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Any syndrome of deficiency panting (Xu Chuan) is nothing but due to Qi deficiency. Panting caused by Qi deficiency accounts for seven or eight out of ten cases. If one observes that there is no external wind pathogen and no internal excess heat, yet panting occurs, it belongs entirely to the category of deficiency panting. In cases of Spleen and Lung Qi deficiency, the pathology remains in the Middle and Upper Jiao, and the source of transformation (Hua Yuan, referring to the generation of Qi and Blood) is not depleted; thus, the disease is still shallow. However, in cases of Liver and Kidney Qi deficiency, the pathology originates from the Lower Jiao, affecting both the root and the branches, making the disease deep. At this stage, it is imperative to rapidly rescue the root to assist and support the True Qi, so as to potentially restore life. For those who have been ill for a long time and developed panting, or whose panting worsened after long-term use of phlegm-resolving and Qi-moving formulas, or who present with panting and coughing above and diarrhea below, or women who suffer from excessive blood loss postpartum leading to sudden exhaustion of Ying Qi (Nutritive Qi), causing isolated Yang to lack foundation and resulting in panting—this is named "Isolated Yang and Absolute Yin" (Gu Yang Jue Yin), representing a critical state of extreme depletion. Such conditions are already difficult to treat; one must avoid further damaging the foundation.

1. Regarding deficiency panting, if the patient has no other ailments such as wind-cold cough, but suddenly presents with shortness of breath resembling panting, or experiences panting upon slight exertion, hunger, emission of essence, profuse sweating, defecation or urination, recovery from severe illness, or after menstruation in women—with worsening panting, airway obstruction where upper and lower breaths seem disconnected, and a critical, perilous condition—if one observes no pathogenic factors in the exterior or interior, and the pulse is weak and forceless, all such presentations should be primarily treated with Zhenyuan Yin (True Origin Decoction), with modifications according to the base formula, yielding miraculous effects. Additionally, formulas such as Xiaoying Jian (Minor Camp Decoction), Daying Jian (Major Camp Decoction), and Dabu Yuanyuan Jian (Great Tonification of the Original Source Decoction) may be selected as appropriate. The Classic states: "The Liver suffers from tension; urgently feed sweet flavors to relax it," which refers to such cases. If loose stools are accompanied by cold in the lower body, Yougui Yin (Right Restoration Decoction), Yougui Wan (Right Restoration Pill), or Shengshu Jian (Holy Atractylodes Decoction) are suitable.

2. For Spleen and Lung Qi deficiency presenting with slight heat and thirst in the Upper Jiao leading to panting, Shengmai San (Generate the Pulse Powder) is indicated. If there is only Qi deficiency without heat, Dushen Tang (Single Ginseng Decoction) is most appropriate. If fire scorches Lung Metal, causing significant heat in the Upper Jiao, restlessness, thirst, and profuse sweating, with panting due to Qi deficiency, Ren Shen Baihu Tang (Ginseng White Tiger Decoction) is indicated. If the fire resides in the Yin aspect, Yunnv Jian (Jade Maiden Decoction) is indicated, though this pattern typically occurs only in summer. If Yin deficiency causes fire Qi to rush upward from the lower abdomen leading to panting, the method should be tonifying Yin and descending fire, using Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) added with Huangbai (Phellodendron Bark) and Zhimu (Anemarrhena Rhizome).

3. Panting caused by water disorders results from Kidney pathogens interfering with the Lung. Since water cannot transform, the child disease affects the mother; unless Jing-Qi (Essence-Qi) is exhausted, how could it reach this state? Ninety percent of these cases are deficiency patterns, with occasional mixed deficiency and excess patterns. Therefore, when treating water-induced panting, one should not recklessly use attacking drugs. Instead, refer to the treatments in the Edema chapter; once the edema subsides, the panting will naturally settle. Ancient methods for treating panting and inability to lie flat due to water qi accumulating under the heart and ascending to the Lung recommend Shenyi Tang (Mysterious Elixir Decoction) from *Zhizhi Fang*. However, this decoction primarily targets the Qi aspect; it is suitable if the water retention is due to Qi stagnation, but if it is due to Qi deficiency, Jiajian Jingui Shenqi Tang (Modified Golden Chamber Kidney Qi Decoction) should be used.

4. For elderly and frail individuals suffering from long-term Qi deficiency leading to panting, the primary approach should be nourishing the Lung. For patterns with Yin excess, warming and nourishing is appropriate, using herbs such as Ren Shen (Ginseng Root), Dang Gui (Angelica Sinensis Root), Sheng Jiang (Fresh Ginger Rhizome), Rou Gui (Cinnamon Bark), Gan Cao (Licorice Root), possibly added with Bai Zhu (Atractylodes Macrocephala Rhizome) or Cang Zhu (Atractylodes Lancea Rhizome). For patterns with Yang excess, nourishing is appropriate, using herbs such as Ren Shen (Ginseng Root), Shu Di Huang (Prepared Rehmannia Root), Mai Dong (Ophiopogon Tuber), E Jiao (Donkey-hide Gelatin), Wu Wei Zi (Schisandra Berry), pear juice, and cow's milk.

5. Panting caused by Guan Ge (Obstruction and Repletion) syndrome: As stated in the *Su Wen: Chapter on the Six Periods and Viscera Manifestations*, when the Renying pulse is four times larger than the Cunkou pulse, it is called Ge Yang (Repletion of Yang); when the Cunkou pulse is four times larger than the Renying pulse, it is called Guan Yin (Obstruction of Yin); when both Renying and Cunkou pulses are more than four times larger, it is called Guan Ge. This definition of Guan Ge refers to the pulse, not the disease name per se. Many people today suffer from this condition but are unaware of it. Moreover, contemporary practitioners often examine only the Cunkou pulse, disregarding the Renying. If the pulses in both wrists are floating, wiry, and extremely vigorous, reaching more than four times the normal size, this indicates the condition. The pathology necessarily involves palpitations at Xulijump point (Vul Li) and incessant panting. This type of panting usually lacks cough; the patient feels a pounding sensation in the chest and diaphragm, feeling distended yet not truly distended, feeling short of breath yet not truly short of breath. Panting worsens with slight exertion or excessive talking, and may even progress to whole-body trembling and agitation. This is inevitably due to emotional desires injuring Yin, leading to rootless Yuan Qi (Original Qi) and severe separation of isolated Yang—a critical state that is mostly incurable. Detailed discussions on formulas can be found in the Guan Ge chapter.

6. In any case of panting and rapid breathing, if the pulse is weak, fine, and choppy, it indicates deficiency of Yang within Yin; if the pulse is floating, large, wiry, and hollow (Kou), feeling empty upon pressure, it indicates deficiency of Yin within Yang. Generally, if panting is urgent and the patient cannot lie down, accompanied by such pulses, it signifies severe deficiency of Yuan Qi, a sign of impending death. Reckless use of draining or attacking methods will inevitably exacerbate the condition and cause danger. The use of bitter-cold or purgative drugs will lead to immediate death.