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**Clanging Stomach (Zaochao) and Acid Regurgitation (Tunsuan)** belong to the same category of diseases. They are all caused by the **Liver Qi** (Liver Qi) failing to disperse smoothly, leading to Wood Qi carrying **Ministerial Fire** (Xianghuo) to invade the **Spleen** (Pipi) and **Stomach** (Weixi). This prevents the essence of grains from being transported normally, causing turbid fluids to accumulate and transform into **Phlegm** (Tan) and **Fluid Retention** (Yin). These phlegms also turn sour due to the transformation of Wood Qi. The agitation of Liver Wood disturbs the Middle Jiao (Earth), causing restlessness in the Middle Jiao, resulting in a sensation of clanging stomach that resembles hunger. Patients often seek food to relieve themselves. If they eat a small amount, the clanging subsides temporarily but recurs when eating stops. This is because the Earth is deficient and cannot withstand the shaking of Wood. Therefore, the treatment method must tonify the Spleen and transform Phlegm. When the Earth is thick and capable of bearing things, the Wind-Wood will naturally settle, and there is no need to use herbs that attack the Liver. **Liujunzi Tang** (Six Gentlemen Decoction) is the specific prescription for this condition. If excessive Fire causes acidity, add **Wuzhuyu** (Evodiae Fructus) and **Chuanlianhua** (Coptidis Rhizoma). If one does not first resolve stagnation and tonify Earth, but instead insists on attacking Phlegm, it will eventually lead to deficiency and inevitably transform into diseases such as **Regurgitation** (Fangwei), diarrhea, epigastric fullness, and dizziness.

If clanging occurs after meals, accompanied by the sour and foul smell of undigested food and mental restlessness, **Baohe Wan** (Preserve Harmony Pill) is indicated. For damp-phlegm obstructing Qi mechanism with loss of appetite, take 2 qian of Baohe Wan mixed with 1 qian of **Yueju Wan** (Soar Above Pill). If the pulse is surging and large, indicating excess Fire, use **Erchen Tang** (Two Aged Herbs Decoction) added with Gardenia (Shanzhi) stir-fried with ginger juice and Coptis (Chuanlian). If the pulse is slippery and large, indicating excess Phlegm, use **Daotan Tang** (Guiding Phlegm Decoction) added with Scutellaria (Huangqin), Coptis (Chuanlian), and Gardenia (Shanzhi). If the pulse is wiry and thin with physical fatigue, use Liujunzi Tang added with **Chuanxiong** (Chuanxiong Rhizoma), **Atractylodes Macrocephala** (Cangzhu), and Gardenia stir-fried with ginger juice. If ineffective, combine with **Zuojin Wan** (Assist Metal Pill). There are also cases where excessive use of digestive and purgative herbs leads to hunger without ability to eat, and gradual decline in spirit; here, **Sijunzi Tang** (Four Gentlemen Decoction) added with White Peony Root (Baishao), Tangerine Peel (Chenpi), and Coptis stir-fried with ginger juice is used. For a sensation of emptiness in the heart resembling hunger, do not give food immediately when the desire to eat arises. Instead, regularly take 3 parts of **Zhizhu Wan** (Immature Bitter Orange and Atractylodes Pill) mixed with 1 part of **Yiqing Wan** (Suppress Green Pill). Fluid retention in the Zhongwan area causes clanging, while retained food causes acid regurgitation; thus, patients often burp with a rotten odor and swallow acid water. Some vomit a few mouthfuls of acid water every morning, have no other symptoms during the day, but feel acid-heat in the chest diaphragm; these are all caused by the lack of clarity in the Middle Jiao. Taking Yueju Wan combined with Zuojin Wan is most effective. Women with depression often suffer from this syndrome; Xiaoyao San taken with Zuojin Pill is suitable. For clanging, burping, and epigastric fullness caused by Yin deficiency of Kidney and Liver, where Qi cannot be grasped and returned to its origin, the pulse will be choppy and weak. If Bu Zhong Yi Qi Tang and Erchen Tang are ineffective, use **Sishen Wan** (Four Spirits Pill) added with Coptis before sleep, and **Liuwei Dihuang Wan** (Six Ingredient Pill with Rehmannia) added with Agarwood (Chenxiang) early in the morning.

**Burping (Ai Qi)** Burping belongs to the obstruction of Qi in the Stomach, where Qi fails to circulate freely and forces its way upward. However, if burping results from overeating and emits a smell like rotten eggs, one should identify the offending food and apply digestive methods. It may also result from weak Stomach Qi unable to digest food; in such cases, tonification and digestion should be combined, and pure purgatives should not be used.

**Belching/Hiccups (Yi/KT)** When the fluids and Qi in the Stomach are exhausted, belching/hiccups occur. If belching/hiccups happen frequently in daily life, it is a precursor to **Regurgitation** (Fangwei) and should not be ignored.