Abstract:“All acid eructation is ascribed to heat” is one of the Nineteen items of pathogenesis in the Inner Canon of Yellow Emperor (Huangdi Neijing). This theory underscores the close connection between symptoms such as vomiting and acidity with “heat”. This paper integrates differentiation of syndromes according to the eight principles and the pathological changes of the zang-fu organs of Chinese Medicine dialectical theory, in order to explore the significant implications of this principle for the clinical diagnosis and treatment of gastroesophageal reflux disease (GERD). The primary cause of GERD is identified as “heat” with the fundamental pathogenesis being the upward flow of stomach Qi, which is interconnected with other viscera including the liver, gallbladder, spleen, lung, kidney, and intestines. “Heat” can be categorized into deficiency and excess, and the treatment approach should appropriately combine strategies such as eliminating, reinforcing, harmonizing, and descending. This study aims to offer new perspectives for a thorough analysis of GERD's etiology and pathogenesis, the application of personalized treatments for similar conditions, and the enhancement of clinical efficacy.