四证丹溪主二陈（汤），寒温虚实审其因，若由虚呃人参附，蛔证黄（连）梅椒伯遵。
吞酸病多属于肝，宜以左金丸，连理汤加陈半为主方，小柴胡汤，平胃散佐之。
（经义）《至真要大论》曰∶“诸呕吐酸，暴注下追？皆属于热。”又曰∶“少阳之胜，呕
吞酸连理（汤）左金丸，平胃（散小）柴胡（汤）亦可安，寒热补消灵变用，病机指示属于肝。
三消证∶上消者口渴不止也，治以人参白虎汤；中消者，食入即饥也，治以调胃承气汤
；下消者，饮一溲二也，治以肾气丸。赵养葵云∶无分上、中、下，先以治肾为急。以六味
丸料一斤、入肉桂、五味子各一两，水煎六、七碗恣意冷冻饮料，熟睡而病如失。此以其温药引
其真水，以滋上、中、下之燥也，此为火病，故列于热证。
上消（人参）白虎（汤）中（消调胃）承气（汤），下消肾气丸可贵，赵氏治肾统三消，地黄丸料（一斤加
桂（心）五味子（各一两，水煎冷服。
病阳明之燥热而消渴者，白虎汤主之，此外因之渴也。胃气弱而津液不生者，人参汤主
之，此内因之渴也。有脾不能为胃行其津液，肺不能通调水道，而但消渴者，人但知以凉润
之药治渴，不知脾喜燥而肺恶寒。试观泄泻者必渴，此因水津不能上输，而惟下泄故尔。以
燥脾之药治之，水液上升即不渴矣。故以凉润治渴，人皆知之，以燥热治渴，人所不知也。
人参汤方解（按∶理中丸原方参、术、姜、草各三两，人参汤甘草则用四两，以此分别。
程郊倩云∶参、术、炙草，所以固中州，干姜守中，必假之焰釜薪而腾阳气。是以谷
入于阴，长气于阳，上输华盖，下摄州都，五脏六腑，皆以受气矣，此理中之旨也。
第四种证候，朱丹溪主张使用二陈汤（燥湿化痰、理气和中的方剂），但需仔细辨别寒、温、虚、实的病因。如果是因虚寒导致的呃逆，应使用人参和附子；如果是蛔虫引起的证候，则遵循黄连、乌梅、花椒、川楝子的用法。
吞酸病多归属于肝脏，适宜使用左金丸，以连理汤加陈皮、半夏作为主方，小柴胡汤和平胃散作为辅助方。
《黄帝内经·素问·至真要大论》中说：“各种呕吐泛酸，突然腹泻且急迫下注的病症，都归属于热邪。”又说：“少阳胆经火气偏胜时，会出现呕吐……”
吞酸与连理汤、左金丸，平胃散与小柴胡汤也能使病情安定，根据寒热虚实进行灵活变通运用，病机关键在于病变属于肝。
三消证：上消表现为口渴不止，治疗用人参白虎汤；中消表现为进食后即感饥饿，治疗用调胃承气汤；下消表现为喝一杯水排出两小便，治疗用肾气丸。赵养葵说：无论上、中、下哪种消渴，都应先把治疗肾脏作为紧急任务。用六味地黄丸的药料一斤，加入肉桂、五味子各一两，用水煎煮成六七碗，随意冷冻后饮用，患者熟睡后疾病便如消失一般。这是用温药引导真阴之水，来滋润上、中、下三焦的燥热，这属于火病，所以列在热证中。
上消用人参白虎汤，中消用调胃承气汤，下消用肾气丸尤为珍贵，赵氏主张治肾统摄三消，用地黄丸药料一斤，加入桂心、五味子各一两，水煎冷服。
患阳明经燥热而致消渴的，由白虎汤主治，这是外因引起的口渴。胃气虚弱导致津液不能生成的，由人参汤主治，这是内因引起的口渴。有脾脏不能为胃输送津液，肺脏不能通调水道，从而只出现消渴症状的，人们只知道用凉润的药物来治疗口渴，却不知道脾脏喜欢干燥而肺脏厌恶寒冷。试看泄泻的人必定口渴，这是因为水谷精微不能向上输布，反而向下泄出所致。用燥湿健脾的药物来治疗，水液上升了就不再口渴了。所以用凉润法治疗口渴，人们都知道；用燥热法治疗口渴，人们却不知道。
人参汤方解（按语：理中丸原方中人参、白术、干姜、甘草各三两，人参汤中甘草则用四两，以此加以区分。程郊倩说：人参、白术、炙甘草，是用来巩固中焦脾胃的，干姜守在中焦，必须借助它像釜底添柴一样的热力来升腾阳气。因此，谷物进入阴分，在阳分生长气化，向上输布到华盖（肺），向下固摄州都（膀胱），五脏六腑都能接受气血滋养了，这就是理中汤的宗旨。）
The fourth syndrome is primarily treated by Zhu Danxi with Erchen Tang (Two-Chen Decoction), but the etiology must be carefully examined for cold, heat, deficiency, and excess. If the hiccups are due to deficiency-cold, Ren Shen (Ginseng Radix) and Fu Zi (Aconiti Lateralis Radix Praeparata) should be used; if it is a case of roundworms, follow the usage of Huang Lian (Coptidis Rhizoma), Wu Mei (Mume Fructus), Hua Jiao (Zanthoxyli Pericarpium), and Chuan Bei Mu (Fritillariae Cirrhosae Bulbus).
Acid regurgitation often belongs to the Liver. Zuojin Wan (Left Metal Pill) is suitable, with Lianli Tang (Coptis and Poria Decoction) plus Chen Pi (Citri Reticulatae Pericarpium) and Ban Xia (Pinelliae Tuber) as the main formula, while Xiao Chaihu Tang (Minor Bupleurum Decoction) and Pingwei San (Level the Stomach Powder) serve as adjuvants.
As stated in the *Suwen: Zhi Zhen Yao Da Lun* (Treatise on the Most Essential and Important Principles): "All vomiting and acid regurgitation, sudden diarrhea with urgent downward flow, belong to Heat." It also states: "When Shaoyang (Lesser Yang) fire prevails, vomiting occurs..."
For acid regurgitation, Lianli Tang and Zuojin Wan are effective; Pingwei San and Xiao Chaihu Tang can also bring relief. Apply flexible variations based on cold, heat, deficiency, and excess; the pathogenesis indicates the involvement of the Liver.
Regarding the Three Xiao (Wasting-Thirst) syndromes: Shang Xiao (Upper Wasting-Thirst) is characterized by incessant thirst, treated with Renshen Baihu Tang (Ginseng and White Tiger Decoction); Zhong Xiao (Middle Wasting-Thirst) is characterized by hunger immediately after eating, treated with Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction); Xia Xiao (Lower Wasting-Thirst) is characterized by drinking one part and urinating two parts, treated with Shenqi Wan (Kidney Qi Pill). Zhao Yangkui stated: Regardless of whether it is Upper, Middle, or Lower, treating the Kidney is the priority. Use one jin (approx. 500g) of Liuwei Dihuang Wan ingredients, add Rou Gui (Cinnamomi Cortex) and Wu Wei Zi (Schisandrae Fructus), each one liang (approx. 30g), decoct in water to yield six or seven bowls. Drink freely while cold; after falling into a deep sleep, the illness disappears as if lost. This uses warm medicines to guide the True Water (Kidney Yin) to nourish the dryness of the Upper, Middle, and Lower Jiao. Since this is a Fire disease, it is classified under Heat syndromes.
Shang Xiao is treated with Renshen Baihu Tang; Zhong Xiao with Tiaowei Chengqi Tang; Xia Xiao with Shenqi Wan is highly valued. Mr. Zhao advocates treating the Kidney to govern all three Xiao types, using one jin of Dihuang Wan ingredients, adding Guixin (Cinnamomi Cortex) and Wuweizi (Schisandrae Fructus), each one liang, decocted in water and taken cold.
Xiao-thirst caused by燥热 (Dryness-Heat) in the Yangming channel is primarily treated with Baihu Tang (White Tiger Decoction); this is thirst due to external factors. Thirst caused by weak Stomach Qi failing to generate fluids is primarily treated with Renshen Tang (Ginseng Decoction); this is thirst due to internal factors. In cases where the Spleen cannot transport fluids for the Stomach, and the Lung cannot regulate water passages, resulting solely in wasting-thirst, people only know to treat thirst with cooling and moistening herbs, unaware that the Spleen prefers dryness and the Lung dislikes cold. Observe that patients with diarrhea are invariably thirsty; this is because fluid essences cannot ascend upward but instead leak downward. Treating with herbs that dry the Spleen allows fluids to ascend, and the thirst ceases. Thus, while everyone knows to treat thirst with cooling-moistening methods, few know to treat thirst with warming-drying methods.
Explanation of Renshen Tang Formula (Note: The original Lizhong Wan formula contains Ren Shen, Bai Zhu, Gan Jiang, and Zhi Gan Cao, each at three liang. In Renshen Tang, Zhi Gan Cao is increased to four liang to distinguish them. Cheng Jiaoqian said: Ren Shen, Bai Zhu, and Zhi Gan Cao consolidate the Central Jiao (Spleen and Stomach). Gan Jiang remains in the center; its flame-like heat is necessary to stoke the cauldron and raise Yang Qi. Thus, grain enters the Yin, generates Qi in the Yang, ascends to the Huagai (Lung), and descends to control the Zhou Du (Bladder/Kidney system). The Five Zang and Six Fu organs all receive Qi. This is the essence of Lizhong Tang.)