服后，虽得微汗，而未见何效。妹倩金君笃信西医，似以西医治法胜于中医，于是就诊于某医院，断为肾脏炎症，与以他药及朴硝等下剂。便泻数次，腹胀依然。
盖以朴硝仅能下积，不能下水也。翌日，忽头痛如劈，号泣之声达于四邻，呕出痰水，则痛梢缓。愚曰：此乃水毒上攻之头痛，即西医所谓自家中毒。仲景书中曾载此症，（见赵刻本《伤寒论》第一百六十条）非十枣汤不为功。乘此体力未衰之时，可以一下而愈，迟则不耐重剂也。乃拟方用甘遂三分（此药须煨透，服后始不致作呕，否则吐泻并作，颇足惊人，曾经屡次试验而知），大戟芫花炒各钱半，因体质素不壮盛，改用枣膏和丸，欲其缓下。并令侍役先煮红米粥，以备不时之需。服药后，四五小时，腹中雷鸣，连泻粪水一余次，腹皮弛缓，头痛亦除。惟神昏似厥，呼之不应。其家人咸谓用药过猛。愚曰：勿惊。《尚书》所云若药不瞑眩，厥疾勿瘳,此之谓也。如虑其体力不支，可进已冷之红米粥一杯，以养胃气，而止便泻。如言啜下，果即泻止神清。次日腹中仍微有水气，因复投十枣丸钱半，下其余水，亦去疾务尽之意。嗣以六君子汤补助脾元，且方内白术一味能恢复其吸收机能。故调理旬日，即获全愈。（录《中医内科全书》）此亦古方治今病之一好例也。
奔豚其一
刘右初诊九月十六日始病中脘痛而吐水，自今年六月每日晨泄，有时气从少腹上冲，似有瘕块。气还则绝然不觉。此但肝郁不调，则中气凝滞耳。治宜吴茱萸汤合理中。
淡吴萸四钱生潞党五钱干姜三钱炙草三钱生白术五钱生姜三片红枣十二枚二诊九月十八日两服吴茱萸合理中汤，酸味减而冲气亦低，且晨泄已全痊。惟每值黄昏，吐清水一二口，气从少腹挟痞上冲者，或见或否。治宜从欲作奔豚例，用桂枝加桂汤，更纳半夏以去水。
川桂技三钱白芍三钱生草钱半桂心钱半制半夏五钱生姜五片红枣七枚拙巢注：服后全愈。
【按】本案初诊所谓吐水，二诊所谓吐清水，颇可疑，或即是白津，其说详下案。
奔豚其二（附列门人治验）
周右住浦东初诊气从少腹上冲心，一日四五度发，发则白津出，此作奔豚论。
【按】本案为余在广益中医院所诊得者，余视此颇感兴趣，若自珍其敝帚者然，请从白津说起。
《金履要略》曰：寒疝绕脐痛，苦发则白津出，手足厥冷，其脉沈弦，大乌头煎主之。本条中苦发二字，《千金》《外台》作若发，此不足论。白津二字，《千金》《外台》作白汗,白汗二字在仲圣书中为少见，或以为即《素问》之魄汗，或以为即《脉经》之白汗似未得为的解。若仍作白津，亦未能确指为何物。若释白津为白带尤误。因带则称下，而不称出，称白物而不称白津故也。独本案病者周右告我以一病状，我无成句以形容之。欲得而形容之，除非发则白津出五字，庶足以当之。盖周右每当寒气上冲之时，口中津液即泉涌而出，欲止之不得，其色透明而白。待冲气下降，此种白津方止。其来也不知何自，其止也不知何往。但决非痰浊之属，盖痰浊出于肺胃，此则出于口中，痰浊较浓而厚，此则较淡而清。痰浊之吐出须费气力，此则自然流溢，故二者绝然为二物。夫奔豚为寒性病，既有出白津之例，则寒疝亦为同类之寒性病，其出白津复何疑？师兄吴凝轩渭尝亲见冻毙之人将死之时，口出白津无算，泊泊而来，绝非出于其人之自主，与此正可互相印证，事实之不可诬有如是者！叶案曰：高年少腹气冲，脘下心肋时痛，舌底流涎，得甜昧，或静卧，少瘥，知饥不食，大小便日窒。此皆阴液内枯，阳气结闭。喻西昌有滋液救焚之议。
然衰老关格病，苟延岁月而已，医药仅堪图幸。药用大麻仁、柏子仁、枸杞子、肉苁蓉、紫石英、炒牛膝。细按本病实是奔豚，所谓舌底流涎，即是白津。其用药虽非正道，而足以互证病情者乃至审也。
按依西医解剖学言，唾腺亦名涎腺，涎腺计有三对，曰耳下腺，曰颚下腺，曰舌下腺，其末端各有球囊如葡萄状。耳下腺为最大，在外耳之直下，别有管开口于上颚臼齿之近旁，以输送唾液。颚下腺在下颚之内前部，舌下腺在舌底粘膜之下，其输送管皆开口于舌尖下部之两侧。若唾腺神经起反射兴奋，以致唾液分泌亢盛者，谓之反射性流涎症云云。窃意奔豚病者心腹部分之神经剧受刺激，因反射及于唾腺神经，故分泌唾液特多。此唾液也，实即本案所谓白津。
二诊投桂枝加桂汤后，气上冲减为日二三度发，白津之出亦渐稀。下得矢气，此为邪之去路，佳。
肉桂心一钱半川挂枝三钱大白芍三钱炙甘草三钱生姜三片红枣十枚厚朴钱半半夏三钱
【按】初诊时有为我录方之同学曰：此肝气也。余曰：肝气之名太泛，毋宁遵经旨称为奔豚，同学疑焉。次日病者欣相告，曰：冲气减矣，胃纳亦增，同学愕然焉。余又琐琐重问白津之状，及关于白津之一切，所言悉合，无可疑焉。又曾细按其脉，颇见弦紧之象，与仲圣所言寒疝之脉相似，益见疝与奔豚，确属类似之病。
服桂枝加桂汤而得矢气者，因桂性芳香兼能逐秽故也。然而逐秽气之专功，却不及厚朴，此为余屡次实验而得之者。又以半夏善降，故并用之。
三诊气上冲，白津出，悉渐除，盖矢气得畅行故也。今图其本，宜厚朴生姜甘草半夏人参汤加桂。
【按】余每遇可研究之病，恒喜病者多来受诊几次，俾可详志服药后之经过。但以用经方之故，病者向愈至速，每一二诊后，即不复来。予乃无从详讯，每致大失所望。本案当初诊时，妇鉴于前此就地医治之无效，频问此病尚有愈望否。予期以十日，妇笑颔之。至二诊来时，予鉴于前此查询病情之无从，当即详询妇之沪寓住址。第三诊后，妇果不复来。又越数日，余乃按址趋至其戚家访之。得其外甥女出见，曰：家舅母因病已将全愈，又以家务纷繁，早欣然回浦东去矣。
以余意默忖，此妇病根必然未拔，不久行当重发。夫当其病剧之时，则以身体为重，家事为轻，及其病减之后，又以家事为重，身体为轻，此乃人之常情，安足怪欤？有善怀疑之读者必将问余曰：何谓今图其本？为答此问题起见，余乃不能不发表其未成熟之说。余曰：奔豚病之本源乃肠中之矢气，即肠胃中残余未曾消化之物，因发酵分解所生之瓦斯是也。厚朴生姜甘草半夏人参汤治此最佳。方中人参生姜半夏能健胃降逆，使立建瓴之势，厚朴甘草能逐秽安正，大有剿抚之功。病者服此后，其矢气将更多，矢气既去，腹之胀满者乃渐平。本案周右腹本胀满，两服药后，遂渐平，今特补述于此。病人之腹渐平，奔豚乃免复发，所谓图其本者此也。
我今当补述周妇气上冲之情形，据述其气确发源于小腹，惟并非仅中道一线直上，仿佛腹之两旁皆有小线向上中方向升腾，直冲至心脏部分而杳。方其冲也，颇觉难堪，及其杳也，不知何去。而白津之忽涌忽止，又皆出于不能自主。如是前后数分钟，方复原状。然而神为之疲，食为之减。
吾人当注意此妇之逆气冲至心而杳一语，与经文气从少腹上冲心者气从少腹上至心二语，悉合符节。经文之至字，有以心为止境，至此而止之意。经文之冲字，有以心为正鹄，冲此即中之义。经文冲心至心大同小异之二条，悉主桂枝加桂汤，故我治本案冲心至心之奔豚，亦用桂枝加桂汤。
此妇服药得矢气后，则上冲之气顿减，可见冲心之逆气无非肠中之矢气，肠中之矢气即是冲心之逆气。意者肠中发酵之瓦斯，既不能泄于下，势必膨于中，故腹胀满。而腹之胀满程度又殊有限制，故此时瓦斯乃随时有上溢之可能。适肠系于肠间膜，膜中有无数静脉管吸液上行，平时因血管有关约之作用，瓦斯不能溢入血管。适其人暴受惊恐，关约失其效能（吾人手方握物，受惊则物堕地。书载难产之妇，因骤闻响器掷地，胎儿安下。是皆关约筋因惊失效之明证），于是瓦斯乘机溢入血管。此溢入之量必甚微渺，然其害已烈，观西医之注射液剂，必避免空气之随入，慎之又慎，可见一斑。设瓦斯溢人静脉管，病人之感痛楚尚不甚剧，因瓦斯与静脉血液同向上行故也。设其所溢入者为动脉管，则二者逆向而行，痛楚斯甚。以我亿测，此种瓦斯甚且逆大动脉而上薄心脏，但心脏瓣膜开阖喷压之力殊强，故瓦斯终为击溃，或下退原处而杳。药以桂枝加桂汤者，因桂枝能助动脉血运畅行之故，更加桂心以为君，则其喷压之力更强，而瓦斯乃不能上溢，但能下返（我前释桂枝汤中桂枝之用与此处相合，尚不致有两歧之误）。如此解释，似觅圆满。但依生理书言，肠中毒素每能侵入血管，至肠中之瓦斯殊不能溢入血管之中。然今日之生理尚不足以尽释实际之病理，观肋膜炎病者进十枣汤后，其肋膜间之水竟从肛门而出，即是一例。故我敢依此种病例作奔豚病理之假说如上。假说云者，即假定之学说，并非绝对之真理，姑留此说，以待他人之改正谬误或补充证明者也。
依鄙意，病者肠中先有瓦斯之蕴积，偶受惊恐，则关约失效，致瓦斯溢入血管之中。故仲圣曰皆从惊发得之。发犹言始也，此言大有深意。仲圣又曰：烧针令其汗，针处被寒，核起而赤者，必发奔豚。试问烧针令汗，何故多发奔豚？历来注家少有善解。不知仲圣早经自作注释，曰加温针，必惊也，曰医以火迫劫之，亡阳必惊狂，曰奔豚，……皆从惊发得之。合而观之，则烧针所以发奔豚之理宁非至明？故以经解经，反胜赘说多多。惟其人肠中本有宿气，待时而动，此乃可断言者也。
虽然，余之假说，尚不止于此。设阅者能稍耐烦，容当续陈其义。余曰：此上所述之奔豚病为第一种奔豚，更有第二种奔豚与此稍异，即奔豚汤所主之奔豚病是也。
此二种奔豚乃同源而异流者。同源者何？盖同种因于腹中之瓦斯是也。异流者何？盖一则逆大动脉而犯心藏，一则溢入淋巴管，逆胸导管亦犯心藏，甚且犯胸与咽喉。师曰：奔豚病，从少腹起上冲咽喉，发作欲死。
又曰：奔豚气上冲胸，腹痛，往来寒热，奔豚汤主之。即是此一种犯淋巴系之奔豚。试更详为之证，胸导管之上端适当胸部，其位高于心脏，故曰上冲胸，而不仅曰上至心，此可证者一也。咽中如有炙脔者，属半夏厚朴汤证，其病在咽喉部分之颈淋巴系，属少阳，与此处所谓上冲咽喉极相类，此可证者二也。
淋巴系病即中医所谓少阳病，少阳病以寒热往来为主证，故曰往来寒热，奔豚汤主之，此可证者三也。试察奔豚汤方内有半芩姜草，酷如少阳之主方小柴胡汤，此可证者四也。吾师曾用奔豚汤原方治愈此种奔豚病，其案情详《金匮发微》。读者欲知其详，请自检之，此可证者五也。有此五证，此第二种奔豚病乃告成立。
是故姑以六经言，二种奔豚病同生于太阴，一则发于太阳，一则发于少阳。以生理言，两种奔豚病同生于肠中瓦斯，一则发于循环系，一则发于淋巴系。考之实例，发于循环系者多，发于淋巴系者少，故桂枝加桂汤之用，常较奔豚汤为广。东哲有言曰：奔豚主剂虽多，特加桂汤为最可也。即缘此故耳。至奔豚病之剧者，其逆气同犯循环淋巴二系，亦属可能之事，故用方亦不妨并合。
笔述至此，奔豚病似可告一段落，徜有读者更欲追问肠中瓦斯之所由来，太阴病之所由成，我又安得无言？曰：以生理言，肠中瓦斯之成，实由于胃乏消化力，即西医所谓消化不良症是也。故欲治肠，当先健胃。犹欲求流之长，必先浚其源。虽然，是乃粗浅之言，不值一笑，今当进一步从心理方面言，曰：肠胃机能之所以不良者，乃忧思伤感有以造成之耳。试观吾人偶逢忧伤，则食不下，即下亦不能化，可作明证。故中医谓忧能伤脾，又谓脾主运化，犹言忧令人消化不良也。本此，用敢不揣胃昧。续伸仲圣之说曰：奔豚病，皆从惊恐发之，而从忧伤积之。盖发于骤，而积于渐也。
读者试将前案吾师治验例及本案拙案例合而考之，可知吾所言者，皆实验之论，非玄想之谈。又吾师之案与拙案较，在治法上言，有一不同之点在。读者明眼，谅早已烛之。如其未也，不妨略予思考，得之，然后接阅下文，与吾所言者对勘，此乃治学之一法，添趣之一术也。
吾师前案先用吴茱萸合理中汤，继用桂枝加桂汤纳半夏，拙案则由桂枝加桂汤渐移作厚朴生姜甘草半夏人参汤加桂，一往一来，彼顺此逆。易言之，吾师先治其本，后图其标，余则先治其标，后图其本，与
服下药物后，虽然出了微汗，但未见什么疗效。妹妹倩金君笃信西医，似乎认为西医的治疗方法优于中医，于是去某医院就诊，被诊断为肾脏炎症，医生给予其他药物及朴硝等泻下药。排便数次后，腹胀依然没有缓解。
这是因为朴硝只能通下积滞，不能通下水饮。第二天，突然头痛剧烈如刀劈，哭喊声传到四邻，呕吐出痰涎水液后，疼痛稍微缓解。我说：这是水毒上攻引起的头痛，即西医所说的自体中毒。张仲景的书中曾记载此症（见赵刻本《伤寒论》第一百六十条），非用十枣汤不能奏效。趁此时体力尚未衰弱，可以一次服药而痊愈，拖延下去则身体难以承受重剂了。于是拟定方药使用甘遂三分（此药必须煨透，服用后才不至于引起呕吐，否则吐泻并作，颇为惊人，我曾多次试验得知），大戟、芫花各炒制一钱半，因为患者体质素来不强壮，改用枣膏和丸，想要它缓慢泻下。并让侍者先煮好红米粥，以备不时之需。服药后四五个小时，腹中雷鸣般作响，连续腹泻粪水一两次，腹部皮肤松弛，头痛也消除了。只是神志昏沉类似厥证，呼唤不应。他的家人都说用药太猛。我说：不要惊慌。《尚书》所说的“若药不瞑眩，厥疾勿瘳”，就是这个意思。如果担心他体力不支，可以喝一杯已冷却的红米粥，以养胃气，并停止腹泻。照此说法服下，果然腹泻停止，神志清醒。第二天腹中仍有轻微的水气，因此再次投予十枣丸一钱半，以排出剩余的水饮，这也是祛除病根务求彻底的意思。随后用六君子汤补助脾元，而且方中的白术一味能恢复其吸收机能。所以调理十天，就获得了完全康复。（录自《中医内科全书》）这也是古方治疗今病的一个好例子。
奔豚其一
刘姓患者右脉，初诊于九月十六日。开始发病时中脘部疼痛并呕吐水液，从今年六月起每天早晨腹泻，有时有气从少腹向上冲逆，感觉似有瘕块。气退回后就完全感觉不到了。这仅是肝气郁结不调，导致中气凝滞罢了。治疗宜用吴茱萸汤配合理中汤。
淡吴茱萸四钱，生潞党参五钱，干姜三钱，炙甘草三钱，生白术五钱，生姜三片，红枣十二枚。
二诊于九月十八日。服用两剂吴茱萸汤合合理中汤后，酸味减轻，冲逆之气也降低，且晨泄已经完全痊愈。只是每到黄昏时分，吐出清水一二口，气从少腹挟带痞块上冲的情况，有时出现有时不出现。治疗宜按照欲作奔豚的先例，用桂枝加桂汤，再加入半夏以去除水饮。
川桂枝三钱，白芍三钱，生甘草一钱半，桂心一钱半，制半夏五钱，生姜五片，红枣七枚。拙巢注：服后完全痊愈。
【按】本案初诊所说的吐水，二诊所说的吐清水，颇可疑，或许就是白津，其详细说法见下文案。
奔豚其二（附列门人治验）
周姓患者右脉，住浦东。初诊时气从少腹上冲至心，一天发作四五次，发作时口中流出白津，此按奔豚论治。
肉桂心一钱，川桂枝三钱，大白芍三钱，炙甘草二钱，生姜三片，大红枣八枚。
【按】本案是我在广益中医院诊治所得，我对此颇感兴趣，就像爱惜自己的敝帚一样，请从白津说起。
《金匮要略》说：寒疝绕脐痛，苦发则白津出，手足厥冷，其脉沉弦，大乌头煎主之。本条中的“苦发”二字，《千金方》《外台秘要》作“若发”，这不足讨论。“白津”二字，《千金方》《外台秘要》作“白汗”，“白汗”二字在仲景书中少见，有人以为是《素问》中的魄汗，有人以为是《脉经》中的白汗，似乎都不是确切的解释。如果仍作白津，也不能确切指为何物。如果解释为白带尤其错误。因为带下称为“下”，而不称为“出”，称为“白物”而不称为“白津”。唯独本案患者周右告诉我一种病状，我没有现成的词句来形容它。想要形容它，除非用“发则白津出”五个字，才足以当之。大概周右每当寒气上冲之时，口中津液就泉涌而出，想止也止不住，其色透明而白。待冲气下降，这种白津才停止。它的来源不知从何而来，它的停止也不知去向何处。但这绝不是痰浊之类，因为痰浊出于肺胃，此则出于口中；痰浊较浓而厚，此则较淡而清；吐出痰浊须费力气，此则自然流溢，所以二者绝然是两种不同的东西。奔豚是寒性病，既有出白津的例子，那么寒疝也是同类之寒性病，其出白津又有什么可疑呢？师兄吴凝轩渭曾亲眼见到冻死之人将死之时，口出白津无数，源源而来，绝非出于本人的自主控制，与此正可互相印证，事实的不可欺骗如此！叶天士医案说：高姓少年小腹气冲，心下及胁肋时常疼痛，舌底流涎，得甜味或静卧时稍好转，知饥但不食，大小便每日不通畅。这都是阴液内枯，阳气结闭。喻嘉言有滋液救焚的建议。
然而衰老关格病，苟延岁月而已，医药仅能侥幸图治。药用大麻仁、柏子仁、枸杞子、肉苁蓉、紫石英、炒牛膝。仔细分析本病实是奔豚，所谓舌底流涎，即是白津。其用药虽非正道，但足以互证病情的是非常审慎的。
按依西医解剖学而言，唾腺亦名涎腺，涎腺共有三对，曰耳下腺，曰颚下腺，曰舌下腺，其末端各有球囊如葡萄状。耳下腺为最大，在外耳之直下，别有管开口于上颚臼齿之近旁，以输送唾液。颚下腺在下颚之内前部，舌下腺在舌底粘膜之下，其输送管皆开口于舌尖下部之两侧。若唾腺神经起反射兴奋，以致唾液分泌亢盛者，谓之反射性流涎症云云。我意奔豚病患者心腹部分之神经剧受刺激，因反射及于唾腺神经，故分泌唾液特多。此唾液也，实即本案所谓白津。
二诊投桂枝加桂汤后，气上冲减为日二三度发，白津之出亦渐稀。下得矢气，此为邪之去路，佳。
肉桂心一钱半，川桂枝三钱，大白芍三钱，炙甘草三钱，生姜三片，红枣十枚，厚朴一钱半，半夏三钱。
【按】初诊时有为我记录处方的同学说：这是肝气。我说：肝气之名太泛，不如遵经旨称为奔豚，同学怀疑。次日病人高兴地相告，说：冲气减轻了，胃纳也增加了，同学愕然。我又琐碎地重问白津的形状，及关于白津的一切，所言完全符合，无可怀疑。又曾细按其脉，颇见弦紧之象，与仲圣所言寒疝之脉相似，更见疝与奔豚，确属类似的病。
服桂枝加桂汤而得矢气者，因桂性芳香兼能逐秽故也。然而逐秽气之专功，却不及厚朴，这是我屡次实验而得之者。又以半夏善降，故并用之。
三诊气上冲，白津出，悉渐除，盖矢气得畅行故也。今图其本，宜厚朴生姜甘草半夏人参汤加桂。
厚朴三钱，生姜四钱，半夏四钱，甘草三钱，党参三钱，桂心一钱，桂枝二钱。
【按】我每遇到可研究的病，常喜欢病人多来受诊几次，以便详细记录服药后的经过。但因为用经方，病人向愈至速，每一二诊后，即不再来。我无从详细询问，每每致大失所望。本案当初诊时，妇人鉴于此前就地医治之无效，频频问此病还有治愈希望否。我期以十日，妇人笑着点头。至二诊来时，我鉴于此前查询病情之无从，当即详细询问妇人的上海住址。第三诊后，妇人果然不再来。又过数日，我乃按地址趋至其亲戚家访问。得其外甥女出来相见，说：家舅母因病已将全愈，又以家务纷繁，早欣然回浦东去了。
以我的意思默想，此妇病根必然未拔，不久应当复发。当病重之时，则以身体为重，家事为轻；及其病减之后，又以家事为重，身体为轻，这是人之常情，有什么奇怪的呢？有善于怀疑的读者必将问我：什么叫“今图其本”？为回答这个问题起见，我不能不发表其未成熟之说。我说：奔豚病的本源乃是肠中之矢气，即肠胃中残余未曾消化之物，因发酵分解所生的瓦斯是也。厚朴生姜甘草半夏人参汤治此最佳。方中人参、生姜、半夏能健胃降逆，使建立高屋建瓴之势，厚朴、甘草能逐秽安正，大有剿抚之功。病人服此后，其矢气将更多，矢气既去，腹部之胀满者乃渐渐平复。本案周右腹本胀满，两服药后，遂渐渐平复，现在特别补述于此。病人的腹部渐渐平复，奔豚乃避免复发，所谓“图其本”者此也。
我现在应当补述周妇气上冲的情形，据述其气确实发源于小腹，惟并非仅中道一线直上，仿佛腹之两旁皆有小线向上中方向升腾，直冲至心脏部分而消失。当其冲逆时，颇觉难堪；及其消失时，不知去向何处。而白津之忽涌忽止，又皆出于不能自主。如是前后数分钟，方才复原状。然而精神为之疲乏，食欲为之减少。
吾人当注意此妇之“逆气冲至心而杳”一语，与经文“气从少腹上冲心”者、“气从少腹上至心”二语，完全符合。经文之“至”字，有以心为止境，至此而止之意。经文之“冲”字，有以心为正鹄，冲此即中之义。经文“冲心”“至心”大同小异之二条，都主桂枝加桂汤，所以我治本案冲心至心之奔豚，也用桂枝加桂汤。
此妇服药得矢气后，则上冲之气顿减，可见冲心之逆气无非肠中之矢气，肠中之矢气即是冲心之逆气。我想肠中发酵之瓦斯，既然不能泄于下，势必膨于中，故腹胀满。而腹部之胀满程度又殊有限制，故此时瓦斯乃随时有上溢之可能。适逢肠系于肠间膜，膜中有无数静脉管吸液上行，平时因血管有关约之作用，瓦斯不能溢入血管。适逢其人暴受惊恐，关约失其效能（吾人手方握物，受惊则物堕地。书载难产之妇，因骤闻响器掷地，胎儿安下。是皆关约筋因惊失效之明证），于是瓦斯乘机溢入血管。此溢入之量必甚微渺，然其害已烈，观西医之注射液剂，必避免空气之随入，慎之又慎，可见一斑。设瓦斯溢入静脉管，病人之感痛楚尚不甚剧，因瓦斯与静脉血液同向上行故也。设其所溢入者为动脉管，则二者逆向而行，痛楚斯甚。以我推测，此种瓦斯甚且逆大动脉而上薄心脏，但心脏瓣膜开阖喷压之力殊强，故瓦斯终为击溃，或下退原处而消失。药以桂枝加桂汤者，因桂枝能助动脉血运畅行之故，更加桂心以为君，则其喷压之力更强，而瓦斯乃不能上溢，但能下返（我前释桂枝汤中桂枝之用与此处相合，尚不致有两歧之误）。如此解释，似觅圆满。但依生理书言，肠中毒素每能侵入血管，至肠中之瓦斯殊不能溢入血管之中。然今日之生理尚不足以尽释实际之病理，观肋膜炎病者进十枣汤后，其肋膜间之水竟从肛门而出，即是一例。故我敢依此种病例作奔豚病理之假说如上。假说云者，即假定之学说，并非绝对之真理，姑留此说，以待他人之改正谬误或补充证明者也。
依鄙意，病者肠中先有瓦斯之蕴积，偶受惊恐，则关约失效，致瓦斯溢入血管之中。故仲圣曰皆从惊发得之。发犹言始也，此言大有深意。仲圣又曰：烧针令其汗，针处被寒，核起而赤者，必发奔豚。试问烧针令汗，何故多发奔豚？历来注家少有善解。不知仲圣早经自作注释，曰加温针，必惊也，曰医以火迫劫之，亡阳必惊狂，曰奔豚，……皆从惊发得之。合而观之，则烧针所以发奔豚之理宁非至明？故以经解经，反胜赘说多多。惟其人肠中本有宿气，待时而动，此乃可断言者也。
虽然，余之假说，尚不止于此。设阅者能稍耐烦，容当续陈其义。我说：此上所述之奔豚病为第一种奔豚，更有第二种奔豚与此稍异，即奔豚汤所主之奔豚病是也。
此二种奔豚乃同源而异流者。同源者何？盖同种因于腹中之瓦斯是也。异流者何？盖一则逆大动脉而犯心藏，一则溢入淋巴管，逆胸导管亦犯心藏，甚且犯胸与咽喉。师曰：奔豚病，从少腹起上冲咽喉，发作欲死。
又说：奔豚气上冲胸，腹痛，往来寒热，奔豚汤主之。即是此一种犯淋巴系之奔豚。试更详为之证，胸导管之上端适当胸部，其位高于心脏，故曰上冲胸，而不仅曰上至心，此可证者一也。咽中如有炙脔者，属半夏厚朴汤证，其病在咽喉部分之颈淋巴系，属少阳，与此处所谓上冲咽喉极相类，此可证者二也。
淋巴系病即中医所谓少阳病，少阳病以寒热往来为主证，故曰往来寒热，奔豚汤主之，此可证者三也。试察奔豚汤方内有半芩姜草，酷如少阳之主方小柴胡汤，此可证者四也。吾师曾用奔豚汤原方治愈此种奔豚病，其案情详《金匮发微》。读者欲知其详，请自检之，此可证者五也。有此五证，此第二种奔豚病乃告成立。
是故姑以六经言，二种奔豚病同生于太阴，一则发于太阳，一则发于少阳。以生理言，两种奔豚病同生于肠中瓦斯，一则发于循环系，一则发于淋巴系。考之实例，发于循环系者多，发于淋巴系者少，故桂枝加桂汤之用，常较奔豚汤为广。东哲有言曰：奔豚主剂虽多，特加桂汤为最可也。即缘此故耳。至奔豚病之剧者，其逆气同犯循环淋巴二系，亦属可能之事，故用方亦不妨并合。
笔述至此，奔豚病似可告一段落，倘若读者更欲追问肠中瓦斯之所由来，太阴病之所由成，我又安得无言？曰：以生理言，肠中瓦斯之成，实由于胃乏消化力，即西医所谓消化不良症是也。故欲治肠，当先健胃。犹欲求流之长，必先浚其源。虽然，是乃粗浅之言，不值一笑，今当进一步从心理方面言，曰：肠胃机能之所以不良者，乃忧思伤感有以造成之耳。试观吾人偶逢忧伤，则食不下，即下亦不能化，可作明证。故中医谓忧能伤脾，又谓脾主运化，犹言忧令人消化不良也。本此，用敢不揣冒昧。续伸仲圣之说曰：奔豚病，皆从惊恐发之，而从忧伤积之。盖发于骤，而积于渐也。
读者试将前案吾师治验例及本案拙案例合而考之，可知吾所言者，皆实验之论，非玄想之谈。又吾师之案与拙案较，在治法上言，有一不同之点在。读者明眼，谅早已烛之。如其未也，不妨略予思考，得之，然后接阅下文，与吾所言者对勘，此乃治学之一法，添趣之一术也。
吾师前案先用吴茱萸合理中汤，继用桂枝加桂汤纳半夏，拙案则由桂枝加桂汤渐移作厚朴生姜甘草半夏人参汤加桂，一往一来，彼顺此逆。易言之，吾师先治其本，后图其标，余则先治其标，后图其本，与
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