《伤寒论》霍乱条理中丸后，有脐上筑筑有动气者，去术，加桂。《金匮》水气篇苓桂
术甘
汤下，有少腹有气上冲胸者，去术，加五味子。世谓动气忌术，以术能闭气也。盖动气上冲
者，气之不能四达也。寒水四塞，肾中真气不得旁敷，而逼使直上，故气动也。桂枝、细辛
所以散水而通络，使气旁达也。五味子所以敛肺而降逆，使气归根也。若白术，能利腰脐结
气，似于证无甚相违，而不知腰脐无结，而忽利之，是欲虚其地以受邪，邪将固结腰脐，
上
下格拒，肾阳因之扑灭矣。且甘苦能坚能升，津液不得流通，气机为之升提，即有碍于桂枝
、细辛之功用也。故吾以为凡遇上吐、下泻，以及以腹急痛、痧胀转筋、晕眩颠仆之急病，
又或干呕、噎隔、哕呃之危病，皆以慎用白术为宜。前人谓∶动气难诊于脉，当问而知之，
亦不尽然。其脉当是圆疾如豆，丸丸不去，时上驰如矢也。
按∶动气皆因气行有阻，冲激而然。其动有微有甚，总是中热下寒，肾寒肝热，加以上
有寒
闭，其情更急。凡痰饮停积，以及素患疝瘕，时时冲动者，只是升气相碍也。若误汗、误下
、误吐，致气从少腹上冲者，则防暴脱矣。若久病阳微，肾气上越者，其势更难挽回。前人
指为肝肾气绝，阴邪上犯，故动气之暴发而危者，总由肾阳骤熄，水精不能四布，寒极化燥
，如水成冰，其气上逆，直欲凌犯君火之位故也。人身亦如六合，此时地与四维，气皆闭塞
，只得一线直上。辛能开腠理，通气，致津液，故重用桂枝、细辛以开之。白术之忌，盖恶
其涩津升气也；汗、吐、下之禁，盖恶其伤津损气也。又按∶齿暴长，为髓溢，浓饮术汁即
消。魏玉横谓∶此即术消肾气之证。非也。齿暴长者，肝肾湿热太盛，火郁风生，故静者动
也。术能收摄湿邪，培土镇风，风定，故齿复其坚静之本体矣。是镇肝也，非消肾也。
《伤寒论》中关于霍乱治疗的条文提到，服用丸药后，如果感到脐上跳动不安、有动气现象的，应当去掉白术，加入桂枝。《金匮要略》水气病篇中苓桂术甘汤（茯苓、桂枝、白术、甘草组成的方剂）的用法下指出，如果有少腹部有气向上冲击胸部的症状，应当去掉白术，加入五味子。世人认为有动气时忌用白术，是因为白术能闭塞气机。大概动气上冲的情况，是气不能向四周通达的表现。寒水之气在四周壅塞，肾中的真气无法向旁侧敷布，反而被逼迫直接向上，所以出现气动。桂枝和细辛的作用是散除水饮并疏通经络，使气能够向旁侧通达；五味子的作用是收敛肺气并降逆，使气回归根本。至于白术，虽然能疏通腰脐部位的气结，看似与病情没有太大冲突，但不知道如果腰脐部位并没有气结，却突然使用白术去利它，这是想要使该处空虚以招致邪气，邪气将会牢固地结聚在腰脐，导致上下格拒不通，肾阳因此会被扑灭。况且甘味和苦味的药物具有坚固和升提的作用，如果津液不能流通，气机就会随之升提，这也会妨碍桂枝、细辛发挥功效。所以我认为是凡遇到上吐、下泻，以及因腹部急痛、痧胀转筋、晕眩跌倒等急症，或者是干呕、噎隔、呃逆等危重病症，都应当谨慎使用白术为宜。前人曾说：动气在脉象上难以诊断，应当通过询问得知，但这也不完全正确。其脉象应当是圆滑疾速如豆粒般，连续不断，时而向上奔驰如箭射一般。
按语：动气都是因为气行受阻，受到冲击而产生的。其跳动有轻微和严重之分，总是属于中焦热而下焦寒，肾寒而肝热的情况，再加上上面有寒邪闭阻，病情更加紧急。凡是痰饮停积，以及素来患有疝气或瘕块，时时冲动的人，只是升发之气受到阻碍罢了。如果是误用发汗、误用攻下、误用催吐，导致气从少腹向上冲逆的，就要防止暴脱了。如果是久病阳气微弱，肾气上越的，其形势更难挽回。前人将其指为肝肾之气绝断，阴邪上犯，所以动气暴发且危险的，总归是由于肾阳骤然熄灭，水精不能向四周布散，寒极转化为燥，就像水结成冰一样，气机上逆，直欲侵犯君火（心火）的位置。人身也如同六合（天地四方），此时地面与四维方向，气机都闭塞不通，只剩下一线之气直上。辛味药物能开泄腠理，通行气机，输送津液，所以重用桂枝、细辛来开通它。禁忌使用白术，大概是厌恶它涩滞津液、升提气机；禁忌发汗、催吐、攻下，大概是厌恶它们损伤津液和气机。又按语：牙齿突然变长，称为髓溢，浓煎白术汁服用即可消退。魏玉横说：这就是白术消除肾气的证候。这是不对的。牙齿突然变长的原因，是肝肾湿热太盛，火郁而生风，所以静止的东西变得动了。白术能收摄湿邪，培补脾土以镇熄肝风，风定之后，牙齿就恢复了其坚静的本体。这是镇压肝风，而不是消除肾气。
In the "Shanghan Lun" (Treatise on Cold Pathogenic Diseases), regarding the treatment of Huoluan (cholera-like disease with vomiting and diarrhea), it is stated that after taking pill medicine, if there is a sensation of throbbing or moving Qi above the umbilicus, Baizhu (Atractylodis Rhizoma) should be removed and Guizhi (Cinnamomi Ramulus) added. In the section on Shuiqi (Water Qi/Edema) in the "Jingui Yaolue" (Essential Prescriptions from the Golden Cabinet), under the usage of Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction), it is indicated that if there is a sensation of Qi rushing upward from the lower abdomen to the chest, Baizhu (Atractylodis Rhizoma) should be removed and Wuweizi (Schisandrae Fructus) added. The world believes that moving Qi contraindicates the use of Baizhu because Baizhu can obstruct Qi flow. Generally, moving Qi rushing upward indicates that Qi cannot reach all directions. When cold water pathogen blocks the surroundings, the true Qi of the Kidney cannot spread laterally but is forced to rush directly upward, thus causing moving Qi. Guizhi (Cinnamomi Ramulus) and Xixin (Asari Radix et Rhizoma) are used to dissipate water pathogen and unblock collaterals, allowing Qi to reach laterally; Wuweizi (Schisandrae Fructus) is used to astringe Lung Qi and descend rebellious Qi, allowing Qi to return to its root. As for Baizhu (Atractylodis Rhizoma), although it can benefit the Qi stagnation at the waist and umbilicus, seemingly not conflicting much with the syndrome, one does not realize that if there is no Qi stagnation at the waist and umbilicus, suddenly using Baizhu to drain it would empty the location to invite pathogens. The pathogens will then firmly knot at the waist and umbilicus, causing rejection between upper and lower parts, and Kidney Yang will be extinguished thereby. Moreover, sweet and bitter flavors can firm and ascend; if body fluids do not circulate freely, the Qi mechanism will be lifted, which would hinder the efficacy of Guizhi (Cinnamomi Ramulus) and Xixin (Asari Radix et Rhizoma). Therefore, I believe that whenever encountering acute diseases such as vomiting, diarrhea, abdominal cramping pain, Sha Zhang (sand swelling) with tendon twitching, dizziness, or fainting, or critical diseases like dry retching, dysphagia, or hiccups, it is advisable to use Baizhu (Atractylodis Rhizoma) cautiously. Predecessors said: Moving Qi is difficult to diagnose by pulse alone and should be known through inquiry, but this is not entirely accurate. The pulse should be round, rapid like a bean, continuous, and sometimes racing upward like an arrow.
Note: Moving Qi arises because Qi movement is obstructed and impacted. The movement varies from mild to severe, always involving heat in the middle and cold in the lower jiao, cold in the Kidney and heat in the Liver, compounded by cold closure above, making the condition more urgent. In cases where phlegm-fluids are stagnant, or where there is a history of hernia or masses causing periodic surging, it is merely due to obstruction of ascending Qi. If mistaken sweating, purging, or emesis causes Qi to rush upward from the lower abdomen, one must prevent sudden collapse. If chronic illness leads to weak Yang and upward floating of Kidney Qi, the situation is even harder to reverse. Predecessors attributed this to the exhaustion of Liver and Kidney Qi and invasion of Yin pathogens. Thus, sudden and dangerous outbreaks of moving Qi are generally due to the sudden extinction of Kidney Yang, preventing the distribution of water essences, extreme cold transforming into dryness, similar to water turning to ice. The Qi rebels upward, directly attempting to invade the position of Jun Huo (Heart Fire). The human body is like the Six Directions (Heaven, Earth, and four cardinal points); at this time, Qi is blocked everywhere, leaving only a single line rising straight up. Pungent flavors can open interstices, promote Qi circulation, and distribute fluids, so heavy doses of Guizhi (Cinnamomi Ramulus) and Xixin (Asari Radix et Rhizoma) are used to open these blockages. The contraindication of Baizhu (Atractylodis Rhizoma) stems from its tendency to astringe fluids and lift Qi; the contraindication of sweating, emesis, and purging stems from their tendency to damage fluids and Qi. Another note: Sudden elongation of teeth, termed Marrow Overflow, can be resolved by drinking concentrated decoction of Baizhu (Atractylodis Rhizoma). Wei Yuheng claimed this was a case of Baizhu eliminating Kidney Qi. This is incorrect. Sudden elongation of teeth is caused by excessive damp-heat in the Liver and Kidney, with fire stagnation generating wind, causing stillness to become motion. Baizhu can gather damp pathogens and strengthen Earth to suppress Wind; once the wind settles, the teeth return to their firm and quiet state. This is suppressing the Liver, not eliminating Kidney Qi.