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The *Xuanming Wuqi Pian* (Chapter on Five Qi and Their Pathological Manifestations) states: Among the diseases caused by the five qi, the Heart corresponds to belching.

The *Maijie Pian* (Chapter on Pulse Resolution) states: What Taiyin refers to as "qi moving upward to the Heart causing belching" occurs because yin qi is excessive and moves upward to invade the Yangming channel. Since the collaterals of Yangming connect to and belong to the Heart, it is said that qi moves upward to the Heart causing belching.

The *Jingmai Pian* (Chapter on Meridian Channels) states: When the Foot-Taiyin Spleen channel is diseased, the root of the tongue becomes stiff, vomiting occurs after eating, epigastric pain arises, abdominal distension occurs with frequent belching, and upon defecation or passage of flatus, one feels relieved as symptoms subside.

The *Kouwen Pian* (Chapter on Questions Concerning the Mouth) asks: Why do people belch? What qi causes this? The answer is: Cold qi lodges in the Stomach, rebellious qi rises from below and scatters upward, then emerges from the Stomach, thus causing belching.

The *Yinyang Bie Lun* (Treatise on Differences Between Yin and Yang) states: When Er-Yang (Yangming) and Yi-Yin (Jueyin) are involved in disease onset, the main symptoms include fright, back pain, frequent belching, and frequent yawning; this condition is named Fengjue (Wind-Jue).

The *Bi Lun* (Treatise on Bi Syndrome) states: In Xinbi (Heart Bi), blood vessels are obstructed. When vexation occurs, there is palpitation in the lower chest like drumbeating; sudden upward rushing of qi leads to panting, dry throat, and frequent belching.

The *Sanbu Jiuhou Lun* (Treatise on Three Regions and Nine Palpations) states: If there are seven types of critical illnesses and the pulse conditions are also deteriorated, death will ensue, inevitably accompanied by hiccups and belching.

The *Zhihen Yao Da Lun* (Great Treatise on the Most Essential Truths) states: When Jueyin Wind-Wood governs the Earthly Branches, wind excess prevails, and the people suffer from obstruction in the diaphragm and pharynx, vomiting after eating, abdominal distension with frequent belching, relief upon defecation or flatus, and heaviness of the body. When Taiyang Cold-Water governs the Heavenly Stem, cold excess prevails, and the people suffer from discomfort in the chest, hypochondrium, and epigastrium, red face, yellow eyes, frequent belching, dry throat; in severe cases, dark complexion, thirst, and desire to drink, with the disease root lying in the Heart. When Shaoyin Fire experiences a return (rebound), internal heat arises, external edema appears, along with hiccups and belching.

The *Sishi Cini Cong Lun* (Treatise on Following or Opposing Needling According to Seasons) states: When needling the Zang organs, if the Heart is punctured, death occurs within one day, and the sign of movement is belching.

The *Zhunao Jingzhong Lun* (Treatise on Key Points for Meridian Termination) states: When Taiyin qi terminates, abdominal distension and closure prevent breathing, accompanied by frequent belching and vomiting.

(The *Neijing* does not mention "nausea"; all vomiting syndromes belong to this category. Detailed scriptural meanings are found in this section, totaling three entries.)

Nausea syndrome refers to the rebellion of stomach qi and a feeling of unsettled restlessness in the epigastrium. Whenever nausea with the urge to vomit occurs, saliva flows in the mouth, cannot be swallowed, and swallowing exacerbates the nausea, leading subsequently to vomiting. There are also cases where vomiting does not occur but nausea is intermittent. Although called nausea, this is actually a disorder of the Stomach, not the Heart. The causes of this syndrome include cold, food stagnation, phlegm-fluid retention, foul odors, fire pathogens, damp-cold injuring the Stomach, or pathogens such as cold damage, malaria, and dysentery residing in the Stomach. To investigate, one need only examine deficiency/excess and cold/heat. For nausea caused by excess pathogens, cessation occurs once the pathogen is expelled; onset is rapid, and recovery is swift. For nausea caused by deficiency pathogens, recovery requires significant restoration of Stomach qi. Moreover, eight or nine out of ten cases are deficiency-cold. Even when nausea is due to excess pathogens, it is invariably because Spleen qi is weak and fails to transform and transport. Therefore, treating nausea requires recognizing deficiency within excess and avoiding reckless attacking methods, while never neglecting the protection of Stomach qi.

1. Deficiency-Cold Nausea: This is the most common type. If it is not acute/sudden but chronic, or occurs in individuals with insufficient form and qi, it is due to weak Stomach qi. Treatment should primarily focus on warming and tonifying. If mild Spleen-Stomach deficiency generates phlegm, or if accompanied by acid regurgitation, belching of rotten food, cough, and nausea, Liu Junzi Tang (Six Gentlemen Decoction) is suitable. If Spleen and Kidney deficiency-cold cause phlegm stagnation, cough, and nausea, Jinshui Liujun Jian (Golden Water Six Gentlemen Decoction) is indicated. If Spleen-Stomach deficiency-cold causes spontaneous diarrhea, abdominal pain, vomiting, and nausea associated with Taiyin, Wenyin Yin (Warming Stomach Decoction), Lizhong Tang (Regulate the Middle Decoction), or Shengzhu Jian (Holy Atractylodes Decoction) may be used. If Spleen and Kidney deficiency-cold impair upper and lower circulation, causing distension, vomiting, or persistent nausea/vomiting due to Cold Damage Yin syndromes with deep penetration into the Three Yin channels, Liyin Jian (Nourishing Yin Decoction) or Wenyin Yin (Warming Stomach Decoction) are appropriate.

2. Excess Pathogen Nausea: Caused by temporary pathogenic stagnation invading the Stomach; vomiting expels the stagnation, resolving the nausea. If residual pathogens remain, treat according to the method above. If nausea involves much phlegm, wind-cold cough, injury from raw/cold foods, or excessive alcohol consumption leading to Spleen-Stomach disharmony, Erchen Tang (Two Old Decoction) or Chupi Banxia Tang (Tangerine Peel and Pinellia Decoction) are suitable. If Spleen-Stomach has much stagnation, or cold-dampness injures the Spleen causing nausea, Pingwei San (Level the Stomach Powder) is indicated. If Stomach cold with much stagnation, injury from raw/cold foods, unclear cold-phlegm, acid regurgitation, distension, and nausea occur, Hewei Yin (Harmonize Stomach Decoction) or Hewei Erchen Jian (Harmonize Stomach Two Old Decoction) are used. If foul turbid cold pathogens cause distension, abdominal pain, and nausea, Tiaoqi Pingwei San (Regulate Qi Level the Stomach Powder) is indicated. If summerheat-heat contraction with fire excess causes vexation and nausea, Zhongjing's Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction by Zhang Zhongjing) is used. If nausea results from Chinese herbal toxicity or other poisons, seek treatment methods in the respective toxicology sections immediately.