Belching

Modified xiao yao san, how exactly? And when you say "results are positive but symptoms remain" - what exactly has changed and how and what exactly remains. What is your overall diagnosis for the patient along with supporting signs - tongue, pulse, etc.

Right, well the pattern is stomach qi rebellion first, then liver qi stag, kidney yin xu, and mid jiao qi stag. Pulse is thin and wiry, tongue scant coat, sl deep central crack. Symptoms include a dry belch, quiet mainly, but can be loud, abd discomfort mainly on the sides of the abdomen, stress exacerbates symptoms. Food seems to have little to no effect, patient tends to crave moist cooling foods. Patient is 57 yo female, menopausal, insomnia, night sweats also present. Formula included xiao yao san as base with the addition of suan zao ren tang, and er chen tang as modifiers. Symptoms of discomfort resolved, while belching continued with little change. My formulary is not exhaustive at this point and not all herbs are within access at the moment, but any suggestions are still appreciated.