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Without chills or fever, and other external diseases. Diet remains normal. Suddenly severe panting occurs. Panting worsens with movement and slightly decreases during quiet lying down; this is one of the two major diseases. Movement is slightly tolerable, but cannot lie flat on the back; this is the second major disease. Both are caused by cold-dampness and cold-phlegm injecting into the Mingmen (Gate of Life). The former condition results from latent cold in winter or long-standing dampness rising from the knees and shins to the lower abdomen, passing through the Bladder channel to enter the Lungs. There are also cases where it follows the Taiyang (Greater Yang) channel upward along the spine and back to enter the Lungs. Coughing must appear first. Pathogenic qi reverses from below upwards, causing Yuan Qi (Original Qi) to float and fail to return to its nest, hence worsening with movement. The latter condition results from cold-phlegm originating in the Yangming (Yang Brightness) channel, flowing downward along the Chong (Penetrating) and Ren (Conception) vessels. A sign of hidden discomfort between the two breasts must appear first, or it originates in the spine/back, flowing downward along the waist and Kidneys, with a sign of hidden distension inside both waists appearing first. Cold-phlegm is tangible pathogen, attacking from above downwards, suppressing Yuan Qi. Lying flat causes Qi in the Shanzhong (Chest Center) to become even more discontinuous, hence worsening when lying down. Treatment method: For the former condition, imitate the methods for cold-damp Hongjiao (Gouty Arthritis), hernia, and Bentun (Rushing Pig) to drive pathogens out downward. If accompanied by cough, additionally imitate Xiao Qinglong Tang (Minor Blue Dragon Decoction), using a mild dose after meals to slightly open the upper Jiao. For the latter condition, use raw Lujiaojiao (Deer Antler Glue), Zishiyingshi (Hematite), Rougui (Cinnamon Bark), and Zexie (Alisma) to strike directly at Mingmen. Assist with raw Fuzi (Aconite Lateral Root) and Shichangpu (Acorus Rhizome) to warm Yangming and the Chong and Ren vessels. Use Gouji (Cibotium Rhizome), Duhuo (Angelica Pubescens Root), and Daodou (Dolichos Bean Seed) to warm the waist and spine. Ancient formulas such as Chi Wan (Red Pill), Da Jianzhong Tang (Major Construct the Middle Decoction), Da Wutou Jian (Major Aconite Decoction), Heixi Dan (Black Tin Pill), Poyin Dan (Break Yin Pill), Banshu Wan (Half-Sulfur Pill), and Sanshi Hanshi San (Three Stones Cold Food Powder) are all excellent prescriptions. Once phlegm clears and panting settles, observe the transformed syndrome and adjust accordingly.

I once treated Mrs. Xie suffering from the former condition. Her pulse was short and contracted in both Cun (Inch) positions, and surging and wiry behind the Guan (Bar) position, trembling under light pressure like shivering. Treated according to the method, but she feared the harshness of the medicine and refused to take it. She passed away after a month. It was spring. I also treated Patient Yang suffering from the latter condition. His pulse was sunken and unrising in the left Guan position, and trembled violently in both Chi (Cubit) positions, intermittent and discontinuous. Treated according to the method. After three doses, panting settled, and the pulse rose and became continuous. However, the pulse seemed too vigorous. I warned him: "Rest quietly, and regulate with herbs that astringe Yang and calm Yin. Do not relax." But he continued running around, drinking alcohol, and eating as before. Stopping medication for half a month, the panting recurred. He took Maxing Shigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction) on his own and died. It was autumn. Yang considered himself an expert in medicine. I told him: "The disease trend is very dangerous, the root is deep, and the mechanism is subtle. The future exit path for pathogenic qi may be in the bowel movements or urine, or in the Lungs. Fortunately, it occurred in autumn, allowing time for calm regulation. If it had occurred in spring, even divine pills would not suffice." Yang agreed quite well, and showed that a phlegm tumor on his back, large as an inverted bowl, had existed for decades but suddenly disappeared now, verifying the efficacy of my recognition of cold-phlegm flowing downward. Yet he changed course midway. Is this destiny? Or human action?

Another case: Cheng suffered from nocturnal wandering and night travel. Suddenly after midnight, cold qi rushed up from the navel, heart palpitations and floating qi, high shaking of the crown, incessant spontaneous sweating, a state resembling collapse. Using raw Fuzi (Aconite Lateral Root), Rougui (Cinnamon Bark), Hulusba (Cibotium Barometz Spore), Sangpiaoxiao (Mantis Egg Case), added with Shanzhuyu (Cornus Fruit) and Niuxi (Achyranthes Root), one dose stabilized it. Ten consecutive doses cured it. Another case: Yang suffered from a febrile disease previously, cured by heavy use of Fuling (Poria) and Zexie (Alisma). Consequently, he feared warming herbs as if they were poison arsenic. One day, sudden chest bi (obstruction) and qi stagnation occurred, upper and lower qi failing to connect, breathing requiring shoulder lifting, trending toward panting. I said: "Only Chenxiang (Aquilaria Wood) and Rougui (Cinnamon Bark) will do." Reluctantly taken, one dose stabilized it. Four to five doses cured it. This was not self-inflicted illness but due to medicinal error, thus easier to reverse.

Further note: Sudden panting and the previous chapter's Water Qi Overwhelming Heart syndrome, if the trend is urgent and drug power insufficient to apply, or the severity is great and drug power cannot control, moxibustion on Shanzhong (CV17) and Guanyuan (CV4) is required, along with moxibustion on Jianjing (GB21), Quepen (ST12), and Dazhui (GV14), which is extremely effective. Guanyuan is three cun below the umbilicus, measured by the width of the middle, index, and ring fingers. I have also treated wind-damp entering collaterals, causing Qi Bi resembling panting, applying moxibustion separately to upper/lower and front/back areas, achieving great merit. Recorded here for reference. Whenever back Qi pulls downward, unable to rise, even to the point of heaviness and distension in the Weijian (tailbone) and buttocks, moxa Mingsmen (BL52) and Weicang (BL49), plus Zhangmen (LR13). Mingsmen is located about three cun lateral to the waist, in the seam of the floating ribs. Weicang is in the seam of the rib above it. When chest Qi sinks, unable to rise, even to the point of heaviness and distension in the umbilical-abdomen, moxa Guanyuan (CV4), Huangshu (CV15) beside the umbilicus, and Zhangmen (LR13), or additionally ShiDou (ST24) beside the nipples. When chest-back Qi wraps over the shoulder, causing congestion and uncomfortable breathing, moxa Jianjing (GB21), Dazhui (GV14), and Quepen (ST12), possibly adding ShiDou (ST24) and GeShu (BL17). If drum-like distension causes panting, besides the above acupoints, also moxa Shuifen (CV9), Tianshu (ST25), and Shuidao (ST28), as well as the sides above the sacrum. After moxa-ing various points, always add 2-3 moxa cones to Jianjing (GB21) each side to prevent Fire Qi from rushing upward.