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Wheezing caused by Cold Damage, how should it be elucidated? The Lung governs Qi. When the body is exposed to cold or when cold drinks are ingested, the Lung is injured. Consequently, Lung Qi rebels and moves upward, surging with急促 (rapid) breathing, panting with frequent respiration, opening the mouth and raising the shoulders, shaking the body, and rolling the abdomen. This is defined as wheezing (Chuan). In Cold Damage, wheezing may arise because pathogenic factors are in the Exterior, causing Qi obstruction; or it may arise because Water-Qi attacks the Lung. These situations differ. For patients with a chronic history of wheezing who experience an attack, Guizhi Jia Houpo Xingren Tang (Cinnamon Twig Decoction plus Magnolia Bark and Apricot Seed) should be used. In Taiyang Disease (Disease of the Taiyang Channel), characterized by headache, fever, body ache, lower back pain, joint pain, aversion to wind, absence of sweating, and wheezing, diaphoretic therapy (Fahan) should be employed. If, after inducing sweating, the patient drinks excessive water, wheezing will inevitably occur; similarly, washing the body with cold water can also induce wheezing. In Cold Damage, if there is Water-Qi in the Epigastrium (Xin Xia), presenting with dry heaving, fever, cough, or wheezing, Xiao Qinglong Tang (Minor Blue Dragon Decoction) with Mahuang removed and Xingren added is the primary treatment. This aims to disperse Cold-Water. The Classics state: For those who wheeze and sweat, Gegen Huangqin Huanglian Tang (Kudzu Root, Scutellaria, and Coptis Decoction) should be administered to clear and drain. For those who sweat and wheeze, Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction) should be given to release the exterior and diffuse. How do these two scenarios differ? If pathogenic factors attack internally, causing Qi rebellion and obstruction leading to wheezing, accompanied by sweating due to wheezing, this indicates that pathogens are in the Interior. Although the Exterior syndrome may not yet be resolved, harmonizing methods should not be used. If external pathogenic factors are abundant and obstructive, causing Qi obstruction and wheezing, even if sweating occurs but wheezing persists, this indicates that pathogens are in the Exterior. Even if sweating or purgative therapies have already been applied, diffusing methods may still be used. This represents the profound wisdom of ancient physicians. In Cold Damage, wheezing caused solely by pathogens in the Exterior implies that the Heart and Abdomen must be soft and not hard. However, if abdominal fullness accompanies wheezing, it becomes a indication for purgation. The Classics state: Shortness of breath, abdominal fullness, and wheezing, accompanied by tidal fevers, indicate that the Exterior is resolving and interior excess can be attacked. This is wheezing caused by distension. Alternatively, if internal pathogenic factors are excessive and Zheng-Qi (Upright Qi) is on the verge of collapse, with Qi stagnating and rebelling upward, wheezing also manifests. The Classics state: Fixed gaze, delirious speech, and wheezing with chest fullness indicate death. Furthermore, sweating with wet hair and ceaseless wheezing indicates the exhaustion of Lung Qi; sweating like oil and ceaseless wheezing indicates the exhaustion of Life Gate Fire. All these are untreatable forms of wheezing. When examining illnesses, one must carefully deliberate.

Vomiting caused by Cold Damage, how should it be elucidated? "Ou" (vomiting with sound) refers to the act of vomiting with audible sounds. Commonly referred to as "ou". "Tu" (spitting up) refers to expelling food contents. Therefore, there is "gan ou" (dry heaving without expulsion), but no "gan tu" (dry spitting). Hence, feeling the urge to vomit after eating is called gan ou, whereas expelling food immediately upon entering the mouth is called tu. Thus, the severity of Ou and Tu can be distinguished. Vomiting in Cold Damage may be attributed to Heat or to Cold. Regarding Tu, it is generally said to result from Deficiency-Cold. The Classics state: The defining symptoms of Taiyin Disease are abdominal fullness with vomiting, inability to eat, worsening diarrhea, and spontaneous abdominal pain. It also states: Vomiting occurs due to Deficiency-Cold in the Stomach. However, causes for Ou are different; Ou may stem from Heat, Cold, retained Fluids, or pus in the stomach lining, all of which must be clearly differentiated. Vomiting accompanied by fever indicates the presence of Chaihu Tang (Bupleurum Decoction) syndrome. Da Chaihu Tang (Major Bupleurum Decoction) is indicated for persistent vomiting, urgency in the epigastrium, and slight irritability; this represents vomiting caused by pathogenic Heat. If there is Cold-Fluid above the Diaphragm causing dry heaving, emetics should not be used; instead, warming methods should be applied. For dry heaving with expulsion of saliva and headache, Wuzhuyu Tang (Evodia Decoction) is the primary treatment; this represents vomiting caused by Cold-Pathogens. Vomiting followed by thirst indicates impending resolution; thirst followed by vomiting indicates retained Water in the Epigastrium, belonging to the category of Fluid-Retention syndromes, representing vomiting due to retained fluids. Patients with vomiting caused by abscesses/pus do not require specific treatment; once the pus is expelled, they heal spontaneously. This is vomiting due to pus in the stomach lining. Although such cases vary, generally, when exterior pathogens in Cold Damage attempt to transmit inward, causing rebellious Qi in the Interior, vomiting occurs. Therefore, Shaoyang (Half-Exterior Half-Interior) syndromes often feature vomiting. After three days of Cold Damage, the Yang channels are exhausted, and Yin channels should receive pathogens. If the patient can eat and does not vomit, it indicates that the Yin channels have not received pathogens. Thus, we know that transmission of pathogens to the Interior inevitably leads to vomiting. In the case of Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction), the absence of vomiting and thirst indicates no Heat in the Interior. In the case of Shizao Tang (Elaeagnus Fruit Decoction), dry heaving, shortness of breath, sweating, and aversion to cold being absent indicate that the Exterior is resolved but the Interior is disharmonious. From this, it is evident that vomiting is clearly related to Interior Heat. For diseases involving vomiting, rebellious Qi must be dispersed, and Phlegm-Fluids must be purged. Qianjin Fang states: Patients with vomiting should take fresh ginger frequently; this is the sacred medicine for vomiting, intended to scatter rebellious Qi. Jingui Yaolue states: Banxia (Pinellia Rhizome) is used for vomiting to remove water; once the water is gone, vomiting stops. This intends to purge Phlegm-Fluids. If vomiting is frequent, even if Yangming Syndrome exists, purgatives should not be used, because the Qi is rebellious and has not yet consolidated into Excess. If vomiting is accompanied by a weak pulse, free urination, slight body heat, and cold extremities, it is difficult to treat, indicating severe Deficiency-Cold. Physicians must examine the deficiency or excess of pathogens and the favorable or unfavorable course of the disease before administering medicines. Only then will the treatment principles be correct.