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Liu XX from Yanshan, aged 25, suffered from shortness of Qi (Shortness of Breath) caused by blood stasis.

Etiology: Due to working outdoors and exerting effort to lift heavy objects, he initially felt pain in the hypochondrium. After a few days, the pain subsided, but he continued to feel an obstruction in the hypochondrium hindering respiration.

Symptoms: His physique was originally robust. Since falling ill, after delaying for half a year, he gradually became emaciated and weak. He often felt an object obstructing the flow of Qi under the right hypochondrium. When speaking with others, he would often stop at half a sentence, waiting for the Qi to rise before continuing. If he became angry occasionally, the symptoms worsened. The pulse was near normal, but slightly weak and lacking smoothness.

Diagnosis: This is due to excessive exertion, causing blood that does not follow its normal course to stagnate within the meridians of the Liver Channel (Liver Meridian), blocking the pathway for the ascending and descending of Qi. Fortunately, although the pulse is slightly weak, it still has strength to support the body. One can use only herbs that resolve blood stasis to slowly dissolve the stasis, and the Qi will naturally become regulated.

Prescription: Panax Notoginseng Radix et Rhizoma (Guang Sanqi) (4 liang)

Pulverized into fine powder. Take 1 qian and 5 fen per dose, delivered with decoction made from 3 qian of raw Maltae Fructus (Sheng Maiya). Administer twice daily.

Formula Analysis: Panax Notoginseng Radix et Rhizoma is a supreme herb for stopping abnormal bleeding and also for resolving blood stasis. Moreover, it resolves stasis without damaging new blood; taking it alone for a long time causes no harm. It is a unique category among herbs, its efficacy being truly inconceivable. I have frequently used it to eliminate long-standing blood stasis, always achieving success. As for Maltae Fructus (Maiya), it is originally used for digesting food; when boiled raw, it is good at soothing Liver Qi and can also resolve stasis. Therefore, it is used as a decoction to deliver the Panax Notoginseng Radix et Rhizoma.

Outcome: After four days of taking the medicine, a strand of purple blood was discharged from the nostrils, and breathing became smoother. Continuing to take the medicine until it was exhausted, he recovered completely.

Interrogation: Someone asked, "Respiration resides in the Lung, yet you now say that accumulated blood stasis in the Liver Channel can hinder respiration. What is the rationale?" I replied: "According to physiology, respiratory Qi can reach the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel). Medical texts also state that exhalation is governed by the Heart and Lung, while inhalation is governed by the Kidney and Liver. If one claims that respiration is limited solely to the Lung, then both aforementioned statements could be discarded. In fact, the Heart, Lung, and Liver are originally connected in a system, which further connects downward to the Chong and Ren vessels. Within the connection between the Heart and Lung, there are originally two tubes: one is the arterial tube (blood vessel), and the other is the venous tube (return vessel). The arterial tube descends, and the venous tube ascends. The Lung is the organ initiating respiration, but respiration is not limited to the Lung. Thus, inhaled Qi can descend via the arterial tube, and exhaled Qi can ascend via the venous tube. Regardless of whether Qi ascends or descends, it passes through the Liver. Therefore, blood stasis in the Liver Channel hinders the ascending and descending of Qi. Based on this argument, while respiration relates greatly to the Lung, the system connecting the Heart and Lung also manages branches of respiration."