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After taking the medicine, although a slight sweat was produced, no significant effect was observed. My sister's husband, Mr. Jin, firmly believed in Western medicine and seemed to think that Western medical treatments were superior to Traditional Chinese Medicine (TCM). Consequently, he consulted at a certain hospital and was diagnosed with renal inflammation (Kidney Inflammation). The physicians prescribed other medications along with laxatives such as Natrii Sulfas (Puxiao, 朴硝). After several bowel movements, the abdominal distension remained unchanged.

This is because Natrii Sulfas can only purge accumulation but cannot drain water retention. The next day, he suddenly suffered from severe headache, described as if his head were being split open, with cries of anguish reaching the neighbors. After vomiting phlegm-fluid, the pain slightly eased. I said: This is a headache caused by water-toxin attacking upwards, which corresponds to what Western medicine calls autointoxication. This syndrome is recorded in Zhang Zhongjing's works (see Zhao edition of *Shanghan Lun*, Article 160). Only Shizao Tang (Ten Date Decoction) can achieve efficacy. Taking advantage of the fact that his physical strength has not yet declined, he can be cured with a single administration; delaying treatment would make it difficult for him to tolerate heavy doses. Therefore, I formulated a prescription using Kansui Radix (Gansui, 甘遂) 3 fen (this herb must be thoroughly roasted before use to prevent vomiting afterwards; otherwise, simultaneous vomiting and diarrhea may occur, which is quite alarming, as I have verified through multiple trials), Euphorbiae Pekinensis Radix (Daji, 大戟) and Genkwa Flos (Yuanhua, 芫花) stir-fried, each 1 qian. Because the patient's constitution was inherently weak, I used Jujubae Fructus paste (Zaogao, 枣膏) to form pills, aiming for a gradual purgative effect. I also instructed the attendant to prepare red rice porridge in advance for emergency needs. Four to five hours after taking the medicine, borborygmus (rumbling sounds in the abdomen) occurred, followed by one or two episodes of watery stool. The abdominal wall relaxed, and the headache disappeared. However, he became confused and appeared similar to syncope, unresponsive to calls. His family members all claimed the medication was too potent. I said: Do not be alarmed. As stated in the *Book of Documents* (*Shangshu*), "If the medicine does not cause dizziness or discomfort, the serious disease will not be cured." This is exactly what is meant. If you worry about his physical weakness, he can drink a cup of cooled red rice porridge to nourish stomach Qi and stop the diarrhea. Following this advice, the diarrhea indeed stopped, and consciousness cleared. The next day, there was still slight fluid retention in the abdomen, so I administered another 1 qian of Shizao Wan (Ten Date Pills) to expel the remaining fluid, reflecting the intention to eliminate the disease root completely. Subsequently, Liujunzi Tang (Six Gentlemen Decoction) was used to supplement the Spleen Yuan. Moreover, the Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) in the formula can restore absorptive function. Thus, after ten days of regulation, full recovery was achieved. (Recorded in *Zhongyi Neike Quanshu*). This is also an excellent example of ancient formulas treating modern diseases.

Ben Tun (Running Piglet) Case One

Patient Liu, Right Pulse. First Visit: September 16.
The illness began with pain in the Zhongwan region and vomiting of water. Since June of this year, he has had morning diarrhea daily. Sometimes, Qi rushes upward from the lower abdomen, feeling like a mass. When the Qi retreats, the sensation disappears completely. This is merely Liver Qi stagnation and dysfunction, leading to stagnation of Middle Qi. The treatment should utilize Wuzhuyu Tang (Evodia Decoction) combined with Lizhong Tang (Regulate the Middle Decoction).

Evodiae Fructus (Wuzhuyu, 吴茱萸) 4 qian, Codonopsis Radix (Dangshen, 党参) 5 qian, Zingiberis Rhizoma Recens (Shengjiang, 生姜) 3 qian, Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao, 炙甘草) 3 qian, Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) 5 qian, Zingiberis Rhizoma Recens (Shengjiang, 生姜) 3 slices, Jujubae Fructus (Dazao, 红枣) 12 pieces.

Second Visit: September 18.
After taking two doses of Wuzhuyu Tang combined with Lizhong Tang, the sour taste decreased, and the rushing Qi subsided. The morning diarrhea was completely cured. However, every evening, he vomited one or two mouthfuls of clear water, and the phenomenon of Qi rushing upward from the lower abdomen carrying a palpable mass sometimes appeared and sometimes did not. The treatment should follow the precedent of impending Ben Tun, using Guizhi Jia Guixin Tang (Cinnamon Twig Plus Cinnamon Heart Decoction), adding Pinelliae Rhizoma Preparatum (Banxia, 半夏) to remove fluid.

Cinnamomi Ramulus (Guizhi, 桂枝) 3 qian, Paeoniae Radix Alba (Baishao, 白芍) 3 qian, Glycyrrhizae Radix et Rhizoma (Caogan, 甘草) 1.5 qian, Cinnamomi Cortex (Guixin, 桂心) 1.5 qian, Pinelliae Rhizoma Preparatum (Banxia, 半夏) 5 qian, Zingiberis Rhizoma Recens (Shengjiang, 生姜) 5 slices, Jujubae Fructus (Dazao, 红枣) 7 pieces. Note by Zhuozhao: Fully recovered after taking the medicine.

[Commentary] The "vomiting water" mentioned in the first visit and "vomiting clear water" in the second visit are suspicious; they might refer to "Baijin" (White Saliva), as detailed in the following case.

Ben Tun Case Two (Including Student's Verified Cases)

Patient Zhou, Right Pulse, residing in Pudong.
First Visit: Qi rushed upward from the lower abdomen to the heart, occurring four to five times a day. During attacks, Baijin (White Saliva) flowed out. This is treated as Ben Tun.

Cinnamomi Cortex (Rougui, 肉桂) 1 qian, Cinnamomi Ramulus (Guizhi, 桂枝) 3 qian, Paeoniae Radix Alba (Baishao, 白芍) 3 qian, Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao, 炙甘草) 2 qian, Zingiberis Rhizoma Recens (Shengjiang, 生姜) 3 slices, Jujubae Fructus (Dazao, 红枣) 8 pieces.

[Commentary] This case was diagnosed by me at Guangyi TCM Hospital. I found it quite interesting, akin to cherishing one's own broken broom. Let us start with Baijin (White Saliva).

*Jinkui Yaolue* states: "Cold hernia causes pain around the navel. If it attacks severely, Baijin flows out, hands and feet become cold, and the pulse is deep and string-taut. Da Wutou Jian (Major Aconite Decoction) governs it." The phrase "Ku Fa" (severe attack) in this article appears as "Ruo Fa" (if it attacks) in *Qianjin Fang* and *Waitai Miyao*, which is not worth discussing. The term "Baijin" appears as "Baihan" (White Sweat) in *Qianjin Fang* and *Waitai Miyao*. "Baihan" is rare in Zhang Zhongjing's books. Some consider it to be "Po Han" (Soul Sweat) from *Suwen*, or "Baihan" from *Maijing*, but these seem inaccurate interpretations. If retained as Baijin, it still fails to specify what it is. Interpreting it as leukorrhea is particularly erroneous because leukorrhea is referred to as "xia" (downward discharge), not "chu" (outflow), and is called "baiwu" (white substance), not "baijin". Only Patient Zhou told me of a symptom for which I had no existing phrase to describe. To describe it, the five characters "Fa Ze Baijin Chu" (When it attacks, Baijin flows out) suffice. Basically, whenever Zhou felt cold Qi rushing upward, saliva gushed from his mouth uncontrollably, transparent and white. It stopped only when the rushing Qi subsided. Its origin and destination were unknown. It was certainly not phlegm-dampness, as phlegm originates from the Lung and Stomach, whereas this came from the mouth; phlegm is thick and dense, while this was thin and clear; expelling phlegm requires effort, while this flowed naturally. Thus, they are distinctly different substances. Ben Tun is a cold syndrome; since there is an example of discharging Baijin, then Cold Hernia, being a similar cold syndrome, discharging Baijin is also unquestionable. My senior brother Wu Ningxuan Wei once personally witnessed dying frozen people spitting out countless amounts of Baijin continuously, definitely not under their voluntary control, which corroborates this case perfectly. Facts cannot be deceived! Ye Tianshi's case notes: "Young Gao had Qi rushing in the lower abdomen, pain below the heart and in the hypochondrium, salivation under the tongue, relief with sweet tastes or lying quietly, hunger without desire to eat, and daily constipation. These indicate internal depletion of Yin fluids and closure of Yang Qi. Yu Xichang proposed nourishing fluids to save from burning."

However, for elderly patients with Guan Ge syndrome, life is merely prolonged, and medicine offers only hope for luck. Medicines used include Cannabis Seed (Hemaoren, 大麻仁), Biota Seed (Baiziren, 柏子仁), Goji Berry (Gouqizi, 枸杞子), Cistanche Stem (Roucongrong, 肉苁蓉), Purple Quartz (Zhiyingshi, 紫石英), and Stir-fried Achyranthes Root (Chao Niuxi, 炒牛膝). Carefully analyzing this illness, it is actually Ben Tun. The so-called salivation under the tongue is indeed Baijin. Although the medication was not the orthodox approach, it sufficiently corroborated the condition with great prudence.

According to Western anatomy, salivary glands are also known as salivary glands, consisting of three pairs: parotid, submandibular, and sublingual glands, each ending in grape-like sacs. The parotid gland is the largest, located directly below the external ear, with a duct opening near the upper molar teeth to transport saliva. The submandibular gland is in the anterior part inside the lower jaw, and the sublingual gland is under the mucosa of the tongue floor; their ducts open on both sides of the lower tip of the tongue. If the salivary nerve receives reflex excitation causing hypersecretion of saliva, it is called reflex sialorrhea. I surmise that in Ben Tun patients, nerves in the heart and abdomen are severely stimulated, which reflexively affects the salivary nerves, causing excessive saliva secretion. This saliva is precisely the Baijin mentioned in this case.

After the second visit, administering Guizhi Jia Guixin Tang reduced the upward rushing Qi to two or three times a day, and the flow of Baijin gradually thinned. Passing flatus (Fashi, 矢气) occurred, which is the path for evil to exit; this is auspicious.

Cinnamomi Cortex (Rougui, 肉桂) 1.5 qian, Cinnamomi Ramulus (Guizhi, 桂枝) 3 qian, Paeoniae Radix Alba (Baishao, 白芍) 3 qian, Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao, 炙甘草) 3 qian, Zingiberis Rhizoma Recens (Shengjiang, 生姜) 3 slices, Jujubae Fructus (Dazao, 红枣) 10 pieces, Magnoliae Officinalis Cortex (Houpo, 厚朴) 1.5 qian, Pinelliae Rhizoma Preparatum (Banxia, 半夏) 3 qian.

[Commentary] During the first visit, a classmate recording the prescription said: "This is Liver Qi." I replied: The name "Liver Qi" is too broad; it is better to follow the classics and call it Ben Tun. The classmate doubted this. The next day, the patient happily reported: "The rushing Qi has decreased, and my appetite has increased." The classmate was astonished. I asked again in detail about the appearance of Baijin and everything related to it; his answers matched perfectly, leaving no doubt. I also carefully palpated the pulse, which showed a string-taut and tight quality, similar to the pulse of Cold Hernia described by Zhang Zhongjing, further confirming that Hernia and Ben Tun are indeed similar diseases.

Taking Guizhi Jia Guixin Tang resulted in passing flatus because Cinnamon has an aromatic nature and can expel turbidity. However, its specific merit in expelling turbid Qi is inferior to Magnoliae Officinalis Cortex (Houpo, 厚朴), which I have verified through repeated experiments. Since Pinelliae Rhizoma Preparatum (Banxia, 半夏) is good at descending, they were used together.

In the third visit, the upward rushing Qi and flow of Baijin gradually ceased, likely because flatus could circulate freely. Now, to address the root, Houpo Shengjiang Gancao Banxia Renshen Tang Plus Cinnamon (Magnolia Bark, Fresh Ginger, Licorice, Pinellia, and Ginseng Decoction plus Cinnamon) is appropriate.

Magnoliae Officinalis Cortex (Houpo, 厚朴) 3 qian, Zingiberis Rhizoma Recens (Shengjiang, 生姜) 4 qian, Pinelliae Rhizoma Preparatum (Banxia, 半夏) 4 qian, Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) 3 qian, Codonopsis Radix (Dangshen, 党参) 3 qian, Cinnamomi Cortex (Guixin, 桂心) 1 qian, Cinnamomi Ramulus (Guizhi, 桂枝) 2 qian.

[Commentary] Whenever I encounter a disease worthy of study, I prefer the patient to come for consultations several times so I can record the progress after taking medicine. However, due to the use of Jingfang (Classic Formulas), patients recover quickly and often do not return after one or two visits. I am unable to ask in detail, leading to great disappointment. At the first visit of this case, the woman, frustrated by previous ineffective local treatments, frequently asked if there was any hope for cure. I promised ten days, and she nodded smilingly. At the second visit, having failed to inquire about the condition previously, I immediately asked for her Shanghai address in detail. After the third visit, she indeed did not return. Several days later, I visited her relatives' home according to the address. Her niece came out and said: "My aunt has almost fully recovered from the illness and, due to busy household chores, has happily returned to Pudong."

In my opinion, the root of this woman's illness must not have been eradicated, and it would likely recur soon. When the illness was severe, body health took precedence over household affairs; when the illness subsided, household affairs took precedence over body health. This is human nature, nothing strange about it. Skeptical readers will surely ask me: What does "addressing the root now" mean? To answer this, I must present my immature theory. I say: The root of Ben Tun disease is flatus in the intestines, i.e., gas generated by fermentation and decomposition of undigested residues in the gastrointestinal tract. Houpo Shengjiang Gancao Banxia Renshen Tang is best for treating this. In the formula, Ginseng, Fresh Ginger, and Pinellia strengthen the stomach and descend rebellious Qi, establishing a dominant position; Magnolia Bark and Licorice expel turbidity and stabilize righteousness, achieving both suppression and pacification. After taking this, the patient will pass more flatus. Once the flatus is expelled, abdominal distension will gradually subside. Patient Zhou originally had abdominal distension, which gradually subsided after two doses of medicine. I specially add this here. When the patient's abdomen gradually flattens, Ben Tun avoids recurrence. This is what is meant by "addressing the root."

I should now supplement the description of Woman Zhou's upward rushing Qi. She stated that the Qi indeed originated from the lower abdomen, but not just in a straight line up the center. It seemed as if small lines on both sides of the abdomen rose towards the center, rushing directly to the heart area and then disappearing. During the rush, it was very unbearable; when it disappeared, the destination was unknown. The sudden surge and cessation of Baijin were also involuntary. This cycle lasted several minutes before returning to normal. However, spirit became fatigued, and appetite decreased.

We should pay attention to the phrase "rebellious Qi rushes to the heart and disappears," which aligns perfectly with the classic texts "Qi rushes from the lower abdomen to the heart" and "Qi rises from the lower abdomen to the heart." The character "Zhi" (arrive) in the text implies making the heart the boundary, stopping upon arrival. The character "Chong" (rush) implies making the heart the target, hitting it means striking it. Both articles mentioning "Chong Xin" (rush to heart) and "Zhi Xin" (arrive at heart) prescribe Guizhi Jia Guixin Tang. Therefore, for this case of Ben Tun rushing to and arriving at the heart, I also used Guizhi Jia Guixin Tang.

After this woman passed flatus following medication, the upward rushing Qi instantly decreased. This shows that the rebellious Qi rushing to the heart is none other than intestinal flatus, and intestinal flatus is the rebellious Qi rushing to the heart. I suppose that gas fermented in the intestines, unable to discharge downwards, inevitably expands in the middle, causing abdominal distension. However, the degree of abdominal distension is limited, so at this time, gas has the potential to overflow upwards at any moment. The mesentery attaches to the intestinal membrane, which contains numerous venous vessels absorbing fluid upwards. Normally, due to the constrictive function of blood vessels, gas cannot overflow into them. Suddenly, the patient suffered extreme fright, causing the constrictive function to fail (When we hold something in our hand and get startled, the object falls. Records show that during difficult labor, if a woman hears a loud noise of something dropping, the fetus is delivered easily. These are clear proofs that constrictive muscles fail due to fright). Thus, the gas took the opportunity to overflow into the blood vessels. The amount overflowing must be very minute, but its harm is severe. Observing that Western injection agents strictly avoid air entry, we can see a glimpse of this. If gas overflows into venous vessels, the patient feels less pain because gas and venous blood move upwards together. If it overflows into arterial vessels, they move in opposite directions, causing severe pain. By my speculation, this gas even rushes against the large artery towards the heart. However, the strong pumping force of the heart valves crushes the gas or forces it back to its original place and disappearance. Using Guizhi Jia Guixin Tang works because Cinnamon Twig assists smooth circulation of arterial blood. Adding Cinnamon Heart as the sovereign herb strengthens this pumping force, preventing gas from overflowing upwards and forcing it to return downwards (My previous explanation of Cinnamon Twig in Guizhi Tang aligns with this usage, avoiding contradiction). Such an explanation seems satisfactory. However, physiology books state that intestinal toxins often invade blood vessels, but intestinal gas certainly cannot overflow into blood vessels. Yet, current physiology is insufficient to fully explain actual pathology. For example, after pleurisy patients take Shizao Tang, fluid between the pleura exits through the anus. Therefore, I dare to propose this hypothetical pathology for Ben Tun based on such cases. A hypothesis is an assumed theory, not absolute truth. I leave this theory here for others to correct errors or provide supplementary proof.

In my opinion, the patient first had gas accumulation in the intestines. Occasional fright caused the constrictive function to fail, leading to gas overflowing into blood vessels. Hence, Zhang Zhongjing said: "All arise from fright." "Fa" means beginning; this statement has profound meaning. Zhang Zhongjing also said: "Needling to induce sweating, where the needle site is exposed to cold, resulting in nodules rising and turning red, will definitely trigger Ben Tun." Why does needling to induce sweating often cause Ben Tun? Few commentators have explained this well. Little did they know that Zhang Zhongjing provided his own commentary: "Applying warm needles must cause fright," "Doctors using fire to coerce sweating causes loss of Yang, leading to fright and mania," "Ben Tun... all arise from fright." Viewing these together, is the reason why needling causes Ben Tun not extremely clear? Therefore, interpreting classics with classics surpasses verbose explanations. It can be asserted that the person originally had residual gas in the intestines, waiting for the right time to move.

Although, my hypothesis goes further. If readers can bear patience, I will continue to elaborate. I say: The Ben Tun described above is the first type. There is a second type slightly different, which is the Ben Tun governed by Bentong Tang.

These two types of Ben Tun share the same source but differ in flow. What is the same source? Both originate from gas in the abdomen. How do they differ? One rebels against the large artery and attacks the Heart Organ; the other overflows into lymphatic vessels, rebels against the thoracic duct, also attacking the Heart Organ, and even affecting the chest and throat. The Master said: "Ben Tun disease starts from the lower abdomen, rushes up to the throat, and attacks are so severe one wishes to die."

It also says: "Ben Tun Qi rushes up to the chest, abdominal pain, alternating chills and fever, Bentong Tang governs it." This is the type of Ben Tun affecting the lymphatic system. Let us prove this in detail. The upper end of the thoracic duct is in the chest, higher than the heart, hence it says "rushes up to the chest," not just "arrives at the heart." This is proof one. "Feeling like a grilled meat lump in the throat" belongs to Banxia Houpo Tang syndrome; its disease is in the cervical lymphatic system of the throat, belonging to Shaoyang, which is very similar to "rushing up to the throat" mentioned here. This is proof two.

Lymphatic system diseases are what TCM calls Shaoyang disease. Shaoyang disease primarily presents with alternating chills and fever, hence "alternating chills and fever, Bentong Tang governs it." This is proof three. Examining Bentong Tang, it contains Banxia, Huangqin, Shengjiang, and Gancao, resembling Xiao Chaihu Tang, the main formula for Shaoyang. This is proof four. My master once cured this type of Ben Tun using the original Bentong Tang formula; the case details are in *Jinkui Fawei*. Readers wishing to know more can check it themselves. This is proof five. With these five proofs, the second type of Ben Tun disease is established.

Therefore, speaking in terms of Six Meridians, both types of Ben Tun originate in Taiyin; one manifests in Taiyang, and one in Shaoyang. Physiologically, both types originate from intestinal gas; one manifests in the circulatory system, and one in the lymphatic system. Examining instances, those manifesting in the circulatory system are more common, while those in the lymphatic system are fewer. Thus, the use of Guizhi Jia Guixin Tang is often broader than Bentong Tang. Dongzhe said: "Although there are many main agents for Ben Tun, Jia Gui Tang is the most suitable." This is the reason. For severe cases of Ben Tun, the rebellious Qi may simultaneously affect both circulatory and lymphatic systems, which is possible, so combining formulas is acceptable.

Writing至此, the discussion on Ben Tun seems to reach a pause. If readers wish to追问 further about the origin of intestinal gas and the formation of Taiyin disease, how can I remain silent? I say: Physiologically, the formation of intestinal gas is actually due to the stomach's lack of digestive power, i.e., Western medicine's dyspepsia. Therefore, to treat the intestines, one must first strengthen the stomach. Just as one must dredge the source to ensure a long stream. Although this is shallow talk, unworthy of a smile, let us go further psychologically. I say: The reason for poor gastrointestinal function is created by sorrow, worry, and sadness. Observe that when we encounter sorrow, food does not go down, or if it does, it cannot digest, which serves as clear evidence. Hence, TCM says sorrow injures the Spleen, and the Spleen governs transportation and transformation, meaning sorrow causes indigestion. Based on this, I dare to extend Zhang Zhongjing's theory: "Ben Tun disease arises from fright and terror, and accumulates from sorrow and grief." It arises suddenly but accumulates gradually.

Readers, please combine my master's verified case from the previous chapter and my humble case from this chapter to examine. You will know that what I say is based on experimentation, not fantasy. Comparing my master's case with mine, there is one difference in treatment method. Discerning readers have likely seen this. If not, please ponder briefly. Once understood, read the following text and compare it with what I say. This is a method of scholarship and a way to add interest.

My master's previous case first used Wuzhuyu Tang combined with Lizhong Tang, then Guizhi Jia Guixin Tang adding Banxia. My case gradually shifted from Guizhi Jia Guixin Tang to Houpo Shengjiang Gancao Banxia Renshen Tang Plus Cinnamon. One goes forward, one comes back; one follows, one opposes. In other words, my master first treated the root, then addressed the branch; I first treated the branch, then addressed the root. And