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师曰：病有奔豚，有吐脓，有惊怖，有火邪，此四部病，皆从惊发得之。
【按】
篇中祗有奔豚一证，而吐脓、惊怖、火邪皆简脱，必有缺文。
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师曰：奔豚病从少腹起，上冲咽喉，发作欲死，复还止，皆从惊恐得之。
【注】
奔豚者，肾病也，以其病从少腹上冲咽喉，有如豚，窜奔突之状，故名之也。发作则
肾气上乘于心而欲死，作已则气衰复还于肾而止，故其病虽有微甚不同，然必皆从惊
恐得之。盖惊伤心，恐伤肾，两藏交病也，水能胜火，肾上凌心，故治法宜泻肾而补
心也。
【集注】
张从政曰：惊者，为自不知故也；恐者，为自知也。
周扬俊曰：少阴脉循喉咙，因其所系之经，而上冲殊便也。
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发汗后，烧针令其汗，针处被寒，核起而赤者，必发奔豚，气从少腹上至心，灸其核
上各一壮，与桂枝加桂汤主之。
【注】
此条与『伤寒论』同。『伤寒论』中无「发汗后」三字，而有「太阳伤寒者，加温针
必惊也」十一字，当从『伤寒论』为是。盖明所以致惊之由非一端，即寒侵针处，亦
能为是病也。夫太阳伤寒者，加温针必惊也，谓病伤寒之人，卒然加以温针，其心必
惊，非谓温针之后必生惊病也。烧针，即温针也，烧针取汗亦汗法也。针处宜当避寒
，若不知谨，外被寒袭，火郁脉中，血不流行，所以有结核肿赤之患也。夫温针取汗
，其法亦为迅烈矣，既针而荣不奉行作解，必其人素寒阴盛也。故虽有温针之火，但
发核赤，又被寒侵，故不但不解，反召阴邪，而加针之时，心既惊虚，所以肾水阴邪
，得上凌心阳而发奔豚也。奔豚者，肾水阴邪之气，从少腹上冲于心，若豚之奔也。
先灸核上各一壮者，外祛其寒邪，继与桂枝加桂汤者，内伐其肾邪也。
【集注】
周扬俊曰：奔豚，北方肾邪也。烧针令汗，纵不合法，与少阴何与而作奔豚？盖太阳
相表里也，针处被寒，核起而赤，吾知前此之邪未散，而后此之邪复入，惟桂能伐肾
邪也。所以用桂加入桂枝汤中，一以外解风邪，一以内泄阴气也。先灸核上者，因寒
而肿，惟灸消之也。
老师说：疾病中有奔豚，有吐脓血，有惊怖，有火邪，这四种病，都是从惊恐受惊而引发的。
【按语】
本篇中只有奔豚这一种证候，而吐脓、惊怖、火邪都简略脱漏了，必定是有缺文。
老师说：奔豚病从少腹（下腹部）发起，向上冲撞至咽喉，发作时痛苦欲死，停止后又恢复平静，这都是因为惊恐而引发的。
【注释】
奔豚，属于肾病，因为它的病势从少腹向上冲撞至咽喉，像小猪一样窜动奔跑的样子，所以叫它奔豚。发作时肾气上乘于心而使人痛苦欲死，发作过后气衰复还于肾而停止，所以这种病虽然有轻重不同，但必定都是从惊恐引发的。大概是因为惊恐伤心，恐惧伤肾，心和肾两脏同时受病。水能克火，肾水上凌心火，所以治疗方法应当泻肾而补心。
【集注】
张从政说：惊，是因为自己不知道原因；恐，是因为自己知道原因。
周扬俊说：少阴经脉循行经过喉咙，因为它所联系的经脉，所以气上冲非常方便。
发汗后，用烧针（温针）令其出汗，针刺部位受寒，出现红肿硬结且发红的，一定会引发奔豚，气从少腹上冲至心，应在红肿硬结上各灸一壮，主方用桂枝加桂汤。
【注释】
这一条与《伤寒论》相同。《伤寒论》中没有“发汗后”三个字，而有“太阳伤寒者，加温针必惊也”这十一个字，应当以《伤寒论》为准。这是为了说明导致惊恐的原因不止一端，即寒气侵袭针刺部位，也能导致这种病。所谓“太阳伤寒者，加温针必惊也”，是说患伤寒的人，突然加上温针，心里必定惊恐，并不是说温针之后必然产生惊恐病症。烧针，就是温针，烧针取汗也是发汗法。针刺部位应当避寒，如果不知谨慎，外被寒气侵袭，火郁在脉中，血液不流通，所以有结核红肿的祸患。温针取汗，这种方法也很迅烈，既然针刺后营气不能顺利运行解表，一定是这个人素来阳虚阴盛。所以虽然有温针的火力，但只发出红肿硬结，又被寒气侵袭，因此不仅不解表，反而招引阴邪，而在施针的时候，心已经惊恐虚弱，所以肾水阴邪之气，能够上凌心阳而引发奔豚。奔豚，是肾水阴邪之气，从少腹上冲于心，像猪奔跑一样。先在红肿硬结上各灸一壮，是为了在外祛除寒邪，接着给予桂枝加桂汤，是为了在内攻伐肾邪。
【集注】
周扬俊说：奔豚，是北方肾邪。烧针令汗，纵然不符合治法，与少阴有什么关系却会作奔豚？因为太阳与少阴相表里。针刺部位受寒，红肿硬结，我知道之前的邪气未散，之后的邪气又入内，只有桂枝能攻伐肾邪。所以用桂枝加入桂枝汤中，一方面在外解除风邪，一方面在内泄除阴气。先在硬结上灸，是因为受寒而肿，只有艾灸才能消除它。
The Master said: There are conditions of Ben Tun (Rushing Pig), vomiting of pus, fright and terror, and fire pathogen. These four categories of diseases all arise from fright and alarm.
[Commentary]
This chapter only contains the syndrome of Ben Tun, while vomiting of pus, fright/terror, and fire pathogen are briefly omitted or missing; there must be lacunae in the text.
The Master said: The disease of Ben Tun starts from the lower abdomen, rushes upward to the throat, is agonizing during attacks as if one were about to die, and then subsides and stops. All such cases arise from fright and fear.
[Annotation]
Ben Tun is a kidney disease. Because its pathological qi rushes from the lower abdomen up to the throat, resembling the darting and rushing movement of a piglet, it is named Ben Tun. During an attack, kidney qi surges upward to invade the heart, causing agony akin to death; after the attack, the qi weakens and returns to the kidney, leading to cessation. Thus, although the severity of the disease may vary, it invariably arises from fright and fear. Fright injures the heart, and fear injures the kidney; both organs suffer simultaneously. Since water overcomes fire, kidney water invades the heart fire. Therefore, the treatment method should involve draining the kidney and tonifying the heart.
[Collected Annotations]
Zhang Congzheng stated: "Fright" (Jing) occurs when one is unaware of the cause; "fear" (Kong) occurs when one is aware of the cause.
Zhou Yangjun stated: The Shaoyin meridian runs along the throat; due to its connection with this meridian, the upward rush is facilitated.
After inducing sweating, if warm needles (burned needles) are used to induce further sweating, and the needle sites become exposed to cold, resulting in nodular swellings that are red, Ben Tun will inevitably develop. Qi will rush from the lower abdomen to the heart. Apply moxibustion to each nodule once (one zhuang), and administer Guizhi Jia Gui Tang (Cinnamon Twig Decoction with Additional Cinnamon Twig) as the primary formula.
[Annotation]
This passage is identical to that in *Shanghan Lun* (Treatise on Cold Damage). *Shanghan Lun* lacks the three characters "after inducing sweating" but includes the eleven characters "In Taiyang cold damage, adding warm needles will surely cause fright." This version from *Shanghan Lun* is likely correct. It clarifies that the causes for fright are manifold; even cold invading the needle site can induce this condition. The statement "In Taiyang cold damage, adding warm needles will surely cause fright" means that a patient with cold damage, suddenly subjected to warm needles, will certainly experience mental fright; it does not mean that warm needles inevitably lead to a fright disorder. Burned needles refer to warm needles; using burned needles to induce sweating is also a sweating method. Needle sites should be protected from cold. If carelessness allows external cold invasion, fire becomes trapped within the vessels, blood circulation stagnates, leading to the affliction of nodular swelling and redness. Warm needles to induce sweating is a rapid and intense method. If, after needling, the Ying (Nutritive) Qi fails to circulate and resolve the exterior, it indicates the person has innate deficiency of Yang and excess of Yin. Thus, despite the heat of the warm needles, only nodular redness appears. Combined with cold invasion, instead of resolving the exterior, it attracts Yin pathogens. Furthermore, at the time of needling, the Heart was already frightened and deficient, allowing Kidney Water Yin pathogens to ascend and overwhelm Heart Yang, triggering Ben Tun. Ben Tun refers to the Qi of Kidney Water Yin pathogens rushing from the lower abdomen to the heart, resembling a running pig. Applying moxibustion to the nodules first expels external cold pathogens; subsequently administering Guizhi Jia Gui Tang attacks internal Kidney pathogens.
[Collected Annotations]
Zhou Yangjun stated: Ben Tun is the evil of the North, associated with the Kidney. Using warm needles to induce sweat, even if improper in technique, what does it have to do with Shaoyin to produce Ben Tun? Because Taiyang and Shaoyin are interior-exteriorly related. When the needle site is invaded by cold, causing nodular swelling, I know that previous pathogens remain unresolved and new pathogens enter subsequently. Only Cinnamon Twig (Guizhi) can attack Kidney pathogens. Therefore, additional Cinnamon Twig is added to Guizhi Tang: one function to release exterior Wind pathogens externally, and another to vent internal Yin Qi internally. Moxibustion is applied to the nodules first because they swell due to cold, which only moxibustion can dissipate.