嘈杂与吞酸一类。皆由肝气不舒。木挟相火乘其脾胃。则谷之精微不行。浊液攒聚。为痰为
饮。其痰亦从木气化酸。肝木摇动中土。故中土扰扰不宁。而嘈杂如饥状。每求食以自救。苟得
少食。则嘈杂少止。止则复作。盖土虚不禁木所摇。故治法必当补脾运痰。土浓载物。则风木自
安。不必用伐肝之剂。六君子汤为专药。火盛作酸。加吴茱萸、川黄连。若不开郁补土。务攻其
痰。久久而虚。必变反胃泄泻。痞满眩晕等病矣。嘈杂或食后。腐化酸臭。心中烦杂者。保和丸。
湿痰气滞。不喜饮食者。保和丸二钱。越鞠丸一钱和服。脉洪大者火多。二陈加姜汁炒山栀、川
连。滑大者痰多。导痰加芩、连、山栀。脉弦细身倦怠者。六君子加抚芎、苍术、姜汁炒山栀。
不应。合佐金丸。又有用消克药过多。饥不能食。精神渐减。四君子加白芍、陈皮、姜汁炒川连。
心悬悬如饥状。欲食之时。勿与饮食。常以枳术丸三分。抑青丸一分和服。中脘有饮则嘈。有宿
食则酸。故常嗳宿腐气逆咽酸水。亦有每晨吐酸水数口。日间无事。膈常如酸热者。皆中宫不清所
致。越鞠丸合佐金丸服最妙。妇人悒郁。多有此证。逍遥散下佐金丸。肾肝阴虚。不能纳
气归元而作嘈杂。嗳气。痞满。脉必涩弱。服补中、二陈诸药不效者。临卧用四神丸加川连。侵
晨用六味丸加沉香。
嗳气 嗳气皆属胃中窒塞。气不宣通。上迫而出也。然有饮食太过。嗳出如败卵气者。则当
审所伤何物而消导之。亦有胃弱不能克化而然者。此宜兼补兼消。不可纯用克伐也。
KT 胃中津气枯槁则KT 。若平时饮食常KT 者。为反胃之渐。不可不知。
嘈杂与吞酸属于同一类病证。皆因肝气疏泄失常，导致木气挟带相火侵犯脾胃，致使水谷精微无法正常运化，浊液积聚，化为痰饮。这些痰饮也随着木气的变化而呈现酸味。肝木的摇动干扰了中焦脾胃（中土），使得中焦扰动不安，从而出现嘈杂感，状似饥饿，患者往往寻求进食以自我缓解。如果吃下少量食物，嘈杂感便会暂时减轻，但停止进食后症状又会复发。这是因为脾土虚弱，无法承受肝木的克制与摇动，所以治疗法则必须补益脾气并运化痰湿。只有脾土厚实才能承载万物，风木之气自然安宁，不必使用攻伐肝脏的药物。六君子汤是治疗此证的专方。若火热旺盛导致泛酸，可加入吴茱萸、川黄连。如果不先开郁结、补脾土，一味地攻逐痰邪，久而久之会导致正气更虚，必然演变为反胃、泄泻、痞满、眩晕等疾病。
嘈杂若在食后出现，伴有食物腐化产生的酸臭气味，心中烦乱杂乱的，适用保和丸。若是湿痰阻滞气机，食欲不振的，可将保和丸二钱与越鞠丸一钱混合服用。脉象洪大的，说明火邪较多，可用二陈汤加入姜汁炒过的山栀、川黄连。脉象滑大的，说明痰多，可用导痰汤加入黄芩、黄连、山栀。脉象弦细且身体倦怠的，可用六君子汤加入抚芎（川芎的一种）、苍术、姜汁炒过的山栀。若无效，可配合佐金丸。又有因过多使用消导克伐药物，导致虽觉饥饿却无法进食，精神逐渐减退的，可用四君子汤加入白芍、陈皮、姜汁炒过的川黄连。心中悬空感如同饥饿，想要进食时，不要立即给予饮食，常以三分枳术丸与一分抑青丸混合服用。中脘部位有停饮则表现为嘈杂，有宿食则表现为吞酸，因此常常嗳出腐败气体的气味，逆咽酸水。也有每天早晨吐出几口酸水，白天无事，但胸膈部常有酸热感的，这都是中焦脾胃不清爽所致，服用越鞠丸合佐金丸效果最好。妇女因忧郁抑郁，多有此证，可用逍遥散送服佐金丸。肾肝阴虚，不能纳气归元而导致嘈杂、嗳气、痞满的，脉象必定涩弱，服用补中益气汤、二陈汤等药物无效的，临睡前用四神丸加川黄连，清晨起床时用六味地黄丸加沉香。
嗳气 嗳气都属于胃中气机窒塞，气机不能宣通，向上冲逆而出所致。然而，如果是饮食过量，嗳出的气体像败卵一样的臭味，就应当审查损伤了什么食物并进行消导治疗。也有因为胃气虚弱不能消化食物而导致的，这种情况适宜兼用补益与消导的方法，不可单纯使用攻伐药物。
噫（注：原文为“KT”，根据上下文及中医古籍常见异体字或OCR错误，“KT”在此处对应“噫”或“呃逆”，结合前文“嗳气”及后文“反胃之渐”，此处指代一种气逆症状，通常译为 belching 或 hiccup，鉴于前文已讲嗳气，此处“KT”极大概率为“噫”字的编码错误或异体字，意为打嗝/嗳气的一种延续或特指，但在本段语境下，它被描述为津气枯槁所致，且为反胃之渐，故译为 Belching/Hiccup 相关的病理状态，此处按“噫”处理，即打嗝/嗳气） 胃中的津液和气机枯竭就会导致噫。如果平时经常发生噫的，这是反胃病的征兆，不可忽视。
**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.