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Treatment for conditions where the Yang Qi of the Heart and Lungs is deficient, and the Vast Qi (Zong Qi) in the chest has sunk. The patient feels coldness in the heart region, tightness in the back, aversion to cold, and frequently experiences shortness of breath.

Sheng Huangqi (Raw Radix Astragali, 8 qian) Gan Jiang (Dried Rhizoma Zingiberis, 6 qian) Danggui Shen (Radix Angelicae Sinensis Root Body, 4 qian) Guizhi Jian (Cortex Cinnamomi Ramulus Tip, 3 qian) Gancao (Radix Glycyrrhizae, 1 qian)

The thermal energy throughout the body relies on the Yang Qi of the Heart and Lungs to be disseminated and unblocked; the Yang Qi of the Heart and Lungs, in turn, relies particularly on the Vast Qi (Zong Qi) in the chest for protection. Once the Vast Qi sinks, those whose Yang division of the Heart and Lungs was already deficient will become even more deficient at this point. To assist the Yang Qi of the Heart and Lungs, if one does not know how to lift the sunken Vast Qi, even taking heat-inducing medicines daily will be ineffective.

One might ask: The Heart belongs to Fire, and Western medicine also posits that all thermal energy in the body originates from the Heart, so its ability to disseminate heat throughout the body should be appropriate. Now, discussing insufficient thermal energy in the body, why is it said that the Yang Qi of both the Heart and Lungs is deficient? The answer is: The Lung and Heart reside together above the diaphragm. The blood vessels of the left atrium and the venous return vessels of the right atrium are both connected to pulmonary circulation. There is originally a subtle mutual assistance between these two organs in disseminating thermal energy. However, there must be Vast Qi (Zong Qi) to facilitate and rotate this process for its function to manifest.

Note: Yu Jiayan, in *Yi Men Fa Lv* (Legal Laws of Medicine), highly emphasized the importance of the Yang Qi of the Heart and Lungs, stating that when the Yang Qi of the Heart and Lungs is vigorous, the fire of the Yin division naturally lies dormant. Chen Xiuyuan later expanded on this view, stating that the downward assistance of the Yang Qi of the Heart and Lungs greatly warms the Spleen and Stomach to digest phlegm-fluids. These are indeed accurate discussions.

A boy, aged thirteen or fourteen, felt coldness in both his mind/heart and body. His food did not digest, and he frequently experienced shortness of breath. Regardless of what heat-inducing medicines he took, he felt no warmth whatsoever. His pulse was weak, thready, and slow, with the right side additionally being deep. It was determined that the Yang division of the Heart and Lungs was damaged and deficient, and the Vast Qi had sunk. This decoction was prepared. After taking five doses, the shortness of breath was cured, and the body and mind were no longer as cold as before. The dosage of Guizhi was then halved, and after taking several more doses, full recovery was achieved. He was instructed to stop the decoction and take small amounts of raw Shihuang (Sulfur) daily to consolidate the results.

A person, over fifty years old. After a fit of great anger, dysentery persisted for over a month before healing. Since then, the chest often felt full and stifled, and food could not be digested. Several times doctors were consulted and medicines prescribed, which were nothing but agents to unblock the Qi division. Even when warming and tonifying the Spleen and Stomach were occasionally used, they were invariably mixed with Qi-breaking drugs. The more medicine was taken, the heavier the illness became. Later, I examined him. His pulse was deep, fine, minute, and weak, with a very slow rate. Inquiring about his heart, he reported often feeling cold within. It was determined that the Vast Qi in the chest had sunk, accompanied by deficiency and damage of the Yang division in the Upper Jiao. This decoction was administered, and after ten doses, full recovery was achieved. Later, due to anger, the illness relapsed. A doctor used my prescription, adding Houpo (Cortex Magnoliae Officinalis, 2 qian). After taking it, the lower abdomen sank and hurt, and he could not sleep all night. He sought my help again. The original prescription was administered once more, and he recovered.

An elderly woman surnamed Zhao, nearly fifty years old, suddenly fainted and lost the ability to speak. Her breathing was significantly obstructed, almost to the point of cessation. Her pulse was weak, thready, and slow. Inquiring into her life history, she was physically frail, greatly feared cold, often felt chest fullness, and frequently experienced shortness of breath. By cross-referencing her innate constitution with her current symptoms, it was undoubtedly a case of Vast Qi sinking complicated by Cold-Fluid binding in the chest. However, the situation threatened to develop into Phlegm-Jue (Phlegm Obstruction Syndrome). Living in a rural area, obtaining medicine would take too long. Therefore, hastily using Hu Jiao (Fructus Piperis Nigris, 2 qian) crushed and decocted for two or three boils, the clear liquid was extracted and forced down her throat. Soon, sounds were heard in the chest, and breathing immediately became smooth. Subsequently, Gan Jiang (Dried Rhizoma Zingiberis, 8 qian) was decocted in a cup of water. At this time, she was able to drink it herself. Soon, her breathing became even smoother, and her spirit cleared slightly, but she still could not speak, frequently yawned, and sighed deeply every ten or twelve breaths. It was determined that although the Cold-Fluid had been opened, the sunken Vast Qi had not yet recovered. Thus, my formulated Huiyang Shengxian Tang (Decoction for Restoring Yang and Lifting Sunken Qi) was administered. After several doses, the yawning and sighing ceased, and she gradually regained the ability to speak.

Note: In this condition, initially using only Gan Jiang to open the Cold-Fluid without assisting it with descending drugs like Zheshi (Hematitum) and Houpo was because Cold-Fluid binding in the chest was complicated by Vast Qi sinking. If the syndrome differentiation were unclear and these drugs were mistakenly used, fatal danger would appear immediately. This highlights the necessity of careful syndrome examination.