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Damage to yáng qì; it may be a) due to use of cold bitter medicinals, or sweating, or diarrhea during the course of disease; b) due to direct strike by cold evil or prevalence of internal cold yīn qì, described in Plain Questions (素问 sù wèn, yīn yáng yìng xiàng dà lùn) as When yīn prevails, yáng ails; c) due to sudden joy that causes the heart spirit to float astray and qì to be easily worn and dissipated, causing heart palpitation, fearful throbbing, abstraction, and insomnia.

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