论
《内经》曰；胃为水谷之海，无物不受。若夫湿面鱼腥，水果生冷，以及烹饪调和，粘滑难化等物，恣食无节，朝
伤暮损，而成清痰稠饮，滞于中宫。故谓嘈杂嗳气，吞酸痞满，甚则为翻胃膈噎，即此之由也。夫嘈杂之为证也，似饥
不饥，似痛不痛，而有懊 不自宁之状者是也。其证或兼嗳气，或兼痞满，或兼恶心，渐至胃脘作痛，乃痰火之为患也。
治法以南星、半夏、橘红之类，以消其痰。芩、连、栀子、石膏、知母之类，以降其火。苍术、白术、芍药之类，以健
脾行湿，壮其本元。又当忌口节欲，无有不安者也。
脉法
右寸关脉紧而滑。两寸弦滑，胸中有留饮。寸脉横者，膈上有横积也。
右关弦急甚者，木乘土位，欲作胃反，难治。
方法
丹溪曰∶此为食郁有热，炒栀子、姜炒黄连，乃必用之药也。
肥人宜二陈汤，少加抚芎、苍术、白术、栀子。
若湿痰气滞，不喜食，用三补丸加苍术，倍香附。大抵嘈杂是痰因火动，令人心嘈，似饥非饥，有积有热也，治痰
为先，宜用山栀、姜汁炒黄连为君，南星、半夏、陈皮为臣，热多加青黛。（若食郁有热，栀子与姜炒黄连不可无。）
蒋氏子心嘈索食，以白术、黄连、陈皮为丸，白汤下七、八十丸，数服而止。
嘈杂眩远，是火动其痰，二陈加栀子、芩、连之类。
嗳气，胃中有火有痰，用南星、半夏、软石膏、香附作丸，或煎服之。盖胃中有郁火，膈上有稠痰也。
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。
（以上丹溪方法凡八条）
三圣丸 治嘈杂神效。
白术（四两） 黄连（五钱） 橘红（一两）
上为细末，神曲糊为丸，如绿豆大，每服五十丸，津唾下，或姜汤下。
术连丸 治嘈杂。
白术（四两） 黄连（四钱五分）
上为细末，神曲糊丸，如黍米大，津唾送下。
软石膏丸 治嘈杂嗳气。
南星（泡制） 半夏（泡洗） 软石膏（ ） 香附（童便浸透） 栀子（炒，各等分）
上为细末，粥丸如梧桐子大，每服五十丸，姜汤下。
曲术丸 治中脘有饮则嘈，宿食则酸。（方见吞酸门。）
论说
《黄帝内经》记载：胃是容纳水谷的脏腑，没有什么是它不能接受的。如果是湿面、鱼类、腥味食物，以及水果、生冷之物，还有烹饪调和后粘滑难以消化的食物，放纵饮食没有节制，早晨损伤晚上损耗，从而形成清稀的痰和浓稠的饮邪，停滞在中焦脾胃。所以所说的嘈杂、嗳气、吞酸、痞满等症状，严重的甚至发展为翻胃（呕吐反出）和膈噎（吞咽困难），就是由于这个原因造成的。所谓嘈杂这种病证，感觉像饥饿又不是饥饿，感觉像疼痛又不是疼痛，而有心中烦闷不自安的状态。这种病症或者兼有嗳气，或者兼有痞满，或者兼有恶心，逐渐发展到胃脘部疼痛，这是痰火为患的结果。治疗方法用南星、半夏、橘红这类药物，来消除痰浊；用黄芩、黄连、栀子、石膏、知母这类药物，来降泄火热；用苍术、白术、芍药这类药物，来健脾祛湿，强壮根本元气。还应当忌口并节制房事，就没有不安稳的道理了。
脉法
右手寸部和关部脉象紧而滑。两手寸部脉象弦滑，说明胸中有停留的饮邪。寸部脉象横溢，说明膈上有横向积聚的病理产物。
右手关部脉象弦急严重的，是肝木乘克脾土，想要发作胃反（呕吐），难以治疗。
方法
朱丹溪说：这是因为食积郁结而生热，炒栀子、姜汁炒黄连，是必须使用的药物。
肥胖的人适宜用二陈汤，少量加入抚芎（川芎）、苍术、白术、栀子。
如果是湿痰气滞，不喜欢吃东西，用三补丸加上苍术，加倍使用香附。大抵嘈杂是因为痰因火动，让人心里烦乱，似饥非饥，有积滞有热邪，治疗以化痰为先，适宜用山栀、姜汁炒黄连作为主药，南星、半夏、陈皮作为辅药，热邪重的多加青黛。（如果是食积郁结生热，栀子和姜汁炒黄连不可不用。）
蒋氏的儿子心中烦嘈索求食物，用白术、黄连、陈皮制成丸药，用温开水送服七八十丸，服用几次后就停止了。
嘈杂伴有眩晕视远模糊，是火动其痰，在二陈汤基础上加栀子、黄芩、黄连这类药物。
嗳气，是胃中有火有痰，用南星、半夏、软石膏、香附制成丸药，或者煎服。因为胃中有郁结之火，膈上有浓稠的痰。
打嗝吞酸，这是食积郁结生热，火气冲上，以黄芩为主药，南星、半夏、陈皮为佐药。
（以上朱丹溪的方法共八条）
三圣丸 治疗嘈杂非常有效。
白术（四两） 黄连（五钱） 橘红（一两）
上面三种药研成细末，用神曲糊制作成丸药，如绿豆大小，每次服用五十丸，用唾液送下，或者用姜汤送下。
术连丸 治疗嘈杂。
白术（四两） 黄连（四钱五分）
上面两种药研成细末，用神曲糊制成丸药，如黍米大小，用唾液送下。
软石膏丸 治疗嘈杂嗳气。
南星（炮制） 半夏（炮洗） 软石膏（缺重量） 香附（童便浸透） 栀子（炒，各等分）
上面几种药研成细末，用米粥制成丸药如梧桐子大小，每次服用五十丸，用姜汤送下。
Treatise
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The Stomach is the sea of water and grain, accepting all things. If one consumes wet noodles, fish, pungent foods, fruits, raw and cold items, as well as cooked foods that are sticky, slippery, and difficult to digest, indulging in eating without restraint, causing damage morning after evening, this leads to the formation of clear phlegm and thick fluid retention stagnating in the middle jiao (middle burner). Therefore, symptoms such as zaozha (sickly hunger/irritability), aqi (belching), tun-suan (acid regurgitation), and piman (fullness and obstruction), and in severe cases, fanwei (vomiting with reflux) and ge-ye (dysphagia/chest obstruction), arise from this cause. Regarding the syndrome of zaozha (sickly hunger/irritability), it presents as a sensation resembling hunger but not being hunger, resembling pain but not being pain, accompanied by a state of inner restlessness and discomfort. This syndrome may be accompanied by aqi (belching), or piman (fullness and obstruction), or nausea, gradually progressing to pain in the epigastrium; this is a disorder caused by phlegm-fire. The treatment method involves using herbs such as Nanxing (Arisaema Rhizoma prepared), Banxia (Pinellia Rhizoma), and Juhong (Citri Reticulatae Pericarpium) to resolve phlegm; Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), Shigao (Gypsum Fibrosum), and Zhimu (Anemarrhenae Rhizoma) to descend fire; and Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), and Shaoyao (Paeoniae Radix Alba) to strengthen the Spleen, promote dampness resolution, and bolster the root vitality. One must also observe dietary restrictions and moderate sexual desire, ensuring no unrest remains.
Pulse Diagnosis
The pulse at the right Cun (inch) and Guan (bar) positions is tight and slippery. A wiry and slippery pulse at both Cun positions indicates retained fluid in the chest. A transverse pulse at the Cun position indicates horizontal accumulation above the diaphragm.
If the pulse at the right Guan position is wiry and urgent to an extreme degree, it signifies Liver Wood overacting on Spleen Earth, suggesting impending Weifan (stomach reversal/vomiting), which is difficult to treat.
Methods
Zhu Danxi stated: This is due to food stagnation with郁 (depression) generating heat. Chao Zhizi (Stir-fried Gardeniae Fructus) and Jiangchao Huanglian (Ginger-stir-fried Coptidis Rhizoma) are essential medicines.
For obese individuals, Erchen Tang (Two-Cured Decoction) is suitable, with small additions of Fuxiong (Chuanxiong Rhizoma), Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), and Zhizi (Gardeniae Fructus).
If there is damp-phlegm and qi stagnation with loss of appetite, Sanbu Wan (Three-Tonifying Pill) should be used with added Cangzhu (Atractylodis Rhizoma) and doubled Xiangfu (Cyperi Rhizoma). Generally, zaozha (sickly hunger/irritability) is caused by phlegm stirred by fire, making the heart feel irritable, resembling hunger but not being hunger, involving accumulation and heat. Treatment prioritizes resolving phlegm, preferably using Shanzhi (Mountain Gardeniae/Zhizi) and Jiangzhi Chao Huanglian (Ginger-juice stir-fried Coptidis Rhizoma) as the sovereign herb, Nanxing (Arisaema Rhizoma prepared) and Banxia (Pinellia Rhizoma), Chenpi (Citri Reticulatae Pericarpium) as minister herbs, and Qingdai (Indigo Naturalis) added if heat is severe. (If there is food stagnation with depression generating heat, Zhizi and Ginger-stir-fried Huanglian cannot be omitted.)
The son of Mr. Jiang suffered from heart irritability and craved food. He was prescribed pills made of Baizhu (Atractylodis Macrocephalae Rhizoma), Huanglian (Coptidis Rhizoma), and Chenpi (Citri Reticulatae Pericarpium), taken with warm water, 70-80 pills per dose, which ceased after several doses.
Zaozha (sickly hunger/irritability) with dizziness and blurred vision is caused by fire stirring phlegm; use Erchen Tang (Two-Cured Decoction) with added Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), and Huanglian (Coptidis Rhizoma).
Aqi (belching) occurs when there is fire and phlegm in the Stomach; use Nanxing (Arisaema Rhizoma prepared), Banxia (Pinellia Rhizoma), Ruangao (Soft Gypsum/Shigao), and Xiangfu (Cyperi Rhizoma) made into pills, or decocted for administration. This is because there is depressed fire in the Stomach and thick phlegm above the diaphragm.
Yiqi (burping) and tun-suan (acid regurgitation) result from food stagnation with depression generating heat, where fire qi rushes upward. Huangqin (Scutellariae Radix) serves as the sovereign herb, with Nanxing (Arisaema Rhizoma prepared), Banxia (Pinellia Rhizoma), and Chenpi (Citri Reticulatae Pericarpium) as assistant herbs.
(Above are eight methods from Zhu Danxi.)
Sansheng Wan (Three-Sage Pill) treats zaozha (sickly hunger/irritability) with miraculous effect.
Baizhu (Atractylodis Macrocephalae Rhizoma) (4 liang), Huanglian (Coptidis Rhizoma) (5 qian), Juhong (Citri Reticulatae Pericarpium) (1 liang).
Grind the above into fine powder, mix with Shenqu paste to form pills the size of mung beans. Take 50 pills per dose, swallowed with saliva or ginger soup.
Shulian Wan (Bupleurum-Coptis Pill) treats zaozha (sickly hunger/irritability).
Baizhu (Atractylodis Macrocephalae Rhizoma) (4 liang), Huanglian (Coptidis Rhizoma) (4 qian 5 fen).
Grind the above into fine powder, mix with Shenqu paste to form pills the size of millet seeds, swallowed with saliva.
Ruangao Wan (Soft Gypsum Pill) treats zaozha (sickly hunger/irritability) and aqi (belching).
Nanxing (Arisaema Rhizoma prepared), Banxia (Pinellia Rhizoma washed/prepared), Ruangao (Soft Gypsum/Shigao) [weight missing], Xiangfu (Cyperi Rhizoma soaked in child's urine), Zhizi (Gardeniae Fructus stir-fried) [equal parts each].
Grind the above into fine powder, mix with congee to form pills the size of paulownia seeds. Take 50 pills per dose, with ginger soup.
Qushu Wan (Shenqu-Baizhu Pill) treats zaozha (sickly hunger/irritability) when there is fluid retention in Zhongwan (CV12), and tun-suan (acid regurgitation) when there is retained food. (Formula seen in the Acid Regurgitation section.)