（注释参古方选注）
奔豚者。病从腹中有气攻上。一如江豕以臀愤起而攻也。阅伤寒论。凡伤寒发奔
豚者二。一曰烧针令其汗。针处被寒。核起而赤者。必发奔豚。气从少腹上冲心者。
灸其核上各一壮。与桂枝加桂汤。一曰发汗后。其人脐下悸者。欲作奔豚。茯苓桂
枝甘草大枣汤主之。
邵评∶针处被寒。寒从针孔而入也。核起而赤者。针处红肿如核。寒气所郁也。心
气因寒而内虚。肾虚因寒而上逆。发为奔豚。气从少腹冲心。寒邪挟水气凌心也。灸其核上。以杜再
入之邪。与加桂汤以泄上逆之气。若脐下悸者。心气不足。肾水乘火而上克也。肾气上冲。名曰奔豚。
盖肾为水脏。豚为水畜也。茯苓以泄水。桂枝伐肾邪。以保心气。甘枣培土以制水也。因奔豚者。豚为水
畜。奔则昂首疾驰。酷肖水势上干之象。然悸在脐下。其水尚在下焦。欲作奔豚。尚未发
也。当先其时而治之。
按此二症。一属少阴寒气凌心。故用桂枝加桂。温肾散寒。病由外召寒邪。仍从太
阳表治。惟加桂枝两数。便可以温少阴。而泄阴邪矣。一属水邪上逆。故重用茯苓以制水邪。
桂枝保心气以御水凌。甘草大枣补脾土以制水泛。取甘烂水者。不欲
其助水性也。伤寒奔豚。惟此二方为主治。而汗后脐下悸。作奔豚之症尤多。定当以苓桂甘枣汤为治。
若夫金匮要略中所载奔豚汤。方用半夏、生姜、（散结）芍药、甘草、（安中气）芎归、（和心气）
黄芩、（泻火）生葛、（欲降先升）甘李根皮。（大寒折冲逆之气）此治因惊恐而得奔豚者。
其为病也。聚散靡常。作止无定。腹痛冲逆。发则为热。退则为寒。乃心中热邪凝结
而成。与伤寒水气寒邪作奔豚者迥异。不可混治。
邵评∶此言杂病亦有奔豚者。与上伤寒之奔豚不同。由于肝邪内发。上犯于心。
肝胆相火内郁。是奔豚之属于热者。较寒水上凌逆心而作奔豚者。大相迳庭
矣。盖伤寒之奔豚因于寒。以桂枝为主药。杂病之奔豚由火热。当宗金匮方为主。
王晋三先生曰。奔豚气有三。犯肺之奔豚属心火。犯心之奔豚属肾寒。脐下悸。欲
作奔豚。属水邪。证自分途。治亦各异。
邵评∶心火克肺金。由于火热。宜金匮方治之。肾寒克心火。由于寒。用桂枝加桂
法。肾水上逆凌心。由于水气。用苓桂甘枣方。
（注释参考古方选注）
奔豚病，是指腹中有气向上攻冲，就像江猪用臀部发力跃起进行攻击一样。阅读《伤寒论》，凡是伤寒引发的奔豚病共有两种情况：第一种是烧针迫汗，针刺部位受寒，出现红肿如核状，必然引发奔豚，表现为气从少腹上冲至心胸，此时应在红肿处各灸一壮，并服用桂枝加桂汤。第二种是发汗之后，患者感到脐下悸动，这是将要发作奔豚的前兆，应以茯苓桂枝甘草大枣汤主治。
邵评：针刺部位受寒，是因为寒气从针孔侵入。红肿如核，说明针处红肿，这是寒气郁结所致。心气因寒而内虚，肾气因寒而上逆，从而引发奔豚，气从少腹冲撞心胸，这是寒邪挟带水气凌犯心脏。在红肿处施灸，是为了杜绝外邪再次侵入；给予加桂汤，是为了泄降上逆之气。如果是脐下悸动，则是心气不足，肾水乘心火虚弱而上克。肾气上冲，称为奔豚。因为肾为水脏，豚为水畜。茯苓用于利水，桂枝伐除肾中邪气以保护心气，甘草和大枣培补脾土以制约水湿。之所以称奔豚，是因为豚是水畜，奔跑时昂首疾驰，非常像水势上干之象。然而悸动位于脐下，说明水邪尚在下焦，属于“欲作奔豚”，即尚未真正发作。应当在其发作之前进行治疗。
按语：这两种症状，一种属于少阴寒气凌犯心脏，所以使用桂枝加桂汤，温补肾阳、散除寒邪。此病由外感寒邪引起，仍从太阳表证治疗，只是增加了桂枝的用量，便可以温通少阴，泄除阴邪。另一种属于水邪上逆，所以重用茯苓以制约水邪，桂枝保护心气以抵御水气凌犯，甘草和大枣补益脾土以制止水湿泛滥。选用甘烂水煎药，是不希望其助长水性。伤寒引起的奔豚，主要以上述两方为主治，其中发汗后脐下悸动、欲作奔豚的症状尤为多见，应当定以苓桂甘枣汤作为治疗方法。
至于《金匮要略》中所记载的奔豚汤，方剂组成包括半夏、生姜（散结）、芍药、甘草（安中气）、川芎当归（和心气）、黄芩（泻火）、生葛根（欲降先升）、甘李根皮（大寒折冲逆之气）。这是治疗因惊恐而引发的奔豚。这种病症，聚散无常，发作停止没有定规，腹痛且气上冲逆，发作时发热，退去时发冷，这是由于心中热邪凝结而成，与伤寒因水气寒邪引发的奔豚截然不同，不可混淆治疗。
邵评：这里说的是杂病也有奔豚，与上述伤寒之奔豚不同。这是由于肝邪内发，上犯于心，肝胆相火内郁，属于热性的奔豚，与寒水上凌犯心脏引发的奔豚相比，大相径庭。大概伤寒之奔豚因于寒，以桂枝为主药；杂病之奔豚由火热引起，应当遵循《金匮》方剂为主治。
王晋三先生说：奔豚气有三种，犯肺的奔豚属于心火，犯心的奔豚属于肾寒，脐下悸动欲作奔豚属于水邪，证候自然分途，治疗方法也各异。
邵评：心火克肺金，由于火热，宜用《金匮》方剂治疗。肾寒克心火，由于寒，用桂枝加桂法。肾水上逆凌犯心脏，由于水气，用苓桂甘枣方。
(Annotations refer to Ancient Formula Selections)
Ben Tun (Rushing Pig Syndrome) refers to a condition where Qi attacks upward from the abdomen, resembling a river pig leaping up using its hindquarters. In reading the *Shanghan Lun* (Treatise on Cold Pathogenic Diseases), there are two types of Ben Tun caused by Shanghan: The first is induced by burning needles to induce sweating; if the needle site becomes cold and presents with nodular redness, Ben Tun will inevitably occur, characterized by Qi rushing from the lower abdomen to the heart/chest. Moxibustion should be applied once at each nodular site, followed by administration of Guizhi Jia Gui Tang (Cinnamon Twig Decoction with Added Cinnamon). The second type occurs after sweating therapy, where the patient experiences palpitations below the navel, indicating impending Ben Tun; this should be treated primarily with Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction).
Shao's Commentary: Cold invading the needle site enters through the puncture. Nodular redness indicates swelling and redness at the site due to cold pathogen stagnation. Heart Qi becomes internally deficient due to cold, and Kidney Qi rebels upward due to cold, triggering Ben Tun. Qi rushing from the lower abdomen to the heart represents cold pathogen carrying water Qi to overwhelm the Heart. Moxibustion at the nodules prevents further invasion of pathogens; adding Gui (Cinnamon Twig) in the decoction drains rebellious Qi. If palpitations occur below the navel, it signifies insufficient Heart Qi, allowing Kidney Water to overcome Fire and attack upward. Upward rebellion of Kidney Qi is named Ben Tun. Since the Kidney is the Water Organ and the pig is a water animal, Fuling (Poria) drains water, Guizhi (Cinnamon Twig) suppresses Kidney pathogens to protect Heart Qi, and Gancao (Licorice) and Dazao (Jujube) nourish Spleen Earth to control Water. It is called Ben Tun because the pig, a water animal, runs with head high and fast, resembling the image of water surging upward. However, since palpitations are below the navel, the water pathogen remains in the Lower Jiao; "impending Ben Tun" means it has not yet fully erupted. Treatment should precede the eruption.
Note: These two syndromes differ in nature. One belongs to Shaoyin Cold overwhelming the Heart, hence Guizhi Jia Gui Tang is used to warm the Kidney and dissipate cold. As the disease originates from external cold, it is still treated via the Taiyang exterior level, merely increasing the dosage of Guizhi to warm Shaoyin and drain Yin pathogens. The other belongs to Water Pathogen rebelling upward, hence heavy use of Fuling to control water, Guizhi to protect Heart Qi against water flooding, and Gancao and Dazao to tonify Spleen Earth to stop water overflow. Using "Ganlan Shui" (dried/rotten water) for decoction avoids aiding the water nature. For Shanghan-induced Ben Tun, these two formulas are primary. Among them, post-sweating palpitations below the navel indicating impending Ben Tun are particularly common, so Linggui Gancao Dazao Tang should be the definitive treatment.
Regarding the Bentun Tang recorded in *Jingui Yaolue*, the formula contains Banxia (Pinellia Rhizome), Shengjiang (Fresh Ginger) [disperses knots], Shaoyao (Peony Root), Gancao (Licorice Root) [calms Middle Qi], Xiong Gui (Ligusticum Chuanxiong Rhizome and Angelica Sinensis Radix) [harmonizes Heart Qi], Huangqin (Scutellaria Root) [drains fire], Sheng Gegen (Kudzu Root) [descends by first ascending], and Gan Li Gen Pi (Prunus Spinosa Bark) [greatly cold to check rebellious Qi]. This treats Ben Tun caused by fright and alarm. The pathology involves irregular aggregation and dispersion, unpredictable onset and cessation, abdominal pain with upward rushing, fever upon onset, and chills upon remission. It results from congealing Heat Evil in the Heart, which is radically different from Ben Tun caused by Water Qi and Cold Evil in Shanghan; they must not be confused or treated identically.
Shao's Commentary: This states that miscellaneous diseases also include Ben Tun, distinct from the aforementioned Shanghan Ben Tun. It arises from Liver Pathogen originating internally and attacking the Heart, with Depressed Ministerial Fire in the Liver and Gallbladder. This constitutes Heat-type Ben Tun, which differs significantly from Cold Water flooding the Heart. Generally, Shanghan Ben Tun is due to Cold, using Guizhi as the main herb; Miscellaneous Disease Ben Tun is due to Fire/Heat, adhering to Jingui formulas.
Mr. Wang Jin San stated: There are three types of Ben Tun Qi. Ben Tun attacking the Lung belongs to Heart Fire; Ben Tun attacking the Heart belongs to Kidney Cold; Palpitations below the navel indicating impending Ben Tun belong to Water Pathogen. The syndromes naturally diverge, and treatments differ accordingly.
Shao's Commentary: Heart Fire overcoming Lung Metal is due to Heat, suitable for Jingui formula treatment. Kidney Cold overcoming Heart Fire is due to Cold, using the Guizhi Jia Gui method. Kidney Water rebelling to overwhelm the Heart is due to Water Qi, using the Linggui Gancao Dazao formula.