吞酸者，湿热郁积于肝而出，伏于肺胃之间，必用 食菜蔬自养。宜用炒吴茱萸，
顺其性而
苍术、茯苓为辅佐。冬月倍茱萸，夏月倍黄连，汤浸炊饼，丸如小丸吞之。仍教以 食蔬
菜自养，即安。
戴云∶湿热在胃口上，饮食入胃，被湿热郁遏，其食不得传化，故作酸也。如谷肉在器
，湿热则易为酸也。
入方
茱萸（一两，去枝梗，煮少时，浸半日，晒干） 陈皮（一两） 苍术（米泔浸，一两） 黄连（二两
陈壁土炒，去土秤） 黄芩（一两，如上土炒）
或加桔梗一两，茯苓一两。
上为末，神曲糊丸，绿豆大。每服二三十丸，时时津液，食后服。
〔附录〕吞酸，与吐酸不同，吐酸《素问》以为热，东垣又为寒，何也？吐酸是吐出酸
。平时津液，随上升之气郁积而久，湿中生热，故从火化，遂作酸味，非热而何？其有郁
之久，不能自涌而出，伏于肺胃之间，咯不得上，咽不得下，肌表得风寒则内热愈郁，而酸
味刺心，肌表温暖，腠理开发，或得香热汤丸，津液得行，亦可暂解，非寒而何？《素问》
言热，言其本也；东垣言寒，言其末也。
附方
曲术丸 治中脘宿食留饮，酸，蜇心痛，或口吐清水。
神曲（炒，三两） 苍术（泔浸炒，一两半） 陈皮（一两）
上为末，生姜汁煮神曲糊为丸。每七十丸，姜汤下。
加味平胃散 治吞酸或宿食不化。
生料平胃散加神曲、麦芽炒，各半钱，术、朴不制。上生姜三片，水煎五钱服。
嗳气 胃中有火有痰。
入方
南星 半夏 软石膏 香附
一本有炒栀子
上作丸，或作汤服之。盖胃中有郁火，膈上有稠痰故也。
软石膏丸亦不可服，本方痰条下云∶噫气吞酸，此系食郁有热，火气冲上，黄芩为
君，南星、半夏、陈皮为佐，热多加青黛。
吞酸，是由于湿热郁积于肝脏而发出，潜伏在肺和胃之间，必须依靠食用蔬菜来调养身体。适宜使用炒过的吴茱萸，顺应其药性，并以苍术、茯苓作为辅助药物。冬季服用时加倍吴茱萸的用量，夏季服用时加倍黄连的用量，用汤水浸泡炊饼（一种面食），制成小丸吞服。仍然教导患者以食用蔬菜来自我调养，病情即可安定。
戴元礼说：湿热位于胃口之上，饮食进入胃中，被湿热所郁结遏制，食物不能正常传导消化，所以产生酸味。就像谷物和肉类放在容器中，遇到湿热就容易变酸一样。
入方药物组成：
吴茱萸（一两，去除枝梗，煮片刻，浸泡半天，晒干）；陈皮（一两）；苍术（用米泔水浸泡，一两）；黄连（二两，用陈壁土炒制，去土后称重）；黄芩（一两，如上法用土炒）。
或者加入桔梗一两，茯苓一两。
以上药物研为细末，用神曲糊制作成丸剂，大小如绿豆。每次服用二三十丸，时常吞咽津液，饭后服用。
〔附录〕吞酸与吐酸不同。《素问》认为吐酸属于热证，李东垣又认为是寒证，这是为什么呢？吐酸是指将酸水吐出。平时分泌的津液，随着上升之气郁积日久，湿中生热，因此从火化，从而变成酸味，这难道不是热证吗？有的人郁结时间很久，不能自行涌出，潜伏在肺胃之间，咳不出来，咽不下去，肌表受到风寒侵袭则内热更加郁结，酸味刺痛心脏；如果肌表温暖，腠理开发，或者喝下香热的汤药或丸药，津液得以运行，也可以暂时缓解，这难道不是寒证吗？《素问》所说的热，是指疾病的本质；李东垣所说的寒，是指疾病的表现。
附方：
曲术丸：治疗中脘部宿食停滞、留饮，伴有吞酸、刺痛心痛，或者口吐清水的症状。
神曲（炒，三两）；苍术（米泔水浸泡后炒，一两半）；陈皮（一两）。
以上药物研为细末，用生姜汁煮神曲糊作为粘合剂制作成丸剂。每次服用七十丸，用姜汤送服。
加味平胃散：治疗吞酸或宿食不化。
在生料平胃散的基础上，加入炒神曲、炒麦芽各半钱，苍术、厚朴不经过炮制。上生姜三片，加水煎煮，取五钱药液服用。
嗳气：胃中有火邪和有痰浊。
入方药物组成：
天南星；半夏；软石膏；香附。
有的版本还有炒栀子。
以上药物制作成丸剂，或者煎汤服用。这是因为胃中有郁结之火，膈上有稠厚的痰浊所致。
软石膏丸也不可以服用，在原方的痰证条目下记载：噫气吞酸，这是由于食郁有热，火气冲上所致，以黄芩为君药，天南星、半夏、陈皮为佐药，热象加重时加入青黛。
Swallowing acid (acid regurgitation) arises from damp-heat accumulating and stagnating in the Liver, lodging between the Lung and Stomach. It is essential to nourish oneself by consuming vegetables. It is advisable to use stir-fried Evodiae Fructus (Wuzhuyu), following its nature, with Atractodis Rhizoma Preparatum (Cangzhu) and Poria (Fuling) as adjuvant herbs. In winter, double the dosage of Evodiae Fructus; in summer, double the dosage of Coptidis Rhizoma (Huanglian). Soak these in decoction along with steamed wheat bread (Chuibing), form into small pills, and swallow them. Continue to advise the patient to nourish themselves with vegetables, and the condition will stabilize.
Dai Yuanli stated: Damp-heat resides above the stomach opening. When food enters the Stomach, it is constrained by damp-heat, preventing normal digestion and transmission, thus generating acidity. Just as grains and meats placed in containers turn sour when exposed to damp-heat.
Prescription ingredients:
Evodiae Fructus (Wuzhuyu) (1 liang, remove branches and stalks, boil briefly, soak for half a day, dry); Citri Reticulatae Pericarpium (Chenpi) (1 liang); Atractodis Rhizoma Preparatum (Cangzhu) (soaked in rice wash water, 1 liang); Coptidis Rhizoma (Huanglian) (2 liang, stir-fried with old wall soil, remove soil and weigh); Scutellariae Radix (Huangqin) (1 liang, stir-fried with soil as above).
Alternatively, add Platycodonis Radix (Jiegeng) 1 liang and Poria (Fuling) 1 liang.
Grind all ingredients into powder, bind with paste made from Medicated Leaven (Shenqu), and form pills the size of mung beans. Take 20–30 pills per dose, swallowing saliva frequently, taken after meals.
[Appendix] Swallowing acid differs from vomiting acid. The *Suwen* attributes vomiting acid to heat, while Li Dongyuan attributes it to cold. Why? Vomiting acid involves expelling acidic fluid. Normally secreted fluids, stagnant due to ascending Qi over a long period, generate heat from dampness, transforming via fire, thus becoming acidic—is this not a heat syndrome? However, in cases where stagnation persists for a long time without being expelled, lodging between the Lung and Stomach, unable to be coughed up or swallowed down, exposure to wind-cold on the body surface exacerbates internal heat stagnation, causing acidic pain piercing the heart. If the body surface is warm, pores open, or aromatic hot decoctions/pills are ingested allowing fluids to circulate, temporary relief occurs—is this not a cold syndrome? The *Suwen*’s mention of heat refers to the root cause; Li Dongyuan’s mention of cold refers to the manifestation.
Attached Prescriptions:
Quzhu Wan (Curd and Atractylodes Pill): Treats retained food and fluid in the Zhongwan region, accompanied by swallowing acid, stabbing heart pain, or vomiting clear fluid.
Medicated Leaven (Shenqu) (stir-fried, 3 liang); Atractodis Rhizoma Preparatum (Cangzhu) (soaked in rice wash water and stir-fried, 1.5 liang); Citri Reticulatae Pericarpium (Chenpi) (1 liang).
Grind into powder, bind with paste made by boiling Shenqu in ginger juice. Take 70 pills per dose, administered with ginger decoction.
Jiawei Pingwei San (Modified Pingwei Powder): Treats swallowing acid or undigested retained food.
Add stir-fried Medicated Leaven (Shenqu) and stir-fried Malto (Maiya), each 0.5 qian, to Raw Material Pingwei San. Do not process Atractodis Rhizoma (Cangzhu) and Magnoliae Officinalis Cortex (Houpo). Add 3 slices of fresh Ginger, decoct in water, and take 5 qian of the liquid.
Belching: Caused by fire and phlegm in the Stomach.
Prescription ingredients:
Arisaematis Rhizoma Preparatum (Nanxing); Pinelliae Rhizoma Preparatum (Banxia); Gypsum Fibrosum (Ruan Shigao); Cyperi Rhizoma (Xiangfu).
Some versions include stir-fried Gardeniae Fructus (Zhizi).
Form into pills or decoct for administration. This is due to stagnant fire in the Stomach and thick phlegm above the diaphragm.
Ruan Shigao Wan (Soft Gypsum Pill) should not be used. Under the phlegm section of the original formula, it states: Belching and swallowing acid result from food stagnation with heat, where fire Qi rushes upward. Scutellariae Radix (Huangqin) serves as the sovereign herb, Arisaematis Rhizoma Preparatum (Nanxing), Pinelliae Rhizoma Preparatum (Banxia), and Citri Reticulatae Pericarpium (Chenpi) serve as assistant herbs. If heat is severe, add Indigo Naturalis (Qingdai).