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The treatment of panting and shortness of breath (Chuan Cu Zheng) requires classification. For symptoms of rapid breathing with upward rushing Qi, differentiation and specific treatment are necessary.
Rough-and-ready practitioners only use Zhenyuan Yin (Nourishing Decoction). Zhenyuan Yin is indicated for conditions where Blood deficiency leads to Qi having no attachment; this decoction is used to nourish and soothe the condition. The moistening properties of Shu Di Huang (Prepared Rehmannia Root) and Dang Gui (Angelica Sinensis) in the formula serve to nourish; the sweet and relaxing nature of Gan Cao (Licorice Root) serves to relieve urgency. This is a tonic for daily maintenance, not an emergency rescue formula. Nowadays, when physicians encounter symptoms of impending collapse of Yuan Qi (Original Qi) with upward rushing Qi, they often prescribe this decoction, thereby hastening the crisis, which is truly lamentable!
When Yin pathogens prevail, Long Lei Fire (Ministerial Fire from the Kidney) rushes forth. Panting syndromes often belong to disorders of Fluid Retention (Yin Pathogen). Since Fluid Retention is a Yin pathogen, unless the sun shines brightly (Yang Qi is sufficient), how can the myriad Yins retreat? If one uses herbs like Di Huang (Rehmannia Root) to support and harmonize Yin, then Yin mist will rush and rebel unchecked, Fluid Retention will surge uncontrollably beyond salvation, and the fire of Long Lei will consequently gallop even more fiercely.
Excess-type panting is aided by Phlegm-Fluids. In excess-type panting, if Wind-Cold is not resolved and Phlegm-Fluids act as internal support, severe coughing ensues, leading to the onset of panting.
Ting Li Da Zao Xie Fei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung) and Shi Zao Tang (Ten Date-Dates Decoction) are indicated. For panting caused by Excess of Lung Qi and obstruction of the Qi pathways, Ting Li Da Zao Xie Fei Tang is the primary formula. For coughing, panting, retention of fluids beneath the heart, and fullness/pain in both hypochondria, Shi Zao Tang is the primary formula.
Qing Long (Azure Dragon) type formulas, such as Xiao Qing Long Tang, resolve the exterior and simultaneously promote urination, treating combined interior-exterior pathogens by addressing them from both sides.
Deficiency-type panting requires tonification and warming. Deficiency-type panting involves shortness of breath with inability to sustain inhalation, and a deficient, fine, and weak pulse. The characters "Wen" (Warm) and "Bu" (Tonify) should be read together. Some achieve tonification through warming, while others achieve warming through tonification. One must absolutely avoid the approach of Zhenyuan Yin, which risks stagnating Phlegm-Saliva.
Gui Ling (Cinnamon and Poria) types and discussions on Shen Qi Wan (Kidney Qi Pill): Zhang Zhongjing stated: "For shortness of breath accompanied by slight fluid retention, it is appropriate to eliminate it via urination; Gui Ling Zhu Gan Tang (Poria, Cinnamon, Atractylodes, and Licorice Decoction) is the primary formula, and Shen Qi Wan is also indicated."
To calm rebellious Qi and drain Ben Tun (Running Piglet) syndrome: For rebellious Qi rushing upward, Xiao Ban Xia Jia Fu Ling Tang (Pinellia, Ginger, and Poria Decoction) is used to descend it. At the onset of Ben Tun syndrome, there is moving Qi below the umbilicus; if prolonged, it rushes upward to the heart. Fu Ling Gui Zhi Gan Cao Da Zao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction) is used to calm it.
Zhen Wu Ji (Zhen Wu Formulations) treat the root cause. The Classics state: "The branch is in the Lung, the root is in the Kidney." Zhen Wu Tang (True Warrior Decoction) treats the source of panting.
Jin Shui Mu (Mother of Metal and Water) governs all Kun (Earth/Spleen-Stomach). The Lung belongs to Metal and governs the upper; the Kidney belongs to Water and governs the lower. Deficiency-type panting is a critical sign of the failure of Heaven (Lung/Metal) and Water (Kidney/Water) to interact. Treating disease requires seeking its root. One must understand that Heaven and Water are one Qi, but situated within them is Kun Earth (Spleen/Stomach). Moreover, Earth is the mother of Metal, and Metal is the mother of Water. In critical conditions, the Spleen and Stomach must be the primary focus.
Liu Jun Zi Tang (Six Gentlemen Decoction) has wonders hard to describe. Liu Jun Zi Tang added with Wu Wei Zi (Schisandra Berry), Gan Jiang (Dried Ginger), and Bei Xi Xin (Asarum) is a miraculous agent for treating panting. Add Xing Ren (Apricot Seed) if facial edema is present; add Da Huang (Rhubarb) if the face is hot as if intoxicated. When contemporary physicians hear this method, they are invariably shocked. Only those who have studied the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) will know that my words are not erroneous.
Other branch-treating agents forget the root. Only Hei Xi Dan (Black Tin Pill) can anchor and grasp Yuan Qi; it is an essential formula for treating panting. Other formulas such as Su Zi Jiang Qi Tang (Perilla Fruit Descending Qi Decoction), Ding Chuan Tang (Calming Panting Decoction), and Chen Xiang Hei Qian Dan (Aloeswood and Black Lead Pill) are harmful agents.