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Cheng Wuji: Shortness of breath (Duan Qi) is characterized by rapid and shallow breathing, resembling panting (Chuan) but not being panting. Panting involves opening the mouth and raising the shoulders, whereas shortness of breath is merely rapid breathing that cannot continue smoothly; it resembles panting without raising the shoulders, and resembles groaning without pain. Some attribute it to excess patterns (The Classic says: Shortness of breath with abdominal fullness and panting, accompanied by tidal fever, indicates that the exterior syndrome is about to resolve and interior purgation can be applied; this is excess-type shortness of breath). Some attribute it to deficiency patterns (The Classic says: The Dubo pulse is faint and tight; tight indicates cold, faint indicates deficiency. When faint and tight contend together, shortness of breath results; this is deficiency-type shortness of breath). Some locate the pathogen in the exterior (The Classic says: Shortness of breath occurs solely because sweating was incomplete; re-inducing sweating will lead to recovery. If contending with wind-dampness, with sweating leading to shortness of breath, dysuria, and aversion to wind, Gancao Fuzi Tang [Licorice and Aconite Decoction] is indicated; this is shortness of breath due to pathogens in the exterior). Some locate the pathogen in the interior (The Classic says: Dry retching, shortness of breath, sweating, and absence of aversion to cold indicate that the exterior has resolved but the interior is disordered; Shizao Tang [Ten Jujube Decoction] is indicated. Or, if a physician incorrectly applied purgation to a Taiyang disease, resulting in shortness of breath, irritability, mental vexation, epigastric hardness, and formation of chest binding (Jie Xiong), Daxiexiong Tang [Major Emoda Chest-Binding Decoction] is indicated; this is shortness of breath due to pathogens in the interior). Treatments vary accordingly. Generally, shortness of breath belongs to excess patterns. *Jin Gui Yao Lue* states: Shortness of breath where respiration is insufficient indicates an excess pattern. Furthermore, fluid retention in the heart region also causes shortness of breath. *Jin Gui Yao Lue* states: Consuming little food but drinking much water leads to fluid retention in the heart region; mild cases manifest as shortness of breath. Scholars must carefully examine and distinguish these.

Exterior Syndromes: Shortness of breath, joint pain with inability to flex or extend, sweating, dysuria, aversion to wind, and bodily edema indicate wind-dampness, suitable for Gancao Fuzi Tang [Licorice and Aconite Decoction] (Formula discussion see Body Pain section). Shortness of breath, abdominal fullness, and hypochondriac pain, where the patient presents with wiry, floating, and large pulses, unresolved exterior, anhidrosis, somnolence, jaundice, difficult urination, and tidal fever, are treated with Xiaochaihu Tang [Minor Bupleurum Decoction] (Discussion see Stomach Excess, Formula see Alternating Chills and Fever section).

Interior Syndromes: If the exterior is unresolved, with continuous sweating on the hands and feet, or tidal fever, Dachengqi Tang [Major Rhubarb Decoction] is suitable (Formula discussion see Tidal Fever section). If the exterior has resolved, with epigastric stuffiness and hardness, dry retching, and shortness of breath, Shizao Tang [Ten Jujube Decoction] is suitable (Formula see Hypochondriac Fullness and Pain section).

Incomplete Sweating: Shortness of breath and irritability. If sweating was incomplete, with continued slight sweating, no aversion to cold, unresolved exterior symptoms, and facial redness, it constitutes a combined disease; re-inducing sweating will lead to recovery (Discussion see Facial Redness section).

After Purgation: If after purgation there is mental vexation and epigastric hardness/pain, Daxiexiong Tang [Major Emoda Chest-Binding Decoction] is used (Discussion see Chest Binding section).

Diagnosis: The Dubo pulse is faint and tight; tight indicates cold, faint indicates deficiency. When faint and tight contend together, shortness of breath results. Sitting while leaning forward indicates shortness of breath.

Appendix:
Tao Hua: In typhoid diseases, failure to induce sweating or purgation, or post-sweating/purgative deficiency causing rebellious qi that fails to connect continuously, is termed shortness of breath. It must be treated by distinguishing excess and deficiency. This is distinct from panting syndromes.
Wu Qian: Following sweating, vomiting, or purgation, if primordial qi is weak, the pulse is faint and deficient, and qi fails to connect resulting in shortness, Renshen Yiqi Tang [Ginseng Qi-Boosting Decoction] is used. For any yin syndromes with weak, fine, deep, and slow pulses, cold extremities, aversion to cold on the face as if scraped by a knife, and difficulty in distributing breath through the mouth and nose leading to shortness, Sini Tang [Recovery the Lost Yang Decoction] added with Renshen [Ginseng] is primarily indicated. Additionally, consuming little food but drinking much water, causing fluid retention in the heart region which leads to shortness of breath and mental distress, is treated with Fuling Gancao Tang [Poria and Licorice Decoction].