于余，余曰∶蓄饮也，世无知者。为制一方，其病立已。其人因受业于余。
潘埙曰∶余昔年脾胃受病，每日申未时饭，至二鼓食消方寝，夜半睡醒，嗳气吞酸，糟粕乘气浮上，起坐
摩娑久之复寝，漫服枳术平胃散，或分消，或疏导，久不效。自思年六旬外，恐脾胃弱，不能运化，却去晚餐，
凡粘硬果物及湿热酒面，一切不入口，不知何以致此？因读东垣脾胃泻论，乃知阳气下陷，阴火上冲，脾胃不
实故耳。得一方曰∶补脾胃泻阴火升阳汤，药品主佐在本方，并服药时日，所宜所忌，切中病情。又读调理脾
胃治验，谓不可用淡渗之剂，抑遏阳气，反助阴邪，必加升阳风药，以羌、独活、升麻、防风、炙甘草根，截
入煎药，水煎服。乃根据方服之，片时后阳气缕缕而上，不数日阴火渐伏，脾胃实而愈。
高鼓峰治杭人沈孟嘉妻，患吞酸膈痛屡年矣，肌肉枯削，几于绝粒。诊之，六脉细数，此木乘脾土也。先
投六君子汤加炮姜十余剂，觉吞酸减半。继用补中益气汤加半夏、炮姜，十余剂而吞酸尽去，膈痛亦除。次用
归脾汤倍木香，加炮姜，吞八味而全愈。
薛立斋治一妇人，饮食后或腹闷，或吞酸，自服枳术丸，饮食日少，胸膈痞满，腿肉酸痛，畏见风寒。或
用养胃汤，腿痛浮肿益甚，月经不行。此郁结所伤，脾虚湿热下注。清晨四君子汤、芎、归、二陈，午后以前
汤送越鞠丸，诸症渐见愈。又用归脾、八珍二汤兼服，两月余而经行。
一妇人胸满少食，或腹胀吞酸，或经候不调，此中气虚不能施行化也。用补中益气加砂仁、香附、炮姜，
而进饮食。更以六君，芎、归、贝母、桔梗，而经自调。
一妇人饮食少思，胸中嘈杂，头晕吐痰。此中气虚而有热，用六君子汤加黑山栀、桔梗而愈。后因劳碌，
头晕发热，吐痰不食，用补中益气加半夏、茯苓、天麻而痊。
一妇人中脘嘈杂，口中辛辣，或咳嗽吐痰发喘，面色或白或赤。此脾气虚而肺中伏火也，用六君子加山栀、
桔梗、柴胡，及炒黑片芩、苓，治之寻愈。
一妇人嘈杂吞酸，饮食少思，大便不实。此脾气虚寒而下陷，用补中益气汤加茯苓、半夏、炮姜渐愈，又
常服人参理中丸而安。
一妇人饮食后嘈杂吞酸。此热郁为痰，用六君子汤送越鞠丸渐愈，又用加味归脾汤而痊。后因怒，两胁
胀痛，中脘作酸，用四君子汤送左金丸渐安，仍用六君汤送下越鞠丸而瘥。
朱丹溪治一人，因湿热病，呕吐酸水如醋，用二陈汤加姜炒芩、连、苍术、白术、栀子、藿香、香附、砂
仁而愈。
陈三农治一妇，每食止碗许，稍加，非大便泄泻即噎腐吞酸，腹胀痞闷。此脾虚寒不能化也，用六君子加
茱、连、藿香、香附、砂仁、神曲、煨姜而愈。
薛立斋治一妇人，饮食少，每碗许稍加，非大便不实，必吞酸嗳腐。或以为胃火，用二陈、黄连、枳实，
加内热作呕。曰∶末传寒中，故嗳气吞酸，胀满痞闷。不信，仍用火治，虚症并至，月经不止。始信，以六君
子加炮姜、木香，数剂元气渐复，饮食渐进。又以补中益气，饮食渐进，加炮姜、木香、茯苓、半夏，数剂全
愈。后因饮食劳倦，兼之怒气，饮食顿少，元气顿怯，用前药便加发热，诚似实火，脉洪大，按之而虚，两尺
如无。此命门火衰，用补中益气加姜、桂，及八味丸，兼服两月余，诸症悉愈。此症若因中气虚弱者，用
人参理中汤，或六君子加木香、炮姜。不应，用左金丸，或越鞠丸。虚寒者加附子，或附子理中汤，无有不愈。
一男子虚弱恶食，虽热食亦少，作胀吞酸，日削瘦，服参、苓等药，及灸脾 等穴不应，用八味丸治之而
愈。此真气不足，不能生土，虚火上炎之症也。
一妇人年二十余，饮食每每因怒气吞酸嗳腐，或兼腿根 疼，服越鞠丸等药不应。此脾气虚，湿气下注而
然，以六君子汤、香附、砂仁、藿香、炮姜，数剂少愈，更以六君汤数剂而愈。
一男子瘰 已愈，患吞酸，服参、术药不应。彼谓余毒，薛治以附子理中丸而愈。
张景岳曰∶予向在都中治一 绅，病吞酸，告以为寒，彼执为热，坚持造酒之说，以相问难，莫能与辨，
竟为芩、连之属所毙。此见理不真而固执，以致酿成大害者。（选。）
对我而言，我说：这是水饮停聚的病证，世上没有人知道。我给他制定了一个方子，他的病立刻就好了。那个人因此拜我为师学习医术。
潘埙说：我早年脾胃受了病，每天申时、未时（下午3点到7点）吃饭，到了二更天（晚上9点到11点）食物消化完才能睡觉。半夜睡醒后，打嗝吞酸，糟粕随着气机浮泛上来，起身坐好抚摸腹部很久才再入睡。随意服用枳术平胃散，或者用分消、疏导的方法治疗，长久都没有效果。自己思考年纪六十多岁，恐怕脾胃虚弱，不能运化水谷，于是戒掉晚餐，凡是粘硬的水果以及湿热性质的酒面，一概不入口，不知道为什么会这样？因为读了李东垣的《脾胃论》，才知道是阳气下陷，阴火上冲，脾胃不实的原因。得到一个方子叫作补脾胃泻阴火升阳汤，药物的君臣佐使在本方中已有说明，包括服药的时间、适宜和禁忌的事项，都切中病情。又读《调理脾胃治验》，说不可使用淡渗利湿的药物，以免抑制遏止阳气，反而助长阴邪，必须加入升阳的风药，如羌活、独活、升麻、防风、炙甘草根，截断放入煎药的水中煎服。于是按照方子服用，片刻之后阳气一缕缕上升，不到几天阴火逐渐潜伏，脾胃充实而痊愈。
高鼓峰治疗杭州人沈孟嘉的妻子，患吞酸膈痛多年了，肌肉枯瘦削薄，几乎要断绝饮食。诊察脉象，六脉细数，这是肝木乘克脾土所致。先投予六君子汤加炮姜十余剂，感觉吞酸减少了一半。继而又用补中益气汤加半夏、炮姜，十余剂后吞酸完全去除，膈痛也消除了。接着用归脾汤倍加木香，加炮姜，吞服八味丸，全部痊愈。
薛立斋治疗一个妇人，饮食后有时腹部闷胀，有时吞酸，自行服用枳术丸，饮食日渐减少，胸膈痞满，腿部肌肉酸痛，害怕见到风寒。有人用养胃汤治疗，腿痛浮肿更加严重，月经不行。这是郁结所伤，脾虚导致湿热下注。清晨服用四君子汤、川芎、当归、二陈汤，午后以前汤送服越鞠丸，各种症状渐渐好转。又用归脾汤、八珍汤兼服，两个多月后月经来潮。
另一个妇人胸满少食，有时腹胀吞酸，有时月经不调，这是中气虚弱不能施行运化功能。用补中益气汤加砂仁、香附、炮姜，从而增进饮食。再用六君子汤、川芎、当归、贝母、桔梗，月经自然调顺。
另一个妇人饮食少想，胸中嘈杂，头晕吐痰。这是中气虚弱而有热，用六君子汤加黑山栀、桔梗而痊愈。后来因为劳碌，头晕发热，吐痰不食，用补中益气汤加半夏、茯苓、天麻而康复。
另一个妇人中脘嘈杂，口中辛辣，有时咳嗽吐痰发喘，面色或白或赤。这是脾气虚而肺中伏火，用六君子汤加山栀、桔梗、柴胡，以及炒黑的黄芩、茯苓治疗，不久痊愈。
另一个妇人嘈杂吞酸，饮食少想，大便不成形。这是脾气虚寒而下陷，用补中益气汤加茯苓、半夏、炮姜渐渐好转，又常服人参理中丸而安定。
另一个妇人饮食后嘈杂吞酸。这是热郁形成痰浊，用六君子汤送服越鞠丸渐渐好转，又用加味归脾汤而痊愈。后来因为发怒，两胁胀痛，中脘作酸，用四君子汤送服左金丸渐渐安宁，仍用六君子汤送服越鞠丸而病愈。
朱丹溪治疗一个人，因为湿热病，呕吐酸水像醋一样，用二陈汤加姜炒黄芩、黄连、苍术、白术、栀子、藿香、香附、砂仁而痊愈。
陈三农治疗一个妇人，每顿饭只吃一碗左右，稍微多吃一点，不是大便泄泻就是噎腐吞酸，腹胀痞闷。这是脾虚寒不能运化，用六君子汤加吴茱萸、黄连、藿香、香附、砂仁、神曲、煨姜而痊愈。
薛立斋治疗一个妇人，饮食少，每碗左右稍微多吃一点，不是大便不成形，就是吞酸嗳腐。有人认为是胃火，用二陈汤、黄连、枳实治疗，导致内热加重并呕吐。我说：这是末传寒中，所以嗳气吞酸，胀满痞闷。病人不信，仍然用火法（清热泻火）治疗，虚症一并出现，月经不止。这才相信，用六君子汤加炮姜、木香，几剂后元气渐渐恢复，饮食逐渐增加。又用补中益气汤，饮食逐渐增加，加炮姜、木香、茯苓、半夏，几剂后完全痊愈。后来因为饮食劳倦，加上怒气，饮食顿时减少，元气顿时怯弱，用前面的药便加上发热，确实像实火，脉洪大，但按之空虚，两尺脉如同没有。这是命门火衰，用补中益气汤加干姜、肉桂，以及八味丸，兼服两个多月，各种症状全部痊愈。这种病症如果是因中气虚弱引起的，用人参理中汤，或者六君子汤加木香、炮姜。如果无效，用左金丸，或者越鞠丸。虚寒者加附子，或者附子理中汤，没有不痊愈的。
一个男子虚弱恶食，即使是热食也吃得很少，感到胀气吞酸，日渐消瘦，服用参、苓等药物，以及灸脾俞等穴位没有反应，用八味丸治疗而痊愈。这是真气不足，不能生养脾土，虚火上炎的病症。
一个二十多岁的妇人，饮食每每因为怒气而吞酸嗳腐，有时兼大腿根部疼痛，服用越鞠丸等药没有反应。这是脾气虚，湿气下注所致，用六君子汤、香附、砂仁、藿香、炮姜，几剂后稍有好转，再用六君子汤几剂而痊愈。
一个男子瘰疬已经痊愈，患吞酸，服用参、术类药物没有反应。他认为是有余毒，薛立斋用附子理中丸治疗而痊愈。
张景岳说：我以前在京城治疗一个绅士，病吞酸，我告诉他这是寒证，他坚持认为是热证，坚持认为可以造酒的说法，以此质问我，无法与他辩驳，最终被黄芩、黄连之类的药物害死。这是见理不真而固执，以致酿成大祸的例子。（选自……）
To me, I said: This is a case of fluid retention (accumulation of pathological fluids), which no one in the world understands. I prescribed a formula for him, and his illness was cured immediately. Consequently, this person became my student.
Pan Xun stated: In my earlier years, my Spleen and Stomach were diseased. Every day during the Shen and Wei hours (3 PM to 7 PM), after eating, it was not until the Er Gu hour (9 PM to 11 PM) that the food was digested and I could sleep. Upon waking at midnight, I experienced belching and acid regurgitation; waste products floated upward with the Qi movement. I would get up, sit, and massage my abdomen for a long time before sleeping again. I casually took Zhi Zhu Ping Wei San (Bitter Orange, Atractodes, and Magnolia Bark Powder), or used methods of separation and elimination, or dredging and guiding, but these were ineffective over a long period. Reflecting on myself being over sixty years old, I feared my Spleen and Stomach were weak and unable to transport and transform nutrients. Thus, I eliminated dinner, avoiding all sticky, hard fruits, as well as damp-heat-inducing wines and wheat noodles, wondering why this occurred. By reading Li Dongyuan’s *Pi Wei Lun* (Treatise on the Spleen and Stomach), I realized that Yang Qi had sunk downward, Yin Fire surged upward, and the Spleen and Stomach lacked solidity. I obtained a formula called Bu Pi Wei Xie Yin Huo Sheng Yang Tang (Tonify the Spleen and Stomach, Drain Yin Fire, and Ascend Yang Decoction). The roles of the herbs (monarch, minister, assistant, courier) were explained within the formula itself, along with instructions on timing, suitability, and contraindications, which precisely matched the condition. Furthermore, reading *Tiao Li Pi Wei Zhi Yan* (Verified Experiences in Regulating the Spleen and Stomach), I learned that diuretic and leaching agents should not be used, as they suppress and restrain Yang Qi, thereby assisting Yin Evil. Instead, wind herbs that ascend Yang must be added, such as Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Sheng Ma (Cimicifugae Rhizoma), Fang Feng (Saposhnikoviae Radix), and Zhi Gan Cao (Prepared Licorice Root). These were added to the decoction and boiled in water. Following this prescription, shortly after taking it, Yang Qi rose gradually. Within a few days, Yin Fire subsided, the Spleen and Stomach became solid, and I recovered.
Gao Gufeng treated the wife of Shen Mengjia from Hangzhou, who had suffered from acid regurgitation and chest diaphragm pain for many years. Her muscles were emaciated, and she was nearly starving. Upon pulse diagnosis, her six pulses were fine and rapid. This indicated Liver Wood encroaching upon Spleen Earth. Initially, he administered Liu Jun Zi Tang (Six Gentlemen Decoction) with Pao Jiang (Prepared Ginger) for more than ten doses, reducing acid regurgitation by half. Subsequently, he used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with Ban Xia (Pinelliae Rhizoma) and Pao Jiang for another ten doses, completely eliminating acid regurgitation and relieving the chest pain. Finally, he prescribed Gui Pi Tang (Restore the Spleen Decoction) with doubled Mu Xiang (Aucklandiae Radix) and Pao Jiang, combined with Ba Wei Wan (Eight-Ingredient Pill), resulting in full recovery.
Xue Lizhai treated a woman who, after eating, sometimes experienced abdominal stuffiness or acid regurgitation. She self-medicated with Zhi Zhu Wan (Bitter Orange and Atractodes Pill), leading to decreased food intake, chest and diaphragm fullness, soreness and pain in the leg muscles, and aversion to wind and cold. Another practitioner used Yang Wei Tang (Nourish the Stomach Decoction), which worsened her leg pain and edema, and stopped her menstruation. This was caused by constraint injury, with Spleen deficiency leading to damp-heat pouring downward. In the morning, she took Si Jun Zi Tang (Four Gentlemen Decoction), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Er Chen Tang (Two-Cured Decoction). In the afternoon, Yue Ju Wan (Pill to Resolve Depression) was taken with the morning decoction. Gradually, all symptoms improved. She then concurrently took Gui Pi Tang and Ba Zhen Tang (Eight-Treasure Decoction). After more than two months, her menstruation resumed.
Another woman presented with chest fullness, poor appetite, occasional abdominal distension with acid regurgitation, and irregular menstruation. This was due to Middle Qi deficiency failing to perform transformation and transportation. Bu Zhong Yi Qi Tang was used with Sha Ren (Amomi Fructus), Xiang Fu (Cyperi Rhizoma), and Pao Jiang, which improved her appetite. Then, Liu Jun Zi Tang with Chuan Xiong, Dang Gui, Bei Mu (Fritillariae Cirrhosae Bulbus), and Jie Geng (Platycodonis Radix) was used, regulating her menstruation naturally.
Another woman had poor appetite, gastric discomfort (zao re), dizziness, and expectoration. This was Middle Qi deficiency with heat. Liu Jun Zi Tang was modified with Hei Shan Zhi (Black Gardenia Fruit) and Jie Geng, curing her. Later, due to overwork, she developed dizziness, fever, expectoration, and anorexia. Bu Zhong Yi Qi Tang was modified with Ban Xia, Fu Ling (Poria), and Tian Ma (Gastrodiae Rhizoma), leading to recovery.
Another woman had epigastric discomfort, a spicy taste in the mouth, occasional cough with expectoration and wheezing, and complexion varying between pale and red. This was Spleen Qi deficiency with latent fire in the Lung. Liu Jun Zi Tang was modified with Shan Zhi, Jie Geng, Chai Hu (Bupleuri Radix), and fried black Huang Qin (Scutellariae Radix) and Fu Ling. She recovered soon after.
Another woman had gastric discomfort and acid regurgitation, poor appetite, and loose stools. This was Spleen Qi deficiency and cold with sinking Qi. Bu Zhong Yi Qi Tang was modified with Fu Ling, Ban Xia, and Pao Jiang, leading to gradual improvement. She also frequently took Ren Shen Li Zhong Wan (Ginseng Regulate the Middle Pill) to maintain stability.
Another woman had gastric discomfort and acid regurgitation after meals. This was heat constraint generating phlegm. Liu Jun Zi Tang was used to deliver Yue Ju Wan, leading to gradual improvement. She was then cured by Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). Later, due to anger, she experienced distending pain in both hypochondria and sourness in the epigastrium. Si Jun Zi Tang was used to deliver Zuo Jin Wan (Left Metal Pill), bringing gradual relief. She continued with Liu Jun Zi Tang delivering Yue Ju Wan until recovery.
Zhu Danxi treated a man who, due to a damp-heat disease, vomited acidic water resembling vinegar. He was cured using Er Chen Tang (Two-Cured Decoction) modified with ginger-fried Huang Qin, Huang Lian (Coptidis Rhizoma), Cang Zhu (Atractodis Rhizoma), Bai Zhu (Atractodis Macrocephalae Rhizoma), Zhi Zi (Gardeniae Fructus), Huo Xiang (Pogostemonis Herba), Xiang Fu, and Sha Ren.
Chen Sansan treated a woman who could only eat about one bowl per meal. If she ate slightly more, she either suffered diarrhea or experienced choking, putrid belching, and acid regurgitation, accompanied by abdominal distension and stuffiness. This was Spleen deficiency and cold failing to transform food. Liu Jun Zi Tang was modified with Zhu Yu (Evodiae Fructus), Lian (Huang Lian), Huo Xiang, Xiang Fu, Sha Ren, Shen Qu (Massa Medicata Fermentata), and Wei Jiang (Baked Ginger), curing her.
Xue Lizhai treated a woman with poor appetite. Eating slightly more than one bowl resulted in either loose stools or acid regurgitation and putrid belching. Some attributed this to Stomach Fire and prescribed Er Chen Tang, Huang Lian, and Zhi Shi (Immature Bitter Orange), which exacerbated internal heat and vomiting. Xue stated: "This has transmitted to Cold in the Interior, hence belching, acid regurgitation, distension, and stuffiness." The patient did not believe him and persisted with heat-clearing treatments, leading to the appearance of deficiency symptoms and continuous menstruation. Only then did she accept treatment. Liu Jun Zi Tang with Pao Jiang and Mu Xiang was given for several doses, gradually restoring Yuan Qi and increasing food intake. Bu Zhong Yi Qi Tang was then used, adding Pao Jiang, Mu Xiang, Fu Ling, and Ban Xia, leading to complete recovery after several doses. Later, due to dietary indiscretion, fatigue, and anger, her food intake suddenly dropped, and Yuan Qi became deficient. Taking the previous herbs caused fever. Although it resembled excess fire, the pulse was large and forceful on superficial palpation but empty on deep pressure, with the two Chi pulses feeling absent. This indicated decline of Ming Men (Gate of Life) Fire. Bu Zhong Yi Qi Tang with Jiang (Sheng Jiang/Radix Zingiberis Recens or Gan Jiang/Radix Zingiberis Preparata) and Gui (Rou Gui/Cortex Cinnamomi) was used, along with Ba Wei Wan (Eight-Ingredient Pill), taken concurrently for over two months, curing all symptoms. For cases due to Middle Qi weakness, Ren Shen Li Zhong Tang or Liu Jun Zi Tang with Mu Xiang and Pao Jiang should be used. If ineffective, use Zuo Jin Wan or Yue Ju Wan. For deficiency-cold, add Fu Zi (Aconiti Lateralis Radix Preparata) or use Fu Zi Li Zhong Tang. There will be no failure to cure.
A weak man with aversion to food, eating little even hot food, experiencing bloating and acid regurgitation, and wasting away, did not respond to Ren Shen (Ginseng Radix), Fu Ling, or moxibustion on Pi Shu (BL20). He was cured by Ba Wei Wan. This was a case of insufficient True Qi failing to generate Earth (Spleen/Stomach), with deficient fire flaming upward.
A woman in her twenties often experienced acid regurgitation and putrid belching due to anger, sometimes with pain at the root of the thigh. Yue Ju Wan and other medicines were ineffective. This was Spleen Qi deficiency with dampness pouring downward. Liu Jun Zi Tang with Xiang Fu, Sha Ren, Huo Xiang, and Pao Jiang brought slight improvement after several doses. Further doses of Liu Jun Zi Tang led to full recovery.
A man whose scrofula (luo li) had healed subsequently developed acid regurgitation. He did not respond to Ren Shen and Bai Zhu. Believing it was residual toxin, Xue Lizhai treated him with Fu Zi Li Zhong Wan, curing him.
Zhang Jingyue stated: Previously, when I was in the capital, I treated a gentleman suffering from acid regurgitation. I informed him it was a Cold pattern, but he insisted it was Heat. He stubbornly adhered to the theory that alcohol brewing caused it, questioning me without resolution. He ultimately died due to treatment with Huang Qin and Huang Lian. This illustrates how incorrect understanding and obstinacy can lead to disastrous consequences. (Selected.)