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。
奔豚具如下文。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。或云。东方肝木。其病发惊骇。四部病皆以肝为主。奔豚惊怖。皆肝自病。奔豚因惊
而发病。惊怖即惊以为病也。吐脓者。肝移热于胃。胃受热而生痈脓也。火邪者。木中有火。因惊而
发。发则不特自燔。且及他脏也。亦通。
师曰。奔豚病从少腹上冲咽喉。发作欲死。复还止。皆从惊恐得之。
前云惊发。此兼言恐者。肾伤于恐。而奔豚为肾病也。豚、水畜也。肾、水脏也。肾气内动。上
冲胸喉。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。
奔豚。气上冲胸。腹痛。往来寒热。奔豚汤主之。
此奔豚气之发于肝邪者。往来寒热。肝脏有邪。而气通于少阳也。肝欲散。以姜、夏、生葛散之。
肝苦急。以甘草缓之。芎、归、芍药理其血。黄芩、李根下其气。桂、苓为奔豚主药。而不用者。病
不由肾发也。
奔豚汤方
甘草 芎 当归 黄芩 芍药（各二两） 半夏 生姜（各四两） 生葛（五两） 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。
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。
此肾气乘外寒而动。发为奔豚者。发汗后烧针复汗。阳气重伤。于是外寒从针孔而入通于肾。肾
气乘外寒而上冲于心。故须灸其核上。以杜再入之邪。而以桂枝汤外解寒邪。加桂内泄肾气也。
桂枝加桂汤方
桂枝（五两） 芍药 生姜（各三两） 甘草（二两炙） 大枣（十二枚）
上五味。以水七升。微火煮取三升。去滓。服一升。
发汗后。脐下悸者。欲作奔豚。茯苓桂枝甘草大枣汤主之。
此发汗后心气不足。而后肾气乘之。发为奔豚者。脐下先悸。此其兆也。桂枝能伐肾邪。茯苓能
泄水气。然欲治其水。必益其土。故又以甘草、大枣补其脾气。甘澜水者。扬之令轻。使不益肾邪也。
茯苓桂枝甘草大枣汤方
茯苓（半斤） 甘草（二两） 大枣（十五枚） 桂枝（四两）
上四味。以甘澜水一斗。先煮茯苓减二升。内诸药。煮取三升。去滓。温服一升。日三服。（甘
澜水法取水二斗置大盆内以杓扬之上有珠子五六千颗相逐取用之也）
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 originate from fright and alarm.
Ben Tun is described in the following text. Vomiting of pus differs in having either cough or vomiting; its origin from fright remains unclear. Fright and terror refer to frightfulness. Generally, when a disease arises from fright, the qi of fright itself becomes the pathogenic qi. Fire pathogen is discussed later in the section on palpitations and anxiety, and in the Taiyang Chapter of Shanghan Lun, which states: "In a Taiyang condition, if treated with moxibustion or heat application such that sweating does not occur, the patient will inevitably become restless. If the condition persists beyond the expected cycle, hematochezia (blood in stool) will definitely occur. This is named Fire Pathogen." However, it is not stated here that it originates from fright. The section on palpitations and anxiety states: "For Fire Pathogen conditions, Guizhi Qu Shaoyao Jia Shu Xi Mu Li Long Gu Jiuni Tang (Cinnamon Twig Decoction without Peony plus Chinese Dodder Herb, Oyster Shell, and Dragon Bone for Rescue against Adversity) should be administered." This indicates that fright was caused by the fire pathogen, rather than the fire pathogen being caused by fright. Similarly, the three subsequent clauses regarding the diagnosis and treatment of Ben Tun do not necessarily have to originate from fright and alarm. Generally, this condition has distinctions between miscellaneous diseases and cold damage. Those originating from fright and alarm belong to miscellaneous diseases; those originating from excessive sweating and cold exposure after burning needles belong to cold damage. As for vomiting of pus and fire pathogen, Zhang Zhongjing must have had specific meanings; we shall leave these questions open for future scholars to resolve. Some say: In the East, Liver Wood governs, and its pathological manifestation includes fright and shock. All four categories of diseases are primarily governed by the Liver. Ben Tun and fright/terror are both self-pathologies of the Liver. Ben Tun develops due to fright becoming the disease; fright/terror is simply fright manifesting as disease. Vomiting of pus results from Liver transferring heat to the Stomach; the Stomach,受热 (heated), generates carbuncles and pus. Fire pathogen implies fire within wood, triggered by fright; upon eruption, it not only burns itself but also affects other organs. This explanation is also plausible.
The Master said: Ben Tun disease involves qi rushing upward from the lower abdomen to the throat. During an attack, the patient feels as though death is imminent, after which it subsides and stops. All cases arise from fright and alarm.
The previous text mentioned "fright," while this one adds "alarm." Kidney injury from alarm leads to Ben Tun, which is a Kidney disease. Tun (pig) is an aquatic animal. Kidney is the Water organ. When Kidney Qi moves internally and rushes upward to the chest and throat, resembling the sudden charge of a pig, it is named Ben Tun. It can also originate from Liver pathology, as the Liver and Kidney reside together in the Lower Jiao, and their Qi both tend to rebel upward.
Ben Tun, characterized by Qi rushing upward to the chest, abdominal pain, and alternating chills and fever, is treated with Bentong Tang.
This type of Ben Tun Qi originates from Liver pathogen. Alternating chills and fever indicate Liver pathogen affecting the Shaoyang channel. The Liver desires dispersion; Ginger, Pinellia, and Pueraria are used to disperse it. The Liver suffers from tension; Licorice is used to relax it. Chuanxiong, Angelica Sinensis, and White Peony Root regulate the Blood. Scutellaria and Plum Root Bark descend the Qi. Cinnamon Twig and Poria are primary herbs for Ben Tun, but they are omitted here because the disease does not originate from the Kidney.
Bentong Tang Formula
Gancao (Licorice Root), Chuanxiong (Szechwan Lovage Rhizome), Danggui (Angelica Sinensis Root), Huangqin (Scutellaria Root), Shaoyao (White Peony Root) [each 2 liang]; Banxia (Pinellia Tuber), Shengjiang (Fresh Ginger) [each 4 liang]; Shengge (Pueraria Root) [5 liang]; Ganli Gen Bapi (Inner Bark of Sweet Plum Root) [1 sheng].
Nine ingredients. Boil in 2 dou of water until reduced to 5 sheng. Take 1 sheng warm, three times daily and once at night.
After sweating therapy, if burning needles were used to induce further sweating, and the needle sites became cold, presenting as red nodules, Ben Tun will definitely develop. Qi will rush from the lower abdomen to the heart. Apply moxibustion, one cone per nodule. Treat with Guizhi Jia Gui Tang.
This occurs when Kidney Qi moves due to external cold, triggering Ben Tun. After sweating, burning needles cause further sweating, severely damaging Yang Qi. External cold enters through the needle punctures and connects to the Kidney. Kidney Qi, aided by external cold, rushes upward to the Heart. Therefore, moxibustion is applied to the nodules to prevent further invasion, while Guizhi Tang resolves external cold, and added Cinnamon Twig drains Kidney Qi internally.
Guizhi Jia Gui Tang Formula
Guizhi (Cinnamon Twig) [5 liang]; Shaoyao (White Peony Root), Shengjiang (Fresh Ginger) [each 3 liang]; Gancao (Licorice Root, honey-fried) [2 liang]; Dazao (Jujube Fruit) [12 pieces].
Five ingredients. Boil in 7 sheng of water over low heat until reduced to 3 sheng. Strain. Take 1 sheng.
After sweating therapy, if there is palpitation below the umbilicus, indicating impending Ben Tun, treat with Fuling Guizhi Gancao Dazao Tang.
This occurs when Heart Qi is deficient after sweating, allowing Kidney Qi to invade and trigger Ben Tun. Palpitation below the umbilicus is the precursor sign. Cinnamon Twig can subdue Kidney pathogen; Poria can drain dampness/water. However, to treat water, Spleen Earth must be strengthened. Thus, Licorice and Jujube are used to tonify Spleen Qi. Ganlan Shui (Gently Rolling Water) is prepared by agitating water with a ladle to make it light, preventing it from aiding the Kidney pathogen.
Fuling Guizhi Gancao Dazao Tang Formula
Fuling (Poria) [8 liang]; Gancao (Licorice Root) [2 liang]; Dazao (Jujube Fruit) [15 pieces]; Guizhi (Cinnamon Twig) [4 liang].
Four ingredients. Boil in 1 dou of Ganlan Shui. First boil Poria until reduced by 2 sheng, then add remaining herbs. Boil until reduced to 3 sheng. Strain. Take 1 sheng warm, three times daily. (Method for Ganlan Shui: Place 2 dou of water in a large basin, agitate vigorously with a ladle until 5,000–6,000 pearl-like bubbles form and chase each other on the surface, then use.)