嗳气嘈杂。审右寸关。紧滑可治。弦急则难。两寸弦滑。留饮胸间。脉横在寸。有积上
拦。
夫嗳气者。胃虚火郁之所成也。因胃中有火。治疗之法。虚则补之。热则清之。气则顺
之。气顺则痰消也。
一论嗳气者。胃中有火痰也。宜用
星半汤
南星（姜制二钱） 半夏（姜制二钱） 石膏（二钱） 香附（二钱） 栀子（炒三钱）
上锉一剂。生姜煎服。或以姜捣汁亦可。盖胃中有郁火。膈上有稠痰故也。
一论嗳气声闻于外。因气胸膈闷。有痰。舌黑。乃痰之症也。宜服
导痰汤
陈皮（二钱） 半夏（姜炒二钱） 白茯苓（去皮三钱） 白术（一钱五分去芦） 香附（二钱）
青
皮（去穣二钱） 黄芩（炒二钱） 栝蒌仁（三钱） 砂仁（八分） 黄连（姜炒二钱） 甘草（八分）
上锉。生姜三片。水煎服。
一论妇人嗳气。胸紧。连嗳十余声不尽。嗳出气。心头略宽。不嗳即紧。宜
破郁丹
香附（四两） 栀子仁（炒四两） 黄连（姜汁炒二两） 枳实（麸炒一两） 槟榔（二两） 莪
术（制二两） 青皮（去穣一两） 苏子（一两）
栝蒌仁（一两）
上共为末。水丸如梧子大。每服三十丸。食后。滚水送下。或以分心气饮服之。立效。
一上舍饮食失宜。胸膈膨胀。嗳气吞酸。以自知医。用二陈、枳、连、苍、柏之类。前
症
益甚。更加足指肿痛。指缝出水。余用补中益气加茯苓、半夏治之而愈。若腿足浮肿。或
肿寒热呕吐。亦用前药。
嗳气伴有嘈杂感。诊察右手寸部和关部的脉象，若见紧滑脉则病情可治；若见弦急脉则难治。两手寸部脉象弦滑，提示胸间有停饮（水液代谢障碍形成的病理产物）。脉象横溢于寸部，提示体内有积滞且病势向上冲逆。
所谓嗳气，是由胃气虚弱、火邪郁结所导致的。因为胃中有火热之邪，治疗原则应当是：虚证则用补法，热证则用清法，气滞则用顺气法。气机顺畅则痰浊自消。
第一种论述：嗳气是因为胃中有火邪和痰浊所致。适宜使用星半汤。
制南星（姜汁炮制二钱） 制半夏（姜汁炮制二钱） 石膏（二钱） 香附（二钱） 栀子（炒三钱）
以上药材锉碎为一剂，加生姜煎服。或者将生姜捣取汁液服用亦可。这是因为胃中有郁结之火，膈上有稠厚痰浊的缘故。
第二种论述：嗳气声音响亮传至体外，因气机阻滞导致胸膈闷胀，体内有痰，舌苔发黑，这是痰证的典型表现。适宜服用导痰汤。
陈皮（二钱） 制半夏（姜炒二钱） 白茯苓（去皮三钱） 白术（一钱五分，去芦头） 香附（二钱） 青皮（去瓤二钱） 黄芩（炒二钱） 瓜蒌仁（三钱） 砂仁（八分） 黄连（姜炒二钱） 甘草（八分）
以上药材锉碎，加生姜三片，用水煎服。
第三种论述：妇女出现嗳气，胸部紧绷，连续嗳气十余声仍不尽兴，嗳气后心头感觉略微宽松，若不嗳气则感到紧绷不适。适宜使用破郁丹。
香附（四两） 栀子仁（炒四两） 黄连（姜汁炒二两） 枳实（麸炒一两） 槟榔（二两） 莪术（炮制二两） 青皮（去瓤一两） 苏子（一两） 瓜蒌仁（一两）
以上药材共同研为细末，用水泛丸，如梧桐子大小。每次服用三十丸，饭后用滚开水送下。或者配合分心气饮服用，立即见效。
第四种情况：一位上舍人（官职名或尊称）饮食不节制，导致胸膈部膨胀，嗳气并伴有吞酸（反酸），自行就医，使用了二陈汤、枳实、黄连、苍术、黄柏等药物，结果原有症状更加严重，并增加了足趾肿痛、脚趾缝渗出的症状。我采用补中益气汤加入茯苓、半夏进行治疗而痊愈。如果是腿部足部浮肿，或者伴有肿胀、寒热往来、呕吐等症状，也使用上述方药。
Belching accompanied by a sensation of stomach discomfort (Zaocha). Examination of the Cun and Guan positions on the right hand: a tight and slippery pulse indicates a treatable condition, whereas a wiry and rapid pulse indicates difficulty in treatment. A wiry and slippery pulse at both Cun positions suggests retained fluid (Liu Yin) in the chest. A pulse overflowing horizontally at the Cun position indicates accumulation with upward rebellion.
Belching is caused by deficiency of Stomach Qi and stagnation of Fire. Since there is Heat-Fire in the Stomach, the therapeutic principle is: tonify for deficiency, clear for heat, and regulate Qi for stagnation. When Qi flows smoothly, phlegm dissipates.
First discussion: Belching results from Fire-Phlegm in the Stomach. The appropriate formula is Xingban Tang (Arisaema and Pinellia Decoction).
Prepared Arisaema cum Bile (Jiangzhi Nanxing, processed with ginger juice, 2 qian)
Prepared Pinellia Rhizome (Jiangzhi Banxia, processed with ginger juice, 2 qian)
Gypsum Fibrosum (Shigao, 2 qian)
Cyperi Rhizoma (Xiangfu, 2 qian)
Gardeniae Fructus (Zhizi, stir-fried, 3 qian)
Crush these ingredients into one dose. Decoct with fresh ginger and take orally. Alternatively, crush fresh ginger to extract juice and take it. This is due to stagnant Fire in the Stomach and thick Phlegm above the Diaphragm.
Second discussion: Belching audible externally, accompanied by chest oppression due to Qi stagnation, presence of Phlegm, and a black tongue coating, indicates a Phlegm syndrome. The appropriate formula is Daotan Tang (Phlegm-Resolving Decoction).
Citrus Reticulatae Pericarpium (Chenpi, 2 qian)
Prepared Pinellia Rhizome (Jiangchao Banxia, stir-fried with ginger, 2 qian)
Poria (Baifuling, peeled, 3 qian)
Atractylodis Macrocephalae Rhizoma (Baizhu, 1.5 qian, remove rhizome base)
Cyperi Rhizoma (Xiangfu, 2 qian)
Citri Reticulatae Viride Pericarpium (Qingpi, 2 qian, remove pith)
Scutellariae Radix (Huangqin, stir-fried, 2 qian)
Trichosanthis Semen (Gualouren, 3 qian)
Amomi Fructus Rotundus (Sharen, 0.8 fen)
Coptidis Rhizoma (Huanglian, stir-fried with ginger, 2 qian)
Glycyrrhizae Radix et Rhizoma (Gancao, 0.8 fen)
Crush these ingredients. Decoct with three slices of fresh ginger in water and take orally.
Third discussion: In women, belching accompanied by chest tightness, continuous belching for more than ten times without relief, feeling slightly relaxed in the heart region after belching, but tight again if belching does not occur. The appropriate formula is Poyu Dan (Qi-Breaking Pill).
Cyperi Rhizoma (Xiangfu, 4 liang)
Gardeniae Fructus (Zhiziren, stir-fried, 4 liang)
Coptidis Rhizoma (Huanglian, stir-fried with ginger juice, 2 liang)
Immature Bitter Orange (Zhishi, bran-stir-fried, 1 liang)
Arecae Semen (Binglang, 2 liang)
Curcumae Zedoariae Rhizoma (Ezhu, processed, 2 liang)
Citri Reticulatae Viride Pericarpium (Qingpi, 1 liang, remove pith)
Perillae Fructus (Suzi, 1 liang)
Trichosanthis Semen (Gualouren, 1 liang)
Grind all ingredients into fine powder. Form pills using water, sized like wu zi (seeds of Cercis chinensis). Take 30 pills per dose after meals, washed down with boiling water. Alternatively, administer with Fenxin Qi Yin (Cardiac-Qi-Separating Drink) for immediate effect.
Fourth case: A gentleman (Shangshe) suffered from improper diet, leading to chest and diaphragmatic distension, belching, and acid regurgitation (Tunsuan). He self-medicated with Erchen Tang, Zhishi, Huanglian, Cangzhu, and Huangbai. Consequently, his previous symptoms worsened, and he developed swelling and pain in the toes with exudate between the toe webs. I treated him with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fuling and Banxia, resulting in recovery. For edema of the legs and feet, or cases accompanied by swelling, alternating chills and fever, and vomiting, the aforementioned prescription is also used.