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Treats deficiency of both Yin and Yang, with panting and counterflow that is urgent and hurried, showing signs of impending collapse. It also treats Kidney deficiency failing to secure, where Qi from the Chong vessel attacks upward, causing Stomach Qi to fail to descend and resulting in fullness and oppression.

Ye Tai Shen (Wild Rhizoma Panacis Japonici, 4 qian) Sheng Zhe Shi (Raw Haematitum, 6 qian, finely crushed) Sheng Qian Shi (Raw Semen Euryales, 5 qian) Sheng Shan Yao (Raw Rhizoma Dioscoreae Oppositae, 5 qian) Yu Rou (Flesh of Fructus Corni, 6 qian, pits completely removed)
Sheng Long Gu (Raw Os Draconis, 6 qian, pounded into fine powder) Sheng Mu Li (Raw Concha Ostreae, 6 qian, pounded into fine powder) Sheng Hang Shao (Raw Radix Paeoniae Albae, 4 qian) Su Zi (Fructus Perillae, 2 qian, stir-fried and pounded)

Sheng Zhe Shi has the strongest descending pressure; it can suppress the counterflow of Stomach Qi and Chong Qi, open the chest and diaphragm, sink phlegm and saliva, stop vomiting, and unblock dry constipation. When used appropriately, it indeed yields rapid effects. For deficiency patterns, it can be used together with Ren Shen.

In Zhang Zhongjing's Xuan Fu Dai Zhe Shi Tang, Zhe Shi and Ren Shen are used together. It treats "after Han syndrome treated by sweating, or after treatment by emesis or purgation, epigastric stuffiness and hardness, with persistent belching." In this formula (Shen Zhen Zhen Qi Tang), Ren Shen borrows the descending power of Zhe Shi to rescue Yuan Qi on the verge of collapse, thereby stabilizing and anchoring it, which also aligns with the principle of Xuan Fu Dai Zhe Shi Tang.

A woman in her thirties, after mental exertion compounded by emotional injury to the Heart, suddenly suffered severe panting and counterflow, extremely urgent. Her father-in-law, who knew medicine, treated her with herbs to tonify and astringe Yuan Qi, but she felt chest obstruction and could not tolerate the medication. Another doctor diagnosed an external contraction and administered a small dose of Da Qing Long Tang, which worsened the panting. Upon my consultation, her pulse was floating and slightly rapid, vanishing upon heavy pressure, indicating a pattern of deficiency of both Yin and Yang. Since Yang deficiency fails to self-secure Yuan Qi, and Yin deficiency causes the Liver and Kidney to fail to grasp Qi, panting ensues. I prepared this decoction for her. After taking one dose, before finishing the cup, she said, "I have life now." Upon inquiry, she stated, "Previously, breathing was only in the throat, nearly collapsing; now the Qi has descended to the Dantian." Indeed, one dose cured more than half the illness, and after several more doses, she fully recovered.

Another woman in her twenties, due to a quarrel with her husband, swallowed opium out of anger. Although saved, she suddenly developed severe panting and counterflow, extremely urgent. Moments later, breathing stopped abruptly, with no breath remaining. After approximately ten breaths' worth of time, her limbs moved chaotically, as if accumulating extreme force, after which the panting resumed as before. This cycle continued endlessly, approaching critical danger. Several doctors were consulted but did not know the disease. Later, I examined her pulse: the Left Guan position was wiry and hard, and the Right Cun position was powerless. After deep reflection, I suddenly realized: "This must be anger stimulating Fire of the Liver and Gallbladder, rushing upward to attack Stomach Qi. Stomach Qi naturally descends; because of the assault by Liver-Gallbladder Fire, it reverses and flows upward, forcing Lung Qi to also reverse upward. This is the origin of the urgent panting and counterflow. The counterflow Qi attacks upward, filling the chest and diaphragm, squeezing the Great Qi in the chest downward. The Lung hangs in the chest; without the enveloping support of Great Qi for even a moment, respiration cannot occur. This is the origin of the abrupt cessation of breathing (this principle becomes clear when referring to the postscript of Sheng Xian Tang). When Great Qi accumulates to its limit and then opens, it still reaches the chest and diaphragm, stirring the Lung, allowing respiration to resume. The counterflow Qi then continues its impact, which is why the disease condition cycles. *Shennong Bencao Jing* records that Gui Zhi treats upper Qi cough and counterflow, constrained Qi, sore throat, and spitting inhalation (inhaling without returning to the root, i.e., spitting out); thus, its ability to descend counterflow Qi is known. Its nature is warm and unobstructed; it can descend counterflow Qi and also raise Great Qi. Therefore, I used only Gui Zhi Jiao (tips of Cinnamomi Ramulus) 3 qian, decocted in water and drunk. Within moments, breath harmonized as usual. With just the slight power of Gui Zhi, it achieves both raising collapsed Qi and descending counterflow, rescuing human life in an instant. Truly, Heaven alone produces such a unique herb! However, unless one has personally experienced it, who would believe its efficacy so miraculous? Subsequently, Shen Zhen Zhen Qi Tang was used, removing Shan Yao and Su Zi, adding Gui Zhi Jiao 3 qian and Zhi Mu 4 qian. After several doses, the illness did not recur. This is a special type of panting syndrome, so it is recorded here.

Appendix:
Letter from Zhang XX of Qing County, Zhili:
The wife of Wu XX of Ding County was ill, and medications had no effect. I diagnosed her pulse as floating and powerless. There was郁结 (stagnation/constraint) in the chest, as if something were blocking it. When food reached the stomach, it often felt hot and failed to descend. Mimicking the principle of Shen Zhen Zhen Qi Tang, I used Ye Tai Shen 6 qian and Zhe Shi fine powder 2 liang. Decocting and administering these two herbs, the chest immediately felt open. After two doses, food descended without obstruction. Because the stool remained dry, I added Dang Gui and Rou Cong Rong, each 4 qian, to be decocted and taken together. The illness disappeared.

Letter from Zhang XX of Jixi County, Anhui:
Hong XX, over fifty years old, came from a poor family, had previously smoked opium, and had quit for only a few years. He developed panting from chronic cough. Forced to work hard, the condition worsened every winter, though attacks often resolved spontaneously without medication. This time, the panting started with an external contraction, accompanied by fever and headache. The physician prescribed large doses of Bie Huo (Qiang Huo and Du Huo), Fang Feng, and Ge Gen to disperse the exterior extensively. This resulted in continuous sweating for two days, urgent panting and counterflow preventing lying flat, chest stuffiness and abdominal distension, no bowel movement for over ten days, speech interrupted by lack of breath, and occasional convulsions. Various signs indicated a critically dangerous state. His pulse was faint and fine, barely rising. His physical appearance was severely decadent. Detailed examination confirmed the fear of separation of Yin and Yang. Fortunately, having recently read the explanation of Zhe Shi and remembering its indications, I suspected it fit well. However, fearing its heavy sedative nature might cause Zheng Qi to sink further, I hesitated repeatedly. Finally, I combined it with Zhen Lu Dang Shen, Sheng Huai Shan Yao, Ye Fu Shen, Jing Yu Rou, Guang Ju Hong, Jing Ban Xia, Long Gu, Mu Li, Su Zi, and Niu Bang Zi. All were prescribed according to the syndrome, and the formula was largely identical to Shen Zhen Zhen Qi Tang. One dose cured more than half the illness; two doses allowed him to walk with a cane; three doses restored him to health. Meeting him last month, he said he no longer feared cold in winter, nor did the illness recur in spring.