症属胃，俗云心 ，非也。其状似饥非饥，似痛非痛，脘中懊 不安，或兼嗳气痞闷，渐至吞酸停饮，
胸前隐痛。丹溪谓皆痰火为患，或食郁有热。华岫云谓脾属阴主血，胃属阳主气；胃易燥，全赖脾阴以和之；
脾易湿，必赖胃阳以运之；合冲和之德，为后天生化之源。若胃过燥，则 杂似饥，得食暂止。治当以凉润
养胃阴，如天冬、麦冬、玉竹、柏子仁、石斛、莲、枣之品。或稍佐微酸。如白芍、枣仁、木瓜之属。若热病
后，胃津未复，亦易虚 。治当以甘凉生胃液，如生熟地黄、当归、沙参、蔗汁之属。或但调其饮食。凡甘滑
之类。若胃有痰火，或恶心吞酸，微烦少寐，似饥非饥。治宜清火，如黄连、山栀，俱用姜汁炒，及芩、芍、
竹茹等。稍佐降痰。如二陈汤，及橘红、半夏曲。又有脾胃阳衰，积饮内聚，似酸非酸，似辣非辣，治宜温通。
外台茯苓饮加减。但由脾虚，饮食不化，吐沫嗳腐，治宜健运。六君子汤加砂仁、鸡内金。或肝火作酸，
左金丸。 杂醋心，吴茱萸汤。食后嗳腐，保和丸。湿痰阻气，气郁气。妇女悒郁胸 ，逍遥散下左金丸。血
虚心 ，宜地黄、白芍、天冬、麦冬、茯神、
枣仁等。大抵脉洪数者多火，宜姜汁炒山栀、川连等。脉滑大者多痰，宜导痰汤加芩、栀、竹茹等。脉沉
弦者多郁，越鞠丸。又有过用消克药，饥不能食，精神渐减，异功散加白芍、红枣、莲子、枣仁。皆 症所当
审治者。
《医通》曰∶ 杂与吞酸一类，皆由肝气不舒，木挟相火以乘脾土，胃之精微不行，浊液攒聚，为痰为饮，
都从木气化酸，肝木摇动中土，中土扰扰不安，故 杂如饥，求食自救，得食稍止，止则复作。盖土虚不禁木
所摇，治法必补脾运痰，土浓载物，则风木自安，不必伐肝。但以六君子汤为专药，若火盛作酸，加吴茱萸、
川黄连。若不开郁补土，务攻其痰，久久致虚，必变反胃、痞满、眩晕等病矣。
病症属于胃，民间俗称“心嘈”，这是错误的。其症状表现为似饥饿又不是饥饿，似疼痛又不是疼痛，胃脘部烦闷不安，有时兼有嗳气和痞塞闷胀感，逐渐发展为吞酸和停饮，胸前隐隐作痛。朱丹溪认为这都是痰火为患，或者是食积郁而化热。华岫云说脾属阴主血，胃属阳主气；胃容易干燥，完全依赖脾阴来调和它；脾容易湿滞，必须依赖胃阳来运化它；二者合起来具有冲和的德性，是后天化生之源。如果胃过于干燥，则出现嘈杂似饥的感觉，进食后暂时缓解。治疗应当用凉润之品滋养胃阴，如天冬、麦冬、玉竹、柏子仁、石斛、莲子、大枣等药物。或者稍微佐以微酸的药物，如白芍、酸枣仁、木瓜之类。如果在热病之后，胃津尚未恢复，也容易出现虚性嘈杂。治疗应当用甘凉之品滋生胃液，如生地黄、熟地黄、当归、沙参、甘蔗汁等。或者仅仅调理饮食，凡是甘甜滑腻之类的食物。如果胃中有痰火，或者恶心吞酸，轻微烦躁睡眠少，似饥非饥。治疗宜清火，如黄连、山栀，都用姜汁炒制，以及黄芩、白芍、竹茹等。稍加降痰药物，如二陈汤，以及橘红、半夏曲。又有脾胃阳气衰微，水饮积聚在内，感觉似酸非酸，似辣非辣，治疗宜温通，用《外台秘要》茯苓饮加减。但如果是因为脾虚，饮食不消化，吐沫嗳出腐臭气味，治疗宜健脾运化，用六君子汤加砂仁、鸡内金。如果是肝火导致泛酸，用左金丸。如果是嘈杂伴醋心感，用吴茱萸汤。如果是食后嗳出腐臭气味，用保和丸。如果是湿痰阻滞气机，气郁导致气滞，妇女忧郁胸胁胀满，用逍遥散送服左金丸。如果是血虚导致的嘈杂，适宜用地黄、白芍、天冬、麦冬、茯神、酸枣仁等。大抵脉象洪数者多属火，适宜用姜汁炒的山栀、川连等。脉象滑大者多属痰，适宜用导痰汤加黄芩、山栀、竹茹等。脉象沉弦者多属郁，用越鞠丸。又有过度使用消导克伐药物的，导致饥饿但不能进食，精神逐渐减退，用异功散加白芍、红枣、莲子、酸枣仁。这些都是嘈杂症应当仔细辨证治疗的。
《医宗必读》（注：原文《医通》通常指《类证治裁》引用的《医宗必读》或相关医籍观点，此处依原文译）说：嘈杂与吞酸一类病症，都是由肝气不舒畅，木气挟带相火来乘袭脾土，胃中的精微物质不能正常运行，浊液聚集，形成痰饮，都随着木气的变化而化为酸味，肝木摇动中焦脾土，中焦脾土扰动不安，所以出现嘈杂似饥的感觉，寻求食物来自救，进食后稍微缓解，缓解后又发作。这是因为土气虚弱不能承受木气的摇动，治疗方法必须补脾并运化痰湿，土气浓厚能承载万物，则风木自然安宁，不必攻伐肝木。只要以六君子汤作为专用药，如果火势旺盛导致泛酸，加吴茱萸、川黄连。如果不疏解郁结、补益脾气，一味攻伐痰湿，久而久之导致虚弱，必然转变为反胃、痞满、眩晕等疾病。
The disorder belongs to the Stomach; the common saying that it is "Heart Zaoza" (a sensation of hunger-like discomfort in the chest/epigastrium) is incorrect. Its manifestations resemble hunger but are not hunger, and resemble pain but are not pain. There is a feeling of restlessness and vexation in the epigastrium, sometimes accompanied by belching and a sensation of fullness and stuffiness. It gradually progresses to acid regurgitation and fluid retention, with dull pain in the chest. Zhu Danxi stated that these are all caused by Phlegm-Fire, or by food stagnation generating heat. Hua Xiuyun said that the Spleen belongs to Yin and governs Blood, while the Stomach belongs to Yang and governs Qi; the Stomach tends toward dryness and relies entirely on Spleen Yin to harmonize it; the Spleen tends toward dampness and must rely on Stomach Yang to transform it; together they embody the virtue of harmony and serve as the source of postnatal transformation. If the Stomach becomes excessively dry, a sensation of Zaoza resembling hunger occurs, which is temporarily relieved by eating. Treatment should employ cooling and moistening herbs to nourish Stomach Yin, such as *Asparagi Radix* (Tian Dong), *Ophiopogonis Radix* (Mai Dong), *Polygonati Odorati Rhizoma* (Yu Zhu), *Platycladi Semen* (Bai Zi Ren), *Dendrobii Caulis* (Shi Hu), Lotus Seeds (Lian Zi), and Jujube Dates (Da Zao). Alternatively, slightly add mildly sour herbs, such as *Paeoniae Radix Alba* (Bai Shao), *Ziziphi Spinosae Semen* (Suan Zao Ren), and *Chaenomelis Fructus* (Mu Gua). If after an febrile disease, Stomach fluids have not yet recovered, deficiency-type Zaoza is also prone to occur. Treatment should employ sweet and cool substances to generate Stomach fluids, such as *Rehmanniae Radix Praeparata* (Shu Di Huang), *Rehmanniae Radix* (Sheng Di Huang), *Angelicae Sinensis Radix* (Dang Gui), *Glehniae Radix* (Sha Shen), and Sugarcane Juice (Zhe Zhi). Or simply regulate the diet, favoring sweet and slippery foods. If there is Phlegm-Fire in the Stomach, or nausea and acid regurgitation, with slight irritability and insomnia resembling hunger but not hunger, treatment should clear Fire, using *Coptidis Rhizoma* (Huang Lian) and *Gardeniae Fructus* (Zhi Zi), both stir-fried with Ginger Juice, along with *Scutellariae Radix* (Huang Qin), *Paeoniae Radix Alba* (Bai Shao), and *Bambusae Caulis in Taeniam* (Zhu Ru). Add slightly phlegm-resolving herbs, such as *Er Chen Tang* (Two-Aged Decoction), *Citri Reticulatae Pericarpium* (Ju Hong), and *Pinelliae Fermentatum* (Ban Xia Qu). Furthermore, if Spleen and Stomach Yang are declining, with fluid accumulation internally, causing sensations that resemble sourness but are not sour, and spiciness but are not spicy, treatment should warm and unblock, using *Waitai Fuling Yin* (Fuling Decoction from the External Cabinet) modified. However, if due to Spleen deficiency, food fails to digest, leading to vomiting of saliva and belching of putrid smells, treatment should strengthen and transform, using *Liu Jun Zi Tang* (Six Gentlemen Decoction) added with Amomum Fruit (Sha Ren) and *Gallus Gallus Domesticus Gigerium Endothelium Corneum* (Ji Nei Jin). If Liver Fire causes acid regurgitation, use *Zuo Jin Wan* (Left Metal Pill). For Zaoza with a vinegar-heart sensation, use *Evodiae Fructus Decoction* (Wu Zhu Yu Tang). For belching of putrid smells after eating, use *Bao He Wan* (Preserve Harmony Pill). For damp-phlegm obstructing Qi and Qi stagnation causing Qi depression, or for women with melancholy and chest/hypochondriac distension, use *Xiao Yao San* (Free and Easy Wanderer Powder) administered with *Zuo Jin Wan*. For blood-deficiency type Zaoza, suitable herbs include *Rehmanniae Radix*, *Paeoniae Radix Alba*, *Asparagi Radix*, *Ophiopogonis Radix*, *Poria* (Fu Shen), and *Ziziphi Spinosae Semen*. Generally, a洪数 (Hong-Shu / Surging-Rapid) pulse indicates much Fire, suitable for Gardeniae stir-fried with Ginger Juice and Coptis. A 滑大 (Hua-Da / Slippery-Big) pulse indicates much Phlegm, suitable for *Dao Tan Tang* (Phlegm-Guiding Decoction) added with Scutellaria, Gardenia, and Bamboo Sap. A 沉弦 (Chen-Xian / Deep-Wiry) pulse indicates much Depression/Stagnation, treated with *Yue Ju Wan* (Resolve Five Stagnations Pill). Additionally, overuse of digestive and draining medicines can lead to hunger without ability to eat, and gradual decline of spirit; treat with *Yi Gong San* (Extraordinary Merit Powder) added with White Peony, Red Dates, Lotus Seeds, and Sour Jujube Seed. These are all conditions of Zaoza that require careful differentiation and treatment.
*YiTong* (Medical Compendium) states: Zaoza and acid regurgitation belong to the same category, all arising from Liver Qi not flowing freely, with Wood carrying Ministerial Fire to invade Earth, preventing the Stomach's essential nutrients from circulating normally. Turbid fluids accumulate, forming Phlegm and Fluid Retention, all transforming into acidity following the Wood Qi transformation. Liver Wood agitates the Middle Earth, causing the Middle Jiao to be restless and uneasy, hence the sensation of Zaoza resembling hunger, seeking food to save oneself. Eating provides slight relief, but once relieved, it recurs. This is because Earth is deficient and cannot withstand the agitation of Wood. The treatment method must tonify the Spleen and transform Phlegm; when Earth is thick and capable of bearing things, Wind-Wood will naturally settle, and there is no need to attack the Liver. Use *Liu Jun Zi Tang* as the specific remedy. If Fire is excessive causing acid regurgitation, add Evodia and Coptis. If one does not resolve stagnation and tonify Earth, but instead insists on attacking Phlegm, long-term use will lead to deficiency, inevitably transforming into disorders such as Regurgitation, Fullness-Stuffiness, and Dizziness.