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。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。
〔程〕篇目止有奔豚一证。而吐脓惊怕火邪。皆简脱。必
有缺文。经曰。太阳伤寒者。加温针必惊也。若针处被寒。核起而赤者。必作奔豚。发汗后。脐下悸者。欲
作奔豚。故奔豚病从惊发而得。
〔尤〕吐脓有咳与呕之别。其从惊得之。旨未详。惊怖即惊恐。盖病从惊得。
而惊气即为病气也。火邪。见后惊悸部。及伤寒太阳篇。云。太阳病。以火熏之。不得汗。其人必躁。到经不
解。必圊血。名为火邪。然未尝云从惊发也。惊悸篇云。火邪者。桂枝去芍药加蜀漆牡蛎龙
骨救逆汤主之。此亦是因火邪而发惊。非因惊而发火邪也。即后奔豚证治三条。亦不必定从惊恐而得。盖
是证有杂病伤寒之异。从惊恐得者。杂病也。从发汗及烧针被寒者。伤寒也。其吐脓火邪二病。仲景必别有
谓。姑阙之以俟知者。前云惊发。后兼言恐者。肾伤于恐。而奔豚为肾病也。 水畜也。肾水脏也。肾气内
动。上冲咽喉。如豕之突。故名奔豚。亦有从肝病得者。以肾肝同处下焦。而其气并善上逆也。
〔鉴〕张从政曰。惊者为自不知故也。恐者为自知也。
巢源云。夫奔豚气者。肾之积气。起于惊恐忧思所生。若惊恐。则伤神。心藏神也。忧思则伤志。肾藏
志也。神志伤动。气积于肾。而气下上游走。如豚之奔。故曰奔豚。其气乘心。若心中踊踊。如车所惊。如
入所恐。五脏不定。食饮辄呕。气满胸中。狂痴不定。妄言妄见。此惊恐奔豚之状。若气满支心。心下闷乱。
不欲闻人声。休作有时。乍瘥乍极。吸吸短气。手足厥逆。内烦结痛。温温欲呕。此忧思奔豚之
状。诊其脉。来触祝。触祝者（外台。无两触字。）病贲豚也。
案灵邪气脏腑病形篇云。沉厥奔豚。足不收不得前后。盖本篇所论即是也。而难经。名肾积为奔豚。然与
此自别。故杨玄操注难经云。又有奔豚之气。非此积病也。名同而病异。可以见耳。后
世有奔豚疝气之称。（见于和剂指南。直指方等。）即
内经所谓冲疝。（出于骨空论。）疝病而为奔豚气者。张氏医说云。以肾气奔冲为奔豚。谓豚能奔逸。而
不能远也。此解得之。沈注云。状如江豚。此说本于丹溪心法。决不可从。
奔豚气。上冲胸腹痛。往来寒热。奔豚汤主之。
〔徐〕此乃奔豚之气。与在表之外邪相当者也。故状如奔豚。而气上冲胸。虽未至咽喉。亦如惊发之奔
豚矣。但兼腹痛。是客邪有在腹也。且往来寒热。是客邪有在半表里也。
〔沈〕是以芎归姜芍。疏养厥阴少
阳气血之正。而驱邪外出。以生葛李根。专解表里风热。而清奔豚逆上之邪。黄芩。能清风化之热。半夏以和
脾胃。而化客痰。
〔尤〕桂苓为奔豚主药。而不用者。病由肾发也。
奔豚汤方（外台。引集验。主疗药味并同。）
甘草 芎 当归（各二两） 半夏（四两） 黄芩（二两） 生葛（五两） 芍
药（二两） 生姜（四两） 甘李根白皮（一升）
上九味。以水二斗。煮取五升。温服一升。日三。夜一服。
案本草别录云。李根皮。大寒无毒。治消渴。止心烦逆奔豚气。知是李根皮。乃本方之主药。
外台。短剧奔豚汤。疗虚劳五脏气乏损。游气归上。上走时。若群豚相逐憧憧。时气来便自如。坐惊
梦精。光竭不泽。阴痿上引少腹急痛。面乍热赤色。喜怒无常。耳聋目视无精光。
于本方内。去芎 黄芩。加桂心人参。
又广济。奔豚气在心。吸吸短气。不欲闻人语声。心下烦乱不安。发作有时。四肢烦疼。手足逆冷。
于本方内。去芎 当归黄芩生葛芍药生姜。加干姜茯苓
人参附子桂心。（案本方奔豚汤证。而属虚寒者。宜用此方。）
又集验。奔豚茯苓汤。疗短气五脏不足。寒气厥逆。腹胀满。气奔走冲胸膈。发作气欲绝。不识人。气
力羸瘦。少腹起腾踊。如豚子走上走下。驰往驰来。寒热。拘引阴器。手足逆冷。或烦热者。
于本方内。去黄芩芍药。加茯苓人参。
又疗奔豚气。从下上者汤方。
于本方内。去甘草芎 当归。加人参桂心。
又短剧奔豚汤。疗手足逆冷。胸满气促。从脐左右起郁冒者。
于本方内。去当归芍药半夏生姜。加桂心栝蒌人参。
又牡蛎奔豚汤。疗奔豚气。从少腹起憧胸。手足逆冷。
牡蛎（三两熬） 桂心（八两） 李根白皮（一斤切） 甘草（三两炙）
上四味。切。以水一斗。煮取李根皮。得七升。去滓。内余药。煮取三升。分服五合。日三夜再。
活人李根汤。治气上冲。正在心端。
于本方内。去芎 生葛。加茯苓桂枝。
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。（太阳中篇无发汗后三字。心下。有者字。）
〔鉴〕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。既针而营不奉行作解。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。
〔魏〕灸后与桂枝加桂汤主之。意取升阳散邪。固卫补中。所以为汗后感寒。阳衰阴乘之奔豚立法也。与前
条心动气驰。气结热聚之奔豚。源流大别也。
桂枝加桂汤方
桂枝（五两） 芍药（三两） 甘草（二两炙） 生姜（三两） 大枣（十二枚）
上五味。以水七升。微火煮取三升。去滓。温服一升。
柯氏方论云。更加桂者。益火之阳。而阴自平也。桂枝更加桂。治阴邪上攻。只在一味中加分两。不
于本方外求他味。不即不离之妙如此。茯苓桂枝甘草大枣汤证已在里。而
奔豚未发。此证尚在表。而奔豚已发。故有不同。
发汗后脐下悸者。欲作奔豚。茯苓甘草大枣汤主之。（太阳中篇后下。有其人二字）
〔鉴〕周扬俊曰。汗本心之液。发汗而脐下病悸者。心气虚而肾气动也。
〔程〕汗后脐下悸者。阳气
虚。而肾邪上逆也。脐下为肾气发源之地。茯苓。泄水以伐肾邪。桂枝。行阳以散逆气。甘草大枣。甘温助
脾土以制肾水。煎用甘澜水者。扬之无力。全无水性。取其不助肾邪也。
〔鉴〕欲作奔豚者。有似奔豚之状。而将作未作也。
茯苓桂枝甘草大枣汤方
茯苓（半斤） 甘草（二两炙） 大枣（十二枚） 桂枝（四两）
上四味。以甘烂水一斗。先煮茯苓。减二升。内诸药。煮取三升。去滓。温服一升。日三服。甘烂水法。
取水二斗。置大盆内。以杓扬之。水上有珠子五六千颗相逐。取用之。（甘烂水法。原文为细注。今据伤寒
论大书。烂徐沈金鉴。作澜。盖本于玉函。甘烂之义。详见于伤寒论辑义。）
〔徐〕仲景论证。每合数条。以尽其变。言奔豚由于惊。
又言其从少腹冲至咽喉。又言其兼腹痛。而往来寒热。又言
其兼核起。而无他病。又言汗后脐下悸。欲作奔豚。而未成者。其浅深了然。用和解用伐肾。用桂不用桂。酌
治微妙。奔豚一证。病因证治。无复剩义。苟不会仲景立方之意。则峻药畏用。平剂寡效。岂古方不宜于今哉。
肘后。治卒厥逆上气。气支两胁。心下痛满。淹淹欲绝。
此谓奔豚病。从卒惊怖忧迫得之。气从下上。上冲心胸。脐间筑筑发动。有时不疗。杀人方。
甘草（二两炙） 人参（二两） 吴茱萸（一升） 生姜（一斤） 半夏（一升） 桂心（三两）
上六味。切。以水一斗。煮取三升。分三服。○千金。名奔气汤。治大气上奔胸膈中。诸病发时。迫满
短气不得卧。剧者便 欲死。腹中冷湿气。肠鸣相逐成结气。用桂五两。
甘草三两。（外台。广济。疗奔豚气在胸心迫满支胁方。用半夏四两。吴茱萸一两。）
圣惠方 治奔豚气上下冲走。闷乱面青。宜服此方。
甘李根皮（三两） 生姜（二两炒干） 吴茱萸（一两）
上捣细罗为散。每服一钱。水一中盏。煎至六分。去滓
热服。（案以上二方。盖奔豚之要药。品味亦单捷。验之颇效。故附之备考。）
又方 槟榔（三枚捣罗为末） 生姜汁（半合）
上以童子小便一大盏微过。入前药二味。搅令匀。分为三服。如人行五六里。进一服。须臾下利为效。（
案此外台。广济疗香港脚冲心闷欲死方。今移以治奔豚气。正见运用之妙。故亦附之。）
老师说：疾病中有奔豚病，有吐脓病，有惊怖病，有火邪病。这四种病，都是从受惊引发的。
老师说：奔豚病，从少腹（下腹部）起始，向上冲撞至咽喉，发作时感觉快要死去，随后又停止缓解。这都是因为惊恐导致的。
〔程〕这一篇的题目只有奔豚一证，而吐脓、惊怕、火邪等内容都被删减遗漏了，必定是有缺文。经文说：太阳伤寒患者，如果加用温针，一定会引起惊恐。如果针刺部位受寒，出现红肿硬结且发红的，一定会发作奔豚。发汗之后，脐下悸动的，想要发作奔豚。所以奔豚病是从受惊引发的。
〔尤〕吐脓有咳嗽和呕吐的区别，它从惊恐引发，其旨意尚不明确。惊怖就是惊恐。大概是因为病从惊恐引发，而惊气本身就成为了病气。火邪，见后文的惊悸部，以及《伤寒论》太阳篇中说：太阳病，用火熏法治疗，未能出汗，病人一定烦躁。到了经气传变的时间仍未解除，一定会便血。这叫做火邪。然而并没有说它是从惊恐引发的。惊悸篇说：火邪病，用桂枝去芍药加蜀漆牡蛎龙骨救逆汤主治。这也是因为火邪而引发惊恐，而不是因为惊恐而引发火邪。即后文关于奔豚证治的三条内容，也不必一定说是从惊恐引发的。大概这种病有杂病和伤寒的区别。从惊恐引发的，属于杂病；从发汗及烧针后受寒引发的，属于伤寒。至于吐脓和火邪这两种病，张仲景必定另有含义，暂且保留疑问以等待知晓的人。前文说“惊发”，后文兼言“恐”，是因为肾受到恐惧的伤害，而奔豚是肾病。水属畜类，肾是水脏。肾气在内扰动，向上冲撞咽喉，像猪一样突进，所以名叫奔豚。也有从肝病引发的，因为肝肾同处下焦，而且它们的气机都善于上逆。
〔鉴〕张从政说：惊是自己不知道原因而产生的，恐是自己知道原因而产生的。
巢元方说：奔豚气，是肾的积气，起于惊恐忧思所生。如果惊恐，则伤神，心藏神；忧思则伤志，肾藏志。神志受伤动摇，气积聚于肾，而气在体内上下游走，像猪奔跑一样，所以叫奔豚。如果气乘袭心脏，心中跳动不安，像被车惊吓，像进入恐怖境地，五脏不定，饮食就呕吐，气满胸中，狂乱痴呆不定，胡言乱语，看见幻象，这是惊恐奔豚的症状。如果气满支撑心胸，心下闷乱，不想听人声，发作有时，时而好转时而加剧，呼吸短促，手足厥冷，内心烦闷结痛，恶心欲呕，这是忧思奔豚的症状。诊察它的脉象，来势急促有力（触祝）。所谓触祝（《外台秘要》无两个“触”字），是病为奔豚。
按《灵枢·邪气脏腑病形》篇说：沉厥奔豚，足不能收，大小便不通。大概本篇所论述的就是这个。而《难经》将肾积命名为奔豚，但这与此自不相同，所以杨玄操注释《难经》说：又有奔豚之气，不是这种积病。名称相同而病情不同，可以由此看出。后世有奔豚疝气的称呼（见于《和剂局方》、《指南总录》、《直指方》等），即《内经》所说的冲疝（出于《骨空论》）。疝病而表现为奔豚气的，张氏医说认为：以肾气奔冲作为奔豚，谓猪能奔跑但不能远行。这个解释是对的。沈注说：形状像江豚。这种说法本于《丹溪心法》，决不可采用。
〔徐〕这是奔豚之气，与在表的外邪相当。所以症状像奔豚，气向上冲胸，虽然未到咽喉，也像受惊引发的奔豚。但兼有腹痛，说明客邪在腹部。而且往来寒热，说明客邪在半表半里。
〔沈〕因此用川芎、当归、生姜、芍药，疏养厥阴、少阳的气血正气，而驱邪外出。用生葛根、李根白皮，专门解表里的风热，而清降奔豚逆上的邪气。黄芩，能清风化之热。半夏调和脾胃，而化解客痰。
〔尤〕茯苓、桂枝是奔豚的主药，而这里不用，是因为病由肾发起。
奔豚汤方（《外台秘要》引用《集验方》，主疗药味并相同。）
甘草、川芎、当归（各二两）、半夏（四两）、黄芩（二两）、生葛（五两）、芍药（二两）、生姜（四两）、甘李根白皮（一升）
以上九味药，用水二斗，煮取五升，温服一升，每日三次，夜间一次服用。
按《本草别录》说：李根皮，大寒无毒，治消渴，止心烦逆奔豚气。可知李根皮是本方的主药。
《外台秘要》引《短剧方》奔豚汤，治疗虚劳五脏气乏损，游气归上，向上走窜时，像一群猪互相追逐般心神不宁，时气来时便如常，坐卧惊恐梦遗精出，目光枯竭无光泽，阳痿上引少腹急痛，面色乍热赤色，喜怒无常，耳聋目视无精光。
在本方内，去掉川芎、黄芩，加入桂心、人参。
又《广济方》：奔豚气在心，呼吸短促，不想听人说话，心下烦乱不安，发作有时，四肢烦疼，手足逆冷。
在本方内，去掉川芎、当归、黄芩、生葛、芍药、生姜，加入干姜、茯苓、人参、附子、桂心。（按：本方奔豚汤证，若属虚寒者，宜用此方。）
又《集验方》：奔豚茯苓汤，治疗短气五脏不足，寒气厥逆，腹胀满，气奔走冲胸膈，发作时气欲绝，不识人，气力羸瘦，少腹起腾踊，像小猪子上走上走下，驰往驰来，寒热，拘挛牵引阴器，手足逆冷，或烦热者。
在本方内，去掉黄芩、芍药，加入茯苓、人参。
又治疗奔豚气，从下往上冲的汤方。
在本方内，去掉甘草、川芎、当归，加入人参、桂心。
又《短剧方》奔豚汤，治疗手足逆冷，胸满气促，从脐左右起郁冒者。
在本方内，去掉当归、芍药、半夏、生姜，加入桂心、栝蒌、人参。
又牡蛎奔豚汤，治疗奔豚气，从少腹起冲胸，手足逆冷。
牡蛎（三两，熬制）、桂心（八两）、李根白皮（一斤，切）、甘草（三两，炙）
以上四味药，切碎，用水一斗，先煮李根皮，得七升，去滓，加入其余药物，煮取三升，分次服用五合，每日三次，夜间两次。
《活人书》李根汤，治疗气上冲，正在心端。
在本方内，去掉川芎、生葛，加入茯苓、桂枝。
发汗后，烧针令其出汗。针刺部位受寒，出现红肿硬结且发红的，一定会发作奔豚。气从少腹上至心。在红肿硬结上各灸一壮，用桂枝加桂汤主治。（《伤寒论·太阳中篇》无“发汗后”三字，“心下”后有“者”字。）
〔鉴〕烧针，即温针。烧针取汗，也是汗法。针刺部位应当避寒，如果不知谨慎，外受寒袭，火郁于脉中，血液不流行，所以有结核肿赤的病患。温针取汗，其方法也迅烈。既然针刺后营气未奉行解散之职，一定是其人素体寒盛阴盛。所以虽然有温针之火，只发出核赤，又被寒侵，所以不仅不解，反而招致阴邪。而在施针之时，心既因惊而虚，所以肾水阴邪得上凌心阳，而发奔豚。奔豚，是肾水阴邪之气，从少腹上冲于心，像猪奔跑一样。先在核上各灸一壮，以祛除外寒邪；继与桂枝加桂汤，以内伐肾邪。
〔魏〕灸后给予桂枝加桂汤主治。意在升阳散邪，固卫补中，所以是为汗后感寒，阳衰阴乘的奔豚立法。与前条心动气驰，气结热聚的奔豚，源流大相径庭。
桂枝加桂汤方
桂枝（五两）、芍药（三两）、甘草（二两，炙）、生姜（三两）、大枣（十二枚）
以上五味药，用水七升，微火煮取三升，去滓，温服一升。
柯氏方论说：更加桂，是为了益火之阳，而阴自平。桂枝多加桂，治疗阴邪上攻，只在一味药中增加分量，不在本方之外寻求其他药物，不即不离的妙处如此。茯苓桂枝甘草大枣汤证已在里，而奔豚未发；此证尚在表，而奔豚已发，所以有所不同。
发汗后脐下悸动的，想要发作奔豚，用茯苓甘草大枣汤主治。（《伤寒论·太阳中篇》后下有“其人”二字。）
〔鉴〕周扬俊说：汗本是心的液，发汗后脐下病悸，是心气虚而肾气动。
〔程〕汗后脐下悸动，是阳气虚，而肾邪上逆。脐下是肾气发源之地。茯苓，泄水以伐肾邪；桂枝，行阳以散逆气；甘草、大枣，甘温助脾土以制肾水。煎药用甘澜水，是因为扬之无力，全无水性，取其不助肾邪。
茯苓桂枝甘草大枣汤方
茯苓（半斤）、甘草（二两，炙）、大枣（十二枚）、桂枝（四两）
以上四味药，用甘烂水一斗，先煮茯苓，减二升，加入诸药，煮取三升，去滓，温服一升，每日三次。甘烂水法：取水二斗，置大盆内，以杓扬之，水上有珠子五六千颗相逐，取用之。（甘烂水法，原文为细注，今据《伤寒论》大书，烂通徐、沈、金鉴作澜，盖本于《玉函经》，甘烂之义，详见于《伤寒论辑义》。）
〔徐〕仲景论证，每合数条，以尽其变。言奔豚由于惊，又言其从少腹冲至咽喉，又言其兼腹痛，而往来寒热，又言其兼核起，而无他病，又言汗后脐下悸，欲作奔豚，而未成者。其浅深了然，用和解、用伐肾、用桂不用桂，酌治微妙。奔豚一证，病因证治，无复剩义。苟不会仲景立方之意，则峻药畏用，平剂寡效，岂古方不宜于今哉？
《肘后备急方》：治卒厥逆上气，气支两胁，心下痛满，淹淹欲绝。
此谓奔豚病，从卒惊怖忧迫得之。气从下上，上冲心胸，脐间筑筑发动，有时不疗，杀人。
《千金方》：甘草（二两，炙）、人参（二两）、吴茱萸（一升）、生姜（一斤）、半夏（一升）、桂心（三两）
以上六味药，切碎，用水一斗，煮取三升，分三服。○《千金方》名奔气汤，治大气上奔胸膈中，诸病发时，迫满短气不得卧，剧者便欲死，腹中冷湿气，肠鸣相逐成结气，用桂五两，甘草三两。（《外台秘要》、《广济方》：疗奔豚气在胸心迫满支胁方，用半夏四两，吴茱萸一两。）
《圣惠方》：治奔豚气上下冲走，闷乱面青，宜服此方。
甘李根皮（三两）、生姜（二两，炒干）、吴茱萸（一两）
以上捣细罗为散，每服一钱，水一中盏，煎至六分，去滓热服。（按：以上二方，盖奔豚之要药，品味亦单捷，验之颇效，故附之备考。）
以上以童子小便一大盏微过，入前药二味，搅令匀，分为三服。如人行五六里，进一服。须臾下利为效。（案：此系《外台秘要》、《广济方》疗香港脚冲心闷欲死方，今移以治奔豚气，正见运用之妙，故亦附之。）
The Master said: There are diseases of Ben Tun (Rushing Pig), vomiting of pus, fright and terror, and fire pathogen. These four categories of disease all arise from fright.
The Master said: The disease of Ben Tun starts from the lower abdomen (Shaofu), rushes upward to the throat. During an attack, the patient feels as if they are about to die, after which it subsides. All these cases result from fright and fear.
[Cheng] This chapter title only lists the single syndrome of Ben Tun, while the contents regarding vomiting of pus, fright/terror, and fire pathogen have been omitted or lost; there must be missing text. The Classic states: In Taiyang cold damage, if warm needle therapy is added, it will certainly cause fright. If the acupuncture site is exposed to cold, resulting in a red nodule, Ben Tun will certainly develop. After sweating therapy, if there is palpitation below the umbilicus, Ben Tun is about to develop. Thus, Ben Tun arises from fright.
[You] Vomiting of pus differs between coughing and vomiting; its origin from fright is unclear. "Jingbu" (fright and terror) is essentially fright. It seems that when the disease originates from fright, the qi of fright itself becomes the pathogenic qi. "Fire pathogen" is discussed in the subsequent section on palpitations and fright, and in the Taiyang chapter of *Shanghan Lun*, which states: In Taiyang disease, if fire moxibustion/fumigation is used and sweat is not produced, the person will become irritable. When the meridian cycle completes without resolution, blood in the stool will occur. This is named Fire Pathogen. However, it does not state that it arises from fright. The Palpitations chapter states: For Fire Pathogen, Guizhi Qu Shaoyao Jia Shujimu Lulonggu Jiuni Tang (Cinnamon Twig Decoction Modified by Removing Peony, Added with Bunge's Thistle Root, Oyster Shell, and Dragon Bone for Rescue) is the primary treatment. This indicates that fright was caused by the fire pathogen, not that fright caused the fire pathogen. Similarly, the three subsequent treatises on Ben Tun do not necessarily imply it always arises from fright. Generally, this disease has distinctions between miscellaneous diseases and cold damage. Cases arising from fright belong to miscellaneous diseases; those arising from sweating therapy or exposure to cold after burning needles belong to cold damage. Regarding vomiting of pus and fire pathogen, Zhang Zhongjing likely had other specific meanings; we leave them aside pending further knowledge. The earlier mention of "fright" and later addition of "fear" relates to the kidney being injured by fear, and Ben Tun being a kidney disease. Water is associated with the pig (tun); the kidney is the water organ. Internal movement of kidney qi rushes upward to the throat, like a pig charging, hence the name Ben Tun. It can also originate from liver disease, as the liver and kidney both reside in the lower jiao, and their qi tends to rebel upward.
[Jian] Zhang Congzheng stated: Fright arises from unknown causes, while fear arises from known causes.
Chao Yuanfang stated: Ben Tun Qi is accumulated qi of the kidney, originating from fright, fear, worry, and overthinking. Fright injures the Shen (Spirit), which resides in the Heart; worry and overthinking injure the Zhi (Will), which resides in the Kidney. When Spirit and Will are injured and disturbed, qi accumulates in the Kidney and moves up and down within the body, running like a pig, thus called Ben Tun. If the qi attacks the Heart, one feels palpitations, as if startled by a carriage or entering a terrifying situation. The five zang organs become unstable, food and drink are vomited immediately, qi fills the chest, madness and dementia ensue, speech and visions are delusional. These are the symptoms of Ben Tun due to fright. If qi fills and supports the chest and heart, causing oppression and confusion below the heart, aversion to sound, with episodes occurring at intervals, alternating between remission and exacerbation, shortness of breath, cold extremities, internal irritability and pain, nausea, these are symptoms of Ben Tun due to worry and overthinking. Pulse diagnosis reveals a rapid and forceful pulse ("Chuzhu"). As noted in *Wai Tai Mi Yao*, the term "Chuzhu" may vary. This indicates the disease is Ben Tun.
According to the *Ling Shu: Xieqi Zangfu Bingxing* chapter: Chen Jue Ben Tun involves inability to move the legs and inability to urinate or defecate. This likely refers to the condition discussed in this text. However, *Nan Jing* names renal accumulation as Ben Tun, which is distinct from this. Yang Xuancao, commenting on *Nan Jing*, stated: There is also Ben Tun Qi, which is not this type of accumulation disease. The names are the same, but the diseases differ. Later generations referred to "Ben Tun Hernia" (seen in *Heji Ju Fang*, *Zhi Zhi Fang*). This corresponds to "Chong Hernia" mentioned in the *Nei Jing* (*Gukong Lun*). Zhang Shi's medical theories state: Renal qi rushing defines Ben Tun, noting that pigs can run but not far. This explanation is correct. Shen Zhu stated: The shape resembles a river dolphin. This view stems from *Danxi Xinfa* and should definitely not be followed.
For Ben Tun Qi, characterized by upward rushing to the chest and abdomen, alternating chills and fever, Ben Tun Tang is indicated.
[Xu] This represents Ben Tun Qi corresponding to exterior pathogens. Thus, the symptoms resemble Ben Tun, with qi rushing to the chest. Although it may not reach the throat, it is similar to Ben Tun triggered by fright. However, the accompanying abdominal pain indicates the pathogen is in the abdomen. Furthermore, alternating chills and fever indicate the pathogen is in the half-exterior, half-interior level.
[Shen] Therefore, Chuanxiong, Danggui, Shengjiang, and Baishao soothe and nourish the righteous qi of the Jueyin and Shaoyang meridians, driving out the pathogen. Shengge (Pueraria) and Ganligen Baipi (Plum Root Bark) specifically resolve exterior-interior wind-heat and clear the rebellious qi of Ben Tun. Huangqin clears heat transformed from wind. Banxia harmonizes the spleen and stomach, resolving phlegm.
[You] Fuling (Poria) and Guizhi are the main herbs for Ben Tun, yet they are not used here because the disease originates from the Kidney.
**Ben Tun Tang Formula** (As cited in *Wai Tai Mi Yao* from *Ji Yan Fang*, indications and ingredients are identical.)
Gancao (Licorice Root), Chuanxiong (Sichuan Lovage Rhizome), Danggui (Angelica Sinensis Root) — each 2 liang; Banxia (Pinellia Tuber) — 4 liang; Huangqin (Scutellaria Root) — 2 liang; Shengge (Kudzu Root) — 5 liang; Baishao (White Peony Root) — 2 liang; Shengjiang (Fresh Ginger) — 4 liang; Ganligen Baipi (Bark of Prunus mume root) — 1 sheng.
These nine ingredients are boiled in 2 dou of water until 5 sheng remain. Take 1 sheng warm, three times daily and once at night.
According to *Bencao Bie Lu*: Li Gen Pi (Plum Root Bark) is very cold, non-toxic, treats thirst, stops irritability and rebellious Ben Tun Qi. Thus, Li Gen Pi is the principal herb of this formula.
*Wai Tai Mi Yao* cites *Duan Ju Fang*'s Ben Tun Tang for treating deficiency labor with exhaustion of the five zang qi, wandering qi returning upward, moving upwards resembling a group of chasing pigs, causing restlessness. When seasonal qi arrives, it resolves spontaneously. It treats nocturnal emissions due to fright dreams, depleted luster of the eyes, impotence with upward pulling pain in the lower abdomen, sudden facial redness, mood swings, deafness, dull vision.
Modification: Remove Chuanxiong and Huangqin; add Guixin (Cinnamon Bark) and Renshen (Ginseng).
*Guang Ji Fang*: For Ben Tun Qi in the heart, causing shortness of breath, aversion to speech, mental restlessness, episodic onset, limb pain, cold extremities.
Modification: Remove Chuanxiong, Danggui, Huangqin, Shengge, Baishao, Shengjiang; add Ganjiang (Dried Ginger), Fuling (Poria), Renshen (Ginseng), Fuzi (Aconite Root), Guixin (Cinnamon Bark). *(Note: For Ben Tun patterns belonging to deficiency-cold, this modified formula is appropriate.)*
*Ji Yan Fang*: Ben Tun Fuling Tang treats shortness of breath, insufficiency of the five zang, cold qi reversal, abdominal fullness, qi rushing to the chest and diaphragm, feeling of impending death during attacks, unconsciousness, emaciation, jumping sensation in the lower abdomen like a piglet moving up and down, alternating chills and fever, contraction of the genitalia, cold extremities, or irritability.
Modification: Remove Huangqin and Baishao; add Fuling (Poria) and Renshen (Ginseng).
Another decoction for Ben Tun Qi rising from below:
Modification: Remove Gancao, Chuanxiong, Danggui; add Renshen (Ginseng) and Guixin (Cinnamon Bark).
*Duan Ju Fang* Ben Tun Tang treats cold extremities, chest fullness, shortness of breath, dizziness arising from the left and right sides of the umbilicus.
Modification: Remove Danggui, Baishao, Banxia, Shengjiang; add Guixin (Cinnamon Bark), Gualou (Trichosanthes Fruit), Renshen (Ginseng).
*Muli Ben Tun Tang* treats Ben Tun Qi rising from the lower abdomen to the chest, with cold extremities.
Muli (Oyster Shell, calcined) — 3 liang; Guixin (Cinnamon Bark) — 8 liang; Li Gen Baipi (Plum Root Bark, sliced) — 1 jin; Gancao (Licorice Root, honey-fried) — 3 liang.
These four ingredients are sliced. Boil in 1 dou of water until Li Gen Pi yields 7 sheng. Strain, add remaining herbs, boil to 3 sheng. Take 5 he per dose, three times daily and twice at night.
*Huo Ren Shu* Li Gen Tang treats qi rushing upward, centered at the heart.
Modification: Remove Chuanxiong and Shengge; add Fuling (Poria) and Guizhi (Cinnamon Twig).
After sweating therapy, if burning needles were used to induce sweat, and the needle site became exposed to cold, resulting in a red nodule, Ben Tun will certainly develop. Qi rises from the lower abdomen to the heart. Apply one moxa cone to each nodule. Treat with Guizhi Jia Gui Tang (Cinnamon Twig Decoction with Additional Cinnamon). *(Note: In the Taiyang Chapter of Shanghan Lun, "after sweating" is absent; "below the heart" includes the character "zhe".)*
[Jian] Burning needle refers to warm needle therapy. Using burning needles to induce sweat is a sweating method. The needle site must be protected from cold. Negligence leads to external cold invasion, trapping fire in the vessels, causing stagnant blood flow and resulting in nodules and redness. Warm needle therapy is vigorous. If Ying Qi fails to disperse after needling, it indicates inherent cold and excess yin. Despite the heat of the needle, only redness appears. Combined with cold invasion, instead of resolving, it attracts yin pathogens. At the time of needling, the Heart is frightened and deficient, allowing Kidney Water Yin Pathogens to overwhelm Heart Yang, triggering Ben Tun. Ben Tun is the qi of Kidney Water Yin Pathogens rushing from the lower abdomen to the Heart, like a charging pig. Moxa on the nodule dispels external cold; Guizhi Jia Gui Tang internally subdues Kidney pathogens.
[Wei] After moxibustion, Guizhi Jia Gui Tang is administered. The intent is to raise Yang, scatter pathogens, secure the exterior, and tonify the middle. This establishes the treatment for Ben Tun caused by cold after sweating, where Yang is deficient and Yin invades. This source is vastly different from the previous case of Ben Tun involving Heart agitation, qi stagnation, and heat accumulation.
**Guizhi Jia Gui Tang Formula**
Guizhi (Cinnamon Twig) — 5 liang; Baishao (White Peony Root) — 3 liang; Gancao (Licorice Root, honey-fried) — 2 liang; Shengjiang (Fresh Ginger) — 3 liang; Dazao (Jujube) — 12 pieces.
These five ingredients are boiled in 7 sheng of water over mild heat until 3 sheng remain. Strain, take 1 sheng warm.
Ke Shi's commentary states: Adding more Gui increases Fire Yang, thereby balancing Yin. Increasing the dosage of Guizhi to treat Yin pathogens attacking upward demonstrates the subtlety of adjusting dosage within a single herb rather than adding new ones. The Fuling Guizhi Gancao Dazao Tang pattern is interior with Ben Tun not yet developed; this pattern is still exterior with Ben Tun already developed, hence the difference.
After sweating, if there is palpitation below the umbilicus, indicating Ben Tun is about to develop, Fuling Gancao Dazao Tang is indicated. *(Note: In the Taiyang Chapter of Shanghan Lun, "this person" follows.)*
[Jian] Zhou Yangjun stated: Sweat is the fluid of the Heart. Palpitation below the umbilicus after sweating indicates Heart Qi deficiency and Kidney Qi movement.
[Cheng] Palpitation below the umbilicus after sweating indicates Yang Qi deficiency and rebellious Kidney Pathogens. The area below the umbilicus is the source of Kidney Qi. Fuling drains water to subdue Kidney pathogens; Guizhi promotes Yang to dissipate rebellious Qi; Gancao and Dazao, being sweet and warm, assist Spleen Earth to control Kidney Water. The use of Ganlan Shui (Gentle Rolling Water) is because it has been agitated until it loses its heavy water nature, preventing it from aiding Kidney pathogens.
[Jian] "About to develop Ben Tun" means symptoms resembling Ben Tun are present, but the full syndrome has not yet manifested.
**Fuling Guizhi Gancao Dazao Tang Formula**
Fuling (Poria) — 8 liang; Gancao (Licorice Root, honey-fried) — 2 liang; Dazao (Jujube) — 12 pieces; Guizhi (Cinnamon Twig) — 4 liang.
These four ingredients are boiled in 1 dou of Ganlan Shui. First boil Fuling until reduced by 2 sheng, then add other herbs. Boil to 3 sheng. Strain, take 1 sheng warm, three times daily.
*Method for Ganlan Shui:* Take 2 dou of water, place in a large basin, stir vigorously with a ladle until 5,000–6,000 bubbles chase each other on the surface. Use this water. *(Note: Original text details this in small print; modern editions follow Shanghan Lun, interpreting "lan" as "lan" [agitated], based on Yuyang Jing. See Shanghan Lun Ji Yi for detailed meaning.)*
[Xu] Zhang Zhongjing often combines several clauses to exhaust variations. He states Ben Tun arises from fright; describes it rushing from the lower abdomen to the throat; mentions accompanying abdominal pain and alternating chills/fever; notes accompanying nodules without other diseases; and describes post-sweating palpitation below the umbilicus indicating impending Ben Tun. The depth and progression are clear. Treatment involves harmonizing, subduing the Kidney, using Gui vs. not using Gui, demonstrating subtle therapeutic principles. For Ben Tun, the etiology, symptoms, and treatment are fully explained. If one does not understand Zhang Zhongjing's formulation intent, one fears potent herbs and finds mild formulas ineffective. Is it that ancient formulas are unsuitable for today?
*Zhou Hou Bei Ji Fang* treats sudden reversal of qi ascending, qi obstructing both hypochondria, pain and fullness below the heart, feeling of impending death.
This is defined as Ben Tun disease arising from sudden fright, terror, worry, and distress. Qi rises from below, rushing to the chest and heart, with throbbing at the umbilicus. If untreated, it can be fatal.
*Qian Jin Fang*: Gancao (Licorice Root, honey-fried) — 2 liang; Renshen (Ginseng) — 2 liang; Wuzhuyu (Evodia Fruit) — 1 sheng; Shengjiang (Fresh Ginger) — 1 jin; Banxia (Pinellia Tuber) — 1 sheng; Guixin (Cinnamon Bark) — 3 liang.
These six ingredients are sliced. Boil in 1 dou of water until 3 sheng remain. Divide into three doses.
*Qian Jin Fang* calls this Ben Qi Tang, treating massive qi rushing to the chest and diaphragm. During attacks, oppression, fullness, shortness of breath, inability to lie down, severe cases feel like death, cold damp qi in the abdomen, intestinal rumbling forming stagnation. Uses Guizhi 5 liang, Gancao 3 liang. (*Wai Tai Mi Yao*, *Guang Ji Fang*: For Ben Tun Qi in chest/heart with oppression and hypochondriac fullness, uses Banxia 4 liang, Wuzhuyu 1 liang.)
*Sheng Hui Fang* treats Ben Tun Qi rushing up and down, causing confusion and bluish face. Take this formula.
Ganligen Pi (Plum Root Bark) — 3 liang; Shengjiang (Fresh Ginger, stir-fried dry) — 2 liang; Wuzhuyu (Evodia Fruit) — 1 liang.
Grind into fine powder. Take 1 qian per dose with 1 zhann of water, boil to 6 fen. Strain and take hot. *(Note: These two formulas contain key herbs for Ben Tun, with simple and effective compositions, so they are included for reference.)*
Another Formula: Binglang (Areca Seed, ground) — 3 pieces; Shengjiang Zhi (Ginger Juice) — 0.5 he.
Mix with 1 zhann of young boy's urine (slightly warmed). Stir well. Divide into three doses. Administer every 5-6 li of walking. Diarrhea indicates efficacy. *(Note: This is adapted from Wai Tai Mi Yao/Guang Ji Fang for Crab-leg attacking the heart causing suffocation and near-death sensation, applied here to Ben Tun Qi, showing flexible application.)*