending Weifan (Stomach Reversal/Vomiting of undigested food), which is difficult to treat.
[Pathogenesis]
"Zaot" (Clamoring/Discomfort) is caused by phlegm stirred by fire. The symptoms present as feeling hungry but not really, feeling painful but not really, resembling a state of inner restlessness and inability to find peace. This condition may be accompanied by belching or nausea, gradually progressing to epigastric pain; this is the harm caused by phlegm-fire.
[Therapeutic Methods]
Treatment methods involve using herbs such as Nanxing (Arisaematis Rhizoma), Banxia (Pinelliae Rhizoma), and Juhong (Tangerine Peel) to eliminate phlegm; using Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), and Zhimu (Anemarrhenae Rhizoma) to descend fire; using Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), and Shaoyao (Paeoniae Radix) to strengthen the spleen, remove dampness, and consolidate the root vitality; additionally, one should practice sexual moderation, ensuring stability.
Case 1: A corpulent patient presenting with Zaot was treated with Erchen Tang (Two-Aged Decoction) plus Fuxiong (Chuanxiong Rhizoma), Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), and Chao Zhizi (Fried Gardeniae Fructus).
Case 2: A patient with damp-phlegm and Qi stagnation, disliking food intake, was treated with Sanbu Wan (Three-Supplement Pill) plus Cangzhu (Atractylodis Rhizoma) and double the dose of Xiangfu (Cyperi Rhizoma).
[Formulas]
Huatan Qinghuo Tang (Phlegm-Resolving and Fire-Clearing Decoction) [Commentary: According to this commentary, this formula treats phlegm-fire Zaot]: Treats Zaot.
Ingredients: Tian Nansheng (Arisaematis Tuber), Banxia (Pinelliae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Baishao (White Peony Root), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), Gancao (Licorice Root).
Preparation and Administration: Cut into pieces, decoct with three slices of fresh ginger and take orally.
Yangxue Siwu Tang (Blood-Nourishing Four Substances Decoction): Treats blood deficiency causing Zaot.
Ingredients: Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligusticum Chuanxiong Rhizome), Baishao (White Peony Root), Shudihuang (Rehmanniae Radix Preparata), Renshen (Ginseng Radix), Fuling (Poria), Banxia (Pinelliae Rhizoma), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), Gancao (Licorice Root).
Preparation and Administration: Cut into pieces, decoct with three slices of fresh ginger and take orally. For better efficacy, remove Renshen (Ginseng Radix) and add Xiangfu (Cyperi Rhizoma) and Beimu (Fritillariae Thunbergii Bulbus).
Fuling Buxin Tang (Poria Heart-Nourishing Decoction) [Commentary: According to this commentary, this formula treats blood deficiency Zaot]: Treats heart and chest Zaot in women with excessive Qi and deficient Blood.
It is a combination of Shenqi Yin (Ginseng and Perilla Decoction) and Siwu Tang (Four Substances Decoction).