《论》曰∶诸动气者，不可发汗，亦不可下。按∶此动气一证，即筑筑然动于脐傍，及左乳之
下曰虚里者，皆其联系者也。考之《难经》，则以脐之上下左右，分心肾肝肺四脏，而各列其证。
在《伤寒论》所载亦详。成无己曰∶动气者，脏气不治，正气内虚也。虽诸说如此，然皆未尽其要
，所以今之医家，多不识此为何证，而且疑为未见此证也。余尝留心察此，所见极多。盖动气之在
脐傍者，皆本于下焦之阴分，凡病关格劳损者，多有此证，而尤于瘦薄者易见之。其动之微者，则
止于脐傍上下，其动之甚者，则连及虚里心胁，真若舂舂连续，而混身皆振动者。此以天一无根，
故气不蓄脏，而鼓动于下，诚真阴不守，大虚之候也。何以验之？但察于呼吸饥饱之顷，可得其征。
凡病此者，馁时则动甚，饱时则稍缓，呼出则动甚，吸入则稍缓，但虚甚者动必甚，虚微者动亦微
，岂非虚实之明证乎。即在病者，虽常觉其振动，而无疼无痒，尚不知为何故，医家多不以为意，
弗能详察，故不知为何病，此动气之不明也久矣。此动气之见于虚损者极多，而见于伤寒者亦不少
也。精虚者既不可汗，阴虚者又不可下，仲景但言其禁，而不言其治，然则动气之治，岂无法乎？
独于霍乱条中云∶脐上筑者，肾气动也，用理中丸去术加桂四两以治之，此其意在脾肾，概可知也
。然余之治此，则惟直救真阴，以培根本，使其气有所归，无不获效。欲察虚实者，最不可忽此一
证，《类经》虚里穴下有详注，当并考之。
《黄帝内经》中说：凡是出现动气症状的，不可使用发汗法，也不可使用泻下法。
按照我的理解：这种“动气”证候，表现为脐旁有剧烈跳动感，以及左侧乳头下方名为“虚里”的部位也有跳动，这些都是相互关联的表现。
查阅《难经》，是以脐部的上、下、左、右来区分心、肾、肝、肺四脏，并分别列出各自的证候。
在《伤寒论》中对此记载也很详细。
虽然各家说法如此，但都没有触及要害，因此现在的医生，大多不认识这是什么证候，甚至怀疑从未见过这种病证。
我曾经留心观察此症，见到的病例非常多。
大概动气出现在脐旁的，都根源于下焦的阴分，凡是患有关格病（小便不通与呕吐并见）或劳损病的患者，多有此证，尤其在身体消瘦瘦弱的人身上更容易见到。
其跳动轻微的，仅局限于脐旁的上下部位；其跳动剧烈的，则牵连到虚里及心胁部位，真的像捣米一样连续不断，甚至全身都在振动。
这是因为先天之本（天一所生之元气）没有根基，所以气不能藏于脏腑，而在下部鼓动，这确实是真阴不守、极度虚弱的征候。
如何验证呢？只要在呼吸、饥饿或饱食的时候进行观察，就能得到证据。
凡是患此病的人，饥饿时跳动加剧，饱食时稍缓解；呼气时跳动加剧，吸气时稍缓解。
总之，虚得越厉害，跳动就越剧烈；虚得轻微，跳动也就轻微，这难道不是虚实明证的体现吗？
即使是病人自己，虽然常觉得身体振动，但没有疼痛也没有瘙痒，尚且不知道是什么原因，医生们也多不在意，不能详细检查，所以不知道是什么病，这种对动气的认识不明已经很久了。
精气亏虚者既不可发汗，阴虚者又不可泻下，张仲景只说了禁忌，而没有说治疗方法，那么治疗动气难道没有办法吗？
只在霍乱条文中说：脐上筑动（跳动如捣物），是肾气动扰，用理中丸去掉白术加上四两桂枝来治疗，这其中的用意在于调理脾肾，概略可知了。
然而我治疗此症，则是直接挽救真阴，以培补根本，使气有所归依，没有不获效的。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: In cases of "moving qi" (abnormal pulsation or movement of Qi), sweating therapy is contraindicated, and purgative therapy is also contraindicated.
According to my understanding: This syndrome of "moving qi" manifests as a throbbing sensation beside the umbilicus, and pulsations at the area below the left breast known as Xuli (Vulnerable Chamber), all of which are interconnected.
Consulting the *Nan Jing* (Classic of Difficult Issues), it distinguishes the four Zang organs—Heart, Kidney, Liver, and Lung—by the areas above, below, left, and right of the umbilicus, listing their respective syndromes.
It is also detailed in the *Shanghan Lun* (Treatise on Cold Damage).
Cheng Wuji stated: "Moving qi" refers to the dysfunction of Zang Qi and internal deficiency of True Qi.
Although various theories state this, none have grasped the essence; therefore, many contemporary physicians do not recognize what syndrome this is, and some even doubt that such a syndrome exists.
I have paid close attention to observing this condition and have encountered many cases.
Generally, moving qi located beside the umbilicus originates from the Yin aspect of the Lower Jiao (Lower Burner). Patients suffering from Guan Ge syndrome (obstruction characterized by vomiting and inability to urinate) or consumptive diseases often present this symptom, especially those who are emaciated.
When the movement is mild, it is confined to the areas above and below the umbilicus; when severe, it extends to the Xuli point and the hypochondrium/heart region, resembling continuous pounding, with the entire body trembling.
This occurs because the Primordial Qi (originating from Tianyi) lacks root, causing Qi to fail to reside within the Zang organs and instead surge in the lower part. This is indeed a sign of failing True Yin and extreme deficiency.
How to verify this? One can observe signs during respiration, hunger, or satiety.
In patients with this condition, movements intensify during hunger and subside slightly after eating; they intensify during exhalation and subside slightly during inhalation. Generally, the greater the deficiency, the more intense the movement; the slighter the deficiency, the milder the movement. Is this not clear evidence of deficiency versus excess?
Even the patients themselves, although frequently feeling the vibration, experience no pain or itching, and remain unaware of the cause. Physicians often disregard it and fail to examine it in detail, thus failing to identify the disease. The lack of clarity regarding "moving qi" has persisted for a long time.
This moving qi appears very frequently in consumptive diseases and is also not uncommon in cold damage diseases.
Those with Essence deficiency cannot undergo sweating therapy, and those with Yin deficiency cannot undergo purgative therapy. Zhang Zhongjing only mentioned these prohibitions without discussing treatment methods. Does this mean there is no method to treat moving qi?
In the section on Huoluan (Cholera-like disorder), it states: "Pounding above the umbilicus indicates Kidney Qi moving"; it should be treated with Lizhong Wan (Regulate the Middle Pill) with Baizhu (Atractylodis Rhizoma) removed and Guizhi (Cinnamon Twig) added in an amount of four liang. This intention to regulate the Spleen and Kidney can be generally understood.
However, in my treatment of this condition, I directly rescue True Yin to nourish the root, allowing the Qi to find its residence, achieving efficacy in all cases.
For those wishing to distinguish between deficiency and excess, this syndrome must not be neglected. Detailed notes are provided under the Xuli acupoint in the *Lei Jing* (Classified Classic); these should be consulted together.