嘈杂与吞酸一类，皆由肺受火伤，不能平木，木挟相火乘肺，则脾冲和之气索
矣。谷之精微不行，浊液攒聚，为痰为饮，其痰亦或从火木之成化酸，肝木摇动中土，故中土扰扰不
宁，而为嘈杂如饥状，每求食以自救，苟得少食，则嘈杂亦少止，止而复作。盖土虚不禁木所摇，故
治法必当补土伐木治痰饮。若不以补土为君，务攻其邪，久久而虚，必变为反胃，为泻、为痞满、为
眩晕等病矣。脉洪大者火多，二陈汤加姜汁炒山栀、黄连。脉滑大者痰多，二陈汤加南星、栝蒌、黄
芩、黄连、栀子。肥人嘈杂，二陈汤少加抚芎、苍术、白术、炒栀子。脉弦细身倦怠者，六君子汤加
抚芎、苍术、白术、姜汁炒栀子。有用消克药过多，饥不能食，精神渐减，四君子加白芍、陈皮、姜
汁炒黄连。心悬悬如饥，欲食之时，勿与以食，只服三圣丸佳。心下嘈杂者，导饮丸最妙。
肾主欠嚏。经云∶肾为欠为嚏是也。运气欠嚏有三∶一曰寒。经云∶太阳司天，寒气下临，心气
上从，寒清时举，鼽嚏，喜悲，数欠是也。二曰火。经云∶少阳司天之政，三之气，炎暑至，民病嚏
欠是也。三曰湿郁其火。经云∶阳明司天之政，
初之气，阴始凝，民病中热，嚏欠是也。
【欠伸】经云∶二阳一阴发病，主惊骇背痛，善噫善欠。王注云∶气郁于胃，故欠生焉。运气欠
伸皆属风。经云∶厥阴在泉，风淫所胜，病善伸数欠，治以辛是也。《灵枢》口问篇，黄帝曰∶人之
欠者，何气使然？岐伯曰∶卫气昼日行于阳，夜半则行于阴，阴者主夜，夜者卧；阳者主上，阴者主
下，故阴气积于下，阳气未尽，阳引而上，阴引而下，阴阳相引故数欠。阳气尽，阴气盛，则目瞑；
阴气尽，阳气盛，则寤矣。泻足少阴，补足太阳。针灸欠伸有二法∶此其一也。其二取胃。经云∶胃
足阳明之脉，是动则病振寒，善伸数欠，视盛、虚、热、寒、陷下调之也。仲景云∶中寒家，善欠。
【嚏】《灵枢》口问篇，黄帝曰∶人之嚏者，何气使然？岐伯曰∶阳气和利，满于心，出于鼻，
故为嚏。补足太阳荥、眉本。一曰眉上也。运气嚏有三∶一曰热火。经云∶少阴司天之政，热病生于
上，民病血溢，鼽嚏。又云∶少阴司天，热气下临，肺气上从，病嚏鼽衄。又云∶少阴之复，燠热内
作，烦躁鼽嚏。又云∶少阳所至为
鼽嚏。又云∶少阳司天，火气下临，肺气上从，咳嚏鼽衄。治以诸寒是也。二曰金不及火乘之。经曰∶
金不及曰从革，从革之纪，其病嚏咳鼽衄，从火化者是也。三曰燥金。经云∶阳明所至，为鼽嚏是也。
刘河间云∶嚏，鼻中因痒而气喷作于声也。鼻为肺窍，痒为火化，心火邪热干于阳明，发于鼻而痒则
嚏也。或故以物扰之痒而嚏者，扰痒属火故也。或视日而嚏者，由目为五脏神华，太阳真火晃曜于目，
心神躁乱而热发于上，则鼻中痒而嚏也。仲景云∶其人清涕出，发热色和者善嚏。
嘈杂与吞酸属于同一类病证，皆因肺脏受火热之邪损伤，无法制约肝木（平木），导致肝木挟带相火侵犯肺脏，从而使脾脏冲和之气耗散。水谷的精微物质不能正常输布，浊液积聚，形成痰饮；这些痰饮也可能随着火、木的化生而变成酸味。肝木摇动中焦脾胃（中土），导致中焦扰乱不安，出现像饥饿一样的嘈杂感，患者往往寻求食物来缓解自身不适，如果吃一点东西，嘈杂感就会暂时减轻，但不久后又会发作。这是因为脾土虚弱，无法抵御肝木的克制，所以治疗必须采用补益脾土、疏泄肝木并化痰饮的方法。如果不以补益脾土为主，一味地攻伐邪气，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。脉象洪大的，说明火邪较多，用二陈汤加姜汁炒山栀、黄连；脉象滑大的，说明痰湿较多，用二陈汤加天南星、瓜蒌、黄芩、黄连、栀子；体型肥胖者患嘈杂，用二陈汤少量加入抚芎、苍术、白术、炒栀子；脉象弦细且身体倦怠的，用六君子汤加抚芎、苍术、白术、姜汁炒栀子；有人因过多使用消食克伐的药物，导致饥饿却无法进食，精神逐渐减退，用四君子汤加白芍、陈皮、姜汁炒黄连；心中空虚如饥，想吃东西时，不要立即给食物，只服用三圣丸效果较好；心下嘈杂的，导饮丸最为巧妙。
肾主管呵欠和喷嚏。医经说：“肾表现为呵欠和喷嚏”，就是这个道理。运气学说中呵欠和喷嚏有三种成因：一是寒邪。医经说：“太阳司天之年，寒气下行，心气上从，寒冷清肃时常发生，出现鼻塞流涕、打喷嚏，喜欢悲伤，频繁打呵欠。”二是火邪。医经说：“少阳司天之政，在三之气阶段，炎热暑气到来，民众患病出现打喷嚏、打呵欠。”三是湿气郁结导致火邪内蕴。医经说：“阳明司天之政，在初之气阶段，阴气开始凝结，民众患中热病，出现打喷嚏、打呵欠。”
【呵欠伸展】医经说：“阳明与厥阴发病，主要表现为惊骇、背痛，容易嗳气、打呵欠。”王冰注解说：“气郁结在胃中，所以产生呵欠。”运气学说中呵欠伸展都属于风邪。医经说：“厥阴在泉，风邪过胜，疾病表现为喜欢伸展、频繁打呵欠，治疗用辛味药。”《灵枢·口问》篇中，黄帝问：“人打呵欠，是什么气引起的？”岐伯回答：“卫气白天运行于阳分，半夜则运行于阴分。阴分主夜间，夜间主睡眠；阳分主上部，阴分主下部。所以阴气积聚在下部，阳气未尽，阳气牵引向上，阴气牵引向下，阴阳相互牵引，所以频繁打呵欠。阳气耗尽，阴气旺盛，眼睛就闭合睡觉；阴气耗尽，阳气旺盛，人就醒来了。”治疗方法是泻足少阴经，补足太阳经。这是针灸治疗呵欠伸展的方法之一。第二种方法是取胃经。医经说：“足阳明胃经，发生病变时会战栗发冷，喜欢伸展、频繁打呵欠，需根据经脉的盛、虚、热、寒、陷下等情况进行调理。”张仲景说：“患有中寒症的人，喜欢打呵欠。”
【喷嚏】《灵枢·口问》篇中，黄帝问：“人打喷嚏，是什么气引起的？”岐伯回答：“阳气调和顺畅，充满于心，出于鼻，所以打喷嚏。”治疗方法是补足太阳经的荥穴和眉本穴（一说在眉上）。运气学说中喷嚏有三种成因：一是热火。医经说：“少阴司天之政，热病生于上部，民众患病出现血溢、鼻塞流涕、打喷嚏。”又说：“少阴司天，热气下行，肺气上从，疾病表现为打喷嚏、鼻塞流涕、鼻出血。”又说：“少阴复气，燠热内生，烦躁、鼻塞流涕、打喷嚏。”又说：“少阳所至表现为鼻塞流涕、打喷嚏。”又说：“少阳司天，火气下行，肺气上从，咳嗽、打喷嚏、鼻塞流涕、鼻出血。”治疗用各种寒凉药物。二是金气不足，被火邪乘袭。医经说：“金气不足称为从革，从革之纪，疾病表现为打喷嚏、咳嗽、鼻塞流涕、鼻出血，这是从火化生的表现。”三是燥金。医经说：“阳明所至，表现为鼻塞流涕、打喷嚏。”刘河间说：“喷嚏，是因为鼻中发痒，气息喷发而出发出声音。鼻子是肺的窍道，痒是由火化生，心火邪热干扰阳明经，反映在鼻子上发痒就会打喷嚏。或者是故意用物体刺激鼻子使其发痒而打喷嚏，这种刺激发痒属于火邪所致。或者是看太阳时打喷嚏，因为眼睛是五脏神气的精华所在，太阳真火闪耀于眼中，心神躁乱而热气发于上部，导致鼻中发痒而打喷嚏。”张仲景说：“那人流出清鼻涕，发热但面色平和，喜欢打喷嚏。”
Chaoza (Rumbling in the stomach) and Tun Suan (Acid regurgitation) belong to the same category of diseases. They are all caused by the Lung being injured by Fire pathogen, failing to control Liver Wood (Ping Mu). Consequently, Liver Wood carries Ministerial Fire to invade the Lung, causing the harmonious Qi of the Spleen to dissipate. The refined essence of food and drink fails to circulate properly, turbid fluids accumulate, forming Phlegm and Fluid Retention (Tan Yin). These phlegms may also transform into an acidic nature due to the transformation of Fire and Wood. Liver Wood agitates the Middle Earth (Spleen and Stomach), causing disturbance in the Middle Jiao, resulting in a sensation of rumbling similar to hunger. Patients often seek food to relieve themselves; if they eat a little, the rumbling subsides temporarily but recurs later. This is because the Earth is deficient and cannot withstand the agitation of Wood. Therefore, the treatment method must involve tonifying Earth, subduing Wood, and resolving Phlegm and Fluid Retention. If one does not prioritize tonifying Earth but instead insists on attacking the pathogen, prolonged use will lead to further deficiency, inevitably transforming into Fan Wei (Regurgitation), Xie Xie (Diarrhea), Pi Man (Fullness and obstruction), Xuan Yun (Vertigo), and other diseases. A洪大 (Hong Da - Surging and large) pulse indicates excess Fire; use Er Chen Tang (Two-Aged Decoction) with Jiang Zhi Chao Shan Zhi (Ginger-processed Gardenia Fructus) and Huang Lian (Coptidis Rhizoma). A滑大 (Hua Da - Slippery and large) pulse indicates excess Phlegm; use Er Chen Tang with Nan Xing (Arisaematis Rhizoma Preparatum), Gua Lou (Trichosanthis Fructus), Huang Qin (Scutellariae Radix), Huang Lian, and Zhi Zi (Gardeniae Fructus). For obese patients with Chaoza, use Er Chen Tang with a small amount of Fu Xiong (Ligusticum Chuanxiong Rhizoma), Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Chao Zhi Zi (Processed Gardenia Fructus). For those with a弦细 (Xian Xi - Wiry and fine) pulse and body fatigue, use Liu Jun Zi Tang (Six-Gentlemen Decoction) with Fu Xiong, Cang Zhu, Bai Zhu, and Jiang Zhi Chao Zhi Zi. For cases where excessive use of digestive and reducing herbs leads to hunger without ability to eat, and gradual decline in spirit, use Si Jun Zi Tang (Four-Gentlemen Decoction) with Bai Shao (Paeoniae Radix Alba), Chen Pi (Citri Reticulatae Pericarpium), and Jiang Zhi Chao Huang Lian. When the heart feels empty like hunger and there is a desire to eat, do not provide food immediately; taking San Sheng Wan (Three-Sage Pill) is preferable. For epigastric Chaoza, Dao Yin Wan (Guide Out Fluids Pill) is most effective.
The Kidney governs Qian (Yawning) and Ti (Sneezing). The Classics state: "The Kidney manifests as yawning and sneezing." In the theory of Six Qi (Yun Qi), there are three causes for yawning and sneezing: First, Cold. The Classics state: "When Tai Yang governs the year, Cold Qi descends, Heart Qi responds from above. Cold and clarity frequently occur, leading to Biu (nasal congestion/discharge), Ti, sorrowfulness, and frequent Qian." Second, Fire. The Classics state: "In the administration of Shao Yang governing the year, during the third Qi period, hot summer heat arrives, and the people suffer from Ti and Qian." Third, Dampness stagnating Fire. The Classics state: "In the administration of Yang Ming governing the year, during the first Qi period, Yin Qi begins to condense, and the people suffer from middle heat, Ti, and Qian."
[Yawning and Stretching] The Classics state: "When Yang Ming and Jue Yin are affected, the main symptoms are fright, back pain, frequent Yi (belching), and Qian." Wang Bing's commentary notes: "Qi stagnates in the Stomach, thus Qian arises." In Yun Qi theory, yawning and stretching are attributed to Wind. The Classics state: "When Jue Yin is in the lower position, Wind excess causes disease characterized by frequent stretching and yawning; treat with Pungent substances." In the *Kou Wen* chapter of *Ling Shu*, the Yellow Emperor asked: "What Qi causes yawning?" Qibo replied: "Wei Qi travels through the Yang meridians during the day and enters the Yin at midnight. Yin governs night, and night governs sleep; Yang governs the upper, Yin governs the lower. Thus, Yin Qi accumulates below, while Yang Qi has not yet exhausted. Yang pulls upward, Yin pulls downward; the mutual pulling of Yin and Yang causes frequent yawning. When Yang Qi exhausts and Yin Qi becomes abundant, the eyes close (sleep); when Yin Qi exhausts and Yang Qi becomes abundant, one awakens." The treatment involves draining Foot Shaoyin and supplementing Foot Taiyang. This is one method of acupuncture for yawning and stretching. The second method involves selecting the Stomach meridian. The Classics state: "Foot Yangming Stomach Meridian, when disturbed, causes chills, frequent stretching, and yawning; regulate according to fullness, deficiency, heat, cold, or sinking." Zhang Zhongjing stated: "Those suffering from internal Cold often yawn."
[Sneezing] In the *Kou Wen* chapter of *Ling Shu*, the Yellow Emperor asked: "What Qi causes sneezing?" Qibo replied: "Yang Qi is harmonious and smooth, fills the Heart, and emerges from the Nose, thus causing sneezing." The treatment involves supplementing the Ying-Spring point of Foot Taiyang and Mei Ben (one view says it is above the eyebrow). In Yun Qi theory, there are three causes for sneezing: First, Hot Fire. The Classics state: "When Shao Yin governs the year, Heat disease arises in the upper part, and the people suffer from blood hemorrhage, nasal discharge, and sneezing." It also states: "When Shao Yin governs the year, Heat Qi descends, Lung Qi responds from above, causing sneezing, nasal discharge, and epistaxis." It also states: "When Shao Yin returns, internal warmth arises, causing irritability, nasal discharge, and sneezing." It also states: "Shao Yang arrival manifests as nasal discharge and sneezing." It also states: "When Shao Yang governs the year, Fire Qi descends, Lung Qi responds from above, causing cough, sneezing, nasal discharge, and epistaxis." Treat with various Cold-natured medicines. Second, Metal deficiency allowing Fire to exploit it. The Classics say: "Metal deficiency is called Cong Ge. In the Ji of Cong Ge, the disease manifests as sneezing, cough, nasal discharge, and epistaxis, which transforms according to Fire." Third, Dry Metal. The Classics state: "Yang Ming arrival manifests as nasal discharge and sneezing." Liu Hejian said: "Sneezing occurs because itching in the nose causes Qi to spray out with sound. The nose is the orifice of the Lung; itching is generated by Fire. When Heart Fire and evil heat interfere with Yang Ming, manifesting as itching in the nose, sneezing occurs. Or, if one intentionally stimulates the nose to cause itching and sneeze, this stimulation-induced itching belongs to Fire. Or, sneezing upon looking at the sun, because the eyes are the splendor of the Five Zang Shen, and the True Fire of Tai Yang shines in the eyes, causing mental restlessness and heat rising to the upper part, leading to nasal itching and sneezing." Zhang Zhongjing stated: "If a person has clear nasal discharge, fever, but a normal complexion, they tend to sneeze."