动气者。筑筑然动于脐旁上下左右。甚者连及虚里心胁。而浑身振动也。此病由于妄汗妄下。气血大
亏。以致肾气不纳。鼓动于下而作也。或由其人少阴素亏。因
病而发。恒见于瘦薄虚弱之人。方书都以理中汤去白术、加肉桂、倍茯苓治之。以
伐肾邪。恐未切当。盖奔豚属水邪。而动气属肾虚。不若八味饮加五味、胡桃。直培
根本。以收纳肾气。多服自效。
邵评∶动气由于土虚不能制水。水气凝结而成。肾中虚气。逆乘土位也。若虚里
穴。在乳下。其动应衣。宗气泄也。大虚之症。治当大补。盖由妄汗妄下。伤其正气。
其人肾气本虚。素有动气在于上焦。因之而发。肾真不纳。治以补肾纳气为主。
理中汤补脾土。去白术。嫌滞气也。加桂、苓。泄水以伐肾邪。然动气一症。是肾气
亏乏。气少收纳。非肾中水邪上逆。与奔豚不同。宜补肾气。不宜伐肾邪。故用八
味饮以补肾真。加五味子、胡桃。敛纳肾气为治。
又评∶奔豚与动气。其因各异。辨治极当。
凡伤寒至发动气。必肾气大亏。水火并衰。其见证。六脉迟软。舌润不渴。脐腹冷如
冰。暖炉昼夜不舍。饱则动缓。饥则动甚。于此可知其虚。非大剂八味多服不除。寒甚。加炮姜。若止少
阴水亏。动气亦不甚。必有舌干口渴脉数可凭。宜都气饮。加胡桃肉以纳之。左归饮加减亦可。
邵评∶阴亏虚热见症。脉象与阳虚者。自是不同。都气饮、六味丸加五味子。以补
阴纳气壮水之剂。此言伤寒之发动气者。
杂症虚。亦发动气。宜照本病施治。如怯弱痢疾之类。
邵评∶杂症之有动气。总由脾肾两虚。参合其所患之本病。而辨别治之。
动气，表现为脐旁上下左右有筑筑然跳动的感觉。严重的甚至波及虚里穴及心胁部位，导致全身震颤。此病是由于误用发汗或攻下法，导致气血严重亏损，致使肾气不能摄纳，在下部鼓动而引发。或者因为患者素来少阴经气不足，因病诱发。这种情况常见于形体消瘦、体质虚弱的人。医书中多以理中汤去掉白术，加入肉桂，加倍茯苓来治疗，以祛除肾邪。恐怕这并不恰当。因为奔豚属于水邪为患，而动气属于肾虚所致。不如使用八味饮（金匮肾气丸）加入五味子、胡桃仁，直接培补根本，以收纳肾气，长期服用自然见效。
邵评：动气是由于脾土虚弱不能制约肾水，水气凝结而成。肾中的虚气逆乘脾土之位。如果是指虚里穴，位于乳下，其跳动能使衣服颤动，这是宗气外泄的表现，属于大虚之症，治疗应当大补元气。这是由于误汗误下，损伤了正气，患者肾气本虚，素有动气在上焦，因此发作。肾真元不纳，治疗应以补肾纳气为主。理中汤用于补益脾土，去掉白术是担心其阻滞气机；加入肉桂、茯苓，是为了泄水以祛除肾邪。然而动气这一病症，是肾气亏乏，气少收纳，并非肾中水邪上逆，与奔豚不同。适宜补肾气，不宜伐肾邪。所以使用八味饮来补肾真元，加入五味子、胡桃仁，收敛并收纳肾气作为治疗方法。
又评：奔豚与动气，病因各异，辨别治疗非常得当。
凡是伤寒发展到引发动气的阶段，必定是肾气大亏，水火两衰。其见证为六脉迟软，舌润不渴，脐腹部冷如冰，昼夜离不开暖炉。饱食后跳动减缓，饥饿时跳动加剧，由此可知其虚证本质。若非大剂量八味饮多服不能根除。若寒象严重，加炮姜。如果只是少阴经水液亏损，动气也不严重，必然有舌干口渴、脉数等可凭据的症状，适宜使用都气饮，加入胡桃肉以纳气。左归饮加减也可使用。
邵评：阴虚虚热的见证症状，脉象与阳虚者自然是不同的。都气饮、六味丸加五味子，是补阴纳气、壮水制火的方剂。这里说的是伤寒引发的动气。
杂病中的虚证也会发动气，应当根据原发病进行治疗。例如怯弱痢疾之类。
邵评：杂病中出现动气，总归是脾肾两虚，需结合其所患的本病进行辨别和治疗。
Dongqi (Abdominal Pulsation) manifests as a throbbing sensation moving up, down, left, and right around the navel. In severe cases, it extends to the Xuliri (Precordial Region/Heart Base) and hypochondrium, causing tremors throughout the body. This condition arises from improper use of sweating or purgative methods, leading to a severe deficiency of Qi and Blood, resulting in the failure of Kidney Qi to grasp and retain, causing stirring and movement below. Alternatively, it may be triggered by illness in individuals with pre-existing deficiency of the Shaoyin (Lesser Yin) channel. It is commonly seen in emaciated and weak individuals. Medical texts generally treat this with Lizhong Tang (Regulate the Middle Decoction), removing Baizhu (Atractylodis Macrocephalae Rhizoma), adding Rougui (Cinnamomi Cortex), and doubling the dosage of Fuling (Poria). The intent is to attack the pathogenic factor of the Kidney. However, this may not be entirely appropriate. Ben Tun (Running Piglet) belongs to Water Pathogen, whereas Dongqi belongs to Kidney Deficiency. It is better to use Bawei Yin (Eight-Ingredient Replenishing Pill / Jin Gui Shen Qi Wan) added with Wuweizi (Schisandrae Fructus) and Hutaoren (Walnut Seed) to directly cultivate the root and grasp the Kidney Qi; long-term administration will yield efficacy.
Shao's Commentary: Dongqi occurs because Spleen Earth is deficient and cannot control Kidney Water, causing Water Qi to coagulate. The deficient Qi within the Kidney rebels and attacks the position of the Earth (Spleen/Stomach). If referring to the Xuliri acupoint located below the breastbone, where the pulsation causes clothing to move, this indicates leakage of Zong Qi (Gathering Qi) and represents a critical deficiency syndrome; treatment should focus on massive tonification. This results from improper sweating and purging damaging the Righteous Qi; the patient's Kidney Qi was originally deficient, and pre-existing Dongqi in the Upper Jiao (Upper Burner) is thus triggered. The Kidney's True Qi fails to grasp; treatment should prioritize tonifying the Kidney and grasping Qi. Lizhong Tang tonifies Spleen Earth; Baizhu is removed to avoid stagnating Qi; Rougui and Fuling are added to drain Water and attack the Kidney pathogen. However, Dongqi is characterized by a lack of Kidney Qi and insufficient grasping ability, not by the rebellion of Kidney Water Pathogen upwards, which differs from Ben Tun. It is suitable to tonify Kidney Qi rather than attack the Kidney pathogen. Therefore, Bawei Yin is used to tonify Kidney True Qi, and Wuweizi and Hutaoren are added to astringe and grasp Kidney Qi for treatment.
Further Commentary: Ben Tun and Dongqi have different etiologies; distinguishing and treating them is highly appropriate.
Whenever Taiyang Disease (Exogenous Cold Damage) progresses to induce Dongqi, it implies a severe deficiency of Kidney Qi and simultaneous decline of Water and Fire. Clinical manifestations include slow and soft pulses in all six positions, a moist tongue without thirst, and an umbilical and abdominal coldness like ice, requiring heat sources day and night. The pulsation slows after full meals and intensifies during hunger, revealing its deficiency nature. Without large doses of Bawei Yin administered over time, it cannot be cured. If cold signs are severe, Paojiang (Prepared Ginger) is added. If there is only a deficiency of Water in the Shaoyin channel, Dongqi is not severe; there must be symptoms such as a dry tongue, thirst, and rapid pulse to rely upon. Duiqi Yin (All-Inclusive Decoction) added with Hutaoren (Walnut Seed) to grasp Qi is suitable. Zuoi Yin (Left-Restoring Decoction) with modifications can also be used.
Shao's Commentary: Symptoms of Yin deficiency with empty heat present pulse characteristics naturally different from those of Yang deficiency. Duiqi Yin and Liuwei Wan (Six-Ingredient Rehmannia Pill) added with Wuweizi are formulas that tonify Yin, grasp Qi, and strengthen Water to control Fire. This refers to Dongqi induced by Taiyang Disease.
Deficiency syndromes in miscellaneous diseases can also induce Dongqi; treatment should follow the management of the primary disease, such as in cases of asthenic dysentery.
Shao's Commentary: Dongqi appearing in miscellaneous diseases is fundamentally due to dual deficiency of Spleen and Kidney; differentiation and treatment must be combined with the underlying disease.