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Panting and urgency arise when Qi is constrained by Fire, leading to the accumulation of phlegm in the Lung and Stomach. Individuals who consume rich and fine foods, or those who are overly indulgent with children, easily accumulate heat in the upper Jiao, resulting in panting and coughing; such cases should be treated with sweet and cold formulas. The *Mai Jing* (Classic of Pulse Diagnosis) states: "When Lung Qi is excessive, there will be cough, upward rushing of Qi, panting, thirst, vexation, chest fullness, and shortness of breath. These are all caused by the Fire of the Chong Mai (Penetrating Vessel) moving within the chest; the root lies in the Lower Jiao, not the Upper Jiao." Generally, deficiency patterns in miscellaneous diseases often originate from excess conditions, while pathogenic factors in disease transmission follow a pattern from Root to Branch. Any irregularity in diet, overexertion, unregulated emotions, or consumption of food and drink that is too hot or cold can damage the Six Fu Organs if contracted; these are all due to insufficiency of Middle Qi, manifesting as abdominal distension, fullness, cough, and vomiting of food. Such cases should be treated with large doses of sweet, acrid, and hot formulas. It is also stated: "If the Yin pulse at the Cun position is Excess, it indicates Lung Excess. The Lung will necessarily be distended, with upward rushing of Qi, obstruction in the throat accompanied by vomiting sensations, and spontaneous sweating—all signs of Lung Excess. If the Yin pulse at the right Cun position is Deficient, it indicates Lung Deficiency, manifesting as dry throat without fluids, and insufficient Qi for breathing. However, 'Excess' refers to the excess of pathogenic factors in the Lung, while 'Deficiency' refers to the insufficiency of righteous Qi in the Lung." Therefore, Hua Tuo said: "Excess leads to panting, reduction leads to withering." The *Huo Ren Shu* (Book of Vitality) states: "Panting arises from excess Qi." This does not mean Lung Qi is excessive, but rather that Fire within the Lung is excessive. Thus, bitter and cold formulas are used to drain, not to drain the Lung itself, but to drain the Fire within the Lung, which effectively tonifies the Lung. The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) further states: "In real panting (Shi Chuan), Qi is excess and Lung is盛 (prosperous/excessive), with difficult respiration and blocked lung orifices. If the Cun pulse is deep and excess, draining the Lung is appropriate. In false panting (Xu Chuan), Qi is short and Kidney is deficient, initially feeling short of breath, with fullness in both hypochondria. If the left Chi pulse is large and deficient, this is a Kidney Deficiency syndrome, and treatment should tonify the Kidney. Do not assume children have no desires and thus cannot have Kidney Excess; those with congenital insufficiency are truly deficient." Therefore, excess is cleared from above, and deficiency is warmed and tonified from below. Moreover, treating lower disorders for upper symptoms is a key principle of treatment. Generally, initial panting is mostly due to external causes and should be treated according to the Branch. For example, if due to wind-phlegm obstruction, it must be accompanied by high fever, cough, nasal congestion, and headache; if due to unruptured smallpox/rash, it must be accompanied by convulsions, irritability, body heat, and cold feet; if due to stagnation and distension, it must be accompanied by vomiting, aversion to food, belching with foul odor, and abdominal pain; if due to fright-epilepsy and phlegm-heat, it must be accompanied by twitching and spasms, blueish complexion, and crying; if due to phlegmatic asthma with severe panting, it must occur suddenly in winter/autumn cold, with mouth open and shoulders raised. If it is not the aforementioned symptoms, but occurs after other diseases, it is either "daughter causing mother's deficiency" or simultaneous Spleen and Lung exhaustion, and should mostly be treated according to the Root. Furthermore, shortness of breath resembling panting but not being true panting is harder to categorize with panting. For various panting syndromes that persist and do not heal, one may first use astringent/purgative drugs (Jie Yao) for one or two doses to stop them; after stopping, treat according to phlegm or fire respectively. However, panting and distension are interrelated, both involving difficulty in urination; thus, panting leads to distension, and distension leads to panting. Panting preceding distension indicates the Lung as the primary organ; distension preceding panting indicates the Spleen as the primary organ. The *Jing* (Classic) states: "The Lung governs all vessels, regulates water passages, and transmits downward to the Bladder." It also states: "The Bladder is the official of the capital, storing fluids; only through Qi transformation can they be excreted." This indicates that urination depends on the descending function of Lung Qi. If the Lung is affected by pathogens and pants, it loses its descending command, causing water to overflow into the skin and generate edema/fullness. Here, panting is the Root, and edema is the Branch; treatment should focus primarily on clearing Metal (Lung) and descending Qi, with promoting urination secondary. Additionally, the Spleen governs muscles and dislikes dampness controlling water. If Spleen Qi is deficient and cannot control water, water-dampness acts recklessly, invading muscles externally and overflowing internally upwards, preventing Lung Qi from descending and causing panting. Here, edema is the Root, and panting is the Branch; treatment should focus primarily on strengthening the Spleen and promoting water movement, with clearing Metal secondary. Using drying-Spleen herbs for Lung syndromes will make the Metal drier and panting worse; using cooling-Metal herbs for Spleen syndromes will make the Spleen colder and distension more severe. If panting sounds suddenly erupt like a saw without fever, with eyes rolling up; nostrils, hypochondria, and chest opening wide; abdomen hard with visible green veins, spitting saliva, lack of facial luster, and black lips; panting/wheezing occurring specifically during Zi and Wu hours after other illnesses have slightly improved; panting with urgent eyes, sweat on the black part of the eye, and bluish color at the Yintang point—these are all untreatable cases. If the pulse is slippery and hands/feet are warm, survival is possible; if the pulse is choppy and limbs are cold, death ensues. The *Jing* states: "For panting with wheezing and shoulder lifting, the pulse should be Excess and Large. Slow indicates survival, rapid indicates death." Since panting with wheezing and shoulder lifting is a Yang syndrome, the pulse should be Excess and Large. If Excess and Large but slow, pathogenic factors recede, so survival is possible. If Excess and Large but rapid, pathogenic factors increase, and death is certain.