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Xiao (Asthma with wheezing) presents as resembling panting but is not panting; breathing produces sounds, and the throat makes a "ya-xia" noise incessantly. This is due to phlegm knotting in the throat, linked with Qi, so that every opening and closing of the mouth generates sound. This condition arises from phlegm-fire郁结 (stagnating) internally, wind-cold binding externally, and excessive consumption of sour and salty flavors, leading to heat accumulation. One must avoid wind and cold, and regulate rich and strong-flavored foods. If dietary habits are not regulated, the residual phlegm in the chest will combine with new food intake, causing Xiao to recur. The treatment method should utilize herbs such as Su Zi (Perilla Seed), Zhi Ke (Bitter Orange), Jie Geng (Platycodon Root), Fang Feng (Siler Root), Ban Xia (Pinellia Tuber), Gua Lou (Trichosanthes Fruit), Kuan Dong Hua (Coltsfoot Flower), Sang Bai Pi (Mulberry Root Bark), Xing Ren (Apricot Seed), Fu Ling (Poria), Gan Cao (Licorice Root), and Bai Guo (Ginkgo Seed). Cold-natured formulas are contraindicated for fear that external wind-cold cannot be resolved; hot-natured formulas are contraindicated for fear that phlegm-fire will easily ascend. In winter, add Ma Huang (Ephedra Herb); in summer, add Shi Gao (Gypsum Fibrosum); if accompanied by cold, add more Sheng Jiang (Fresh Ginger), focusing on releasing the exterior and dispersing cold.

There is another type where True Qi is extremely deficient, and rootless Qi rushes upward, resembling both Xiao and Chuan (Panting). The patient opens their mouth and widens their eyes, with Qi rushing upward, exhaling much more than inhaling. The treatment method requires vigorous tonification and guiding Qi back to its source. Do not treat only the superficial symptoms, lest the condition become incurable.

For Kidney Xiao with severe and urgent fire, bitter-cold medicines should not be used abruptly. Instead, use warm, astringent methods. Use Jiao Mu (Black Pepper Seed) 5-6 qian, ground into fine powder, taken in 2-3 doses, mixed with Fresh Ginger decoction. After the panting stops, treat the phlegm according to the phlegm, and treat the fire according to the fire. Because if fire is too intense, cold medicines may struggle to control it initially. When the disease is severe, one should not directly clash with the pathology, as this only increases harm. It is like when a thief's momentum is too sharp, one should temporarily avoid the锋芒 (sharp edge) and rely on strategy to overcome it. As stated in the *Classic* (Huangdi Neijing): "When the pathogen is at its peak, it will inevitably be destroyed; because it declines, matters will prosper greatly."

Zhang often treated cases after major illnesses or after smallpox in children, where there was suddenly a sawing sound in the throat, inability to sleep or lie down, with a strong Cun (inch) pulse and weak Chi (cubit) pulse. All such cases were cured using Ba Wei Wan (Eight-Ingredient Pill) added with Niu Xi (Achyranthes Root) and Wu Wei Zi (Schisandra Berry), administered morning and evening, one dose each time.

Dai said: For Tan (Phlegm) syndrome, movement always produces phlegm sounds; for Fire flaming syndrome, symptoms come and go intermittently, improving after eating but worsening after digestion. Generally, this is due to excess fire in the Stomach and thick phlegm above the Diaphragm. Eating causes the phlegm to sink temporarily, stopping the panting; but after a while, food enters the Stomach, further assisting the fire, causing the phlegm to rise again, making the panting worse. Laypeople do not understand this and treat it as Stomach deficiency, using drying and heating medicines, which is adding fire to fire. In the past, someone suffered from this, and treatments for Stomach deficiency failed. Later, they were cured using Dao Shui Wan (Water-Guiding Pill) to promote bowel movements five or six times.

Lou Quanshan treated a woman over fifty years old who had chronic phlegm-fire. Suddenly, she experienced severe panting with phlegm spurting like a spring, sweating like oil, and a floating, surging pulse, appearing as if life was ending. Quickly administer Mai Dong (Ophiopogon Tuber) 2 qian, Ren Shen (Ginseng Root) 3 qian, and Wu Wei Zi (Schisandra Berry) 1.5 qian, decocted and taken orally. The panting settled, sweating stopped, and she recovered.

*Bencao Gangmu* records a man over fifty suffering from Shanghan (Cold Damage) cough, with a sawing sound in his throat. One dose of Du Shen Tang (Single Ginseng Decoction) removed the snoring/wheezing sound. After two or three doses, the cough gradually subsided. After consuming two or three jin of Ginseng, the illness completely healed. Materia Medica states that for treating deficiency-type panting, use Ren Shen alone, ground into powder, mixed with egg white and fresh water, taken as one qian. Two people once walked together, one holding Ren Shen in their mouth, the other not. Both walked three to five li. The one without Ren Shen panted severely, while the one with Ren Shen maintained normal breath. This verifies the ability of Ren Shen to stabilize panting.

Xiao (Asthma with wheezing) occurs because of tenacious phlegm in the Diaphragm and exogenous pathogens out of season. Cold binds the exterior, Yang Qi merges into the Diaphragm, unable to vent, causing stagnant heat and rebellious Qi, resulting in coarse sounds known as Xiao, which is an excess of exogenous pathogens. Cu (Rapid/Shallow breathing) is Chuan (Panting), which is a deficiency of Lung Qi. However, Xiao triggered by cold has two types: those belonging to internal and external cold, treated by warming the Lung to seize cold-phlegm. If belonging to "cold wrapping heat," the treatment should take advantage of August and September before the cold sets in, first using Da Cheng Qi Tang (Major Order the Qi Decoction) to purge phlegm-heat. By winter, when there is no heat to wrap, Xiao will naturally not occur.

Upper Qi panting with a slippery pulse and warm hands and feet indicates survival (Sheng). A choppy pulse and cold limbs indicate death (Si). Panting with rebellion, rapid pulse, heat, and inability to lie down is difficult to treat. Sweating like oil, moist hair upon sweating, and ceaseless panting indicate death. Fixed gaze, delirium, and panting indicate death. Cases arising after major illnesses are mostly critical. Upper panting/cough with lower diarrhea indicates death.