仲景所谓奔豚气，与《难经》肾积，其证不同，而如巢元方犹不免牵混，后世或以为疝气之名，要在学人分
别之焉。盖其扩充仲景者，则寥寥罕闻尔。
源候 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，如人所恐，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，病
奔豚也。（《病源论》）（按∶若心中踊踊以下，《外台》引《短剧文》有少异，又车字作事字是，盖此段义不
无疑，姑存之。）
治方 《肘后》疗卒厥逆上气，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。此药须预蓄，得病便急合服之。（《千金方》桂五两，甘草三两。
张文仲同。）（《外台》）《千金》名奔气汤。（今本甘草二两）（按∶此系吴茱萸汤加减方。）
《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，手足逆冷方。
李根白皮（八两） 半夏（七两洗） 干姜（四两） 茯苓（三两） 人参（二两） 甘草（二两炙）
附子（一两炮） 桂心（四两）
上八味切，以水一斗，煮取三升，绞去滓，分三服，别相去如人行六七里。（《外台》）《圣惠》治奔豚气，
脐腹胀痛，翕翕短气，发作有时，四肢疼闷，甘李根散，于本方去茯苓、甘草，加吴茱萸、当归、槟榔。
《短剧》疗卒伤损，食下则觉胸中偏痛栗栗然，水浆下亦尔，问病与相应，急作此方。
生李根（一斤细锉之） 麦门冬（一斤去心） 人参（二两） 桂心（二两） 甘草（一两炙）
上五味 咀，以水一斗，煮取三升，分三服。范汪同。（《外台》）
《短剧》牡蛎奔豚汤，疗奔豚气，从少腹起憧胸，手足逆冷方。
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，以水一斗七升，煮取李根白皮得七升，去滓内余药，再煮取三升，分服五合，日三夜再。（同上）
治奔豚气，上下冲走，闷乱面青，宜服此方。
甘李根皮（三两锉） 生姜（二两炒干） 吴茱萸（一两）
上件药捣，细罗为散，每服一钱，水一中盏，煎至六分，去滓热服。（《圣惠》）
又方。
槟榔（三枚捣罗为末） 生姜汁（半合）
上件药，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。（同上）（先教谕曰∶此《外台》治香港脚冲心方。又《千金》治胸腹背闭满，上气喘息，下气汤方，大腹槟
榔二七枚，杏仁四七枚， 咀，以童子小便三升，煎取一升半，分再服。）《医林方》备急压气散，于本方加
紫苏穗，水煎（不用童便）。
代赭石汤，治逆气上冲，奔遍息道，滞塞不通。
代赭石（打碎二两） 陈皮 桃仁（炒） 桂 吴茱萸（盐炒各半两）
上各锉碎，每服秤二两，水三大盏，生姜三分切，同煎至一盏，其下去滓，食前温服，一日一服。（《御药
院方》）
牵牛丸（当作散），治气筑奔冲不可忍。
黑牵牛（半两纸箱内或银石器中炒黄色） 槟榔（一分锉）
上为末，每服一大钱，浓煎紫苏、生姜汤调下。（《卫生家宝》）（按∶此不必奔豚，姑附于兹。）
张仲景所说的奔豚气，与《难经》中记载的肾积（肾脏积聚之病），其证候表现不同，但巢元方仍然未能避免将二者混淆，后世有人将其视为疝气（指腹内结块或痛引阴囊等病症）的名称，关键在于学习者加以区分。至于那些对张仲景理论进行扩充阐发的内容，则寥寥无几，鲜有听闻。
病因病机 所谓奔豚气，是肾脏的积气，由惊恐、忧愁、思虑所引发。如果受到惊恐，则会损伤神志，因为心藏神；如果忧愁思虑过度，则会损伤意志，因为肾藏志。神志受到损伤扰动，气积聚于肾，并在体内上下游走，像小猪奔跑一样，所以称为奔豚。当这股气上冲侵犯心脏时，会出现心中悸动不安，如同受车马惊吓一般，如同被人恐吓一般，五脏功能紊乱，饮食即呕吐，胸中气满，精神狂乱痴呆不定，胡言乱语，幻视幻听，这是惊恐所致奔豚的表现。如果气满支撑于心下，心中烦闷混乱，不喜欢听到人声，发作和休止有一定时间，时而好转时而加重，呼吸短促，手足冰冷，内心烦躁且伴有结滞疼痛，恶心欲呕，这是忧思所致奔豚的表现。诊察其脉象，若脉搏跳动急促有力（原文“触祝”疑为形容脉象急促或特殊形态，此处依语境译为急促有力或特定脉象特征），则是奔豚病的征象。（出自《诸病源候论》）（按：从“若心中踊踊”以下一段，《外台秘要》引用《小品方》（注：原文作《短剧文》，通常指《小品方》或类似佚书，此处保留原意）时有细微差异，另外“车”字作“事”字更为恰当，大概这段文字的含义存在疑问，姑且保存原文。）
治疗方剂 《肘后备急方》治疗突然厥逆、气机上逆，气滞两胁，心下疼痛胀满，昏昏欲绝，这被称为奔豚，此病因突然惊怖、忧愁逼迫而得，气从下向上，上冲心胸，脐间筑筑跳动，发作有时，不治疗会致死。
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，分三次服用。此药需要预先储备，发病时立即煎服。（《千金方》中桂五两，甘草三两。张文仲方相同。）（《外台秘要》）《千金方》将此方命名为奔气汤。（今本甘草为二两）（按：此为吴茱萸汤的加减方。）
《广济方》治疗奔豚气在心，呼吸短促，不喜欢听到人说话的声音，心下烦乱不安，发作有时，四肢烦疼，手足逆冷。
李根白皮（八两） 半夏（七两，洗） 干姜（四两） 茯苓（三两） 人参（二两） 甘草（二两，炙） 附子（一两，炮） 桂心（四两）
以上八味药切碎，用水一斗，煮取三升，过滤去渣，分三次服用，两次服药间隔时间约为行人行走六七里的路程。（《外台秘要》）《太平圣惠方》治疗奔豚气，脐腹胀痛，呼吸短促，发作有时，四肢疼痛烦闷，用甘李根散，即在上述方剂中去掉茯苓、甘草，加入吴茱萸、当归、槟榔。
《小品方》治疗突然外伤损，进食后感觉胸中偏侧疼痛战栗，饮水浆也是如此，询问病情与之相应，需紧急制作此方。
生李根（一斤，细锉） 麦门冬（一斤，去心） 人参（二两） 桂心（二两） 甘草（一两，炙）
以上五味药切碎，用水一斗，煮取三升，分三次服用。范汪方相同。（《外台秘要》）
《小品方》牡蛎奔豚汤，治疗奔豚气，从少腹起冲至胸部，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）
以上四味药切碎，用水一斗七升，先煮李根白皮至剩七升，去渣，加入其余药物，再煮取三升，每次服用五合，每日三次，夜间两次。（同上）
治疗奔豚气，气上下冲走，面色青紫烦乱，适宜服用此方。
甘李根皮（三两，锉） 生姜（二两，炒干） 吴茱萸（一两）
以上药物捣碎，过细筛成为散剂，每次服用一钱，用水一中盏，煎至六分，去渣热服。（《太平圣惠方》）
又一方。
槟榔（三枚，捣罗为末） 生姜汁（半合）
以上药物，用童子尿一大盏稍微加热。加入前两种药，搅拌均匀，分三次服用，约在行人行走五六里时，服用一次，不久后腹泻即为有效。（同上）（先教谕说：这是《外台秘要》治疗脚气冲心的方子。另外《千金方》治疗胸腹背闭满，上气喘息的方子，大腹槟榔十四枚，杏仁二十一枚，切碎，用童子尿三升，煎取一升半，分两次服用。）《医林方》备急压气散，在上述方基础上加紫苏穗，水煎（不用童便）。
代赭石汤，治疗逆气上冲，奔遍呼吸通道，阻滞不通。
代赭石（打碎二两） 陈皮 桃仁（炒） 桂 吴茱萸（盐炒，各半两）
以上各药锉碎，每次称取二两，用水三大盏，生姜三分切片，同煎至一盏，去渣，饭前温服，一日一次。（《御药院方》）
牵牛丸（应当是散剂），治疗气机筑动奔冲，难以忍受。
黑牵牛（半两，在纸盒内或银石器中炒至黄色） 槟榔（一分，锉）
以上研为末，每次服用一大钱，用浓煎的紫苏、生姜汤调服。（《卫生家宝》）（按：这不一定是奔豚，姑且附于此。）
Chongjing (Zhang Zhongjing) described *Ben Tun Qi* (Rushing Pig Syndrome), which differs in clinical presentation from the *Shen Ji* (Kidney Accumulation) recorded in the *Nan Jing* (Classic of Difficult Issues). However, Chao Yuanfang failed to avoid conflating the two, and later generations sometimes regarded it as a name for *Han Qi* (Hernia Syndrome). It is crucial for scholars to distinguish between them. Expansions upon Chongjing's theories regarding this condition are rarely heard of.
Etiology and Pathogenesis The so-called *Ben Tun Qi* is an accumulation of Qi in the Kidney, arising from fright, fear, worry, and overthinking. Fright and fear damage the Shen (Spirit), as the Heart houses the Shen; worry and overthinking damage the Zhi (Will), as the Kidney houses the Zhi. When the Shen and Zhi are injured and disturbed, Qi accumulates in the Kidney and moves up and down like a running piglet, hence the name *Ben Tun*. When this Qi attacks the Heart, one experiences palpitations and agitation in the chest, akin to being startled by a carriage or terrified by a person. The Five Viscera become unstable, leading to vomiting after eating or drinking, chest fullness, manic and foolish behavior with instability, delusions, and hallucinations. This characterizes the fright-induced *Ben Tun*. If Qi fills and obstructs the epigastrium, causing mental confusion, aversion to human voices, periodic onset and remission, alternating between mild and severe symptoms, shortness of breath, cold extremities, internal irritability with knotted pain, and nausea, this characterizes the worry-induced *Ben Tun*. Palpation of the pulse revealing a specific rapid or striking quality indicates *Ben Tun Qi*. (From *Zhu Bing Yuan Hou Lun*) [Note: The passage starting from "palpitations in the heart" varies slightly in *Wai Tai Mi Yao*'s citation of *Xiao Pin Fang*, where "carriage" is written as "affair." There are doubts about the meaning of this section, so it is preserved here.]
Treatment Formulas *Zhou Hou Bei Ji Fang* (Emergency Prescriptions Kept Up My Sleeve) treats sudden syncope with rebellious Qi, Qi stagnation in both hypochondria, pain and fullness in the epigastrium, and a昏沉 (dizzy/faint) sensation approaching death. This is called *Ben Tun*, caused by sudden fright, terror, worry, and pressure. The Qi rises from below, rushing to the chest and heart, with throbbing sensations at the umbilicus occurring periodically. Without treatment, it can be fatal.
Gan Cao (Licorice Root, 2 liang, honey-fried) Ren Shen (Ginseng Root, 2 liang) Wu Zhu Yu (Evodia Fruit, 1 sheng) Sheng Jiang (Fresh Ginger, 1 jin) Ban Xia (Pinellia Tuber, 1 sheng) Gui Xin (Cinnamon Twig Center, 3 liang)
Cut the above six herbs, decoct in 10 dou of water until 3 sheng remain, divide into three doses. This medicine should be prepared in advance and taken immediately upon onset. (*Qian Jin Fang* uses 5 liang of Cinnamon Twig and 3 liang of Licorice; Zhang Wenzhong's formula is identical.) (*Wai Tai Mi Yao*) *Qian Jin Fang* names this *Ben Qi Tang*. (Current editions list Licorice as 2 liang.) [Note: This is a modification of *Wu Zhu Yu Tang*.]
*Guang Ji Fang* treats *Ben Tun Qi* affecting the Heart, with shortness of breath, aversion to hearing voices, mental restlessness and discomfort in the epigastrium, periodic attacks, limb pain and heaviness, and cold extremities.
Li Gen Bai Pi (White Bark of Plum Root, 8 liang) Ban Xia (Pinellia Tuber, 7 liang, washed) Gan Jiang (Dried Ginger, 4 liang) Fu Ling (Poria, 3 liang) Ren Shen (Ginseng Root, 2 liang) Gan Cao (Licorice Root, 2 liang, honey-fried) Fu Zi (Aconite Lateral Root, 1 liang, processed) Gui Xin (Cinnamon Twig Center, 4 liang)
Cut the above eight herbs, decoct in 10 dou of water until 3 sheng remain, strain, and divide into three doses. Space the doses apart by the time it takes a person to walk six or seven li. (*Wai Tai Mi Yao*) *Tai Ping Sheng Hui Fang* treats *Ben Tun Qi* with abdominal distension and pain, shortness of breath, periodic attacks, and limb pain/heaviness using *Gan Li Gen San*. Remove Poria and Licorice from the base formula, add Wu Zhu Yu, Dang Gui, and Bin Lang.
*Xiao Pin Fang* treats sudden trauma/injury where eating causes lateral chest pain and trembling, and drinking liquids does the same. Upon confirming the condition, prepare this formula urgently.
Sheng Li Gen (Raw Plum Root, 1 jin, finely cut) Mai Men Dong (Ophiopogon Tuber, 1 jin, core removed) Ren Shen (Ginseng Root, 2 liang) Gui Xin (Cinnamon Twig Center, 2 liang) Gan Cao (Licorice Root, 1 liang, honey-fried)
Cut the above five herbs, decoct in 10 dou of water until 3 sheng remain, divide into three doses. Fan Wang's formula is the same. (*Wai Tai Mi Yao*)
*Xiao Pin Fang* Mu Li Ben Tun Tang (Oyster Rushing Pig Decoction) treats *Ben Tun Qi* rising from the lower abdomen to the chest, with cold extremities.
Mu Li (Oyster Shell, 3 liang, calcined) Gui Xin (Cinnamon Twig Center, 8 liang) Li Gen Bai Pi (White Bark of Plum Root, 1 jin, cut) Gan Cao (Licorice Root, 3 liang, honey-fried)
Cut the above four herbs, decoct in 1.7 dou of water. First decoct the White Bark of Plum Root until 7 sheng remain, strain, add the remaining herbs, and decoct again until 3 sheng remain. Take 5 he per dose, three times daily and twice at night. (Ibid.)
For *Ben Tun Qi* with Qi rushing up and down, causing cyanosis and mental confusion, take this formula.
Gan Li Gen Pi (Sweet Plum Root Bark, 3 liang, cut) Sheng Jiang (Fresh Ginger, 2 liang, stir-fried until dry) Wu Zhu Yu (Evodia Fruit, 1 liang)
Pound the above herbs, sieve finely to make a powder. Take 1 qian per dose, decoct in 1 zhong of water until 6 fen remain, strain, and take hot. (*Tai Ping Sheng Hui Fang*)
Another Formula.
Bin Lang (Areca Seed, 3 pieces, pounded and sieved to powder) Sheng Jiang Zhi (Ginger Juice, 0.5 he)
Take the above ingredients, heat 1 zhong of urine from an uncircumcised boy slightly. Mix with the two powders evenly, divide into three doses. Administer one dose every time a person has walked five or six li. Diarrhea shortly after administration indicates efficacy. (Ibid.) [Xian Jiaoyu noted: This is a formula from *Wai Tai Mi Yao* for Foot-Qi attacking the Heart. Also, *Qian Jin Fang* has a formula for chest/abdominal/back fullness and rebellious Qi using Areca Seeds and Almonds decocted in urine.] *Yi Lin Fang* Bei Ji Ya Qi San adds Perilla Fructus/Stems to the base formula, decocted in water (without urine).
Dai Zhe Shi Tang (Hematitum Decoction) treats rebellious Qi rushing upward, blocking the respiratory passages.
Dai Zhe Shi (Hematitum, crushed 2 liang) Chen Pi (Tangerine Peel) Tao Ren (Peach Kernel, stir-fried) Gui (Cinnamon Twig) Wu Zhu Yu (Evodia Fruit, salt-stir-fried, each 0.5 liang)
Crush all herbs. Weigh 2 liang per dose, decoct in 3 large cups of water with 3 fen of sliced Fresh Ginger until 1 cup remains. Strain and take warm before meals, once daily. (*Yu Yao Yuan Fang*)
Qian Niu Wan (Should be San/Powder), treats unbearable Qi surging and pounding.
Hei Qian Niu (Black Morning Glory Seed, 0.5 liang, stir-fried in a paper box or silver/ceramic vessel until yellow) Bin Lang (Areca Seed, 1 fen, cut)
Pound into powder. Take 1 large qian per dose, mix with strong decoction of Perilla and Fresh Ginger to swallow. (*Wei Sheng Jia Bao*) [Note: This may not necessarily be *Ben Tun*, but is attached here for reference.]