Symptoms and Treatment of ‘Running Piglet Syndrome ’
Professor Zhang Enqin
UK Academy of Chinese Medicine
Abstract: “Running Piglet Qi” is a term in Traditional Chinese Medicine (TCM). During an attack, the patient feels a rush of qi rising from the lower abdomen to the chest and throat, resembling a piglet running around inside the abdomen, hence the name. The Eastern Han Dynasty physician Zhang Zhongjing’s Synopsis of Prescriptions of the Golden Chamber records treatments for this condition including “Running Piglet Decoction,” “Cinnamon Twig Decoction with Added Cinnamon,” and “Poria, Cinnamon Twig, Licorice, and Jujube Decoction.” In the medical case presented in this article, the author treated Running Piglet Qi with a modified version of the Inula and Hematite Decoction, achieving significant results.
Keywords: Running Piglet Syndrome , Inula and Hematite Decoction
Bentun (running piglet) was first recorded in books such as Huangdi Neijing, Nanjing, Jin Gui Yao Lue, and Zhu Bing Yuan Hou Lun. The term “Bentun” derives from its primary symptom: qi rushing from the lower abdomen to the chest and throat, which feels agitated like a piglet rushing around. Attacks may be accompanied by abdominal pain, chest tightness, and palpitations, but these symptoms disappear quickly. TCM sees the condition as often being associated with mood swings (fear, anxiety) or cold pathogens in the lower abdomen, and is closely linked to the heart, liver, kidneys, and Chong Mai. In Western medicine, its symptoms can be associated with neurosis, hysteria, depression, anxiety, and menopausal syndrome.
Causes
Emotional factors: Emotional fluctuations such as consternation, worry, and anger can lead to liver qi stagnation and poor qi flow.
Cold invasion: Excessive sweating and exogenous wind and cold can lead to insufficient heart yang, causing kidney yin and cold water to rise.
Clinical Manifestations
Main Symptoms: Qi ascends from the lower abdomen to the chest and throat, feeling like a running piglet.
Symptoms: Attacks are characterized by excruciating uncomfortableness, often accompanied by abdominal pain, chest tightness, palpitations, panic, irritability, wheezing, and vomiting. Severe cases may include fainting and convulsions.
Characteristics of an attack: The discomfort is intense during an attack, but the symptoms will resolve suddenly, with the patient feeling normal afterward.
Similar conditions in Modern Medicine :
Neurosis, hysteria, depression and anxiety, menopausal syndrome, heart disease (some symptoms are similar), abdominal epilepsy, functional abdominal pain syndrome, etc.
Traditional Chinese Medicine Treatment Methods
Treatment Principles: Depending on the specific cause and symptoms, methods are used to soothe the liver and relieve depression, or warm the yang and dispel cold.
Traditional prescriptions from source texts:
Bentun Tang: For symptoms of liver qi rising.
Guizhi Jiagui Tang: For symptoms of chills after yang deficiency and sweating.
Fuling Guizhi Gancao Dazao Tang: For symptoms of water-cold rising after sweating.
Modified Xuanfu Daizhe Tang is often used by the author, with good results.
Acupuncture treatment:
Based on syndrome differentiation, appropriate acupoints (such as Taichong(Lr3), Gongsun ( Sp4), Neiguan (P6), Qihai (Ren 6) , and Guanyuan（Ren 4) are selected for acupuncture or moxibustion.
Case History for running piglet syndrome:
A middle-aged woman came to the clinic in June of this year. She said that she suffered from “viral flu” in May and the effect of taking Western medicine had not been obvious. She started experiencing a sense of air rushing from the lower abdomen to the chest, with a feeling of suffocation and urgency, and even “feeling near-death”, panicking, and sweating. Each attack lasted for 2-3 hours. She had been to a local hospital for examination, and also been treated by some Chinese practitioners with acupuncture and herbal medicines. However, the doctors didn’t know what kind of disease it was, and they were ineffective. Later, she was introduced by a friend to the Kings TCM and Herbal Centre UACM and saw Professor Zhang Enqin, who diagnosed her with running piglet syndrome. The prescription was based on classical herbal formulas created by Zhang Zhongjing, a modified version of Inula and Hematite Decoction. Prescription (dosage for granules):
Xuan Fu Hua 1g
Ban Xia 1g
Dai Zhe Shi 1g
Huang Lian 0.5g
Huang Qin 1g
Gua Lou 1g
Zhi Shi 1g
Mu Xiang 1g
Chen Xiang 1g
Dan Shen 1g
Bai He 1g
Total 10.5g (daily dosage)
The patient was instructed to take 1/3 of a day’s dosage in the afternoon, 1/3 in the evening, and 1/3 before sleep. Granules were to be added to a half of a cup of boiling water, stirred until dissolved and drank after the temperature became comfortably warm. The symptoms disappeared after five weeks of continuous use. When Dr Zhang called her in August, she said she has not had a relapse so far and was very grateful.
References
- Essentials of The Golden Cabinet , Chinese -English version , Original author Zhang Zhongjing , Translation editor Li Zhaoguo , Liu Xiru , published by Shanghai Salinan Press in June 2017
- Shang Han Lun Study Guide, English version , Engin Can ( Zhang Enqin ) , published by the People ‘s Medical Publishing House, in June 2022
About the author：
Professor Enqin Zhang (Engin Can), president of UK Academy of Chinese Medicine, a fellow member of ATCM and a senior member of the Royal Society of Medicine. He wrote & edited the 14-volume “A Practical English-Chinese Library of TCM “, the world’s first English-Chinese bilingual TCM textbooks, published by Shanghai University of TCM Press in 1990; “Research on Classic Prescriptions” published by Yellow River Publishing House in 1987; and “Shang Han Lun Study Guide ” published by People’s Medical Publishing House in 2012. He practices at King’s Cross TCM & Herbal Center UACM, London, also acting as a distinguished Professor for Shaanxi University of Chinese Medicine, a visiting professor at Shanghai University of Chinese Medicine and Zhejiang Chinese Medical University and teaches students of the training courses and master’s and doctoral programs on Chinese medicine and acupuncture at London.
奔豚症治
英國中醫學院 張恩勤教授
摘要：奔豚氣乃一中醫學病名，發作時病人自覺有一股氣從小腹上沖胸咽的感覺，宛如小豬在腹內奔突一樣，故名。東漢醫家張仲景之【金匱要略】載有「奔豚湯」、「桂枝加桂湯」以及「茯苓桂枝甘草大棗湯」等治療此病。在本文介紹的醫案中，作者則以旋覆代赭湯加減治療奔豚病，效果顯著。
關鍵字：奔豚氣 旋覆代赭湯
「奔豚」最早記載於《黃帝內經》、《難經》、《金匱要略》和《諸病源候論》等著作，因其以陣發性氣從小腹部上沖至胸咽為主要症狀，宛如豚竄奔突之狀，故得此名。發作時伴隨腹痛、胸悶、心悸等症狀，發作後如常人。中醫認為， 此病多與情緒波動（驚恐、憂思）或下焦虛寒有關，與心、肝、腎三臟及沖脈關係密切。 在西醫學中，其症狀可能對應於神經官能性、癔症、憂鬱、焦慮、更年期症候群等。
病因
情緒因素： 驚恐、憂鬱、暴怒等情緒波動，導致肝氣鬱結，氣機逆亂。
寒邪侵襲： 因汗出過多，外寒侵襲，導致心陽不足，腎臟陰寒之水氣乘虛上逆。
臨床表現
主要症狀：自覺氣從少腹上沖胸咽，如小豬奔跑狀。
發作症狀： 發作時痛苦難忍，常伴隨腹痛、胸悶、心悸、恐慌、煩躁不安、喘逆、嘔吐等，嚴重者可能出現抽搐、厥逆。
發作特徵: 發作時痛苦異常，發作結束後症狀會突然消失，恢復正常。
現代醫學對應疾病
神經官能症、癔病、 憂鬱症、焦慮症、更年期症候群、冠狀動脈心臟病（部分症狀類似）、腹型癲癇 、功能性腹痛。
中醫治療方法
治療原則： 根據具體病因和證型，採取疏肝降逆或溫陽散寒降逆的方法。
常用方劑：
奔豚湯：: 適用於肝氣上逆的證型。
桂枝加桂湯：: 用於發汗後陽虛寒逆的證型。 茯苓桂枝甘草大棗湯：: 用於發汗後水寒上逆的證型。
旋覆代赭湯加減。張恩勤教授多用此方，效果顯著。
針灸治療： 依辨證選擇對應穴位（如太衝、公孫、內關、氣海、關元等）進行針刺或艾灸。
醫案舉例：
中年女性，今年6月22日來診。自述於今年5月患「病毒性流感」服藥效果不顯。自覺有一股氣從小腹上沖胸部的感覺，伴隨窒息緊迫感，甚至「瀕死感」，驚恐不安，汗出，每次發作2-3 小時。曾去英國醫院檢查，也去過幾家藥局針灸和吃中藥，醫師們不知道這是什麼病，都無效。後來經朋友介紹來英國中醫學院門診，張恩勤教授診為 “奔豚氣（癔病）” 。處方是採用東漢醫家張仲景的「旋覆代赭湯「加減。處方（中藥濃縮顆粒）：旋覆花1g, 代赭石1g, 半夏1g, 黃連0.5 g , 黃芩1g, 瓜蔞1g, 枳實1g,木香1g, 沉香1g, 丹參1g, 百合1g, 鬱合仁酸椰果酸以上是一日的劑量，分午後、晚餐和睡前三次服用。方法：將草本顆粒一日量的三分之一放入杯中，加入開水半杯，攪拌均溶解，待溫度降至溫後服用。連服五週後症狀消失。今年8月電話回訪時說至今沒再復發，表示非常感謝。
參考書目
1. 金匱要略 漢英對照版，原著張仲景，翻譯李照國、劉希茹，上海三聯書社2017年6 月出版
2. 傷寒論研習指導，英文版，張恩勤，人民衛生出版社2012年6月出版
作者簡介：張恩勤教授，英國中醫學院院長，英國中醫藥學會資深會員，英國皇家醫學會資深會員。曾主編世界第一套英漢對照系列中醫教學【英漢對照實用中醫文庫】14冊，上海中醫藥大學出版社1990年出版；【經方研究】，黃河出版社1987年出版；【傷寒論研習指導），人民衛生出版社2012年出版。目前在英國中醫學院倫敦國王十字街中醫藥中心教學行醫，兼世界中醫藥學會臨床療效評估委員會委員，陝西中醫藥大學特聘教授，上海中醫藥大學和浙江中醫藥大學客座教授，在倫敦教授中醫針灸培訓班和碩士和博士課程
