bubble_chart Concept

Panting, abbreviated as "喘" (chuan), is a clinical symptom characterized by rapid breathing. In severe cases, it may even involve open-mouth breathing, shoulder lifting, flaring of the nostrils, and an inability to lie flat. It is commonly seen in the course of various acute and chronic sexually transmitted diseases.

Panting has been referred to by many names in historical medical texts. For example, in Suwen, it is called "喘息" (chuan xi) or "喘逆" (chuan ni); in Jingui Yaolue, it is referred to as "abnormal rising of qi"; in Zhubing Yuanhou Lun, it is called "逆氣" (ni qi); and in Jingyue Quanshu, it is termed "panting".

In medical literature before the Jin and Yuan dynasties, there was no strict distinction between panting and wheezing, and the two were often conflated. However, they differ in terms of disease cause, mechanism of disease, and clinical manifestations, and thus should be distinguished. Wheezing has a deep-rooted cause and manifests as episodic phlegm-induced panting, characterized by rapid breathing and wheezing sounds in the throat; whereas panting often occurs in conjunction with various acute and chronic sexually transmitted diseases, involving rapid breathing but without wheezing sounds in the throat. Yixue Zhengzhuan ．asthma states: "Generally, wheezing is named for the sound, while panting is named for the breath. Panting with a sound like a water chicken in the throat is called wheezing; rapid and continuous breathing that cannot be controlled is called panting." This shows that wheezing must involve panting, but panting does not necessarily involve wheezing.

bubble_chart Syndrome Analysis

1. Kidney Deficiencyphlegm Obstruction︰Symptoms include wheezing and coughing, shortness of breath, more breathing and less breathing, more phlegm and chest tightness, accompanied by soreness in the waist and cold limbs, frequent urination, white and greasy tongue coating, and a thin and slippery pulse. It also has the symptoms of excessive phlegm and saliva. The mechanism of disease is that phlegm and saliva accumulate in the upper part and kidney qi is lost in the lower part. The treatment should be descending qi and resolving phlegm, which warms the kidneys and absorbs less. Use Perilla Fruit Qi-Descending Decoction to add or subtract.
2. Kidney Deficiencyphlegm Obstruction︰Symptoms include wheezing and coughing, shortness of breath, more breathing and less breathing, more phlegm and chest tightness, accompanied by soreness in the waist and cold limbs, frequent urination, white and greasy tongue coating, and a thin and slippery pulse. It also has the symptoms of excessive phlegm and saliva. The mechanism of disease is that phlegm and saliva accumulate in the upper part and kidney qi is lost in the lower part. The treatment should be descending qi and resolving phlegm, which warms the kidneys and absorbs less. Use Perilla Fruit Qi-Descending Decoction to add or subtract.
3. Kidney Deficiencyphlegm Obstruction︰Symptoms include wheezing and coughing, shortness of breath, more breathing and less breathing, more phlegm and chest tightness, accompanied by soreness in the waist and cold limbs, frequent urination, white and greasy tongue coating, and a thin and slippery pulse. It also has the symptoms of excessive phlegm and saliva. The mechanism of disease is that phlegm and saliva accumulate in the upper part and kidney qi is lost in the lower part. The treatment should be descending qi and resolving phlegm, which warms the kidneys and absorbs less. Use Perilla Fruit Qi-Descending Decoction to add or subtract.
4. Kidney Deficiencyphlegm Obstruction︰Symptoms include wheezing and coughing, shortness of breath, more breathing and less breathing, more phlegm and chest tightness, accompanied by soreness in the waist and cold limbs, frequent urination, white and greasy tongue coating, and a thin and slippery pulse. It also has the symptoms of excessive phlegm and saliva. The mechanism of disease is that phlegm and saliva accumulate in the upper part and kidney qi is lost in the lower part. The treatment should be descending qi and resolving phlegm, which warms the kidneys and absorbs less. Use Perilla Fruit Qi-Descending Decoction to add or subtract.
5. Kidney Deficiencyphlegm Obstruction︰Symptoms include wheezing and coughing, shortness of breath, more breathing and less breathing, more phlegm and chest tightness, accompanied by soreness in the waist and cold limbs, frequent urination, white and greasy tongue coating, and a thin and slippery pulse. It also has the symptoms of excessive phlegm and saliva. The mechanism of disease is that phlegm and saliva accumulate in the upper part and kidney qi is lost in the lower part. The treatment should be descending qi and resolving phlegm, which warms the kidneys and absorbs less. Use Perilla Fruit Qi-Descending Decoction to add or subtract.
6. Kidney Deficiencyphlegm Obstruction︰Symptoms include wheezing and coughing, shortness of breath, more breathing and less breathing, more phlegm and chest tightness, accompanied by soreness in the waist and cold limbs, frequent urination, white and greasy tongue coating, and a thin and slippery pulse. It also has the symptoms of excessive phlegm and saliva. The mechanism of disease is that phlegm and saliva accumulate in the upper part and kidney qi is lost in the lower part. The treatment should be descending qi and resolving phlegm, which warms the kidneys and absorbs less. Use Perilla Fruit Qi-Descending Decoction to add or subtract.
7. Failure of Kidney to Receive Qi︰The symptoms include panting for a long time, shortness of breath, more exhalation and less inhalation, especially when moving, accompanied by soreness and weakness in the waist and knees, green face and cold limbs, light tongue texture, and heavy and thready pulse. It is caused by insufficient kidney yang, loss of intake and absorption, and failure of Qi to return to the original state. Therefore, excessive breathing and short breathing are accompanied by soreness and weakness in the waist and knees, green complexion, cold limbs and other symptoms of kidney yang deficiency. The difference between the two syndromes lies in the symptoms of kidney yang deficiency.
8. Kidney Deficiencyphlegm Obstruction︰Symptoms include wheezing and coughing, shortness of breath, more breathing and less breathing, more phlegm and chest tightness, accompanied by soreness in the waist and cold limbs, frequent urination, white and greasy tongue coating, and a thin and slippery pulse. It also has the symptoms of excessive phlegm and saliva. The mechanism of disease is that phlegm and saliva accumulate in the upper part and kidney qi is lost in the lower part. The treatment should be descending qi and resolving phlegm, which warms the kidneys and absorbs less. Use Perilla Fruit Qi-Descending Decoction to add or subtract.
9. Edema Due to Yang Deficiency︰Symptoms include wheezing, coughing, shortness of breath, inability to lie down, palpitation fear of cold, sore waist and cold limbs, oliguria, edema, fat and light tongue texture, white and slippery coating, and heavy and fine pulse manifestation. It has symptoms such as palpitation, oliguria, and edema. The mechanism of disease is insufficient kidney yang, water failing to transform into qi, and ascending heart and lungs. To treat warming yang and excreting water, choose True Warrior Decoction.

The clinical differentiation of panting primarily lies in distinguishing between deficiency and excess. Jingyue Quanshu states: "Panting is a critical condition; failure to treat it correctly often leads to mistakes. To differentiate, there are only two syndromes: one is excess-type dyspnea, and the other is deficiency-type dyspnea." This clearly emphasizes the importance of distinguishing between deficiency and excess in panting. The common characteristics of excess-type dyspnea include a sudden onset, deep and prolonged breathing with ease in exhaling, coarse and loud breathing sounds, and a rapid, forceful pulse. The common characteristics of deficiency-type dyspnea include a gradual onset, short and difficult breathing with ease in inhaling, worsened panting upon exertion, timid and low breathing sounds, and a weak or floating and feeble pulse. Linzheng Zhinan Yi'an mentions: "In the lungs, it is excess; in the kidneys, it is deficiency." Therefore, the treatment for excess-type dyspnea focuses on expelling pathogenic factors and regulating qi, with emphasis on the lungs. The treatment for deficiency-type dyspnea focuses on nourishing and consolidating, with emphasis on the kidneys. As for complex cases involving both deficiency and excess, it is essential to differentiate the primary and secondary aspects, assess the urgency, and apply syndrome/pattern differentiation and treatment accordingly.

bubble_chart Documentation

1. Shengji Zonglu．cold-damage disease section: "It is said that cold-damage disease panting has various symptoms. There are cases where pathogenic qi is on the surface, the surface is not resolved without sweating and panting occurs; there are cases where pathogenic qi is inside, sweating occurs without aversion to cold, abdominal distension and fullness and panting occurs. There are cases with tidal fever. There are cases where there is water below the heart and panting occurs. The ancients treated it, each seeking its root. Therefore, those on the surface should be treated with sweating, those inside should be treated with purging, and as for those with water below the heart and panting, they should be treated by promoting urination."
2. Zhengyin Maizhi．Panting syndrome discussion: "All meridians can cause panting, but it mostly occurs in the lung and stomach. Panting with cough and phlegm is due to the lung; panting with vomiting is due to the stomach."
3. Zhengyin Maizhi．External contraction panting: "Summerheat dampness panting and counterflow syndrome, restless thirst, rough breathing, talkativeness, heavy body, sweating but still feeling hot, this is the panting syndrome of summerheat dampness."
4. Zhengyin Maizhi．Internal damage panting: "Food accumulation panting and counterflow syndrome, chest fullness, epigastralgia abdominal pain, aversion to food and feeling of fullness, constipation or diarrhea, abnormal rising of qi panting and counterflow, panting vomiting and belching, this is the panting and counterflow syndrome of food accumulation."
5. Jingyue Quanshu．Panting: "The syndrome of anuria and vomiting causing panting,... the disease must have weak interior pulsation and continuous panting. This type of panting often has no cough, but feels like the chest and diaphragm are pounding, seemingly distended but not distended, seemingly short but not short, slightly exerting oneself causes severe panting, talking too much also causes severe panting, even to the point of the whole body trembling, anxious and restless, this must be due to emotional desires damaging yin, leading to the original qi being rootless, a sign of solitary yang separation."