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(Breathing is rapid and short, with breath unable to continue, resembling panting but without shoulder lifting; resembling groaning but without pain. The etiology may be excess or deficiency; the disease location may be in the exterior or interior; the nature may be Yin or Yang; or it may be due to excessive drinking causing water retention under the heart. Each case requires careful examination.)

Shortness of breath, pain in bone joints, sweating, difficulty in urination, aversion to wind, and bodily swelling indicate Wind-Dampness (Gancao Fuzi Tang). Shortness of breath accompanied by abdominal fullness, hypochondriac pain, a wiry, floating, and large pulse, unrelieved exterior syndrome, absence of sweating, drowsiness, yellowish skin, difficulty in urination, and tidal fever indicate Shaoyang syndrome (Xiaochaihu Tang). Unrelieved exterior syndrome, shortness of breath, continuous sweating on the hands and feet, or tidal fever indicate Yangming Fu-organ excess (Da Chengqi Tang). If the exterior syndrome has resolved, epigastric stuffiness and hardness, dry retching, and shortness of breath indicate fluid retention (Shizao Tang). After purgation, mental restlessness, oppression, and hard pain indicate Phlegm-Heat binding (Daxiexin Tang). Note: After sweating, vomiting, or purging, if the pulse is faint and breath cannot continue, administer Yigong San. For Yin syndrome with a deep pulse, cold extremities, and difficult breathing, administer Sini Tang plus Renshen. For excessive drinking with water retention, administer Fuling Gancao Tang. These supplements the incomplete records of Zhang Zhongjing.

(Duyu Mao refers to coma. Yu implies stagnation leading to Qi obstruction; Mao implies dizziness and clouding of consciousness. The Classics state: "Deficiency and Cold lead to Duyu Mao," yet there are cases suitable for purgation.)

In Taiyang syndrome, after purgation followed by sweating, both exterior and interior are deficient, resulting in Mao (dizziness/clouding). If sweating occurs and the exterior Qi harmonizes, it heals spontaneously; if the interior is not harmonized, then purgation should be administered again (Xiao Chengqi Tang). In Yangming syndrome, with diarrhea, stool alternating between difficulty and ease, slight fever, panting, Mao, and inability to lie down, there is dried feces (Da Chengqi Tang). In Shaoyin syndrome, if the patient desires sleep and diarrhea stops but dizziness and Mao occur, it indicates death. In Jueyin syndrome, with undigested food in stool, deep and slow pulse, red face, and slight body heat, Duyu Mao with sweating will occur, indicating resolution.

Note: Haizang (Zhang Yuansu) stated that Heart Fire steaming the Lungs causes mental confusion; purgation would be a mistake. Zhizi Qinlian Tang is appropriate. If the pulse is floating at Bing, Daochi San is appropriate. If the pulse is deep at Ding, Xiexin Tang is appropriate. Liu Hejian stated: Heat syndromes typically present with rapid pulses. However, extreme heat may paradoxically cause deep and fine pulses; misdiagnosing this as Cold is an error. Jiedu Tang combined with Da Chengqi Tang for purgation is appropriate. Alternatively, if failure to purge leads to faint pulse and Mao, urgent purgation would cause sudden extinction of residual Yin Yin; non-purgation also leads to death. Use Jiedu Tang to nourish Yin and retreat Yang, so the pulse harmonizes and life is preserved. Zhongjing said: Blood deficiency leads to Jue, and Jue inevitably leads to Mao. He also said: In Shaoyin syndrome, if diarrhea stops and dizziness/Mao occurs, it indicates death, due to extreme deficiency and collapse. Whether deficiency or excess, careful differentiation is required.