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The syndrome of acid regurgitation is caused by the encroachment of Liver Wood (Liver dysfunction or Qi stagnation) upon Spleen Earth (Spleen and Stomach function). Why is there a distinction between Yin and Yang? It is unknown that although the Liver Meridian belongs to Yin in Five Elements theory, the Liver contains Ministerial Fire. This fire attacks the Spleen and Stomach, thereby dividing the condition into Yin and Yang categories.

Generally speaking, when the Spleen is invaded by Liver Fire, it mostly belongs to the Yin syndrome; when the Stomach is invaded by Liver Fire, it mostly belongs to the Yang syndrome.

In cases attacking the Yang aspect: The patient experiences epigastric discomfort (Za Cha), feeling as if burning with fire. After drinking water, vomiting occurs immediately. The vomitus must be yellowish-green in color, smelling sour like vinegar and unbearable. For this, Jie Suan Tang (Acid-Resolving Decoction) is prescribed. The efficacy of this formula lies in its use of superior herbs for soothing the Liver, which simultaneously resolves the stagnant Fire Qi, leading to immediate recovery.

In cases attacking the Yin aspect: Although there is a sensation of sourness in the chest, it is not severe. Food eaten today will inevitably lead to acid regurgitation and inability to swallow the next day. Although the mouth feels thirsty, drinking water exacerbates the sourness and causes vomiting, resulting in the expulsion of clear water only. In such cases, warm-natured substances can be used, but cold-natured ones should be avoided. Ba Wei Di Huang Wan (Eight-Ingredient Pill from the Kidney Treasury) is prescribed, which indeed suits the syndrome. However, the efficacy of pills is ultimately slower than that of decoctions. I have now formulated a prescription specifically for treating acid regurgitation of the Yin type, which yields miraculous results. Named Bu Yin Hua Suan Tang (Yin-Nourishing Acid-Resolving Decoction), symptoms lessen after one dose and resolve completely after two doses. The brilliance of this formula lies in its emphasis on strengthening the Spleen over nourishing the Kidney. When the Spleen is strong, Dampness naturally dissipates; once pathogenic water is removed, True Water (Kidney Yin/Body Fluids) is generated. As Kidney Water circulates within the Spleen, Spleen Qi connects to the upper part of the Stomach. How could Cold at the stomach opening then cause acid regurgitation and vomiting? If one does not understand how to tonify the Spleen within the context of the Kidney, but only seeks to stop acid at the upper Stomach, the condition will inevitably evolve into Fan Wei (Reverse Regurgitation/Pyrosis), which becomes difficult to arrest.

Jie Suan Tang (Acid-Resolving Decoction)
Chai Hu (Bupleuri Radix, 2 qian) Bai Shao (Paeoniae Radix Alba, 5 qian) Cang Zhu (Atractylodis Rhizoma, 5 qian) Chao Zhi Zi (Gardeniae Fructus, Stir-fried, 3 qian) Fu Ling (Poria, 5 qian) Chen Pi (Citri Reticulatae Pericarpium, 1 qian) Hou Po (Magnoliae Officinalis Cortex, 1 qian) Shen Qu (Massa Medicata Fermentata, 1 qian) Sha Ren (Amomi Fructus Rotundus, 3 grains) Zhi Ke (Aurantii Fructus Immaturus, 0.5 fen) Xiang Fu (Cyperi Rhizoma, 2 qian) Decoct with water and take orally.

Bu Yin Hua Suan Tang (Yin-Nourishing Acid-Resolving Decoction)
Rou Gui (Cinnamomi Cortex, 0.5 fen) Shu Di Huang (Rehmanniae Radix Praeparata, 5 qian) Shan Yao (Dioscoreae Rhizoma, 1 liang) Shan Zhu Yu (Corni Fructus, 3 qian) Qian Shi (Euryales Semen, 5 qian) Chen Pi (Citri Reticulatae Pericarpium, 0.5 fen) Yi Yi Ren (Coicis Semen, 5 qian) Che Qian Zi (Plantaginis Semen, 3 qian) Fu Zi (Aconiti Lateralis Radix Praeparata, 1 qian) Ren Shen (Ginseng Radix, 5 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 5 qian) Bai Jie Zi (Sinapis Semen, 3 qian) Decoct with water and take orally.