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In Shaoyin disease, when Yang-pathogenic heat is accompanied by retained fluid, after six or seven days, the patient may instead suffer from restlessness and insomnia. Accompanied by diarrhea, thirst, cough, and vomiting, the treatment should be Zhu Ling Decoction (Zhu Ling Tang).
[Note] "Shaoyin Yang-pathogen with retained fluid" refers to a Shaoyin heat syndrome complicated by retained fluid pathology. Shaoyin disease typically presents with drowsiness; however, if after six or seven days the patient experiences irritability and insomnia, this indicates Shaoyin heat. Diarrhea with thirst, cough, vomiting, and dysuria indicate the retention of water-fluids. Zhu Ling Decoction (Zhu Ling Tang) clears heat and promotes diuresis, which is an appropriate treatment. See the Shaoyin chapter for details.

In Shaoyin disease, when Yin-cold pathogen is accompanied by water-qi (fluid retention), symptoms include abdominal pain, heaviness and deep soreness in the limbs, dysuria, and spontaneous diarrhea. The treatment should be Zhen Wu Decoction (Zhen Wu Tang) to regulate the condition. If cough worsens, add Dried Ginger (Gan Jiang) and other acrid herbs; if urination is normal, remove Poria (Fu Ling); if vomiting occurs, remove Aconite Root (Fu Zi) and double the amount of Fresh Ginger (Sheng Jiang); if diarrhea occurs, remove Peony Root (Bai Shao) and add Dried Ginger (Gan Jiang) to calm the interior.
[Note] "Shaoyin Yin-pathogen with water-qi" refers to a Shaoyin cold syndrome complicated by water-qi pathology. The main manifestations of fluid-retention disease include abdominal pain, heavy and painful limbs, spontaneous diarrhea, and dysuria. Zhen Wu Decoction (Zhen Wu Tang) is indicated to warm the middle and promote diuresis. Associated symptoms may include cough, normal urination, vomiting, or diarrhea. For cough, add Fresh Ginger (Sheng Jiang), Ephedra Stem (Ma Huang), and Schisandra Fruit (Wu Wei Zi). If urination is clear/normal, remove Poria (Fu Ling). For vomiting, remove Aconite Root (Fu Zi) and double Fresh Ginger (Sheng Jiang). For diarrhea, remove Peony Root (Bai Shao) and add Dried Ginger (Gan Jiang).

Panting involves noisy breathing with frequent mouth opening; shortness of breath resembles panting but without shoulder elevation. Rapid and difficult breathing indicates an excess syndrome, while short, intermittent breathing suggests a deficiency syndrome. Internal causes involve fluid retention or phlegm-heat; external causes require differentiation of Yin/Yang and Exterior/Interior. Direct staring, coma, sweating that wets the hair, thready pulse, and cold extremities indicate a critical condition where life is hard to save.
[Note] Panting (Chuan Xi) refers to rapid breathing with audible sounds, frequent mouth opening, shoulder lifting, and abdominal movement. Shortness of breath (Duan Qi) resembles panting but lacks mouth opening and shoulder lifting. Both conditions relate to Qi disorders in the chest. The Lung governs Qi, so these are attributed to the Lung. Whether panting or shortness of breath, if breathing is obstructed and unable to distribute Qi smoothly, it is an Excess syndrome (Yu Zheng). If breathing is empty and unable to continue, it is a Deficiency syndrome (Xu Zheng). Internal causes refer to lung injury from drinking cold fluids or phlegm-heat. External causes refer to body cold injuring the exterior; the exterior governs skin and hair, which correspond to the Lung. Pathogens affecting the skin/hair can spread to muscles, chest, abdomen, and stomach, causing panting. One must examine Yin/Yang and Exterior/Interior to treat according to the transformation of the disease. Panting or shortness of breath combined with direct staring, coma, moist sweating, thready pulse, and cold extremities are signs of death. If seen with Three-Yin cold syndromes, it is Yin-panting; treat with Si Ni Decoction (Si Ni Tang) plus Apricot Seed (Xing Ren) and Schisandra Fruit (Wu Wei Zi), doubling Ginseng (Ren Shen) for deficiency. If seen with Three-Yang heat syndromes, it is Yang-panting; treat with Bai Hu Decoction (Bai Hu Tang) or Ge Gen Huang Qin Huang Lian Decoction (Ge Gen Huang Qin Huang Lian Tang). If seen with Taiyang exterior syndromes, it is Exterior-panting: use Ma Huang Decoction (Ma Huang Tang) for no sweat, Da Qing Long Decoction (Da Qing Long Tang) for irritability, or Gui Zhi Jia Hou Po Xing Zi Decoction (Gui Zhi Jia Hou Po Xing Zi Tang) for sweating. If seen with Yangming interior syndromes, it is Interior-panting: use Da Cheng Qi Decoction (Da Cheng Qi Tang), or Da Xian Xiong Wan (Da Xian Xiong Pill) if complicated by Chest Binding (Jie Xiong). If complicated by water-qi: use Xiao Qing Long Decoction (Xiao Qing Long Tang) for exterior excess; Wu Ling San (Wu Ling Powder) plus Lepidium Seed (Ting Li Zi) for exterior deficiency or dysuria; Ting Li Da Zao Decoction (Ting Li Da Zao Tang) for interior excess, or Shi Zao Tang (Shi Zao Decoction) if complicated by hard/painful abdomen/flanks; Zhen Wu Decoction (Zhen Wu Tang) for interior cold. If pulse is thready/fine, breath is short and weak, without Yin/Yang/Exterior/Interior signs, it is Qi-deficiency panting; treat with Bao Yuan Decoction (Bao Yuan Tang) plus Schisandra Fruit (Wu Wei Zi) and Apricot Seed (Xing Ren). If panting with sticky sputum and rattling sound in throat, it is Phlegm-panting: severe cases use Gua Di San (Gua Di Powder) or Meng Shi Gun Tan Wan (Meng Shi Rolling Phlegm Pill); mild cases use Er Chen Tang (Er Chen Decoction) plus bitter Ting Li Zi and Perilla Seed (Su Zi).